Health Care Reform

Floor Speech

HEALTH CARE REFORM -- (House of Representatives - April 27, 2009)

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Mr. FLEMING. Well, first of all, I want to thank my friend from Louisiana, Mr. Scalise, or should I say Dr. SCALISE. We have made him an honorary doctor tonight. Also I want to thank Doctors MURPHY and GINGREY for their comments. I do want to follow up on some of these comments. I think they all fit together nicely.

You know, first of all, I would like to say that the United States delivers the best health care in the world, or at least among the best, arguably the best, but the financing of it is a basket case.

You heard, Mr. Speaker, Dr. GINGREY talk about the 47 million uninsured, which is a very fluid number. But, you know, I have often said through my experience that these 47 million are not the people you think they are. They are not the poor, because we do have programs for the poor. They are not the elderly. We have Medicare for the elderly. And they are not those in stable employment in corporate America.

They are, for the most part, small business owners and their employees. There are really several reasons why insurance is difficult to obtain or to afford for these people, and I won't go into all of that in detail, but I do want to hit eight points that I recommend in terms of health care reform.

Mr. FLEMING. Before I get to that, I want to contrast with you what I understand the Democrat offering is on this subject, and that is a, more or less, expanding Medicare, which we have today for the elderly and for the disabled to everyone. I think there are a lot of satisfied recipients of Medicare out there. However, I would remind everyone that Medicare exists only because it's propped up by taxpayers and by private insurance. So, if we expand Medicare to everyone, who is going to prop that large system up, perhaps as much as 17 percent of our total economy?

I really think that we can have our cake and eat it, too. I think, Mr. Speaker, that we can have excellent insurance coverage and that we can actually cut costs in the process. So here is point 1:

Despite the need for Federal and State governments to pay many of the health care insurance bills, the government, itself, should get out of the administration programs. Why is that?

Any politician who tells you that when he is elected or that when she is elected that he is going to do away with all fraud and abuse in government is either lying to you or really has no idea what he's talking about. The reason for that, as we apply that to health care, is: If you take, for instance, two physicians who are treating the same pneumonia, physician 1 treats it with an office visit, with maybe a follow-up office visit and with, perhaps, a prescription for antibiotics. The other physician admits a patient to the hospital, costing upwards of $7,000 to $10,000. The question is: Who is right?

The answer is they're both right, but one costs many times more than the other. We really, currently, don't have a way of saying, Well, what is the best and most efficient cost in every case for every patient?

I would submit to you, Mr. Speaker, that the Federal Government does not have the ability to micromanage care to its most efficient point. However, we can--if we are allowed to provide health care through administrative means, that is--pay the money to certain organizations of providers and allow them to make those decisions as to where they can cut the waste out, and to do so through competition, I think we could actually save money and see improvement in care and certainly in customer service.

Second and as part of that is: physicians and other health care providers should be allowed to come together in both vertical and horizontal integration so that, instead of having a reimbursement rate that's dictated by the Federal Government--it's the only part of the economy, incidentally, in which the Federal Government determines the actual price that anyone is paid, the so-called ``price regulation.'' If we move from that into price competition where you have groups of providers who come together and who group together and who compete for covered lives and, in doing so, work efficiencies into the system of lowering the cost and improving the quality, I think we would see much more for our money, and certainly our patients would.

Third, we need to provide basic health care insurance for every American, at least make it affordable. In doing that, remember that today, through the EMTALA laws passed in the 1980s, someone with or without insurance can appear to the emergency room, simply request care and will be provided care despite that person's ability to pay. Well, that's all well and good, but what often happens is it's a person arriving to the emergency room who's receiving the highest cost of care and oftentimes the lowest quality of care because it's provided at the wrong time during the illness. Ultimately, someone else, such as other subscribers and taxpayers, end up paying the cost.

If we had private insurance for those individuals who were uninsured, oftentimes they wouldn't need to come to the emergency room. They could simply receive early treatment, diagnostic treatment or even prevention therapy, before ever having the need to come to the emergency room.

Fourth, we should allow the public to be informed consumers with simple and transparent systems so that they can make wise choices.

Fifth, we should reform antiquated insurance laws and give incentives to the young and healthy to opt into private insurance so that we have large risk pools and so that we do away with the term ``preexisting illness.''

Sixth, we need to move forward on incentives for providers to move into the digital age with electronic health records. That will greatly enhance communication. At least in my own experience, I've had electronic health records in my clinic now for over 10 years. It has actually lowered our cost and has improved our efficiency.

Seventh, we should make family physicians the linchpin of our health care system. Supported by midlevels, they can have a tremendous effect on lowering the cost while improving care.

Finally, we need to provide strong incentives for patients to function as consumers and to behave in every way possible to prevent disease rather than enter the system at the worst possible time when cost is the highest and outcomes are the poorest.

So, you see, Mr. Speaker, while we are not hearing about these solutions from the other side of the aisle even though there's a placeholder for over $600 billion as a down payment towards health care reform, on our side, we're being very specific about what can be done and about what should be done. Many private and connected governmental agencies agree with these major points that I've discussed today.

So, with that, I thank the gentleman, Mr. Scalise, for allowing me this time, and certainly, I yield back my time.

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