Making Continuing Appropriations for Fiscal Year 2014

Floor Speech

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Mr. PAUL. There has been some discussion. The Senator from Kansas recently put this question forward, how we would fix ObamaCare if we were allowed to. I think there are two parts to that. The first part of the question is, will we be allowed to offer any amendments to try to make ObamaCare less bad, to try to fix ObamaCare? Will Republicans, which is virtually half of the country, be allowed to participate in this process at all?

ObamaCare was passed with entirely Democratic votes, not one Republican vote. It is a policy that has been very partisan. It is a policy that now even supporters of ObamaCare are saying: My goodness, this is going to really be a problem for the country. But the Senator is exactly right, we are getting ready to go through a process where there are going to be no amendments on fixing ObamaCare. There will not be one thing offered.

Former President Bill Clinton is saying there are problems with it, the Teamsters, Warren Buffett, the 15,000 people at UPS who lost their spousal insurance are saying there is a problem with this. Are we going to be allowed to offer amendments?

It appears as if there will not be any amendments. It appears there is nothing forthcoming that there will be a need to debate. This is important for the American people because this is being portrayed as the Republicans are obstructionists, that Republicans don't want to do this, Republicans don't want to do this.

It is exactly the opposite. The President wants 100 percent of ObamaCare as he wrote it, as the Democrats wrote it, with no Republican input. So when we go around the country and people say why can't you guys get along, figure out some way of making our health care system better, it is because we are getting 100 percent of ObamaCare as written by the President and it is his way or the highway.

What he is talking about is really, even though they say the opposite, he wants to shut the Government down. They salivate at shutting the government down. Over the last 3 months as the Senator brought this issue forward, who has been talking about shutting the government down? Has the Senator been talking about it? No. Have I been talking about it? No. We have been specifically saying we don't want to do that. Who talks about shutting the government down, nonstop, every day? The Democrats, the President, and their liberal friends in the media.

As I get to my question, what I want to ask is about how we would fix it. I think Senator Roberts is right. The other side says they don't have any answers, they are not willing to fix ObamaCare. The truth of the matter is we have been talking about this for years now but we have been drowned out by the ObamaCare I want everything all the time, everything I want I am going to get. There are many fixes for our health care.

I am a physician and practiced for 20 years. I saw it every day. The No. 1 complaint I got: Health insurance costs too much. So what did ObamaCare do for health insurance costs? It drove them up. It did absolutely nothing. Even they are admitting it. But you have to understand why health care costs went up. Health care costs went up because we are mandating what health insurance.

People say I would like to have my kids covered. Sure we can cover your kids, but it is not going to be free. It is going to have a cost. So everything the people say they want is not free. It elevates the price of your health insurance. When you elevate the price of health insurance, what happens? Poor people have more difficulty buying their health insurance.

What else did ObamaCare do that we did, that is exactly the opposite of what we should do. There is something called health savings accounts that originated about 10 or 15 years ago. They were expanded gradually and they were the best thing to happen to health care probably in the last 30 years. But what happened? We went the opposite way. ObamaCare is now narrowing the health savings account. Why are the health savings accounts important? Because you can save money tax-free, you can carry it over from year to year, and then you can buy higher deductibles. So contrary to what people think, it may be counter-intuitive to some people, the way to fix health insurance is to have higher deductibles, because what does that mean? Cheaper insurance. You want cheaper and cheaper insurance. As you have higher deductibles, you have cheaper insurance. When you have cheaper insurance, you have all this extra money that you can use to pay for day-to-day health care. When you do that, what happens? You drive the price of health care down. I know that is exactly right.

As you increase deductibles, as you get the consumer involved in health care, your prices go down. In my practice as an ophthalmologist, there are two things that insurance did not cover at all and the prices were reduced most dramatically in the two areas in which the health insurance did not cover anything. If you want to buy contact lenses, most of the time health insurance doesn't cover it. The price went down every year. Lasik surgery to get rid of the need for glasses, much more expensive but the price went down for 20 years because the consumer paid.

What would the consumer do--or the patient? The average patient calls 4 doctors before they have Lasik surgery, so the thing is they drive prices down. People say I don't want to pay more out of pocket, I want to pay less. That is a natural impulse to want to pay less. You may pay less at the door, but you are paying more for premiums. Or if you are not paying it and your employer is paying more for premiums, what ends up happening is there are fewer jobs.

I know the Senator from Texas is familiar with philosopher and parliamentarian and French writer Frederic Bastiat. Bastiat often talks about the seen and the unseen. It is the consequences that are visible to the naked eye before you get started, but then there are the things you didn't realize were going to happen, the unintended consequences. It is like saying let's have government build the hospitals. Let's have government hire the doctors. Let's have government build everything. We would see all these bright, shiny things and we would not see where the money came from, where the money was not spent, where the economic growth could have occurred. What we have to think about when we think about ObamaCare is we have to think about do you believe in freedom or coercion? ObamaCare is riddled with mandatory, mandatory this, mandatory that, I think there are several mandates.

When you hear the word mandate that is not freedom, that is your government telling you that you have to do something. It should be about mandatory versus voluntary. We should have bills that originate here that say you are free to do things. We have gone the opposite way. We are taking away freedom and we are adding mandates. At its core, ObamaCare is about freedom versus coercion and as you add in these levels of coercion, not only do you lose your freedom, they cost money so it becomes more expensive.

We took a health care system where 85 percent of the people had insurance and we made it more expensive for everybody. We made it more expensive by mandating what goes into the insurance. For example, for a 30-year old, or for a 32-year-old, it is illegal to buy a high deductible policy. You will not hear this. ObamaCare has made it illegal to buy a high deductible policy. You can get it under age 30 but not over 30. Why would you want that? Maybe you are a plumber in your own business and you want to have a $5,000 deductible so up can pay $1,000 a year in premiums or $2,000 a year in premiums. But how do you ever get there? You never get there unless you allow freedom. You need the freedom of the marketplace. Instead of limiting it, realize what you are getting. When you ask for ObamaCare you are getting ObamaCare, you are getting mandates, but you are getting limited choices. Freedom means choices. Mandates, coercion, means less choices.

The exchanges will be very few choices. I will be on the exchanges. I will have to go to the exchange in Kentucky and buy my insurance. I am not very happy about it. In fact I think if I have to do it I think Justice Roberts ought to have to do it. Justice Roberts loves ObamaCare so much I am for voting to have Justice Roberts trot on down to the ObamaCare registry, the ObamaCare index, and get his insurance like the rest of us.

We talked about some amendments to include people, I think everybody, all Federal employees. If ObamaCare is so good, everybody ought to get it. The thing is we would be so fed up that we would rebel in this country. That is what I think the Senator from Texas has started, hopefully a rebellion against coercion, rebellion against mandates, a rebellion against everything that says that big government wants to shove something down your throat, they say take it or we will put people in jail. People say we aren't going to put anybody in jail. The heck they won't. You will get fined first. If you don't pay your fines, you will go to jail. They are telling you that you have to take their health insurance as they conceived of it, with absolutely no Republican input. Not one Republican vote, and they are unwilling to have any amendments.

What is this fight about? This fight is about whether or not we are going to have a society or a Congress where we can debate over how to fix things. ObamaCare is a disaster. Even its own authors are now saying it is a train wreck waiting to happen. Even the President, who is in love with this ObamaCare, is saying it is going to be a problem. He is delaying the individual mandate.

He is delaying the individual mandate.

But realize on another level what some of our complaints are. Some of our complaints are that by making it mandatory, and by him doing it after the fact, he is not obeying the law. This is pretty important.

We talk about the rule of law a lot of times around here, but what is important about the rule of law is that Congress passes legislation and the President can sign it and execute it. ObamaCare was passed with only Democratic votes. But here is the thing, he is now amending it after the fact.

We saw one of the union officials coming out with a gleeful smile on his face from the White House. Is he going to get a special deal that nobody else gets? Is the President going to come to your town or my town in middle America and meet with me and give people in my town an exemption? No. He has been giving exemptions to his friends. This is patently un-American, and it is unconstitutional. We will fight this through the court cases, but it will take a year or so before we can get to the Supreme Court.

Can the President amend legislation? Can he write legislation without the approval of Congress? That is what he is doing. His argument would be: I am trying to fix the problems the legislation created. Yes, the legislation was 2,000 pages and nobody read it, and then they created 20,000 pages of regulations.

We have no idea who to call in many of the States. If you do know who to call and there has been an exchange set up, there are limited choices. Where you might have had hundreds of choices, you will now have two or three choices. Where you once had freedom, you are going to have coercion. Where you once had the ability to buy cheaper insurance and pay your out-of-pocket expenses on a day-to-day basis yourself and buy cheaper insurance, it will no longer exist because the government now says they know what is best for you. They know what you should do. Your choices have gone out the window.

We talked about amendments. If we were allowed to have amendments and the ability to try to fix ObamaCare, I would try to bring the price down. The best way to bring the price down is not to tell people they have to have a deductible or an HSA, but it is to expand their ability to choose an HSA. An HSA is a health savings account.

Before ObamaCare, you could put $5,000 a year in your HSA, and now it has gone to $2,500 a year. If you have a child who is autistic or a child with spinal bifida or a child with a severe learning disability, you can spend $10,000 a year on their health care in trying to help them adapt to life.

Right now what is happening is they are limiting that ability. Health savings accounts should be unlimited. We should take them from $2,500, where the President has squashed them, and make them unlimited. If you get lucky and don't get sick, your health savings account should be able to go into your kid's education. Health savings accounts should not be for just the family but for every individual of the family. They should be enormous over time, and then you would buy cheaper insurance.

This is also the answer as to how you drive the price down. Here is something, as a physician, people would say to me: I went to the hospital and had heart surgery that cost $100,000. When I looked at my bill very closely, the mouthwash was $50, and I was infuriated. I would say: Did you call? Did you try to negotiate with the hospital? They would answer: No, my deductible is $50.

When you have a low deductible and you don't have to pay, you are not connected to the product. Unless you are connected to the product, prices don't come down. This is a fundamental aspect of capitalism. That is why when you go to Walmart or any retail store such as Hobby Lobby, the prices are bid down because there is competition and you ask about the price.

Think about it. If you went to Walmart and your copay was $10 every time you went to Walmart, would you ever look at any prices after you paid $10? You can see what would happen to the entire retail world if we had health insurance for buying goods. If you had a health insurance copay of $100 to buy a car, the price of cars would go through the roof because you wouldn't care about the price. This is about having some sense.

The people who gave you ObamaCare are not bad people. They have big hearts but not necessarily big brains. They want to help people, but they have not figured out that the unintended consequences of ObamaCare are that part-time workers will have less hours, and full-time workers, who are on the margin, as far as their hours go, with a business that is struggling will lose their jobs.

If I have 51 employees, I may go back to 49 employees if I am struggling. If I have 1,000 employees, and I provide health insurance for them but my competitor decides to dump them on the government exchange, maybe I have to do that too so I can compete because maybe I have to offer the lowest price. Maybe the end result of ObamaCare is the people it was intended to help are precisely who it is going to hurt.

I think we have to think this through. We have to think as a society whether we are for choice or against choice, whether we are for mandates or for volunteerism. I think it is very important that we look beyond the immediacy of what we are trying to do, and, as I said, I don't discount the motives of the people on the other side. I think they want to help people, but I think they are going to hurt the people they want to help.

As we look at this ObamaCare debate and this disaster, there is another question you might ask: If ObamaCare is such a great thing, you would think you could give it away--this is something that will be free. And they are having trouble giving it away. So what have they done? They are spending tens of millions of dollars to advertise to you that it is such a great thing. If you can't sell somebody something that is free, I think there is a problem. ObamaCare is free and they can't sell it. They have enlisted the President now to sell it. They are going to barnstorm all across America selling something that is free. They will have government agents on planes flying hither and yon, knocking on your door, saying: Please take this free health care. Please sign up for free health care. If you cannot sell free health care, there must be a problem with it.

We are spending tens of millions of dollars on TV, and millions more having people going door to door to convince people that it is a good idea. Ultimately we should try to help those who cannot help themselves, but in order to figure out how you want to help the 15 percent who don't have health insurance, we should have looked at the problem more carefully. Of the 15 percent who don't have health insurance, one-third of them are young and healthy and make more than $50,000 a year. So one-third of the problem had nothing to do with not being--well, it did have something to do with not being able to afford it. It had to do with the health insurance costing too much. So we should have tried to figure out how we lower health care costs, and if you are a young, healthy person, we should have expanded health savings accounts. There are ways we could fix this.

What I would ask the Senator from Texas is: Does he see a way forward? Does he see that we can get the other side to come forward and tell the American people that, yes, we made some mistakes? We made some mistakes, and even our friends are telling us we made these mistakes and we want to work with you. Because I think the problem, the perception out there is that we don't want to work with them, but it is completely the opposite of the truth. The truth of the matter is, as I see it, they won't work with us. They won't open the process and we can't have a debate. We are having a debate, but where is the other side? Why can't we influence legislation? Why can't we be part of trying to fix health care? I don't know if ObamaCare is fixable, but health care is fixable.

The main problem of health care is price. It costs too damn much. Can we fix that? Could they come to the Senate floor and say: We are going to have amendments, we are going to have an open amendment process, and we are going to try to fix ObamaCare?

Does the Senator see an opening where maybe the President would compromise and come and say: Yes, I am willing to work with you in order to fix health care in this country?

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Mr. PAUL. One of the questions that should not only be asked of the Senator but should be asked of the President: Why doesn't the President voluntarily take ObamaCare? It is his baby, and if he loves it so much, why doesn't the President take it? He could voluntarily go on the exchanges.

I am sure they would welcome him down at the DC exchanges. In fact, I think that ought to be a question they ought to ask him at the press briefing today: Mr. President, are you willing to take ObamaCare? If you don't want it, why are we stuck with it?

So if the President can't take it, if Chief Justice Roberts doesn't want it--here is the thing. If we want to see a rebellion, we should ask Federal employees to take ObamaCare--that is what my amendment says--not just Congress. I am willing to take it. I don't want it. I absolutely don't want it, and I have been frank about it. I am not a hypocrite. I didn't vote for it, I think the whole thing is a mess, and I don't want it. But the thing is, if I have to take it, I think the President ought to get it. He ought to get a full dose of his own medicine.

I think Justice Roberts should get it. I think he contorted and twisted and found new meaning in the Constitution that isn't there. So if he wants it so much, if he thinks it is justified, if he is going to take that intellectual leap to justify ObamaCare, he ought to get it. There are millions of Federal employees. They don't want it. Guess who they vote for usually?

I think it is a partisan question. I think if we were to put it forward and say ObamaCare is such a wonderful program for everybody, let's give it to the Federal employees, my guess is we wouldn't get a single vote from the opposition party, but we will not even get a chance because they don't want to talk about it: ObamaCare is good. We want to shove it down the rest of America's throat, but we exempt ourselves.

I have a constitutional amendment. I frankly think Congress should never pass any law if they are exempted from it. I think there is an equal protection argument for how it would be unconstitutional for us to do so. Yet we have done it repeatedly.

But my question to the Senator from Texas is, What does he think? Does the Senator from Texas think maybe we should ask the President to come down today and sign up for ObamaCare? I think we should ask him that today, every day, and henceforth: Mr. President, if it is such a good idea, why don't you get it?

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