[Congressional Record Volume 155, Number 125 (Tuesday, September 8, 2009)]
[Senate]
[Pages S9112-S9115]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. KYL. Mr. President, my colleague, Senator McCain, has spoken to 
the issue that is on the minds of all Americans today and which the 
Senate and House of Representatives will again take up as we return 
from the August recess; that is, how to deal with the issues that 
confront us in the delivery of health care today without doing damage 
to the care and the coverage that most Americans have and believe 
serves them well.
  The approach I heard from my constituents over the recess was very 
similar to what Senator McCain has spoken about, which should not seem 
to be a big coincidence since we represent the same State. On one 
occasion we called about 50,000 Arizonans, had them on the telephone 
for about an hour and a half, and asked for their views, and gave our 
thoughts in response to their questions.
  What I have been struck by is the consistency of the views that have 
been expressed in the various forums I had around the State, consistent 
with the townhall meetings Senator McCain had right in the heart of the 
Phoenix metropolitan area, views people expressed to me in every 
location, from the doctor's office I went to, to people meeting with me 
in my office, to folks at church. The message seems to be pretty much 
the same. And I think Senator McCain articulated it well when he 
characterized it as anxiety and concern.
  One of my colleagues said he denoted in his constituents, in these 
townhall meetings, real fear. I think that is true. Because even though 
we know there are some things that need to be done to improve health 
care delivery in this country, most people, according to surveys, have 
insurance and believe what they have serves them very well or at least 
well. Our goal, therefore, is to try to solve the specific problems 
that exist without doing harm to the system that treats the others.

  As I said, a lot of our constituents were very fearful that they were 
going to have to pay much more in taxes; that their debt burden as a 
part of what this entire country owes would be increased significantly 
because of the costs of the health care reforms that have been 
proposed; that they wouldn't be able to keep the insurance they have 
even if they like it; that the way they receive care--the advice they 
get from their doctor about what their family's needs are--would not 
necessarily be respected if the government has a large role in deciding 
what to pay for and what not to pay for; and generally that the 
government's continued takeover piece by piece of the American economy 
would not serve individual Americans well. To be sure, they agreed that 
some health care costs are growing too fast and need to be controlled 
and that there are some Americans who don't have health coverage and 
really don't have a way to get it without public health. Those are the 
two key areas in which they recognize there is a role for government to 
play in reform.
  But they also wonder why certain problems are not being tackled--the 
problem, for example, of what one characterized as ``jackpot justice,'' 
where trial lawyers bring lawsuits and sometimes get big rewards but 
frequently simply settle the cases, and the net result is that the 
medical profession in this country--doctors primarily but hospitals and 
others--spend an enormous amount of money, estimated to be at least 
$100 billion a year, on what is called the practice of defensive 
medicine; that is to say, doing things--ordering tests, referring 
patients to other physicians and so on--all of which are really 
unnecessary for the care and treatment of the patient but which will 
protect the doctor in the event there is a claim of medical 
malpractice. This happens because the lawyers involved get so-called 
expert witnesses who come to court and tell the jury that the standard 
of care in the community is that if the child falls down on the 
playground and gets a bump on the head, you order a CAT scan. It 
doesn't matter whether or not from the physician's observations he can 
see that the child really, if the parents just watch him carefully that 
evening, should be just fine; no, to protect himself or herself against 
medical liability or malpractice claims, they order a CAT scan or some 
other kind of test. The net result of that, as I said, is an expense of 
over $100 billion a year in unnecessary medical tests and procedures. 
The cost of those items, of course, is passed on to all the rest of us.
  Another estimate is that 10 percent of every health care dollar is 
spent on the premiums physicians spend for their malpractice insurance. 
As lawyers, some of us know you have to pay some money for malpractice 
insurance before you can start work on January 1. That is fair. But how 
about $200,000 in medical malpractice premiums for a neurosurgeon, for 
example. That is an awful lot of money if you are an OB-GYN, for 
example. This estimate of 10 percent of health care dollars spent on 
premiums means that if we could reduce the incidence of malpractice 
claims, we could reduce that premium cost, the physicians wouldn't have 
to pass it on to the insurance companies, who wouldn't have to pass it 
on to us, and again, our health care could be cheaper.
  So because of premium costs and because of the practice of defensive 
medicine, this jackpot justice system has not served us well.
  One would think that if we are interested in controlling costs, if we 
are making insurance more affordable for small businesses--for big 
businesses, for that matter--for their employees, and for us as 
individuals, and if we want to encourage more physicians to stay in 
practice, then what we would do is tackle this problem. Is there one 
word about medical malpractice reform in any of the bills, the bill 
that came out of the HELP Committee in the Senate, the bill currently 
pending in the Finance Committee, or the bill that came out of the 
House of Representatives? The answer is no, not a word about medical 
malpractice reform. Why? Well, Howard Dean, the former Democratic 
Governor of Vermont and Democratic National Committee chairman, was 
very honest about this on August 17 at a townhall meeting with 
Representative Moran in Virginia. He was asked that question, and he 
said: When you write a big bill, you don't want to take on too many 
special interests, and the people who wrote this bill simply didn't 
want to take on the trial lawyers, and, he said, that is the truth. It 
is the truth.
  The reality is that the President is going to ask everybody else to 
sacrifice. For example, seniors are going to have to take a $400 
billion to $500 billion cut in Medicare, which will mean less care for 
them. If small businesses are going to have to pay a tax on every one 
of their employees in order to make sure they get covered with 
insurance; if the pharmaceutical companies are going to have to pony 
up--I have forgotten how many hundreds of billions of dollars it was 
for more drugs for seniors, for example; if everybody else is going to 
have to sacrifice, why didn't we ask the poor trial lawyers to give up 
just a little bit here? We are not saying malpractice claims couldn't 
be filed. That is the way doctors and hospitals and others are kept 
honest. When you make a mistake, you are going to have to pay for it. 
But we can make sure the system works to prevent the kind of jackpot 
justice I spoke about.
  There are at least five different kinds of medical malpractice 
reforms that have worked. One was offered by Senator Enzi in the HELP 
Committee; it is called health courts. The State of Texas and the State 
of Arizona have both adopted certain kinds of medical malpractice 
reforms. In Arizona, it has begun to work. In Texas, something like 
7,000 doctors have moved into the State, with premiums being reduced by 
either 21 or 23 percent. In other words, medical malpractice costs can 
be reduced to provide care, and by reducing that cost, people's 
premiums can be cut, and that will make insurance more affordable and 
more people will be able to get it.
  My point here is simply to say this: What we found as we talked to 
our constituents was a fear that in order to solve two or three very 
discrete problems, there were people here in Washington who wanted to 
remake the whole system, throw out what we have, and impose on it a new 
regulatory regime. Whether there is a government option or government 
insurance plan is only part of the issue. The problem is

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that there is government control of everybody irrespective of that, and 
people are concerned as a result that their care will be rationed, that 
taxes will go up, and that, in fact, their premiums will go up.
  How could that be if we are going to try to make care less expensive? 
I will give one example. I talked to people who are relatively young 
and relatively healthy, and they are very aware that if they are put in 
the same pool with everybody else, with the people who are sicker and 
older, they are all put into one pot and you can't discriminate on the 
basis of health condition--and we do believe people with preexisting 
conditions should be able to get insurance--then, naturally, the people 
who are younger and healthier are going to be paying more for their 
insurance than they would if they were in a category all by themselves, 
and that is what the actuarial data shows us. So it might make 
insurance more affordable for somebody who is older and sicker, but it 
will definitely raise the cost of insurance for those who are younger 
and healthier. There have to be ways to avoid that perverse result. 
There are, in fact, and Senator McCain talked about a couple of those 
that I will mention in just a moment.
  There ought to be a way to ensure that everyone in this country can 
get affordable, quality health insurance without taxing all employers, 
especially small businesses--the very entities we are counting on to 
bring us out of this recession. We know that almost all of the jobs 
created in this country in the last 2 or 3 years were created by small 
business. Large businesses lost--in fact, we have lost about 3 million 
jobs in this country. In this recession, 3 million jobs have been lost. 
How are those jobs going to come back? It is going to be through small 
business. That is where over 80 percent of the jobs are created, and 
that is where they will be re-created to get us out of this recession. 
Why, when we are in the middle of this recession, would we want to tax 
people to say: If you want to hire somebody, it is going to cost you X 
amount. Why don't we give them an incentive to hire more people, not 
give them a disincentive through taxation. Why would we raise the taxes 
of all businesses, including, by the way, raising taxes on insurance? 
Insurance companies are fun to pick on, I grant. But does the insurance 
company just pass the cost of that tax that is going to be imposed on 
it to its premium holders? Of course. There is no free lunch. We end up 
paying the taxes. As everybody knows, corporations don't pay taxes, 
people do.

  The net result is that when people are concerned about the economy, 
No. 1, about our rising debt, about the potential they are going to be 
taxed, and about the need to re-create jobs, what they are telling us 
and what they told me when I was back home is: Solve those problems 
first. When you get that solved, then if you still want to look at 
health care, go ahead and do that. But in the process of doing that, 
don't throw the baby out with the bathwater. Don't try to throw out a 
system that works for most people. If you have a specific problem, 
target solutions to that problem. You could cover the 12 million people 
who can't afford insurance and who need to get it today, you could buy 
them all insurance with the savings you get with malpractice reform. 
Why don't we do that? The jackpot justice system is a problem in and of 
itself, and we have a problem because some people can't afford 
insurance and we need to help them get it. The money we save from one 
can help pay for insurance for the other. Why not do that? We don't 
need to change the entire system of health in this country in order to 
do that.
  Since everyone knows Medicare is in trouble, why would we get it in 
further trouble by cutting it by $500 billion, and instead applying 
that savings back in to help make Medicare solvent, provide coverage 
for people with that money when, in fact, you could get the money 
elsewhere.
  That is what people are concerned about. They see some problems, but 
they see a solution that does not fit the problems, and they are afraid 
of it because it is too big, it is too much. People are trying to do it 
too fast. In fact, one asked why were they trying to rush this bill 
through before the end of August when it doesn't even take effect in 
most aspects until the year 2013. Good question. It has been a good 
thing that the American people have had a chance to consider this, that 
we have had a chance to read it and we have had a chance to talk about 
it.
  Here is the bottom line. Republicans have a lot of alternatives. 
Senator McCain talked about them: the malpractice reform; getting rid 
of the waste, fraud, and abuse in programs such as Medicare; selling 
insurance across State lines; providing association health plans so 
that small businesses can compete with the insurance companies in the 
same way the big businesses compete. These are ideas that can 
discretely be put into place to solve specific problems, and at the end 
of the day we will have achieved two things: We will have reduced the 
cost of health care premiums and the cost of health care for everybody, 
not just a few, and at the same time we will have been able to, with 
that savings, provide coverage for people who need it and cannot get 
it. To do that, it is not necessary to scrap everything we have and 
create a whole new system where the government takes over health care 
just as it has insurance and banking and automobiles and everything 
else.
  So that is what I am hearing from my constituents, and I hope, as we 
are reengaged in this debate, we will do the one fundamental thing our 
Founding Fathers had in mind when they set up the kind of system we 
have here, and that is that we will listen to our constituents, never 
forgetting they are our bosses and we work for them.
  I thank the Chair.
  The PRESIDING OFFICER (Mr. Kaufman). The Senator from Rhode Island is 
recognized.
  Mr. WHITEHOUSE. Mr. President, I ask unanimous consent to speak for 
up to 15 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WHITEHOUSE. Mr. President, why are we working so hard on health 
care reform right now? Well, one reason is because the present system 
is out of control and unsustainable. This is the cost curve of our 
national health expenditures. In 2009, it hit $2.5 trillion, and it is 
going to continue to go up to the point where right now it is estimated 
that in the year 2016--which is not too far from where we are right 
now--in the year 2016, a standard family policy on average in Rhode 
Island will cost that family $26,000 a year. A middle-class family in 
Rhode Island cannot afford $26,000 a year just for health insurance. 
Something urgent has to be done.
  During the 8 years of the Bush administration, it probably increased 
by nearly $1 trillion, and nothing got done. Our friends on the other 
side of the aisle were happy as clams with that state of affairs. Now, 
in the first year of the Obama administration, with more progress made 
on health care than at any time since back when the Clintons tried it, 
we hear once again the catcalls and the criticisms from our 
colleagues--anything to stand in the way of progress. But that is why 
it is so important. We simply can't afford not to do so when we look at 
the risks our country faces economically.
  There has been some criticism of the stimulus bill, the Economic 
Recovery and Reinvestment Act. This is it right here: $0.8 trillion. 
From all the noise on the other side of this Chamber, one would think 
this dwarfed, shadowed the fiscal health of the Republic, but, in fact, 
it is a tiny little sliver compared to the debt that was run up during 
the Bush administration. We see that $8.9 trillion is the difference 
between what the nonpartisan CBO projected when President Bush took 
office from President Clinton and when President Bush left us when he 
was done--$8.9 trillion. This doesn't even count the Bush hangover of 
all the spending President Obama has had to do to help save the banks, 
to help save the financial system, and to help save the American auto 
industry.
  He campaigned on none of that. None of us wanted to do that. When 
catastrophe asserted itself, we had to respond. The catastrophe took 
place not on President Obama's watch but beforehand. He has led this 
effort to put out the fires. The big risk is the $38 trillion in 
unfunded liability for Medicare alone. That is part of that climbing 
cost picture that is driving us out of control.
  Of that, the Lewin Group--a pretty respected group around these parts 
for their opinions on health care--says the

[[Page S9114]]

excess costs in the health care system add about $1 trillion a year: 
$151 billion for excess costs for incentives to overuse services; $519 
billion for excess costs from poor care management and lifestyle 
factors; $135 billion a year for excess costs due to competition and 
regulatory factors; $203 billion a year from excess costs due to 
transactional inefficiencies.
  We can reform this health care system in a way that improves the 
quality of care, while addressing this $1 trillion in excess costs, 
which, according to George Bush's former Treasury Secretary, Paul 
O'Neil, who ran the Pittsburgh Regional Health Initiative and knows 
something about health care, is associated with ``process failures.''
  Process failures can be corrected. One of the ways you can correct 
them is with a competitive public option. We have had a lock in the 
main middle market of health care by the private insurance market for 
all these years. This is what we are left with--$1 trillion in waste 
from process failures. Obviously, they failed at the job. They have 
catastrophically, indisputably failed.
  All we ask is to put a public option in side by side to compete with 
them--in the same way a public option in workers' compensation 
insurance competes in Senator McCain's home State of Arizona with the 
private insurance providers in workers' compensation. I don't hear 
complaints from him about the business community and the workers' 
compensation.
  In the home State of Senator Ensign, Nevada, there is actually a 
single-payer public option for workers' compensation health insurance, 
and his employers seem absolutely fine with it. So it is not as if it 
is some strange, bizarre idea out on the fringes; it is a way of doing 
business in some of the home States of the opponents of this.
  Our colleagues and their predecessors in this Chamber opposed 
Medicare when it was first proposed. Now it is probably the most 
popular program in the country. We have seen them in this Chamber 
fighting against children's health insurance. It was only thanks to our 
beloved colleague, Senator Kennedy, coming back from his sick bed to 
cast the tie-breaking vote, that we actually were able to win that 
against Republican opposition.
  The ideas they have seem, to me, to be abject failures. One is to 
continue the lock for private health insurance companies so they are 
the only place you can get coverage, unless you are old enough for 
Medicare or you qualify for Medicaid or you are in the military. That 
is clearly not a sign of success.
  As Senator McCain indicated, it would be good to be able to cross 
State lines and buy insurance from out-of-State insurance companies. 
Yes, look how well that turned out for us with the credit card 
industry. We just had to pass legislation, thanks to Chairman Dodd, to 
rein in the abuse and practices of the credit card industry because you 
can go to practically unregulated States and get credit cards that 
don't have basic consumer protections.
  We don't want to see that in health insurance. We want careful, 
thoughtful local regulation of health insurance. We have 100,000 people 
who are killed every year by medical errors--and who knows how many 
injured--and the solution our friends across the aisle see is to take 
away the damages that the worst injured Americans are entitled to. That 
is how the reform they proposed in the HELP Committee works. It cuts 
damages, caps them, meaning it only would affect the people for whom 
the damages are the highest, who are harmed the worst, who would 
disproportionately be women because of the way it was organized, 
focusing on economic damages. So if you take a system where you kill 
100,000 Americans every year because of medical errors--and injure who 
knows how many more--and your solution to the problem is to put the 
cost of it entirely on the backs of the worst victims of that error and 
injury, I think that is a mistake.
  We would prefer, as Democrats--and I think as rational people--to 
reduce the incidence of malpractice and error, reduce the errors of 
malpractice claims by reducing the incidence of malpractice and error. 
We put enormous effort in this bill into putting structures into place 
to allow that to happen.
  In terms of the real fear people heard when they went back home, it 
was a little disingenuous when that fear was whipped up by our 
colleagues with false statements about death panels in the legislation, 
how this was socialized medicine, and how a bureaucrat would jump in 
between you and your doctor if the bill passed. That is patently false. 
It spread like wildfire. Who wouldn't be afraid of those things? Now 
they observe there is real fear out there. I also had the opportunity 
to travel around my State during this break, similar to many 
colleagues, and I sat down with my constituents and heard what they had 
to say about health care reform. I sat down with hospital executives; 
pediatricians; OB/GYNs; family physicians; critical care doctors; the 
State medical society; health insurers; CVS, the pharmaceutical chain 
that makes its home in Rhode Island; the Rhode Island MS chapter; 
business community leaders; members of our Rhode Island quality 
institute, which is reforming health care at the State level and it 
gives great leadership to our country right now; and with members of 
all walks of life who have come together and are working tirelessly to 
help build our State's information technology infrastructure.
  I learned a great deal from those individuals and institutions. I 
learned a great deal also at two community dinners I held in West 
Warwick and in Johnston, RI, where hundreds of Rhode Islanders came out 
to join me and our senior Senator Jack Reed, not only for spaghetti and 
meatballs--and they were good. I think I might be the only Senator to 
introduce meatballs into the townhall formula, and it worked fine. They 
were for a serious, civil, and constructive debate on the state of our 
current health care system. It brought out some stories I wish to share 
quickly this afternoon.
  The first story is about Christine, who is a wife and mother, from 
Coventry, RI. Her family's struggle to maintain health insurance has 
left her and her husband with very difficult choices and few options. 
In 2007, Christine was diagnosed with multiple sclerosis. Shortly 
thereafter, she lost her job. She was shifting the family's coverage to 
her husband's employer, when her husband was laid off as well. That 
left Christine and her husband and their 6-year-old son with no health 
insurance. Still reeling from those bits of bad news, Christine and her 
husband were faced with decisions no one should be forced to make. 
Without medical insurance, with no affordable options for health 
coverage because of Christine's preexisting condition, they faced a 
choice now of leaving their home--think about that. You have a 6-year-
old son who might lose his home--or paying for health insurance. At the 
moment, they cannot see a way to manage both.
  As Christine told me:

       I don't want any handouts. Unfortunately, life has handed 
     me and my family a difficult path, and right now my family 
     needs a little help. We should not have to make a decision 
     between our health and our financial stability.

  Until her husband finds a job, Christine says that every day they 
hold their breath and pray nothing will happen because that is all our 
broken health care system now has to offer them.
  I also met Anna from Johnston, RI, who shared the story of her sister 
Tina. As is the story of so many today, Tina's husband lost his job. 
Their only option for health insurance was through COBRA. At $1,500 a 
month, on top of mortgage and car payments and groceries, Tina knew, 
financially, this coverage was unsustainable. Finally, she had to give 
it up.
  Shortly after dropping coverage, Tina began to lose weight. Anna 
explained that, at first, she thought her sister's weight loss was a 
reaction to the stress of the family's financial situation. But then 
the weight loss continued, and they realized something was seriously 
wrong. Despite urging from her family, Tina resisted going to the 
doctor because she was afraid the medical bills would make a very 
difficult financial situation unbearable.

  Eventually, Tina felt so sick they called the ambulance, and she was 
taken to the hospital. Tina died 3 days later of a heart attack, 
complicated by bone cancer and diabetes. When Anna talked to the doctor 
who treated Tina, they asked the family why Tina had avoided coming to 
the hospital for so

[[Page S9115]]

long because, with proper early intervention, her sister's conditions 
would have been treatable.
  Anna told me she understands people get sick and die, but the manner 
in which her sister passed away was tragic because it didn't have to 
happen.
  Over the August recess, I also heard from Rhode Islanders through the 
health care storyboard I ran on my Web site. Two of the stories are 
remarkable.
  The first is from Ken, a recent Rhode Island College graduate from 
Greenville. He worked hard, dreaming he would be the first in his 
family to achieve a college degree. A year after graduation, Ken has 
that college degree, but he cannot find a full-time job with health 
insurance benefits. In this difficult economy, he works two part-time 
jobs at minimum wage, and he has no health benefits.
  Ken wasn't looking to make a six-figure salary after graduation, but 
he was looking to be able to get by. On his current income, he has 
difficulty making ends meet with his day-to-day expenses, and he says 
it will take years to pay off his student loans at this rate.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. WHITEHOUSE. I ask unanimous consent for 5 more minutes.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. WHITEHOUSE. Ken is having a hard time making ends meet with his 
day-to-day expenses, and it will take years to pay off his student 
loans. On such a limited income and in this situation, health insurance 
is simply not an option for Ken.
  Ken is discouraged and frustrated. Despite his hard work and 
achievement, he knows that at any moment he is one sickness or injury 
away from thousands of dollars in debt or ruined credit that would 
affect his chances for a prosperous future. He has worked for 
everything he has earned, but health care costs are so high he is 
scared about his future, if nothing is done to fix our health care 
system.
  Last is Beth, a small business owner in Providence. She and her 
husband have two full-time and two part-time employees. They find 
themselves at the whim of insurance companies. Because they don't have 
the bargaining power to negotiate the terms of their health insurance 
package, they have seen 41 percent increases in their insurance rates 
for 2 years in a row.
  Beth told me the cost of health insurance is breaking the backs of 
small entrepreneurs, those critical drivers of innovation and building 
blocks of our Nation's economy. She doesn't understand how or why 
anyone would start their own business under the deep financial burdens 
imposed on small business by our current health insurance system.
  Beth also cannot afford health insurance coverage for her twin 3-
year-old girls. Beth admits she is terrified about what might happen to 
them without the safety net that health coverage offers. She urges us 
to work quickly toward reform so others do not have to struggle with 
the same fear and frustration as her family.
  The Senate has been working hard on health reform legislation since 
the very beginning of this year. The process is trying and tiring and 
extremely complex. As we turn up the heat even more the next few weeks 
and become mired in the intense process of drafting a final bill and 
getting it to the floor, I urge my colleagues to remember health care 
reform is not about the interest groups, it is not about parliamentary 
procedures, it is not about secret meetings, and it is not about CBO 
scores. Reforming our health care system in America is about Christine 
and Tina and Beth and Ken and thousands like them in every one of our 
States across the country. And it means injecting some fairness and 
some reason into a system that has punished the sick, rewarded the 
greedy, and discouraged those who try to do the right thing.
  For me, these stories reinforce the urgency of what we need to get 
done in the Senate. I am fully committed to completing this task, as I 
know the Presiding Officer is, and I look forward to getting it done 
over the next few weeks.
  In closing, let me just say this is the first time I have spoken on 
the Senate floor since our colleague, Senator Kennedy, has left us. His 
desk is three down from me. I don't know if the camera shows it now, 
but there is a black drape over it and some flowers and a copy of 
Robert Frost's ``The Road Less Traveled.'' I know this poem meant a lot 
to him, and he certainly meant a lot to me as a very gracious mentor 
with vast experience who could easily have ignored a new colleague. But 
he took an interest, and I will never forget his kindness to me.
  We all will miss his booming voice. He could fill this Chamber with 
his voice. We will miss his rollicking good humor. No one enjoyed life 
and enjoyed his colleagues more than the senior Senator from 
Massachusetts. We will miss his masterful legislative skills as we try 
to work our way through the obstructions the other side will be 
throwing up against progress on health care reform. His wise voice and 
counsel will be missed.
  Finally, we will miss his lion's heart. He knew when the fight was 
right, he knew when it was worth fighting for, and he was in it to win 
it.
  Ted, God bless you. We miss you.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from North Dakota.
  Mr. DORGAN. Mr. President, I ask unanimous consent to speak in 
morning business for 15 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DORGAN. Mr. President, let me follow on the remarks of my 
colleague from Rhode Island as he discussed briefly at the end of his 
remarks the loss of our colleague and friend, Senator Ted Kennedy.
  The desk that is now cloaked in black and adorned with flowers is a 
desk that was once occupied by Senator John F. Kennedy, then occupied 
by Senator Robert Kennedy, and for many years occupied by Senator Ted 
Kennedy.
  He was an extraordinary friend to all of us, a remarkable legislator. 
This is not a case of the Senate just losing one Senator. He was such a 
much larger presence than that in the public life of our country and 
particularly in the workings of this Congress.
  My thoughts and prayers have been with Ted Kennedy and his family 
over these many months as he has battled brain cancer. Now, since his 
death, we have all reflected on what he meant to us and to this 
country.
  Today it seems inappropriate to take the floor of the Senate without 
at least acknowledging the absence of our friend, Ted Kennedy, and to 
send our prayers to his family.

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