The Doctor's Caucus
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Mr. ROE of Tennessee. Thank you, Dr. Broun.
I bring with me tonight a blank sheet of paper. On this blank sheet of paper is where we ought to go back with health care and start over. That's what the people in my district and in the State of Tennessee have overwhelmingly told me. I was at a convention in Gatlinburg this weekend. They understand it. They get it. And who gets it the most are our senior citizens.
When I came here, I came as a 31-year practice physician, private practice. I also taught in medical school some, and run a small business, and also was mayor of a city, the largest city in our district. So I have been used to balancing budgets, not raising taxes. And I
do believe in smaller, more efficient government. And by far and away after seeing this, I call it the Twilight Zone here inside 395. No one understands in the State of Tennessee or in the cities where I go to, in Kingsport, and Bristol, and Newport, and Gatlinburg, and Sevierville, and all the cities in my district, Rogersville, they have to balance a budget. The county mayors have to balance a budget, the city mayors, the local city commissioners.
One of the things that I have paid very close attention to since I have been here is I have tried to not vote, and to the best of my knowledge have not voted for any unfunded mandate for local or State government. I have had enough of that when I had the Clean Water Act and ozone and everything else as a mayor I had to deal with, with no money to deal with it.
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Mr. ROE of Tennessee. I think until we do that, you are going to see, and you see this fiscal irresponsibility around the world. You've seen the Greece meltdown, and you've seen Spain is in trouble. Italy is in trouble. The EU is having problems even being held together now because of the spending and social programs that are going to have to be paid for. We're going down the same path. And I just asked myself today, how long can you continue to run enormous, 43 percent this year of our budget is deficit spending, how long can you continue to run almost half the dollars you spend are borrowed dollars until you can't do that any more and then a true crisis hits?
But what I was going to bring up was I came here with high ideals and high thoughts about health care. I had spent my career doing that, and I said, you know, I think I can go to Washington and have something to offer in the debate. What really disappointed me is we have 10 doctors on the Republican side in the Doctors Caucus, and not one of us in a meaningful way was consulted about this health care bill. When I tell people that, they can't believe it.
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Mr. ROE of Tennessee. It's the most astonishing thing I have ever heard of, Dr. Broun, in my life is you would have the expertise here. And I know people think this is all politics and games and so forth. I came here very sincerely wanting to be part of this debate and offer 30-plus years of experience about what worked and what didn't work. And the thing that this bill has that the Senate has, about half of it is what we had already tried in our State that failed miserably. And I wanted to explain what went wrong so that we wouldn't magnify this debate 50 times across America.
When I came here, I recognized the problems were ever-rising costs, number one. Number two, we had a lot of uninsured people that needed health care services in this country. You've dealt with them. Dr. Fleming has dealt with them. I've dealt with that problem. And preexisting conditions. And so we had a way, very easily, to deal with those without a massive 2,500-plus page bill that almost nobody read. And that's very frustrating to me to see no physicians involved, no malpractice reform in this bill, which has to be in there. No doctor fix.
And so the folks understand what we are talking about, our physicians that accept Medicare, many of them now, hundreds have left in Texas--I was reading an article the other day--won't take Medicare any more. And why? Because for years now we've been putting off a proposed cut. And this year, next week, there is going to be a 21 percent cut in your doctor's pay for Medicare.
The problem is when you do that, that's going to do three things. That's going to decrease your access to your doctor, it's going to decrease the quality of care because you can't get to your doctor, and number three, it's going to increase the cost to patients when they can least afford it. We on our side have been tasked, the Physicians Caucus has been tasked with a true doctor fix. Not this stuff tomorrow that's going to be done and voted on where 2013, I believe it is, 3 years from now, there's a 35 percent cut. So the doctors get a reprieve for 36 months, a car payment basically, a 36-month reprieve and you're facing the same thing again instead of a true fix for this very, very real problem.
So we had those three things. It didn't take a trillion dollars--and Dr. Broun and Dr. Fleming, you can't spend a trillion dollars without helping some people. When people ask me, Is there anything in this bill you like? I said, well, you can't spend a trillion dollars and not help some people. That's not the issue. The issue is, could you have done the same thing and done it better with a lot less money?
I think more importantly than this, is that ultimately this right here, I can write the prescription, no pun intended, I can write the prescription right now of what's going to happen in this country. You set up a scenario where the private sector will fall apart, and I think in a very few years. I don't think it will take long. And then the politicians right here on this House floor are going to step up once again and say, Oh, see, we told you this wasn't going to work. And here's the government, we'll take the whole thing over. When that happens, my friends, rationing of care is going to occur. And there's no doubt in my mind that will occur.
You brought up a minute ago, Dr. Broun, about the costs and the government estimates of Medicare. I know those numbers. In 1965, Medicare cost $3 billion. The estimate 25 years later was it was going to be $15 billion. The actual number in 1990 was $90 billion. They missed it by a factor of six. That's how much they missed it by. In TennCare, in Tennessee we brought forth this managed care plan, uninsured, costs going up, the same argument I just made, and guess what? In 10 budget years we tripled our costs--just in 10 years.
So from 2010 to 2020, if we triple, it will be exactly as you just pointed out, it will be a $3 trillion program, not a $1 trillion program, and that will probably be on the low side.
I think the other thing about this particular plan--and we'll get into it in more detail here in a moment. But what folks don't understand between the difference of Medicare and Medicaid, Medicare you've actually paid a premium in for that. You paid 2.9 percent of your salary, either as employee or employer, both shares are. So there's a premium. It may not be the right number to actually fund it properly, but you are paying into that.
Medicaid's a flat-out entitlement. It just comes right out of a general fund from taxpayers to pay for it, and we're going to expand that by some 20 million people. We've seen the problem in Tennessee when you do that, when you don't put the patient in control on health care expenses. They'll explode like they did in Tennessee.
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Mr. ROE of Tennessee. It is not going to matter about health care if we don't get our budget in order, if we don't get our deficits in order. And these budget deficits that you see out into the next 6 to 8 years that they predicted is without health care. And if it adds on top of that, I don't see how we can afford it, how we can go forward as a nation. And I am truly concerned about that for the people who are retired on fixed incomes, for young entrepreneurs.
Look at what a business would do right now. Let's say a business looks up, and this ObamaCare plan, they can pay a fine that's $2,000 per employee and they can put them on the exchange--which is not even calculated into these numbers, this $1 trillion.
There's a business in Tennessee--I won't say where--that's using--the government will again decide what's adequate health insurance coverage. Not you, not you as an individual. You won't go out as a family. The government will decide if your plan is adequate. And if it is not adequate, then you'll have to buy an adequate plan.
Well, this particular company's plan wouldn't be considered adequate right now. It would cost them $40 million to comply with this. Or they could drop the folks in their business into the exchange, pay the $2,000 fine and have a net $40 million savings.
So what are they going to do? They're going to drop those people into a plan. They will not pay the cost of the care. And it's going to amplify much faster. And that's why I said a moment ago that you're going to have people step up real soon and say, See, we told you that the private sector failed.
No. Businesses are making a perfectly logical business decision.
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