Health Care And Education Reconciliation Act Of 2010

Floor Speech

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Mr. Speaker, this week, each of us cast the most historic vote any of us is likely to ever make. With it, revolutionary changes have been made to the American health care system that will forever alter its very nature. This vote was a long time coming and much needed, unfortunately, what we did pass is long on promises of improved care, but preciously short on reforms that the American people really need for better and more affordable care.

It is no secret that the health care system is in need of reform. In 2007, the latest year that figures were available, total health expenditures reached $2.2 trillion, which translates to $7,421 for every man, woman and child; millions of Americans are without health insurance and San Diego doctors are finding it increasingly difficult to care for our city's most vulnerable residents. This week's debate was full of passion over many issues and arguments over the proper answer to health reform. While we can argue over many points, there is one issue where there is no debate: we need health care reform.

Studies have shown that the visit rates to emergency rooms for patients with no insurance are twice that of those with private insurance. While I support insuring all Americans can access health insurance and believe it must be the first priority of any health care reform legislation, I cannot support a bureaucratic system dictated and controlled by the Federal Government. Congress, just like the medical profession, must adhere to the Hippocratic Oath of: ``Above all, do no harm.''

Throughout the past year, I have supported many bipartisan issues that will increase health quality and access for not just San Diegans but all Americans without limiting our choice of health care options--many of which were in the legislation we passed Sunday night. We must first allow Americans to have the same insurance as the Congress of the United States. It is not fair to stand here today and pontificate on the benefits of health care if we do not allow hard working Americans to have the same health care choices we enjoy. Citizens of this great country must be allowed to shop wherever they want in the United States for health insurance, free from the barriers of state lines. If New Jersey offers a plan that is cheaper than California, Californians should have the ability to purchase that plan. We must enact strong medical tort reforms that can save billions of dollars--$54 billion to be exact according to Congress' own Congressional Budget Office, CBO. Finally, I support strong enforcement mechanisms to prevent illegal immigrants from receiving taxpayer subsidized health care.

It is important to remember that American health care is in many ways the envy of the world. From our first class medical facilities to our world renowned life science enterprise, we are the leader in innovative care and solutions. These innovations are allowing Americans suffering from major illnesses to live longer, healthier lives. For instance, in a single decade, from 1993-2003 U.S. heart disease deaths dropped by 22 percent. However, for all these benefits there is work to be done but not at the expense of destroying the entire health care system.

The health care bill that was signed into law will destroy our already fragile economy and lead to government control of health care. Under this new law, there will be more than $520 billion in tax increases, including a $27 billion employer mandate tax and $15 billion individual mandate tax. With 1 in 9 San Diegans out of work, this will exacerbate the problem.

There are many examples in this legislation of government control but one striking example is the Independent Medicare Advisory Commission. The creation of the so-called Independent Payment Advisory Board (IPAB,) which for the first time will give unelected and unaccountable bureaucrats the mandate to make important decisions about the future of the Medicare program. The cuts they propose would be in addition to the over half trillion dollars of Medicare and Medicaid cuts already in this bill.

We all agree that Medicare reform is needed but the IPAB actually carves out large areas of the Medicare budget from potential savings, leaving draconian cuts in the reimbursement of life saving and life enhancing drugs as a likely outcome. As Co-Chair of the House Biomedical Research Caucus, I have seen the great promise that developments in medical technology can mean for American seniors. Just last summer, the existing Preventive Services Task Force changed its recommendations on mammograms, confusing millions of Americans in the process. Can you imagine if those recommendations had the force of law? As science progresses to further embrace the benefits of personalized medicine, we need to make sure that the unchecked decisions of a federal board in Washington do not unwittingly sabotage the doctor-patient relationship. I am very troubled by this provision, and I want to work with my colleagues on both sides of the aisle to fix it or repeal it before it becomes effective.

In order to pass this legislation, many back room deals were cut. From the ``Cornhusker Kickback'' to the ``Louisiana Purchase,'' many states were taken care of in order to secure support. However, California was once again left on the outside looking in. This bill does nothing to fix the Geographic Practice Cost Index (GPCI), which to date finds San Diego doctors being paid at a rate of rural practitioners; all the while they continue to practice in a high cost area. Additionally, this legislation does nothing to fix the sustainable growth rate problem that finds California doctors facing continuing cuts in Medicare payment rates year after year and threatens patient's access to care.

I was in favor of rejecting this plan and coming back to the table and develop a proposal that fully addresses medical malpractice awards so we can save health care costs, allow United States citizens to purchase their health care across state lines and provide tax credits so hard working Americans, not Washington D.C., are in charge of their health care.

A strong and accessible health care system is one of the most fundamental components of a strong economy. I am committed to working in a bipartisan manner with my colleagues to put in place real reform that will protect the doctor-patient relationship but will not bankrupt our economy in the process. American families deserve better than socialized health care and I plan on helping to deliver it. I will continue to work with my colleagues to reform a broken health care system in a way that is sustainable, protects the promises we have already made to our nation's seniors and does not infringe on our liberties.

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