mr. chairman , i thank the gentleman for yielding me time .  mr. chairman , i wish to speak very briefly about an aspect of fiscal responsibility , the rule called pay-as-you-go , because there is a connection between our lack of fiscal responsibility and these draconian cuts we are seeing in vital services , like the $ 20 billion that people who are poor and dependent on medicaid will be forced to endure .  our colleagues in the majority have consistently opposed democratic efforts to reinstall pay-as-you-go rules for both entitlement spending and new tax cuts .  in fact , they just denied the house the ability to vote on such a proposal offered by the gentleman from tennessee ( mr. cooper )  and the blue dogs .  these paygo reforms were put in place in the 1990s and were essential to the successful effort achieved then to balance the budget .  paygo reforms have been endorsed in their entirety by alan greenspan , but the republicans do not want them applied to tax cuts .  why ?  because doing so would require that they identify specific revenue measures , most likely spending cuts , which would provide the offsets , vital spend services being cut , such as medicaid .  so we should reinstate paygo .  we should not support this budget , that destroys so much which is a part of our health care delivery , medicaid .  