[Congressional Record Volume 154, Number 32 (Wednesday, February 27, 2008)]
[Senate]
[Pages S1258-S1264]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
REQUIRING A REPORT SETTING FORTH THE GLOBAL STRATEGY OF THE UNITED
STATES TO COMBAT AND DEFEAT AL QAEDA AND ITS AFFILIATES--MOTION TO
PROCEED
The PRESIDING OFFICER. Under the previous order, pursuant to rule
XXII, the Chair lays before the Senate the pending cloture motion,
which the clerk will report.
The assistant legislative clerk read as follows:
Cloture Motion
We, the undersigned Senators, in accordance with the
provisions of rule XXII of the Standing Rules of the Senate,
hereby move to bring to a close debate on the motion to
proceed to Calendar No. 576, S. 2634, global strategy report.
Russell D. Feingold, Edward M. Kennedy, Patrick J. Leahy,
Robert Menendez, Ron Wyden, Sherrod Brown, Richard
Durbin, Bernard Sanders, Patty Murray, Joseph R. Biden,
Jr., Frank R. Lautenberg, Christopher J. Dodd, John D.
Rockefeller, Amy Klobuchar, Charles E. Schumer, Tom
Harkin, Barbara Boxer.
The PRESIDING OFFICER. By unanimous consent, the mandatory quorum
call is waived.
The question is, Is it the sense of the Senate that the debate on the
motion to proceed to S. 2634, a bill to require a report setting forth
the global strategy of the United States to combat and defeat al-Qaida
and its affiliates, shall be brought to a close?
The yeas and nays are mandatory under the rule.
The clerk will call the roll.
The assistant legislative clerk called the roll.
Mr. DURBIN. I announce that the Senator from West Virginia (Mr.
Byrd), the Senator from New York (Mrs. Clinton), the Senator from
Massachusetts (Mr. Kennedy), and the Senator from Illinois (Mr. Obama)
are necessarily absent.
Mr. KYL. The following Senators are necessarily absent: the Senator
from Missouri (Mr. Bond), the Senator from
[[Page S1259]]
Minnesota (Mr. Coleman), the Senator from Texas (Mr. Cornyn), and the
Senator from Arizona (Mr. McCain).
Further, if present and voting, the Senator from Minnesota (Mr.
Coleman) and the Senator from Texas (Mr. Cornyn) would have voted:
``yea.''
The PRESIDING OFFICER. Are there any other Senators in the Chamber
desiring to vote?
The yeas and nays resulted--yeas 89, nays 3, as follows:
[Rollcall Vote No. 34 Leg.]
YEAS--89
Akaka
Alexander
Allard
Baucus
Bayh
Bennett
Biden
Bingaman
Boxer
Brown
Brownback
Bunning
Burr
Cantwell
Cardin
Carper
Casey
Chambliss
Coburn
Cochran
Collins
Conrad
Corker
Craig
Crapo
DeMint
Dodd
Dole
Domenici
Dorgan
Durbin
Ensign
Feingold
Feinstein
Graham
Grassley
Gregg
Harkin
Hatch
Hutchison
Inhofe
Inouye
Isakson
Johnson
Kerry
Klobuchar
Kohl
Kyl
Landrieu
Lautenberg
Leahy
Levin
Lieberman
Lincoln
Lugar
Martinez
McCaskill
McConnell
Menendez
Mikulski
Murkowski
Murray
Nelson (FL)
Nelson (NE)
Pryor
Reed
Reid
Roberts
Rockefeller
Salazar
Sanders
Schumer
Sessions
Shelby
Smith
Snowe
Specter
Stabenow
Stevens
Sununu
Tester
Thune
Vitter
Voinovich
Warner
Webb
Whitehouse
Wicker
Wyden
NAYS--3
Barrasso
Enzi
Hagel
NOT VOTING--8
Bond
Byrd
Clinton
Coleman
Cornyn
Kennedy
McCain
Obama
The PRESIDING OFFICER. On this vote, the yeas are 89, the nays are 3.
Three-fifths of the Senators duly chosen and sworn having voted in the
affirmative, the motion is agreed to.
The PRESIDING OFFICER. The Senator from Colorado.
Mr. ALLARD. Mr. President, I was scheduled to speak at 6:30. We had a
vote at 6:30. It is my understanding that I now have the floor to speak
on the bill on which we just voted.
The PRESIDING OFFICER (Mr. Casey). The Senator is recognized.
Mr. ALLARD. I rise to discuss the war in Iraq and specifically the
legislation at hand which directs the President to transition the
mission of U.S. forces in Iraq.
The Senate has voted on this same issue on four separate occasions in
this session alone. Not one of those times did the measure receive even
one-third of the Senate's support. Nonetheless, here we are again
debating the policies of the war.
Let me be clear. There is certainly nothing wrong with openly
debating those policies. It is our responsibility as Members of this
body to discuss thoroughly what is arguably the most important and
defining issue of our day. In fact, I find it highly curious there was
an attempt to castigate those who voted for this debate and who wanted
the full 30 hours to talk about this vital issue. Some in this body
seem to have perhaps been a little too clever and tried to summon as
much outrage against debating this matter as they were prepared to use
in support of debate.
I do question exactly what those in support of this bill hoped to
realistically accomplish with this debate and this legislation before
us given the gains that have been made through the surge strategy. Last
May when the surge was being implemented, only 29 Senators voted for
similar legislation. Undoubtedly, much has changed for the better since
that point. Violence in Iraq is down 60 percent since the start of the
surge and 80 percent in and around Iraq. There has been a 30-percent
increase since June in insurgent weapon caches discovered. Economic
improvements continue. Oil production is constantly increasing, up 50
percent from this time last year. And oil revenues are nearly double
what they were last year. In Baghdad alone, 21 new health clinics
opened this year, 1,885 new schools have been built, and another 1,604
have been refurbished throughout Iraq.
Because of reconstruction and rebuilding, electricity demand is up 25
percent. A year ago, it would have been laughable to suggest that Anbar
Province be transferred to Iraqi control. But that will happen in May.
When this occurs, Anbar will be 10 out of 18 provinces under full Iraqi
control.
The city of Ramadi in Anbar was once one of the most dangerous cities
in Iraq. It is now one of its safest following the surge. The number of
U.S. combat battalions operating in Ramadi has decreased from five to
two in less than a year.
An Army combat brigade that has been stationed in Ramadi for over a
year is scheduled to leave the area in March and is not scheduled to be
replaced. The United States is on pace to transfer control of all Iraqi
provinces by the end of the year.
The surge strategy is brilliant in its simplicity: Exert our military
forces to quell insurgent violence in order to create an environment
suitable for fostering and sustaining a legitimate government capable
of governing its citizens. Real political progress will only be reached
when Iraqis feel secure, and the results of the surge are proving this
to be exactly the case.
Thus far the surge is producing its intended results by eliminating
terrorists, interrupting communications between insurgents in many
areas in Iraq, and ensuring safety for the people which, in turn,
allows far broader, far greater cooperation and association with the
United States.
Only with these security improvements do Iraqis have a reasonable
chance of finding a political solution. This strategy is convincing
many Iraqis to abandon terrorist methods and turn against groups such
as al-Qaida.
Our efforts are reuniting torn communities and enabling political
process. Obviously, this Nation would have been better served had the
surge strategy been implemented earlier. But the ability to criticize
strategy is not the same as the ability to strategize.
So I applaud those who did finally implement the surge strategy and
congratulate them on their vision. As we know, Iraq must stand up
before we can stand down. Again, David Petraeus has stated there cannot
be solely a military solution to violence without political action. And
he is absolutely correct in his assertion.
In recent weeks, Iraqis have made tremendous political strides under
what are still difficult and onerous conditions and as a result
increased security in their nation. February 13 saw the Council of
Representatives pass three key pieces of legislation: amnesty for Sunni
security detainees, a provincial powers law, and a budget.
Debaathification reform was enacted last month as well.
Let's talk about those political accomplishments. The general amnesty
law passed by the Shiite-majority Parliament sets the guidelines in
providing amnesty for thousands of detainees held in Iraq detention
facilities. This helps to remove one of the greatest stumbling blocks
to reconciliation between Sunnis and Shiites.
The Iraqi Parliament has also passed the provincial powers law which
outlines the balance of authorities between the central and local
governments while also specifying that provincial elections be held on
October 1 of this year. The Iraqi Parliament approved a $48 billion
budget, representing a step toward Iraq using its own resources to
provide for security and infrastructure reconstruction. This Sunni-Shia
compromise budget allows the Kurds a larger share of the budget, which
is 17 percent. Iraqi oil revenues have soared with the rise of global
prices, and Iraqi production has increased due to gains in security.
The money is now going to the provinces on a regular basis where it
will fund urgently needed reconstruction and humanitarian relief. The
Iraqi Government is now providing the kind of services that give the
Iraqi people a stake in their own success.
Finally, the President's council approved the law of accountability
and justice on February 3, 2008. This law could allow thousands of
former Ba'ath party officials to return to Government jobs and receive
pensions, helping the reconciliation process and stimulating the
economy. In addition, even more groundbreaking legislation is slated
for consideration in the very near future. These initiatives include a
hydrocarbons law to determine the level of control allocated to the
central Government as well as an election law that is being drafted
currently by the Prime Minister's office. While the job is far
[[Page S1260]]
from over and much work is still required, these recent accomplishments
on the political and economic fronts continue to gather momentum and
show important signs of progress and create reasons for optimism. There
is much criticism of flaws in the Iraqi Government's processes and
outcomes, but any Member of this body who considers throwing stones in
that direction should first glance at any newspaper, news show, citizen
rally, or public opinion poll, and reflect on who among us is producing
perfect and flawless legislation.
Even the media, which has often been one-sided on the war, has for
several months now been forced to report that the surge and coalition
efforts have been succeeding. Let's look at some of the headlines:
The Washington Post, February 23, 2007, ``Sadr Extends Truce in
Iraq''; the Los Angeles Times, February 22, 2008, ``U.S. Micro-Loan
Effort Yields Big Results in Iraqi Province''; the Colorado Springs
Gazette, February 18, 2008, ``Baghdad Neighborhood is a Model of
Progress''; Reuters, February 16 of this year, ``Attacks in Baghdad
Fall 80 Percent''; Reuters, a February 13 article, ``Iraq Lawmakers
Pass Key Budget and Amnesty Laws''; Reuters on January 17 of 2008,
``Iraqi Forces Could Control All Provinces This Year''; even the New
York Times, February 14, 2008, ``Making (Some) Progress in Iraq''; the
Washington Post on February 10, 2008, ``Diary of an Insurgent in
Retreat: Al-Qaeda in Iraq Figure Lists Woes''; the AP, February 2,
2008, ``Lynch: US Surge Tipped Scales in Iraq''; an AP article on
January 21, 2008, ``U.N. Envoy Applauds Cut in Iraqi Violence''; the
Winston-Salem Journal, February 12, 2008, ``Iraq is Much Changed Since
Surge Started One Year Ago''; Tacoma News Tribune, February 14, 2008,
``Iraq Reaches Benchmark for Healing.''
Coalition success is being seen all over Iraq. It is being reported.
The only people who seem to refuse to see it or admit we are winning in
Iraq are my colleagues on the other side of the aisle who continue time
and again to bring this issue to the floor claiming that the surge has
not worked and urging immediate troop withdrawal. Certain Members of
Congress continue to deny that any progress has been made. Earlier this
month the Speaker of the House described the surge as a failure.
Opponents long criticized the administration for not sending more
troops to Iraq. But when this strategy was installed, it was also
attacked as opponents declared that this effort was essentially too
little, too late. When the surge began to show great military success,
it faded from the floor of this body.
That is why we welcome the chance to spend 30 hours on this topic. It
is a shame that now, when both military and political success is being
realized, we are only debating whether to retreat. If that is the
ground the majority wishes to stand on, so be it.
For a moment let's consider the severity of the issue at hand. We are
debating whether to deploy our forces which would essentially concede
the country to whatever group eventually gains control that would
likely plunge the country into further unrest and chaos. It seems we
are acting under the assumption that if we get all of our forces out,
we can slam the door behind us and all will be fine. This policy fails
to lend any consideration to what would certainly be dire consequences
that would ensue as a result of our Nation abandoning Iraq at this
critical juncture. To do this would simply be irresponsible and
shortsighted. Iraq is the pivotal front in our global war on terror. To
intentionally abandon our progress and lose the battle would surely
cause irrevocable harm to our efforts to secure our Nation. Osama bin
Laden had referred to Iraq as the central front in the war against
America and the West. Al-Qaida in Iraq shares this view of the
situation. Leaving prematurely would only strengthen al-Qaida and
enable terrorists to set up training camps in Iraq and plot further
attacks on the United States.
The National Intelligence Council stated:
If such a rapid withdrawal were to take place, we judge
that al Qaeda in Iraq would attempt to use parts of the
country--particularly al-Anbar province--to plan increased
attacks in and outside Iraq.
By passing this legislation, we would be running away from a war from
the floor of the Senate. When has it ever been sound policy for
legislators to micromanage a war from Washington? I don't ever recall
in our history this tactic being successful in achieving our strategic
goals. In fact, let me remind our colleagues, we have seen terrible
results from political motives being placed above military necessity.
Installing an artificial deadline is not what we need. It is not what
is good for the Nation. It is not good for the future of Iraq and the
long-term stability of that region. We have heard from our military
intelligence professionals who have warned about the possible
consequences of hasty withdrawal and the potentially catastrophic
results that may ensue. We should also listen to our folks on the
ground. I have heard time and time again from our service men and women
from all branches of the military who have returned from Iraq that
progress is being made, and they are proud of the contributions they
are making to this Nation and to the long-term stability of Iraq and
the Middle East.
In my lifetime I have witnessed few events that compare to the joy
and jubilation that accompany the homecoming of a military unit. When I
have seen a brigade return home to Fort Carson or a wing to Peterson
Air Force base, there are no words to describe the sheer emotion of
seeing families returned to loved ones and friends. However,
redeploying our forces at this point is not the proper course of action
and not in the best interests of our Nation. Our military does not
exist just to come marching home, and our military understands this.
They exist to fight our enemies and secure our vital national
interests. Removing Saddam Hussein from power was in our national
interest. Stability in the Middle East is in our national interest.
Securing Iraq from terrorist control is in our national interest.
Pandering speeches about bringing the troops home that strive for mere
political points and fail to acknowledge strategic realities are not in
our national interest.
We still have a job that needs to be completed. We still have work to
do. When the time is right, we will redeploy responsibly. The Iraqi
Government is making progress. We are beginning to be able to stand
down to a greater extent than we have in the past. General Petraeus and
Ambassador Crocker will return to Washington and report on the progress
in Iraq in April. We owe to it our men and women in harm's way to
listen to the experts and make our decisions off of their findings.
I yield the floor.
The PRESIDING OFFICER. The Senator from Wisconsin.
Mr. FEINGOLD. Mr. President, I am pleased the Senate has voted
overwhelmingly to allow some debate of the Feingold-Reid al-Qaida bill,
but it is pretty clear to everyone that this body still doesn't fully
understand and is not ready to address head on the threat posed by al-
Qaida. As was made clear during debate on the Iraq redeployment
legislation, too many Members confuse the war in Iraq with the fight
against al-Qaida. That is true of the administration too. While it is
focused on Iraq, al-Qaida has reconstituted itself along the
Afghanistan-Pakistan border. Don't take my word for it. Listen to our
intelligence community.
Early this month, the Director of National Intelligence testified
before Congress that the central leadership based in the border area of
Pakistan is al-Qaida's most dangerous component. A few months ago, the
DNI again repeated the intelligence community's assessment that over
the last few years ``Al Qaeda's central leadership has been able to
regenerate the core operational capabilities needed to conduct attacks
in the Homeland''--our homeland, Mr. President, the United States of
America.
The DNI also testified that al-Qaida ``is improving the last key
aspect of its ability to attack the U.S.: the identification, training,
and positioning of operatives for an attack in the Homeland.''
Meanwhile, the Federally Administered Tribal Areas in Pakistan is
serving as a staging ground for al-Qaida in support of the Taliban and
providing it with a base similar to the one it used to have across the
border in Afghanistan. The Chairman of the Joint Chiefs of Staff, ADM
Mike Mullen, testified
[[Page S1261]]
recently that ``the most likely near term attack on the United States
will come from Al Qaeda via'' its safe havens in Pakistan--not in Iraq,
in Pakistan. Over the past year, we have seen an unprecedented rise in
suicide bombings in Pakistan. The Taliban is gaining ground in
Afghanistan. While we may be sending an additional 3,200 marines to
Afghanistan in the near future, we have been fighting for far too long
there with too few soldiers and too few reconstruction funds.
With the Joint Chiefs of Staff saying in ``Iraq we do what we must
and in Afghanistan we do what we can,'' it is no wonder that
Afghanistan is teetering on the edge. Let me remind my colleagues that
it was from Afghanistan--Afghanistan, not Iraq--that the 9/11 attacks
were planned. And it was under the Taliban regime, which is once again
gaining ground, that al-Qaida was able to flourish so freely.
Al-Qaida affiliates from Africa to Southeast Asia pose a significant
terrorist threat. While we have been so myopically fixated on Iraq, the
threat from an al-Qaida affiliate in north Africa has grown and now,
according to the DNI's testimony, ``represents a significant threat to
the United States and European interests in the region.'' Since its
merger with al-Qaida in September 2006, it has expanded its targets to
include the United States, the United Nations, and other interests. And
it likely got a further boost when al-Qaida leadership announced last
November that the Libyan Islamic Fighting Group united with al-Qaida
under AQIM's leadership. Its possible reach covers Tunisia, Morocco,
Nigeria, Mauritania, Libya, and other countries. Meanwhile, it is using
deadly tactics that suggest it is acquiring knowledge from the war in
Iraq. That is right. The war in Iraq may be being used as a training
ground by forces that wish to do us harm. Another way of saying it is,
our troops are being used as a way to train people to give them the
skills to launch attacks in other places.
Al-Qaida has affiliates around the world--in Saudi Arabia, the United
Arab Emirates, Yemen, Lebanon, where al-Qaida poses a growing threat,
the Horn of Africa, and Southeast Asia. We cannot ignore the rest of
the world to focus solely on Iraq. Al-Qaida is and will continue to be
a global terrorist organization with dangerous affiliates around the
world. We are watching al-Qaida strengthen and develop its affiliates
around the world while we remain bogged down in Iraq.
We need a robust military presence and an effective reconstruction
program in Afghanistan. We need to build strong partnerships where al-
Qaida and its affiliates are operating--across north Africa, in
Southeast Asia, and along the border between Afghanistan and Pakistan,
and we need to address the root causes of the terrorist threat, not
just rely on military power to get the job done.
We can start doing that by passing S. 2634. This bill requires the
administration to provide Congress with a report outlining a
comprehensive global strategy to defeat al-Qaida and its affiliates.
The strategy must ensure U.S. resources and assets are targeted
appropriately to meet the regional and country-specific threats we
face, and that troop deployments do not overstretch our military.
Who could oppose a commonsense bill such as this? Well, as I noted
earlier, the administration actually issued a veto threat for this
bill. That threat makes the baffling argument that preparing a report
on the threat of al-Qaida may somehow ``inhibit the President's
constitutional authority as Commander in Chief.'' That is not all. The
administration also argues that preparing a plan that prioritizes
operations against al-Qaida would tie the hands of commanders.
This is just plain double-talk. We are trying to help our commanders
and the rest of our Government to properly dedicate their resources to
our most pressing national security concern. This bill does not tell
our commanders how to carry out any operations; it merely requires a
report. The Congress has a constitutional responsibility, in
collaboration with the President, to determine what are our national
security priorities. That is what we should be doing. That is what this
bill would do. Unless the President has completely abandoned the idea
of civilian control of the military, and of the shared responsibilities
between the legislative and executive branches, then he should have no
objection to my bill.
The administration does say that it ``supports the bill's goals and
intent, with regard to updating and informing Congress and the American
people on the strategy to combat terrorism.'' I guess that is good
news. But then it cites two documents it has already prepared on this
topic. One is the September 2006 National Strategy for Combating
Terrorism, which sets broad goals but does not include the detail
called for in our bill about how limited resources will be allocated to
achieve this strategic vision. That 2006 document also does not
prioritize the geographic--country and region-specific--threats we face
from AQ and its affiliates, which is essential because how else--how
else, Mr. President--will we know where to focus our resources?
The other document cited by the administration is the National
Implementation Plan. I am a member of both the Senate Intelligence and
Foreign Relations Committees, and I am not even allowed to see that
document. The administration will not even share it with the full
Intelligence Committee. So the idea this document is an acceptable
substitute for what is called for in the Feingold-Reid bill is absurd.
The administration suggests our bill limits the President's authority
to withhold information. Now, I agree we need to protect classified
information, and there is nothing in my bill--nothing--that would
prevent the addition of a classified annex. Much of our strategic
planning, however, is not classified, consistent with our country's
belief in open government and accountability.
The American people deserve to be told, to the extent possible
without divulging classified information, what their government is
doing to protect them. The President's veto threat is further evidence
of his unwillingness to be straight with the American people about the
fact that the war in Iraq is actually undermining our national
security. The President's current strategy is to prioritize operations
in Iraq, even to the detriment of operations in Afghanistan against
those who attacked us on 9/11.
Now, that does not make sense. It has to change, and we have to
change it today by passing this Feingold-Reid bill, refocusing our
attention and resources on al-Qaida.
Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from North Carolina.
Health Care Reform
Mr. BURR. Mr. President, one of the most pressing issues in America
today is: What will Congress do to address health care? The American
people deserve a 21st century health care system--not just a delivery
system of doctors and hospitals but a system that is integrated, one
that recognizes society has changed.
This body, several years ago, extended a new benefit to Medicare,
where we covered prescription drugs in a health care delivery system
that was created in the 1960s, when drugs were not a common treatment
for disease. It took us until the 21st century to recognize that if we
would enhance the benefit so we could match the disease with some of
the breakthroughs, that the outcome was different, that Americans
actually got better, that the cost actually went down because we
eliminated the number of incidents.
America's health is at risk. When I say America's health is at risk,
I am talking about the physical health and the economic health of this
country. It is impossible to believe that unless you transform health
care so it works for everybody in this country that American business
can be competitive in a global marketplace that is not coming, that we
are part of today.
Now, Republicans want to propose to this body and to America one main
goal. That goal is that we are committed--Republicans are committed--to
providing every American with genuine access to quality, affordable
health care that protects the sacred doctor-patient relationship. This
is what everybody thinks of when they think of a health care plan:
health care coverage that recognizes them as an individual and coverage
they need to provide security for their family.
Let me restate it. We are committed to providing every American with
genuine access to quality, affordable health care that protects the
sacred
[[Page S1262]]
doctor-patient relationship. Nothing else should get between that. It
should not be determined based upon an arbitrary third-party reimburser
or the Federal Government. The reality is, when we provide every
American with this opportunity, we have a system that functions like
the marketplace is designed.
How do we get there? No. 1: access and choice. All Americans have a
right to choose their doctor, to choose their hospital, and, I believe,
to choose the health care plan they want, and, more importantly, they
deserve. No Washington, DC, bureaucrat should deny that right.
Americans like choice. We know that. Americans do not like to have
one choice. They like multiple choices. As a matter of fact, when you
have one, you really do not have a choice. Some politicians want to
give America one choice. It is the debate potentially of this next
election cycle.
Let me teach America a new word. It is called ``universal control.''
Universal control: when one entity is in charge of the only choice, and
now they control how they provide that; they control what it looks
like; they control where you get it; they control what the cost is. All
of a sudden, this innovative, creative health care system we have had
in America--that has not worked for everybody because our target has
not been to make sure every American is covered--all of a sudden it
totally breaks down.
Well, one health care package, one set of doctors, one set of
treatments, one set of prescriptions is not what America is looking
for. America is looking for choice. North Carolinians do not want one
choice, and they certainly do not want bureaucrats in Washington, DC,
defining what their choices are going to be.
A majority of Americans are willing to pay a little bit more to have
more choices. I strongly believe doctors and patients--not lawyers and
bureaucrats--should have the power to make health care decisions.
The challenge is that Americans believe that is the most important
thing. Clearly, access to health care is directly dependent upon cost.
Americans must have access and choice, but they also have to have
affordable coverage. Republicans believe the best health care in the
world is worthless if Americans cannot afford it, and I think we would
all agree.
It would drive down costs by giving Americans control over their own
health care choices, making sure patients have the information they
need to make good decisions, guaranteeing vigorous competition that
benefits patients, and holding the entire health care system
accountable to the patients' needs.
You see, in many cases we have used Government as the accountability
measure. We miss the boat. The accountability measure is making sure
patients hold the system, patients hold the doctors, patients hold the
hospitals accountable; more importantly, patients hold the insurers
accountable.
This belief that a patient cannot negotiate with an insurer--well,
quite frankly, these days are over. We need to drive down costs. We
need to give Americans control over their own health care choices. We
need to make sure patients have the information they need to make good
choices--the right choices for them, for their family, for their age,
for their illness or their health conditions, and, more importantly,
for their income, guaranteeing vigorous competition that benefits
patients. The focus here is on patients, holding the entire health care
system accountable to patients' needs.
I would suggest if health care could be more like a television--with
a television, you have real competition. You have a choice of over the
air, you have a choice of basic, you have a choice of cable, you have a
choice of cable with premiums, and you have a choice of DirectTV. In
fact, with television, you know exactly what comes with each option.
You know exactly how much it costs, and you know you get what you pay
for. That can be the only reason that on-demand sports has become so
popular. It is because when you want to watch a sporting event, and you
see exactly what the cost is, you can make a calculation as an
individual as to whether that is worth it to you. Americans should have
all the competition, the choice, the control, and the information they
need when it comes to health care decisions. So affordable coverage.
Let me tell you a story. My oldest son is now 23. Shortly before he
became 22, I was notified by the Office of Personnel Management in
Washington that in the Federal Government, regardless of where you were
in the Federal Government, your children, when they turned the age of
22, even if they were in school--which mine were--had to be dropped
from your health insurance.
Now, forget the fact--I can see the Presiding Officer is struggling
with this. That does not save any money. You are exactly right. You are
taking the healthiest of America, and you are taking them out of the
risk pool that helps hold down the risk for us older guys who are more
susceptible to disease. But somewhere the Federal Government got this
idea that they are going to save money by dropping people when they
become 22 years old--the healthiest of the American population.
So I went through the realization that this is actually going to
happen. There is no way you can change it. So I called OPM to say:
Surely, you have negotiated coverage for our children. I would like
something that resembles the plan I had with Blue Cross Blue Shield.
They quoted me the exact same plan: $5,400 a year. Twenty-two years
old, healthy as a bull, still in college, and all of a sudden, as a
parent, I was strapped with the decision that for him to have coverage
it was going to cost $5,400. If it was his decision alone, he would
have said: No way. Affordability was not met from the standpoint of
what he was getting in coverage for what it was costing.
I did not stop there. I picked up the phone. I called the university
he was at and found out a local insurer, insurance agent, had
negotiated with Blue Cross Blue Shield coverage for kids who fell into
this situation where they did not have insurance. I described to him
the plan. He quoted me the exact same plan that as a Member of the
Senate I had, which, before, my son was covered under, with the same
deductible, the same copay, the same limits--the exact same plan. But
this was negotiated by an independent insurance agent in Chapel Hill,
NC, against the same Blue Cross Blue Shield that the Federal
Government, representing 1.3 million employees, negotiated with; and on
behalf of my son, he negotiated a cost of $1,500 per year--$1,500
versus $5,400, a fairly significant savings.
We sit here and wonder: What can the American people do with the
right information relative to the decisions they have to make as it
relates to health care coverage? If it is that difficult to figure out
how to have the coverage you need at the cost you can afford, envision
how difficult it is for a patient without information to decide what
type of chemotherapy they are going to take, when all of a sudden the
doctor walks in and says: You have cancer and you are going to die
without treatment. This is a difficult thing without the ability to go
out and search for the information.
The third item is quality care and prevention. Here is a unique word
in health care, ``prevention.'' It is something that probably for
decades we should have incorporated into the coverage each of us has.
We believe in strengthening health care by providing consistent,
dependable quality and promoting the principles of prevention. What is
prevention? Let's change our habits. Let's educate ourselves. Let's do
the things that keep us healthy. And let's actually pay annually to let
somebody go in and see the doctor and make sure there is not a health
condition they have that could be prevented, early, without the
incidence of an inpatient stay in the hospital.
We will harness the powerful promise of advanced research and modern
technology to create innovative new treatments and breakthrough cures,
promote wellness, and empower consumers with accurate, comprehensive
information on quality health care that is available for them.
Choice, information: I believe strengthening health care by providing
consistent, dependable quality and promoting prevention is absolutely
essential.
Creating innovative new treatments and breakthrough cures: Let me ask
my colleagues, if innovation didn't take place, what would the
diabetics do
[[Page S1263]]
today, those who currently have a diabetic pump that is implanted in
their side, that automatically reads their blood sugar 24 hours a day,
administers the insulin when they need it. No longer do they go through
a finger prick. No longer do they get an inconsistent reading. No
longer do they inject themselves later than they need to keep a
balance. Why is that important? Because for somebody with diabetes who
can constantly maintain their blood sugar at the right level, it means
none of the horrors we heard about and saw and that many families lived
with before when the management was not as precise. The result was,
eventually they began to go blind, eventually began to have a toe, two
toes, all their toes, a foot, a leg amputated because of the effects of
diabetes. Forget the number of times the person might have been
admitted to the hospital to get their blood sugar in balance so they
could at least delay the deterioration. Now technology allows a
diabetic to insert a pump and to keep a constant read and a constant
regulation of their blood sugar. The net result is the system saves a
tremendous amount of money. The individual saves a tremendous amount of
money. The individual's quality of life is that much better.
For a student who had diabetes, the likelihood was that they would
never play organized sports because the demands on an athlete mean they
have a blood sugar spike that is incredible, and without the ability to
regulate that, it was impossible. Now kids are playing soccer at every
age and running around with a pump that is automatically reading their
blood sugar.
How about for some of us who are a little bit older and we probably
are susceptible--because we haven't done everything we should do
regarding healthy habits, we are susceptible to high cholesterol. Where
would we be without the pharmaceuticals' breakthrough of cholesterol
drugs? I will tell my colleagues where we would be. We would be funding
$8,000-plus bypass surgeries at an alarming rate that would bankrupt
the system, both public and private. But today we have this little pill
we can take. It doesn't take the place of exercise, it doesn't take the
place of diet, but it certainly enhances our chances that we are not
going to be selected to have bypass surgery, open-heart surgery; that
we are not going to have the recovery time, the loss of productivity at
work because innovation allowed us now to inject in that quality arena
a different outcome based upon innovation.
We want to promote wellness. We want to empower consumers with
accurate, comprehensive information. The United States has the best
health care system in the world. I will tell my colleagues, North
Carolina is a big reason as to why health care is so good. We need to
make sure quality stays high while improving the access. Congress needs
to foster--not hinder--research and development of treatments and
cures.
I just mentioned prevention and wellness. Those words need to be the
first thing Americans think about when they think ``health care'' or
when they think ``doctors.'' Prevention and wellness. Doctors should be
paid to help people stay healthy instead of just paying them to treat
individuals who are sick.
My final thought for this section: Patients should have as much
information prior to using doctors and hospitals as they do prior to
buying cars. What a novel idea. The Centers for Medicare and Medicaid
Services is starting to provide quality, Web-based information about
nursing homes and hospitals. The initiative needs to keep growing so
all patients have the ability to research all aspects of health care.
That happens in real time at the tips of our fingers. Access and
choice, affordable coverage, quality care and prevention.
The fourth piece--and we shouldn't be shocked because this is
America--personal ownership and security. But this is something our
system has never incorporated. We believe Americans should own and
control their health care coverage and should have the freedom and the
flexibility to take it with them when they change jobs, just like a
401(k).
Hard-working Americans deserve the peace of mind to know the care
they need will be the care they receive and that their financial
security will be protected from catastrophic events.
Americans will achieve this security and will receive better care if
the health care system is highly personalized and guarantees patient
control. What does that mean? With the right information, with the
right resources, any American should have the ability to construct a
health care plan that meets their age, their health, their income, and
have the financial security of knowing they are covered. Some might
call this ala carte, the ability to construct something that meets--for
those of us who are over a certain age, we have probably already been
instructed by our spouses that we have had all the children we are
going to have. That is a little tough in this body because we have had
some Members who had them at quite a late stage in life. But I fall
into that category. I can't buy health insurance coverage that doesn't
come with maternity coverage. I pay for it knowing I am never going to
use it.
Now, maybe I am helping to subsidize somebody else. But while we are
here talking about every American being insured, the reason we are here
is because that subsidy is going on today. It goes on in every company.
In goes on with everybody who pays out of pocket. It is something that
happens to each of us who have health insurance, and it is triggered by
somebody who receives a service in health care and either won't or
can't pay. So to recover the cost of the delivery of that benefit,
hospitals, doctors, every delivery point in health care does what they
call cost-shift. They charge that cost of delivering that service over
to the people who have coverage or who can pay.
When all of a sudden you have a goal and a commitment that every
American is insured, the cost-shift goes away. What is the score on
that? It is $200 billion a year. So that is $200 billion that today
does not go to the delivery of one ounce of care. It is shifted to
people who can pay or who are covered. All of a sudden now we know the
answer to why health care increases at double-digit rates of inflation
on an annual basis. It is because as the pool of uninsured continues to
grow, the amount of cost-shift continues to grow, and the cost-shift is
directly dumped on those companies that provide coverage for their
employees, for us as individuals if we go to the marketplace and we buy
coverage or to us who pay out of pocket when we access health care
because it is shifted evenly across the system.
Forget the fact that if we adopt this, if we achieve it, that, one,
we have a more manageable system--a system, quite honestly, that
incorporates access and choice, affordability, quality and prevention
and wellness, personal ownership, and the security of knowing you have
coverage. We drive the costs down for every American.
The goal is to continue to have the best health care system in the
world, to continue to drive innovation and medical breakthroughs, and
to do it in a way that brings the overall cost of health care down. If
we can begin to see the trend line on inflation and health care begin
to go south, it is amazing what type of an incentive it will be to
individuals who now engage in the prevention and wellness section and
begin to look at ways that they can control the cost of their health
care because it is now theirs, they own it, they have constructed it,
they can change it as they need to, and--oh, yes, by the way, to
accomplish this, we have to have 50 States that have high-risk pools
that take those individuals with preexisting conditions, and we
collectively buy their cost of insurance down to an equal amount for
those of us who are healthy. A lot of States around the country
currently do it. Mine just happened to pass it last year. We are late
coming to the game. But the reality is that all 50 States should and
will and have to do it if we want the system to work.
There is a way to maintain the highest level of care in the world,
the highest commitment to innovation and breakthroughs, to look down
the road and know we are going to cure things tomorrow, that today
there is only one outcome and it is to live. If we don't change and
transform our health care system and begin to promote prevention and
wellness and to drive the costs down, the first thing that will leave
is innovation, the innovation that treats
[[Page S1264]]
many of us today in a totally different way, with a multitude of
options we never had. If, in fact, we don't begin to change this, the
system will reflect one choice, one doctor, one hospital, one delivery
port.
I challenge my colleagues today that is universal control, control
where one entity--the Federal Government--dictates where we go, who we
see, what they are reimbursed for delivering the service, and the
outcome will be the lack of innovation, the lack of breakthroughs, and
no reason for the American people to make healthy choices and to engage
in prevention and wellness.
That is where we are. I hope my colleagues on both sides of the aisle
will engage and encourage our leadership to have a healthy debate on
health care. I haven't locked in to any prescribed legislation tonight.
It is the principles of the Republican Conference that I am here to
present and will continue to come back to the Senate floor to present.
I encourage my colleagues on both sides of the aisle: let's come to the
floor. Bring your legislation. Let's examine it, let's debate it, let's
let America see it. Let them be the judge. At the end of the day, it is
the American people who will influence where this debate goes, and that
is exactly who should influence it. They are the patients of the future
health care system.
I yield the floor.
The PRESIDING OFFICER. The Senator from Colorado is recognized.
____________________