Addressing The Health Care Crisis
Floor Speech
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Mr. FLEMING. Well, thanks to my colleague and the gentleman from Tennessee, Dr. ROE. Dr. ROE certainly has a lot to bring to the table being a physician for many years and also having quite a political background being mayor of a city and actually having balanced a budget and even having a surplus, something we don't see very often these days. And so I thank the gentleman for that.
Yes, I wanted to make a few comments, as well, regarding this health care debate that is coming to a head here very soon. Patients are very simple in what they want from health care. Certainly they want choice. They want affordability. They want control. And they want good results. And I think that that is quite reasonable. And certainly on the other side of the aisle where there is a debate about a single-payer system, really a government-run system, I think that there is not any disagreement about the fact that we want everyone to have access to health care, and we want everyone to have access to good health care.
I think where the debate begins to fall down is that in our opinion on this side of the aisle, we feel that a government-run system is not a well run system. It is an inefficient system. It is a wasteful system. We have many, many examples of why that is true. We don't have to even turn to health care. We can look at any system that has been run by government, and not just the United States Government. Cities and States all reveal considerable waste because it is the nature of the system itself. On the other hand, in the private system, there is the administrative ability to remove fraud, waste and abuse.
I will give you an example. Today with Medicare and Medicaid, we recognize that there is fraud, waste and abuse. Everyone knows it. Many politicians get up and clamor that they will be able to remove it, but none has been able to do that. The reason is because of the nature of government itself. Government cannot remove fraud, waste and abuse. In order to attempt to do so, it has to build, first of all, a large bureaucracy. It has to catch the offenders. With that, there has to be prosecution of the offenders. And when you get down to it, you only find the very most egregious small percentage of those who are actually committing fraud, waste and abuse. So you get really a small tip of the iceberg. So much more is underneath that a government can never get to.
On the other hand, if you look at a private business, private business has all sorts of ways of finding fraud, waste and abuse and removing it administratively. For instance, a physician who is practicing inefficient medicine in an organization, in a private organization, he can be reeducated, or she can be re-educated, or just simply removed entirely from employment. But government is unable to micromanage individual behavior. And every time we attempt, we simply run cost up. And I will give you another good example of that. If you look at the post office and compare it to FedEx or UPS, you will see these private companies run so efficiently and so profitably. And yet, of course, the post office does not run efficiently. There are long lines. And that is just one way to control cost, and then, of course, ultimately we have to pay higher rates.
So I think that we really have to look at the endemic problems within a private system versus a public system when we see that really there are only two ways to control cost in a public system. And we are attempting one of them and have been doing so for the last 20 or 30 years, and that is price controls, price controls on the providers, the hospitals and the doctors. And that would be a wonderful thing perhaps, at least for consumers, if it worked. But what goes up faster than health care every year? Nothing that I'm aware of. It is the one part of the economy where we have price controls, the only one, and yet it goes up faster than anything else.
Well, what is the only other way we can control costs? That is rationing. And you say, well, we are not rationing care today. Look at Medicare and Medicaid, still a reasonably smaller percentage of the total health care system here, and it is able to provide good service to recipients, even though they are government-run programs, only because you have a much larger private system that is able to keep it supported. Now if we expand that to a large, government-run health care system, it is going to make up 17 percent of our entire economy. Where are we going to get the money to prop that system up? Where is it going to come from? And so what we are going to end up with is the same place where Canada, the U.K. and all the other countries that have gone to a single-payer, government-takeover-run system, and that is that there is going to have to be cuts. When we get up to a point where budgets have to be evaluated, we are going to have to make cuts. And when you make cuts, that equals rationing.
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Mr. FLEMING. I thank the gentleman from Tennessee, Dr. ROE, for his excellent comments.
What you're pointing out is that rationing is not just about inconvenience, although there is a lot of inconvenience where someone has to wait 6 months to get a surgery, elective surgery or something like that. But it also means accepted death rates and accepted morbidity rates so that people go unable to work because they need a hip replacement or someone dies waiting for needed surgery for a disease disorder. They go delayed diagnosis for a tumor which is going to end up in much more cost down the line because it wasn't prevented or diagnosed earlier. So rationed care I think is unacceptable to the American mind. And I would just say that if we go towards a government-run system, we have to be willing to accept the fact that we will have rationed care. I don't see any way around that.
I do want to just sum up before I yield, and that is that I think that in evaluating the American psyche today when it comes to health care, we find that 83 percent of Americans like the health care the way it is. They like their insurance coverage. They like the doctor that they see. They are happy. The problem that we are talking about today is the 47 million uninsured. And who are these people? Well, statistics tell us that probably 10 million or so of those are illegal aliens. And, of course, that is a whole other debate. We need immigration reform. There is also probably half that number who are young adults who are healthy who elect not to get any health care insurance coverage. And so we have a real challenge before us to entice or to incentivize them to join, because if they join into the plan, we can work through preventive health care and early diagnostic care to prevent them from disease down the road, and also their dollars up front will help fund the last 10 million, which is the most critical 10 million, and that is older adults who are not Medicare age who do not have affordable accessibility to health care coverage, and therein lies a problem. They are not the poor. They are not the elderly. And they are not people that work for corporations. They are small business owners and their employees, a critical 10 million population that are finding their ways into the emergency rooms late in their illness with outcomes poor, far more cost required. And of course we physicians and hospitals have a mandate to provide care to them regardless of their ability to pay, which is a noble American concept. But the problem is, that cost has to be passed on to others, taxpayers, those who are paying their insurance subscription rates. And I'm sure we, as Americans, are willing to do that to an extent. But if you take those same dollars and you allow these people to get insurance and early preventive care, have a medical home, a family doctor, those costs will collapse. They don't have to be the high-price, low-yield kind of care that they get through the emergency room.
And lastly, I think it is important that we look at reforming health care laws where we can allow physicians and hospitals and other providers to come together to begin to work together and to compete to lower the overall cost of health care rather than having it being dictated from Washington, which as I pointed out, is really a very poor way to try to cut costs.
And then finally, that we do away, remove from the lexicon, the idea and even the verbiage that says ``preexisting illness.'' There should never be that term used ever again.
In conclusion, I just want to emphasize the need to remove the term ``preexisting illness'' from the lexicon and that we make it easy and affordable for all Americans to access the health care system; but as I say, I think we all tonight would agree that that is done much better through a private plan rather than through a government plan. I know that we hear some rhetoric about, well, let's have both a private plan and a public plan--and I'm sure that my colleagues tonight will expand on this--but if you have one plan that's controlled and subsidized by the government, whose responsibility it is to be sure that there's an even playing field in the competitive arena, we know that the public plan will always receive advantages and benefits, and the private plan will then atrophy. I think it's far better to work through the private arena and to let the government do what it does best, and that is to protect its citizens and to ensure an even playing field.
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