mr. mcdermott said, the house is a great investment. so if it's a great investment if it's something we ought to do as homeowners is buy a home and invest in those homes stands to reason we probably ought to go for the best thing that we can without regard to our ability to repay. but what you've basically stated, and i know it's kind of a crudely simple comparison that i'm making here is that the people that are lending you money for an investment like that are vitally interested in your capacity to repay that loan. and if you could not demonstrate a capacity to repay that loan, you're probably not going to benefit from that loan correct? >> that's right. >> so as mr. sanford stated a minute ago and others here have stated, our creditors must be interested in our capacity to repay, don't you think? >> yes. >> do you think there's coming a point in time that they may ask of us to start doing some things like looking at our budgets as everyday americans look at their budgets and start doing away with cable and expensive vacations and unn

mr. mcdermott said, the house is a great investment. so if it's a great investment, if it's something we ought to do as homeowners is buy a home and invest in thunderstorms, it stands to reason we probably ought to go for the best thing that we can without record to our ability to repay. but what you basically stated and i know it's kind of a crudely simple comparison that i'm making here, is that the people that are lending you money for an investment like that are vitally inned in your capacity to repay that loan. and if you could not demonstrate a capacity to repay that loan you probably are not going benefit from that loan correct? >> that's right. >> so as mr. sandford stated a minute ago and others here on the diaz stated our creditors must be interested in our ability to repay? >> yes. >> do you think there's a point in time where they may ask of us to start doing some things like looking at our budgets as every day americans look at their budgets and start doing away with cable and expensive vacations and unnecessary costs that

mr. roskam: dr. mcdermott. mr. mcdermott: thank you, mr. chairman. i appreciate you letting me be and adjunct member of the committee. there's a recent article in the "wall street journal" talking about the conglomeration or the merging of health care providers. insurance companies. and they are talking about what's happening in a variety of markets around the united states. and i -- in talking about antitrust questions. and the whole question our fraud laws are based up to this point, on a fee for service system. are really designed to deal with the fee-for-services. now we have managed care and all these things going on. i would like to hear you talk about where you think health care is going in terms of the mergers in these states where you're going to have -- if the free enterprise system is based on competition, it means you have to have more than one or maybe more than two to have anything that could be called real competition. if it's just two gorillas dividing up the pie in the state of whatever, it becomes not very competitive. so i'm intere

mr. mcdermott from the acting ranking chair's position a moment ago opened his line of questioning about your house and if it's okay, i'm a fellow arkansan, you can truck me that i'm not trying to trick you. if i get too personal let me know. nice home? >> sure. >> we've already established you took out a mortgage. was it the nicest home you looked at? >> no. >> so there were nicer homes? >> well, i dreamed when i looked at the other ones but realistically that's what i could afford. >> so there were nicer homes bigger homes. >> yes. >> probably some in some gates communities. just a lot of amenities you would like to have had. you dreamed so why'd you buy the house you got? >> it's what i could afford and what i could -- it was a loan i could pay back. >> so when you went to the lender they were interested in your ability to repay? >> that's right. >> how novel. wsh any other considerations in what you were doing say main innocence and upkeep newt costs, taxes those kinds of things? >> oh, absolutely. that factored in our decision. >> you might have had kids going to college that might

mr. chairman, thank you for time. >> dr. mcdermott. >> thank you, mr. chairman. appreciate you letting me be an adjunct member to the committee. there's a recent article in "the wall street journal" talking about the conglomeration or the merging of health care providers, insurance companies. and they are talking about what's happening in a variety of markets around the united states. and talking about antitrust questions come and the whole question, our fraud laws are based up to this point on a fee for service system. the stark law and other aspects of it are really designed to do with the fee-for-service system. now we have managed care in all these things going on. i would like to talk about where you think health care is going in terms of the mergers in these estates where you're going to have if the free enterprise system is based on competition it means you've got to have more than one, or maybe more than to do anything that could be called we'll competition. i mean, if it's just to guerrillas dividing up the pot in a state of whatever, it becomes not very

mr. mcdermott will remember this. he was in congress then so he was away from it but in the late 1990s we actually had health care reform that had passed in 1993. it was repealed in 1995 but it left in place that you could get health insurance after a three-month preexisting waiting period. what the net result was, we effectively what would be left with the affordable care act is guaranteed issue and you would wind up with the healthy people dropping out as rates started to rise, the sick people staying and you couldn't stick with it. in the state of washington where we had a comparable situation in the 1990s the market actually collapsed. we lost our individual market. it took legislative action to see it restored just as i came into office in 2001. we would see in those 34 state that is are in a position right now to have federally facileitate facilitated facilitated, they, in fact, could be in a position to see exactly what happened in the state of washington which is a collapse. this based of course on the failure

mr. mcdermott. >> mr. chairman, thank you. ms.urwell, it's really nice out in seattle i'm not sure you made the right choice coming back here to work. >> i'm in the wrong washington, is that what you're telling me? >> i listen to this and we're all talking about if the president does this and whatever but let's talk a specific because i think that we haven't heard a specific come out of the republicans in -- since the bill was passed. they've never put anything on the table. now we have a bill 1016 put in by senator johnson from wisconsin and his -- it's his solution if the bill fails, and as i read read it quickly it repeals the individual mandate, it reveals the employer mandate and it says that the states can continue the funding down -- and the standard of benefits that people get are not the national standards, but whatever the state of mississippi or alabama or georgia or texas or one of these states that has not had an exchange, whatever they set as a benefit, we know it will be lower because it already is, they won't cover

mr. mcdermott is recognized for five minutes. >> mr. chairman. do you own a house? >> i do. >> did you pay cash for it? >> i did not. >> so you went in debt to buy that house. >> that's right. is that a common occurrence in the united states? >> it is. so we have a population that understands the idea of investment creates debt and that in the end in 30 years you'll have a house probably and you'll have some house that's probably worth quite a bit more than what you paid for it maybe already is. would that be true? >> that would. >> that would be a projection you would expect. >> yes. >> now, the idea of investment, is one i think we lost sight of in congress. republicans don't seem to want to invest any more. and i was reading "the new york times" and couldn't believe on 22nd of april that i saw a great political leader of the conservative right had come out with a suggestion we should double the nih budget. newt gingrich. i ask unanimous consent to put his editorial in the record. >> objection. >> even as we let financing for basic scientific and medical research

mr. mcdermott. >> mr. chairman, thank you. ms.urwell, it's really nice out in seattle i'm not sure you made the right choice coming back here to work. >> i'm in the wrong washington, is that what you're telling me? >> i listen to this and we're all talking about if the president does this and whatever but let's talk a specific because i think that we haven't heard a specific come out of the republicans in -- since the bill was passed. they've never put anything on the table. now we have a bill 1016 put in by senator johnson from wisconsin and his -- it's his solution if the bill fails, and as i read read it quickly it repeals the individual mandate, it reveals the employer mandate and it says that the states can continue the funding down -- and the standard of benefits that people get are not the national standards, but whatever the state of mississippi or alabama or georgia or texas or one of these states that has not had an exchange, whatever they set as a benefit, we know it will be lower because it already is, they won't cover

mr. mcdermott: i ask to revise and extend my remarks. the speaker pro tempore: without objection. mr. mcdermott: mr. speaker mr. levin was correct. when we were designing the affordable care act, everyone was expected to share in the cost as we work for the american people. the medical device industry said how about 2.3%? we'll go for that. they agreed to it. here they are asking for us to give them nothing, no taxes. they don't have to pay anything, no matter how they benefit from it. now repealing this tax, which the nonpartisan analysts have shown has no negative effect on jobs, will add 24.-- $24.4 billion to the deficit. it would eliminate an important source of revenue simply to appease an industry that has benefited directly and greatly from the expansion of the coverage of a.c.a. on top of that, the bill is a distraction from a more important issue that the congress needs to address in the context of medical devices. they would not let us vote on an amendment in the committee to bring up the institution of unique device identifiers. an essential tool of improving patient safety

mr. mcdermott, three minutes, on the health subcommittee. the speaker pro tempore: yes, sir. the gentleman from washington is recognized. mr. mcdermott: mr. speaker, i rise in opposition to this bill. this legislation is a ghost hunt. it doesn't exist. there is no yaub. there's nobody been -- there's no ipab. there's nobody been appointed. it won't happen until 2024. the question is, why are we out here? well, we're out here because some people think that trying to control costs in health care is a bad idea. if you go back and read the medicare legislation when it was put in, the a.m.a. extracted from this congress the right to charge their usual and customary fees. and they have been driving the costs and we've been trying to control it wall kinds of mechanisms all the way through -- control it all kinds of mechanisms all the way through. we've actually extended the life of medicare to 30 -- 2030. and we're spending right now 17% of our gross domestic product. when i came to this congress it was about 13% or 12%. it's only gone up. we have not been able to do it ourselves. s

mr. mcdermott. >> mr. chairman, thank you. ms. burwell, it's really nice out in seattle.you made the right choice coming back here to work. >> i'm in the wrong washington. is that what you're telling me? >> i listen to think and we're all talking about if the president does this and whatever, but let's talk about a specific. i think that we haven't heard a specific come out of the republicans since the bill was passed. they've never put anything on the table. now we have a bill 1016, put in by senator johnson from wisconsin. it's his solution if the bill fails. and as i read it quickly t repeals the individual mandate, it repeals the employer mandate, and it says the states can continue the funding down and the standard of benefits that people get are not the national standards but whatever the state of mississippi or alabama or georgia or texas or one of these states that has not had an exchange, whatever they set as a benefit. we know it'll be lower because it already is. they won't cover people in medicaid. so they clearly don't care about the level of health care. but

mr. mcdermott and long time support for the nation's -- nations in africa and acknowledge some several ambassadors that are here from south africa. i also want to thank the chairman of the ways and means, mr. ryan, and really appreciate you for the timing. you made a commitment as soon as you took over as chair. you received numerous delegations from the continent and made that commitment and followed through on it and in particular the timing because it was so important as you and chair and ranking member and the chair of the subcommittee that we did this soon and didn't wait until agoa was near expiration. we did that a couple of years ago with third-country fabric and found that many jobs on the continent were lost. i thank you for your leadership and following through. the importance of re-authorizing agoa and strengthening trade and investment between the united states and nations of africa is clear. since the enactment in 2001, agoa has increased exports to the united states and led to jobs. agoa has generated approximately 100,000 jobs in the u.s. and 350,000 direct jobs and a million indir

mr. mcdermott is recognized for five minutes. >> mr. chairman. do you own a house? >> i do. >> did you pay cash for it? >> i did not. >> so you went in debt to buy that house. >> that's right. is that a common occurrence in the united states? >> it is. so we have a population that understands the idea of investment creates debt and that in the end in 30 years you'll have a house probably and you'll have some house that's probably worth quite a bit more than what you paid for it, maybe already is. would that be true? >> that would. >> that would be a projection you would expect. >> yes. >> now, the idea of investment, is one i think we lost sight of in congress. republicans don't seem to want to invest any more. and i was reading "the new york times" and couldn't believe on 22nd of april that i saw a great political leader of the conservative right had come out with a suggestion we should double the nih budget. newt gingrich. i ask unanimous consent to put his editorial in the record. >> objection. >> even as we let financing for basic scientific and medical research

mr. mcdermott: i have generally admired president obama's bold policy decisions, however, the announcement to send another 150 military advisors to iraq and arm the shia forces and kurdish peshmerga is a grave misjudgment. arming the sunni tribes could undermine iraqi prime minister abecause dee and the central government -- abadi and the central government the u.s. is trying desperately to prop up. sunni assistance may in turn push iran to more aggressively arm their shia militias in iraq. worse still arming the shia fighters will further inflame iraq's deep sectarian divide which isis has exploited so skillfully. the kurdish peshmerga is perhaps the most only reliable and ready force deserving u.s. military assistance but no amount of heavy weaponry will defeat isis without a concerted political settlement both in baghdad and damascus. all of this comes just days after president obama said yet again, we do not have a complete strategy to defeat isis in iraq or syria. the u.s. has few palatable options when it comes to entangling the re's current -- untangling the region's current chaos.

mr. levin from the very, very beginning working with jim mcdermott working with the republicans gave birth to this bill 10 years ago and his guidance and support and the ways and means members have given anotherier. karen bass came to us and gave africa and those types of issues that people left behind and she managed to make certain and everyone knows that this country cares and cares deeply. it is ironic as we talk about africa we are talking about haiti and talking about developing countries and we are talking about those workers who through no fault of their own and because of international and national decisions, have lost the opportunity to have self-esteem and have a job. these are issues that we have touched on in this bill. these are the issues that go no where to how far america has to go in order to be fair and equal and allow us really, to include real wages real education, real opportunity, and the pursuit of happiness. but since we are trying and since there is nothing in this bill that doesn't point us in the right direction, and especially the same day that this united stat