Doctor's Hour

Floor Speech

Doctor's Hour

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Mr. FLEMING. Well, I thank my friend and fellow colleague, both a physician and fellow Member of Congress, BILL CASSIDY, and also fellow Louisianan. And of course tonight we're going to be talking about a lot of different things relative to what is really the hottest topic maybe in a decade, health care reform, which both sides of the House are very interested in.

You know, you hear often from this side of the aisle that well, for heavens sakes, we want health care reform. But you guys, on the other hand, Republicans, you want the status quo. Well, I can tell you personally, that I ran for Congress with the overarching intent of getting up here and participating in reform. What I want to bring forth first, before we get into some more details is, I think there's a litmus test as to how good a government-run system is, that proposed by the President and the Democrats. And so, the question is, a rhetorical question is, if it's so good, then shouldn't Congress be the first ones to sign up for it individually, for them and their families?

And, in fact, to see to that, I set forth House Resolution 615, which is supported by 66 Republicans, including our leadership on down, and all it says is that if a Member of Congress votes for a government-run health plan, a public option, if you will, then he or she is willing to forego the waiver, the carve out, the exception, if you will, that's built into their version, and join it immediately for themselves.

Mr. CASSIDY. Now, Congressman Fleming, how many Democratic cosponsors do you have?

Mr. FLEMING. I'm sad to say to my friend, and I thank you for yielding back, that so far we have no Democrats, goose egg, zero Democrats.

Mr. CASSIDY. Now, reclaiming my time, because we heard a presentation prior to this that, by golly, this is the best thing since sliced bread; this is the plan that's going to fix everything, and why wouldn't you be on it. So I'm kind of asking you, Dr. FLEMING, why wouldn't they want to be on it.

Mr. FLEMING. Well, I think that is the $100,000, or shall I say, $1.6 trillion question, because apparently they're not so enthralled with it that they would like to be in it themselves. And in fact, I put it to the test by actually putting it on my Web site and asking people if they would like their congressman to support it, that they would actually reach out. We have 150,000 Americans who signed the petitions, and the number is growing drastically every day.

And so I would say that, as we go through this debate, that we simply ask our constituents out there to hold us in Congress accountable by contacting your Congressperson or Senator or even the President and say, Mr. President, Mr. or Ms. Congressperson, Mr. or Ms. Senator, will you go to fleming.house.gov and sign up, cosponsor or whatever, House Resolution 615, that simply says that if you're willing to vote for it you're willing to join it.

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Mr. CASSIDY. Hang on. Hold that thought. Let me give one more David Brooks quote and call on our colleague, Dr. FLEMING okay? Another David Brooks quote talking about the CBO report, speaking about how much it would cost. This is devastating. The plan was sold as a way to bend the cost curve to reduce the rate of health care cost growth. Instead, the cost of the plan to the Federal budget would rise by 8 percent a year, and there wouldn't be anything close to offsetting revenues to pay for it.

Now, Dr. FLEMING, can you sustain a health care system which has out of control inflation, if you will?

Mr. FLEMING. Well, my answer to the gentleman is that I would look to the experience of other health care systems in other countries. If you look at Medicare and Medicaid, we've not been able to do that. Medicare is running out of money. We don't have a solution to that. The States all across the country are having tremendous difficulty figuring out how they're going to pay for Medicaid budgets, their part of it. And then if you look at the U.K., you look at Canada, countries around the world who have these systems, none of them have been able to claim that they can control costs. They're inflation rates are 10 percent or more.

Mr. CASSIDY. Reclaiming my time, part of this plan is to increase Medicaid eligibility, i.e., put more people on to Medicaid. Yet what we've just heard is that Medicaid is bankrupting States, or causing them to raise taxes.

Mr. FLEMING. Absolutely.

Mr. CASSIDY. So going back to my question, if you cannot control costs, can you sustain a health care system?

Mr. FLEMING. In my opinion, no, because, again, if you can't do it for a smaller system, how can you enlarge the system and somehow make it mysteriously work, particularly when there are no models? Massachusetts, Tennessee, TennCare, and so on and so forth, no one has an example of a government-run system that works.

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Mr. FLEMING. Will the gentleman yield?

May I add that the bill, itself, is scored at over $400 billion to be taken out of the current Medicare program. That's over $400 billion to be taken out of the current Medicare program. So that's actually in their bill itself. So I don't see how they can claim that the elderly will get more care. They're only going to get less care.

Mr. BOOZMAN. I agree with the gentleman. If he would yield?

Mr. FLEMING. Yes.

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Mr. CASSIDY. Now, Dr. Broun, if I could reclaim my time, earlier, Dr. ROE had suggested--we spent the first half in kind of a critique of what our folks, our colleagues across the aisle, have put forward; but we've set aside our second half to kind of talk about what works. This is kind of a nice segue because I think, one, we know that lowering administrative costs will help, and we know that malpractice reform can also address some of these issues.

I'll go back to the central theme, which has to be that any effective reform has to put the patient in the middle; and when you put the patient in the middle, you've got to give them transparent costs so they know what they're buying before they go in there, and you need to encourage them to make the lifestyle changes because, ultimately, a patient, she or he, is ultimately responsible for his own health.

I know that, Dr. Fleming, in your business--because you're not only a physician, a congressman, husband, and a father, but you're also a small business man--could you relate your experience with health savings accounts? Perhaps define them for us and say how it worked in your small business.

Mr. FLEMING. Absolutely. I will tell you, approximately 5 years ago, and this is when health savings accounts really----

Mr. CASSIDY. Will you define what that is, please?

Mr. FLEMING. Yes. A health savings account is really very simple, where either the subscriber--the employee--or the employer, as in our case, puts part of the subscription costs into a savings account.

Mr. CASSIDY. Reclaiming my time, you put a portion of that health premium into a bank account of sorts that the patient/employee then controls?

Mr. FLEMING. Not only does he control, but it is nontaxed, and he can use it to buy prescription drugs, to pay the deductible or whatever.

And we were up against a situation where, like many small businesses, our premiums were going up 9, 10 percent, sometimes 15 percent per year, and we were pulling our hair out trying to figure out what else we could do. And this idea of health savings accounts came out, and we said, Well, let's try this. I had some reluctance from my employees, but we increased the deductible, and the extra amount that we would have paid for the increase in subscription costs, we put it into a health savings account for each and every one of them.

The results were dramatic. The costs flatlined. They did not go up. And since then, they've never gone up more than 3 percent a year. It's empowered the employee, the patient, the family, to buy medications at will.

And it was very interesting. I had one employee who was complaining as we implemented. She said, Well, gee, I spend $200 a month for inhalers, and how is this going to help me out because I'm going to be spending a lot of time. I said, Well, let me suggest that you stop smoking, and with the money that you save by not having to use inhalers, you will have plenty of money left over. She took me up on it, and now she doesn't need them.

Mr. CASSIDY. Reclaiming my time, could she have used her HSA to buy the medication to help her get off of cigarettes?

Mr. FLEMING. Absolutely.

Mr. CASSIDY. Now, I like that because it puts the patient, the empowered patient in the middle so that she's making the best decisions not only for her wallet, but also for her health and, by the way, for her job because you are able to keep your costs down and keep her employed.

Fair statement?

Mr. FLEMING. Absolutely.

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