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GOP Doctor's Caucus: The Anniversary of ObamaCare

Floor Speech

Location: Washington, DC

Mr. BURGESS. I thank the majority leader for allowing me to participate in this hour this afternoon. I may well be joined on the floor by some people who wish to speak on the very important occasion of the 3-year anniversary of the signing into law of the President's takeover of American health care, the so-called, inappropriately titled, Patient Protection and Affordable Care Act. I'd just point out that I did attempt to have the word ``affordable'' stricken from the title 3 years ago, but I was overruled in that endeavor.

It was indeed 3 years ago, March 21, the first day of spring of 2010. The first 3 months of 2010 had seen some pretty unusual activity here in Washington as this bill ground to its eventual rendezvous with destiny in the east room of the White House on the 21st of that month.

Many may recall that during the year of 2009, there was, in fact, at least what gave the semblance of some debate over here in the people's House, over here in the committees of the House of Representatives. But when this bill got over to the Senate, it was drastically changed, all debate was concluded, and then it was simply a matter of convincing enough Democrats to vote for the Senate bill, and it was eventually signed into law.

I do want to spend some time going through the history of how we got here because I do feel that that is important and people need to understand how a very bad process, a very flawed process gave rise to a very flawed law, which now, 3 years later, we see right on the cusp of the full implementation of this thing, is really going to have a profound and detrimental effect on our country from the standpoint of our economy, our workforce and our job-creation situation with small businesses. Certainly the practice of medicine itself is going to be negatively impacted by the many pages of regulation that are now proceeding in a torrent from the Federal agencies since the President's reelection.

First, I want to take a moment and recognize someone who has been a leader on trying to bring to the surface some of the problems contained within the President's Affordable Care Act, a fellow physician, an anesthesiologist from Maryland. I want to recognize the gentleman from Maryland for as much time as he may consume.


Mr. BURGESS. I thank the gentleman, the doctor from Maryland, for participating with us today.

He used an interesting phrase. Now, instead of the trickle-down economics that Republicans have been criticized for for so many years, it looks like we've got bubble-up poverty that is coming from the Affordable Care Act, and its devastating effect on employers and employees across this country is certainly something I hear about every time I go home to the 26th District in north Texas.

In fact, 2 weeks ago, I was on a panel in Irving, Texas, with a variety of business owners, hospitals, insurance interests. They were talking about the coming implementation of parts of the Affordable Care Act. We've heard all along from the people who run the small

shops--the restaurants, the franchises--of the difficulty that this onerous bill is going to place upon their shoulders, but I was hearing from people that I had not heard from before--car painters, metal shop fabricators, those people who have those shops at between 40 and 60 employees, those who are above 50 employees who are looking for ways to reduce their workforces, and those below 50 employees who understand that they must never do so.

The gentleman also brought up the ``49ers,'' the businesses that will not go above 49 employees. There are also the ``29ers,'' the employers who will not keep somebody on the payroll for longer than 29 hours lest it trigger all of the other requirements of them under the Affordable Care Act. Then you've got the employers on the other side of the question, the large employers, who are looking at a cost of providing health insurance for their employees, which is steadily going up in spite of the assurances of the President and of the Secretary of Health and Human Services.

Those costs are going up every year. They're looking at those costs that are rising. They're looking at the fine under the employer mandate. Some are doing some simple math and are saying, I could save a lot of money--I mean a lot of money--by simply moving my employees off employer-sponsored insurance and into the health exchanges; and that, as a consequence, would balloon the cost for the Federal Government for delivering on this legislation.

We do hear a lot about the effect on the economy. The doctor was right to touch on the effects on the health profession, itself; but there is virtually no aspect of American life that will be untouched by this legislation. Every man, woman, and child amongst us for the next three generations is going to be affected by, again, a law which became law as a result of the worst type of process.

We are very fortunate now to be joined by another person who, for the time that she has been in Congress, since 2006, has been a leader on the dangers and the perils of letting your government control your health care; otherwise they can control every aspect of your life. I am happy to yield to the gentlelady from Minnesota (Mrs. Bachmann).


Mr. BURGESS. I thank the gentlelady from Minnesota for coming and participating. You have a way of saying these things that none of the rest of us are capable of, and your voice is an important one in this debate.

Thank you for recognizing that there were alternatives and there were suggestions. There were ideas that were emanating from the Republican side of the aisle during this entire what passed for debate on the Affordable Care Act.


Mr. BURGESS. Well, I tried to get the word out there. The fact of the matter is, those of us who were here remember the summer of 2009. For most of us, it is indelibly etched on our memories because we went home that summer to our August town halls, and they were unlike anything anyone had ever seen.

I went to Denton, Texas, the town where I grew up. Normally if I can get three dozen people there, the staff is high-fiving all around because we got the word out and we got a good turnout for the town hall. I had 2,000 people show up that morning. We weren't ready for 2,000 people. I had to move the entire event outside and stand under the August sun in Texas on a platform, on a riser with a handheld microphone and a little portable speaker because people wanted to be heard.

They didn't want to hear from me. They didn't care what my ideas were. They wanted me to know what they thought. And they thought: do not do this, do not take a system that is arguably working for 60 to 70 percent of the country and destroy it, because then we will have nothing. So keep the system as it is working and don't trouble those waters because it's not necessary. But if you really have to do something, if you just have to do something, would you help us with cost, because we're concerned about cost. We see cost going up every year. We do wonder at some point if we will be priced out of the system.

So they sent us back here at the end of the August recess with a very clear message: don't mess up the system that's working and help us with cost.

So the President comes to the House of Representatives that September--many of you will remember that--and he was going to lecture us on why we needed to do his plan and his bill. I honestly thought when the President asked for time to come and address a joint session of the House and Senate here in the well of the House, I thought maybe he was going to say: Okay, I heard the American people, let's hit the pause button, let's hit the reset button, let's do something differently from what I've been talking about.

But, no, we doubled down on it. He said: Let's go faster, we've got to get this done. And, again, it was because we have to have control over you, Mr. and Mrs. America, because otherwise we're afraid we'll never get it. Because, do not forget, at the time the President's chief of staff said: Do not let a good crisis go to waste. The country was in economic turmoil. We got a great crisis out there. Let's just take everyone's health care while we're at it, and then we will have that control established, and the people will never get it back once we've taken it.

But the people told us: Don't mess up the system that works. And when you stop and look at it and you take a step back, you actually had a system of employer-sponsored insurance, whether you liked it or not, that was working arguably well. Polls showed that 65 to 67 percent of people said: Okay, this is what we've got, I like this, I can deal with it, I understand it, it's what I've always had.

You also had people who did not have those large-group employer policies. They were the small-group market, the individual market. That's where we should have focused our energy. Those were the individuals who actually needed the most help. Those were the people who needed the protections in the marketplace that, perhaps, they lacked.

The President made a big deal of 12 million to 18 million people in this country with preexisting conditions. How many people signed up to the Federal preexisting program right before the Supreme Court ruled on the Affordable Care Act? 65,000.

That, as the gentlelady from Minnesota points out, was a manageable problem. That could have been dealt with in an afternoon. The best way to deal with it was to help those States that already had a preexisting program or reinsurance, help them fund those programs that they historically have had trouble funding. Those States that just cannot or will not do one, provide them an alternative stream to bring those patients into their Medicaid system, or even the system that's provided for State employees. But it was doable.

Instead, we have a new Federal program that, guess what, today if you try to sign up because you've got a preexisting condition, you're turned away. They ran out of money. They didn't plan enough.

So before the exchanges kick in January 1 for the next 8, 9, 10 months, those people are out in the cold, the very people that the President said he was setting out to protect. The population was small; it was manageable. It could have been handled without the Federal takeover of health care from everything in your pill box to your Band-Aid box.

I see we've been joined by one of the outspoken leaders on this issue, the doctor from Tennessee, Dr. Roe. Dr. Roe, I appreciate your service in the Congress, and we're anxious to hear your thoughts on the third anniversary of, If You Like What You Have, You Can Keep It.


Mr. BURGESS. I'm so glad that you came to the floor because you bring up an important point. I actually want to ask you a question on one of the things that you brought up.

Many people forget that access to an insurance policy, access to a Federal program, is not the same as access to a physician or access to care. In other words, you can show up with a card, and if there's no office open that takes that card, you're about in the same shape you were before the card was produced. Is that not correct?


Mr. BURGESS. If the gentleman would yield for a further question.

Then where do those patients go for their care? You just said it, but I would love for you to repeat it.

Mr. ROE. If you look at Massachusetts, we were told that the number of ER visits were going to go down. They didn't. They went up. That's exactly where they end up. They end up in the emergency room for primary care, which is where they should not be.

Mr. BURGESS. Well, if the gentleman will yield, Doctor, if I recall correctly, on the floor of this House we heard over and over again the problem with the cost of health care in this country is those people who are uninsured. Those free riders who won't bother to buy insurance, they show up at the emergency room. It is the highest delivery point cost. They're the ones that are driving up the cost of care. I heard this in the Supreme Court the second morning in the oral arguments. The Solicitor General made this very point. It's the free riders that are driving the cost up.

Listening to you, it almost sounds as if patients for whom Medicaid is provided as the point of coverage, if there are no providers to provide that coverage, they do what they've always done. They go to the emergency room, the highest cost point for the access for care. How are we solving that problem by increasing that population?

Mr. ROE of Tennessee. Dr. Burgess, one of the great frustrations I've had in my short 4-year political career here--this is my third term--was there were nine of us in the Physicians Caucus when I showed up here. Not one of us was asked about this bill. I spent my life out there in the private world, 31 years, practicing medicine, providing care for patients, not bureaucracies and this, but actually seeing one patient right after another, delivering their babies, operating on them.

And what happens is, when you have a public program that promises more than it can produce, guess what? You get that patient in the hospital, and because it doesn't pay for the cost of the care, what happens? You shift that cost to the private sector, not only taking in inflation, but that cost shifting, to force it up. And you were led to believe it was the ``free riders.'' It's the public programs that are the biggest problem there, that are forcing those shifts in costs, and hospitals are caught in a dreadful situation.

They agreed to take the cuts in Medicare because they thought they were going to get an increase in insured people. It turns out what Congresswoman Bachmann brought up about how can you lose your private insurance, there may be as many people that lose their private insurance as we increase in Medicaid, which is a failed program now.

How bad is that when you take people who had insurance they liked, and they lost it, and now they are forced to no program or a Medicaid program that is fading?

Mr. BURGESS. As the gentleman also points out, no, members of the Physicians Caucus, the Doctors Caucus, were not frequently or ever consulted on this issue. But I know people--and I know, Mr. Speaker, I must refer my comments to you--who might just be casual observers of the conversation this morning and would say, Well, the two doctors are self-serving. Of course you want to be in charge, because that's the way you are.

But the Governors have a big footprint in the delivery of health care in this country. Where were the Governors? Why were the Governors not down in the East Room of the White House? Why weren't the special interests, why wasn't Pharma, why weren't the insurance companies, why wasn't the Service Employees Industrial Union down at the White House making these decisions and not the Nation's Governors? That's one of the great mysteries that may never be answered, but it's a question the American people should ask themselves. Because in all 50 States in this country, the Governors have an enormous health care footprint. They're the ones that administer the State Medicaid programs. They administer the programs for their employees' health insurance. They have their State prison programs. They have an enormous interest in the cost of health care. The Governors should have been invited from the get-go. It is a travesty that they never were. It's political malpractice that the Governors were not involved in the development of this policy.

Mr. ROE of Tennessee. Will the gentleman yield?


Mr. ROE of Tennessee. One of the things I noticed with our Democratic Governor, Phil Bredesen, who is a health care specialist and was the Governor of our State of Tennessee 8 years during the 2000s, the Obama administration would have been well-served to pay attention to Governor Bredesen, because Governor Bredesen was forced with a situation where he had to balance a budget. The health care costs were eating up this budget, and he had to cut the rolls. That's how the Governor elected to take care of this. After they cut the providers until there weren't any providing, he then had to cut the rolls from the TennCare program. That was very painful and hard to do.

And I would certainly warn Governors out there, when you massively expand these rolls, let me tell you, politically that was very difficult for the legislature and for our Democratic Governor. My hats are off to him for the decisions he had to make. Those were not easy for him to make. And you're absolutely right, the Governors are really the thought processes and the experiments in the local governments and State governments that you can actually do something and see whether it works instead of this massive mess that we have.

I just got a schematic of this yesterday. It's a 21-page--and I should have brought it down here on the House floor--schematic about trying to figure out whether you qualify for health insurance.

Let me tell you how it was when I hired somebody in my office. When I hired a new employee, guess what I did? They came in said, Dr. Roe, do you have health insurance? I said, Yes, we provide health insurance; go sign up on the way out. It took 5 minutes.

This thing is going to take you a week to go through to figure out whether you belong in the Medicaid box,

whether you belong in the private insurance box, whether you're going to get it at all, whether you get the subsidy or you don't. It's maddening. And it provides nothing to increase the quality of the care that we are required to do to give to our patients.

Mr. BURGESS. I thank the gentleman for his participation.

The gentlewoman from Minnesota mentioned the effects on the economy, and the effects of this law on the economy are profound. We just passed a budget for the next fiscal year in the House of Representatives. I'm grateful that the budget didn't allow space for the reformation of this health care law, the removal of this health care law.

But I think we're also joined by another gentleman from Texas who wanted to speak briefly about some of the economic effects, and I'm happy to yield to my friend, Mr. Gohmert, from Tyler, Texas, to speak on the economic effects.


Mr. BURGESS. I thank the gentlelady for her comments.

Where has the press been on this? Can you imagine if 500,000 children lost their health insurance under a Republican President? That would be the headline. We wouldn't hear anything else out of the press for a week. If people still showed up for the Federal preexisting program and the President said, ``No, no more, we're out of money,'' if it were a Republican President, that's all we'd hear about: the Republican President has prevented people from signing up to his own preexisting program that he started.

People need to be aware of what is happening. These things have been insidious. It's been 3 years. There's been a lot of information. It's complicated. I don't understand it anyway. Why do I have to be involved? You have to be involved. As the gentlelady just said, it is going to affect you and your family. Every man, woman, and child in this country for the next three generations is going to be affected by this very bad bill.

It was the worst of processes. This was a bill that came over here from the Senate. The House really never debated this thing. The House passed a bill, H.R. 3590, in July of 2009, but it was a housing bill. H.R. 3590 got over to the Senate. Harry Reid said, I need a bill number for my health care bill. Here's H.R. 3590. What does it do? Oh, housing. Strip all the language out. So he amended it: strike all after the enacting clause and insert. And what was inserted? The rest of the health care law.

The Senate had to digest it and pass it in a few days' time right before Christmas Eve. A big snowstorm was bearing down on Washington. They all voted for it to get out of town--60 votes in the Senate. It passed.

Nancy Pelosi said, What is this thing? It's garbage. I haven't got 100 votes for this over in the House. But over the next 3 months, they twisted enough arms and they broke enough knees that this thing finally got the votes 3 years ago yesterday, and 3 years ago today it was signed into law. It was signed into law to the detriment of the entire country.

I thank the gentlelady for joining me. I thank all the other Members who are here.

Mr. Speaker, I yield back the balance of my time.

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