House Session 2012 - 03 - 21 - 15 - 03 - 25 - 16 - 05 - 51

ON THIS VOTE THE YEAS ARE 308, THE NAYS ARE 101. THREE ANSWERING PRESENT. AND THE JOURNAL STANDS APPROVED. FOR WHAT PURPOSE DOES THE GENTLEMAN FROM INDIANA RISE? MR. SPEAKER, I RISE TODAY TO ASK UNANIMOUS CONSENT THAT I BE 3697. REMOVED AS A CO-SPONSOR ON H.R. IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERED. FOR WHAT PURPOSE DOES THE GENTLEMAN FROM MISSOURI RISE? MR. SPEAKER, I ASK UNANIMOUS CONSENT TO HAVE MY CO-SPONSOR FROM H.R. 3359. IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERED. FOR WHAT PURPOSE DOES THE GENTLELADY FROM TEXAS RISE? MR. SPEAKER, ON H.RES. 591, ROLL CALL VOTE 119, I WAS DETAINED ON OFFICIAL BUSINESS AND I WOULD LIKE TO INDICATE THAT I WOULD HAVE VOTED NO ON H.RES. 591, THE RULE TO H.R. 5. I ASK UNANIMOUS CONSENT THAT IT BE PLACED APPROPRIATELY IN THE RECORD. WITHOUT OBJECTION, IT WILL SO BE NOTED. -- JACKSON SCRAX JACKSON THANK YOU THANK YOU. FOR WHAT PURPOSE DOES THE GENTLEMAN FROM MICHIGAN RISE? MR. SPEAKER, I WOULD ASK UNANIMOUS CONSENT THAT ALL MEMBERS MAY HAVE FIVE LEGISLATIVE DAYS TO REVISE AND EXTEND THEIR REMARKS AND -- ON THE LEGISLATION AND TO INSERT ON H.R. 5. IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERED. THE GENTLEMAN FROM MICHIGAN. MR. SPEAKER, I WOULD -- WE ARE NOW -- I WOULD ASK FOR ORDER. THE GENTLEMAN FROM MICHIGAN. THE GENTLEMAN FROM MICHIGAN. THE CHAIR DECLARES THE HOUSE IN THE COMMITTEE OF THE WHOLE ON THE STATE OF THE UNION FOR THE CONSIDERATION OF H.R. 5. THE CHAIR APPOINTS THE GENTLEMAN FROM GEORGIA, MR. WESTMORELAND, TO PRESIDE OVER THE COMMITTEE OF THE WHOLE. THE HOUSE IS IN THE COMMITTEE OF THE WHOLE ON THE STATE OF THE UNION FOR CONSIDERATION OF H.R. 5 WHICH THE CLERK WILL REPORT BY TITLE. A BILL TO IMPROVE PATIENT ACCESS TO HEALTH CARE SERVICES AND PROVIDE IMPROVED MEDICARE CARE -- MEDICAL CARE. PURSUANT TO THE RULE, THE BILL IS CONSIDERED READ THE FIRST TIME. GENERAL DEBATE SHALL BE CONFINED TO THE BILL AND AMENDMENTS 591. SPECIFIED IN HOUSE RESOLUTION IT SHALL NOT EXCEED SIX HOURS EQUALLY DIVIDED AMONG AND CONTROLLED BY THE RESPECTIVE CHAIRS AND RANKING MINORITY MEMBERS OF THE COMMITTEES ON ENERGY AND COMMERCE, THE JUDICIARY COMMITTEE AND WAYS AND MEANS. THE CHAIR RECOGNIZES THE GENTLEMAN FROM MICHIGAN, MR. UPTON. THANK YOU, MR. SPEAKER. I WOULD YIELD MYSELF AS MUCH TIME AS I MIGHT CONSUME. THE GENTLEMAN IS RECOGNIZED. MR. SPEAKER, I RISE TODAY IN SUPPORT OF THE PATH ACT WHICH ADDRESSES TWO OF THE MOST GLARING DEFICIENCIES IN THE PRESIDENT'S OVERHAUL OF THE HEALTH CARE SYSTEM. BY WHAT IT DOES, IT ALSO -- AND ALSO BY WHAT IT FAILS TO DO, THE HEALTH CARE LAW THREATENS ACCESS TO QUALT QUALITY HEALTH CARE FOR LITERALLY MILLIONS OF AMERICANS. SECTION 3403 OF THE AFFORDABLE CARE ACT ESTABLISHED THE INDEPENDENT PAYMENT ADVISORY BOARD OR IPAB, A PANEL OF 15 UNELECTED, UNACCOUNTABLE BUREAUCRATS WILL BE GIVEN THE POWER TO MAKE MAJOR DECISIONS REGARDING WHO GOODS AND SERVICES ARE VALUABLE. THESE DECISIONS WOULD THEN BE FASTTRACKED, ESSENTIALLY BYPASSING THE LEGISLATIVE PROCESS, WITH ALMOST NO OPPORTUNITY FOR DISCUSSION OR REVIEW. THE PATH PREVENTS -- THE PATH ACT PREVENTS THIS BY REPEALING IPAB. I SUSPECT THAT MOST AMERICANS STILL BELIEVE THAT PATIENTS AND THEIR DOCTORS SHOULD HAVE A VOICE AND SHOULD BE ABLE TO DECIDE WHAT HEALTH CARE SERVICES THAT THEY FIND VALUABLE. AND I THINK THEY STILL BELIEVE THAT MAJOR POLICY DECISIONS AFFECTING THE MEDICARE PROGRAM AND THE HEALTH CARE SYSTEM IN GENERAL NEED TO GO THROUGH THE REGULAR LEGISLATIVE PROCESS AND BE SUBJECT TO THE NORMAL SYSTEM OF CHECKS AND BALANCES ACCORDING TO THE CONSTITUTION. IT IS ENCOURAGING THAT THE CO-SPONSORS OF LEGISLATION TO REPEAL IPAB INCLUDES 20 DEMOCRATS AND THAT THE BILL WAS FAVORABLY REPORTED OUT OF THE ENERGY AND COMMERCE COMMITTEE EARLIER THIS MONTH WITHOUT ANY RECORDED OPPOSITION. A VOICE VOTE. I ENCOURAGE MY COLLEAGUES ON BOTH SIDES OF THE AISLE TO SUPPORT REPEALING IPAB AND NOT TO BLOCK ITS PASSAGE AT THE EXPENSE OF OUR SENIORS IN THE BLIND EFFORT TO SUPPORT THE PRESIDENT'S SIGNATURE LEGISLATION. THE LEGISLATION TODAY ALSO INCLUDES REFORMS THAT WILL THE COST OF HEALTH CARE, A GLARING EMISSION IN -- OMISSION IN THE PRESIDENT'S HATE CARE LAW. THE HEALTH CARE LAW FAILED TO PROVIDE ANY MEANINGFUL REFORM TO THE MEDICARE SYSTEM WHICH IS ONE OF THE LARGEST COST DRIVERS -- DRIVERS OF OUR HEALTH CARE SYSTEM. THE CURRENT SYSTEM IS RESPONSIBLE FOR AS MUCH AS $200 BILLION A YEAR IN UNNECESSARY SPENDING ON DEFENSIVE MEDICINE. IT FAILS TO COMPENSATE INJURE THEED PATIENTS AND IT THREATENS ACTION TO QUALITY HEALTH CARE BY DRIVING GOOD DOCTORS OUT OF HIGH-RISK SPECIALTIES SUCH AS OBJECTS TRETICS AND NEUROSURGERY. ACCORDING TO THE C.B.O., THESE COMMONSENSE REFORMS WILL REDUCE THE FEDERAL DEFICIT BY $48.6 BILLION OVER THE NEXT 10 YEARS. SO, HOW HAVE OPPONENTS PROPOSED TO FIX THIS PRESENT SYSTEM? THEY WANT TO SPEND MORE, $50 MILLION IN GRANTS FOR STATE DEMONSTRATIONS IS CALLED FOR IN CARE LAW IS NOT A SOLUTION. IT'S AN ABDICATION OF RESPONSIBILITY. THE PRESIDENT PROMISED TO LOOK AT REPUBLICAN IDEAS FOR MEDICAL LIABILITY REFORM, PASSING THIS LEGISLATION IS THE VERY FIRST STEP TOWARDS ALLOWING THE PRESIDENT TO MAKE GOOD ON THAT PROMISE. SO HEALTH CARE DECISIONS SHOULD BE MADE BETWEEN A DOCTOR AND A PATIENT. THAT RELATION DOESN'T WORK WHEN BUREAUCRATS AND TRIAL LAWYERS COME BETWEEN THEM. SO I URGE MY COLLEAGUES TO VOTE IN SUPPORT OF THIS LEGISLATION AND I RESERVE THE BALANCE OF MY TIME. THE GENTLEMAN FROM CALIFORNIA IS RECOGNIZED. MR. CHAIRMAN, I YIELD MYSELF AS MUCH TIME AS I MAY CONSUME. THE GENTLEMAN IS RECOGNIZED. MR. CHAIRMAN, I RISE IN OPPOSITION TO H.R. 5. IT COMBINES TWO VERY BAD IDEAS INTO ONE TERRIBLE BILL THAT IS ANTI-SENIOR, ANTI-CONSUMER AND ANTI-HEALTH. IT'S NO ACCIDENT THAT WE'RE CONSIDERING THE LEGISLATION DURING THE SECOND ANNIVERSARY OF THE AFFORDABLE CARE ACT. BECAUSE THIS IS A THINLY VEILED PARTISAN ATTEMPT TO CONFUSE THE PUBLIC AND OBSCURE THE LAW'S SUCCESS IN COVERING YOUNG PEOPLE , REDUCING COSTS FOR SENIORS AND PROVIDING IMPROVED HEALTH BENEFITS. TITLE 1 OF THE BILL BEFORE US, THE MEDICAL MALPRACTICE PROVISIONS, HAVE BEEN AROUND FOR OVER A DECADE. DEMOCRATIC OR REPUBLICAN THEY HAVE NOT BEEN ENACTED UNDER CONGRESSES AND PRESIDENTS. BECAUSE THEY ARE AN EXTREME INTRUSION ON THE AUTHORITY OF THE STATES TO SET THEIR OWN LIABILITY RULES AND WOULD SHIELD BAD ACTORS FROM ACCOUNTABILITY . WHEN THEY CAUSE INJURY AND DEATH LET'S BE CLEAR. THIS BILL IS MUCH BROADER THAN TRADITIONAL MEDICAL MALPRACTICE LEGISLATION. IT PROTECTS MANUFACTURERS, DISTRIBUTORS, SUPPLIERS, MARKETERS, EVEN PROMOTERS OF HEALTH CARE PRODUCTS. AND IT GIVES THEM PROTECTION EVEN IF THEY INTENTIONALLY CAUSE HARM. INSURANCE COMPANIES AND H.M.O.'S ARE PROTECTED AS WELL. THE BILL SHIELDS DRUG AND DEVICE MANUFACTURERS WITH COMPLETE IMMUNITY FROM PUNITIVE DAMAGES NO MATTER HOW RECKLESS THEIR CONDUCT. SO LONG AS THEIR PRODUCTS WERE AT ONE TIME APPROVED BY THE F.D.A. THIS BILL PREEMPTS STATE ACTION IN AN AREA THAT HAS TRADITIONALLY BEEN LEFT TO THE STATES. TO THE EXTENT THAT WE DO HAVE A MEDICAL MALPRACTICE PROBLEM IN THIS COUNTRY, IT SHOULD BE ADDRESSED AT THE STATE LEVEL. STRIPS AWAY STATE LAW, IT PUTS IN PLACE A FEDERAL SCHEME THAT WILL NOT REDUCE MEDICAL ERRORS, WILL NOT AWARD APPROPRIATE AND ADEQUATE COMPENSATION WHEN AN INJURY OCCURS AND WILL NOT LOWER HEALTH CARE COSTS. THE SECOND PART OF THE BILL WOULD REPEAL THE INDEPENDENT PAYMENT ADVISORY BOARD OR IPAB WHICH HELPS KEEP MEDICARE COSTS UNDER CONTROL IF THEY RISE MORE THAN ANTICIPATED. IPAB'S ROLE IS TO RECOMMEND EVIDENCE-BASED POLICIES TO IMPROVE MEDICARE WITHOUT HARMING PATIENTS. REPEALING IPAB IS THE HEIGHT OF HYPOCRISY. THE MAIN REPUBLICAN ATTACK ON MEDICARE AND THE AFFORDABLE CARE ACT IS THAT WE CANNOT AFFORD THEM. HOUSE REPUBLICANS ARE PROPOSING CHANGES THAT WOULD DESTROY MEDICARE BECAUSE THEY SAY TAKING CARE OF OUR SENIORS JUST COSTS TOO MUCH. AND YET TODAY THEY WILL VOTE FOR A BILL THAT ELIMINATES ONE OF MEDICARE'S COST-SAVING INNOVATIONS AND SADDLES MEDICARE WITH OVER $3 BILLION IN UNNECESSARY COSTS. IT'S NO WONDER THAT THE PUBLIC HOLDS CONGRESS IN SO LITTLE REGARD. THE REPUBLICAN MASTER PLAN FOR MEDICARE IS TO END THE GUARANTEE COVERAGE AND SHIFT MORE COSTS ONTO SENIORS AND PEOPLE WITH DISABILITIES. THEY DON'T HOLD DOWN THE COSTS, THEY SIMPLY SHIFT THEM ON TO SENIORS AND DISABLED PEOPLE, ONTO MEDICARE TO PAY MORE FOR IT OUT OF THEIR OWN POCKETS. THIS IS PART OF THE REPUBLICAN ASSAULT ON MEDICARE. REPEAL THE BACKSTOP IN MEDICARE THAT KEEPS MEDICARE AFFORDABLE FOR SENIORS. I WANT TO BE CLEAR ABOUT WHAT THE IPAB IS AND WHAT IT ISN'T. THE BOARD IS EXPLICITLY IN STATUTE PROHIBITED FROM RATIONING. IT ALSO IS PROHIBITED FROM MAKING RECOMMENDATIONS THAT INCREASE COSTS TO SENIORS OR CUT BENEFITS. IPAB ALSO DOESN'T TAKE AWAY THE ROLE OF CONGRESS. IPAB MAKES RECOMMENDATIONS BUT CONGRESS CAN AND SHOULD ACT ON THOSE RECOMMENDATIONS. WE HEAR A LOT ABOUT THESE UNELECTED BUREAUCRATS. LET ME TELL YOU, AND THIS PLACE THERE ARE A LOT OF ELECTED . BUREAUCRATS. HERE'S THE DIFFERENCE BETWEEN THE DEMOCRATIC APPROACH AND REPUBLICAN APPROACH TO MEDICARE. DEMOCRATS IN CONGRESS ARE COMMITTED TO PRESERVING MEDICARE AND PROTECTING SENIORS' BENEFITS. REPUBLICANS HAVE PROPOSED ENDING MEDICARE'S GUARANTEE OF COVERAGE SO THEY CAN PAY FOR TAX BREAKS FOR OIL COMPANIES AND MILLIONAIRES. LET ME UNDERSCORE THAT. THEY WANT TO TAKE MONEY OUT OF MEDICARE SO THEY CAN GIVE MORE TAX BREAKS TO BILLIONAIRES AND OIL COMPANIES. LIKE SOME OF MY COLLEAGUES, I HAVE CONCERNS ABOUT SOME ASPECTS OF THE IPAB. I DON'T AGREE WITH THE PREMISE THAT WE NEED IPAB TO MAKE CONGRESS DO ITS JOB, BUT NO ONE SHOULD THINK THAT THE HYPERBOLE OF IPAB REPUBLICAN'S RATIONING, FACELESS BUREAUCRATS, PULLING THE PLUG ON PATIENTS, THAT CAME FROM THEIR PROPAGANDA WORD MASTERS. HOUSE REPUBLICANS ARE VOTING TO REPEAL THE INDEPENDENT PAYMENT ADVISORY BOARD BECAUSE THEY SIMPLY WANT TO ELIMINATE MEDICARE. THEY WANT TO PROVIDE VOUCHERS INSTEAD OF BENEFITS. THEY WANT TO SHIFT COSTS TO THE BENEFICIARIES. THEY WANT TO PUT MEDICARE INTO A DEATH SPIRAL AND LEAVE INSURANCE COMPANIES IN CHARGE OF SENIORS' CARE. THEN, IT WOULD BE THE INSURANCE COMPANIES WHO COULD THEN RATION CARE, CUT BENEFITS AND ACCORDING TO THE CONGRESSIONAL BUDGET OFFICE, LIKELY INCREASE OUT-OF-POCKET COSTS BY $6,000. DOES ANYBODY DOUBT INSURANCE COMPANIES RATION CARE? TRY TO GET AN INSURANCE POLICY IF YOU HAVE A PREVIOUS MEDICAL CONDITION. THEY WON'T EVEN COVER YOU. OR THEY CHARGE YOU SO MUCH YOU CAN'T AFFORD IT. IS THAT WHAT WE WANT, LET THE INSURANCE COMPANIES MAKE THESE DECISIONS FOR OUR SENIORS AND DISABLED PEOPLE? H.R. 5 IS A PARTISAN ASSAULT ON MEDICARE, AN ASSAULT ON PATIENTS WHO ARE INJURED BY CARELESS DOCTORS AND DRUG COMPANIES AND AN ASSAULT ON STATES' RIGHTS. I URGE MY COLLEAGUES TO VOTE NO ON H.R. 5, AND I RESERVE THE BALANCE OF MY TIME. THE GENTLEMAN FROM MICHIGAN. I WOULD YIELD TO MR. BARTON, THE GENTLEMAN FROM TEXAS, TWO MINUTES. THE GENTLEMAN FROM TEXAS IS RECOGNIZED FOR TWO MINUTES. I THANK THE DISTINGUISHED CHAIRMAN AND WOULD ASK UNANIMOUS CONSENT TO REVISE AND EXTEND MY REMARKS. WITHOUT OBJECTION, SO ORDERED. THANK YOU. WE HAVE JUST HEARD AN ARGUMENT FROM ONE OF THE AUTHORS, IF NOT THE CHIEF AUTHOR OF THE NEW HEALTH CARE LAW, SO IT'S UNDERSTANDABLE THAT FORMER CHAIRMAN WAXMAN WOULD RISE IN -- INDIGNANT DEFENSE OF HIS PRODUCT AND OPPOSE THIS BILL. BUT H.R. 5, THE PATH BILL, IS IN ACT WALT A RATION -- ACTUALITY A RESPONSE TO REFORM THE AFFORDABLE CARE ACT. THE INDEPENDENT PAYMENT ADVISORY BOARD IS AN INDEPENDENT 15-MEMBER PANEL APPOINTED BY THE PRESIDENT UNLESS THE PRESIDENT DOESN'T APPOINT IT UNLESS THREE OF THE PRESIDENT'S CHIEF ADVISORS BECOME THE BOARD, AND IF THEY DON'T DECIDE TO DO IT THEN ONE PERSON, THE SECRETARY OF HEALTH AND HUMAN SERVICES, HAS THE AUTHORITY WHEN THIS KICKS IN IN 2014 TO MAKE ALL KINDS OF DECISIONS THAT THE RECOGNIZE REAM IMPACT HEALTH CARE IN AMERICA. I DON'T THINK AND A MAJORITY OF MY COLLEAGUES DON'T THINK IT'S THE WAY IT SHOULD BE DONE, SO THIS BILL IN ONE PARAGRAPH AT THE -- I THINK ON PAGE 24, REPEALS THAT SECTION. THAT IS A GOOD START. IT IS NOT THE END-ALL BE-ALL BUT IT'S A GOOD START OF REGAINING CONTROL OF HEALTH CARE BY INDIVIDUALS IN THE MARKETPLACE. THE OTHER THING IT DOES IS PUT IN A MEDICAL MALPRACTICE REFORM THAT IS LONG OVERDUE. THE PRESIDENT IN THE STATE OF THE UNION SAID HE WAS FOR MEDICAL MALPRACTICE. I AM TOLD HE SAID HE'S NOT FOR THIS MEDICAL MALPRACTICE. JUST LIKE HE'S NOT AGAINST THE KEYSTONE X.L. BUT HE CALLS SENATORS TO OPPOSE IT WHEN IT CAME UP IN THE OTHER BODY. WE NEED MEDICAL MALPRACTICE REFORM. INDEPENDENT OBSERVERS HAVE SAID THAT THIS BILL THAT CONGRESSMAN GINGREY OF GEORGIA IS THE ORIGINAL SPONSOR OF WOULD SAVE $48 BILLION OVER I THINK A 10-YEAR PERIOD IF ENACTED. $48 BILLION. THAT'S REAL REFORM. IT DOES NOT PREEMPT STATES. IT ALLOWS THE STATES TO CONTINUE THEIR PARTS OF MEDICAL MALPRACTICE THAT THEY ALREADY ENACTED. SO I ASK THAT WE VOTE FOR THIS PIECE OF LEGISLATION AND THANK THE CHAIRMAN AND THE SUBCOMMITTEE CHAIRMAN AND ALL THE MEMBERS THAT MADE IT POSSIBLE. THE TIME OF THE GENTLEMAN HAS EXPIRED. THE GENTLEMAN FROM CALIFORNIA. MR. CHAIRMAN, I'M AT THIS TIME TO YIELD THREE MINUTES TO THE DISTINGUISHED REAL ESTATE AND SOON-TO-BE CHAIRMAN OF THE HEALTH SUBCOMMITTEE, THE GENTLEMAN FROM NEW JERSEY, MR. PALLONE. THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED FOR THANK YOU. THREE MINUTES. THANK YOU, CHAIRMAN WAXMAN. YOU KNOW, I HAVE A GREAT DEAL OF RESPECT FOR MY FORMER CHAIRMAN AND COLLEAGUE FROM TEXAS, BUT THE PROBLEM THAT I LISTEN TO HIM IS THAT IT'S ALWAYS THE SAME. IT'S MY WAY OR THE HIGHWAY. AND IT'S VERY UNFORTUNATE BECAUSE THERE HAVE BEEN MANY OPPORTUNITIES IN THE COMMITTEE WHERE WE COULD HAVE WORKED TOGETHER AND COME UP WITH LEGISLATION ON THINGS LIKE MALPRACTICE REFORM AND IPAB, BUT THAT'S NOT WHAT WE GET FROM AISLE. THE REPUBLICAN SIDE OF THE THEY JUST CONSTANTLY WANT TO DO THEIR OWN THING AND AS HE SAID, THE PRESIDENT MAY BE FOR MALPRACTICE REFORM, BUT IF HE'S NOT FOR THIS MALPRACTICE REFORM THEN HE'S A BAD GUY. THAT'S THE POINT. WE NEED TO GET TOGETHER. IF WE ARE EVER GOING TO ACCOMPLISH ANYTHING WE NEED TO GET TOGETHER AND I DON'T SEE THAT ON THE REPUBLICAN SIDE OF THE AISLE TODAY. I AM VERY DISAPPOINTED IN THE PROCESS OF CONSIDERING H.R. 5. I AM DISAPPOINTED AND FRUSTRATED THAT MY REPUBLICAN COLLEAGUES HAD THE OPPORTUNITY TO BRING TO THE FLOOR THAT I AND SOME OF MY DEMOCRATIC COLLEAGUES SUPPORTED BUT WHAT THEY DECIDED TO DO INSTEAD IS SIMPLY PLAY POLITICAL GAMES, AGAIN. POLITICAL GAMES OVER AND OVER ALL SECTORS OF THE HEALTH CARE INDUSTRY AGREE THAT THE INDEPENDENT PAYMENT ADVISORY BOARD, IPAB, SHOULD BE REPEALED. I'M THE FIRST ONE TO TELL YOU HOW MUCH I AM OPPOSED TO IPAB. IN FACT, DURING THE ENERGY AND COMMERCE COMMITTEE SUBCOMMITTEE ON HEALTH MARKUP I VOTED IN FAVOR OF ITS REPEAL. BUT UNFORTUNATELY, MY REPUBLICAN COLLEAGUES HAVE NO INTEREST IN TRULY REPEALING IPAB. THEY ONLY CARE ABOUT DEFACING THE AFFORDABLE CARE ACT AND CONTINUING THEIR POLITICAL GAME OF REPEALING THE LAW PIECE BY PIECE. NOW, I KNOW THAT BECAUSE THEY'VE DECIDED TO PAY FOR THE IPAB REPEAL WITH H.R. 5, ONE OF THE MOST CONTROVERSIAL AND HISTORICALLY PARTISAN BILLS OF THE PAST DECADE. WE'VE BEEN THROUGH THE SAME DEBATE EVERY TIME, EVERY YEAR, ON THE FLOOR AGAIN. EACH YEAR THE REPUBLICANS HAVE BEEN IN CHARGE, WE'RE FORCED TO CONSIDER IDENTICAL LEGISLATION THAT CONTAINS THE EXACT SAME AREAS IN WHICH WE REMAIN DIVIDED. IN FACT, THE REPUBLICANS WERE NOT ENABLE TO ENACT THIS BILL INTO LAW WHEN THEY HAD THE MAJORITIES IN THE HOUSE AND SENATE AND PRESIDENCY AND THE REASON IS BECAUSE THEY HAVE ZERO DESIRE TO SOLVE THE PROBLEMS OF THIS COUNTRY. ALL THEY'RE INTERESTED IN ACCOMPLISHING IS A POLITICAL MESSAGE TO TAKE HOME TO THEIR DISTRICTS. I'VE SAID AGAIN AND AGAIN I WILL WORK WITH MY COLLEAGUES IN TRULY ADDRESSING MALPRACTICE REFORM BUT THOSE CALLS HAVE GONE UNANSWERED. THERE HAS BEEN LITTLE EFFORT ON THE PART OF THE REPUBLICANS TO REACH ACROSS THE AISLE AND WORK WITH DEMOCRATS ON A SATISFACTORY SOLUTION TO MEDICAL LIABILITY REFORM. I DO UNDERSTAND THAT MEDICAL MALPRACTICE AND LIABILITY IS A VERY REAL PROBLEM FOR DOCTORS IN MY HOME STATE AND IN THE COUNTRY BUT H.R. 5 IS NOT THE ANSWER. ANY TRUE REFORM MUST TAKE A BALANCED APPROACH AND INCLUDE PROTECTIONS FOR THE LEGAL RIGHTS OF PATIENTS AND BE LIMITED TO MEDICAL MALPRACTICE. TODAY, MY VOTE ON THIS PACKAGE IS A NO VOTE ON H.R. 5 ALONE. AS I'VE STATED, IT'S TOO CONTROVERSIAL AND EXTREME IN ITS CURRENT FORM, ALTHOUGH IT'S DESCRIBED AS A MEDICAL MALPRACTICE MEASURE, H.R. 5 EXTENDS FAR BEYOND THE FIELD OF MALPRACTICE LIABILITY. I'M JUST EXTREMELY DISAPPOINTED. I'M BEING HONEST IN SAYING I AM REPUBLICAN LEADERSHIP HAS VERY DISAOPPONENTED THAT THE ROBBED MANY DEMOCRATS OF THEIR ABILITY TO VOTE CLEANLY ON IPAB REPEAL AND HAVE INSTEAD YET AGAIN POLITICIZED THIS BODY. WHEN WILL YOU LEARN? I YIELD BACK. THE TIME OF THE GENTLEMAN HAS EXPIRED. THE GENTLEMAN FROM MICHIGAN. MR. SPEAKER, I'D YIELD TWO MINUTES TO THE GENTLELADY FROM NORTH CAROLINA, THE VICE CHAIRMAN -- CHAIRWOMAN OF THE ENERGY AND COMMERCE COMMITTEE, MRS. MYRICK. THE GENTLELADY FROM NORTH CAROLINA IS RECOGNIZED FOR TWO MINUTES. THANK YOU, MR. CHAIRMAN. MR. SPEAKER, THIS IS WASHINGTON SO WE HAVE TO HAVE AN ACRONYM FOR EVERYTHING UP HERE. THE IPAB ISN'T A NEW TECHY TECHNIQUE BUT AN EXAMPLE OF ONE MISGUIDED PARTS OF LAW. THE BUDGET-BUSTING HEALTH CARE ABOUT? WHAT'S THIS DEBATE REALLY WE ALL KNOW THAT MEDICARE'S HEADED TOWARD FINANCIAL CATASTROPHE, AND THE HEALTH REFORM LAW ONLY SUCCEEDED IN PUTTING THE PROGRAM IN A MORE PRECARIOUS POSITION. THERE'S NO EASY SOLUTION TO THIS PROBLEM BUT REPUBLICANS HAVE PUT FORWARD A PLAN THAT WOULD ACTUALLY SET THE PROGRAM ON A HEALTHY FISCAL PATH AGAIN WITHOUT HURTING THOSE WHO ARE ALREADY ON THE PROGRAM. OF COURSE, BECAUSE THIS IS WASHINGTON, RATHER THAN HAVING A HARDY DEBATE, THESE PROPOSALS CONTINUE TO BE DEMAGOGUED AND DERIDED. INSTEAD, THE HEALTH REFORM BILL GAVE US IPAB, AN UNACCOUNTABLE BILL TAXED WITH LIMITING PROCEDURES AND TREATMENTS IN ORDER TO CONTROL COSTS. IT'S A TOPDOWN, UNCONSTITUTIONAL, INEFFECTIVE AND INEFFICIENT WAY TO SOLVE MEDICARE'S FISCAL PROBLEMS. AND IF YOU THINK THIS BOARD WON'T MAKE RECOMMENDATIONS TO LIMIT THE USE OF EXPENSIVE BUT LIFE-SUSTAINING TREATMENT, YOU HAVEN'T BEEN PAYING ATTENTION. BUT HERE'S SOMETHING THAT GETS LOST IN THE DEBATE. IPAB JUST DOESN'T APPLY TO MEDICARE BENEFICIARIES FOR SENIORS WHO ARE ON GOVERNMENT PROGRAMS. FIRST OFF, THOSE OF US WHO HAVE BEEN HERE FOR A WHILE KNOW THAT PRIVATE INSURERS TEND TO FOLLOW MEDICARE. WE SEE IT ALL THE TIME. ONCE MEDICARE CHANGES TREATMENT, THOSE DECISIONS PUSH PRIVATE PAYERS TO ALSO MOVE IN THAT DIRECTION BECAUSE SO MUCH OF OUR HEALTH CARE SYSTEM RELIES ON MEDICARE'S POLICIES. THE GOVERNMENT ALREADY CONTROLS SO MUCH OF OUR HEALTH CARE SYSTEM, AND THAT'S WHY ALL THESE INEFFICIENCIES ABOUND. IF THAT WEREN'T ENOUGH, STARTING IN 2015, THE IPAB CAN MAKE DECISIONS ABOUT WHAT PRIVATE PLANS WILL COVER. YES, 15 PEOPLE WILL BE DECIDING COVERING. WHAT PRIVATE COMPANIES WILL BE THAT'S WHAT'S FUNDAMENTALLY WRONG WITH THE HEALTH CARE REFORM LAW, AND WE SHOULD REPEAL THE WHOLE THING. BUT IN THE MEANTIME, LET'S REPEAL THIS ILL CONCEIVED BOARD AND ADDRESS THE COUNTRY'S MEDICAL MALPRACTICE PROBLEMS WHILE WE'RE AT IT. THE TIME OF THE GENTLELADY HAS EXPIRED. THE GENTLEMAN FROM CALIFORNIA. MR. CHAIRMAN, I'M PLEASED TO YIELD TO AN IMPORTANT MEMBER OF OUR COMMITTEE, THE GENTLEMAN FROM TEXAS, MR. GREEN, FOR TWO MINUTES. THE GENTLEMAN FROM MINUTES. TEXAS IS RECOGNIZED FOR TWO THANK YOU, MR. SPEAKER, AND I THANK MY COLLEAGUE AND RANKING MEMBER ON OUR ENERGY AND COMMERCE COMMITTEE. I RISE IN OPPOSITION TO THIS BILL. I'M NOT AS OPPOSED TO ALL OF IT. IN FACT, I AM A STRONG SUPPORTER OF THE REPEAL OF THE IPAB PROVISIONS. HOWEVER, WE CAN'T UNDERMINE AMERICANS RIGHT THROUGH COURT PLACING ARBITRARY LIMITS ON MALPRACTICE CASES. DOES. THAT'S WHAT THIS BILL BEFORE US IT -- WE SHOULDN'T SOLVE A BAD POLICY PROBLEM BY IMPLEMENTING MORE BAD POLICY. WE SHOULD BE PASSING GOOD LEGISLATION, NOT TRYING TO PASS SOMETHING THAT HAS NO CHANCE OF BECOMING LAW AND THAT'S WHAT THIS BILL DOES. THE AFFORDABLE CARE ACT, THE STATUTE OF THIS BILL, HAS HAD ENORMOUS POSITIVE IMPACT OF THE CONSTITUENTS I REPRESENT. IN THE LAW IT'S NOT TOTALLY EFFECTIVE YET BUT IT'S GETTING BETTER. I WAS PROUD TO SUPPORT THIS LANDMARK LEGISLATION AS PART OF THE ENERGY AND COMMERCE COMMITTEE AND ON THE HEALTH SUBCOMMITTEE. BEFORE THE PASSAGE OF THE AFFORDABLE CARE ACT, OUR CONGRESSIONAL DISTRICT HAD THE LARGEST PERCENTAGE OF UNINSURED THAN ANY DISTRICT IN OUR COUNTRY. WE STILL HAVE A LOT OF WORK TO DO BUT THINGS ARE GETTING BETTER. FOR THE LAST TWO YEARS, 53,000 CHILDREN IN OUR DISTRICT CAN'T LOSE THE SECURITY OFFERED BY HEALTH INSURANCE DUE TO PRE-EXISTING CONDITIONS. 3,400 SENIORS SAVED AN AVERAGE OF $540 ON PRESCRIPTION DRUGS. 9,000 YOUNG PEOPLE NOW HAVE HEALTH INSURANCE THAT THEY DIDN'T HAVE BEFORE THE AFFORDABLE CARE ACT. THE AFFORDABLE CARE ACT IS NOT PERFECT BUT NO BILL IS PERFECT. THE BILL BEFORE US TODAY IS FAR FROM PERFECT. I SUPPORT THE REPEAL OF IPAB. I OPPOSED IPAB IN 2009 WHEN IT CAME UP IN OUR COMMITTEE AND MARKUP OF THE AFFORDABLE CARE ACT. I DO NOT BELIEVE A PANEL OF OUTSIDERS APPOINTED BY THE PRESIDENT SHOULD TAKE RESPONSIBILITIES FOR WHAT CONGRESS NEEDS TO DO IN MAKING DECISIONS ON MEDICARE PAYMENT RATES. THAT'S PART OF OUR JOB AS A MEMBER OF CONGRESS. HOWEVER, THIS BILL HAS STEPPED TOO FAR, AND I WANT THE OPPORTUNITY TO VOTE ON FREESTANDING IPAB REPEAL BUT I CAN'T VOTE ON H.R. 5 BECAUSE IT'S A BRIDGE TOO FAR. I YIELD BACK MY TIME. THANK YOU. THE TIME OF THE GENTLEMAN HAS EXPIRED. THE GENTLEMAN FROM MICHIGAN. MR. CHAIRMAN, AT THIS POINT I YIELD TWO MINUTES TO THE GENTLEMAN FROM FLORIDA, MR. STEARNS. THE GENTLEMAN FROM FLORIDA IS RECOGNIZED FOR TWO MINUTES. I THANK THE DISTINGUISHED CHAIRMAN. THIS BILL, CONTRARY TO THE GENTLEMAN FROM TEXAS SAID, IS AN OPPORTUNITY FOR HIM TO VOTE TO NOT LET BUREAUCRATS MAKE THE DECISION. HE HAS A CHANCE TO DO THIS. I'M A LITTLE SURPRISED WHY HE'S SAYING HE'S AGAINST THE BILL. I THINK MANY OF US WILL REPEAT THE SAME ARGUMENTS. THE FUNDAMENTAL POINT IS THIS BILL WILL SAVE ALMOST $50 BILLION OVER 10 YEARS. MANY PEOPLE ON THIS SIDE DON'T WANT TO SAVE MONEY? I THINK EVERYBODY ON BOTH SIDES MONEY. OF THE AISLE WOULD LIKE TO SAVE SO THIS IS REALLY STOPPING THIS DEFENSIVE MEDICINE AN UNTOLD AMOUNT OF LITIGATION BY PASSING THIS BILL. THIS COULD EFFECTIVELY CREATE PREMIUMS FOR EVERYBODY AND LOWER THE COST OF HEALTH CARE. THIS BILL WOULD ELIMINATE THE INDEPENDENT PAYMENT ADVISORY BOARD, IT'S GIVEN THE COLONIAL NAME OF IPAB. JUST THIS MORNING AS CHAIRMAN OF THE OVERSIGHT AND INVESTIGATION COMMITTEE, WE HELD A HEARING ON THE PRESIDENT'S FAILED HEALTH CARE LAW. IT'S CLEAR THAT COUNTLESS PAGES OF REGULATION, RULES, REQUIREMENTS FOR OBAMACARE HAVE BEEN INCREDIBLY CONFUSING. AND WHEN WE HAD THIS HEARING IT WAS BROUGHT UP CLEARLY THAT THIS BILL OVER TWO YEARS HAS GIVEN ALMOST 1,700 WAIVERS TO ENTITIES WHO CANNOT COMPLY WITH THIS HEALTH CARE BILL. SO MY CONSTITUENTS AND INDIVIDUALS THROUGHOUT THIS COUNTRY WHO VIEW THESE MASSIVE NEW RULES AND REGULATIONS AS INCREASING INTERFERENCE OF THE FEDERAL GOVERNMENT INTO THEIR AND OBVIOUSLY BUSINESS LIVES. COMMUNITIES, THEY'RE SEEKING WAIVERS, 1,700 ENTITIES ASKING FOR WAIVERS BECAUSE THEY CAN'T COMPLY. IT CREATES UNCERTAINTY IN THE MARKETPLACE. SO, FOR ALL THESE REASONS WE NEED -- MUST PASS THIS BILL. IN FACT, IPAB IS S.G.R. ON STEROIDS. RATHER THAN FIXING THE S.G.R. PROBLEM IN THE HEALTH CARE LAW, DEMOCRATS ARE HAPPY TO ALLOW CONTINUED CUTS TO PHYSICIAN PAYMENTS AND THEN DOUBLE DOWN ON FURTHER CUTS THROUGH IPAB. THIS IS A GROUP OF 15 UNELECTED BUREAUCRATS WHO WOULD SAVE MEDICARE BY MAKING DRACONIAN CUTS TO PROVIDER PAYMENTLESS. DEMOCRATS WANTED TO CONTROL -- PAYMENTS. DEMOCRATS WANTED TO CONTROL THE FUTURE COSTS OF MEDICARE BY GIVING UNELECTED BUREAUCRATS THE AUTHORITY TO CUT PAYMENTS TO DOCTORS AND HOSPITALS. IF DEMOCRATS ARE SERIOUS THEY WOULD SUPPORT THIS BILL. SAID WE HAVE TO -- NANCY PELOSI SAID WE HAVE TO PASS THIS BILL TO FIND OUT WHAT'S IN IT. I'M DETERMINED TO MAKE SURE WE DON'T HAVE TO FULLY IMPLEMENT COSTS. THE BILL SO WE CAN SEE WHAT IT WITH THAT I YIELD BACK. THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM CALIFORNIA. MR. CHAIRMAN, I'M ALWAYS AMUSED WHEN I HEAR PEOPLE TALK ABOUT GOVERNMENT INTERFERENCE IN OUR LIVES. IF PEOPLE THINK MEDICARE IS AN UNJUST GOVERNMENT INTERFERENCE IN THEIR LIVES, THEY CAN FOREGO THEIR MEDICARE. BUT I DON'T KNOW TOO MANY PEOPLE WHO WOULD LIKE TO DO THAT AND WHAT THE REPUBLICANS ARE PROPOSING IS TO TAKE THAT MEDICARE AWAY FROM THEM AND TURN IT OVER TO PRIVATE INSURANCE. PUT THAT TO A VOTE. I DON'T THINK THE AMERICAN PEOPLE WOULD SUPPORT THAT EATER. I'M PLEASED AT THIS TIME -- EITHER. I'M PLEASED AT THIS TIME TO YIELD TO A VERY IMPORTANT MEMBER ON OUR COMMITTEE, ESPECIALLY IN THE HEALTH COMMITTEE, THE REPRESENTATIVE FROM THE *** ISLANDS, MRS. CHRISTENSEN, FOR TWO MINUTES. THE GENTLELADY FROM THE *** ISLANDS IS RECOGNIZED FOR TWO MINUTES. I THANK YOU FOR YIELDING. MR. SPEAKER, I RISE TODAY IN A TIME WHEN WE SHOULD ALL BE CELEBRATING THE MANY GREAT SUCCESSES OF THE AFFORDABLE CARE ACT ON ITS SECOND ANNIVERSARY. DEMOCRATS HAVE RIGHTLY BEEN APPLAUDING THE HEALTH CAN CANNED -- THE HEALTH AND ECONOMIC BENEFITS OF AFFORDABLE, RELIABLE ACCESS TO HIGH QUALITY HEALTH CARE SERVICES BROUGHT ABOUT BY THAT LANDMARK LAW. NOT SO WITH OUR REPUBLICAN COLLEAGUES WHO CHOOSE TO IGNORE OR MISREPRESENT THE MANY BENEFITS MILLIONS OF PEOPLE HAVE BEEN ENJOYING BECAUSE OF THE AFFORDABLE CARE ACT. THEN COMES THIS DISASTROUS MARRIAGE BETWEEN TWO BILLS. ONE THAT WILL REPEAL THE INDEPENDENT PAYMENT ADVISORY BOARD WITH SOME -- WHICH SOME DEMOCRATS LIKE MYSELF SUPPORT AND THE OTHER MALPRACTICE BILL WHICH I STRONGLY OPPOSE BECAUSE IT WILL TRAMPLE STATES' RIGHTS, PROVIDING EXTRAORDINARY DEVICE AND HEALTH INSURANCE PROTECTIONS FOR DRUG AND MEDICAL COMPANIES, MAKING IT NEARLY IMPOSSIBLE FOR THOSE HARMED TO SEEK AN ACHIEVED JUSTICE. I SUPPORT THE IPAB REPEAL BECAUSE IN ITS CURRENT FORM IT WILL NOT ACHIEVE SIGNIFICANT SAVINGS OR ENSURE QUALITY ACCESS TO HEALTH CARE UNDER MEDICARE. ADDITIONALLY, A PHYSICIAN WHO PRACTICAL -- AS A PHYSICIAN WHO PRACTICED FOR MORE THAN TWO DECADES, I'M OPPOSED TO ITS BROAD AUTHORITY TO MAKE RECOMMENDATIONS THAT WOULD DETRIMENTALY AFFECT HEALTH CARE PROVIDERS AND EVENTUALLY THE MEDICARE BENEFICIARIES. HOWEVER ATTACHING AT THE VERY LAST MINUTE A MEDICAL MALPRACTICE BILL THAT PROVIDES PROTECTION TO EVERY ENTITY INVOLVED IN MEDICAL MALPRACTICE AND HEALTH CARE LAWSUITS EXCEPT THE VICTIM IS JUST PLAIN WRONG. AND NO PUN INTENDED BUT ADDING INSULT TO INJURY IS THE FACT THAT THE MEDICAL MALPRACTICE BILL IS COMPLETELY OUTDATED. THE BILL WAS DESIGNED MORE THAN TWO DECADES AGO. BACK THEN WE ZR CHALLENGE WITH MAGAZINE -- WE DID HAVE CHALLENGE WITH MALPRACTICE INSURANCE BUT THOSE CHALLENGES HAVE BEEN ADDRESSED. THIS COUNTRY. TODAY WE DO NOT HAVE A CRISIS IN I STRONGLY OPPOSE H.R. 5 AND ENCOURAGE MY FRIENDS ON THE OTHER SIDE OF THE AISLE IN THE FUTURE, IF IT'S MORE THAN JUST POLITICAL RHETORIC, TO QUIT WHILE THEY'RE AHEAD. THANK YOU AND I YIELD BACK THE BALANCE OF MY TIME. THE GENTLELADY'S TIME HAS EXPIRED. THE GENTLEMAN FROM PENNSYLVANIA. AT THIS TIME I YIELD TO DR. BURGESS. THE GENTLEMAN FROM TEXAS IS RECOGNIZED FOR TWO I THANK THE MINUTES. CHAIRMAN FOR THE RECOGNITION. MR. SPEAKER, I WILL FOCUS MY REMARKS ON THE INDEPENDENT PAYMENT ADVISORY BOARD BECAUSE IT ENCOMPASSES ALL THAT IS WRONG WITH THE AFFORDABLE CARE ACT. THE HEALTH LAW ITSELF CONTAINS POLICIES THAT WILL DISRUPT THE PRACTICE OF MEDICINE. ALONG WITH THE MANY EXCESSES AND CONSTRICTIONS WITHIN THE LAW, THE INDEPENDENT PAYMENT ADVISORY BOARD REPRESENTS THE VERY WORST OF THE WORST OF WHAT WILL HAPPEN. AS A PHYSICIAN, AS A MEMBER OF CONGRESS, AS A FATHER, AS A HUSBAND, AS A PATIENT IN HIS 60'S I AM OFFENDED BY THE BOARD. INDEPENDENT PAYMENT ADVISORY THIS BOARD IS NOT ACCOUNTABLE TO ANY CONSTITUENCY AND IT EXISTS ONLY TO CUT PROVIDER PAYMENTS TO FIT A MATHEMATICALLY CREATED TARGET. THE BOARD THROWS THE GOVERNMENT INTO THE MIDDLE OF WHAT SHOULD BE A SACRED RELATIONSHIP BETWEEN THE DOCTOR AND THE PATIENT. THE DOCTOR AND THE PATIENT SHOULD HAVE THE POWER TO INFLUENCE PRICES AND GUIDE CARE, NOT THIS BOARD. BEYOND CONTROLLING MEDICARE, THE INDEPENDENT PAYMENT ADVISORY BOARD'S RATIONING WILL SERVE AS A BENCHMARK FOR PRIVATE CHANGES. INSURANCE CARRIERS' OWN PAYMENT THAT'S RIGHT. ALTHOUGH MR. WAXMAN, THE MOMENT THE FACT THAT PRIVATE INSURANCE WOULD BE PART OF MEDICARE, THIS THING WILL ACTUALLY DICTATE THE BEHAVIOR OF PRIVATE INSURANCE'S -- PRIVATE INSURANCES IN THIS COUNTRY. THE BOARD WILL HAVE FAR-REACHING IMPLICATIONS BEYOND MEDICARE FOR OUR NATION'S DOCTORS. BECAUSE OF THE LIMITATIONS ON WHAT THE CONTROL BOARD CAN CUT, THE MAJORITY OF SPENDING REDUCTIONS WILL COME FROM CUTS TO PART B, DOCTORS' FEES. DOCTORS WILL BECOME INCREASINGLY UNABLE TO PROVIDE THE SERVICES THAT THE BOARD HAS DECIDED ARE NOT VALUABLE. IS THE ANSWER TO SQUEEZE OUT DOCTORS? SOUNDS LIKE RATIONING TO ME. SO WHICH SOUNDS LIKE THE BETTER OPTION? MEDICARE BANKRUPTCY AND AN UNELECTED BOARD DECIDING THE CARE OF MEDICARE BENEFICIARIES OR DOCTORS AND PATIENTS DECIDING AND DEFENDING THE RIGHT OF THE CARE THAT THEY RECEIVE? THE FUTURE OF AMERICAN HEALTH CARE SHOULD NOT BE LEFT UP TO TO TO THIS PANEL. IT'S AN ALOOF ARBITRARIER OF HEALTH CARE WHO DEPEND ON HEALTH CARE. I'LL JUST LEAVE YOU WITH A QUOTE FROM THE AMERICAN MEDICAL ASSOCIATION. IT PUTS OUR HEALTH POLICY AND PAYMENT DECISIONS IN THE HANDS OF AN INDEPENDENT BODY WITH NO ACCOUNTABILITY, MAJOR CHANGES IN THE MEDICARE PROGRAM SHOULD BE DECIDED BY ELECTED OFFICIALS. ASSOCIATION. FROM THE AMERICAN MEDICAL I YIELD BACK. THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM CALIFORNIA. MR. CHAIRMAN, I AM PLEASED AT THIS POINT TO YIELD TO MY COLLEAGUE FROM CALIFORNIA, ONE OF THE KEY PEOPLE IN THE AUTHORSHIP OF THE AFFORDABLE CARE ACT, GEORGE MILLER, FOR THREE MINUTES. THE GENTLEMAN FROM CALIFORNIA IS RECOGNIZED FOR THREE MINUTES. I THANK THE GENTLEMAN FOR YIELDING. MR. SPEAKER, I CAME TO CONGRESS IN 1975 AND SINCE THAT TIME I'VE BEEN INVOLVED IN THE DEBATE OVER NATIONAL HEALTH REFORM PROPOSALS. THROUGHOUT THESE DEBATES LAWMAKERS STRUGGLE WITH HOW TO CONTROL COSTS WITHOUT SACRIFICING QUALITY CARE. UNFORTUNATELY FOR DECADES CONGRESS CHOSE TO KICK THE CAN WHILE COSTS CONTINUED TO CLIMB AND TO SOAR. THIS TREND ENDED WITH THE AFFORDABLE CARE ACT. FOR THE FIRST TIME CONGRESS PUT IN PLACE SPECIFIC IDENTIFIABLE MEASURES THAT WILL MAKE OUR HEALTH CARE SYSTEM MORE TRANSPARENT AND EFFICIENT. THIS INCLUDES THE CREATION OF THE INDEPENDENT PAYMENT ADVISORY BOARD, THIS BOARD WILL BE A BACKSTOP TO ENSURE THAT FEDERAL HEALTH PROGRAMS OPERATE EFFICIENTLY AND EFFECTIVELY FOR BOTH SENIORS AND THE TAXPAYERS. WE NEED TO GIVE THESE BECAUSE WITHOUT THESE INNOVATIONS A CHANCE TO WORK INNOVATIONS THERE IS LITTLE HOPE THAT -- TO GET HEALTH CARE COSTS UNDER CONTROL. 535 MEMBERS OF CONGRESS CANNOT BE NOR SHOULD THEY BE THE DOCTORS WHO THINK THEY KNOW BEST OF THE PRACTICE OF EVERY MEDICAL FIELD. 535 MEMBERS OF CONGRESS ARE NOT IMMUNE TO SPECIAL INTERESTS THAT HAVE A FINANCIAL STAKE IN THE DECISIONS THAT ARE MADE. NOT NECESSARILY THE BEST INTERESTS OF THE SENIOR, THE MEDICINE IN THIS COUNTRY. TAXPAYERS OR THE DELIVERY OF BUT PERHAPS IN THE BEST INTEREST OF THEIR COMPANIES. THAT'S WHY THE AFFORDABLE CARE CREATED AN INDEPENDENT BOARD OF HEALTH EXPERTS TO MAKE RECOMMENDATIONS TO IMPROVE THE SYSTEM. IT DOES NOT USURP THE ROLE OF CONGRESS, IT SIMPLY ACTS AS A FAILSAFE IN CASE GOVERNMENT SPENDING EXCEEDS BENCHMARKS. UNDER THE LAW DOCTORS WILL ATTAIN FULL AUTHORITY TO RECOMMEND THE TREATMENT THEY THINK ARE BEST FOR PATIENTS. THE LAW ALSO PROHIBITS THE RECOMMENDATIONS THAT WOULD RATION CARE, CHANGE PREMIUMS OR REDUCE MEDICARE BENEFITS. IN SHORT THIS INDEPENDENT BOARD IS ABOUT STRENGTHENING MEDICARE WITH EVIDENCE-BASED DECISION MAKING. WITHOUT INNOVATIVE REFORMS LIKE THE BOARD, MEDICARE'S FUTURE WILL BE PUT IN JEOPARDY, KICKING THIS CAN DOWN THE ROAD ANY FURTHER WILL ONLY BOLSTER THOSE WHO SEEK TO KILL MEDICARE. WE MUST STRENGTHEN MEDICARE, NOT END THE MEDICARE GUARANTEE. THE AFFORDABLE HEALTH CARE ACT STRENGTHENS MEDICARE, EXTENDS THE LIFE OF THE TRUST FUND AND HAS ALREADY LOWERED THE COST FOR MILLIONS OF SENIORS. HOWEVER, WITHOUT INNOVATION, OUR CURRENT SYSTEM WILL BE UNSUSTAINABLE FOR OUR NATION'S FAMILIES, BUSINESSES AND TAXPAYERS. THE REPUBLICAN PLAN TO END ALTERNATIVE. MEDICARE GUARANTEE IS NO INNOVATION IS THE ALTERNATIVE. AND I URGE MY COLLEAGUES TO THE INDEPENDENT PAYMENT ADVISORY BOARD AND REJECT THIS LEGISLATION. THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM PENNSYLVANIA. MR. CHAIRMAN, I WOULD MUCH RATHER HEAR FROM SOME OF OUR DOCTOR FRIENDS WHO ARE SPEAKING SO ELOQUENTLY. I HAVE ANOTHER DOCTOR MEMBER OF THE HEALTH SUBCOMMITTEE FROM PENNSYLVANIA, DISTINGUISHED GENTLEMAN, DR. TIM MURPHY. I YIELD FOR TWO MINUTES. THE GENTLEMAN FROM PENNSYLVANIA IS RECOGNIZED FOR TWO MINUTES. I THANK THE GENTLEMAN. WHEN I WAS A STATE SENATOR OF PENNSYLVANIA I TOOK ON H.M.O.'S AND PLANS THAT MADE DECISIONS BY ACCOUNTANTS AND M.B.A.'S AND NOT M.D.'S. IT WAS IMPORTANT TO DO THAT BECAUSE WE FOUND THAT DOCTORS COULD NOT MAKE DECISIONS EVEN THOUGH THEY WERE SUPPOSEDLY EMPOWERED TO DO THAT. INSTEAD, THERE WAS BOARDS THAT WOULD MAKE DECISIONS FOR THEM. AND NOW HERE WE ARE WITH DEJA VU ALL OVER AGAIN. WE'RE ABOUT TO HAVE 15 PRESIDENTIAL APPOINTMENTS, EVEN UNDER THE ADVICE OF BOTH CHAMBERS OF COMMERCE -- EXCUSE ME, BOTH CHAMBERS OF CONGRESS, NONE OF THEM ARE INVOLVED WITH MEDICINE, MAKING DECISIONS WITH REGARDS TO WHO MAKES DECISIONS FOR YOU. IN TERMS OF WHAT GETS PAID AND HOW MUCH GETS PAID TO DOCTORS AND HOSPITALS. BUT AS IT GOES THROUGH, WHAT HAPPENS IF THERE'S A DECISION THAT SAYS IT'S NOT GOING TO BE COVERED? CAN YOU CALL THE BOARD ITSELF? NO. CAN YOU -- CAN YOUR DOCTOR CALL NO. THE BOARD? BOARD? CAN YOUR HOSPITAL CALL THE NO. CAN YOUR MEMBER OF CONGRESS CALL NO. THE BOARD? IN FACT IT WILL TAKE AN ACT OF CONGRESS PASSED BY THE HOUSE AND SENATE AND SIGNED BY THE PRESIDENT TO OVERRIDE THAT. SO WHO IS THIS PANEL AND WHAT DECISIONS CAN THEY MAKE? IT'S PEOPLE WHO ARE INVOLVED WITH FINANCE, ECONOMICS, HOSPITAL ADMINISTRATION, REIMBURSEMENTS. SOME PHYSICIANS, A HEALTH PROFESSIONALS, PHARMACY BENEFIT MANAGERS, EMPLOYERS, PEOPLE INVOLVED WITH OUTCOME RESEARCH AND MEDICAL HEALTH SERVICES AND ECONOMICS. WHAT'S MISSING FROM THAT IS ANY REQUIREMENT THAT IT MIGHT BE PEOPLE WHO HAVE KNOWLEDGE OF AS ONCOLOGY, PEDIATRICS, GERIATRIC MEDICINE, FAMILY MEDICINE, SURGERY, AND THE LIST GOES ON AND ON. SO IN OTHER WORDS WHAT'S GOING TO HAPPEN HERE IS NOT ONLY YOU DON'T LIKE YOUR DOCTOR, YOU MAY NOT BE ABLE TO KEEP IT, BUT IF YOUR DOCTOR DOESN'T LIKE WHAT IS GOING TO BE COVERED, THERE'S ABOUT THAT. NOTHING THAT HE OR SHE CAN DO THIS IS NOT THE PRACTICE OF MEDICINE. THIS IS THE PRACTICE OF GOVERNMENT OVERTAKING MEDICINE. WHILE AMERICANS WERE BEGGING FOR US TO FIX A BROKEN SYSTEM WHAT THEY GOT WAS HALF A TRILLION IN NEW TAXES, TRILLIONS -- HALF A TRILLION IN MEDICARE CUTS, TRILLIONS IN NEW COSTS AND MASSIVE MANDATES. 1,978 NEW RESPONSIBILITIES OF THE SECRETARY OF HEALTH, 150 BOARDS, PANELS AND COMMISSIONS YET TO BE APPOINTED AND WE DON'T KNOW WHAT'S GOING TO HAPPEN. WE NEED TO RETURN HEALTH CARE TO FIXED. WHERE IT REALLY IS GOING TO BE AND WITH THAT I YIELD BACK. THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM CALIFORNIA. MR. CHAIRMAN, I YIELD MYSELF ONE MINUTE. THE GENTLEMAN IS RECOGNIZED. WE'RE TALKING ABOUT THE INDEPENDENT PAYMENT ADVISORY BOARD. ADVISORY BOARD. AND THE APPOINTED MEMBERSHIP OF THE BOARD SHALL INCLUDE PHYSICIANS AND OTHER HEALTH PROFESSIONALS, EXPERTS IN THE AREA OF PHARMACEUTICAL ECONOMICS OR PRESCRIPTION DRUG BENEFIT PROGRAMS, EMPLOYERS, THIRD PARTY PAYERS, INDIVIDUAL SKILLS IN THE CONDUCT AND INTERPRETATION OF BIOMEDICAL HEALTH SERVICES. DOT, DOT, DOT. THESE ARE PEOPLE WHO WILL GIVE US SOME RECOMMENDATIONS BUT THEY CAN'T GIVE US A RECOMMENDATION TO TAKE AWAY SERVICES. THEY CAN'T GIVE US A RECOMMENDATION TO IMPOSE MORE COSTS ON THE MEDICARE BENEFICIARIES. AND WHEN THEY GIVE US THEIR ACT ON IT. RECOMMENDATIONS, CONGRESS CAN AND IF WE DON'T LIKE IT, WE CAN CHANGE THEM. I THINK WE HAVE THE REPUBLICANS TRYING TO SCARE PEOPLE. THEY COME IN AND SAY, MEDICARE COSTS TOO MUCH. WELL, IF IT COSTS TOO MUCH, THAT'S WHY WE NEED THIS BACKUP. TO BE SURE THAT WE'RE HOLDING DOWN COSTS. THEY SAY IT COSTS TOO MUCH AND THEREFORE LET'S END IT. THAT DOESN'T MAKE ANY SENSE. I THINK THE AMERICANS SHOULD NOT BE FOOLED. MR. CHAIRMAN, I'D LIKE TO NOW YIELD TO MY COLLEAGUE FROM CALIFORNIA, THE CHAIRMAN OF THE SUBCOMMITTEE OF THE WAYS AND MEANS COMMITTEE, MR. STARK, FOR THREE MINUTES. THE GENTLEMAN FROM CALIFORNIA IS RECOGNIZED FOR THREE MINUTES. THANK YOU, MR. CHAIRMAN. I ASK UNANIMOUS CONSENT TO I -- REVISE AND EXTEND MY REMARKS AND WITHOUT OBJECTION, SO ORDERED. I WANT TO THANK AT THIS TIME. CHAIRMAN WAXMAN FOR YIELDING ME I RISE IN OPPOSITION TO H.R. 5, BROUGHT TO THE FLOOR BY MY REPUBLICAN COLLEAGUES. IT DOES TWO THINGS. REPEALS IPAB AS CREATED THE AFFORDABLE CARE ACT, AND IT ENACTS A MEDICAL MALPRACTICE REFORM LONG SOUGHT BY MY REPUBLICAN FRIENDS AS A WAY TO PROTECT PHARMACEUTICAL COMPANIES, MEDICAL DEVICE COMPANIES, HEALTH CARE PROVIDERS FROM ANY LIABILITY OR FULL LIABILITY THAT MAY CAUSE HARM OR DEATH. THE MEDICAL MALPRACTICE PART OF THIS BILL IS SO BAD THE CALIFORNIA MEDICAL ASSOCIATION REJECTS THE BILL AND SAYS TO VOTE NO UNLESS THEY HAD A DECENT MEDICAL MALPRACTICE REFORM PART IN IT AND WHEN THE DOCTORS WILL REJECT MEDICAL MALPRACTICE REFORM ISSUES, YOU KNOW IT'S GOT . TO BE BAD. THIS EXTREME PROPOSAL IS REALLY NOT NEEDED. I HAPPEN TO AGREE WITH THE PART OF THE BILL THAT REPEALS IPAB. WE REFUSE TO INCLUDE IT IN THE HOUSE VERSION OF HEALTH REFORM, AND CONGRESS HAS ALWAYS STEPPED IN IN ITS CONGRESSIONAL MANNER TO STRENGTHEN MEDICARE'S FINANCES WHEN NEEDED, AND I SEE NO NEED FOR US TO RELINQUISH THAT DUTY. TO LOOK AT THE HEALTH REFORM LAW. IT'S EXTENDED SOLVENCY, IT SLOWS SPENDING GROWTH, IT'S LOWERED BENEFICIARY COSTS, IT'S MODERNIZED THE DELIVERY SYSTEM, CREATED NEW FRAUD-FIGHTING TOOLS. WE'VE DONE A GOOD JOB. IN FACT, C.B.O. PROJECT THAT IPAB WON'T EVEN BE TRIGGERED UNTIL THE NEXT 10 YEARS, PROVING WE'VE ALREADY DONE OUR JOB HERE IN CONGRESS OF STRENGTHENING MEDICARE'S FINANCES. TODAY'S REPUBLICAN SUPPORT TO REPEAL IPAB ISN'T A SINCERE INTEREST IN PROVIDING MEDICARE FOR ALL. THEY STILL WANT TO GIVE US AN UNFUNDED OR UNDERFUNDED VOUCHER, SLASH AND BURN FUNDING AND DESPITE MY OPPOSITION TO IPAB, IT'S FAR LESS DANGEROUS TO MEDICARE THAN THE REPUBLICAN VOUCHER PLAN PUT FORTH IN THE HOUSE REPUBLICAN BUDGET THIS WEEK. IF IPAB DOESN'T UNDERMINE MEDICARE'S GUARANTEED BENEFITS AND ITS ABILITY TO REDUCE MEDICARE SPENDING, IT HAS GUARDRAILS TO PREVENT IT. IT DOESN'T PREVENT COSTS TO COME FROM REDUCING MEDICARE AND INCREASING COSTS ON BENEFICIARIES. IT PROHIBITS RATIONING AND HAS ANNUAL LIMITS ON THE CUTS. THE REPUBLICAN VOUCHER PLAN HAS NONE OF THESE PROTECTIONS. THE REPUBLICANS ARE CONTINUING THE MARCH BEGUN BY NEWT GINGRICH TO HAVE MEDICARE WITHER ON THE VINE, AND I URGE MY COLLEAGUES TO VOTE NO ON YET ANOTHER POLITICAL STUNT WHICH REALLY THANKFULLY IS NOT VESTED TO BECOME LAW AT THIS TIME. I YIELD BACK. THE TIME OF THE GENTLEMAN HAS EXPIRED. PENNSYLVANIA. THE GENTLEMAN FROM THANK YOU, MR. CHAIRMAN. I JUST LIKE TO TAKE 30 SECONDS TO RESPOND TO THE -- THE GENTLEMAN IS RECOGNIZED FOR 30 SECONDS. BEFORE I YIELD TO MR. BASS, HE MENTIONED THAT THIS SO-CALLED EXPERT PANEL CARE PROFESSIONALS. COULD HAVE PHYSICIANS, HEALTH SECTION 3403-G OF PPACA ON PAGE 432, SPECIFICALLY ON MAJORITY FOR THE PANEL. THERE'S A SPECIFIC PROHIBITION THAT YOU CAN'T HAVE A MAJORITY OF HEALTH CARE PROVIDERS OR PHYSICIANS ON IPAB. AS FAR AS THIS BEING RECOMMENDATIONS, YOU CAN'T APPEAL, YOU CAN'T SUE THIS BOARD ONLY WITH 3/5 VOTES IN BOTH CHAMBERS CAN YOU OVERTURN THEIR RECOMMENDATIONS. I YIELD ONE MINUTE TO THE GENTLEMAN FROM NEW HAMPSHIRE, MR. BASS. THE GENTLEMAN FROM NEW HAMPSHIRE IS RECOGNIZED FOR TWO MINUTES. I THANK MY FRIEND FOR YIELDING. MR. SPEAKER, I RISE IN SUPPORT OF THE BILL CONSISTING OF TWO BILLS, TORT REFORM AND REPEAL ADVISORY BOARD. OF THE INDEPENDENT PAYMENT I WASN'T HERE WHEN THE OBAMA HEALTH CARE LAW OR AFFORDABLE CARE ACT WAS PASSED. YOU WOULD HAVE THOUGHT THAT NOBODY SUPPORTED THIS BILL. OF ALL THE SPEAKERS WE HAD I THINK THREE HAVE ADMITTED THEY SUPPORTED IT THEN. AND NOW YOU THINK IT NEVER EXISTED. WELL, ANY AGENCIES THAT'S SCORED BY C.B.O. TO SAVE $3.1 BILLION IS NOT GOING TO DO IT BY PROVIDING MORE SERVICES TO PRESERVATION. SENIORS OR INNOVATION OR IT'S GOING TO DO IT BY CUTTING PAYMENTS TO PROVIDERS OR CUTTING SERVICES TO BENEFICIARIES. IT'S AS SIMPLE AS THAT. AND THIS IS THE BEGINNING OR PERHAPS THE CORE OF WHAT REPRESENTS A FEDERAL GOVERNMENT TAKEOVER OF HEALTH CARE SERVICES IN THIS COUNTRY. SURE, THERE MAY BE A PROCESS WHEREBY RECOMMENDATIONS COULD GO TO THE CONGRESS, BUT INSTEAD OF THE RELATIONSHIP BEING BETWEEN A PATIENT AND A DOCTOR, IT IS GOING TO BE GOVERNED MORE BY A FEDERAL BUREAUCRACY THAT WILL MAKE THESE DECISIONS. I URGE SUPPORT OF THE PENDING BILL, H.R. 5. THE TIME OF THE GENTLEMAN HAS EXPIRED. THE GENTLEMAN FROM CALIFORNIA. MR. CHAIRMAN, I YIELD MYSELF A MINUTE. THE GENTLEMAN IS RECOGNIZED. WE HEARD THEM IN 1965 WHEN MEDICARE WAS BEING PROPOSED. SOCIALIZED MEDICINE, AN UNFAIR GOVERNMENT INTRUSION INTO OUR LIVES. MEDICARE IS A POPULAR, SUCCESSFUL PROGRAM. I SUPPORT IT BUT THE REPUBLICANS DIDN'T SUPPORT IT THEN AND THEY DON'T SUPPORT IT NOW. THE AFFORDABLE CARE ACT IS AN EXCELLENT BILL. I PROUDLY VOTED FOR IT BECAUSE AS A RESULT OF THAT LEGISLATION, WE'RE ALREADY SEEING YOUNG PEOPLE BEING ABLE TO GET INSURANCE UP TO 26 YEARS OF AGE ON THEIR PARENT'S POLICIES. WE'RE ALREADY SEEING SENIORS GET HELP TO PAY FOR THEIR PRESCRIPTION DRUGS. WE ARE SEEING INSURANCE COMPANIES PROHIBITED FROM THE ABUSES WHERE THEY PUT LIFETIME LIMITS AND ARE GOING TO BE STOPPED FROM DENYING PEOPLE HEALTH INSURANCE BECAUSE OF PRE-EXISTING MEDICAL CONDITIONS. THIS IS GOOD AND WE ARE GOING TO GET MORE BENEFITS FOR OVER 30 MILLION MORE AMERICANS WHEN THE BILL IS FULLY IN PLACE. IT'S A GOOD BILL. THE REPUBLICANS WOULD LIKE TO REPEAL IT BUT LET'S NOT FORGET, THEY DIDN'T WANT MEDICARE IN THE FIRST PLACE. MR. CHAIRMAN, NOW THAT I USED MY MINUTE, I'D LIKE TO YIELD TO THE -- TO A MEMBER OF OUR COMMITTEE FROM THE STATE OF ILLINOIS WHO HAS BEEN VERY INVOLVED IN HELPING SENIORS ON ALL OF THESE PROGRAMS, WHETHER IT'S SOCIAL SECURITY OR MEDICARE OR MEDICAID. SHE'S VERY KNOWLEDGEABLE AND HIGHLY RESPECTED. A LITTLE SHORTER THAN THE PODIUM, BUT I'M PLEASED TO YIELD HER THREE MINUTES. THE GENTLELADY FROM ILLINOIS IS RECOGNIZED FOR THREE MINUTES. THANK YOU VERY MUCH FOR -- THANK YOU VERY MUCH. I ASK UNANIMOUS CONSENT TO REVISE AND EXTEND MY REMARKS. WITHOUT OBJECTION, SO ORDERED. H.R. 5 REPRESENTS ANOTHER IN A LONG LINE OF PARTISAN POLITICAL ATTACKS ON THE AFFORDABLE CARE ACT. SINCE ITS PASSAGE TWO YEARS AGO, THIS HISTORIC LAW HAS BEEN UNDER ATTACK. TODAY'S BILL WOULD REPEAL THE INDEPENDENT PAYMENT ADVISORY BOARD. THE AFFORDABLE CARE ACT IS REPLETE WITH PROVISIONS TO LOWER MEDICARE COSTS FROM UNPRECEDENTED TOOLS TO FIGHT FRAUD TO EFFICIENCY REFORM. THE IPAB IS A BACKSTOP TO THOSE PROVISIONS. WHEN THE AFFORDABLE CARE ACT DOES NOT DO AND WHAT THE IPAB IS PROHIBITED FROM DOING IS INCREASE COSTS TO SENIORS AND PEOPLE WITH DISABILITIES OR CUT BENEFITS. AND THAT MAY BE WHY MY REPUBLICAN COLLEAGUES DON'T LIKE IT. IF YOU LOOK AT THEIR PROPOSAL TO TAKE AWAY THE MEDICARE GUARANTEE AND TURN IT INTO A VOUCHER PROGRAM, YOU CAN SEE WHY. INSTEAD OF LOWERING COSTS FOR EVERYONE, AS THE AFFORDABLE CARE ACT DOES, THE REPUBLICAN PLAN JUST SHIFTS COSTS ON THE BACKS OF THOSE WHO CAN LEAST AFFORD IT -- SENIORS, DISABLED PEOPLE AND THEIR FAMILIES. THESE ARE THE SAME PEOPLE WHO ARE HARMED BY THE TORT REFORM H.R. 5. FEDERAL INTRUSION, COUPLED WITH CONSUMERS. THE DISREGARD FOR INJURED INSTEAD OF WORKING TO IMPROVE HEALTH CARE QUALITY, AS THE AFFORDABLE CARE ACT DOES, H.R. 5 SIMPLY RESTRICTS THE RIGHTS OF PATIENTS HARMED BY DANGEROUS DRUG COMPANIES, NURSING HOMES, MEDICAL DEVICE MANUFACTURERS, DOCTORS OR HOSPITALS. I'M ESPECIALLY OPPOSED TO ARBITRARY CAPS ON NONECONOMIC DAMAGES. ECONOMIC DAMAGES PROVIDE COMPENSATION FOR LOST WAGES. NONECONOMIC DAMAGES PROVIDE COMPENSATION FOR INJURIES THAT ARE JUST AS REAL AND DAMAGING. INJURIES LIKE EXCRUCIATING PAIN OR DISFIGUREMENT, LOSS OF A SPOUSE OR GRANDPARENT, INABILITY TO BEAR CHILDREN. THESE ARE DISCRIMINATORY FOR SENIORS AND CHILDREN WHO DON'T HAVE LOST WAGES, WHO AREN'T WORTH MUCH. HIGHER COSTS TO DISABLED PEOPLE AND SENIORS AND FEWER LEGAL RIGHTS FOR INJURED CONSUMERS, IT'S A BAD DEAL ON BOTH COUNTS. MR. SPEAKER, I YIELD BACK TO MR. WAXMAN. THE GENTLELADY YIELDS BACK HER TIME. THE GENTLEMAN FROM PENNSYLVANIA. MR. CHAIRMAN, AT THIS TIME I YIELD ONE MINUTE TO ANOTHER DISTINGUISHED MEMBER OF THE HEALTH SUBCOMMITTEE, MR. GUTHRIE FROM KENTUCKY. THE GENTLEMAN FROM KENTUCKY IS RECOGNIZED FOR ONE MINUTE. I THANK THE GENTLEMAN FOR YIELDING. THANK YOU, MR. SPEAKER. I RISE TODAY IN SUPPORT OF H.R. 5, LEGISLATION TO REPEAL THE IPAB, AND MAKE CRITICAL REFORMS TO MEDICAL LIABILITY SYSTEM. THE IPAB WAS CREATED IN THE HEALTH CARE LAW AS A WAY TO CONTAIN GROWING COSTS BURKS THE REALITY IS MOST SAVINGS WILL LIKELY BE FOUND BY PLACING DECISIONS IN THE HANDS OF UNELECTED BUREAUCRATS. AND IT ADDRESSES THE CRITICAL ISSUE OF MEDICAL LIABILITY REFORM. OUR CURRENT TORT SYSTEM IS DRIVING DOCTORS OUT OF THE PRACTICE OF MEDICINE. THOSE REMAINED ARE FORCED TO PRACTICE DEFENSIVE MEDICINE. THE CONGRESSIONAL BUDGET OFFICE HAS ESTIMATED THAT MEDICAL LIABILITY REFORM WILL SAVE HARDWORKING TAXPAYERS OVER $40 BILLION. H.R. 5 MAKES TWO COMMONSENSE REFORMS TO PROTECT DOCTORS AND PATIENTS. I URGE MY COLLEAGUES TO SUPPORT THE BILL AND YIELD BACK THE BALANCE OF MY TIME. THE GENTLEMAN YIELDS BACK HIS TIME. THE GENTLEMAN FROM CALIFORNIA. MR. SPEAKER, MAY I INQUIRE HOW MUCH SIDE HAS? THE GENTLEMAN FROM CALIFORNIA HAS 36 MINUTES REMAINING. AND THE GENTLEMAN FROM PENNSYLVANIA HAS 44 MINUTES REMAINING. MR. CHAIRMAN, AT THIS TIME I YIELD FIVE OF OUR 36 MINUTES TO THE GENTLEMAN FROM IOWA, MR. BRALEY. THE GENTLEMAN FROM IOWA IS RECOGNIZED FOR FIVE MINUTES. I THANK THE GENTLEMAN FOR YIELDING. MR. SPEAKER, HERE WE GO AGAIN. MY CONSERVATIVE FRIENDS ARE ONCE MORE TRYING TO TAKE AWAY RIGHTS OF AMERICAN CITIZENS THAT ARE AS OLD AS THE DECLARATION OF INDEPENDENCE AND THE BILL OF RIGHTS, AND THEY'RE DOING IT BY TALKING ABOUT TAKING AWAY THE RIGHTS OF PATIENTS WITHOUT EVER MENTIONING THE WORD PATIENT SAFETY. THIS ISSUE HAS BEEN WITH US FOR A LONG TIME, AND IN FACT ABOUT 10 YEARS AGO, THE HIGHLY REGARDED INSTITUTES OF MEDICINE DID THREE STUDIES ON THE ISSUE OF PATIENT SAFETY AND THE ALARMING COST IT ADDS TO OUR OVERALL HEALTH CARE DELIVERY SYSTEM. THE FIRST OF THEIR STUDIES WAS CALLED TO ERR IS HUMAN, BUILDING A SAFER HEALTH SYSTEM. AND ON THIS COVER IT SAYS, FIRST, DO NO HARM. THE STUDY CONCLUDED THAT EVERY YEAR UP TO 98,000 PEOPLE DIE IN THIS COUNTRY DUE TO PREVENTABLE MEDICAL ERRORS. AND IT ALSO TAUGHT IN THIS -- TALKED IN THIS STUDY ABOUT THE COST OF THOSE MEDICAL ERRORS. THE COST OF FAILING TO STOP THESE PREVENTABLE MEDICAL ERRORS IS BETWEEN $17 BILLION AND $29 BILLION A YEAR. MULTIPLY THAT OVER THE 10 YEARS OF THE AFFORDABLE CARE ACT, THAT MEANS IF WE ELIMINATED THOSE ERRORS, WE WOULD SAVE $170 BILLION TO $290 BILLION A YEAR. SO DO WE FOCUS ON PATIENT SAFETY AND PREVENTING MEDICAL ERRORS? NO. WE FOCUS ON TAKING AWAY THE RIGHTS OF THE MOST SEVERELY INJURED BECAUSE THAT'S WHAT CAPS ON DAMAGES DO. THEY PENALIZE THOSE WITH THE MOST EGREGIOUS INJURIES AND THOSE WHO HAVE NO EARNING CAPACITY. SO WHO ARE THOSE PEOPLE? THEY'RE SENIORS, THEY'RE CHILDREN AND THEY ARE STAY-AT-HOME MOTHERS. THOSE ARE THE ONES MOST SEVERELY PENALIZED WHEN YOU TAKE AWAY THAT. SO I OPPOSE THIS BILL IN THE NAME OF THE TEA PARTY. NOT JUST THE CURRENT TEA PARTY BUT THE ORIGINAL TEA PARTY WHICH WAS FOUNDED IN OPPOSITION REPRESENTATION. TAXATION WITHOUT AND IF YOU GO TO THOMAS JEFFERSON'S DECLARATION OF INDEPENDENCE, YOU WILL SEE THAT GRIEVANCE AGAINST KING GEORGE LISTED, AND RIGHT BELOW IT IN THE DECLARATION OF INDEPENDENCE IS THIS GRIEVANCE, THAT HE HAS TAKEN AWAY THE RIGHT OF TRIAL BY JURY AND THAT RIGHT WAS SO GENTLEMEN, THAT IT WAS EMBEDDED IMPORTANT, LADIES AND IN THE SEVENTH AMENDMENT TO THE BILL OF RIGHTS. AND IT SAYS VERY CLEARLY THAT IN SUITS AT COMMON LAW, WHICH IS WHAT A MEDICAL NEGLIGENCE CLAIM IS, THE JURY GETS TO DECIDE ALL QUESTIONS OF FACT AND NO ONE ELSE. WELL, ONE OF THE MOST IMPORTANT QUESTIONS OF FACT IN A JURY TRIAL IS THE ISSUE OF DAMAGES, AND MY FRIENDS ARE TRYING TO TAKE AWAY THAT RIGHT FROM THE JURY, THE VERY SAME PEOPLE WHO ELECTED US TO CONGRESS, BECAUSE THEY APPARENTLY THINK THAT CONGRESS KNOWS MORE THAN THE PEOPLE WHO SENT US HERE AND WHO GO INTO JURY BOXES ALL OVER COUNTRY IN YOUR STATE AND LISTEN TO THE ACTUAL FACTS OF THE CASE BEFORE DECIDING WHAT'S FAIR, INCLUDING THE ALL-IMPORTANT ISSUE OF WHAT ARE FAIR AND REASONABLE DAMAGES. SO THEY'RE TALKING A LOT TODAY ABOUT DEFENSIVE MEDICINE. I WANT TO TELL YOU ABOUT THE MYTH OF DEFENSIVE MEDICINE. EVERY TIME A HEALTH CARE PROVIDER SUBMITS A FEE FOR SERVICES, THEY REPRESENT THAT THAT MEDICAL PROCEDURE OR THAT MEDICAL TEST WAS MEDICALLY NECESSARY, AND IF THEY DON'T MAKE THAT REPRESENTATION, THEY DON'T GET PAID. WELL, GUESS WHAT, FOLKS? IF SOMETHING IS PERFORMED AND BILLED AS MEDICALLY NECESSARY, THAT BY DEFINITION IS NOT DEFENSIVE MEDICINE, BECAUSE DEFENSIVE MEDICINE IS WHEN YOU'RE DOING SOMETHING THAT'S NOT MEDICALLY NECESSARY TO LITIGATION. PROTECT YOURSELF FROM SO YOU CAN'T HAVE IT BOTH WAYS. YOU CAN'T TAKE THE MONEY AND CLAIM YOU'RE PRACTICING DEFENSIVE MEDICINE. WE ALSO HEARD ABOUT THE MYTH OF THESE CAPS 30 YEARS AGO AND NEVER ADJUSTING THEM FOR INFLATION. THEY ALSO WANT TO TALK ABOUT THE CALIFORNIA BILL THAT WAS PASSED IN THE MID 1970'S AND IMPOSED THE VERY SAME CAP IN THIS BILL, $250,000. WHAT THEY DON'T TELL YOU IS IF YOU ADJUST THAT CAP BASED ON THE RATE OF MEDICAL INFLATION OVER THAT SAME PERIOD OF TIME, THE CAP WOULD NOW BE WORTH ALMOST $2 MILLION, AND THEN IF YOU REDUCED THAT $ 50,000 CAP TO -- $250,000 CAP TO PRESENT VALUE, THOSE ARE ONLY GETTING THE EQUIVALENT OF $64,000 NO MATTER HOW SERIOUS THEIR INJURY IS, AND THAT'S WHY I OPPOSE THIS LEGISLATION AND THAT'S WHY PEOPLE WHO BELIEVE IN THE CONSTITUTION AND IN THE STATES' RIGHTS UNDER THE 10TH AMENDMENT TO DECIDE WHAT THEIR CITIZENS WILL RECEIVE AS JUSTICE SHOULD BE OUTRAGED THAT THIS BILL IS ON THE FLOOR TODAY, AND WITH THAT I YIELD BACK. THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM PENNSYLVANIA. MR. CHAIRMAN, AT THIS TIME I YIELD TO ANOTHER VALUED MEMBER OF THE HEALTH SUBCOMMITTEE TWO MINUTES, THE GENTLEMAN FROM NEW JERSEY, MR. LANCE. THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED FOR TWO MINUTES. LANTS LANCE THANK YOU, MR. SPEAKER, -- THANK YOU, MR. SPEAKER, AND THANK YOU, MR. CHAIRMAN, FOR YIELDING. I RISE TODAY IN SUPPORT OF H.R. 5, AS IT COMBINES THE REPEAL OF THE INDEPENDENT PAYMENT ADVISORY BOARD WITH SIGNIFICANT MEDICAL MALPRACTICE REFORMS THAT WILL HELP REDUCE HEALTH CARE COSTS AND RESERVE PARENTS -- PATIENTS' ACCESS TO MEDICAL CARE. TODAY MARKS THE TWO-YEAR ANNIVERSARY OF HOUSE PASSAGE OF THE PRESIDENT'S HEALTH CARE LAW. DURING THAT DEBATE TWO YEARS AGO I JOINED MEMBERS FROM BOTH SIDES OF THE AISLE IN CALLING ON THE PRESIDENT TO ADDRESS ONE OF THE DRIVERS OF THE HIGH COSTS OF HEALTH CARE BY REFORMING THE CURRENT MEDICAL LIABILITY SYSTEM. UNFORTUNATELY THE PRESIDENT'S HEALTH CARE BILL PASSED THE 21, 2010, ABSENT ANY REAL OR MEANINGFUL MEDICAL LIABILITY REFORM. THE NEW CLAW DID INCLUDE THE INDEPENDENT PAYMENT ADVISORY BOARD OR IPAB, AND THIS COST-CONTROLLED BOARD MADE UP OF 15 UNELECTED AND MIGHT I ADD UNCONFIRMED OFFICIALS HAS THE POWER TO MAKE MAJOR COST-CUTTING DECISIONS ABOUT MEDICARE WITH LITTLE OVERSIGHT OR ACCOUNTABILITY. THE IPAB HAS BEEN CRITICIZED BY BOTH REPUBLICANS AND DEMOCRATS AND ITS REPEAL IS SUPPORTED BY NEARLY 400 GROUPS REPRESENTING PATIENTS, DOCTORS AND EMPLOYERS. TODAY ON THE TWO-YEAR ANNIVERSARY OF THE HOUSE PASSAGE OF THE HEALTH CARE LAW WE HAVE AN OPPORTUNITY TO MOVE TO THE FUTURE AND ENACT REAL HEALTH CARE REFORM THAT WILL HELP BRING DOWN HEALTH CARE COSTS THAT ARE ESCALATING AT UNSUSTAINABLE RATES WHILE AT THE SAME TIME PROTECTING NEEDED CARE FOR OUR SENIOR CITIZENS. AS A MEMBER OF THE HOUSE ENERGY AND COMMERCE COMMITTEE, I'M PLEASED TO HAVE THE OPPORTUNITY TO WORK ON THIS IMPORTANT LEGISLATION AND URGE ALL OF MY COLLEAGUES TO SUPPORT H.R. 5. BALANCE OF MY TIME. MR. SPEAKER, I YIELD BACK THE THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM CALIFORNIA. MR. CHAIRMAN, I'LL CONTINUE TO RESERVE OUR TIME. THE GENTLEMAN FROM CALIFORNIA RESERVES HIS TIME. THE GENTLEMAN FROM PENNSYLVANIA. MR. CHAIRMAN, AT THIS TIME I YIELD TO ANOTHER DISTINGUISHED MEMBER OF THE HEALTH SUBCOMMITTEE, DR. GINGREY, FOR TWO MINUTES. THE GENTLEMAN FROM GEORGIA IS RECOGNIZED FOR TWO MINUTES. MR. CHAIRMAN, I THANK THE GENTLEMAN FOR YIELDING AND OF COURSE I STAND IN STRONG SUPPORT OF H.R. 5, THE PATH ACT. HAVING AUTHORED HALF OF THE LEGISLATION, THAT IS THE HEALTH ACT, THE MEDICAL LIABILITY REFORM ACT, BUT I'M ALSO STRONGLY IN FAVOR OF REPEAL OF IPAB, THE INDEPENDENT PAYMENT BOARD, CREATED UNDER OBAMACARE. WE KNOW AND OUR COLLEAGUES ON THE OTHER SIDE OF THE AISLE, MANY OF THEM KNOW THAT THIS IS THE MOST EGREGIOUS PART OF THIS 2,700-PAGE PIECE OF LEGISLATION WHICH IS NOW THE LAW OF THE LAND. BUT WHAT IT IS, MR. CHAIRMAN, IPAB IS THEIR WAY OF SAVING MEDICARE. I'LL ASK THEM TIME AFTER TIME, WHAT IS YOUR PLAN TO SAVE MEDICARE? THEY HAVE NO ANSWERS. ALL THEY WANT TO DO IS CONTINUE TO CRITICIZE OUR SIDE OF THE AISLE WHEN WE HAVE MEANINGFUL, THOUGHTFUL PLANS TO SAVE AND PROTECT AND STRENGTHEN NOT JUST FOR THESE CURRENT RECIPIENTS UNDER THE MEDICARE PROGRAM, THOSE WHO ARE SENIORS, THOSE WHO ARE DISABLED, BUT ALSO OUR CHILDREN AND OUR GRANDCHILDREN. WHAT DO WE GET FROM THIS SIDE OF THE AISLE, FROM THE DEMOCRATIC SIDE? WE GET IPAB. SAYS NO RATIONING YET THE PROVISIONS CALL FOR CUTTING REIMBURSEMENTS TO PROVIDERS AND EVENTUALLY WITHOUT QUESTION, JUST AS IT HAS IN CANADA, IN THE U.K., MR. CHAIRMAN, THAT LEADS TO DENIAL OF CARE AND IF THAT'S NOT RATIONING I DON'T KNOW WHAT IT IS. LET ME IN THE REMAINING PART OF MY TIME SPEAK A LITTLE BIT IN REGARD TO H.R. 5, THE HEALTH ACT, THE MEDICAL LIABILITY REFORM ACT. THE GENTLEMAN FROM IOWA, THE TRIAL ATTORNEY, WAS JUST UP HERE TRYING TO IMPLY THAT WE WOULD TAKE AWAY A PERSON'S RIGHT TO A REDRESS OF THEIR GRIEVANCES IF THEY HAD BEEN INJURED BY A MEDICAL PROVIDER OR HEALTH CARE FACILITY BECAUSE OF PRACTICE BELOW THE STANDARD OF CARE. I YIELD THE GENTLEMAN ANOTHER MINUTE. THE GENTLEMAN IS RECOGNIZED. I THANK THE GENTLEMAN. THE GENTLEMAN FROM IOWA KNOWS IN FACT THAT THAT IS ABSOLUTELY NOT