September 12, 2012 CONGRESSIONAL RECORD — HOUSE H5913 

made a positive impact on the lives of those 

he has served, and who leaves a legacy worthy of this institution. I wish him, his wife Georgia, and his family well on their future endeavors. 

Mr. RAHALL. Mr. Speaker, it is my distinct 

honor to rise and salute my friend and colleague, the distinguished gentleman from Illinois’ 12th district, JERRY COSTELLO, as he prepares to conclude 24 years of service to his 

country and the people of southern Illinois as 

a Member of the House of Representatives. I 

have worked with JERRY regularly over the 

years on a number of bills and issues, but he 

and I collaborated especially closely these 

past two years on the Committee on Transportation and Infrastructure as we worked to pass 

a long-term Federal Aviation Administration 

(FAA) reauthorization bill. And at every juncture, I never failed to be impressed by his earnest and apparent desire to do right by his 

constituents and the American people. 

JERRY first came to Congress as a freshman 

Member of the Illinois Delegation after his 

election in 1988, but, even before he took the 

oath of office, he had already distinguished 

himself as a faithful public servant of the people of Illinois through his service in the state 

court system and then as chief executive of 

one of Illinois’ largest counties. JERRY came to 

Congress—and this was apparent to me from 

some of my earliest collaboration with him— 

with a strong sense of duty to his constituents 

and to the public at large. For 24 years, this 

has been reflected in the strong spirit of bipartisanship in which JERRY works with our colleagues across the aisle. He finds compromises where others cannot. 

Whether working with JERRY to advance 

clean coal or to make our aviation system 

safer and stronger, I always got the sense he 

was practically an expert in the subject matter. 

And, indeed, he was. In 2007, he was instrumental in helping write and secure House passage of a $68 billion FAA reauthorization. He 

worked to pass the bill again in 2009, and he 

negotiated tirelessly with the other body to 

enact a final bill before the clock ran out last 

Congress. 

Moreover, in the aftermath of the tragic 

crash of Colgan Flight 3407 in 2009, JERRY

wrote and worked in a bipartisan manner to 

pass an airline safety bill that called for the 

strongest aviation safety improvements in 

more than 40 years. The bill made sweeping 

airline safety and pilot training reforms that 

have made the traveling public safer. JERRY’s 

vision, knowledge, and leadership resulted in 

those reforms becoming law. 

This Congress, JERRY and I worked very 

closely as we negotiated with our House and 

Senate colleagues on a long-term FAA bill. 

Before that process began, there were probably some who thought ‘‘slots’’ are something 

you might find in Vegas or Atlantic City. But 

JERRY would patiently explain the other type of 

‘‘slots’’ that loomed large over the FAA bill: 

slots for airlines to fly to Washington National 

Airport. Explaining slots—or any complex aviation issue, for that matter—JERRY would boil 

down years of legislation, rulemaking, and airline mergers and bankruptcies into a few simple words that reflect his good Midwestern 

common sense. 

When JERRY retires at the end of this Congress, we will lose the benefit of his institutional memory, his knowledge of aviation 

issues from top to bottom, and his bipartisan 

approach to solving problems and finding 

common ground. I have no doubt that JERRY’s 

family—his wife, Georgia, his daughter and 

two sons, and his eight grandchildren—are 

looking forward to having him closer to home 

for longer periods of time. On behalf of my 

colleagues, I would like to thank them for 

sharing JERRY with us for these 24 years. His 

good work has made a tremendous difference 

not only for the people of his district, but for 

every American who flies, drives, or takes a 

train in this country. 

Mr. Speaker, with great admiration, I salute 

my friend as he prepares to retire from this 

body, and I join with my colleagues in extending to him every best wish in his future endeavors. 

f 

GOP DOCTORS CAUCUS 

The SPEAKER pro tempore. Under 

the Speaker’s announced policy of January 5, 2011, the gentleman from Michigan (Mr. BENISHEK) is recognized for 60 

minutes as the designee of the majority leader. 

Mr. BENISHEK. Mr. Speaker, as 

many of you may know, before coming 

to Congress, I was a physician in northern Michigan for nearly 30 years, and 

tonight I want to spend a little time 

talking to you about Medicare, the 

President’s health care bill, and just 

health care in general. 

In practice, many of my patients 

were on Medicare, and I know how important medical care is to our seniors. 

It’s an important part of their ability 

to take care of themselves as they get 

older. Really, the reason I’m here 

today is to explain that the GOP and 

the Republicans want to preserve Medicare for our current seniors and for the 

youth that are coming up because right 

now the way Medicare is organized, the 

trust fund will be out of money within 

10 to 12 years. Different accountants 

have different numbers. But basically, 

unless we do something, we’re going to 

run out of money. We just don’t want 

that to happen. I want to see people 

still have access to their care. 

In discussing this issue, it seems as if 

we’ve been attacked for trying to end 

Medicare. But if you see that there’s a 

problem with a system that is running 

out of money and you don’t want to address it, that’s just not right. 

The Doctors Caucus in the House is 

18 physicians, nurses, and dentists that 

represent different areas of the country, and we have a good understanding 

of health care as it exists right now in 

America. Certainly, there are problems 

with health care and access to it. And 

although we have great health care in 

America, the problem is it’s too expensive. Frankly, the President’s health 

care bill makes it more difficult to 

keep Medicare viable. Those are a few 

of the things I want to talk to you 

about this evening, just touch on to let 

you understand what I think about how 

the system is working and how we can 

improve it. 

I don’t think it’s a partisan issue. I 

think it’s something that we need to 

discuss. Frankly, I just don’t think 

that some of the people that have 

passed these laws in Congress really 

understood what they were doing. They 

admitted the fact that they passed the 

bill without really knowing what was 

in it. I just don’t think that’s really a 

good idea. 

What is really the problem with 

Medicare? The problem is that the population of our country is changing. 

There are more older citizens than 

there were; in other words, there are 

10,000 new Medicare beneficiaries being 

added each day. Right now, a little 

over three people are paying into the 

system for every person that is collecting. Because of the large numbers 

of people that are being added to the 

roles, within a few years there are only 

going to be two people paying in for 

each person collecting. That creates a 

problem in the fact that there are not 

as many people paying in as are receiving benefits. With the cost of health 

care going up, it makes it a fiscal cliff. 

The other big problem that we see 

with the Medicare situation is the fact 

that the President’s health care law, in 

order to pay for it, takes $700 billion 

out of Medicare. That’s a lot of money 

to take out of Medicare and still expect 

it to provide care for our seniors, more 

and more of which are coming on to it 

every day. I think that there is certainly some waste, fraud, and abuse 

that can be eliminated, and that will 

help, but it’s just not enough. We have 

to change the system. 

The system that I think we should 

change to, frankly, is the system of 

PAUL RYAN and Mr. WYDEN of Oregon, 

who brought together a program where 

we can put some changes in for those 

people under 55 that will allow them to 

choose between different private insurance plans similar to what Federal employees and Members of Congress have. 

These private plans would be inspected 

and reviewed by the government to be 

sure that they’re adequate and give 

people some flexibility in how they 

spend their money. 

One of the problems I see with Medicare is that the government ends up deciding how to spend the money rather 

than the patient. The patient, to me, is 

the one whose money it is. The people 

who are spending the money should be 

the ones who are deciding how it’s 

spent, not some government person or 

bureaucrat in Washington. 

Show me the slide on the $700 billion. 

I just want to show people the slide 

that demonstrates what’s happened to 

this money. I represent the northern 

half of Michigan. We have many small 

towns and small hospitals in my district. Every little town has their community hospital, and it’s hours sometimes to the next facility. 

b 1820 

This slide here shows the $716 billion 

coming out of the Medicare program, 

and $294 billion of that money is payments to hospitals. The President describes the Medicare cuts as cutting 

waste and overpayments to providers. 


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H5914 CONGRESSIONAL RECORD — HOUSE September 12, 2012 

Well, these hospitals are the ones that 

are providing the care; and as a doctor, 

I’d be a provider as well. 

But when you cut $294 billion from 

our local hospitals, I know, I served on 

the board of a hospital. Our hospitals 

are operating at a razor-thin profit 

margin. They have to stay in the 

black, otherwise they go out of business. They can’t make their payroll. 

We’ve recently had a hospital in our 

district go bankrupt because of their 

problems with payments from Medicare. 

This is going to continue to happen 

as we go forward if we allow this President’s health care bill to continue with 

$156 billion cut from Medicare Advantage, $111 billion to be cut by IPAB and 

other provisions, $66 billion cut from 

home health care agencies, $39 billion 

cut from skilled nursing, $33 billion 

from FFS Medicare providers and $17 

billion from hospice care. 

These are crucial programs for our 

seniors. With more and more seniors 

coming into the program, how are they 

going to be provided care with less 

money? I don’t see it happening. 

What’s going to happen is there are 

going to be fewer hospitals, fewer 

places for patients to get care, so it’s 

going to be difficult; and in my district 

we may have to travel hundreds of 

miles to get seen. I think it’s pretty 

darn scary, to tell you the truth. 

Dr. HARRIS, another member of the 

Doctors Caucus, is here with us tonight. He’s from Maryland, and he’s an 

anesthesiologist. 

Mr. HARRIS. Will the gentleman 

yield? 

Mr. BENISHEK. I yield to the gentleman from Maryland. 

Mr. HARRIS. On those lists of questions of those $716 billion that’s basically going to be transferred from the 

Medicare program to pay for the President’s new health care reform bill, that 

doesn’t even include the over $300 billion to cuts in physician and provider 

payments over the next 10 years under 

the payment form; is that correct? 

Mr. BENISHEK. That’s right. 

Mr. HARRIS. So it’s in addition to 

that $700 billion. There’s another $300 

billion that’s going to get cut from 

payments to providers. Here’s the problem. You know, I think the gentleman 

from Michigan points it out. 

Medicare is going broke, and it’s 

going broke not only because $700 billion was taken out of it to pay for the 

President’s Affordable Care Act, but 

another $300 billion is going to be 

taken out in the physician payment 

formula. 

Now, the CMS actuaries, and that’s 

the department that runs Medicare and 

Medicaid, actually projects that the 

Medicare program could be bankrupt as 

soon as 2016. Four years from now, the 

Medicare program could be bankrupt. 

Now, I’m glad that as part of November’s elections we’re going to discuss 

the future of health care for our seniors, because it is time to say that the 

emperor has no clothes. Our seniors 

know it. 

They know that when, God forbid, 

their physician retires, and they go and 

try to find another physician, and 

they’re on Medicare, they already 

know how hard it is to find a physician 

who can accept them because the reimbursements are already so low. 

The payments to physicians are so 

low already, it’s hard to find that primary care doctor. It’s hard to find that 

specialist who needs to take care of 

you, whether it’s for your blood pressure or your diabetes or whatever problem you have; and the problem is only 

going to get worse. 

Now, the President in his budget 

doesn’t deal with it at all. He pretends 

that Medicare will go on forever and 

ever just the way it is now. That’s just 

not true. 

The Centers for Medicare & Medicaid 

say it could go broke in as little as 4 

years. The Medicare actuaries give it 

the longest lifetime, 10 more years. 

Well, Mr. Speaker, if you’re 55 now, 

that means by the time you’re 65, it’s 

broke. If you’re 61, according to the 

Centers for Medicare, it’s broke by the 

time you reach age 65. And if you’re on 

it now and you’re 70, it could be broke 

by the time you’re 74. 

So we have to stop pretending that 

the Medicare program is going to work 

forever the way it is now. It won’t, because the President took $700 billion 

from it to pay for the Affordable Care 

Act. There is a scheduled cut to physician payments and to provider payments of over $300 billion over the next 

10 years, and our seniors are already 

having problems finding those physicians. 

But in the Medicare costs, if we don’t 

do anything right now, we don’t deal 

with the program and adjust it for people who are younger—and I have a son 

who is 27 years old. He is an accountant. He knows numbers, and he knows 

them backwards and forwards and up 

and down, better at math than I ever 

was. He’s convinced he will never see a 

Medicare program because he’s seen 

the books. 

Medicare payments are projected to 

grow substantially from approximately 

3.5 percent of our economy to 5.5 percent of our economy by 2035, and the 

President has no plan to pay for that 

growth. We know because of the maturing and retiring of the baby boom generation that this is coming. 

This is predictable. We can project 

this. We know that if we don’t change 

the Medicare program to preserve it for 

future generations and to keep it for 

the current generation of Medicare recipients, it goes broke. As I mentioned, 

the physician payment formula in 

Medicare needs to be fixed or, starting 

January 1, payments to physicians and 

providers may go down 30 percent. 

Now, Mr. Speaker, if our seniors 

think it’s hard to find someone to take 

care of them now on Medicare, what do 

they think it’s going to be like when 

the government says to those physicians, we’re going to pay you 30 percent less starting January 1, and this is 

all scheduled to happen. 

The President has no plan. The President suggested no ideas to Congress on 

how to deal with that. What we need is 

leadership on health care, and we’re 

not getting it from the other end of 

Pennsylvania Avenue. 

Already access is an issue because 

back in 2008, 12 percent of physicians 

have said they have to stop seeing 

Medicare patients. We know now that a 

much larger number limit the number 

of Medicare patients they care for. 

As the gentleman from Michigan 

knows, we didn’t go to medical school 

to not take care of patients. We didn’t 

go to medical school to have our staff 

answer a senior calling to say, I’m 

sorry, but we can’t afford to take care 

of you. But that’s exactly the position 

that the President’s plan for Medicare 

is putting physicians and patients in 

right now. That’s the sad fact. 

This emperor has no clothes. The 

Medicare program is on a path to bankruptcy, and there is no plan from the 

White House to solve that problem. It 

merely kicks the can down the road. 

We have heard a lot in the last few 

days and few weeks about SimpsonBowles coming to the rescue. That’s 

going to solve our fiscal problems; if we 

just adopt the Simpson-Bowles Commission, all our fiscal problems go 

away. 

Mr. Speaker, as you probably know, 

Simpson-Bowles decided not to do anything about Social Security and Medicare. 

Now, Social Security, it turns out, is 

pretty solvent. It’s going to be there 

for at least another 20 years, giving us 

a fair amount of time to solve the problem for future generations. But, again, 

the Centers for Medicare says we may 

only have 4 years to solve the Medicare 

problem before it goes bankrupt. 

If our seniors right now think they 

have problems now getting their health 

care and finding those primary care 

doctors and those specialists to take 

care of them, imagine when the program goes bankrupt. 

Now, we have a choice. We can deal 

with it, or we can kick the can down 

the road. I’m proud of the Vice Presidential candidate, one of our colleagues, Mr. RYAN, who has decided 

that the time to kick the can down the 

road is over. It’s time to tell our seniors and Americans what they suspect. 

b 1830 

We’ve been making promises we have 

no way of keeping. We have been spending money we don’t have. And it has to 

stop. And as the gentleman from 

Michigan knows, we have some principles in our plan to deal with the 

bankruptcy of Medicare because, Mr. 

Speaker, it’s not a question of if, it’s 

only a question of when. 

So there are a couple of principles. 

The first principle is: we don’t change 

it for anyone over age 55. If you’re in 

retirement or you’re near retirement, 

you get to keep the very same program 

right now. But we deal with the fact 

that physician and provider pay would 


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September 12, 2012 CONGRESSIONAL RECORD — HOUSE H5915 

be cut January 1. We solve that problem. We say you can’t do that. That 

will limit access. So we deal with that 

issue. We say you have to stop taking 

$700 billion from the program to transfer it to pay for the new President’s 

health care reform; to cover Americans 

who don’t have insurance now by taking it from Medicare patients who do 

have insurance. 

So the first principle, no one over age 

55 is affected. The second principle is: 

for those under age 55, Mr. Speaker, if 

they’re listening now, the program is 

going to be bankrupt when you reach 

age 65 if we don’t do something. We’re 

going to make some commonsense adjustments. We’re going to say that you 

should have access to the same kind of 

care Congressmen and -women have—a 

broad range of health care plans you 

can choose from with the guarantee 

that for at least two of those plans you 

will have 100 percent coverage. 

We all turn on the TV. We hear the 

ads: Mr. RYAN’s plan will cost $120,000 

for every senior, or $200,000 in more 

costs. Here’s the problem. People who 

made the ads didn’t read the bill. The 

bill spells it out quite clearly. Our plan 

is that seniors—again, people age 55, 

when they reach age 65—will have a 

choice of plans just like we have here 

in Congress. The only difference is we 

have to pay a part of all our plans. 

They don’t pay for the two lowestpriced plans. If they choose a plan with 

more options, they may pay something. But they will end up paying even 

less than they do now. 

That’s our solution. Let market 

forces come in and control the cost of 

health care, control that growth in 

cost, and allow real coverage for our 

seniors, for our people age 55, when 

they reach age 65, and preserve it for 

future generations so that my son, the 

accountant, can look at that plan and 

say, You know what? This balances. 

You don’t have to borrow money from 

the Chinese to pay for this plan. We 

don’t have to raise taxes to pay for this 

plan. We actually let market forces 

work, providing the same coverage 

that people in Congress get. And it will 

work. 

So, Mr. Speaker, I’m very glad that 

we have the opportunity to talk about 

this tonight. I’m very glad that this 

November and in the months leading 

up to it we’ll have an honest, frank discussion with the American people 

about the future of health care, the future of health care for our seniors, preserving it, and the future of health care 

for everyone else under the President’s 

affordable care scheme. Because we 

know there are problems with it. 

Americans understand that when you 

put the government in charge of something so vital and personal as health 

care, real problems can occur. And as 

the gentleman from Michigan has 

pointed out, we know those problems. 

They’re predictable problems. A majority of Americans have figured it out. 

Poll after poll after poll says we should 

deal with the President’s Health Care 

Reform Act by repealing it and replacing it, keeping elements that are good. 

Every American either has a preexisting condition or will have one in 

their lifetime. Every American. So our 

plan will have to deal with it. And it 

does deal with it. And for those people 

who want to have their children on 

their policies up until age 25, our plan 

can deal with it—and does deal with it. 

But we certainly don’t need the Independent Payment Advisory Board, 

which the gentleman from Michigan is 

going to discuss, that is going to run 

health care for Medicare. We certainly 

don’t need the Secretary of Health and 

Human Services prescribe what plans 

are going to cover what for every single American. Whether you want it or 

not, you’re paying for it in your plan. 

Because we know that’s only going to 

drive up the cost. 

I’m glad that we’re going to have 

that discussion with the American people because, Mr. Speaker, every American’s health care is so important to 

them and their family. They deserve 

this discussion. They deserve the 

chance to go to the ballot box this November and make a choice about what 

their health care is going to look like 

in the future. And we’re going to have 

a clear choice. It’s going to be a government-run health care plan run by a 

bureaucrat where costs and access are 

controlled and rationed, or it’s going to 

be one where the patient and their physician make the choice about their 

health care, with the government bureaucrat staying out of it, where they 

belong. 

I thank the gentleman from Michigan for yielding. 

Mr. BENISHEK. Thank you. I truly 

appreciate my colleague from Maryland taking a little time to be with us 

tonight and give us his insight as a 

physician here on the floor. 

I would like to say a few words about 

IPAB. This is the Independent Payment Advisory Board. This is the 

mechanism that Mr. Obama’s health 

care plan has for controlling costs. And 

really, what it is, it’s 15 appointed bureaucrats, each making $165,000 a year, 

with no congressional oversight, whose 

only purpose is to reduce Medicare 

spending. So if the Medicare budget 

goes up too much and is over the limit, 

these guys in Washington are going to 

decide what to cut. They’re going to 

decide if you deserve a PSA prostate 

test or deserve a mammogram or you 

deserve a colonoscopy. They’re going 

to decide that they may not pay for 

that. If we don’t act, this board could 

being making these kind of decisions 

as soon as 2015. Denial of payment for 

care is going to really lead to denial of 

care for our seniors. I don’t think it’s 

fair for these Washington bureaucrats 

who know nothing about the patient to 

be making these decisions. 

I’m used to taking care of patients, 

and sometimes we have to make some 

really difficult decisions. But those decisions have been made between the 

physician, the patient, and the family, 

not some bureaucrat in Washington 

who doesn’t know the patient and can’t 

decide if this patient really qualifies 

for care and should not be denied. So I 

just think it’s so wrong to allow bureaucrats that don’t know the patient 

to be making these decisions, and I just 

want to make sure people understand 

the seriousness of this. There’s no appeal from this board. There’s no getting somebody off this board once 

they’re appointed. It’s really unbelievable. 

Tonight, also, I have the pleasure of 

being joined by my colleague from New 

York, a nurse, Ms. BUERKLE of New 

York. 

Thank you for joining us. 

Ms. BUERKLE. Thank you very 

much to my friend and colleague from 

Michigan. Thank you for having this 

Special Order tonight. And I think it’s 

so critical, Mr. Speaker, when the Docs 

Caucus has this event, and the people 

who are speaking are people are passionate about health care. Many of us 

actually came to Congress because we 

were so concerned regarding the Affordable Care Act. I spent my life as a 

nurse and later on as an attorney who 

represented a large teaching hospital. 

And so I am passionate about health 

care. As my colleague before me mentioned, there’s nothing more personal 

than one’s health care. And this Nation 

has the highest quality of health care, 

and we want to make sure we maintain 

the standard that we have. 

I don’t think anyone would disagree, 

Mr. Speaker, that this country needs 

health care reform. And while this law 

may have been the most well-intentioned, I disagreed with it philosophically when I decided to run for Congress. But now that I’m in Congress 

and I have had the opportunity to talk 

to so many folks in my district, this 

law, this Affordable Care Act that was 

supposed to decrease the cost of health 

care and increase access for Americans, 

is not going to do that. And let me, if 

I could, talk just briefly about what is 

going on in my district. 

b 1840 

My district is heavy with ‘‘eds and 

meds,’’ we call it. We have a lot of hospitals in my district, and they’re the 

major employers. 

Now, the hospitals have spoken to 

me. They’re concerned because this Affordable Care Act, this ObamaCare law, 

will decrease the amount of disproportionate share moneys they give because they treat a population of patients who may not have insurance or 

who are underinsured. So they’re concerned about their fiscal, their financial integrity. Those are the hospitals. 

Those are providers. 

The Affordable Care Act doesn’t address the SGR fix, the Medicare reimbursements for physicians. So I’ve got 

physicians who are concerned. It also 

creates a scenario where we will not 

have enough primary care physicians, 

internal medicine, psychiatry, those 

types of physicians who can even 


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H5916 CONGRESSIONAL RECORD — HOUSE September 12, 2012 

render the care. So the providers are 

concerned, the actual people and facilities who render the care. They’re concerned that this law is going to adversely affect them. That’s my first 

concern. 

My second concern are my seniors. 

And in all of this discussion and debate, I think the most disingenuous 

discussion that’s going on out there is 

the denial as to what this law will do 

to seniors and their Medicare coverage. 

I think my colleague ahead of me 

talked about the moral obligation we 

have to our seniors. We have a contract 

with them that when you retire, when 

you turn 65, Medicare, you’ve paid into 

it all your life, and you will be able to 

have that benefit. 

But this law, this Affordable Care 

Act, cuts Medicare by $716 billion. Now, 

there’s no program in the world that 

will not be affected by the loss of that 

much funding and the funding that’s 

being taken out of Medicare, and it’s 

going to be used to fund the rest of the 

entitlement in this law. 

So seniors really need to understand 

the threat to Medicare as we know it is 

this Affordable Care Act. And it has 

changed Medicare as we know it for our 

seniors, and this law will affect everyone who’s on Medicare. 

The discussion about the Ryan budget and the budget we passed out of the 

House, that discussion is only for those 

who are 54 and younger. So anyone who 

is 55 and above, with the Republican 

proposal for Medicare, can take a deep 

breath and they can say, My contract 

with this country, my benefit through 

Medicare will not be touched, and I can 

rely and count on that. That’s a very 

important promise that we can make 

to our seniors. 

But this Affordable Care Act can’t 

make that promise to our seniors because it is cutting Medicare, and as my 

colleague from Michigan talked about, 

this IPAB board will also affect the 

kinds of services that our seniors receive. 

So every American, especially our 

seniors, should be concerned about this 

law that is in place that will go into effect in 2013 and 2014. 

So, we’ve heard from the hospitals 

and the physicians. They’re not happy 

with this law. We’ve heard from the 

seniors. They’re not happy with this 

law. 

I hear from my businesses, my small 

businesses, those entities that we’re 

trying to get this economy going, and 

they’re concerned because they don’t 

know how this law is going to affect 

them. They don’t know whether or not 

they’re going to have to pay the penalty or pay the tax. They’re very concerned because of the uncertainty this 

creates in their businesses. So, they sit 

on cash and they don’t invest and they 

don’t hire. So my small businesses 

don’t like this Affordable Care Act. 

Now, just recently, and we’ve had a 

lot of debate about the tax on small 

medical devices that will occur to any 

small medical device producer in the 

country. Now, that’s a niche sort of industry. It’s one of the only sectors of 

the economy that has grown. It requires R&D. It requires innovation. It 

requires real creative production of 

small medical devices. 

I have a well-known company right 

in my district, and on Monday of this 

week, they announced that they will 

cut 10 percent of their workforce directly related to two things. The first 

is that 2.3 percent excise tax on small 

medical device producers. Ten percent 

of that workforce will be done away 

with because of this Affordable Care 

Act. The other reason they are cutting 

their workforce is because of the tax 

and also because of the fact that, with 

this Affordable Care Act, hospitals and 

physicians are not buying new equipment because they, too, are uncertain 

as to what the Affordable Care Act is 

going to do to them and their business. 

So they’re not buying new equipment 

for their hospitals and their offices. 

So, now we’ve got seniors, hospitals, 

physicians, small medical device companies, businesses very concerned as to 

how this law is going to affect them. 

The Court ruled that it’s a tax, and 

that’s why it’s constitutional. There’s 

21 new taxes in this Affordable Care 

Act. It’s going to affect our jobs and 

our economy. It’s going to affect our 

small businesses. It’s not the right direction for this country. Only the practical listening to people over and over 

again in the district puts that out very, 

very clearly. 

So I think the right thing to do for 

this Nation—and this House, I’m so 

proud we have voted to repeal this law 

twice. We also voted in June to repeal 

the tax on small medical devices. 

That’s the right thing to do. 

The responsible thing to do is enact 

true health care reform that will really 

reduce the cost of health care, that will 

allow patients choice, that will allow 

them to cross State lines to buy their 

insurance. It will allow them to keep 

their insurance even if they lose their 

job. It will have tort reform in it and 

bring down the cost of health care. It 

will repeal the excise tax on small 

medical devices. It will keep the good 

pieces. 

The two things I hear over and over 

again: preexisting conditions—and my 

colleague from Maryland mentioned it. 

Preexisting conditions, along with 

keeping your child on your plan until 

they’re 26. Those two could certainly 

be incorporated in a new truly reformative health care law in this Nation. 

So I thank my colleague from Michigan for all of his good work, for his 

dedication to the health care profession. I’m proud to be a member of the 

Docs Caucus because we are a group of 

people who have committed our life to 

health care. We are passionate about 

making sure that the United States of 

America maintains its high quality of 

health care and also keeps costs and 

accessibility to the highest standard 

for the people who live in this country. 

Mr. BENISHEK. I thank my colleague from New York for joining us 

this evening. I appreciate her insight. 

I just want to say a couple more 

things about this tax that she mentioned on medical device manufacturers. 

You know, in my district as well, we 

have a couple of companies that make 

the drills for orthopedic surgeons 

where they put in the screws and that 

sort of thing. This tax is, I think it’s a 

2.3 percent tax, not on their profits, but 

on their gross. So even a small startup 

company that’s trying to innovate, 

which we have in my district, and create a new device that will help people 

with care, even if they’re losing money, 

they have to pay the tax on any gross 

receipts they have. That, to me, is like 

the most regressive part of that tax. 

Besides that, it’s forcing our medical 

innovators to move their companies 

overseas. I mean, you know, people 

aren’t stupid. They realize that if 

they’re going to be taxed here in this 

country even though they’re losing 

money, they’re going to move that 

manufacturing capability to Europe, 

and that’s already been happening. 

So this law is taking the medical 

innovators in this country—and everyone knows this country has been leading the way in the world in medical innovation for the last hundred years. 

It’s forcing those people to go overseas 

to do business. That’s not good for 

America. That’s taking highly skilled 

people and asking them to go somewhere else to do business because we 

have a bad climate for that. 

I want to talk just a little bit longer 

this evening about some real health 

care reform. 

I mean, as I mentioned, the President’s health care bill doesn’t fix the 

problem with health care. The problem 

with health care is it’s too expensive. 

This bill doesn’t make it less expensive. It’s becoming more expensive. 

When Medicare runs out of money, the 

way they’re going to fix it is by decreasing payment to the hospitals and 

doctors that are providing you with 

care, so they’re not going to want to 

take care of you either. 

So let me just talk a little bit about 

a couple of, I don’t know, commonsense 

ideas that we’re talking about on this 

side of the aisle. 

The first of those is health care insurance. I mean, the problem with insurance is it costs too much. So, what 

can we do to make it cost less? Well, I 

mean, I like to compare the difference 

between health insurance and car insurance. 

b 1850 

In car insurance, you can choose 

from a thousand different companies in 

this country from Florida to California 

to Wisconsin to Michigan and pick a 

company that suits your needs, and if 

you don’t like that company, you 

switch to another company. 

Right now, employers control most 

of the health insurance. We need to 


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September 12, 2012 CONGRESSIONAL RECORD — HOUSE H5917 

have a plan that, number one, gives the 

individual control over their health insurance so that you can pick a health 

insurance policy that you like even if 

the employee next to you chooses a different policy. Why should it have to be 

the same? Why should you have to 

carry insurance for acupuncture if you 

never use acupuncture? Some States 

actually mandate the coverage of acupuncture. This is why insurance costs 

so much. 

Your car insurance does not pay for 

an oil change. It does not pay for new 

tires. It does not pay for routine, small 

expenses that you can expect because 

that’s not what insurance is for. Insurance is for a catastrophic event. If you 

want your car insurance to pay for oil 

changes and new tires, it’s going to 

cost a lot of money because that’s not 

the purpose of insurance. The purpose 

of insurance is to protect you from a 

catastrophic event. 

That’s why the Health Savings Account is an important component of 

free market health care reform because 

then you have—for example, say you’re 

working for somebody; instead of paying your health insurance, your employer pays into a Health Savings Account, which is then your money to use 

for health care. And it comes to you 

tax free, so you’re not paying any taxes 

on it. It would be the same as if your 

employer was paying for a health insurance policy for you. 

So with that money, then, you could 

be paying for your routine health care 

out of that. Now, this is money in your 

account now, so you may want to 

choose how you spend that a little 

carefully because that money is in 

your Health Savings Account, that’s 

money that belongs to you now, and 

you can use that any way you want for 

your health care. Or maybe if you don’t 

even use it all, that would be there for 

you in your estate once you die for 

your children. So you want to be careful with that. 

So when you’re going to go get an 

MRI for your shoulder, you may not 

just go to the place that your doctor 

may recommend, you may shop around 

for an MRI. Because I know, for example, that at some places you can get an 

MRI for $2,500, at another place you 

can get an MRI for $600, the same MRI. 

Unless you actually kind of look 

around for it, you’re not going to be 

able to find that deal. You’re not going 

to even know about it because right 

now you don’t even care about it perhaps because your insurance pays it 

and you have a copay that doesn’t affect you. But if you’re taking this 

money out of a Health Savings Account, you’re going to be shopping 

more. That’s the power of transparency 

in cost. 

So, looking around to see where you 

can save money to keep money in your 

Health Savings Account, and then 

shopping for insurance that suits your 

needs, not the needs of the person next 

to you, but suits your needs so that 

you may choose an insurance company, 

like for your car insurance, that differs 

from our neighbor’s but suits you just 

fine. You may have Chevrolet insurance or you may have Cadillac insurance, but it’s your choice. Those are 

just two things that I think would really diminish the cost of medicine and 

not involve taking over everything by 

the government and actually decrease 

costs. 

The other thing that nobody really 

talks about much in the cost of medicine is the cost of malpractice. Malpractice is something that doctors can 

be very uncomfortable with, but sometimes injuries do occur. Is it a good result for a patient who’s been injured to 

have to go to court for 5 or 6 years and 

then have to pay fees for attorneys of 

50 to 60 percent of the judgment after 5 

or 6 years in court? Is that justice for 

an injured patient? Frankly, it’s not 

something that doctors want to see. 

Doctors want to see, if there is actually an injury, let’s have it dealt with 

in a reasonable fashion. Let’s have it 

adjudicated in an administrative law 

situation when there has been an injury. A panel of people can decide, yes, 

there has been actual injury, let’s 

make a judgment, and let’s give that 

patient a judgment, and let’s get it 

done with within several months. That 

would be better. It would eliminate the 

entire cost of a trial, the attorney fees 

and all that, and physicians would like 

it. Patients would like it, I think, because it would give them speedier access to justice. I think that by doing 

that we would eliminate a lot of the 

extra costs that come into medicine. 

Right now, if you come into the 

emergency room for something, a pain 

in your belly, you’re going to get a 

CAT scan pretty much automatically 

because the doctor is afraid of being 

sued. And it doesn’t cost him anything, 

it doesn’t cost the patient anything, 

he’s going to order a CAT scan, he’s 

going to order the x-ray, he’s going to 

order a lot of tests just to protect himself. These are some of the hidden costs 

of malpractice that people don’t really 

think about. They just think about the 

cost of malpractice as simply the cost 

of the doctor’s insurance, which can be 

expensive. 

Right now, different States will have 

different abilities to attract physicians 

because they have different means of 

dealing with malpractice. But I think 

that for the patient, really, we need to 

have a better system where they get 

compensated faster and with less aggravation than the system we have 

now. 

So, I think the main thing that we’re 

talking about on this side, we talk 

about health care reform, is to talk 

about having a conversation with the 

American people. Maybe you don’t 

agree with some of these ideas on how 

to make our health care system better 

and more efficient. Well, I can understand that. Let’s have a conversation. 

Let’s decide how we can do it better. 

Let’s try a pilot program in one 

State. Let’s allow States to experiment 

in how to do things. Let’s not write a 

bill of 2,700 pages in the middle of the 

night that nobody read and then put it 

on the American people and say it’s 

going to be great, but we don’t know 

what’s in it because we haven’t read it, 

and then go through the next 21⁄2 years 

realizing that it’s a mistake. I mean, 

there definitely needs to be room for 

improvement in our system, but can’t 

we have this conversation in an open 

fashion? I think a lot of people even on 

the other side would realize that, hey, 

we made a mistake, but isn’t it more 

important to admit that we made a 

mistake and try to move forward in a 

fashion that actually cuts cost? We see 

it’s not cutting costs. It’s been devastating to the American economy. 

I’ve talked to small business owners 

across my district over the past 2 years 

and they say the same things again and 

again: There’s regulations cost us 

money and our health care cost us 

money; it’s going to make us not be 

able to hire more people. 

So I think we’ve made some real mistakes here in the past, but now is the 

time to address them and move forward 

and try to make some commonsense 

decisions. Frankly, I’m happy to hear 

from people with ideas. I hear ideas 

from people all the time in the district 

that really make some sense and are 

certainly worth trying out. 

So with that, I want to thank the 

members of the Physicians Caucus that 

were here this evening for our evening 

hour, and I yield back the balance of 

my time. 

f 

PROTECT AMERICA 

The SPEAKER pro tempore. Under 

the Speaker’s announced policy of January 5, 2011, the Chair recognizes the 

gentleman from Texas (Mr. GOHMERT) 

for 30 minutes. 

Mr. GOHMERT. Mr. Speaker, at this 

time I want to yield to my doctor 

friend from Texas, a former student of 

Texas A&M University, as myself, a 

guy who, as a junior in college when I 

was a senior in college, helped tutor me 

to make a 98 on the final exam of our 

accounting course. I yield such time as 

he may consume to my friend from 

Texas (Mr. FLORES). 

RECOGNIZING AMERICAN HERO BRIAN BACHMANN

AND ALL FIRST RESPONDERS ACROSS AMERICA

Mr. FLORES. I would like to thank 

my friend from Texas (Mr. GOHMERT) 

for allowing me a few minutes of his 

time. 

Mr. Speaker, I rise today to recognize 

an American hero, Brian Bachmann, 

who served as Precinct 1 Constable of 

Brazos County, Texas, who was killed 

in the line of duty on August 13, 2012. 

Also, with yesterday being the 11th anniversary of 9/11, I also want to recognize first responders all across our 

country. 

As I began to write my reflections for 

this conversation, which I originally 

delivered on August 18, the words that 

kept coming to mind to talk about 

were the words ‘‘home’’ and ‘‘celebration.’’ 


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