[Congressional Record Volume 155, Number 157 (Tuesday, October 27, 2009)]
[Senate]
[Pages S10760-S10763]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                             BIPARTISANSHIP

  Mr. THUNE. Mr. President, last week, something remarkable happened on 
the floor of the U.S. Senate--bipartisanship broke out. We had a vote 
where 40 Republicans were joined by 12 Democrats and 1 Independent to 
vote down a piece of legislation that would have added $250 billion--
$\1/4\ trillion--to the Federal debt. That $\1/4\ trillion, with 
interest, was $300 billion.
  It was highly anticipated, as we were heading toward that vote, that 
there would be enough support to pass it. But I think it tells Members 
in the Senate, and probably people around the country, that there is a 
certain amount of discomfort among Senators when it comes to spending, 
borrowing, and adding to the debt $\1/4\ trillion. I think that is 
good. That is the kind of bipartisanship I wish we had more of in the 
Senate: bipartisanship in the interest of fiscal discipline. Fiscal 
sanity in this country would be a welcome prize for most Americans.
  As we draw nearer to the next stage of the debate on health care--and 
I would argue that was sort of the first vote on health care reform 
because it was a health care-related vote and, frankly, something many 
of us believe needs to be addressed. The physician reimbursement issue 
is an issue Congress deals with on a year-to-year basis. This would 
have put a 10-year solution in place, but, again, at a cost of $250 
billion--$300 billion with interest--and not paid for, borrowed, put on 
the Federal debt, a Federal debt which is already growing at a record 
pace.
  Last year, the deficit was $1.4 trillion. The deficit this year is 
expected to be at a comparable range, and every single year, as we 
spend more than we are taking in, we borrow more and more from future 
generations. In fact, last year, in fiscal year 2009, which was just 
concluded, 43 cents out of every dollar that was spent by the Federal 
Government was borrowed. Yet we were talking about putting another $\1/
4\ trillion--$300 billion with interest--on that Federal debt with the 
vote that was held last week.
  So I was very pleased that bipartisanship did break out on the floor 
of the Senate and that we were able to defeat a piece of legislation 
that, frankly, would have saddled future generations with even more 
debt than they are already facing.
  I think the next big issue in the debate over health care, Mr. 
President, has to do with whether--in the legislation that is being 
written behind closed doors--there is going to be a so-called public 
option, which is the phraseology that has now been adopted to describe 
what I would characterize as a government plan, and whether that 
government plan is going to have an opt-in for States, an opt-out for 
States, or whether it will have a trigger that will take effect 
somewhere down the road. All these questions, in my mind, belie the 
basic fundamental fact that what we are talking about is government-run 
health care.
  Whether we have a State opt-in or a State opt-out or some sort of 
trigger, the conclusion is still the same: we are going to have a 
government plan that will compete with the private health care market 
and the opportunities that are available to most Americans. When you do 
that, of course, I think you put the competitive marketplace at an 
unfair disadvantage because the government, obviously, will have huge 
advantages, and eventually over time you will see more and more people 
pushed into that government plan, more and more employers will drop 
their coverage as people gravitate toward the government plan.

  My point simply is this: Whether you call it a State opt-in or a 
State opt-out or a trigger, a government plan by any other name is 
still a government plan. What we are talking about is creating a 
mechanism whereby the Federal Government can enter into the marketplace 
and compete against the private sector when it comes to offering health 
care insurance to people in this country. That, to me, is an 
unacceptable outcome and I hope one that will be defeated.
  It seems to me at least that the vote last week perhaps is an 
indication that there already is some discomfort developing among 
Members here, in a bipartisan way, on the direction in which this 
health care debate is headed.
  I think the No. 1 concern most Americans have when it comes to health 
care reform is the issue of cost. It really is. How are my day-to-day 
costs for health care going to be impacted by the debate occurring in 
Washington, DC? Is health care reform going to drive that cost down or 
is it going to increase it?
  What we have questioned consistently with respect to all the 
proposals out there, including the more recent version released by the 
Senate Finance Committee of which we finally got a written copy last 
week, over 1,500 pages, currently being merged with the Senate HELP 
Committee legislation--again in a process which is very closed to most 
Members of the Senate where a handful of people in a room are 
developing this--we hope to see that merged version at some point here 
in the not too distant future and know what it is going to cost because 
I think that is a consideration all of us are going to be following 
very closely: What is this latest version going to cost?
  For most Americans, the issue is going to come back to how it impacts 
my premiums. We have now seen the Congressional Budget Office, we have 
seen the Actuary at the Department of Health and Human Services, we 
have seen a number of independent studies that have said this is going 
to bend the cost curve up, not down. In other words, you are going to 
see overall health care costs increase, you are going to see premium 
costs increase for most Americans.
  In fact, if you are one of the 185 million Americans who derive their 
health insurance through their employer, you are going to see higher 
premiums. There are those who are going to get their insurance through 
an exchange--18 million Americans--for whom subsidies are available. 
But if you are one of the 185 million Americans who get their health 
care insurance through their employer, you are not going to be eligible 
for a subsidy. You are, however, going to be paying the higher taxes 
that are associated with this and you are going to see your premiums go 
up.
  The most recent, I guess, analysis of this, which was released last 
week by the Department of Health and Human Services, by the Chief 
Actuary there, suggested that overall spending for health care at the 
end of the 10-year period would be up 2.1 percent. In other words, 
today we spend about $1 in every $6 of our entire economy--one-sixth of 
our GDP is spent on health care. In 2019, we will be spending 21.3 
percent or over one-fifth of our entire economy on health care. So $1 
out of $5 in our economy is going to pay for health care at the end of 
that period. What does that mean? It means health care spending is 
going to increase by about $750 billion over that period of time. That 
is the wrong direction to go if you are talking about reform.
  As I said before, most Americans, when they look at how this impacts 
them, want to know whether health care reform that is being acted on by 
Congress is actually doing something to impact the cost of their health 
care in a positive way--in other words, that the cost for their 
premiums, their health care premiums, is going down.
  I say again, based upon all the analysis that has been done with 
respect to my State of South Dakota, I have seen several studies which 
suggest that if you buy your insurance in the individual marketplace, 
you could see your

[[Page S10761]]

premiums go up as much as 47 percent. If you are a family buying in the 
individual marketplace, you could see your premiums go up as much as 50 
percent. In fact, there have been some analyses done that suggested 
premiums could go up as much as 73 percent for some people.
  What does that mean to the average American who is observing this 
debate? It means not only are you going to see taxes go up--according 
to the Congressional Budget Office and the Joint Tax Committee, the tax 
increases in the bill are going to hit the middle-income classes the 
hardest. In fact, about 90 percent of the tax burden will be borne by 
those making less than $200,000 a year. According to the Joint 
Committee on Taxation, over 50 percent of the tax burden will be borne 
by those making less than $100,000 a year. The taxes are clearly going 
to hit right at middle-class Americans. If you are a senior over 65, 
you are going to see significant cuts in Medicare because that is one 
of the ways the new expansion of this program, this new entitlement 
program, is financed and paid for. So you are going to see higher 
taxes, you are going to see cuts to Medicare, and then ironically, as I 
said earlier, you are going to see your premiums go up. The average 
American has to be sitting out there asking: What is the whole purpose 
of this exercise?
  One of the things that has been advocated in the debate over health 
care reform is we have to cover the people who are not covered. There 
are a lot of Americans who do not have access to health care coverage 
today. That could be addressed. There are lots of ways that could be 
addressed, but the way it is proposed to be addressed here actually 
leaves 25 million Americans uncovered. So not only have you raised 
taxes, cut Medicare, and increased premiums for people who already have 
insurance, you leave 25 million Americans without health care coverage. 
How can you, in any stretch of the word, characterize or define that as 
health care reform?
  As the debate gets underway, I hope last week's vote was an 
indication, at least, of the initial stages of this debate; that there 
is some bipartisan support for constraining spending, for fiscal 
responsibility, and for fiscal discipline; and that as we get into 
this, we can move away from this discussion about a $2 trillion 
expansion of the Federal Government financed with tax increases and 
Medicare cuts and premium increases for 185 million Americans who get 
their insurance through their employer and start focusing on things 
that actually would provide greater competition and would bend the cost 
curve down, would drive costs down for most Americans. We believe that 
is a fair place to start.
  We think there are things that could be done that would accomplish 
that, one of which is allowing people to buy insurance across State 
lines, creating a bigger market, a more expansive market for people in 
this country. Another is to allow people to join larger groups and get 
the benefit of group purchasing power, small business health plans--
legislation voted on a number of times here and always been defeated. 
We ought to address the issue of medical malpractice reform and 
defensive medicine, which costs, some estimates are, $100 billion a 
year in terms of additional spending.
  There are many solutions that we think make sense that actually do 
get at the issue of cost, which, as I said, is where I think most 
Americans are concerned about health care reform and where all the 
bills we have seen so far, including the one that was released by the 
Senate Finance Committee, fall short. It doesn't do anything to impact 
premiums, the health care costs for most Americans, at least those 
Americans who have health insurance; it raises them at the same time it 
raises taxes on working families in this country and cuts Medicare for 
senior citizens to the tune of $\1/2\ trillion.
  If you take a fully implemented 10-year time period for this--bear in 
mind that many of the tax increases in this bill are implemented 
immediately and the actual other provisions in the bill are implemented 
later on down the road in 2013. So you see a distorted view of what 
this bill really costs. The 10-year fully implemented cost is $1.8 
trillion, almost $2 trillion. That amount, of course, is financed 
evenly between cuts in Medicare Programs and tax increases on people in 
this country.
  I do not think that is what we want to see in terms of reform. It 
certainly is not what I think the American people are expecting 
Congress to do. They are expecting health care reform that does do 
something about getting their costs under control. This bill, the last 
bill we have seen--of course, we have a bill that is being merged now 
behind these closed doors which we hopefully will see in the near 
future--falls short on that account, and that is why I hope there will 
be strong bipartisan opposition to this legislation, allowing us to 
start over and in a step-by-step process work in a way that will 
actually impact, in a positive way, the costs most people are paying 
for insurance in this country by driving the overall cost of health 
care down rather than up.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Nelson of Nebraska). The Senator from 
Illinois.
  Mr. DURBIN. Mr. President, I applaud the remarks of the Senator from 
South Dakota about bipartisan cooperation on health care reform. We 
have been trying all year, and unfortunately there has only been one 
Republican Senator, Senator Snowe of Maine, who has voted to report a 
bill from committee; not a single Republican Congressman--none--and no 
other Republican Senator.
  In fact, when the Health, Education, Labor, and Pensions Committee 
considered this health reform bill--and it is a big one because it 
affects $1 out of $6 in our economy and virtually every American--there 
were over 500 amendments. Over 150 were offered by the Republican side 
of the aisle and adopted. There were 150 Republican amendments, and not 
one single Republican Senator would vote for the bill. That is 
frustrating.
  Senator Max Baucus, the chairman of the Senate Finance Committee, 
determined to get bipartisan support, sat down with three Republican 
Senators literally for months--Senator Grassley of Iowa, Senator Enzi 
of Wyoming, and Senator Snowe of Maine--and said: Let's do this 
together. Let's do a bipartisan bill. Eventually, one fell off, the 
other fell off, and finally Senator Snowe was the only one who would 
vote for it.
  I applaud the Senator from South Dakota calling for bipartisanship. 
We have tried. And the notion that we are going to throw out all we 
have done and start over--what, another 500 amendments in the HELP 
Committee? Another 150 Republican amendments, and then they are going 
to vote against the bill?
  We have a bill moving forward. It is a painful, difficult process, 
and the other side has nothing except criticism. They basically tell us 
what is wrong with our bill, and when we ask them: What will you do to 
significantly change health care in America, they have nothing. The 
current system is unsustainable. The cost of the current system is 
going to break the backs of individuals and families and businesses and 
governments.
  Just 2 weeks ago, the insurance industry told us: If you pass health 
care reform, we guarantee you we will raise premiums. And they will. 
Trust me, they will. How do I know that? They have done that 
consistently every year. They just announced a 15-percent increase in 
health insurance for next year for businesses. Fewer businesses will be 
able to offer health insurance. How can they say this with certainty? 
You would say it is like guaranteeing that the price of a certain 
commodity is going up.
  What about competition? The fact is, there is little or no 
competition in health insurance. First, this is one of two businesses 
in America exempt from antitrust. That means the heads of the insurance 
companies selling health insurance can legally sit down together and 
collude and conspire on the premiums they are going to charge people 
across America. They can decide how much they will charge and agree 
among themselves that they are going to charge the same thing. And they 
can allocate markets in America and say, well, this particular market 
in Los Angeles belongs to this health insurance company, this market in 
Chicago belongs to this health insurance company, and it is legal--the 
McCarran-Ferguson law. It is legal.
  When they threaten to raise health insurance premiums, mark my words,

[[Page S10762]]

they can do it. The only thing that stops them is competition. If there 
is some other entity out there offering health insurance that is 
competitive, at a lower price, then we have competition. What do we 
call that? The public option.
  The people who come to the floor and criticize the notion of a public 
option--I have yet to hear the first person come to the floor and 
criticize Medicare. We created Medicare over 40 years ago and said: If 
you are over the age of 50, we are going to give you peace of mind. You 
won't go to the hospital and lose your life savings because of medical 
bills. That is what Medicare is all about. It has worked. Seniors live 
longer, they get better care, they have their independence, and they 
can live by themselves longer, which is exactly what they want to do. 
And they are not exhausting their savings.
  When I was a child growing up, it was not unusual for grandma or 
grandpa to come and move in with you because they reached a point in 
their lives where they didn't have anything, and their families brought 
them into that spare bedroom. It happened in my family and a lot of 
others. Then came Social Security, then came Medicare, and then came 
independence, where they could have the kind of independence they enjoy 
and want to have.
  How many people have come to the floor criticizing the public option 
in government health insurance and calling for the abolition of 
Medicare? None. Not one. Maybe somebody will. I have yet to hear it.
  I am all for bipartisanship, but I hope we put it in context. If we 
are going to deal with cost, if we are going to make sure Medicare is 
financially sound for years to come, if we are going to make sure the 
abuses of the health insurance companies come to an end--whether 
preexisting conditions or caps on payments for medical care--then we 
have to pass legislation. Merely coming here and saying what is wrong 
with the existing bill is not enough.
  There is also a need for bipartisanship when it comes to the 
unemployed in America. Here is something on which you would think we 
could all basically agree. If you are one of the unfortunate millions 
of Americans out of work, if you have reached the point where you do 
not have a regular paycheck and you are trying to keep the lights on in 
your house, trying to pay the rent or the mortgage, put food on the 
table for your kids and some clothing and basic needs of life, gasoline 
in the car, we have always said in that situation, the American 
family--that is all of us, the collective Nation of America--will come 
and help.
  Unemployment benefits will be the first thing we will help you with 
so you have something, a check, to get by on while you are looking for 
another job. Sadly, this recession has been very deep and has gone on 
for a long period of time. Millions of Americans have exhausted their 
unemployment benefits, and we have extended their benefits, realizing 
we have not turned the corner as we hoped we would, and we still have 
to realize a lot of people will not be able to find jobs quickly.
  It used to be this was done automatically. We said: Well, we may 
bicker and squabble over economic policy. We may disagree on a lot of 
issues, but we will agree on this issue. The safety net in America 
should be there for unemployed people. Unfortunately, that has not been 
the case when it comes to the unemployment benefits we need today.
  We have tried, more than once, to bring to the floor of the Senate a 
bill to extend unemployment insurance for Americans who are still out 
of work and need help. As I said, it should not be a partisan issue. 
The unemployment rate is close to 10 percent across the Nation. In many 
areas of the country, including my home State, it is even higher. Each 
day that goes by more people are running out of their benefits.
  Here is story from a man who has written me from Mt. Vernon, IL, in 
Jefferson County, southern Illinois:

       I have been unable to find a job. I have been unemployed 
     since May 2007. My employment benefits exhausted in 
     September. I am 54 years old. I have worked in factories most 
     of my adult life. Therefore I have gone back to school. I 
     still need a job. I realize I am not the only one. Please 
     help us. I have no health care insurance. I have no life 
     insurance since I lost my job. I am praying for our country. 
     God bless you.

  A woman from my hometown in Springfield, IL, writes:

       Mr. Durbin, I lost my job when the economy went south at 
     the end of last summer. I am 54 years old, and at that 
     awkward age, cannot retire, and not as attractive to 
     employers as a younger job candidate, no degree and not 
     enough work years left to pay back a student loan to get a 
     degree. I have two kids. I am trying to help them get through 
     college. I went from earning $30 an hour in telecom to $8.25 
     hour an hour in retail. Without my unemployment benefits, 
     even my modest house payments are going to become difficult. 
     Can anything be done to move the extension through the 
     Senate? I am down to my last couple of weeks of benefits. I 
     have lots of office skills and experience but cannot quite 
     compete in this tight job market. Thanks for being our voice 
     in the Senate.

  The unemployment rate in Illinois now is 10.5, in Peoria it is 11.1 
percent, in Decatur it is 12.4 percent, in Kankakee it is 12.8 percent, 
and in Rockford it is 15 percent. Our State is not alone with these 
numbers.
  In the 19 days since Republicans in the Senate blocked our move to 
pass a strong unemployment insurance extension bill, another 130,000 
Americans who cannot find work have lost their benefits. If we did not 
pass the extension of unemployment insurance this week, we will put 
200,000 families in a position of not being able to put food on the 
table. It is that stark. It is that real. Some 20,000 of those families 
live in my State.
  How do I explain to my constituents why the Senate has not acted on 
this bill that we obviously need and need desperately? Well, we cannot 
pass it because on the Republican side of the aisle they want to offer 
amendments.
  Do the amendments have anything to do with unemployment or the 
payment of unemployment benefits? No.
  One amendment from a Senator from Louisiana is to, once again, for 
the fourth or fifth time in the Senate in the last few months, flog an 
organization known as ACORN. How many times are we going to take up the 
time in the Senate to go after this organization? I do not know. But as 
long as it is Exhibit A on rightwing radio and TV, Members will come to 
the floor and say: Well, let me do something that might be mentioned 
tomorrow on one of these talk shows.
  Well, that might be an interesting political exercise if it was not 
at the expense of these people who are basically unemployed and running 
out of money. The Senator from Louisiana wants to offer this amendment 
the fourth or fifth time. By the end of this year, nearly 9,000 
families in Louisiana will lose unemployment insurance benefits if we 
do not act; 38,000 families in Alabama; 4,000 families in Kentucky will 
have lost their benefits during the month of October alone; 5,000 
families in Arizona will have lost their assistance this month.
  I would like to believe, at some point, even though we like to give 
speeches on the floor--and I am doing it right now--that you might step 
back and say: It might be more important that we pass this bill and 
then give the speech afterward. I hope we can. We should not be 
surprised families need our help. Unemployment has jumped across 
America. We need to do more than just help Americans find work. We need 
to provide small businesses better access to credit so they can grow 
and create jobs. We need to think about what other incentives we can 
put in place to help all employers, large and small, create jobs. In 
the meantime, we need to fix the safety net.
  I would like to ask my colleagues who come to the floor and ask for 
bipartisanship, can we be bipartisan when it comes to unemployment 
benefits? It is not just the Democrats who are out of work, it is 
Democrats, Republicans, Independents, folks who do not vote, folks who 
do not think much of us, and folks who may have thought a little bit 
more of us before we got into this mess. This is a time for 
bipartisanship. In about an hour we will have a chance to vote. Let's 
hope Members from both sides of the aisle will come forward and stand 
up for these families who are so desperate.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. INHOFE. Mr. President, I ask unanimous consent that I be allowed 
to speak as in morning business for such time as I shall consume.
  The PRESIDING OFFICER. Without objection, it is so ordered.

[[Page S10763]]

  Mr. CARDIN. Mr. President, reserving the right to object, and I am 
certainly not going to object, may I inquire how long my colleague will 
speak?
  Mr. INHOFE. It will not be more than 15 minutes.
  Mr. CARDIN. I ask unanimous consent that I be recognized immediately 
after the Senator from Oklahoma.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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