Floor Statement Opposing Senate Health Care Bill
March 21, 2010
Today the majority seeks to enact its health care reform legislation. While, I appreciate the efforts of the majority to reform our health care system, it is hard to underestimate what a grave mistake it would be to enact this bill. It would fundamentally alter our citizens’ relationship with their government. It would seriously jeopardize our nation’s long-term prosperity. (No, actually not enacting this legislation would jeopardize the nations prosperity - we already pay twice as much as a percentage of GDP than the rest of the industrialized world, and we don't live longer). It would dampen the vitality of our nation’s health care innovators. It would restrict choice and access to medical care for millions of our nation’s elderly and poor. (um, excuse me, this bill is all about providing medical care for the poor) It would tax hundreds of billions of dollars out of the economy in the midst of one of the most serious economic downturns in our nation’s history. (No, this does not add additional burden on the economy, we already carry the burden of the uninsured with our wildly expensive and ineffective emergency room health care. It all gets built into the ridiculous premiums we pay today.)And for all this—for all of these thousands of pages and hundreds of new bureaus, boards, and bureaucracies—it won’t make America any healthier. (Again, not true - its well proven that widely available preventative care (as opposed to extreme high-tech) is by far the best way to extend healthy lives) And perhaps more fundamentally this legislation does not solve the most pressing problem facing our health care sector; namely its upwardly spiraling cost growth. (Again, the truth is actually the opposite - doing nothing is what will keep costs spiraling.) If the majority is successful in passing this bill, they will, at best, celebrate a narrow political victory at the expense of the American public, and at worst, send our nation further down the path towards financial catastrophe. (Too funny, only in the Alice-in-Wonderland world of Garrett is providing near universal health care "a narrow political victory at the expense of the American public".)
For the most part, Republicans and Democrats agree on the problems our health care system faces. Even though Americans spend more on health care than any other country in the world, current projections assume that this level of spending will rise indefinitely. As this spending increases, it is consuming a greater and greater share of workers paychecks. Health insurance is too expensive, and some people with chronic illness struggle to access health care services. We agree on the problems.
But it is rare that a single piece of legislation can so crystallize the differences in governing philosophy between our two political parties. As a solution to these problems in our health care system, the Democrats would propose a massive increase in government involvement—expanding current government run health programs, and creating new ones. (Someone needs to explain to Garrett that requiring everyone to buy *private* insurance is hardly a "government takeover".) Provisions in this legislation would restrict choice, and place greater control of health care in the hands of the federal government. For example, under the bill’s terms, no longer would we exercise a number of freedoms that we now take for granted, such as whether to purchase health insurance or what medical benefits we feel are necessary. Under this bill, this is now a matter for the government to decide. (Get real, the "freedom" to not buy health insurance is a special freedom that only the poor enjoy. Also, the plan benefits are just minimum standards that must be offered by all insurance companies - there is nothing to prevent companies from offering more than the minimum, or extra insurance at extra cost on top.)
This is far, far removed from what our nation’s founders envisioned. (Actually, this is exactly what the founders would have supported - a government that meets the needs of its people, not just the wealthy an powerful. Remember that saying about "the right to LIFE, liberty and the pursuit of happiness"?) And indeed, I submit that, fundamentally, this legislation violates the Constitution and will be found unconstitutional when it is inevitably litigated through our judicial system. (Republicans are in for a rude awakening with this fantasy, just try to pry this out of the hands of Americans who will be enjoying health care peace of mind for the first time.) This legislation would require individuals to purchase private health insurance—health insurance that has been approved by the federal government—or pay a fine. While Congress is granted the authority to “regulate commerce…among the several states,” and the Supreme Court has long allowed Congress to regulate and prohibit all sorts of “economic” activities that are not, strictly speaking, commerce, this is the first time in our nation’s history that Congress would seek to regulate inactivity. And for the first time, Congress would mandate that individuals purchase a private good, approved by the government, as the price of citizenship. (Very funny - the simplest way to deliver this would have been to simply expand something like Medicare for everyone (i.e., the public option), but the role of private insurance companies was maintained to try to get Republican support. Now that they have this, they plan to label it unconstitutional.) This requirement is plainly unconstitutional, and would violate the commerce clause. I have been speaking out on the unconstitutionality of this individual mandate on the House floor, in Budget Committee and through the Constitutional Caucus, of which I am the chair. If we allow that Congress has this authority under the Constitution, then there is virtually no limit on its authority to compel our nation’s citizens to comply with the whims of a Congressional majority. If future Congresses feel that we don’t eat enough vegetables, they could simply mandate that we purchase government approved salads. Or if future Congresses feel that our domestic auto industry needs a boost, they could mandate that we purchase a car from General Motors. (Yet another Republican visit to the "scary place" - paint a ridiculous picture and try to get people to think this is even remotely possible. The usual obstructionist tactics. Gets the tea-baggers going, but most Americans see right through this.)
However, even if we allow that this bill is constitutional, it should still be rejected because it further deteriorates our nation’s financial standing. In Congress, I have the pleasure of serving on the Budget Committee. Ever since I first arrived in Congress, witness after witness—Republican or Democrat, liberal or conservative—who have appeared before the Committee have all noted the serious long-term funding issues that our country faces. Quite simply, we are running out of money to pay for an ever growing government. According to the Peter G. Peterson Foundation, America’s three biggest entitlement programs, Medicare, Medicaid, and Social Security, are projected to consume over 80% of the federal budget within a generation. And the single biggest driver of this increased cost is health care inflation. Medicare alone has a $36.3 trillion unfunded liability. This past week, three members of my staff were blessed with the birth of a child. (Undoubtedly well covered by insurance) As soon as those children took their first breath, they each assumed a health care debt of $121,000. (Completely misses the obvious point that the unfunded entitlements spun out of control under Republican leadership, who raised entitlements while cutting taxes. Or that health care inflation is the result of the current situation, not a result of this reform which makes the first real efforts to bring it under control)
The majority claims that this bill would actually reduce the deficit, but this rests on a number of assumptions that are wildly unrealistic. The budget gimmicks in the bill have been well documented, but among the highlights are that it would: pay for 6 years of benefits with 10 years of taxes; raid the Social Security trust fund of $53 Billion; double count the savings in Medicare to pay for a new entitlement; disregard the increased administrative costs of running these new programs; double count $70 billion in premiums for a new long-term care entitlement which would later have to be used to pay for benefits; and rely on unrealistic Medicare cuts. (The non-political Congressional Budget Office has analyzed this and found it budget neutral. Name a single Republican project that went even close to the effort put into this bill at responsible funding. Funny how Garrett is a budget hawk when Democrats create a plan that benefits a vast amount of Americans, but was strangely silent when Republicans decided to launch multiple unnecessary wars and tax cuts that vastly favored the wealthy.)
This last point is perhaps the most important one. The chief actuary of the Department of Health and Human Services wrote, in a letter to Congress, that the Medicare cuts proposed in this bill are “unrealistic” and could “jeopardize access to care” for seniors. Independent analysis says that many hospitals and health care providers would simply leave Medicare altogether if these cuts are implemented. So, under the terms of this legislation, future Congresses would have to do something it has thus far shown no appetite for: limiting access to vital medical care for our nation’s seniors. (Again, playing both sides of the fence for political posturing - spending paragraphs complaining about costs, and then launching into how any cost containment will have to "limit vital care". Mr. Garrett you can't have it both ways, unless, of course, you are just politically posturing.)
Another major assumption made by the majority is that this legislation would enact a tough “Cadillac tax” on generous employer provided insurance plans. But this tax’s implementation date has been pushed back to 2018; well after President Obama leaves office. For years, Congress has assumed in its revenue projections that millions of middle class tax filers should pay the Alternative Minimum Tax (AMT) each year. But every year, Congress has stepped in and passed legislation to prevent this from happening. Similarly, we should assume that a tax that is so unpopular that it must be pushed out 8 years before being implemented is a tax that may never realistically happen. would actually support this bill (which has many of their ideas in it). If Republicans had some spine and voted as individuals looking out for citizens instead of lemming following their angry Republican leaders (AMT is broke because it has no inflation index, and keeps trapping more people. That's why Congress keeps preventing it from taking full effect. The reason why the Cadillac tax delay is in the bill is because no Republicans would step and help shape the bill. With some bipartisan Republican support every Democrat vote would not have been as critical and this provision could have easily been dropped. If you don't participate you really can't complain about the outcome.)
So this gargantuan health care entitlement, once fully implemented, would end up costing us approximately $200 Billion per year, and then increasing at a rate of 8 percent per year. But we can not afford our current entitlements! How will we be able to afford this when the bill comes due? I worry that this bill is a fiscal disaster of the first order. (Even if this number were true, it amounts to about $5000/year ($200B/40M new people covered) for comprehensive health insurance. Funny how every other nation can support this, but somehow America will not be able to)
It should not have been this way. We had an opportunity to enact real health care reform—reform that would have set our nation on a prudent fiscal path, and one that would not have violated our Constitution. I and my Republican colleagues have proposed a series of reforms, (OK lets hear it...) such as enacting real medical liability reform (a tiny part of the problem, perhaps 3%, but one the republicans love to bring up. Again, if they had participated this could have been easily been added, but without their support every Democratic constituency counted); allowing individuals to purchase insurance across state lines; (the bill actually does this, since there will be consistent health plan minimums nation-wide) allowing individuals to purchase insurance through groups and trade associations the same way unions can; allowing small businesses to band together to purchase insurance (also included in the bill - everyone is in the same boat and gets the big volume discount); and eliminating the discrimination in the tax code against purchasing insurance through the individual market by allowing individuals to deduct insurance premiums the same way their employers can. (Actually, the reverse needs to happen - no deductions for companies or individuals. This would certain help with any revenue issues, but of course that is politically untouchable by Republicans.) While these proposals are not the final word on health care reform, they certainly would have served as a good starting point for bipartisan reform. (and most of them were included, even though no Republicans stepped up and voted for what they know is right, and will be forever stained as members of the party that tried to prevent health care for all Americans)
Instead we are left with this bill which, I am afraid, will do much harm but provide little benefit. I strongly urge that this bill be defeated, so that we can go back to the drawing board and find true bipartisan solutions to the problems facing our health care system. Thank you and I yield back. (Right, go sit back down Mr. Garrett. Maybe next time you will actually be ready to actually help lead our country by working with the Democrats instead of being a Republican lemming.)
