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IN CASE YOU MISSED IT:

Sun, 22 Nov 2009 05:00:00 GMT

Appearing today on ABC's "This Week With George Stephanopoulos" Congressman Marsha Blackburn discussed disturbing recommendations made by the U.S. Preventive Services Task Force (USPSTF) regarding mammograms. Blackburn cited specific language in the House Democrat's health care reform bill that would give those onerous recommendations the force of law.

Watch the full exchange here.

**** FACT CHECK ****
H.R. 3962 and Preventive Services: Read Blackburns detailed analisys of the text of H.R. 3962 to see how recommendations by the USPSTF would achieve binding force and impact American women.

U.S. Preventive Services Task Force: Many have asserted that the USPSTF is an independent panel not connected to the Federal Government. This is untrue. According to their own webpage, the Task Force was first convened by the U.S. Public Health Service and now works under the Department of Health and Human Services Agency for Health Care Research And Quality. Public Law requires that AHRQ convene the USPSTF. Read more at their website: http://www.ahrq.gov/clinic/uspstfab.htm (note the .gov address!)

**** TRANSCRIPT****
STEPHANOPOULOS: Excuse me for a second. I want to bring this back to another controversy we had this week over the cancer deadlines, because it connects to this point in the patient-doctor relationship. You and several others were critical...

BLACKBURN: Yes.

STEPHANOPOULOS: ... of the -- of the guidelines saying that this is -- that under the president's plan, under the Democrat's plan, it's going to lead to more rationing. Yet the American Cancer Society says that the Republican alternative is worse, would do more harm than good, wouldn't give preventive services to anyone, and that under these bills, preventive care is encouraged and actually required by insurance companies. So isn't that an improvement?

BLACKBURN: Well, actually, it is not. And the guidelines that came out this week by the Preventive Services Task Force have a direct link to what would be offered if the House and the Senate bills were to go into law, if they were to be put into law.

And, George, this is exactly how it happens. If you go to page 1,296 of the House bill, the engrossed copy, and you began to read in title three of that bill, on preventive and wellness services, and you get down to section 2301, this is what happens. In section 3131 of that bill, it changes the Preventive Services Task Force to the Clinical Preventive Services Task Force.

[FACT CHECK: Authority for the Task Force on Clinical Preventitive Services in H.R. 3962 is here]

Then, you go back and you see that that task force on preventive clinical services is tasked with rating A, B, C, D, or I all preventive services. Then you go back into section 222 of the bill...

[FACT CHECK: Grading preventive services language is here on page 1302]

(CROSSTALK)

BLACKBURN: Yes, I have read this bill. And that indicates what would be paid or covered. And this is where the actual link comes, and I'll read it for you. In section 2301, it says, "All recommendations of the Preventive Services Task Force" -- that's the group that did the mammograms -- "and the Task Force on Community Preventive Services, as in existence on the day before the date of the enactment of this act, shall be considered to be recommendations of the Task Force on Clinical Preventive Services."

[FACT CHECK: Current USPSTF recommendations having the force of law is here on pages 1329-1330 lines 21-25 and 1-5 respectively ]

STEPHANOPOULOS: So the guidelines -- the point is that the guidelines then...

BLACKBURN: They becomes the law.

STEPHANOPOULOS: ... would -- would become...

BLACKBURN: They become the law, the mandate.

STEPHANOPOULOS: ... would become controlling.

WASSERMAN SCHULTZ: No, they would not be.

BLACKBURN: Yes, they do.

WASSERMAN SCHULTZ: And what's unfortunate is that the Republicans, and Ms. Blackburn, have for the first time politicized breast cancer.

BLACKBURN: That is incorrect.

WASSERMAN SCHULTZ: That is -- no, it is not. And I'm a breast cancer...

BLACKBURN: No, it is incorrect.

WASSERMAN SCHULTZ: As you know, as a breast cancer survivor, Marsha...

BLACKBURN: That is incorrect. It's in the bill, Debbie.

[FACT CHECK: Read exactly where it is in the bill here]

WASSERMAN SCHULTZ: Excuse me.

STEPHANOPOULOS: Let her finish her point.

BLACKBURN: I have a great respect -- yes.

WASSERMAN SCHULTZ: As a breast cancer survivor, I came out against these -- these recommendations. Every major cancer organization has come out against these recommendations. The task force language in that bill actually makes sure that prevention -- preventive services like mammograms and colonoscopies and other cancer screenings would be free. The task force recommendations -- the language in the bill...

(CROSSTALK)

STEPHANOPOULOS: Well, Debbie, let me -- let me clarify this...

(CROSSTALK)

WASSERMAN SCHULTZ: ... that even more women would get access to...

(CROSSTALK)

STEPHANOPOULOS: Excuse me for a second. That -- that is true. But let me clarify a little bit, because under the -- the bill -- and we have -- we have the language, as well. It says that a group health plan and health insurance issuer offering the group (ph) shall provide coverage, but only under -- if the Preventive Services Task Force rates it as an A or B.

[FACT CHECK: H.R. 3962 page 1302 lines 14-16]

BLACKBURN: That's right.

STEPHANOPOULOS: And, actually, under the -- under the task force, they said that these mammograms for women 40 to 50 is rated C. So they actually wouldn't be covered. So you have a great expansion for a broad part of the population, but actually, these guidelines would be controlling for ages 40 or 50.

[FACT CHECK: USPSTS mammogram recommendation for women under 50 is "C" ]

(CROSSTALK)

WASSERMAN SCHULTZ: ... task force's recommendations are simply recommendations. They...

[FACT CHECK: H.R. 3962 "all recommendations of the Preventive Services Task Force...as in existance on the day before the date of the enactment of this Act shall be to be considered recommendations foy the Task Force on Clinical Preventive Services." (page 1329-1330)]

[FACT CHECK: H.R. 3962 page 1317-1318 "If on the basis of findings of research and demonstration projects...the Task Force on Clinical Preventive Services Determines that a subsidy or reward meets the Task Force' standards for a grade A or B the Secretary shall ensure that the subsidy or reward is included in the essential benefits package..."]

BLACKBURN: No.

WASSERMAN SCHULTZ: They aren't controlling.

COBURN: As a physician who's been...

(CROSSTALK)

WASSERMAN SCHULTZ: They aren't going to be -- they aren't going to be binding. They're recommendations.

STEPHANOPOULOS: Well, but the language here says they would be binding on that issue.

(CROSSTALK)

COBURN: Here's the question. Here's the question we ought to be asking. Do these recommendations make sense from a cost standpoint? Absolutely, from a cost standpoint, they're right. You look at the statistical analysis, they make sense.

From a patient standpoint, they're atrocious. And that's the problem with a bureaucracy stepping between a physician and their patient.

STEPHANOPOULOS: Can you weigh in on this?

NELSON: Well, absolutely. I -- I worry about a government-run plan that would be subject to recommendations that might be applied universally without respect to patients. I am concerned about that, not that you can't fix some of those concerns, but you can't fix every one of them, and I am concerned that if it's -- if it's turned over -- look, the insurance industry has its own challenges. And -- and many of those can be handled with transparency and by eliminating pre-existing conditions and rescissions and rating based on health and some of the other ratings -- gender ratings.

But -- but we're not going to -- if we can keep as much of it at the state level is as possible, you've got -- you've got patient's bill of rights, you've got all kinds of mandated coverages, and -- and this can be handled on a state-by-state basis. It gets lost in Washington in a big government-run plan, and I don't know what happens.

STEPHANOPOULOS: But if you don't have these kind of guidelines, how are you going to get the cost control you were talking about 10 minutes ago?

NELSON: Well, I don't mind guidelines and recommendations, but I don't want them to become the equivalent of rules and law.

WASSERMAN SCHULTZ: And we can't...

(CROSSTALK)

BLACKBURN: And it says "shall."

[FACT CHECK: H.R. 3962 page 1317-1318 "If on the basis of findings of research and demonstration projects...the Task Force on Clinical Preventive Services Determines that a subsidy or reward meets the Task Force' standards for a grade A or B the Secretary shall ensure that the subsidy or reward is included in the essential benefits package..." emphasis added.]

WASSERMAN SCHULTZ: We have to make sure that we're not forgetting about the people. And that's what the task force forgot about this week, is that we're not thinking about big, amorphous blobs of -- of people. Making -- these recommendations say that we can trade one life to save the angst and anxiety in a -- a larger group of women, and that's totally inappropriate, but that's also why major experts, medical experts, the cancer society, the colon foundation all came out against this, and that won't be...

BLACKBURN: Well, but still it's a mandate.

WASSERMAN SCHULTZ: ... controlling in the final legislation.

(CROSSTALK)

STEPHANOPOULOS: ... going to be changed?

WASSERMAN SCHULTZ: Actually, you know, I would invite you -- I would invite you...

(CROSSTALK)

BLACKBURN: Well, you know what? I think you and I need to work as -- together on a motion to instruct and get this language out of here, because on page 1,318, it does mandate it. It...

WASSERMAN SCHULTZ: Marsha, first, I would suggest...

BLACKBURN: ... says that the HHS secretary has to do this. So, you know...

WASSERMAN SCHULTZ: No, we have different interpretations, but...

BLACKBURN: ... Debbie is right when she says they forgot about people. Indeed, they did. But we have to realize, this group that made this recommendation, this isn't some outside group. This is a part of HHS. And when you look at the...

WASSERMAN SCHULTZ: It's an independent group. That is not accurate.

BLACKBURN: ... 118 -- when you look at the...

WASSERMAN SCHULTZ: It is not a part of HHS.

BLACKBURN: No, it is a part of HHS.

[FACT CHECK: USPSTF is part of the Department of Health and Human Services ]

WASSERMAN SCHULTZ: No, it is not.

BLACKBURN: And when you look at what is going to happen with these 118 new bureaucracies with 62 directives that are given by the health choices commissioner on what insurance can be offered in this country after 2013 and what is going to be paid, you know that this is the bureaucrat in the exam room. This is how it's going to happen.

WASSERMAN SCHULTZ: Marsha...

BLACKBURN: And this is the first step.

WASSERMAN SCHULTZ: Marsha, there's an insurance company bureaucrat in the -- in between the patient and her doctor right now.

BLACKBURN: This is breast cancer. Well, and people don't like that, and we need to get rid of...

(CROSSTALK)

WASSERMAN SCHULTZ: And your bill -- your -- your alternative...

(CROSSTALK)

BLACKBURN: We need to get rid of all of those insurance bureaucrats.

READ THE BILL, CONNECT THE DOTS, MAMMOGRAMS AND RATIONING

Sat, 21 Nov 2009 05:00:00 GMT

This week, the U.S. Preventive Services Task Force, an agency within the Department of Health and Human Services, published a study recommending that women under 50 do not need to receive annual mammograms. The study created an uproar in Washington while angering and confusing women across America.

Setting the scientific evidence in the study, its methodology, and the troubling implications for women’s health aside, I’d like to show how the Democrat health care bill, H.R 3962 (Full Text Linked Here) will give this troubling study the force of law and result in limited access to mammograms for women enrolled in a health insurance exchange plan or the public option. In short, connecting the dots through H.R. 3962 will illustrate how these regulations place us all on the slippery slope to health care rationing.

STEP 1: Provider Networks And Essential Benefits
Lets start with the full text of H.R. 3962 as finally passed by the House this month. Page 106 of the bill, starting at line 7, sets forth guidelines that all health insurance plans and the public option must comply with. Page 107 goes on to define these plans as “provider networks.”

Jumping a few pages ahead, to page 110, we see on line 3 that the bill lays out precisely what essential health care benefits must be in these approved plans. Those services begin to be outlined on page 111, line 8 . Service 8 (number “8” on line 1 of page 112) says that “preventive services, including those services with a grade of A or B by the Task Force on Clinical Preventive Services” must be covered.

STEP 2: The Task Force
Who is this Task Force on Clinical Preventive Services? Well, their authority begins to be laid out in Section 2301 of the bill, starting at line 18 of page 1296. Their specific authority begins to be spelled out on page 1301 at line 15. The bill says that The Task Force will identify clinical preventive services for review.” The Task Force will “review the scientific evidence related to the benefits, effectiveness, appropriateness, and costs of clinical preventive services.” (page 1302 lines 1-3) The Task Force will then, “determine whether subsidies and rewards meet The Task Force’s standards for a grade of A or B.” (page 1302 lines 14-16)

STEP 3: Services Graded And Provided
On page 1317 at line 21 the bill reiterates that the Secretary of Health and Human Services must include those A and B graded services among essential benefits that all health care plans must include.

Here is where we have to inject a little common sense into H.R. 3962. The bill mandates that all Americans must be able to purchase plans in the exchange and be provided these essential benefits; in this case, preventative care ranked with a grade of A or B. This will be enormously expensive for private plans and for the Federal Government under the pubic option since everyone must be covered.

Because there is no mandate or incentive in the bill to provide coverage for services graded as C or below, it is reasonable to conclude that costs will keep health care plans from providing these services.

Going back to the text of H.R. 3962; on page 1329, line 21 the bill goes into more detail about the Task Force’s recommendations. It says “all recommendations of the Preventive Services Task Force [the panel that issued this week's mammogram reccomendation]… as in existence on the day before the date of the enactment of this Act shall be considered to be recommendations of the Task Force on Clinical Preventive Services…” It goes on to say, and I find this remarkable, that the Preventive Services Task Force automatically becomes the Task Force on Clinical Preventive Services.

STEP 4: What This Means For Mammograms
The very mammogram study that we heard so much about this week, the one conducted by the Preventive Services Task Force, will automatically be the guideline for determining what grade mammograms for women under 50 receive. As you can see here the study recommended a grade of “C” for that service. This all means that getting a mammogram under the age of 50 is not considered an “essential benefit” and will not be covered under the new health care regime.

Blackburn Votes No On "DocFix"

Thu, 19 Nov 2009 05:00:00 GMT

Congressman Marsha Blackburn voted against H.R. 3961, a measure dealing with Medicare compensation rates for doctors. As written, the legislation presented Members of Congress with a stark choice; add a staggering quarter-trillion dollars to the Federal debt, or impose staggering cuts to Medicare in the form of lower compensation rates to doctors while increasing costs for seniors. H.R. 3961 will only temporarily stave off compensation cuts and could ultimately limit patient access.

The Senate failed to pass a companion measure earlier this year, meaning H.R. 3961 has virtually no chance of getting to the President’s desk, regardless of House action.

“As we debated health care reform, the House was promised that $500 billion in Medicare savings could be achieved and dedicated to the establishment of a health insurance exchange. I am baffled and outraged that House Leadership did not first apply these alleged Medicare savings to fixing this important compensation problem before they decided to establish a new entitlement on the backs of our seniors. Consequently, seniors who have paid into Medicare all their lives will now quite literally fund a public option system through higher medical costs.”

“Situations like the one before us, where Congress is forced to choose between patient care and fiscal responsibility, are about to become all too common as the Federal Government moves to take over health care. I hoped that the Majority would deal with this issue responsibly under health care reform legislation last month, but they chose not to.”

“I continue to support bi-partisan approaches that will permanently address averting these scheduled cuts. The bill before us, however, is a temporary bandage that will not address the systemic challenge of doctor’s compensation. It will add to the debt and we will be in the same position again as early as 2011. In voting no, I hope that I can send my colleagues on both sides of the aisle back to the drawing board on this one.”

Congressman Blackburn supported the Republican alternative put forward in a motion to recommit. Republican plans would reform Medicare and put the savings back into the program by addressing the physician compensation cuts. Many of the savings would be realized by implementing meaningful medical liability reform. While the Democrat proposal will increase the deficit by a quarter trillion dollars, the Republican alternative will not.

Blackburn Hails Stimulus Achievements

Tue, 17 Nov 2009 05:00:00 GMT

Congressman Marsha Blackburn (TN-7) today hailed the Obama Administration’s efforts to create jobs and expand the number of Congressional districts in Tennessee. While the stimulus has only “created or saved” 9,548 jobs in Tennessee, Blackburn was gratified to see that it also increased the size of the delegation by 38 seats. Between 1982 and today, Tennessee only had nine Congressional districts.

According to Recovery.gov, Tennessee’s 29th Congressional District gained 20 jobs and more than nine million dollars in stimulus funding. Blackburn’s 7th District only beat the 29th District by 109 jobs. In all, the Stimulus created 28 jobs in Congressional districts that did not exist previously. If the trend continues, Tennessee could have a whopping 49 electoral votes for the 2012 election.

“I have been a vocal advocate for transparency in the stimulus bill, but this is more than I could have expected,” Blackburn said. “Not only can we track how many jobs were in created in each of Tennessee’s congressional districts, but in the process we have found dozens of districts we didn’t even know we had. Once we get all these seats filled, Tennessee will have a larger delegation and more clout than Texas. At nearly $400,000.00 per job, we also know that Tennesseans are the most valuable workers in the nation.”

In total, the stimulus has awarded over three billion dollars in Tennessee and created fewer than ten thousand jobs, regardless of the Congressional district. Unfortunately, more than three hundred thousand Tennesseans remain unemployed.

“Jokes aside, today’s additions to Recovery.gov illustrate what a confused failure the stimulus has been. Clearly, the Administration is incapable of explaining where these funds are being spent or why they aren’t creating jobs. As the debt mounts up, Tennesseans are still looking for work. Tennesseans deserve better and Washington can do better. It is time to incentivize investment and business creation and stop throwing more good money after bad.”

Town Hall Meeting In Lexington

Wed, 11 Nov 2009 05:00:00 GMT

Congressman Marsha Blackburn today announced a town hall meeting in Lexington, TN. The meeting follows last week's House vote on health care reform. Blackburn held eleven public meetings in Tennessee's 7th District in August. She also hosted two telephone town hall meetings in the days leading up to the health care vote.

WHAT: Congressman Blackburn's Town Hall Meeting

WHEN: Saturday, November 14th, 11:00 AM

WHERE: Sparky's Restaurant, 496 W. Church Street, Lexington, TN

Blackburn Votes No On Govt. Takeover Of Health Care

Sat, 07 Nov 2009 05:00:00 GMT

Following a weekend debate, Congressman Marsha Blackburn (TN-7) voted no on H.R. 3962, a bill that would lead to the government takeover of health care.

"There are substantial flaws with our health care system. Unfortunately, there were also substantial flaws in this bill. Republicans and Democrats alike voted against this bill; not because we are satisfied with the status quo, but because this bill will make the state of health care in America much worse. This bill robs the Medicare trust fund of five hundred billion dollars, treating it like a slush fund to build an intrusive and extensive new entitlement. It forces billions in unfunded and unsustanible mandates on Tennessee. It places a bureaucrat between Tennesseans and their doctors. It adds billions in debt but will not heal one American."

"Through this debate, I supported and promoted other legislation that would bring down the cost of care by creating risk pools, association health plans, and allow the purchase of insurance across state lines. The Congressional Budget Office found that legislation I supported would have reduced a typical family's health care premiums by five thousand dollars a year without sacrificing a single American job or adding a dime to the deficit. My colleagues who voted for this bill can't make that claim."

"The proponents of H.R. 3962 began this debate with the claim that 'if you like the plan you have, you can keep it'. In a few short years, Americans will find that this is just another broken Washington promise. Soon, Federal bureaucrats operating under the orders of a Health Choices Commissioner will begin to drive insurance plans out of the market and force unwilling Americans onto a public option that won't meet their needs. Tennesseans know from our experience with TennCare what is in store for the American people and that future saddens me."

Blackburn Reacts To 10.2% Unemployment

Fri, 06 Nov 2009 05:00:00 GMT

Today Congressman Marsha Blackburn (TN-7) reacted to the latest unemployment figures:

“Despite billions in deficit spending and an unprecedented expansion of the Federal Government, unemployment has reached a staggering ten percent nationwide. It is far higher in many places in the 7th District. Despite what the President and Speaker Pelosi would have you believe, there is no such thing as a ‘jobless recovery’. This is the wrong time to enact a multi-trillion dollar health care bill that will raise taxes on small businesses and leave millions more unemployed.”

“For all their talk of ‘stimulus’ liberals in Washington have forgotten that the best economic stimulus is a job. To create jobs we need to reward innovative small businesses, incentivize investment, and truly bring down the cost of health care instead of building yet another dysfunctional federal bureaucracy. In other words, we need to change direction completely.”

Blackburn Makes Eleventh Hour Push To Save States From Billions In Unfunded Mandates

Fri, 06 Nov 2009 05:00:00 GMT

Congressman Marsha Blackburn (TN-07) is submitting a series of Amendments to H.R. 3962 that will save states from tens of billions in unfunded mandates.

“The bill as written will impose a $1.4 billion unfunded mandate on the state of Tennessee through the Medicaid expansion over the next five years. That is just the tip of the iceberg and completely unsustainable.”

Blackburn’s amendments would also ensure that American’s can keep their coverage if they like it by prohibiting the enactment of an insurance exchange until the Secretary of Health and Human Services certifies that such exchange will not rob Americans of their existing coverage. Blackburn’s amendments will secure Health Savings Accounts for the Americans who choose to have them. Additional amendments seek to make H.R. 3962 fiscally responsible by ensuring that it does not consume 25% of the federal budget.

Blackburn will submit these amendments during the Rules Committee proceedings this evening.

Unfunded Mandates: Prohibits the federal government from imposing unfunded health care mandates on the states.

Health Care Rationing: Prevents the federal government from passing any law that would ration health care for the American people.

Preserving Coverage You Like: Prohibits the public option and health care exchange programs from being established until the Secretary of Health and Human Services certifies that the establishment of the government plan and exchange will not (either directly or indirectly) cause the cost of the average price of private health insurance premiums to increase.

Defending The Coverage You Have: Suspends the operation of the government plans unless the HHS Secretary certifies that no American will lose access to his or her current health insurance due to the establishment and operation of the government plan. This will be an annual certification.

Health Savings Accounts: Ensures that nothing shall prevent an individual from purchasing or maintaining insurance qualifying for Health Savings Account deposits and that nothing shall interfere with an individual’s ability to continue to make deposits according to the schedule created in the 2006 HSA legislation.

Federal Budget Protection: Prohibits excess spending in H.R. 3962. When the cost of the reforms made under the bill consume 25% of the federal budget, then the bill is repealed and return to the system was in place before this bill was enacted.

Blackburn Announces Telephone Town Halls

Wed, 04 Nov 2009 05:00:00 GMT

Congressman Marsha Blackburn (TN-7) today announced a series of telephone town hall meetings scheduled for this week. The meetings will allow Congressman Blackburn to listen to constituents ahead of a vote on H.R. 3962, the Democrat health care reform proposal. A vote is expected as early as Saturday.

Residents of Chester, Decatur, Fayette, Hardeman, Hardin, Henderson, McNairy, and Shelby Counties will be invited to call into a meeting on Thursday, November 5th beginning at 5:00 PM Central Time.

Residents of Chetham, Davidson, Hickman, Montgomery, Perry, Wayne, and Williamson Counties are invited to call into the meeting on Friday, November 6th beginning at 5:10 PM Central Time.

Each meeting is expected to last an hour. Constituents wishing to participate should call 877-229-8493 and use the ID code 14988.

Blackburn Respods To Tennessean Editorial

Sun, 01 Nov 2009 04:00:00 GMT

GOP can back health-care reform, just not this plan
By U.S. Rep. Marsha Blackburn
(As printed in The Tennessean)

Your recent editorial “Lawmakers keep up fight for health-care reform” (Oct. 25) perpetuates the misconception that responsible opposition to a deeply flawed piece of legislation translates into opposing reform more broadly. It does not.

Specifically, your statement that Republicans “have been content to oppose every health proposal brought forward” and that such opposition “is pure politics” could not be further from the truth.

I, along with what appears to be a majority of representatives in the House, oppose H.R. 3200 because it will exacerbate, rather than resolve, the problems with our health-care system. That does not mean that I don’t recognize that our system has serious flaws. Nor does it mean that I am any less committed to reform than any of my colleagues. Indeed, I am co-sponsor of three pieces of legislation that I know will better address needed reform:

H.R. 3218, by Rep. John Shadegg, which would allow for small businesses, churches, alumni associations and other small institutions to pool together and offer health plans, much like the co-ops some Democrats have embraced,

H.R. 3713 by Rep. Mike Rogers, which accomplishes most of President Barack Obama’s stated reform aims without imposing a public option.

H.R. 3400, by the Republican Study Committee, which allows insurance plans to be purchased across state lines and includes provisions I authored to allow seniors to opt out of Medicare without putting their Social Security benefits at risk. Many of these substantive efforts at reform were passed in the House in 2006 but failed to clear procedural roadblocks in the Senate.

Second, Republicans are in the distinct minority in Congress. Our votes alone are not sufficient to stop any bill the speaker and majority leader wish to have passed. If health-care reform is stalled, it is because Republicans and Democrats who know the issue well have practical problems with legislation before them.

In maligning our opposition to a public-option plan, “because it is politically too volatile, or because they are beholden to insurance companies for campaign contributions,” you dismiss out of hand the notion that any members of Congress might actually have substance behind their position.

State-run public-option plans, like TennCare, have consistently driven health-care costs up and restricted access. Until public-option advocates can point to a plan that has worked, skeptics are right to reserve their support.

Many Republicans and Democrats in the Tennessee delegation have stated their reservations about the health-care bills — not the principle of reform — under consideration today. Very few have actually voted for it. Our own governor, perhaps the most experienced chief executive the nation has when it comes to health care, has warned us that plans under consideration could bankrupt Tennessee. These are not small concerns cooked up by insurance companies but substantive reservations based on painful past experience.

It is wrong to paint us as partisans or obstructionists because we have raised objections to a single bill whose sponsors have ignored the lessons of history.