I agree with Mr. Thompson, Paul, that to have a serious conversation, we need a plan.

I think the Affordable Care Act needs a chance to move forward to see if this stuff works before you can actually have a serious conversation about a voucher or a premium support plan.

This will not only continue the death spiral that our health care providers are experiencing in the State of Wisconsin...

Thank you, Mr. Chairman. First of all, the Judiciary Committee, not the Health Subcommittee of the Ways and Means, has jurisdiction over constitutional law issues.

Obviously, some of the disturbing trends that they see in that report is mainly the inadequacy of funding for the IRS.

We can go down another route, which merely privatizes Medicare, turns it into a private voucher plan, shifts the cost on the backs of seniors, an additional $6,000.

80 percent of the seniors in western Wisconsin rely on Social Security as their sole source of retirement income, 80 percent. They can't take a $6,000 hit in Medicare.

We have to change the way we pay for health care, so that we are paying for the value or the quality or the outcome of care.

I would be the first to admit that IPAB requires a leap of faith. But I supported it.

We can allow time to transpire for delivery of system and payment reform to take place, or there is the ACO models or medical homes for the better coordinated care.

I think it makes sense. I think it is a fail-safe backstop effort to constrain the largest and fastest growing area of spending.