House Proceeding 10-14-09 on Oct 14th, 2009 :: 2:26:45 to 3:27:20
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2:26:42 to 2:27:02( Edit History Discussion )

Michael C. Burgess: we wo with that, mr. speaker. i yield back. the speaker pro tempore: the gentlelady yields back her time under the saker's announced policy of january 6, 2009, chair recognizes the gentleman from texas, mr. burgess, for 60

2:26:45 to 3:27:20( Edit History Discussion )
Speech By: Michael C. Burgess

2:27:03 to 2:27:25( Edit History Discussion )

Michael C. Burgess: minutes. mr. burgess: i thank the speaker for the recognition. floor to talk more about health care. it is the number one topic of the day here in washington, d.c. it's interesting because probably 50% of ameri more about what are we doing as

2:27:26 to 2:27:47( Edit History Discussion )

Michael C. Burgess: far as job creation. 14% are concerneabout health care. would you think that we would adopt the bill clinton's phrase of focusing like a laser beam on the economy and focusing on job creation. but health care is important and it is appropriate that we spend time discussing it because

2:27:48 to 2:28:11( Edit History Discussion )

Michael C. Burgess: likely than not, before the end of this year, it is possible that some type of bill will pass be to the liking of a great number of americans. i know my comments must be directed to yourself and not to others, but i would say, mr. speaker, that if i were able to

2:28:12 to 2:28:32( Edit History Discussion )

Michael C. Burgess: talk to people about what they could do, a plan foraction, i will be discussing that toward the end of this hour. so i do encourage people to stay tuned to this debate, not necessarily to this discussion this hour, but stay tuned to this debate because it is important. it will affect the lives of

2:28:33 to 2:28:54( Edit History Discussion )

Michael C. Burgess: americans from this day forward for a long, long time. it is extremely appropriate that we take our time, that we get this right, that we do not hurry through the process, that we do not cut corners. . now, mr. speaker, you look at where we are 10 months into

2:28:55 to 2:29:15( Edit History Discussion )

Michael C. Burgess: this year. do we have the trust of e american people in this body? the answer to that question is, it doesn't seem so. what people have seen this year and even going back into last year in the term of the previous president, president

2:29:16 to 2:29:36( Edit History Discussion )

Michael C. Burgess: bush, they saw a couple of bailouts last year, more of the same this year, they've seen stimuluses, automobile takeovers, finance rble -- financial sector takeovers, a bill that passed the floor of this house that many thought was inadviseable in a time of

2:29:37 to 2:29:58( Edit History Discussion )

Michael C. Burgess: economic downturn. and washington still has the nerve to say, trust us, we can take care of you and make your lives better. but the current polling numbers don't suggest that that is something that's believed by the american people. true enough, the president started this year with extremely high approval atings, somewhere likely in

2:29:59 to 2:30:21( Edit History Discussion )

Michael C. Burgess: excess of 80% approval ratings at the time of the inauguration. an extremely popular individual. and has retained a great deal of that popularity, depending upon the poll you select. now it is down to about 50%, 49% this morning in rasmussen, 52% in the real clear politics daily average poll.

2:30:22 to 2:30:42( Edit History Discussion )

Michael C. Burgess: but still, one of every two americans has a favorable what about the united states congress it one of two? one of three? it's one of every five people holds the united states demonk high regard. so with our current approval ratings hovering around 20%,

2:30:43 to 2:31:03( Edit History Discussion )

Michael C. Burgess: why do we think the american people would believe that we in fact do know best and that they should trust us on an undertaking on this mammoth scale. and you can see how big the undertaking is. you heard previous speakers the last hour talk about how difficult it is. we've had three health care bills that passed the various

2:31:04 to 2:31:25( Edit History Discussion )

Michael C. Burgess: committees in the house last summer you had one health care bill that passed the senate health education labor and pensions committee in june of this year, and then most recently, you had the talking points memo that passed out of the senate finance committee yesterday with a single republican vote on that.

2:31:26 to 2:31:46( Edit History Discussion )

Michael C. Burgess: i do not believe there were any republican votes on any of the house products in the three committees that considered this bill under their various jurisdictions. the congress doesn't have a loot of credibility right now on this, or quite frankly many other issues. it would be a great thing, in my opinion if congress spent

2:31:47 to 2:32:08( Edit History Discussion )

Michael C. Burgess: some time in trying to rebuild that credibility. unfortunately, it's the old adage, don't check the weather, we're going to fly anyway. off we go with a big cap and trade bill in june that upset a lot of people, we did three health care bills on the house side in a lot of -- in three

2:32:09 to 2:32:29( Edit History Discussion )

Michael C. Burgess: different committees in july. we ran into town hal meetings in the month of august where people told us what we they thought of our efforts. now we're back in the fall taking up the big bill on health care reform. as we've watched this debate, think back a year ago, we were in the middle of a presidential

2:32:30 to 2:32:50( Edit History Discussion )

Michael C. Burgess: candidates had ideas about what should happen in health care and the possibility of health care reform. remember, now president obama's position last fall was significantly tilted toward getting coverage for the uninsured. it was a moral imperative. it was something we had to do. then we worked through some of

2:32:51 to 2:33:11( Edit History Discussion )

Michael C. Burgess: the more difficult parts of the economic downturn, a lot of job losses were incurred during that time anat the beginning of the year, many more people were concerned about the cost of health care and would they be able to continue to afford their insurance, would they be table continue to afford health care. so affordability became, perhaps, a higher priority for

2:33:12 to 2:33:33( Edit History Discussion )

Michael C. Burgess: members of congress who were considering these reform -- reforms during the spring. in june, when the first congressional committee in the senate, health, education, labor, and pensions committee, passed their bill out of the senate committee, the focus was all on cost and coverage. the cost numbers turned out to

2:33:34 to 2:33:56( Edit History Discussion )

Michael C. Burgess: be significantly higher than anyone thought they'd be. somewhere in the neighborhood of $1.5 trillion over 10 years' time. the coverage numbers were disappointing at only a third of the uninsured actually being picked up. and there's no question that that delayed the second senate committee, the senate finance committee in introducing a bill

2:33:57 to 2:34:20( Edit History Discussion )

Michael C. Burgess: and marking up a bill which they just completed this week, because they were trying to fine tune those numbers. now on the house side, we did in fact get a congressional budget office score that came in around $1 trillion for a 10-year bill. a little disingenuous, because the congressional budget office, in the hearings we had on the energy and commerce, the

2:34:21 to 2:34:44( Edit History Discussion )

Michael C. Burgess: score was administered n on legislative language but on conversations, telephone calls, that the member members of the congressional budget office had with members of the democratic majority who were writing the bill. yes, it was a cost number, but there was some question as to the accuracy of that and then here was a really big problem, one that really hasn't been

2:34:45 to 2:35:06( Edit History Discussion )

Michael C. Burgess: addressed yet, these are enormous programs to undertake. they are not going to start overnight. even if we pass a bill before the end of the year, it is going to become -- going to be some time before these programs whether it be public option, whether it be exchanges within the ste, it's going to be some time before the cente for medicare and medicaid services

2:35:07 to 2:35:27( Edit History Discussion )

Michael C. Burgess: in the department of health and human services which is likely to be charged with writing the rules and regulations churned these new products are formed, it's going to be some time before those things happen. the benefits are not scheduled to begin to kick in until the year 2012 20, 14, it will be some time before those benefit

2:35:28 to 2:35:49( Edit History Discussion )

Michael C. Burgess: os cur. the taxes, of course, will begin the minute the ink is dry on the president's signature on the bill. if we have a tax on high end insurance plans if we have a tax on medical devices if we have a tax on any number of things, these taxes will begin

2:35:50 to 2:36:11( Edit History Discussion )

Michael C. Burgess: to accrue january 1 of that year, but the benefits don't actually begin to kick in for some time. once again, the united states congress, when questiond by the american people, the united states congress says, don't worry, trust us we know best, a plan for you. we know best how to take care of you.

2:36:12 to 2:36:34( Edit History Discussion )

Michael C. Burgess: we know you don't know how to do this for yourself and congress with its 20% approval rating is just the pen for the job to get this done for you. you know, during the presidential campaign of last year, president obama promised to bring all parties together, not negotiate behind closed doors, and to be broadcasting those negotiations on c-span.

2:36:35 to 2:36:55( Edit History Discussion )

Michael C. Burgess: now we had kind of an unusual situation occur in may and june of this year, when various health care community met at the white house and offered up things they could do. things they could do to hold down the cost of health care. you had to to wonder where were these individuals for the 15 years before, but you had

2:36:56 to 2:37:17( Edit History Discussion )

Michael C. Burgess: group, the american medical association, of which i am a member. they were in those meetings. the american hospital association was in those meetings, and offered up a number of things they could do for substantial cost savings. a little controversy last week as the senate was working thru

2:37:18 to 2:37:39( Edit History Discussion )

Michael C. Burgess: its product, will those things the american hospital association offered are those going to be taxed or not? there was some back and forth with the congressial budget office as to wha actually meant. medical devices, again, similar situation. pharma came to the table with

2:37:40 to 2:38:01( Edit History Discussion )

Michael C. Burgess: about $80 billion in cuts they were going to be offering. well, none of these things that are agreed to behind c doors last may, none of these deals are available to us as members of congress so that we

2:38:02 to 2:38:24( Edit History Discussion )

Michael C. Burgess: america's health insurance plan group, when they came to the table and said, we can save you billions of dollars, mr. president, and he said, what took you so long, but as members of the committee that were charged with working through this bill last july, why did we not have that information available to us in why was it a surprise as the senate finance committee when,

2:38:25 to 2:38:45( Edit History Discussion )

Michael C. Burgess: hey we thought these breaks we were giving hospitals were going to fill the -- still be subjected to a corporate income tax, not an offtax item? why was there that discrepancy or that discussion? why not share with us these the deals struck at the white house and indeed last month, i sent a

2:38:46 to 2:39:06( Edit History Discussion )

Michael C. Burgess: letr to the white house and asked for the release of those discussions, the transcripts of those discussions, the minutes and notice of those discussion, pertinent emails that may have occurred during those discussions, and i'm just quoting from my let torte white house. it's been now other four months

2:39:07 to 2:39:27( Edit History Discussion )

Michael C. Burgess: since the white house announced numerous deals th workers in the health care debate. little to know no details have been he leased. recent actions have reminded me of the importance of openness and transparency throughout the legislative process. the very openness and transparency we were promised

2:39:28 to 2:39:48( Edit History Discussion )

Michael C. Burgess: by this president during the campaign. so the letter has gone to the white house, i eagerly await a response to that. i'm in fact somewhat surprised that my committee, the commerce that has a fairly robust oversight and investigation subcommittee, i'm somewhat surprised they have

2:39:49 to 2:40:09( Edit History Discussion )

Michael C. Burgess: not been curious about the deals that were made down at the white house early in the spring, why they have not been curious aut the emails that might have occurred during the back and forth with working through these negotiations. so again, the letter went to the white house on september 30 and i await a reply.

2:40:10 to 2:40:30( Edit History Discussion )

Michael C. Burgess: i will ask later on for unanimous consent to include this letter as part of the congressional re evening so that people will have the opportunity to read through that letter themselves. but again, the american people just simply do not trust the american congress, the united states congress to make these kinds of decisions for them.

2:40:31 to 2:40:52( Edit History Discussion )

Michael C. Burgess: when you look at some recent polling data and the question was asked, if congress works through this process and comes up with a major health care reform piece of legislation, is health care going to get better or is it going to get worse? a quarter of folks think it will get better. about 26% say, yes, congress will make the

2:40:53 to 2:41:13( Edit History Discussion )

Michael C. Burgess: necessary and health care will in fact improvement. 50% say it will get worse. not great numbers for -- with which we're working. you know, it was startling for many of us the interest that was out there over the summer in the august recess on the health care bill, on cap and

2:41:14 to 2:41:34( Edit History Discussion )

Michael C. Burgess: ade, tn hall activity was widely reported in news media outlets across the country. my district back in texas was no exception. town halls where i might typically have 30, 40, 50 people show up on a saturday morning, 1,000 or 2,000 people showed up. one venue we had to change from

2:41:35 to 2:41:55( Edit History Discussion )

Michael C. Burgess: inside to outside and just held the bulk of the meeting out in the parking lot because of the number of people that showed up. i've got to tell you, mr. speaker, august in texas in the parking lot, yo lot of people to stay with you through an hour or so discussion of a health care bill. but they did.

2:41:56 to 2:42:17( Edit History Discussion )

Michael C. Burgess: and they asked questions, and they were respectful. i don't think that this august was an anomaly. i don't think the american people had some sort of fugue state in august where they reacting to the health care legislation and the cap and

2:42:18 to 2:42:38( Edit History Discussion )

Michael C. Burgess: trade legislation and reacted in no uncertain terms as to how angry, howance rble they were about the bills we were passing. but what we get pack to congress in -- when we get back to august in september, it was like august never happened. it was unimportant, don't pay attenon to the people back home because we're congress.

2:42:39 to 2:43:00( Edit History Discussion )

Michael C. Burgess: trust us. we know best. we know best how to take care of you, we know bist how to give you what we think you need. we got back in september and i thght after seeing the august town halls, i thought, this congress would hit the pause button, hit the reset button, hopefully the rewind button on this health care legislation,

2:43:01 to 2:43:21( Edit History Discussion )

Michael C. Burgess: but no such luck. we went at we had a little bit of an extended markup in and commerce committee, where i would suggest to the chairman of the committee, i said august was a rough month for people on both sides of the aisle, even republicans who voted against

2:43:22 to 2:43:43( Edit History Discussion )

Michael C. Burgess: the bill, people were angry that the bill was being considered and would likely pass. on the democratic side there were a number of town halls that were quite contentious. we foughting -- we thought, thought, members would welcome the opportunity to sit down and reornize this. maybe there were some good ideas on the other side. maybe republin members should

2:43:44 to 2:44:05( Edit History Discussion )

Michael C. Burgess: have been brought into this process and take some ownership of this bill if nothing else. don't leave us being the only ones out there to defend it but no, that wasn't the case. the chairman of the committee said august, in so many words, august didn't matter neesm who spoke up were few and far between and these large crowds

2:44:06 to 2:44:26( Edit History Discussion )

Michael C. Burgess: that showed up at the town and didn't unt. . i offered a couple of amendments on our side as did other members on the republican side. but those amendments were struck

2:44:27 to 2:44:47( Edit History Discussion )

Michael C. Burgess: down on a party-line vote. but both sides of the aisle genuinely see a problem and want to work toward improvement of the process. you have heard me say it before and other members of congress say it before. some dispute it as a fact.

2:44:48 to 2:45:12( Edit History Discussion )

Michael C. Burgess: but america has the best health care system in the world. there are distributional problems aninequities that need to be fixed and they are within our capability of fixing. but we do not need to turn the entire system on its head to

2:45:13 to 2:45:33( Edit History Discussion )

Michael C. Burgess: effect those ends. how could we best go about improving health care in america? well, we can ensure that patients continue to have have -- access to care. that would be a good thing for us to work on together, instead of being an obstacle and

2:45:34 to 2:45:54( Edit History Discussion )

Michael C. Burgess: threatening cuts every time you turn around, we could could help doctors, nurses and hospitals to . sometimes it's do as i say and not as i do, but perhaps we

2:45:55 to 2:46:16( Edit History Discussion )

Michael C. Burgess: could set a better example, staying within our ideal weight. maybe that's something we should lok at. bu aga amendment was turned back in my committee on energy and commerce. and you know, one of the keys is going to be if we're going to

2:46:17 to 2:46:38( Edit History Discussion )

Michael C. Burgess: hold down medical costs, we have to involve the patient, we have to have patient involvement in the doctor's office, involvement in making those healthy lifestyle choices. if we don't have the involvement, the health literacy about things like preventive care and things like the

2:46:39 to 2:46:59( Edit History Discussion )

Michael C. Burgess: importance of eating right and staying fit and the importance of regular health checkups and medical sc do that, the costs will continue to increase and increase at a rate at which it's going to be very difficult, regardless of the number of new taxes and cuts to doctors and hospitals and

2:47:00 to 2:47:21( Edit History Discussion )

Michael C. Burgess: nurses, regardless of all those things, it's going to be difficult for congress to keep up. we put the system at risk when we do that. the generation or two coming behind us will say we can no longer afford the type of tax rate that you have left for us and we will have to do something drastically different and we

2:47:22 to 2:47:42( Edit History Discussion )

Michael C. Burgess: don't want to do that and don't need to do that. now, you have heard a lot of discussion about how republicans have been obstructing the process. let me clarify that just for a moment. there are 177 or 178 republicans in this body. 256 democrats in this body.

2:47:43 to 2:48:05( Edit History Discussion )

Michael C. Burgess: it takes 218 votes to pass a bill to send it onto the senate. the democrats in this body could pass whatever bill they want. they do not need republican support and they have told us that on more than one occasion and the famous phrase that came out in january or february, well, we won, so there hasn't

2:48:06 to 2:48:27( Edit History Discussion )

Michael C. Burgess: been a lot of reaching across the aisle, because it wasn't necessary. now, you think back to february, ag approval rating of 75%, 80%. the president could have passed whatever health care bill he wanted in february of this year. there would be nothing anyone

2:48:28 to 2:48:50( Edit History Discussion )

Michael C. Burgess: could have done to stop it and there would have been very few people with the courage to stop it because the president was seen as soap popular.

2:48:51 to 2:49:12( Edit History Discussion )

Michael C. Burgess: they got it passed. no republican bill as it was being written and no republican support on the floor, but they didn't need it. it passed overwhelmingly with only democratic votes and wept the white house and was signed into law by the president. followed by an omnibus bill that

2:49:13 to 2:49:33( Edit History Discussion )

Michael C. Burgess: spent a lot of the same dollars on a lot of the sa things. again, not much in the way of republican support and it passed because after all, 218 votes are all that is required to pass a bill on the floor of this house and the democrats with their 256 majority have more than enough

2:49:34 to 2:49:54( Edit History Discussion )

Michael C. Burgess: votes to pass almost anything they want. now, the republicans even tried? i don't know the answer? i did. i met with the transition team and i met with the chairman and i said i didn't give up a 25-year medical career to sit on the side lines.

2:49:55 to 2:50:15( Edit History Discussion )

Michael C. Burgess: i may not be able to be with you on some issues. there are some things that are the wrong approach to reforming health care, but let's see what can be worked out. i was thanked for my interest and never did get a cal back. i was invited down to the white

2:50:16 to 2:50:38( Edit History Discussion )

Michael C. Burgess: house for a photo op. and as the bill was being written behind closed doors in the varioucommittees, no point was i offered any input. now, i did as many members offer many amendments and we did amend the bill in committee. it will be interesting to see whether or not those amendments

2:50:39 to 2:51:00( Edit History Discussion )

Michael C. Burgess: stay in the bill but i don't think anyone is fooling themselves. there was no way to amend that bill, h.r. 3200. there was no amendment you could offer except striking the language from the bill and offering a new bill. there wasn't -- it wasn't salvageable in my opinion.

2:51:01 to 2:51:21( Edit History Discussion )

Michael C. Burgess: three committees have passed the bill and the incentives will be aligned and some of them will be at 90-degree intersections. so someone will have to redo that bill and that is happening that now and you can expect that there is probably a heavy hand from the white house in aligning all three of those house bills

2:51:22 to 2:51:42( Edit History Discussion )

Michael C. Burgess: into one product. we will see it a few hours before we vote on it. it may come as the early of this month and may come before thanksgiving and i suspect that is true. i don't know whether any members on my side will vote for it. there don't seem to be a large

2:51:43 to 2:52:03( Edit History Discussion )

Michael C. Burgess: number of republicans that are supporting h.r. 3200. i don't know if any democrats will vote against it. we saw it inome committees that there were some democrats thcould not support some agains the public option continues to be a political football, kicked from

2:52:04 to 2:52:27( Edit History Discussion )

Michael C. Burgess: the house wants a robust public option. the senate not so much. how will it pass on the senate side? or will the public option be ignored by the senate or added back in the house-senate conference before we vote on the final product? it's anybody's guess. i would sa

2:52:28 to 2:52:48( Edit History Discussion )

Michael C. Burgess: would say stay tuned because it is going to be an important process. you will have a house, unified bill in the next couple of weeks. how long we have to evaluate that i think is going to be very telling. if it's a short period of time. there is probably stuff in the bill they don't want you to know about before we actually vote. we are arguing for 72 hours.

2:52:49 to 2:53:10( Edit History Discussion )

Michael C. Burgess: and i would tell you what is likely to be at least 1,000-page bill, 72 hours is a very short time to work on a bill of that magnitude. bill la read. there's a lot of referral back to the social security act. there is lot of referral back

2:53:11 to 2:53:32( Edit History Discussion )

Michael C. Burgess: to the medicare or the me provisions in the united states code. so it takes some doing to get through the bill language and really understand what the implications of what you're reading. but, it doesn't mean we shouldn't do it, but it means we need the time to do it and i encourage the democratic leadership to give us the time

2:53:33 to 2:53:53( Edit History Discussion )

Michael C. Burgess: necessary and make the facilities available to us so we can have the opportunity to read through that bill and read through it with experts and come to understand what's being contained within the bill. you know, the president has said repeatedly that if you have good ideas, i will listen.

2:53:54 to 2:54:15( Edit History Discussion )

Michael C. Burgess: in fact, here in the house, in the joint session that was held on september 9, the president said right from the podium behind me and i'm quoting now, i will seek common ground in the weeks ahead. if you come to me with a serious set of proposals, i will be there to listen to you. well, that's interesting, too.

2:54:16 to 2:54:37( Edit History Discussion )

Michael C. Burgess: during the campaign, the presidentaid he would sit down with people who might be regarded as nokes who don't like us -- folks who don't like us very much like ahmadinejad or chavez. the president said i will meet with the leaders thout preconditions.

2:54:38 to 2:55:00( Edit History Discussion )

Michael C. Burgess: whent comes to congressional republicans, he does have a set of conditions. we can't just show up with ideas. i prepared a serious set of proposals and sent it to the white house on september 16 of this year, about a week after we had the joint session of congress. i prepared a number of things within the letter, attached to

2:55:01 to 2:55:21( Edit History Discussion )

Michael C. Burgess: it a number of bills that i had introduced that i thought should be part of whatever type of health care reform is passed. i'm still waiting a response to that. things like addressing the problems of physician workforce, things like addressing the

2:55:22 to 2:55:42( Edit History Discussion )

Michael C. Burgess: liability -- the problems facing liability insurance, the sustainable growth formula, price transparenc good ideas contained within here and i will at the end of this, i will submit thisford. but, again, no response from white house.

2:55:43 to 2:56:03( Edit History Discussion )

Michael C. Burgess: let's talk in some detail about those tings of agree on should be part of meaningful reform and we hear it said all the time that the's agreement like 80%. i think that number is a little bit high. but nevertheless, we hear it said all the time.

2:56:04 to 2:56:25( Edit History Discussion )

Michael C. Burgess: but what is the number one thing i heard about over and over and over again in the town halls in august? the thing that is really grading on the american people is those individuals who want insurance but can't get it, can't get it because they have a pre-existing condition. they had insurance on the job

2:56:26 to 2:56:47( Edit History Discussion )

Michael C. Burgess: and lost their job a couldn't keep up with the cobra payments so they lost their insurance and stuck without insurance and now have a pre-existing condition. wasn't because they wanted to drop their insurance but the conditions were such that the rules we set they didn't have any choice but to let that insurance coverage go though they

2:56:48 to 2:57:08( Edit History Discussion )

Michael C. Burgess: difficult to get back into a state of coverage in the future. anything thing that really bothers people is the fact that americans can do the right thing and have health insurance and pay that premium reli get a tough medical diagnose and the insurance company says, you know what?

2:57:09 to 2:57:29( Edit History Discussion )

Michael C. Burgess: we never meant to offer that policy to you in the first place or there was something obscured in your history and now what are called recisions, we're going to take your policy away. that's wrong and people acknowledge that it's wrong. both sides of the aisle.

2:57:30 to 2:57:50( Edit History Discussion )

Michael C. Burgess: now in cases of fraud, corre the insurance company has to have a right of action. they have to have a way to protect other people that have insurance. you don't want people coming and buying insurance under fraudulent terms. but for people who have an omision from a medical history

2:57:51 to 2:58:14( Edit History Discussion )

Michael C. Burgess: that makes no differee as to their subsequent care and diagnose, these are things that are generally recognized by the american people as being egregious overstepping by the insurance companies and that needs to be fixed. here's the sad part, mr. speaker. that could have been fixed. that could have been fixed before we went home for the august recess, but we simply chose not to do it.

2:58:15 to 2:58:36( Edit History Discussion )

Michael C. Burgess: so if we provide ar way for someone who has a pre-existing condition, perhaps through re-insurance, perhaps through high risk pools, with additional there can be ways to bring individuals who have a pre-existing condition into a state of coverage. it's a shame. it's a shame we never had a

2:58:37 to 2:58:59( Edit History Discussion )

Michael C. Burgess: hearing on that in our health subcommittee. we had hearings on almost every other issue under the sun, but we never had a hearing on is there a way, short of an unconstitutional individual mandate, is there a way to get people insurance coverage who havead a bad medical diagnose and lost their insurance.

2:59:00 to 2:59:22( Edit History Discussion )

Michael C. Burgess: i think we should. bright minds on both sides of the i'll could -- i'll could work out ways that this problem could be solved. recisions, with a history that's now newly disclosed and nothing to do with the medical diagnose and not witheld from the

2:59:23 to 2:59:43( Edit History Discussion )

Michael C. Burgess: insurer, recisions need to stop. . states that have high risk these are states that are working try toufering air -- trying to offer their citizens a method of dealing with this problem.

2:59:44 to 3:00:04( Edit History Discussion )

Michael C. Burgess: we could encourage more states to pick up high-risk pools. we've got some states where they're working well, some where they're working less well. i felt that my home state of texas wasn't working so well. turns out, it's not a bad program, it's just not f to the level it needs to be. if we could encourage a contribution from the federal government, the state

3:00:05 to 3:00:26( Edit History Discussion )

Michael C. Burgess: government, perhaps even the private sector, the insurance companies themselves, perhaps we could get that figure down to a point where people can actually utilize the program because people that then are subsequently covered by the high-risk pools in texas love the program. i had somebody come up to me after a town hall in august, they said, don't do anything

3:00:27 to 3:00:49( Edit History Discussion )

Michael C. Burgess: that's going to mess up my high risk pool, that's the best insurance i've ever had. the problem is, it's limited to the number of people who can access that. we have people losing their jobs. it's unfortunate, disastrous occurrence that happens in a recession when people are laid off. if you have employer-upon sored

3:00:50 to 3:01:10( Edit History Discussion )

Michael C. Burgess: insurance, there's trouble brewing. yes, congress passed many, many years ago. cobra coverage is extended for 18 months, is available to an individual who loses their job, but that's insurance -- that insurance has to be the same insurance that that person had while they were employed. so the individual can pick up

3:01:11 to 3:01:33( Edit History Discussion )

Michael C. Burgess: the premium for that employer-sponsored insurance but guess what, most of the time the employer is not continuing to pay their part so the individual has to pay the entire -- in fact, it's 102%, because there's an administrative cost tacked onto that. that's an expensive issue for someone who just lost their

3:01:34 to 3:01:54( Edit History Discussion )

Michael C. Burgess: job. could we offer people another choice? they lose their job, they have employer-sponsored health care, as long as they keep their insurance, they're protected a pre-existing condition, but they've just lost their premium .

3:01:55 to 3:02:16( Edit History Discussion )

Michael C. Burgess: or become uninsured, we offer two choices. what if we made something else available to people? what if awe allowed people to transition into the individual market and not have to go through the cobra system to do that, but still protect their ability to have the coverage for a pre-existing condition,

3:02:17 to 3:02:38( Edit History Discussion )

Michael C. Burgess: should one have developed or develop during the time that individual is transitioni insurance on the individual market. why does it always have trigger the cobra insurance? why is there not an intermediary step that's less expensive but still provides

3:02:39 to 3:03:01( Edit History Discussion )

Michael C. Burgess: the -- still provides the protection. other things we could do, what if someone has -- has cobe remark has that coverage, but they move to another state and they may not be allowed to take that coverage with them? why not allow that transition from state to state without rerating that individual, without causing that individual

3:03:02 to 3:03:23( Edit History Discussion )

Michael C. Burgess: to be rerated by a new insurance company where their pre-existing conditions that they've acquired along the way prevents them from getting, or obtaing that insurance in the individual markein a new state. i like than to, you think about the national football league. you have a player in the national football league who

3:03:24 to 3:03:44( Edit History Discussion )

Michael C. Burgess: gets traded from one city to another. their insurance goes with them. no problem. if they had a knee injury in one city, it's going to be taken care of in the new city. but if they're a -- if their fan who wants to follow their favorite football player wants to move from city a to city b,

3:03:45 to 3:04:05( Edit History Discussion )

Michael C. Burgess: they have to start all over again if they're in the individual market and they may find they're rerated by their insurance company, reunderwritten by their insurance company. and if they had even a modest diagnosis, high blood pressure, depression, it could be

3:04:06 to 3:04:27( Edit History Discussion )

Michael C. Burgess: expensive for them to buy insurance in that new state why don't we allow that so people don't have to be rerated? and we talked ability buying insurance across state lines? that's heavier for congress to come to that understanding, but thabblet to allow someone to buy in the individual market without being rerated when they

3:04:28 to 3:04:48( Edit History Discussion )

Michael C. Burgess: change states, that's easy. we should be able to do that. begin, i frankly don't understand why we don't take that up. again, remember if we pass the big, comprehensive, public option health care bill, when do you get the benefit? four years. we're going to have people losing jobs next year. we're going to have people losing jobs the year after

3:04:49 to 3:05:12( Edit History Discussion )

Michael C. Burgess: that. what are we going to do for those individuals in the short-term? again, a reference back to the president's own speech he gave here on september 9, when he was at the podium, giving the seech he acknowledged, john mccain was in the audience. he acknowledged john mccain had a good idea for covering people with high-risk pools, perhaps

3:05:13 to 3:05:33( Edit History Discussion )

Michael C. Burgess: that would be a way to provide some immediate relief for people who couldn't wait four years before congress start this is robust public option plan. you hear me talk about medical liability. it is a big deal. the fact that it's been lef out of the house and senate bills is a big deal. we're asking our do our partners, whatever brave

3:05:34 to 3:05:54( Edit History Discussion )

Michael C. Burgess: new world of health care reform we're going to ask our doctors to be there, be at our sides, help us, or be the ones to take care of the patients, answer emergency calls in the wee hours of the morning. we're asking our doctors to stand with us on this yet we

3:05:55 to 3:06:16( Edit History Discussion )

Michael C. Burgess: would simplify doctors across the country, that's bring sense and stability to the medical justice system that we have in this country. tex a very good thing, putting caps on noneconomic damages. they did that in 2003. they had to do it with a constitutional amendment so it

3:06:17 to 3:06:38( Edit History Discussion )

Michael C. Burgess: would become immediately effective and didn't go through court chalenges. it was like turning a switch. things have improved in texas since that bill was passed. but you will also hear people say, oh, medical liability, doesn'tave that money. do whatever you want but it's like 1% savings. but that's based on a very old study that really only looked

3:06:39 to 3:07:00( Edit History Discussion )

Michael C. Burgess: at the cost of the premiums for the sales back in the early 1990's a famous study tchailed tom study, frequently still quoted 15, 20 years later. it said you wouldn't save money wh medical liability. of course they di would happen as far as the

3:07:01 to 3:07:21( Edit History Discussion )

Michael C. Burgess: practice of defensive medicine. so let me ask you this, medical liability premiums have gone up year over year over year. medical liability has continued to be a problem year after year after year. do you think the practice of defensive medicine is more widespread now than it was 20 years ago?

3:07:22 to 3:07:42( Edit History Discussion )

Michael C. Burgess: you bet it is. 20 years ago we didn't have pet scan we pairlied -- barely had m.r.i.'s. the more new things that become available, the doctors are continually trying to see, what's the maximum i can do that if i -- so that i won't look bad if things go wrong and i'm called into court and have

3:07:43 to 3:08:03( Edit History Discussion )

Michael C. Burgess: to defend my medical judgment system of it's nomall wonder that the cost of defensive medicine has gone up and up and up. the congressional budget office puout a new report in a letter to senator hatch. they talk about their new estimate for what medical liability reform would save the

3:08:04 to 3:08:24( Edit History Discussion )

Michael C. Burgess: federal government, and this is just in the medicare and medicaid system. it's estimated to be $54 billion over 10 years. that's getting to be a significant amount of money. but wait a minute. remember that the federal government is now responsible for about 50 cents of every health care dollar spent in this country. 50 cents of every health care dollar you spend in this

3:08:25 to 3:08:47( Edit History Discussion )

Michael C. Burgess: country originates right here on the floor of this house. the $54 billion over 10 years only represents about the medical expenditures in this country. it doesn't count thos by private insurance, those paid for out of just individuals paying their bills or that is gifted to people through charity. so double that number.

3:08:48 to 3:09:10( Edit History Discussion )

Michael C. Burgess: it's over 10-year life of the health care bill that is a potential save wgs modest medical liability reform. again, that's notoing to pay for the whole health care bill, but it will pay 10% of it. don't you think if we can pay for 10% of what's being proposed we ought to at least consider it? that in our committeing, we

3:09:11 to 3:09:31( Edit History Discussion )

Michael C. Burgess: should at least consider it? i'll just tell you what's happened in texas since 2003, when we dipass a cap on since 2003, texas has licensed 15,000 new physicians over a similar time span, preceding that, that number was about 1/3. we gained 192 new

3:09:32 to 3:09:53( Edit History Discussion )

Michael C. Burgess: obstetricians. 26 new county havedded obstetricians, including 10 where there previously was no o.b. doc. 140 counties, there's a lot of counties in texas, but 10 count yips without an obstetrician before that now have one.

3:09:54 to 3:10:16( Edit History Discussion )

Michael C. Burgess: that's prenatal care available that wasn't available before unless you drove miles to a medical center. that's doctors who are there when patients need them, that apreciately, when time is of the essence in the process of having a baby that is a good thing. 3 rural counties gained e.r.

3:10:17 to 3:10:37( Edit History Discussion )

Michael C. Burgess: doctors, including 26 counties emergency room doctor now have one since the passage of common sense medical reform in 2003. doctors have contributed more than $594 since the bill was passed. i introduced similar language

3:10:38 to 3:10:58( Edit History Discussion )

Michael C. Burgess: at the federal level, h.r. 1468, for those keeping score at home. i have offered that as an amendment to our committee bill last july. i was at first struck down on technicality, then on a party line vote. it doesn't seem that the

3:10:59 to 3:11:21( Edit History Discussion )

Michael C. Burgess: democratic majority hased in had any interest in trying to reform the medical justice system in this country, and yet now the congressional budget office in a letter to senator hatch, where we requested a new analysis of the cost of medicine, the cost office said

3:11:22 to 3:11:42( Edit History Discussion )

Michael C. Burgess: it would be a savings of $10 billion over 10 years. they cite several studies where they duaned that information. again argument the end of this hour, i will ask unanimous consent to make the congressional budget office report, the letter to senator hatch, i will ask that we make that part of the record. portability. being able to take your insurance with you.

3:11:43 to 3:12:04( Edit History Discussion )

Michael C. Burgess: you know, there was a time when i was a youngster when you went to high school, perhaps to college but whether you grang waited from high school or started after high school you took a job and probably ontinued that job until you got your gold watch and retirement. it doesn't work that way anymore. i don't know what the figure is, but the estimate from the

3:12:05 to 3:12:25( Edit History Discussion )

Michael C. Burgess: census bureau is people will have 10 or 11 jobs in the course of their productive years. society only makes sense that if we continue and we likely will continue to have insurance, that we allow more portability than is within the system now. now some people have talked about things like defined

3:12:26 to 3:12:50( Edit History Discussion )

Michael C. Burgess: cricks from employers, rather than just the employer providing the insurance, providing a designated sousm money for the purr tcheefs insurance. there is a lot of discrepancy for what insurance costs. the state of new jersey, the average health insurance

3:12:54 to 3:13:14( Edit History Discussion )

Michael C. Burgess: was recently quoted at $10,000. you go across the state line, it drops $6,000 to $4,000. there's not that much difference between those south of ethe line and those north of the line in new jersey. why not look into having people purchase in'r fit their needs and be more affordable. then, again, we get into the

3:13:15 to 3:13:36( Edit History Discussion )

Michael C. Burgess: issue of someone who moves across a state line, why not alow port snblet just for -- in the interest of completeness, the state of texas a family of four, the average insurance premium is $5,000 a year. the state l that is, again, many people on my side of the

3:13:37 to 3:13:59( Edit History Discussion )

Michael C. Burgess: that, well you heard the president talk about it in his speech, he talked about in rural alabama where if someone was going to the individual market they had one company to choose from. insurance companies tend to be national monopolies, they tend to want to form monopolies. but the president is correct,

3:14:00 to 3:14:23( Edit History Discussion )

Michael C. Burgess: you don't get much competition. the president's solution to this problem is, well, let's create a public option. we'll have two insurance companies for that family in alabama to choose from. .

3:14:24 to 3:14:45( Edit History Discussion )

Michael C. Burgess: why not open the market up? we don't ve to create a new program. why not allow them to compete across state lines? interestingly enough, democrats that have opposed this idea year in and year out, now se warming to the concept at the very least. if you have a public option that

3:14:46 to 3:15:08( Edit History Discussion )

Michael C. Burgess: is available in alabama, it's going to be the same option available in tennessee and in texas. that public option is going to be sold across state lines because it is a federal program and it's going to be sold across state lines. so why do't we -- before we go

3:15:09 to 3:15:29( Edit History Discussion )

Michael C. Burgess: to creating a new type of insurance, why don't we allow open competition across state lines? now, cooperatetives are something that we hear of and word gets a lot of traction. co-ops.

3:15:30 to 3:15:51( Edit History Discussion )

Michael C. Burgess: i would be ok with that. but certainly allowing people to ban together, people that may be long to the same alumni association, same church. you name it. dentists, physician offices that want to get the purchasing power of a much larger group in that

3:15:52 to 3:16:13( Edit History Discussion )

Michael C. Burgess: individual market, we should allow them the freedom to be able to me those associations and purchase. you know, tax credits -- and i will admit there are people on my side that get nervous but tax credits to help with the purchase of insurance is something that was talked about during the last presidential campaign.

3:16:14 to 3:16:35( Edit History Discussion )

Michael C. Burgess: i think it is a way to provide immediate help, not help years from now, but immediate help for people who don't have employer-sponsored health insurance where cost has been obstructed. m recisions. we take away some of the issues with portability.

3:16:36 to 3:16:56( Edit History Discussion )

Michael C. Burgess: there may be an affordabil issue and if we could help that with a tax credit or a prefundable tax credit, it is at least worth having a discussion. through all of the hearings we have had on this, we never once, we never once visited that issue.

3:16:57 to 3:17:18( Edit History Discussion )

Michael C. Burgess: we never once invited the congressional budget office in to give us views and estimates on wh like. instead, we said, we're congress and we know best and going to build an insurance company and that will be competition and take it and like it because after all, we know best.

3:17:19 to 3:17:39( Edit History Discussion )

Michael C. Burgess: again, the ability for pep to associate whether it be a church group, alumni association, maybe it's time we gave people not being tied with employers because people change jobs over time. we talked about things like association health plans,

3:17:40 to 3:18:02( Edit History Discussion )

Michael C. Burgess: various bills have been introduced that would deal with this. h.r. 3218, introduced by representative shadegg from arizona is one such plan and certainly that is one that s that is offered as conservatives or republicans' alternatives to

3:18:03 to 3:18:23( Edit History Discussion )

Michael C. Burgess: what is being proposed in health care. medicare payment reform, we're going to pay for half of this $1 trillion bill with cuts in medicare. i got to tell you, i get more letters, more mail from individuals who are doctors who are concerned about what we,

3:18:24 to 3:18:44( Edit History Discussion )

Michael C. Burgess: what congress is doing to them in physician rurement. it's easy to say, doctors make so much money. who cares. december 31 of this year under the current fmula, sustainable growth rate formula, physicians

3:18:45 to 3:19:05( Edit History Discussion )

Michael C. Burgess: will undergo a 20% reduction in reimbursement. baucus's bill does delay it. if we do that, then next year, they face a 25% reduction in reimbursement. and some specialties, cardiologyists in particular

3:19:06 to 3:19:26( Edit History Discussion )

Michael C. Burgess: where there has been rebasing what is called revalue units are facing cuts in 30% at the end of the year. i'm here to tell you that you don't have that much excess capacity in the average doctor's office where you can squeeze out

3:19:27 to 3:19:47( Edit History Discussion )

Michael C. Burgess: 30 cents out of every dollar in savings and expect those offices to stay open. wait a minute. we have an unemployment rate that is approaching 10% cardiologists are facing a 30% in medicare reimbursement where medicare is 50%, 6 % or 70% of

3:19:48 to 3:20:09( Edit History Discussion )

Michael C. Burgess: the business they do. how do we expect them to keep their doors open after january 1. how do we expect them to make employment decisions for their employees in their offices in the next couple of months while they are living with is kind of limbo. they are wondering if we are going to run out the clock on december 31 when these huge cuts

3:20:10 to 3:20:30( Edit History Discussion )

Michael C. Burgess: o into effect. what are they going to tell their employees if they wanted to hire someone new, they aren't thinking about doing that now. and we have a 9.6% unemployment rate. cardiologists are small business those who draw blood in the lab, people who put the patient back

3:20:31 to 3:20:51( Edit History Discussion )

Michael C. Burgess: into the room, all of these jobs are now at risk because of what congress is doing or not doing with fixing the sustainable growth rate formula and the cuts in medicare. if we pass a bill like the baucus, the cuts become more

3:20:52 to 3:21:13( Edit History Discussion )

Michael C. Burgess: deeper and more draconian. you don't save $500 billion over the next 10 years by not making some pretty hars if you think it's pretty bad now, what's it going to look like if well enact some of these things that have been discussed over on the senate side and indeed, on the house side?

3:21:14 to 3:21:35( Edit History Discussion )

Michael C. Burgess: what if we create this body that is going to come to us and say, in order for the books to balance, we're going to have to cut fees that are paid to hospitals, doctors, nurses, nursing homes by whatever percentage amount they say congress, if we pass this law, simply vote that up or down. they don't take any responsibility for it.

3:21:36 to 3:21:58( Edit History Discussion )

Michael C. Burgess: there is no accountability. we just pass those cuts on. that's a terrible way to do business. wouldn't it be better if we found a way to deliver care more economically so we didn't have to come to our provider community, to our doctors, hospitals, nurses, nursing homes and say we're going to have to keep more of your money this

3:21:59 to 3:22:20( Edit History Discussion )

Michael C. Burgess: year in order to make our books balance. the workforce is extremely important. h.r workforce investment act that i introduced last congress and this congress as well, i provided that to the white house. here's the deal. we can sit and talk all night long about health insurance and that may be an important discussion to have, but if you

3:22:21 to 3:22:43( Edit History Discussion )

Michael C. Burgess: don't have any doctors there at the end of the day, all the insurance in the world isn't going to do you a bit of good. in fact, i far rather have a doctor and no insurance than i would having insurance and no doctor. the insurance company typically hasn't been all that great in

3:22:44 to 3:23:06( Edit History Discussion )

Michael C. Burgess: that endeavor, but physicians always respond. preventive care and wellness programs, clearly, these are going to be necessary in the world going forward. the model that was brought to us by safeway stores. the model that we were not allowed to consider in ou markup in committee, but relate stickically, we have to do that,

3:23:07 to 3:23:27( Edit History Discussion )

Michael C. Burgess: h.r. 3148, which is the scoring bill, would allow for congressional budget office to score those savings that could be achieved with healthy lifestyles. we did include some language in the bill that was passed, h. 2249 rkts health care

3:23:28 to 3:23:48( Edit History Discussion )

Michael C. Burgess: transparency bill that i introduced two congresses ago and have continued to introduce every congress. a lot of that language was serted into h.r. 3200, but at the same time the transportation has got to be there. we have to aspeople to make and we have to give them

3:23:49 to 3:24:10( Edit History Discussion )

Michael C. Burgess: information. mandates, they have no place in a free society. when i hear the house talk about an employer mandate, wait a minute, i'm not sure that is constitutional. mandates create lazyness on the part of the insurers and on the part of your congressman. wouldn't it be better if we

3:24:11 to 3:24:32( Edit History Discussion )

Michael C. Burgess: required people to actually buil wanted rather than just force people to take what we think they ought to want. mandates are an afront to a free society. prescription part d, dr. mcclellan when he was constructing that program had six protected classes of drugs

3:24:33 to 3:24:54( Edit History Discussion )

Michael C. Burgess: and said there had to be two drugs offered and people flked to those programs. it has been a success in the number of seniors that have credible drug coverage and seniors that are satisfied. normally, if you have a mandate, you are going to get 90% compliance. we have 8 % compliance with the

3:24:55 to 3:25:15( Edit History Discussion )

Michael C. Burgess: voluntary system right now. you aren't going to get that much more in the mandates. by creating programs that brought value to people's lives, 95% on a credible drug program. i will never sit down and advocate for private insurers, but i will tell you that most americans do have coverage under

3:25:16 to 3:25:36( Edit History Discussion )

Michael C. Burgess: a private insurance and they like it. they don't want to lose it. that has been wub of the obstacles. the president says if you like what you have, you can keep it. i think that's right. 60% of the people people like what they have and don't want that makes it difficult to do it

3:25:37 to 3:25:58( Edit History Discussion )

Michael C. Burgess: on this scale. the federal government, the public option that we already have doesn't pay its full share of the freight in the cost of delivering the care. it's subsidized by the private sector. if you shrink the private sector and grow the public sector, how are you going to make that up? where is that money going to come from and that's something i never hear discussed.

3:25:59 to 3:26:20( Edit History Discussion )

Michael C. Burgess: insurance companies do bad things and we'll hear stories about how bad insurance kpts are. but if we didn't have that cross-zizzation, we won't have the private sector. people would say we are leaning on the private sector to provide for us. no. that's a small amount.

3:26:21 to 3:26:41( Edit History Discussion )

Michael C. Burgess: that cross-zizzation that is coming to the public sector is the lion's share. 7% goes to paying the freight that medicare and medicaid are not carrying themselves. we have a good system. let's build on what we have. let's not tear it down and

3:26:42 to 3:27:03( Edit History Discussion )

Michael C. Burgess: create something out of whole cloth. the government can referee some of these things but the government doesn't need to be the man in charge of all of these things. the united states congress, we got about a 20% approval rating. i think reforms can and should go forward. i think there are good ideas on both sides of the aisle here. i will take the president on his

3:27:04 to 3:27:20( Edit History Discussion )

Michael C. Burgess: word and awaiting his response to my letters. i look forward to this debate we will have over the next several weeks and encourage people every morning when you get up, they need to hear from you on this issue whether you agree with me or not, i promise you the