[Congressional Record Volume 153, Number 87 (Friday, May 25, 2007)]
[Senate]
[Pages S6945-S6949]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTH CARE
Mr. WHITEHOUSE. Madam President, in the last few days, I have come to
the floor to speak about reform of our broken health care system: how
to make that system run better, so that tens of billions of dollars are
not wasted every year, so we no longer lose as many as 100,000
Americans every year to avoidable medical errors, so that we no longer
spend vastly more of our GDP every year than any other industrialized
nation for poorer health care outcomes.
I believe three central things need to be reformed. One is improving
the quality of care in ways that drive down costs. I spoke about that
on Tuesday and used the example of an intensive care unit reform in
Michigan that saved $165 million in 15 months and saved over 1,500-plus
lives. We need to encourage a lot more of that. The second major reform
we need is of health information technology, and I spoke yesterday
about the dire state of information technology in health care today-the
Economist magazine reported that the health care industry was the worst
of any American industry except the mining industry and the significant
savings we could generate from expanding our use of health information
technology. The RAND Corporation predicted that adequate health
information technology would save us from $81 billion to $364 billion
per year. We need desperately to capture those savings.
Today, I want to talk about the third piece of this reform: repairing
our health care reimbursement system, the way we pay for health care,
so that the economic signals we send into the system produce the care
we want. Improving quality of care will be an uphill struggle until our
payment system rewards it. Health information technology will lag
behind other industries until the economics of investing in it makes
sense for participants in the health care sector.
These problems can each be fixed, but the repair will work better if
the three solutions proceed together, not necessarily as one, but
staying close, because they are mutually reinforcing.
The payment system for health care expenditures today sends all the
wrong messages: it rewards procedures rather than prevention; it
rewards office visits more than email contacts; it neglects best
practices and discourages innovation. To a large degree, the system has
been co-opted by today's unfortunate business model for health
insurance. This is a business model which seeks first to cherry-pick
the healthy customers and abandon the sick ones, second to try to deny
coverage if a customer does get sick, and third to try to deny claims
whenever their sick customer's doctor tries to send in the bills.
Health care economics gets in the way of the change we need, gets in
the way of improved quality of care, gets in the way of investment in
information technology and illness prevention, and gets in the way of
lowered costs.
The problem is best exemplified by a tale from a book called
``Demanding Medical Excellence'' by Michael Millenson. Northfield, MN,
Madam President, is a town I am sure you know. It is a town of only a
few thousand people, but it was home to four very innovative doctors at
Family Physicians of Northfield. They discovered they could reduce the
average treatment cost of a urinary tract infection from $133 to only
$39, a savings of nearly 70 percent, by changing their practice
pattern. Instead of doing an office examination, a complete urinalysis
and culture, sensitivity studies for antibiotics, prescribing ten days
of antibiotics, and a follow-up culture, they attained the same results
with a phone conversation with a patient, a complete urinalysis, and a
prescription for three days of antibiotics. But pretty soon, the Family
Physicians at Northfield were so good at treating their patients--for
urinary tract infections and other diagnoses--that their
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waiting room was empty. As a reward for their good work, the practice
lost so much revenue, from never-performed lab tests and empty
appointment calendars that, in 1995, Family Physicians of Northfield,
was forced to close. These doctors were taught a harsh, and perverse,
lesson by our present health care system, and that lesson is: reduce
costs and improve care, and you will be punished.
In Rhode Island, our hospitals are pursuing quality improvement
projects in every intensive care unit in the state, modeled on the
Michigan program that saved $165 million in 15 months and over 1,500
lives as well. The Rhode Island intensive care unit program had a
significant hurdle to overcome, however: the cost was expected to be
$400,000 annually per intensive care unit, and the hospitals had to pay
it. The savings were estimated to be $8 million, but those savings
would not go back to the hospitals. The savings went to payers. So, for
its $400,000 invested, a hospital actually stood to lose money, from
shorter intensive care unit stays and fewer complications, so fewer
procedures to remedy the complications. Truly pushing that quality
envelope, and striving for zero tolerance in infections and errors, was
against the hospital's best economic best interests. It took the
special, collegial relationships developed within our Rhode Island
Quality Institute to solve this payment dilemma between our hospitals
and insurers.
A similar analysis pertains to prevention investments. The payer has
to shoulder 100 percent of the cost today, but the savings in
forestalled illness might not occur for years. Maybe by then the
customer will be some other insurer's customer, then maybe Medicare's.
If you are the insurer, why take the chance and assume that cost, if
the savings will not accrue to you?
There are many ways to repair perverse incentives in the way we pay
for health care, but one that makes sense to me and uses existing
infrastructure would be the following. Let medical societies and
specialty groups, who create ``best-practices'' within their specialty,
submit those best practices--including cost-effective prevention
programs--for approval by local health departments. If, after suitable
administrative procedures, the best practices are approved, reward the
effort by differentiating, in Medicare and Medicaid reimbursement
rates, between care that follows the local best practices and care that
does not. Reward the effort by forbidding any insurer operating in
interstate commerce--any health insurer--from using ``utilization
review''--that is their word for denying payment--for care that is
delivered within these approved best practices. Require them to pay all
those claims, in which the provider followed best practice protocols,
within 30 days.
The legislation I have prepared will do just that.
This legislation sets a lot of good forces in motion. It encourages
development and dissemination of best practices in medicine. It
encourages doctors to follow those best practices, and discourages the
wide and unjustifiable variations in medical treatment evident now. It
encourages a sensible one-time debate in a professional, administrative
forum at the time approval or amendment of the best practices is
sought, and it discourages the wildly expensive payment battle now
fought, claim by claim, between insurers and providers. I know from my
experience as the insurance commissioner for Rhode Island how much time
and money insurers and providers spend in claims administration.
Studies have estimated that $20 billion is spent every year in this
bitter and expanding arms race, both by insurers seeking to deny claims
and doctors seeking to defend their claims, and every dollar of that
fight is wasted. Doctors in Rhode Island tell me regularly that as much
as half of their staff is engaged in this billing battle. Instead of in
providing health care for their patients.
My legislation will engage the medical community in a thoughtful way.
It will bring best practices to the forefront. There is a lot of
discussion about comparative efficiency in health care today, debates
over which treatments and methods are most effective--this legislation
will provide a truly meaningful forum for those discussions. An
example: Recently, the New York Times reported on a 40-step protocol
implemented for bypass surgery patients by Geisinger Health Systems,
which right now can be implemented only within Geisinger hospitals.
This bill would allow these protocols, if pursued by the local
cardiology association and approved by the State health department, to
get favorable reimbursement statewide. I hope this bill will help the
health insurance industry look to a new business model where your
insurance company is looking out for you, is your advocate when you are
sick, reminds you when testing or prevention is appropriate, helps you
find the best practices or care, where your insurer is your navigator
and your adviser in the health care system instead of your adversary.
This legislation can help repair our health care system. It puts the
priorities and incentives in the right place so market forces are
unleashed in our favor. It uses existing structures, just in new ways.
It is designed and mandated to be budget neutral. And it does no harm
if it does not work right away, if doctors do not take it up, if health
departments will not hold the hearings, no harm is done But let's give
it a chance to work.
Let me close by saying how important this moment is. I serve on the
Budget Committee and have heard the troubling facts about what the
health care system will cost us in years to come. By the year 2050, the
combined cost of Medicare and Medicaid will rise to eat up 22 percent
of our gross domestic product. Further, as my friend Budget Chairman
Conrad has noted, the 75-year net present value of the unfunded
liabilities in Social Security and Medicare equal $38.6 trillion, and
$33.9 trillion of this total is for Medicare alone. The health care
system is eating up our economy, costing twice as much as the European
Union average. There is more health care than steel in Ford cars and
more health care than coffee beans in Starbucks coffee. It is
significantly hampering our competitiveness. It is the number one cause
of American family bankruptcies.
By acting now, by acting in advance, by bringing some sensible
economics and some sensible management and some helpful incentives to
our health care system, we can start to grapple with its cost. And if
we take on that fight here and now, while time is still on our side, we
can reduce costs in the best possible way: by improving the quality of
care, by making Americans healthier, by preventing illness before we
have to treat it, by avoiding expensive and often fatal medical errors,
by giving our doctors the decision support other professionals have had
for decades, in sum, by making our health care system better.
Considering the stakes, shame on us if we fail in that duty.
I yield the floor, and I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. REID. Madam President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
SENATE DEMOCRATS
Mr. REID. Madam President, Democrats earned the majority in Congress
last year by strongly opposing the President's failed Iraq policy and
advocating restoration of the values of working families in relation to
our Government. The American people sent a clear message last November
it was time to change course in Iraq. Congressional Democrats made that
our top priority in the first day in this Congress, and have every day
since. In less than 4 months, we have been able to send to the
President's desk a number of things to keep our Government open; and
that is the case literally.
In less than 4 months, we have been able to send to the President's
desk things he refused in years past, because now there is a
Congressional branch he has to deal with.
As it relates to Iraq, the President has vetoed the bill which
reflected the wishes of the American public and many senior military
leaders and a bipartisan majority of Congress.
Last night we sent him another bill that doesn't go as far as I would
like, and the majority of the Democratic Senators, and that is an
understatement. But it does begin the process of holding the President
and the Iraqis accountable.
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Polling Data
I think it is important to note how the American people feel, that
this isn't just a bunch of politicians talking in Washington. There was
a poll taken by the New York Times and CBS that was reported today. It
was a very in-depth poll. When we do polls at home, those of us who
serve in government, they do samplings of 400 to 600 people. This poll
was twice that big. Almost 1,200 adults were sampled, so the margin of
error was very low when this poll was done.
Among other things, it said 61 percent of Americans say the United
States should have stayed out of Iraq, and 76 percent say things are
going badly there, including 47 percent who say things are going very
badly. President Bush's approval ratings remain the lowest of his
office in more than 6 years: 30 percent approve of the job he is doing;
63 percent disapprove. More Americans, 27 percent, now say that
generally things in the country are seriously offtrack. This is the
lowest number of approval and the highest disapproval rating since
these polls have been taken.
Public support for the war has eroded: 61 percent say the country
should have stayed out of Iraq; a majority, 76 percent, including 51
percent of Republicans, say additional troops sent to Iraq this year by
Mr. Bush either have had no impact or are making things worse. Most
Americans support a timetable for withdrawal; 63 percent say the United
States should set a date for withdrawing troops from Iraq sometime next
year. The poll found Americans are more likely to trust the Democratic
Party than the Republican Party by a significant margin. More than half
said the Democratic Party was more likely than the Republican Party to
make the right decisions about the war. More broadly, 53 percent of
those polled said they have a favorable opinion of the Democratic
Party.
As for Mr. Bush, 23 percent approve of his handling of the situation
in Iraq, 23 percent; 72 percent disapprove. Madam President, 25 percent
approve of his handling of foreign policy; 65 percent disapprove. And
27 percent approve of his handling of immigration issues, while 60
percent disapprove.
Senate Agenda
Regarding the war in Iraq, I have spoken over the last week to two
parents in Nevada--one in Reno, one in Fernley--who have lost sons in
Iraq. Multiply that almost 3,500 times. I can't imagine the grief and
despair. During the last 3 days, 17 American soldiers and marines have
been killed in Iraq, 3 days--9, 2, and 6. It is an American tragedy. As
I said last night on this floor, we will not stop our efforts to change
the course of this war until either enough Republicans join us with
regard to this war to reject the President's failed policies or we get
a new President.
At the same time we have opposed the President's Iraq policy, we have
moved forward on legislation that invests in our security, our economy,
and our health. In a matter of days, we will have as law a raise in the
minimum wage. Sixty percent of the people who draw the minimum wage in
America are women, and for more than half those women that is the only
money they get for their families. It was important that we raise the
minimum wage, and we did that. It was long overdue.
We have also provided, and will shortly have signed into law, $400
million to ensure that States don't run out of money for the State
Children's Health Insurance Program. In the coming weeks, we will seek
to reauthorize this successful program that keeps millions of children
healthy. We may not be doing much for adults in health insurance, but
we are taking steps forward with our children.
For 3 years we have tried to pass legislation that would give relief
to farmers and ranchers. We have been unable to do that. The Republican
majority has refused to allow us to do that. Disaster relief for
farmers and ranchers, we did that. That is now going to be signed into
law, $3 billion. Farms have gone bankrupt in the ensuing years of the
need for this relief. I would suggest, if you look on the Internet at
what an emergency supplemental is all about, it talks about emergencies
that occur during the year--floods, fires, drought, hurricanes,
tornadoes. That is why what we did last night, farm relief, $3 billion
to help farmers and ranchers recover from drought, flood, storms, and
other disasters is long overdue. That will be the law in a matter of
days.
Because of global warming, the western part of the United States has
been swept with wildfires. In Nevada, millions of acres have burned.
When these areas burn, we get noxious weeds that come instead of the
plants and grasses that should be there. We are going to have in a
short few days relief. The law has been passed, western wildfire
relief, $465 million to help prevent and fight wildfires in the west
and elsewhere. That is so important.
As I understand, there has been a raging fire on the border of
Minnesota and Canada. It has taken days to put that fire out. That is
what we are talking about. It should have been done a long time ago. We
have had to fight for this. I can remember going to the White House,
being told by one of the President's assistants: Don't worry about
that. We will do it with one of the regular bills.
We are limited on what we can do on regular bills. This is emergency
funding. The President has gone to New Orleans, LA, more than 20 times
since those devastating floods that occurred there as a result of
Hurricane Katrina. The President has talked about it but done very
little. We did something about it. We have overcome the opposition of
the White House, and in the bill that we passed last night, we provided
nearly $6.3 billion to help the people of the gulf coast affected by
Hurricanes Katrina and Rita.
Homeland security--Senator Byrd, from his seat right here, over the
last 5 years has offered many amendments. He wrote a book and talks in
his book about the times he offered amendments to do something about
homeland security. It was defeated on a straight party line basis many
times. Last night we weren't defeated on a straight party line basis.
We didn't get enough, but we did get a billion dollars to look at
programs that are all so absolutely important and necessary: port
security, $110 million; rail and mass transit security, $100 million;
explosive detection systems for airline baggage. It is interesting with
our airlines, you climb in one of those seats in the airplane. You are
seated. You feel pretty comfortable about the person sitting next to
you. But you don't know what is in the cargo of that airplane. We got
some money for that last night, as well we should. Air cargo security,
$80 million to inspect cargo on commercial passenger airlines; $285
million for explosive detection systems for airline baggage. It was
long overdue--not enough but certainly a step in the right direction.
The Republicans had a majority of 55 to 45. They couldn't pass a
budget because it was so skewed toward the rich, so skewed toward the
business community and directed against working class America, they
couldn't pass it. We have a majority, with Senator Tim Johnson being
ill, of 50 to 49, not 55 to 45. But we passed a budget. We passed a
balanced budget that restores fiscal discipline and puts the middle
class first, cutting their taxes while increasing investment in
education, veterans care, and children's health care.
For the second year in a row, we legislated to give the hope of stem
cell research to millions of Americans who suffer from all kinds of
diseases. There is one Senator holding up our overriding the
President's veto. It could be any one of these Republican Senators. We
are at 66. We need one more to override the President's obstinance in
the form of this veto.
What the President has done to stifle hope for millions of Americans
is wrong. We were at a Senate retreat. Michael J. Fox came in, someone
whom Rush Limbaugh made fun of because he shakes when he talks. He has
Parkinson's disease. The renown actor came up and talked to us about
his money he has put in to find a cure for other people who have
Parkinson's disease. He has done good work because the human genome
project is completed, and they found the gene that causes Michael J.
Fox's neurological problems. But he said: We need more help. Stem cell
research would help us find out a way to attack that gene, to take care
of that gene. But the President has stifled, stopped, slowed down the
hope of millions of people just like Michael J. Fox.
[[Page S6948]]
Several other important bills have passed and will soon be on the
their way to the President, such as a continuing resolution. This is
not a name I came up with, the ``do-nothing'' 109th Congress. The
Republicans controlled by significant margins the House and the Senate,
and they have been dubbed by historians and the press as the do-nothing
Congress. They did less and served their constituents less days in
actual work in the Senate and the House than in the history of the
country. They did less and were in session less than the do-nothing
Congress of 1948.
One of the things they didn't do is fund the Government. They lost
the elections last November and just left town and unfunded the
Government. So there was a responsibility upon us, the Democrats, to
fund the Government from February 1 to October 1. We did that. It
wasn't easy, but we did it.
The 9/11 Commission, the President fought it. But there was a hue and
cry to establish an independent bipartisan commission to look at what
happened on 9/11, what went wrong. Led by Congressman Hamilton and
Governor Kean, this independent bipartisan commission came up with
recommendations. We waited almost 3 years for the Republican Congress
to do something. They did basically nothing. The 9/11 Commission, in
fact, gave the Bush administration failing grades, Ds and Fs, in all
that they asked Congress and the President to do. But we, the
Democratic Congress, passed all the recommendations of the bipartisan
9/11 Commission after they had been pushed aside for all those
years. Now, within a matter of weeks, the House will do the same, and
we will send this matter to the President and have him sign it.
Ethics. The most significant ethics and lobbying reform in the
history of our country we did as the first bill we took up. With the
culture of corruption that existed here in Washington in the 109th
Congress with--think about this: Am I making up a culture of
corruption? For the first time in 130 years--approximately 130 years--
someone who was working in the White House was indicted. ``Scooter''
Libby was indicted and convicted. Safavian, who was head of Government
contracting, appointed by the President and responsible for billions of
dollars, was led away from his office in handcuffs because of
sweetheart deals he made with Jack Abramoff and others.
On the other side of the Capitol, in the House, the majority leader
in the House was convicted of three ethics violations in 1 year. What
did they do to respond to that? Changed the ethics rules. He is also
under indictment.
So there certainly was a culture of corruption. Staff members are
still under investigation. Congressmen are still under investigation
because of this culture of corruption. Members of Congress have had to
resign or have lost their races because of being involved in unethical
and criminal activities.
Yes, there was a culture of corruption, and we took this up as our
first legislative measure and passed it. The House passed it yesterday.
We need to go to conference now and send that to the President.
As we all know, we have begun debate on immigration reform. We are
continuing that the week we get back. We have taken action on 7 of our
top 10 legislative priorities we introduced on the first day of the
110th Congress. It is tradition that the majority party introduces the
first 10 bills. We did that. Seven of them we have passed.
In the coming weeks, we expect to turn our attention to the remaining
three.
Energy. As soon as we finish immigration, we are moving to energy
legislation. It is bipartisan. It is legislation that has been reported
out of the Energy Committee on a bipartisan basis, legislation reported
out of the Environment and Public Works Committee on a bipartisan
basis, and legislation that has come from the Commerce Committee on a
bipartisan basis.
It is not everything I want but a great start for one of the big
problems we have facing America today: energy.
In the State of Nevada, my home, we have the third highest gas prices
in the country--Nevada. In Reno, NV, gas prices are around $3.40 a
gallon. We need to do something about it.
The gluttony of the oil companies is unbelievable--making tens of
billions of dollars. It is so interesting, every time at just about
Memorial Day, when people want to travel, their refineries go down,
they need repair. Who makes all the money? It is not the person you go
to who pumps gas in your car or even a self-service station you go to.
They make pennies. They make less than a nickel a gallon. In Reno, NV,
and other places in the country, you can pay $3.40 a gallon at the
place you buy that gasoline, and that person makes almost nothing. It
is made by the gluttonous oil companies, the refiners--record profits,
of course.
We are going to take a whack at that. I hope we can get it passed. It
has some interesting things in it. One of the things it has is CAFE
standards, saying automobiles in our country should be required to have
higher mileage per gallon. We are going to try to get that done.
The bill also includes some legislation dealing with alternative
energy. We cannot produce our way out of the problems we have in
America with oil. We have less than 3 percent of the oil in the world
in America. We cannot produce our way out of our problems. We have to
lessen our dependence on foreign oil.
Today, in America, we will use 21 million barrels of oil. It is hard
for me to comprehend there is that much oil in the ground, let alone
our use of it in 1 day. We import about 65 percent of that oil. This
oil comes from some of the worst tyrannical governments in the world.
Much of that money is used to export communism and other bad things to
countries, including to America.
We must lessen our dependence on foreign oil. This administration is
the most oil-friendly administration in the history of our country. So
we are going to take up this legislation the second week we get back.
The bill will dramatically increase America's renewable fuel production
so we can begin the crucial long-term effort to reduce our dependence
on unsustainable and volatile energy supplies I have talked about.
The bill requires consumer appliances, buildings, lighting and, most
importantly, vehicles to become much more energy efficient. The Federal
Government's own energy performance will be significantly improved as
well.
I so appreciate Senator Bingaman, the chairman of the Energy
Committee, and Senator Boxer, the chairman of the Environment and
Public Works Committee, whose career has been based on things dealing
with the environment. Senator Inouye, chairman of the Commerce
Committee, and his right-hand person in this effort, Senator Kerry,
have done remarkably good work.
This legislation will address the growing threat of price gouging and
energy market manipulation as gas prices continue to set new record
highs almost every day.
I have been so impressed with Maria Cantwell, the Senator from
Washington, for her continual efforts to go after these big gluttonous
oil companies. Her price-gouging legislation and energy market
manipulation legislation has been, in my opinion, a picture of how we
should legislate.
Education. We expect to address reauthorization of the Higher
Education Act in the next few weeks--in the next few months, probably
more likely. I hope to do it, complete it, before our August recess.
Since the act was last authorized in 1998, college costs have
continued to skyrocket. A growing number of students are being priced
out of a college education and all the doors it opens. A child's
ability to be educated should not be dependent on how much money their
parents have.
I, of course, am a big fan of early childhood education. I was so
impressed yesterday, not far from here, the conservative reporter--I
should not say reporter--editorial writer, David Brooks, from the New
York Times, talked about his belief of young people being educated and
how he had become a convert and he now believes that the Government
should be involved in getting kids educated.
Many of those lucky enough to make it through college now begin their
careers saddled by the weight of the money they have had to borrow. In
Nevada, the average debt of a student is $15,000. That is unacceptable.
It is not unusual for someone to graduate from medical school owing
$150,000.
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Now, people say: Well, doctors make a lot of money. They do not make
that much money. One of my friends, a prominent physician in Las
Vegas--I do not think he will mind me mentioning his name; if he does,
he can call me--Dr. Tony Alamo worked hard all his life--his father
came in a boat from Cuba--believes in education. The senior Tony Alamo
did everything he could to get his kids educated. He had a boy become a
doctor.
Now, young Tony is one of the lucky ones because his dad has done so
well with the rags-to-riches story in America, and I am sure as to his
debt, his dad could help him pay it off, if necessary. But Dr. Alamo is
very unusual because he has parents who can help him. He has explained
to me that when doctors graduate from medical school, they get a job,
and a lot of jobs now are with managed care, being they are all over,
and they are salary jobs. They have difficulty with their salary job
paying off their loans.
Our legislation will increase the maximum Pell grant, reduce student
loan interest rates, expand loan forgiveness programs, and cap student
loan payments at no more than 15 percent of their income. Our bill
takes important steps to address this alarming and growing crisis.
We are going to take up the next work period the Defense
authorization bill. One of the things we talked about doing in one of
our 10 bills is to rebuild our military. It is in a state of disarray,
disrepair. We learned that when we found out from the Governor of
Kansas, after that tornado, that half of the equipment of her National
Guard was in Iraq. Could not respond to the crisis there. It is that
way all over the country.
Jim Webb, who is a Senator from Virginia--Jim Webb has a resume of an
American hero because that is what he is. He is a graduate of the Naval
Academy, fought heroically in Vietnam, earned medals for heroism, was
badly injured. His military career ended not because he wanted it to
but because he was hurt and had to get out.
He believes the most important thing we can do to hold the
President's feet to the fire in Iraq is force him to make sure our
troops are ready to go to battle, they are trained properly, they have
that equipment. He has an amendment we are going to work on to get in
the Defense authorization bill.
One of the boys killed from Nevada this past week was on his fourth
tour of duty in Iraq. His friend said: He told me he survived four
explosions, and he didn't think he would survive another one. He did
not. It was an awful death. We now have two hostages, prisoners of war
in Iraq. Remember, when they were captured, they did not know who for
sure the three were because they knew there was a body in the Humvee.
So I called and talked to the dad, and he prayed that his boy was not
in the Humvee, that he was a prisoner. But it didn't work. His boy was
incinerated in the Humvee. They could only find out who he was with
DNA. He was on his fourth tour of duty.
That is what Jim Webb is advocating. That is what we advocate. We are
going to take that up in the Defense authorization bill, to make sure
our troops have what they need. They do not have that now.
The bill last night that we passed provides funding to ensure our
troops, until the first of October--active and retired--get some of the
money they need. But we have to restore and renovate what has been
ruined and damaged in Iraq.
Jack Reed, a graduate of West Point, believes it will take nearly
$100 billion to bring our military up to what it should be. We are
going to work toward that in the Defense authorization bill. That
committee is chaired by Carl Levin. So we are going to make
investments, critical investments to address troop readiness problems
in the Army and Marine Corps caused by the President's flawed Iraq
policy.
We will take a number of steps to reconfigure our national security
strategy to better meet the threats and challenges we face today. That
includes returning focus to the growing and increasingly overlooked
problems in Afghanistan and working to improve special operations
capabilities.
So once the next work session is complete, we will have taken action
on all 10 of our day one priorities and passed most of them with
overwhelming bipartisan support.
Now, we have had to fight to get that support, with cloture, on many
different issues to get to where we could have a vote. But we have made
it, and I appreciate that help from the Republicans.
We have also successfully addressed many crucial issues not on that
list. The FDA reauthorization bill we passed facilitates the timely
review of new drugs while improving the safety of the medicines
patients take and the food we eat. We passed the Water Resources
Development Act, known as WRDA, the first one in about 6 or 7 years. It
will protect America's environment and keep our economy strong. We also
passed the America COMPETES Act, which is an act to return our country
to a position of leadership in science, research, and technology.
I would say by far the most important fight we have taken up this
year is our effort to oppose the President's failed Iraq policy and
bring the war to a safe and responsible end. The next work period, as I
have indicated, will oppose the President's failed policy regarding the
war at every turn. The Defense authorization bill will be a major part
of that battle. We will continue this fight every day. We have had some
bipartisan victories this year and some tough fights as well. Progress
especially on the war has not come easy and that is not likely to
change. But if we continue to work in good faith, seeking
bipartisanship at every opportunity, I have no doubt we can accomplish
great things for the American people.
Madam President, are we in morning business?
The PRESIDING OFFICER. We are not.
Mr. DORGAN. Madam President, I voted in favor of the Vitter amendment
yesterday because I do not support a plan that tells those who came to
this country illegally up until December 31 of last year that they are
excused and now have legal status.
I think that is a mistake.
But I do want to state clearly that there are a fair number of those
12 million people who came in here without legal authorization whose
status must be resolved in a sensitive way. I am talking about those
who have been here for decades, who have raised families, worked hard,
and been model citizens. I believe we should adjust their status and
give them an opportunity to earn citizenship.
That same right, however, should not apply to someone who just last
December decided that they were going to sneak into this country
illegally.
My understanding is that we will have additional amendments that will
be sensitive to the need to distinguish that difference and I intend to
support the amendments that will provide the sensitivity to those
immigrants who have been here leading productive lives for a long
period of time.
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