you know. you've got to do something trickery to get that thing through. mr. mcclintock: justice bran dice told us sunlight is the best -- brandeis told us sunlight is the best disinfectant. suspect the majority seems so frightened of. that's why it's so important to get the 72-hours notice, not just for the members of congress being asked to vote on it, but for the people of the united states who are being asked to live under it or have some chance to know what bills are being proposed and being adopted by this congress in their name. the direct -- that directly affects the quality of their lives and their families' lives. mr. akin: the idea, i was just talking a little bit earlier, did you serve in the california house as well? mr. mcclintock: uh-huh. mr. akin: i'm sure you got phone calls from your constituents saying, hey, congressman, i'm having trouble

with this, that, or the other part of the federal government, and you or your office goes to bat for those people, trying to talk to federal agencies to help them with their problems. i'm just trying to picture in my mind, let's say the democrats jam this thing down everybody's throat. can you picture getting a call from somebody from your district and they say, the bureaucrats that you're in charge of in that federal government just told my mom she couldn't have a heart bypass. can you picture, how will you deal with a constituent like that? mr. mcclintock: that's a story we hear all the time from nations that have allowed the government to take over their health care system. there's an article in the "wall street journal" today telling the story of a canadian from calgary who had a hip problem, it was going to be more than a year before they would allow her the surgery. of course, they're not allowed to have private insurance in canada.

as the bumper sticker says, the government hates competition. she traveled to montana and paid $500,000 out of her own pocket so she could -- and paid $50,000 out of her own pocket to get that surgery done in a timely manner. mr. akin: i think "the wall street journal" had another guy, late 50's, and the canadian system said, sorry, you're too old, you can't get a hip replacements. i'm 62 and my hip has been giving my trouble, i'll probably have to get a hip replacement, i fell on some ice when i was jog, they basically told me, take some aspirin and suck it in, you're not allowed to have that. mr. mcclintock: you may remember the calgary mother, she had identical quintuplets, odds of that are one in a billion or something, one what didn't get a lot of publicity, she had her baby in great falls, montana.

mr. akin: are those all u.s. citizens? mr. mcclintock: she wasn't just visiting montana she had to be rushed 300 miles south to an american hospital to have those babies, just as thewoman with the hip surgery had to travel to montana to have her hip surgery done and the question occurs, if we allow the same thing to happen to the american health care system, where are we going to go for necessary surgery when all of us end up in a waiting list? . we all know that a common hallmark of the bureaucracy are long waiting lines whether it's at the d.m.v. or post office. long waiting lines at the d.m.v. and post office are inconvenient and they are annoying. but a six-month waiting list for needed heart surgery can be down right fatal. mr. akin: congressman mcclintock, you just brought up a little bit of a tender subject for me.

just about six or maybe it was eight weeks ago my father, who is 88, state of missouri, went to a new heart doctor. his new heart doctor took a look at the medicines his previous doctor had prescribed and said what did the doctor do for your heart? my dad said, well, i don't know what you mean, but he gave me these medicines. you can see this troubled look in his new doctor. and the new doctor says, well, you need to come in tomorrow and we are going to give you a chemical stress test. i don't know how that works but it's like a stress test being on a treadmill except it's for older people. they do it chemically somehow. he didn't go very far. the doctor said stop, that's good enough. he said, now, you need to come in beginning of next week for this heart catheterization or whatever it is. so he comes in and they put him out and they take a camera and go up through his leg and look at his heart. he wakes up and they said they

might do -- put some stints in or something. we didn't do anything. and i was at the meeting with the doctor. the doctor said, your heart's in too bad a shape for us to use stints on it. you need open heart surgery. this is, mind you, about a week and a half elapsed or so. so i'm at the meeting on monday he says, well, you need to pick -- here's the numbers. first of all, if you have open heart surgery at 88 years old, because it should have been done earlier, you got about a 10% chance of a major complication. but if you don't get it, this next year, you got a 50% chance of a major heart attack. so you take a look at the numbers and you go, ok, explain it so i understand it. the doctor said, you can come in tomorrow or thursday. so my -- it's monday. my father goes in tuesday. has a seven-way heart bypass and by saturday he's back home again. and he's doing well now. now, people want to say that the american health care system is

broken. but i would suggest that that being done in less than three weeks, a seven-way heart bypass and the technology involved in that, that's the kind of thing that you're never going to see with a government-run health care system. mr. mcclintock: fortunately there is a better alternative. it can be summed up in a word, freedom. we have the ability in the tax system to provide a refundable prepaid tax credit, a health voucher, on a sliding income scale that would bring within the reach of every american family a basic health plan they could choose according to their own needs. they could own regardless of their employer and they could change if it failed to suit their needs. mr. akin: the government want have to run the whole thing at all. mr. mcclintock: correct. it would be the individual owning their own policy. they can tell a nonresponsive insurance company, you're fired. i'll take my business elsewhere.

in all the years i have held public office i never had anybody write a letter to me and say, my grocery store stopped carrying wheaties this month and you need to pass a law to force them to do so. why don't i get those letters? it's easier to take your business to the next supermarket that does have what you want at a price that's competitive. mr. akin: called freedom, isn't it? mr. mcclintock: the problem is today in this country unless you are self-employed chances are you don't own your own health plan. your employer owns it or the government owns it. and you don't control it and can't tell a nonresponsive health plan or a nonresponsive company you're fired because you don't own the plan to begin with. if we can use the tax system to bring within the means of every family that basic health plan that they will own, they will then have the same power that they have over their health plan, over their health insurance company that they have right now over their grocery store to take their business elsewhere if it fails to meet

their needs. i want to thank the gentleman. mr. akin: you are talking about one of a whole series of different republican proposals of what can be done to health care. our position in being very critical of socialized medicine is not to say that there aren't things that are constructive or positive that should be done with our current health care system. in fact, a lot of the problems in our health care system were put there because we already have the government with its big nose in about half of it. there are some things that could be done. as you say one of the things is you own your own health care policy. people sometimes use the word portability. that is if you own it you could take it with you as you go from job to job. it also means if you're insured you are not going to get uninsurable because you already have the health care plan. mr. mcclintock: if you have that voucher that brings within your reach that basic health plan and have the freedom to shop around for that plan that best meets your needs, you are in a

controlling position that will protect you against nonresponsive insurers, nonresponsive health plans. but that's going to require a couple of other things which is also included in republican legislation. one of those things is the freedom to shop across state lines for that plan that might give you better services at a lower cost. i know in california we don't have that freedom. we don't require californians only to shop at california retailers or only to bank at california banks. mr. akin: you don't buy your groceries in california, you could go across the state. mr. mcclintock: we don't allow the freedom of californians to go across state lines to buy a better health plan. mr. akin: that makes sense, doesn't it? the way that works of course you have different states that have their own requirements for health care, but if a plan meets the requirements of a given state and that company wants to sell their health plan to

someone over a state line, now you got a chance for shoppers to get a better price on their product and it tends to break up the monopolies that an insurance company can generate in a particular state market. i pick ture that's going to be particularly effective where you got basically large metropolitan areas that spans several states. you can go back and forth and shop for what's better for you. is that your impression? mr. mcclintock: they asked the question what makes ford a good car? chevrolet. competition. we restrict competition in the health care field and that's one of the reasons why people have such restrictions on their choices. another of the restrictions on their choices of course are the endless number of mandates that are imposed by state governments and the federal government. every one of those mandates requiring you to pay for

coverage you might not want, you might not need, but you're being forced to pay for. mr. akin: or can't afford. mr. mcclintock: there are things that have to be changed. and that's the question of pre-existing conditions. hi a fellow come to me a few years ago, he had left his job and therefore lost his insurance. so he was now trying to get insurance as a private individual. he couldn't find it anywhere. why? pre-existing condition. he had bursitis. he told the -- he says, look, i don't care about the bursitis, i'll take care of that myself. i'm concerned about a catastrophic disease or catastrophic illness. just write me a policy for all of that and i'll take care of the bursitis myself. the response was, we'd love to write you such a policy but we can't. mr. akin: why would that be? mr. mcclintock: it's against the law.

mr. akin: federally? mr. mcclintock: in california. i introduced legislation in the california legislature that would aproduce health plans to write out that pre-existing condition also by the way legislation to allow californians to shop across state lines. both of those were killed on straight party-line votes in the california legislature. now we are watching the same reforms being defeated here by the democrats in this congress. mr. akin: it's interesting we seem to -- as a political party system, the democrats seem to be whetted to try to copy what did not work well in the united kingdom or in canada. could you take a look at these cancer statistics and other measures of quality, and they are bad. if you look overall at cancer in the united kingdom, you are looking at a 50% survival rate. in america the numbers are so much higher. so why do we want to repeat something that doesn't work?

why do we want to mess up something that 100 million americans have got a good system going and we want to turn it over to the government? it's almost like we've got these blinders on regardless of how you define the problem, we know the government should do it all. and so half the democrats want to go that way. the other half are kind of dragging their feet. i'm thankful for them. mr. mcclintock: americans know better. there is a certain degree of skepticism that the same government that pays $400 for a hammer and $600 for a toilet seat and currently running a $1.6 trillion annual deficit is somehow going to keep our health care costs down. there is a great deal of skepticism that the same government that runs fema is going going to somehow bring efficiency to our doctor's offices and there is a great deal of skepticism that the same government that runs the i.r.s. is going to bring compassion and understanding to our insurance companies. mr. akin: that's the thing i find hard, the amount of faith that's required when you take a look at the performance of government agencies to turn our

physical bodies over to those government agencies to take care ever us. it's kind of a hard thing to swallow. as you say the compassion of the i.r.s., the efficiency of the post office, fema we have seen that legendary. we have other ones. you got the department of energy. do you know why the department of energy was created? to make sure that we weren't dependent on foreign oil. aren't you glad we got all those employees making sure we are not dependent on foreign oil? then you got the c.i.a., the cloak and dagger stuff. that would be great, but they are the ones that gave us a report in gulf war one that the iraqis were 10 years away from making a bomb. a nuclear device. when we got in there they were about a year to year and a half away from making it in gulf war one. they got it wrong. we go to gulf war two, they tell us within a year, year and a half they'll have a bomb. we get in there they weren't doing anything. we want to trust our health care to these agencies, it's one

thing, you know, if it's the post office or something, a letter gets missed. but what happens -- that's what i'm asking you, my friend, what happens when we get the call and somebody says, congressman mcclintock, they are not letting my mom get the heart bypass. and i don't have any other alternative. how are we going to deal with that? how can we explain that? mr. mcclintock: we have seen it time and again. every single time whether canada or massachusetts. very consistent results. every time, massive cost overruns that then must be followed by a brutal rationing of care. . mr. akin: we have 50 states and the states to some degree are like laboratories. people can try stuff in the states and see how it works. if it works really well,

perhaps you bring it to the federal level. why would we want to repeat the failed experiment of massachusetts and tennessee? i didn't know exactly what our time was, how much time we had left. six minutes. i yield -- mr. mcclintock: i wanted to thank you, congressman, for organizing the discussion today and including me on it. i know you have some remarks to conclude with so i yield back. mr. akin: i appreciate you taking the same to join -- the time to join me. this is such an important discussion and your experience in california and the great amendments you offered both in california, but now i understand in committee, are making it clear of that promise, not going to spend one dime of deficit, yet it gets defeated on a straight party line vote. it took some courage to offer that amendment but at least it defines where we are in this situation. i'm very thankful you came out and joined with us today on a very important discussion.

the talk is that sometime in the next couple of weeks, this whole thing may come down to a vote. once again, i go back to my own personal experience with having been a survivor of cancer, coming into this very building, having medical doctors tell me, congressman akin, you're fit as a fiddle except for the fact you have cancer. that's a sobering kind of thing. and so what had happened to me was, the insurance companies had discouraged my getting a physical. i should have, if i'd been smart, i would have forced myself to get a physical and line up and wait for it, but i didn't do it until we got here in congress. here's what happened one step worse than an insurance company getting between you and your doctor, that's when the federal government gets in between and starts to ration and dictate what's going to happen. we have this experience of the united kingdom and what happens with cancer there and canada

and spain and look at, despite the complaints about u.s. health care, if you're a sheikh from iran and you've got unlimited dollars to spend, guess where you come? you come to the good old u.s.a. for health care. we still have a lot of good things going on with the level of services we provide. there are changes that need to be made but the change doesn't need to be socialized medicine. doesn't need to be a government system which will crowd out all the private. it doesn't need to be a system which will create an incentive for private companies to dump their employees on the government. doesn't need to be sam which is going to take $500 billion of medicare funds away from people on medicare. doesn't need to be a system that basically guarantees that illegals can get health care at the public trough. it doesn't need to be a system

that says we're going to use federal money to provide abortions for free for anybody who wants those. it doesn't need to be above all a system that's driven by bureaucrats getting between the patient and the doctor. those things are things that we don't need in america. americans in spite of the fact that a great preponderance of media has not been giving all the facts and pointing out these quotations are not threw, -- true, in spite of that, americans across the board, whether liberal or conservative or whatever, they're saying, please don't take care 1/5 of the economy and completely redesign it to fit 15 million people who may not have insurance when 100 million people are comfortable with what they have. we need some reform we need some changes and there are some very good things we can do. we haven't even mentioned tort reform, the high cost of defensive medicine, that's one thing that's needed to be fixed

for a long time. that will drive health care costs down. we haven't mentioned here today the fact that people who work for big companies or the government get to buy their health insurance with pretax dollars, whereas small business or self-employed person has to pay for their health insurance with after-tax dollars that is not just, it should not stand. we should not tolerate this there are changes we need to make. but socialized medicine is not one of them. all you need is a little common sense to look at the far countries or the two states in america that tried to pelosi-type plan and you'll see that this is not the direction we need to go. with that, mr. speaker, i would yield back the balance of my time. the speaker pro tempore: the gentleman yields back his time. under the speaker's announced policy of january 6, 2009, the gentleman from ohio, mr. ryan, is recognized for 60 minutes as the designee of the majority leader. mr. ryan: thank you, mr.

speaker. we have -- this is our traditional 30-something hour, we'll be talking about health care and try to rebut some of the claims that have been made here tonight. but before we do this, we have had a -- several situations going on in the pacific and we wanted to yield as much time as the gentlelady from guam may consume to talk about the circumstances that are going on in her district. i will gladly yield to ms. bordallo. ms. bordallo: mr. speaker, thank you very musm i want to thank the gentleman from ohio for giving me some time to discuss the very serious disaster that just happened in one of the u.s. territories in the pacific. i come to the house floor this evening in the wake of a tsunami that struck yesterday on the shores of the samoan

islands, resulting from an earthquake centered in the tonga trench of the pacific ocean. the epicenter of this earthquake is estimated to be about 120 miles south of the islands of independent or western samoa and american samoa, which is represented in this body by our distinguished colleague, mr. faleomavaega. the strength of the earthquake was measured by the united states geological survey at 8.0 magnitude on the richter scale. eyewitnesses, mechanic, indicate that the tsunami triggered by this earth quage brought four back-to-back series of waves, ranging from 15 to 20 feet in height to the shores of american samoa and that these powerful what waves penetrated up to a mile inland upon impact. given the gravity of the situation at hand, mr. speaker,

i convey on behalf of my constituents, the people of guam, our deepest condolences and sympathies to the governor and the first lady of american samoa and to our colleague, mr. faleomavaega. and their entire community on this tragedy. our hearts and prayers are with the families who have lost loved ones or who have been injured as a result of the disaster. mr. speaker, our island communities in the pacific stand in solidarity with the people of smea what, as do fellow americans across the country. when disaster strike we pull together as americans and as a country and in the pacific, we do so as fellow islanders. the people of american samoa are no strangers to the course of nature and the forces of the sea. the snowian culture has survived over centuries. living in harmony with the sea is rooted deep in their culture and way of life. er that great seafaring and

resilient people with a strong sense of family and community. we know they are pulling together at this time to comfort and console each other to begin to rebuild and recover. their spirit has not been diminished or dampened. rather, it is being tested and they are answering the call tremendously. the fatality rate for this disaster continues to rise as does the number reported to have been injured, and we grieve with our fellow americans. the president this morning issued a major disaster declaration for american samoa and the federal emergency management agency fema, under the leadership of its administrator, mr. frank craig fugate, is marshaling the resources as we speak. a u.s. navy frigate has been dispatched to bring relief. the arrival in samoa of other

assets will continue in the coming hours, bringing food, water, medical supplies, and personnel. all branches of our military, including the national guard, are organizing their contribution to this mission as we speak. our allies and friends in the region have already reached out, extending invaluable diplomatic lines of support and important messages of support. leaders have been in round-the-clock communication with federal leaders and leaders of neighboring islands as to the situation on the ground and the status of recovery efforts. mr. faleomavaega would be with us today as we continue our legislative duties in congress, but recognizably, he's on his way home. i know several of my other colleagues intended to join me tonight in commenting on this tragedy and in sending words of condolence and encouragement to

mr. faleomavaega's constituency. i am facilitating this special order as chairwoman on the subcommittee of insular affairs oceans and wildlife. our chairman of the natural resources committee, mr. rahall, of west virginia is unable to join us in person, but his remarks will be entered into the record and he has asked me to speak to this matter. before yielding, however, i want to also emphasize the importance that this tragedy has underscored for the network of federal disaster and natural hazard resources and partnerships spanning the pacific region. the united states geological survey of the department of the interior has provided realtime data on the earthquake. the pacific tsunami warning sthosme national oceanic atmospheric administration issues the watches, warnings and advisories for the region

with respect to the tsunami and continues to stand watch. the oceans, the national ocean service and other comments of noaa have been working in the region and with local officials in recent years to improve natural hazard planning and map the coastal areas for their vulnerability. fema's national response coordination center and regional response coordination center have been critical to these early response efforts, as has the incident management assistance team and the planning and response team that they have deployed to provide direct support in american samoa. the coast guard and other components of the department of homeland security have set in motion as well important services supporting these recovery efforts. every branch of the armed service under the pacific command is also to be recognized for the humanitarian missions that they have put under way for the people of american samoa, western samoa

and the kingdom of tonga. personnel at the office of affairs at the department of interior and the department of state are also initiating response efforts within their respective agencies and with the governments of the affected islands. most importantly are the first responders and the civilian defense authorities and the personnel of the government of american samoa, including those working at the l.b.j. tropical medical center, caring for the many, many injured. they are to be commended for the outstanding job they are performing in this time of urgent need and ultimately, after recovery, we will review and examine the sequence of steps leading up to and immediately following this natural disaster. we will do so for the purpose of further bolstering our defense and to improve our capability to prepare for and respond to such disasters. i know mr. faleomavaega has long been a leader in congress

for strengthening fema and noaa's capabilities in the pacific region and i have joined him in working to prosect such -- protect such disaster assistance and weather forecast today under the terms of the compact. we have also worked to build the resources in the territory. four years ago, in the aftermath of the devastating tsunami, which hit indonesia and affected more than 12 other countries in southeast asia, mr. faleomavaega introduced legislation to specifically provide for the establishment of a tsunami hazard mitigation program for all the united states insular areas. mr. faleomavaega's legislation was ultimately incorporated into an act of the 109th congress. public law 109-424. which includes tsunami detection, forecasting, warnings, notification, pro pairedness, and mitigation for the entire united states, and

is a basis for the united states leadership toward the development of a global, integrated tsunami warning and education system. mr. speaker, we will have challenges before us in term of preparing our islands and coastal communities for tsunamis and other natural disasters, but we have come a long way, especially since the federal government established the pacific tsunami warning center in hawaii in 1948. on guam, we have weathered many, many soup tire foons and earthquakes, among other natural disasters. we recognize the tremendous lift that is provided to a community when our brothers and our sisters reach out to lend a helping hand and words of encouragement. when backup resources are sent and leaders work together in time of need, we pull together and we recover. this is the american way. but it is also deeply rooted in

the values of the indigenous people of the pacific, including our samoan friends. i know mr. faleomavaega and his constituents and the governor have the support of this body with respect to recovery from this disaster, so we look forward to working with them in the coming days and weeks, to ensure the lines of relief are there for their community: i want to again, mr. speaker, thank mr. ryan of ohio for his indulgence in allowing me to utilize some of his time tonight and mr. speaker, i want to thank my colleagues for keeping the people of american samoa, western samoa and the kingdom of tonga, who have been impacted by this tragedy, in their thoughts and prayers. with that, mr. speaker, i yield back the balance of my time. . mr. ryan: we, mr. speaker, also have the representative here from the northern mariana

islands, mr. sablan, who aid like to yield as much time as he wishes to consume. mr. sablan: i would like to thank the gentleman from ohio for giving me time. mr. speaker, people in the pacific islands may be separated by thousands of miles, but we all feel that we are part of one family. the tragedy that is unfolding on american samoa is not remote loss in the northern mariana islands. we feel the horror and the pain as if it were happening to us. i am not speaking met forically. some in my own -- metaphorically. some in my own family have relatives from american samoa and our islands are home to many american samoans. they are school principals, program administrators, they are engineers, they are neighbors, they are friends, they are family. and they feel vital and much

appreciated role in the life of the northern mariana islands. so today we are terribly, terribly saddened by the loss of life in american samoa, by the images of homes washed away, by the knowledge it will not be days or months but truly years before the people and life of american samoa can be said to be recovered. i come to the floor today hoping to raise the awareness of this house to the challenges our fellow pacific islandsers and fellow americans are facing in american samoa and i hope this house and the federal government as a whole will respond as americans traditionally respond when any community in our nation is struck by natural disaster, with every possible aid and assistance to help american samoans rebuild. i am pleased to call late -- placed a call late yesterday afternoon to our colleague and friend, mr. faleomavaega, just when his tragedy were taking place. he and his staff were on the

phone calling federal and territorial offices to respond to this horrible tragedy. he's doing what he has to do for his people and islands. i want to commend president obama, homeland security secretary janet napolitano, interior secretary ken salazar, and our new assistant secretary for insular affairs who have already responded with the appropriate speed. even as the earthquake struck yesterday and the series of tidal waves began to sweep across the heavily populated coastal areas of samoa, the interior department was keeping the speaker's office and the rest of this house informed of events. the president has promptly declared a disaster declaration and the federal emergency management administration is taking all appropriate response actions. the coast guard is on hand. and other elements of the u.s. military are assisting in bringing personnel and supplies as quickly as they can to american samoa. but the distances to cover are

vast. the logistical difficulties are very great. a disaster of this magnitude only serves to highlight the particular vulnerability of islands to natural disasters, and indeed to any disruption to the normal day to day life. island communities because of their isolation do not have the same resilience that communities on the continent take for granted. the people of american samoa cannot go away from devastation to seek shelters with friends and families in other parts of the united states. there are but a few air flights out and the cost is pribive for a community with income levels way below the national average. fema cannot drive in with trailers to provide emergency housing or tarps and tents to provide temporary shelter. there are no highways across the ocean. though our plans are stand alone, not connected to some

continental network, field supplies are not replenished by pipeline but depend on long distance tankers. food stock on islands are limited. few people can afford to keep much in reserve and now the thin line of supply for food is also no doubt disrupted. mr. speaker, i hope i have made the point. americans in american samoa need the help of the rest of america. in the days of sorrow ahead for american samoa, throughout the long days of recovery, american samoa i urge my colleagues to open their hearts and support every effort to give comfort and aid to a people who are truly in need. i yield back the balance of my time. mr. ryan: i thank the gentleman. and extend the condolences from the people of my district and ohio and the rest of the house. something, tsunamis and hurricanes and all of the natural disasters that we watch

on tv, i think it's important that the representatives come here today and share with us kind of the human side of it. and we realize that these are human beings that have been hurt and families have been displaced. and we want to just extend our condolences to the gentleman and the gentlelady and also the gentleman who couldn't make it here from american samoa. our hour tonight, mr. speaker, what is left of the hour, is to talk about an issue that is pressing for the country. it has been the topic of conversation here in the united states congress for several months. it's been a topic in the country for decades going back to teddy roosevelt, franklin roosevelt, upward and onward to truman and

johnson as of late in the recent history, president clinton in the early 1990's and now president obama. to try to deal with the situation of health care in the united states of america. and this is an issue that we here as elected representatives day in and day out where we get letters from constituents who have problems with the insurance industry, who have been hurt, displaced, not covered, the coverage they have doesn't necessarily work. i think this whole debate breaks down into two separate categories. there's the financial aspect of health care reform. and bending the cost curve and making sure that our country doesn't go belly up because we keep going down the same road and we don't muster up the courage to have change. and then the other track is the

social justice track. the idea that the way that human beings, the way that american citizens are now getting treated by insurance companies is unfair, not right, cruel, and something that needs to stop. so collectively as a country in the past election the country overwhelmingly voted for change. and they overwhelmingly voted for health care change. one of the major planks in president obama's platform was health care, health care reform, bringing some justice to this system. and helping to bend the cost curve in the system. so what we do know from the financial side -- i think everybody recognizes the social justice side. i think everyone has heard stories. it has happened to them. it has happened to family members. it may happen to somebody that

they know. where someone is denied coverage because they have a pre-existing condition. or a family goes bankrupt because of a health care catastrophe in their family. and what this reform does is it eliminates those two major problems that we have in our health care system. where we are collectively as a country saying, it is not right for a human being, a united states citizen to have to file for bankruptcy because they got sick or someone in their immediate family got sick. now, i hope we can all agree upon that. and when some of our friends on

the other side talk about liberty and freedom and they cue up the patriotic music to try to destroy health care reform in the united states, i would like to say and ask the question, how free is the person that just had to file bankruptcy because they got sick? how liberated is the person who has to file bankruptcy because they got sick? is that their idea of freedom, mr. speaker? is that the tea bagger's idea of liberty, mr. speaker? i don't believe that it is. but that is the great debate we are having in this country. there are people in this country who will end up on one side of that fence or the other. and the side that president

obama and the democrats have been pushing is to sigh that -- say that when you go bankrupt because you got sick or someone in your family got sick, you are less free. you have less options. there are others who say, who are trying to kill health care reform, who say you go bankrupt, tough luck. we'd rather have the concept of of liberty, the concept of freedom, but our job when we come to washington and make laws and reforms is to actually take these ideas that the founding fathers have given us, that are writin all over these buildings, all over washington, d.c., and state capitals all over the country, and that our kids read about in the history books and

on the computer, that they -- when they are implemented, those definitions mean something. and this health care reform will make american citizens more free . it will allow them more opportunity, more options. bad enough you got to deal with being sick and you're sick enough that you have to spend so much money that you go bankrupt. then you got to be bankrupt. which is not a pretty process. it strangles your ability to be free. so when i have to laugh if it wasn't so sad when we hear people talk about this debate about liberty and freedom, you're doggone right it is. and we are trying to enhance liberty, enhance freedom. actually make it work for

people. in my congressional district if we do nothing we will have 1,600 families go bankrupt because of health care concerns. 1,600 just in my district. half of the bankruptcies in the united states of america are because of health care issues. to me that doesn't sound like the principle of freedom. and we are going to fix it. the same with pre-existing conditions. so, you're in a job and you have health care and you or your spouse has some kind of condition that you know if you get out of the current pool that you're in, you're going to end up in the shark tank, basically, right now, and you're not going to be able to get health care coverage. so you want to start a business. or you want to go somewhere elsewhere maybe you could make

more money. or you can express more of your talent, more of your ability. you could grow. you could learn new things. and maybe provide more for your family. but you don't do it because you know if you leave your job that you won't be able to get health insurance. now i ask my friends who talk about freedom and liberty, is that person more free? . i don't think they are. so i will have the debate all day long, mr. speaker, with the tea bag groups and the tea baggers and everybody else who want to have this debate about freedom and liberty. because this reform bill is the nurns reform components of this

are about increasing people's freedom. and it's about protecting them in a market in which they need some consumer protections in order for them not to be strangled, not to be strapped, not to force -- be forced to go bankrupt. i'd like to yield to my friend right across the border in pennsylvania. >> i thank the gentleman from ohio. i sat with the gentleman and listened to a group before us, and i couldn't help but think about the fact that they seemed to miss the fact that, i would agree the worst possible thing we could do in health care reform as a congress is to pass a bill that makes the system worse. we're capable of doing that we're not going to do that. but that would be the worst possible outcome, but a very close second is to do nothing. because the gentleman from ohio talked about businesses and

families in this country struggle every day with the decisions relating to the cost of health care. i've -- in visiting my district recently, i had the opportunity to speak to the rotely club in my district. a business owner came up to me afterwards, showed me his health insurance statements, his annual increases for the last four years. the smallest increase he experienced was 28%. that was the smallest increase he had. he told me, i can't do this anymore. i can't afford health care. i'm going to have to tell my 12 employees this week that i have to drop them. he couldn't offer health care anymore. that's unacceptable in america. that's what's going to continue to happen if we sit back and do nothing while the cost of health care continues to rise two and three times the rate of inflation every single year. i had a woman come up to me at

one of my meetings who was one of these people who had attended one of the tea parties the gentleman refers to, she was angry, she was telling me all the reasons she oppose what had she perceived us to be doing on health care and everything else that was getting under her skin and she was really getting herself worked up. she looked at me and said, and don't you dare take my money to pay for those people who don't have health care. because, she said, i worked hard for everything i have and my family's covered and if those people aren't, that's too bad. that's their problem. -- problem. i'm not worried about them. i've worked to put myself in position to provide for my family. forget about those people. that's not my problem. i'm not paying for them. i said, here's the issue. you are paying for them. they show up at the hospital they get treated, and the hospital sends the bill to us. that's how that works.

around this woman who came to this event to fight, she wanted to take me on, when i said that, she softened and she said, you know, it's so funny you say that, because i just had a procedure done at the hospital in february and the insurance company denied part of my claim and i had to pay $18,000 out of pocket. so she went through the bill very closely because she was the one paying the money and she called the hospital and she said, why does everything on this bill cost more than it should? why does an aspirin cost $10? and the hospital told her, well, that's because we have so many people that come through our doors that can't pay at all, we have to shift those costs to the people who can pay. so therefore, everything on the bill costs five times more than it should. similarly, i had a gentleman tell me about all the reasons why he didn't want to do health care reform. and he said that we have the best system anywhere in the

world and everything works fine and even if you don't have insurance you get treated and everything is free and it's great. he said, i have a nephew, who is 15, who had a hip problem he showed up at children's hospital of pittsburgh he got the best care anywhere in the world and he's great and he's fine now and i stopped him, i said, he didn't have insurance, how did he pay for the great care he got? he said, i guess children's hospital paid for it. and i said, well, no, that's not what happened. we paid for it. because children's hospital's those costs and then they transfer the loss to the people who have insurance. that's the way that works. and he got it. and the point of this story is, we can hear all the examples on the other side, politically, of why it's better to do nothing and we should make everybody very afraid of reform. but everybody in the country, every family and every business and every individual in the

country, regardless of their political affiliation, has had an experience in the health care industry that shows them that we can do better. they've had to spend half an hour on the phone haggling with an insurance claims adjuster who just denied their claims. they're the small business owner who has to make the heart wrenching decision to drop coverage for his 12 employees. there's someone who had to wait nine months for an appointment with a dermatologist or had a bad quality experience with a grandparent in a nursing home. everybody has had something happen that shows we can do better. yes, we have to preserve what works in our system. i'm one who believes as much as anybody in this congress, we do have the best health care system anywhere in the world. our innovation, our medical technology, our research, quality and care at the high end, exceeds anything else available anywhere in the world.

there's no question about that. we need to preserve that. that doesn't mean we don't pay too much. costs go up too much. we're pricing our small businesses out of the market. if you get sick or injured, and that insurance company is able to drop you, what's the point of having health care insurance to begin with? if you only have it until you get sick or until you get injured? so what we're saying in the legislation we're considering is, insurance companies won't be able to drop you as soon as you get sick or injured after you paid premiums for years and years. they won't be able to do pre-existing condition exclusions. they won't be able to set your rates based on your individual health status. they have to take all comers, no lifetime caps or annual caps on out of pocket experiences for people with chronic diseases, a big problem in the insurance industry. these are problems we're trying to solve. we're going to help small businesses afford health care by helping business owners like the one i talked about in that

rotary club be able to qualify for tax credits to help afford coverage for his employees. we're going to give more information to health care consumers in the country so they can compare based on costs, quality, and access to providers. all the plans that are available to them. we're going to squeeze out the inefficiencies of the current system. and apply those savings to bringing more people into the system. those who are outside the health care system that simply can't afford health insurance now. these are the reforms we're talking about system of when you see the charts and graphs on the other side of the big bureaucracy, identical to what those charts were in 1993 and they recycled them from 16 years ago, that's not what we're talking about. we can come down and have a discussion on the merits of the canadian health care system. or what they do in great britain. that's interesting. that's interesting discussion to have. but it has nothing to do with

what we're talking about. that's not what we're doing in our bill. it's completely unrelated. in order to scare people and get political support to hoist a failure upon this congress and this administration so they can use it for political purposes, they make things up. mr. ryan: if the gentleman would yield, the issue coming from the other side is interesting because just a couple of years ago, our friends had control of the entire government, they had control of the house, they had control of the senate, your class came in, we had a great year, and -- but prior to 2006, there were six years that president bush, the senate, the house, all republicans. they could have implemented some kind of health care reform, just -- it didn't have to be necessarily what we're doing, but really, you know, not to do anything, to try to bring some justice to this system and in the process spend

$2.5 trillion over 10 years on the bush tax cuts that went to primarily the top 1% of the people in the country. now, we're talking about a bill here that is deficit neutral that will be paid for, that is $8900 billion over 10 years, little more than a third of what they spent on tax cuts, and we start bending the cost river to bring some justice and end these stories. the business person you talked to, people who tells his employees they don't have health care anymore, from the example you used earlier. let's track those 12 families, you know. now they're out in -- they're swimming with the sharks. hopefully no one has a pre-existing condition so when they go out on their own, out of their business, out of the

plan they were in, and try to get some coverage, hopefully they don't have a pre-existing condition. but what if they do? and i bet that there is somebody in that group, some family, some spouse, some worker there, that probably duds. and they're not going to be able to get insurance. or they're going to have insurance that's going to cost so much that it's going to be really not helpful and so they may go without. now, not getting any treatment, it may go a year, may go two year, now all of a sudden, a very small problem turns into a very, very big problem. so that at some point, this person ends up in the emergency room, if they're older, they end up in the medicare program, in both instances, they cost us a heck of a lot more money than they would if they were able to stay in that plan, get preventive care, get consistent treatment, deal with sickness

they may have so it doesn't become chronic and costly, that's what's happening all over the country. we sit here, our friends on the other side, we're scratching our heads going, how does this get so expensive? it happens every day. we see these situations happening all the time. a lady called in to one of my telephone town halls about a month ago, 60 years old, makes $32,000 a year, works in her company, same situation, just dropped her health care. she basically said on the call, you know, i may just wait until i get into medicare. here you have someone that is working, 60 years old, and can't get health care in the united states of america. that is a whole other topic of how bad and wrong and cruel that is, but just from the sheer numbers standpoint this person is going to go five years without health care? and then go into the medicare

program? with how many different problems is she going to have that could have been prevented in those five years? you wonder why medicare is going to go belly up. well, part of the reform is to make sure people that are that age, all american, but people that age will have some basic level of health care. mr. murphy: i would say before turning it over to the gentleman from connecticut, on that point, we, as i said, are already paying for the -- mr. altmire: we, as i said, are already paying for health care so our colleagues listening, we are trying to bring people into this system so that we can spread out the risk pool, bring insurance costs down for everybody, by bringing more people into the risk pool, but if somebody gets sick, they have insurance. they can show up and get an antibiotic in the first place so it doesn't evolve into pneumonia when they spend six days in the hospital two months

later, and then we have to pay their bill. that's the point. we're trying to rationalize the system so that we bring down costs for people who have insurance today. that's the point here. we can have a philosophical argument about what our moral obligation is as a society on offering coverage to everybody and should everybody who lives in the united states of america have access to health insurance. that's not the debate we're having. the debate we're having is, we need to get them their health care in the most appropriate, cost efficient way, that's not the emergency room. that's not the appropriate setting for them. that's only going to drive up costs. by getting them into the system, we're bringing down insurance costs for everybody, getting them their care in a way that's more appropriate and more cost effective. i yield to the gentleman. >> thank you, mr. altmire. i was in a meeting with some hospital c.e.o.'s, they were talking about having a tough year this year and they said

that they were hopeful, though, that they might see some increases from their private providers, from their private insurance companies that send them, obviously, a lot of money. they say that because they were making the case, their private insurers right now, mr. ryan, mr. altmire, because they had had so many people coming in without insurance, because the number of people that no longer have coverage increased and the number of people coming through their doors that don't have any source of payment has gone up, they're hopeful they'll be able to convince the private insurance companies to raise their rates by 5% or so to compensate for all the people come being in the door without insurance that happens every day out there in the negotiations between hospitals and doctors and private insurers. the pressure is on. private insurance companies to make up for all the people that she up -- show up without insurance. the insurance companies don't eat that money they pass that along in higher premium, so everybody out there who is on privelt insurance today, the

70% of individuals who are happy with their current coverage, need to know that your premiums are higher so that those insurance companies can help compensate and keep in business the hospitals and physicians that are caring for all the people who don't have insurance. to your point about how medicare, you know, is taking on the cost of all these folks that are uninsured from age 55 to 65 and then show up at the door with all sorts of problems, let me share this story. in connecticut our major insurer, blue cross/blue shield is walking around with a chart trying to sort of push back as far as i can tell a health care reform. their chart shows, as they claim, that the cost of taking care of a medicare or medicaid patient is comparable or a little bit less -- a little bit more than the cost of taking care of somebody who has no

insurance today. apparently the reason they're showing that chart is to make an argument that you should just leave these people uninsured because if you put them on insurance it will cost you more. we know that's not true. we know that by giving insurance to people, by allowing them access to their primary care physician to give them preventative care, that's going to cost less than leaving them uninsured but they make a totally unfair comparison. they're comparing the cost of somebody that's uninsured to the cost of the medicare and medicaid system which has the sickest, the most expensive people on their rolls. so i think it's a caution for all of our colleagues who look at our current government health care programs, medicare and medicaid, and say, ooh, if you look at the per patient cost there, those are pretty expensive programs. they're pretty expensive programs because medicare and medicaid insure the most expensive people out there. insure the sickest of the sick, the old and the frail and the elderly, all of the end of life care paid for by medicare. mr. ryan: would would -- why do

the programs exist? because you can't make money off of sick people. i mean, how disingenuous to walk around and say, look how expense of medicare is. no kidding. everybody is 65 and older. yes, that's expensive. but no one was doing it. so we decided as a country that it may be a good idea to protect those senior citizen and provide them a little bit of dignity. mr. altmire: and with the insurance -- what the insurance companies call the money that they spend on health care, they call it medical loss, medical loss. that's what it is to an insurance company. to you it's a medical benefit. it is care that you get that keeps you alive. to an insurance company it is called medical loss. it is a bad thing to spend money on you. that doesn't mean there are bad people running insurance companies it just means that in the end if the motivation if profit, if the motionvation is to return the most money to your shareholders as you can, then

every dollar you're spending on care is less money that you're getting on the return for your investment which is why so many of us believe that there is an inherent conflict between good business and good medicine. doesn't mean that both can't co-exist. it means that government has to step in and try to set a set of rules to make sure that in every instance good business doesn't trump good medicine. and i want to give you an example of why that is. you know, every insurance company executive will tell you, if it was up to me i wouldn't deny care for all these people who have pre-existing conditions but if i stop doing that than i'm -- then i'm going to be at a disadvantage. if i start accepting all these patients with cancer and hypertension and lupus and whatever it may be, well then i'm going to get all the sick people, my premiums are going to go up and i can't compete with everybody else. and so they tell you, listen, if it was up to me, i'd do it. but you need to set the playing field even between all of us.

the insurance companies, they may be fighting on a lot of things but they'll tell you that if the government comes in and says that we should all take parent -- patients with pre-existing conditions and we're all living by the same rules, well then that's fair. we can live with that in the end. the fact is that i listen over and over again to our republican friends say that, yeah, we're for that, too, we think we should stop people with pre-existing conditions from being excluded from insurance. well, they had control of this congress for 12 years. they had the house, they had the senate, they had the presidency, they had everything, they didn't do it. they didn't do it. they would have insurers with them on that, they would have the public with them on that but they didn't do it. so it's just beyond me how we can listen to so many of our colleagues on the republican side of the aisle come down here and tell us that they were for this all along. that they were for trying to stop these discriminations against people with pre-existing conditions because they could

have done something about it. they could have done something about it. for all the people out there that say government should stay out of health care, this is a prime example of where government needs to come in and set fair rules that insurance companies need to play by. if you leave it up to the private sector they're going to push -- push people off the rolls. i don't want a government takeover of health care but there are some places that government needs to step in and fix it. mr. ryan: you think about how a game started like basketball or football or just any sport, right? at some point, you know, naismith puts up the peach basket and starts throwing a ball and they decide to cut the hole out and the ball falls through and that will be good but then you start getting teams and at some point someone threw an elbow at somebody's face and hit them with an elbow in the face and they couldn't play anymore and the people organizing the games said, you know what? that's not really fair. that's not what the game is.

so that's illegal because here's the game, you get five people, you put it in the thing, whatever the rules are, and then rules consistently evolve to make the game more fair and so here we are in the united states where we're saying, the government is not going in to run anything. what we're going to do is create new rules and one of the rules is you can't be denied for pre-existing conditions. another rule -- because it's unfair. we're all agreeing as a country and our friends on the other side, we'll see how they vote when they have an opportunity to vote for this, because it's unfair. going bankrupt in the united states for health care reasons is unfair. something we want, we want to change that rule. that rule no longer applies. and so what we're trying to do is make the game of health care more fair. but there's a point that i

wanted to just touch on for a minute. the speaker pro tempore: will mr. ryan yield so the house can receive a message from the senate? mr. ryan: i'd be happy to yield. the speaker pro tempore: the chair will receive a message. the secretary: mr. speaker. the speaker pro tempore: ms. secretary. the secretary: i have been directed by the senate to inform the house that the senate has agreed to the compass report accompanying h.r. 2918, making appropriations for the legislative branch for the fiscal year ending september 30, 2010, and for other purposes. the speaker pro tempore: the gentleman may proceed. mr. ryan: how much time do we have left? the speaker pro tempore: 13 minutes. mr. ryan: thank you. one of the points i wanted to touch base on that mr. murphy just made, how the insurance industry has acknowledged that

this will be a level playing field for all the different insurance companies and if we do pre-existing condition, we do -- making sure that no one can pay any more than a certain percentage of their income out of pocket per year to prevent bankruptcies, those kind of things, there's an point point we need to acknowledge and talk about more. if insurance companies have to cover everyone, if they are forced, they can't play the game that they're playing now, the game now is, how do i get sick people off of my roll so they don't cause me a medical loss and how do i not get people on my rolls that i know are going to toss me money -- cost me money? and those people are going to be diabetics and heart disease and cancer patients and i had one cancer patient come to a round table i had who said, you know, she had cancer but then -- then she lost her job and then was out with another job trying to get insurance on her own, she

was denied, her cancer has been gone for years and years but it hasn't been gone 10 years so they -- the insurance companies would continue to deny her coverage. so what we're saying here, if everybody is covered, if insurance companies can't deny anybody coverage, they have to take you, there's a new business model that will be created within the insurance industry. because the game of keeping people off your rolls or get sick people all of your -- -- or getting sick people all your rolls is over. the new game will be how do we keep the people within our pool under our -- pool, under our coverage, healthy? so you're going to see them investing money into wellness, prevention, they're going to be very interested in what the kids are eating at schools, they're going to be very interested in the pest side that we're putting on ourified -- pesticides that we're putting on our foods that may cause cancer, they're going

to be very interested in owes -- obesity rates, they're going to be interested in what the physical education programs look like in our schools. we could have a real ally within the insurance industry to partner with us, with nutritionists, with dietitians, with, you know, preventative and wellness groups. we will now have an ally. instead the insurance companies are now the enemy because they don't want to make these investments. now they're slowly starting to because i think they're reading the tea leaves here, they're going to be slapped down and they're going to have to cover everybody and because of that they are going to be able to make investments and i think it's going to end up being a very, very good thing. mr. murphy: i agree, mr. ryan. i think that's why on this issue of setting a level playing field amongst insurers where they're not allowed to keep out people who are sick, they're also not

allowed to price people who get sick at an exorbitantly higher rate than other people, you know, insurers want to be part of that change because it does allow them to get back to trying to be will well -- about wellness and health care rather than trying to be about moderating risk. so i think in this we have allies. insurance may not like other parts of this bill, they may not want the public option, put pressure on their rates to come down, but there are a lot of other pieces here that they are partners on. i want to just, for example, one other example, mr. ryan, of where it's appropriate for the government to come in here and set new rules and you said it right here. if you don't want the government regulating health care, well then you've got to dial the clock back about 50 years or so. because the government right now not only is paying about 55% of all health care dollars in this country, but we're heavily regulating health care insurance

today. happens mostly at the state level but every state has a well-staffed insurance department that's regulating health care today. just doesn't do it very well. in large part because if you're an individual buying health care insurance or you're a small business purchasing on behalf of you and maybe five others, you're going to -- you're getting a pretty raw deal. it's simple economics. you're negotiating on behalf of one or five versus large employers who can either bear the risk themselves and they self-insure or they have enough employees so that when they're trying to cut a deal with an insurance company they can get a pretty good deal. but for that one guy out there that's just buying an individual policy, he's paying the highest rate. he's paying the highest rate because he's got no purchasing power. so we're just trying to change the rules for him. he can still go out and purchase insurance but he'd be able to purchase insurance in an exchange that this legislation sets up where he would be joined with everybody else in his state or in his region who is looking

for an individual policy and we would join their forces together and negotiate on their behalf. we'd have insurance companies bid into the exchange, to bid to have the right to offer coverage to all of those individuals and we would leverage the purchasing power of thousands of individuals. now health insurance companies would still be regulated just like they are today, but rather than operating in a market in one state at a time rather than operating in a market where they are allowed to essentially negotiate with one person and one person and one person, they would now be negotiating with a pool of individuals which would lower the cost to those people. just a different way to structure the market. still a regulated insurance market, just a different set of regulations. it's another example of where government by setting a more fair set of rules for insurance companies and individuals can lower prices.

that's what this legislation is talking about doing. not taking over the health care system, but establishing a different set of rules that benefits our constituents, individuals and small businesses who have gotten the short end of the stick so far. mr. ryan: so you got g to this exchange -- there will be an essential benefits package that will be set by the surgeon general and a group of experts who will decide what the essential benefits package would be. . and every insurance company that goes into this exchange will be the bare minimum. my coverage is terrible, there will be this coverage which will be the baseline coverage for every single private private insurance coverage. people who have a lot of money are going to be planches up

there because the insurance companies will be making money. what we're asking is that in addition to all of these private insurers, we put in basically medicare a medicare program, a medicare program that will compete with all of the other private insurers. 80% of the people have medicare, like it. 65% of the american people say this is a good idea. but that medicare that would be in the exchange with all the other insurance companies would compete, but they wouldn't have to put money into marketing or pay a c.e.o. 100,000 a year and would compete and by not having to put that money into advertising and those other things could help bring costs down and everyone else in the exchange would have to compete with that. you want to talk about choice, that is public option and the way we are setting up the

exchange is all about choice. if you are a family of four making less than $89 a year, you are going to qualify for some health care credit, some subsidy. you get the subsidy from the government based on your income and then you go to the exchange and pick any plan you want, no government bureaucrat is telling you, you have to pick this plan. you pick this one. there's none of that. you get the credit and then you go to the exchange. and if you want the public option, can you pick it. if you don't want it, you don't have to pick it. mr. murphy: for those of our colleagues who don't want the exchange, they have to go to the american people and explain to them why they don't believe people should be able to negotiate. they have to make the argument to their constituents why they don't think their constituents should have the choice to choose the same kind of health care that members of congress and medicare beneficiaries and soldiers and veterans and public employees have.

this is about banding people together, giving people more choice and the reason those ideas have broad public support -- every poll says there is support, the exchange and public option in it is that that's what they want, the ability to negotiate and the ability to have more choice. mr. ryan: our friends who want to talk about freedom and liberty want to deny about buying into a medicare-type program. that is limiting the consumer's choice and limiting freedom. they all got to compete and we're go to go help you pay for it because if you don't get insurance, you are going to cost us more and this is all about choice. and you like what you have, you keep it. that's fine. so, you know, this is good. i think about the 1,600 families

in my district that go bankrupt because of health care. i think of the people that will have opportunity and options because of what we're trying to set up here and reform the system. as we close, mr. speaker, woy like to say if you look at what we have tried to do and what we have done over the course of the last seven or eight months, we've taken on the oil industry, we are taking on the insurance industry. since we have been here, we have raised the minimum wage, increased money for pell grants, taken the banks out of student loans so people can afford to go to college, make investments back into the middle class, stimulus money, thousands of teachers are back at school right now, invested in the green technologies, green energy. if you look at issue by issue by issue by issue, everything that we have done has been sticking up for the middle class and

taking on the special interests that have been driving down wages, driving up health care costs, making it difficult for small businesses, making it difficult to go to college, cutting every business in on the deal no matter what and it's important to recognize that this reform proposal and this reform bill is all about giving the middle class consumer protections, choice and affordable health care and a system that has justice. i want to thank my friend from connecticut and thank my friend from pittsburgh, western pa and our condolences to the people out in the pacific who are going through a difficult time. and with that, we yield back the balance of our time. the speaker pro tempore: the gentleman's time has expired.

the chair lace down before the house the following enrolled bills. the clerk: h.r. 2131 an act to amend the restructuring act of 1988 to reauthorize the united states advisory commission on public diplomacy. the speaker pro tempore: upped the speaker's announced policy january 6, 2009, the chair recognizes the gentleman from iowa, mr. king, for 60 minutes.

mr. king: thank you, mr. speaker. it is an honor and privilege to address you here on the floo of the house of representatives and having listened to the dialogue that was presented by my colleagues, often i will be able to see them on c-span and then i'm inspired to come over here and take up the other side of the argument. they have inspired me for a number of years now, especially the gentleman from ohio, who has headed up some of the dialogue that has brought some significant philosophical disagreement, although personal disagreement seems to be nonexist tant. and the strong sales pitch that they have given on the government option compels me to lay out the facts on this case and i'll say present it to you, mr. speaker, from a different perspective. the first perspective is this, this is -- this is the old

hillarycare perspective. this is the flow chart of the basis of the facts on the original national health care act bill that was put together as a result of president bill clinton's speech here in the well on september 22, 1993. and out of that came sometimes closed-door meetings, some say secret, i think they were closed-door meetings and headed up by hillary clinton, now secretary of state. and to take over the entire health care system of the united states, this is the flow chart that grows from it. this is out of the "new york times," mr. speaker as the source of this document. but i had a similar one that i hung in my office for quite a long time. and to see this government that was created by that proposal back in 1993 and 1994 was enough to scare me out of the private sector and into politics to try

to engage in saving americans from this disaster that was coming that was delivered to us and served up at that time by president and mrs. -- the first man and first lady of america for that period of time in the early 1990's. when you have the living day lights scared out of you and into politics, it is in a good position to put the brakes on. this is a black and white policy, mr. speaker. back in those days when we didn't have newspapers that were in full color. the internet was just forming in a way and we see all of these new government agencies that are shaped here and we have some of the things that stand out on it. two cases of ombudsman that are there to be liaisons between people in government because government is impossible. we have to give them om budsmen. and the acronym, i don't

recognize all of them. h.m.o. provided plan is one of them. and the accountable health plan. this black and white, notno car he meant it. and a lot of people didn't think it would hold up and the american people stood with him and many others and they rejected this national health care plan. fast forward 15 years. here's the black and white version, rejected. here's the modern colored version.

and i expect we will have an opportunity to defeat this scary legislation. it's scarier because we can see it now in full color. and the black and white are existing government agencies and programs. so we can see as we look across here, these are just different departments. here are existing -- let me say government-run operations. here is congressional medicare-medicaid services. medicaid. schip. medicare. down here is where i bring your focus. let me predict also we have a chance to kill this and in 15 years we will see the 3d version and you put on your glasses and government will be so complicated that you won't be able to understand it. it's multiple dimensions. anybody that read the bill and didn't look at the flow chart is a brilliant person if they can track all of this.

if you read the bill and follow the flow chart, you have to be a brilliant person. i direct your attention down to the private insurers, mr. speaker. this is 1,300 companies today. the president said there are two principles that we need to fix in health care in the united states. one of them is we don't have enough competition among health insurance companies, so we have 1,300 health insurance companies. he said we need one more. i haven't heard the president say 1,301 private insurance companies is the magic number. he would cringe that adding one more to 1,300 is constructive. it's destructive to the private sector and the american people know it. but these are the private insurers in this white box, existing. and this would be under this bill forced into all of the health insurance policies would have to meet the traditional

health insurance plan in order to qualify. they would have to meet the new government standard. there are approximately 100,000 different varieties of health insurance policies available in the market across the 50 states. you can't buy them from state to state. we need to be able to buy health insurance plans across state plans. it would put them in competition and all 100,000 policies within reach of every american. they want to shut that down and set up a government-regulated health insurance company. and that are the purple circles here to bring your focus, mr. speaker. the qualified health benefits plan. this would be the 100,000 policies that would have to be approved by the new government agency called the health choices administration. and hear about choice and change.

health choices administration commissioner. he is not called a czar. we are full up to here with czars. he would be the central planner for private health insurance in america. a czar, a commissioner, a commisczar. he would be the guy with all the juice and rules if he could direct the administration that would be powered by legislation proposed by this side of the aisle and what looks like a national health care plan. a path, his goal, which is single-payer and we have seen the videotape. the president is for a single-payer plan. that is the socialized model. we know that. let's be honest. if the president would say i think the united states of america can run socialized

medicine better than any country in the world better than any country has, he could make thinks case as to why. they want to say it is not socialized medicine, the same way they argued amnesty isn't amnesty. even if you are the president of the united states, yno carrier >> mr. speaker, i present a conference report on the bill h.r. 3183 for printing under the rule and i want to thank my colleague for giving me the time. i yield back. the speaker pro tempore: thank you. the clerk will report the title. the clerk: conference report to accompany h.r. 3183, making appropriations for energy and water development and related agencies for the fiscal year ending september 30, 2010, and for other purposes. the speaker pro tempore: the

report is ordered printed. the gentleman may continue. mr. king: i thank you, mr. speaker. i thank the gentleman and i'm always happy to yield to the important business of this house. to where i was in this dialogue, about the health choices commissioner making -- calling these shots, mr. speaker, and the very idea that socialized medicine could be called something else. in fact, when we declared it to be the house democrats' health plan, the public option, they want to call it the public option plan, we want to call it the government plan, the government plan is the government insurance plan that would eventually replace most, if not all, of the private health insurance in america. they want to censor that. this chart was banned from being mailed out under our mailing privileges because it was deemed to not be accurate because it called it the organizational chart of the house democrats' health plan.

so i posted it on my web page and said, you know, come and take it. this is the truth. and by the way, this has been clearly and carefully vetted and congressman kevin brady of texas is on the ways and means committee, he carefully went down and examined every component of this bill, put his staff on it, challenged them to make sure it was all correct and this chart has with stood all criticism and -- withstood all criticism and this is a chart that shows what goes on with health care here in the united states. so the points that come from the president are, health insurance -- excuse me, health care in america costs too much money and we have too many that are uninsured. and that we need more competition in health insurance. i think i pointed out the competition is not what we need more of but we can provide the maximum amount if we just simply allow everybody to buy health insurance in america wherever they choose and simply go around these state mandates.

so, for example, a similar policy in new jersey that would cost a young man 25 years old $6,000 a year can be bought in kentucky for $1,000 a year and that's the difference in the mandate. so, yes, surely you think about moving to kentucky. businesses will go there. they need to come to iowa too, by the way, mr. speaker, but we can solve a lot of this health insurance competition simply by allowing insurance to be purchased across state lines. by providing for the portability so people can take it with them. that solves the problem of competition in a far more effective way than the president's proposal of starting up and running and putting taxpayer dollars into a federal health insurance policy. now, the best example i know of to describe what will happen if we have a federal health insurance policy can be what happened with the flood insurance in america in 1968. this congress passed a national flood insurance act. what it did was it put the

federal government in competition with the property and casualty companies that were selling flood insurance at the time. and then the federal government decided, we need to be able to compete in this marketplace and so we'll keep low premiums and we'll require the loans on real estate that are given through national banks to include federal flood insurance. that was 1968, this is 2009, there is no private property and casualty flood insurance policy available in america because the federal government has crowded out all the competition and now they own the flood insurance in the united states. it's been nationalized and the flood insurance program has a $19.2 billion deficit in the red and the only way to get that back is they simply borrow money from the chinese or saudis and drive us further into debt and pay the deficit of a bad business model. that's what's going on with health insurance and now i'm going to make just one more

brief point and i see that the gentlewoman from minnesota has arrived to add her dynamics to this debate. however, these are the insurers, let me see, these are the uninsured in america, mr. speaker, and this is just a little bit because the numbers aren't all the way. 47 million uninsured, 44 million to 47 million. so i simply start out with the high number, 47 million of those uninsured. and then, let's break this down, let's break this down and find out, who really are these people? and do we really want to provide for a government plan out of the taxpayers' dollars to fund this universe of 47 million who don't have health insurance? and so we start around the top. these are the illegals. that number is six million in this chart. it was five million in my other chart. these are the people who were here, barred by law from public benefits, that number was 5.2 million. but they add up to 10 million

people, the legal and illegal who are disqualified from law -- by law from public benefits. then you go to those earning more than $75,000 a year. that's nine million. presumably they can write a check for a premium for their own health insurance but they've opted not to. then you have those eligible for health insurance under their employer, roughly 10 million, 9.7 million is the number i recall, they've opted out, perhaps, they're eligible and didn't sign up or they opted out. then you have those that are -- let's see, then we have those who are eligible for government benefits, that's generally going to be medicaid people. and that's the 9.7 million. it's six million that are eligible by employers that don't sign up now. take all these numbers that come pretty fast, mr. speaker, and i can just tell what you the math is, 47 million minus those that are disqualified for the reasons that i've given leaves us with this number, 12.1 million people that are americans without affordable options.

and that's the universe of people that really we're trying to address. so, here is the real chart. this is all of the american people right here. 306 million people. and here are all the categories of folks that i've listed that i don't believe we should be subsidizing their health insurance. the immigrants, the illegals, those that are already qualified under medicare and don't bother to sign up, those making over $75,000 a year, those that qualify for an employer plan and opt out. that's all of these people along this spectrum from blue to yellow. then we have all of these covered americans here which are 84% of the american people. who are we really trying it to address? americans without affordable options. here they are, less than 4%. and for less than 4% the proposal from the people on this side, and i'm not going to accuse them of being rational, mr. speaker, the proposal is

that we tear asundayer the entire health insurance industry in america and the entire health care delivery system in america, the best in the world by many standards, in order to get at this less than 4% that are americans without affordable options. there would not be a rational person that would declare that to be rational behavior, mr. speaker. and i'd be so happy to yield to the gentlelady from minnesota to pick up wherever it is that i might have left off. mrs. bachmann: i thank the gentleman from iowa for that. yes i will. the speaker pro tempore: the chair lays before the house the following enrolled bill. the clerk: h.r. 2918, an act making appropriations for the legislative branch for the fiscal year ending september 30, 2010, and for other purposes. the speaker pro tempore: the gentlewoman may proceed. mrs. bachmann: thank you, mr. speaker. i thank the gentleman from iowa and i thank you for clearly

laying out what the problem is and what some of the solutions are that are being offered by the democrat majority that controls both the house and the senate and the white house and as the gentleman stated, we're looking at about 85% of the american people who have health care, who have survey after survey demonstrated that they are happy with their health care, they have no desire to change that system that they're currently able to receive. they're very worried, though, because they know that the federal government very likely will cause their current insurance system that they have to go away. and they're right. president obama has made three things abundantly clear. one is that if we have current insurance, we won't lose it, we'll be able to hold onto it. we know he that's false from the legislation the house has taken up, 3200. it states quite clearly that within five years insurance programs would all have to conform with the federal government. and that's individual insurance

plans which are only 8% of all outstanding insurance plans. other programs are employer-sponsored plans. overwhelmingly within five years all insurance plans will have to come under the one-size-fits-all option and isn't it interesting, with the proposal of the public option, pretty soon that will be like the blob that ate new york city. the public option will be the only option for the american people. it happened with the student loan situation two weeks ago -- situation. two weeks ago, the last vote we took was for the government to take over student loans. the government introduced a public option. that one choice, just as representative king of iowa said, adding that one choice to 1,300 insurance companies was like having the federal government add one choice to multiple hundreds of things throughout the country that were already making loans privately to students. but here's the problem.

let's be serious. and let's be honest with the american people. the government doesn't like competition. it didn't like competition when it came to the student loans that were offered. it wanted all of the revenue that potentially could come out of that and it thought it could do a better job, even though the private sector, more people chose to go with private student loans than public student loans. it didn't matter. the federal government wanted to have the whole market it to itself and it captured that market. same thing now with health care. the president of the united states is suggesting that he wants a public option. as a matter of fact, this shouldn't shock anyone. during the course of his campaign when he was running for president he clearly stated that he wanted to see the federal government have a single payer plan where the federal government would be the provider of all of the health insurance in the united states. knowing that it's no shock that this is the direction that this body wants to go. we know that. let's be honest.

let's not dance around it. members within this body on the other side of the aisle, meaning the democrats in this body, numbers of them have said they want a single payer plan. what's that? government takeover of health care. that's the ultimate goal, mr. speaker. to have the government take over health care. what's the result? health care costs far more than it ever did in the past, it will be more expensive to individuals, more expensive to businesses and it will provide less services. we know that. we know that's exactly what's going to happen. despite the fact that the president said, oh, if you have health care you'll.net to keep it. wrong. then the president said, each american would be able to save about $2,500 a year. in other words, we'd see cost savings of about $2,500 a year. there is no estimate anywhere that has ever neverified that wild statement that the president made. then the final statement that the president has made over and

over and over again, people making $250,000 a year or less would not see any tax increases. that's verifiably false. we know exactly that americans will see tax increases. but there's something that hasn't been talked about much. and it's the whole idea of clinics in schools all across america and that's in h.r. 3200. now this would raise the hackles on the necks of school parents all across this country when they understand that section 2511 of h.r. 3200, the house government takeover of health care, has a section, it's called school-based health clinics. and it why you a -- allow a nonprofit health insurance -- agency, just say planned parenthood because that's what this is written for. again, we need to be serious. planned parenthood is an organization that is the largest abortion provider in the united

states and written into this bill is a provision whereby planned parenthood could become the proprietor for school-based clinics in every school across the united states. these have been more accurately called school sex clinics. one of the very first school sex clinic that was put into this country was in st. paul, minnesota. and it was told to the families and the parents that this would actually reduce pregnancy. of course we knew it wouldn't reduce pregnancy. it increased pregnancy. it increased sexually transmitted diseases. it was a disaster for young women in st. paul public schools. the greatest, kindest, most compassionate gift that we can give to our young people, whether it's young boys or young girls, is to teach them and tell them the travesty that they can encounter with early onset of sexual activity. it really is an epidemic now in

this country. for so many girls across this country now, 25% of girls have sexually transmitted diseases, potentially life-threatening sexually transmitted diseases. boys as well. this isn't the kind of country that we grew up in but today, where we have almost a patting on the back of telling young people, it's your choice, do whatever you want to do, now the federal government is going the final step and they're saying, let's put sex clinics in our schools. you can believe this, mr. speaker? let's put sex clinics in our schools, and let's put planned parenthood in charge of these secretary clinics because the bill requires that the schools -- that under this provision, planned parenthood would be authorized to serve as a sponsoring facility for the nation's schools. as a matter of fact, the bulk of this health care bill is scheduled to go into effect in 2013. remember, all the taxes will start this coming january, mr. speaker.

right away, taxes will go into place, but the provisions of this bill actually going into effect in 2013. not the school-based sex clinics. the sex clinics actually would go into effect next summer so that these clinics would appear in public schools next fall and it would require that the school-based sex clinic would provide onsight access during the school -- onsite access during the school day when school was in session and have an established network of support and services with backup health providers when the school is closed. you can imagine that what this would cost, mr. speaker, if every school in the united states had a build-in health clinic? . the bill orders that it protect patient privacy and student records. what does that mean?

parents will never know what kind of treatment that their children are receiving. as a matter of fact, the bill goes on to say what's going to go on. comprehensive health services, physicals, acute chronic medical conditions, followup for specialty care. is that abortion? does that mean a 13-year-old walk into a sex clinic, have a pregnancy test done, have the abortion be back and go home on the school bus that night and mom and dad are never the wiser and don't know any different. as a matter of fact, the bill also provides for mental health planning. this is very concerning. and our state, we have done a lot of research on this. crisis intervention, counseling, treatment, referral of services, including emergency psychiatric care and mom and dad can't know what's going on?

mr. speaker, i am almost without words to think that we have come to the time when the democrats that control washington, d.c. and make no mistake, they control every lever of power in this city, now they want taxpayers to pay for sex clinics all across the united states and planned parenthood, who takes in $1 billion a year, $00 million of which is taxpayer subsidies, hey, that was just the prologue, this is now the gravy train. there will be billions and billions and billions on into the future. what p did the president say? he wants america schools to have longer school days and longer school years. where in the constitution does it say that the president decides how long the school day is or how long the school year

is and now we're go to go have the sex clinics in the schools and they are going to take over the health care services of our kids? i don't know about you, representative king, but this is highly offensive to me as a parent to think that -- the awe dassity, the awe dassity of the president and this congress stepping into this area of privacy of family life. mr. king: reclaiming my time, i so appreciate the analysis that's been delivered, mr. speaker, by the gentlelady from minnesota. and i think about what this is like to be a parent and to deliver your child to a public education system that had this kind of a federal mandate laid out. i think back to the days when education was actually local. and often think about where i live. there was a country school just across the road from my house and i missed going to country school by about five weeks and i regret i didn't have that

experience, but i grew up around people who did. at that time, it was four miles by four miles was the school district and they hired the teachers and approved the curriculum and if they didn't like the job that the teacher was doing, they fired her. and if they happy with the curriculum, they changed it. the moral, academic and religious values of the people who were paying the taxes. today, we have a growing federal reach. it is way down into the heart of our educational system from k-12. wanting to go back to the womb and want to inject themselves into the unborn children as well with planned parenthood and set them up as the protectors of young children when they're the people that abort little babies. we had a debate and vote here on

the floor of the house and there was an amendment that was offered by congressman pence of indiana that would have unfunded planned parenthood. we have to get there eventually. no organization that provides abortion services or counseling should have federal taxpayer dollars involved. $300 million as mrs. bachmann has said, money powered into you might as well say one pot of money and set them up with clinics in our schools so the young girls can go in and out of there and be recruited in the hall ways by an organization that's vested in what? promiscuity. pull it out of the equation and see what they call for services. there is very little. without that, you don't have a

birth control problem and don't have an abortion patrol problem or counseling that goes on with it either. they are a destructive purpose in this society and it is something that no taxpayer should be compelled to fund whether it's in this country or overseas. mrs. bachmann: if the gentleman would yield, planned parenthood has a big problem on their hands, almost on the level of acorn and the problems that acorn has had and it's this. there is a case that has been filed in california and planned parenthood apparently, allegedly has been overcharging the federal government tens of millions of dollars because what is alleged is that planned parent hood has fraudulently marked up their birth control pills that they have been giving out to people. they have been giving out birth control pills free to the people and charging the federal

government. they aren't charging the going rate allegedly. they have overcharged the federal government. the president stood in this chamber and said he was planning to pay for this big health care with getting rid of waste, fraud and abuse in the health care system. planned parenthood can be considered a part of the quote health care system, why? the president considers abortion part of health care. he considers abortion, what he calls reproductive rights which is a code word for abortion, he considers that essential health care. planned parenthood is a part of his essential care. and this is the payoff. this is the payoff to planned parenthood. they would be given free access to our kids all day long and this is an organization who allegedly has overcharged the federal government tens of millions of dollars. here's another opportunity for the i.r.s.

here's another opportunity for them to go after a 501-c-3 organization. they brought in $1 billion and received $300 billion worth of tax benefits, meaning they didn't pay taxesb received $300 billion of taxpayer money. this is an organization that should be investigated by the i.r.s., very likely should lose its 501-c-3 status as well as acorn and have taxpayer subsidies pulled everywhere across the united states. mr. king: i agree with the gentlelady from minnesota and i regret i didn't bring a similar sign for planned parenthood but i did for acorn. as we talk about acorn, they claim they are filed as some kind of a tax -- not tax-free

not-for-profit organizations. we see 45 of their affiliates who have filed not-for-profit organizations. acorn's money flows into a central account and then distributed out to the entities as acorn needs them. one big pot of money, one big cookie jar with state and federal dollars involved, donor dollars involved. and what are they involved in? other enterprises that are involved in unethical and immoral, mr. speaker and i'll go down the list some of the things that acorn has been involved in. by the way, the linkage of some of what is coming out of planned parenthood and that is a constructive linkage to make and this is a natural progresses. funding such huge national and

international organizations for the purposes of breaksing down the core of our society and turning it into an immoral mass of people. they have attacked our institutions and the institutions of government and institutions of the media. mrs. bachmann: if the gentleman would yield. planned parenthood was one of the organizations that gave money to acorn for the purpose of voter registration before this last election and it wasn't just planned parenthood but also the teachers's union. and we have seen videos of little school children, kindergarten school children on videos all across the internet, where little children are being taught praise of the president of the united states almost in a personality, cult-like worship in video. and this is concerning, because we have a teachers union that

came out and gave money to acorn for the purpose of voter i.d. and it's interesting how you can link planned parenthood with acorn and the president and there are a lot of questions that need to be answered. king ki i brought my -- mr. king: i brought my poster to bring clarity to this matter. as critical as the united states senate and united states house of representatives and the public has been of acorn and they deserve a lot more, there hasn't been enough involvement on the president in acorn. his political start was with acorn. i have been with you from the beginning, he says. and some of the statements of the leader of acorn ties that back in. madeline is talmadge and she has said that he and obama were working together in this cause

from the beginning. president obama headed up project vote. project vote is indiscern i believe from acorn and they are one in the same. and so he made his reputation with acorn. acorn was get out the vote for president obama. he paid them to get out the vote, even though they registered as -- let's see production and lighting. mrs. bachmann: staging materials. that was a big problem for the president during the course of the election, because he had falsely listed on his s.e.c. report that money that was given was for staging materials and that was very concerning. that was brought to the attention of the campaign and changed that once they found out about that. $800,000 was transferred from the obama campaign to acorn. you are correct when you went back in history and the president back in 1991 took time off from his law firm to run a

voter registration drive for this and this is in the "wall street journal" article. the drive registered 135,000 voters and considered a major factor in the upset victory over allen dixon. and congressman king, i wonder if you could comment on this. this is something i don't understand. why in the world would acorn have a tax-exempt status? why in the world would acorn be receiving taxpayer money when they work consistently in election afflecks to elect one party, democrat party. why are the taxpayers pay-go alleged loy for the election of democrats? mr. king: according to law they cannot be a 501