[Congressional Record Volume 155, Number 192 (Thursday, December 17, 2009)]
[Senate]
[Pages S13345-S13376]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             DEPARTMENT OF DEFENSE APPROPRIATIONS ACT, 2010

  The ACTING PRESIDENT pro tempore. Under the previous order, the 
Senate will resume consideration of the House message with respect to 
H.R. 3326, which the clerk will report.
  The legislative clerk read as follows:

       House message to accompany H.R. 3326, a bill making 
     appropriations for the Department of Defense for the fiscal 
     year ending September 30, 2010, and for other purposes.

  Pending:

       Reid motion to concur in the amendment of the House to the 
     amendment of the Senate to the bill.
       Reid motion to concur in the amendment of the House to the 
     amendment of the Senate with amendment No. 3248 (to the House 
     amendment to the Senate amendment), to change the enactment 
     date.
       Reid motion to refer the amendment of the House to the 
     Committee on Appropriations, with instructions, Reid 
     amendment No. 3249, to provide for a study.
       Reid amendment No. 3252 (to Reid amendment No. 3248), to 
     change the enactment date.
       Reid amendment No. 3250 (to amendment No. 3249), of a 
     perfecting nature.
       Reid amendment No. 3251 (to amendment No. 3250), of a 
     perfecting nature.

  The ACTING PRESIDENT pro tempore. Under the previous order, Senators 
are permitted to speak for up to 10 minutes each, with the first hour 
equally divided and controlled between the two leaders or their 
designees, with the Republicans controlling the first half and the 
majority controlling the second half.
  The Senator from Arizona is recognized.
  Mr. McCAIN. Madam President, I ask unanimous consent that the Senator 
from Tennessee lead a colloquy including the Senator from Oklahoma, the 
Senator from Wyoming, myself, and the Senator from Kentucky.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. ALEXANDER. Madam President, I thank the Senator from Arizona.
  I was thinking as I listened to the Republican leader, I wonder if 
the Senator noticed the comments of the Governor of California on 
Monday. Governor Schwarzenegger said on ``Good Morning America'' that 
he supports the idea of overhauling health care, but: ``the last thing 
we need,'' said Governor Schwarzenegger, ``is another $3 billion in 
spending when we already have a $20 million deficit.''
  He was referring to one of the unintended consequences of this bill, 
which is big State costs for Medicaid being shifted to the States--
unfunded mandates.
  So here is Governor Schwarzenegger's advice, following up on the 
comments of the leader: ``So I would say be very careful to the Federal 
Government.''
  This is from the Governor of California:

       Before you go to bed with all this, let's rethink it. There 
     is no rush from one second to the next. Let's take another 
     week or two. Let's come up with the right package.

  I wonder if the Senator saw it.
  Mr. McCAIN. I thank the Senator from Tennessee who also understands 
this issue as well as or better than anyone, having been a Governor and 
recognizing the problems the Governors face.
  If I could step back a second, Governor Schwarzenegger is a very 
astute observer of the political scene in California. May I point out 
to my colleagues, in this morning's Wall Street Journal: ``Democrats' 
Blues Grow Deeper in New Poll,'' and then: ``Support for Health 
Overhaul Wanes.''
  There is some remarkable information concerning the mood and views of 
the American people, following on a Washington Post ABC News poll out 
yesterday that says 51 percent of Americans say they oppose the 
proposed changes to the system; 44 percent approve.
  Thanks to the efforts of so many people, including our leadership, we 
have turned American public opinion because we have been informing them 
of the consequences of passage of this legislation.
  Let me quote from the Wall Street Journal article:

       More Americans now believe it is better to keep the current 
     health system than to pass President Barack Obama's plan, 
     according to a new Wall Street Journal-NBC News poll. 
     Findings mark a shift from the fall when the overhaul enjoyed 
     the edge over the status quo. According to the poll, 44 
     percent of Americans said it is better to pass no plan at all 
     compared with 41 percent who said it is better to pass the 
     plan.

  What they are saying is: Don't do this government takeover; don't 
increase taxes; don't increase spending; don't increase the costs. It 
is a remarkable shift, thanks to informing the American people.
  Could I mention a couple of other points made in this poll in the 
Wall Street Journal. In September, 45 percent of Americans said they 
wanted the plan passed; 39 percent wanted to ``keep the current 
system.'' In December, in polling out today, only 41 percent of the 
American people want it passed, and 44 percent say keep the current 
system.
  Then, of course, we have another interesting statistic:

       Trust that the government will do what is right: 21 percent 
     say always or most of the time; 46 percent say only some of 
     the time; and 32 percent of the American people say almost 
     never.

  Of course, the anger and disapproval of this health care plan right 
now is the centerpiece of Americans' dissatisfaction of the way we do 
business.

[[Page S13346]]

  Let me say finally, because my colleagues wish to speak, we don't 
have a bill. We don't have a bill. Here we have been debating all this 
time and we do not have legislation. This was one of the bills we were 
presented with, but we know that significant changes are being made 
behind closed doors. We don't have a CBO estimate of the cost, do we? 
We understand they keep sending estimates over to CBO and it comes back 
and so they send them back, which probably is why last week the Senator 
from Illinois, the No. 2 ranking Democrat, said to me, I don't know 
what is in the bill either. I have the exact quote:

       I would say to the Senator from Arizona that I am in the 
     dark almost as much as he is, and I am in the leadership.

  That is an interesting commentary.
  Of course, the issue of the protection of the rights of the unborn is 
still unclear. That is a big issue for a lot of Americans. It is a big 
issue with me, and I know it is a big issue with my colleagues.
  So here we are back, off of the bill itself, and apparently we are 
going to have some kind of vote on Christmas Eve or something such as 
that.
  What the American people are saying now is, when they say keep the 
status quo, they are saying: Stop. Go back to the beginning. Sit down 
on a bipartisan basis and let's get this done, but let's get it done 
right.
  Americans know that Medicare is going broke. Americans know that 
costs are rising too quickly, but Americans want us to do this right 
and not in a partisan fashion and not with a bill that costs too much, 
taxes too much, and deprives people of their benefits.
  Mr. ALEXANDER. Madam President, I thank the Senator from Arizona for 
his comments. We have two physicians in the Senate, Dr. Coburn from 
Oklahoma and Dr. Barrasso from Wyoming. I wonder if they would bear 
with me for a minute or two to reflect on something the majority leader 
said--minority leader said--I hope he is the majority leader before too 
long--and the Senator from Arizona.
  The minority leader, the Republican leader, talked about a historic 
mistake. There has been a lot of talk around here about making history 
on health care. The problem is there are many different kinds of 
history, as the Republican leader has pointed out. It seems our friends 
on the other side are absolutely determined to pursue a political 
kamikaze mission toward a historic mistake which will be disastrous for 
them in the elections of 2010, but much more important, for the 
country.
  I did a little research on historic mistakes. We have made them 
before in the United States. Maybe we would be wise to take Governor 
Schwarzenegger's advice and slow down and stop and learn from our 
history rather than try to top our previous historic mistakes, such as 
the Smoot-Hawley tariff. That sounded pretty good at the time in 1930 
when the idea was to buy American, but most historians agree it was a 
mistake and it contributed to the Depression.
  There was the Alien and Sedition Act of 1798. It sounded good at the 
time. We were going to keep the foreigners in our midst--they were 
mostly French then--from saying bad things about the government, but it 
offended all of our traditions about free speech.
  In 1969 Congress enacted the ``millionaires' tax,'' they called it, 
to try to catch 155 Americans who weren't paying any tax. That turned 
out to be a historic mistake, because last year it caught 28 million 
American taxpayers until we had to rush to change it.
  Just a couple more. There was the Catastrophic Coverage Act of 1988. 
That was well named, but it turned out to be a catastrophe, a 
congressional catastrophe. The idea was to help seniors deal with 
illness-related financial losses, but seniors didn't like paying for 
it. They surrounded the chairman of the Ways and Means Committee in 
Chicago and now the leader of that group is a Member of Congress.
  Then there was a luxury tax on boats over $100,000, another historic 
mistake, because it raised about half the taxes it was supposed to and 
it nearly sank the boating industry and it put 7,600 people out of 
jobs.
  I ask my friends from Oklahoma and Wyoming--it is going to be a lot 
harder for Congress, if they try to fix the health care system all at 
once, to come back and repeal it than it was to repeal a boat tax. Do 
my colleagues think we ought to take the time to avoid another historic 
mistake?
  Mr. COBURN. Well, I would answer my colleague from Tennessee. As a 
practicing physician, what I see as the historic mistake is we are 
going to allow the Federal Government to decide what care you are going 
to get. We are going to compromise the loyalty of your physician so 
that no longer is he or she going to be a 100-percent advocate for you, 
he or she is going to be an advocate for the government and what the 
government says. Because in this bill--even the one that is going to 
come--there are three different programs that put government 
bureaucracy in charge of what you can and cannot have. It doesn't 
consider your personal health, your past history, or your family 
history; they are going to say here is what you can and cannot do. That 
is called rationing. That is in the bill. That is coming. That is a 
historic mistake because it ruins the best health care system in the 
world in the name of trying to fix a smaller problem in terms of 
access, and it ignores the real problem.
  The real problem is health care in this country costs too much. We 
all know this bill doesn't drive down costs, it increases costs. So 
your premiums go up, your costs go up, your care is going to go down 
because the government is going to tell you what you have to have.
  I think that is a historic mistake and we have not addressed that. I 
wonder what my colleague from Wyoming thinks.
  Mr. BARRASSO. Madam President, I agree completely. As a practicing 
physician taking care of people in Wyoming for 25 years, I have great 
concerns about this bill, what we know for sure is in it, which is $500 
billion of cuts in Medicare to our patients who depend on Medicare, and 
that is a system that we know is going broke. That is why there is a 
front-page story in one of the Wyoming papers: ``Doctors Shortage Will 
Worsen.'' It is going to be harder on rural communities and others 
around the country if this goes through, and we know that because the 
folks who have looked at the parts of the bill we have seen have said 
that one-fifth of the hospitals in this country will be--if they are 
able to keep their doors open--operating at a significant loss 10 years 
from now. That is not the best future for health care in our country.
  I had a telephone townhall meeting. People from all around the State 
of Wyoming were calling in and asking me questions, and they asked: 
What is in the bill? What is coming to the Senate?
  We don't know yet. We haven't seen it.
  They said: Well, when you find out, come home and let's have some 
more townhall meetings so we can have some input.
  That is what we ought to do as a Senate. We ought to know what is in 
the bill and then let us go home and share it with our friends so they 
know. Because right now what the American people have seen of this 
bill, the 2,000-page bill, they rightly believe this will increase the 
cost of their own personal care.
  Mr. COBURN. Madam President, if my colleague would yield, yesterday I 
asked the chairman of the Finance Committee to agree to a unanimous 
consent request that, in fact, for at least 72 hours the American 
people would get to see this bill; the Members of the Senate would get 
to see this bill; that there be a complete CBO score so we can have an 
understanding. He denied that request.
  That comes back to transparency. The American people expect us to 
know exactly what we are voting on. They expect us to have read what we 
are voting on. His explanation was: I can't guarantee that. It presumes 
a certain level of perception on my part, an understanding of delving 
into the minds of the Senators that they could actually understand. 
What does understand mean? That is the kind of gibberish the American 
people absolutely don't want. They want us to know what we are voting 
on when we get ready to vote on this bill.
  Mr. McCAIN. Madam President, isn't that a violation of the commitment 
that was made that for 72 hours any legislation would be online, not 
just for us to see but for all Americans to see?
  Could I ask the Senator from Kentucky, the Republican leader: Is it 
not

[[Page S13347]]

the perception now that this bill is probably going to be pushed 
through? Through various parliamentary procedures, the majority will 
try to force a final vote on this legislation, no matter what, before 
we leave? Isn't that in contradiction to what the majority of the 
American people are saying, that they want us to do nothing? Is this a 
responsible way to govern, to have the Senate in round the clock, 24 
hours, people on the floor, quorum calls and all this kind of stuff; 
and there would also be no amendments allowed at that time for us to at 
least address some of the issues of this bill that begins cutting 
Medicare by $500 billion, increases taxes by $500 billion on January 1, 
and in 4 years begins spending $2.5 trillion? Is this a process the 
American people are reacting to in a negative fashion, obviously, by 
polling data?
  By the way, I ask unanimous consent that the Wall Street Journal 
article entitled ``Democrats' Blues Grow Deeper in New Poll'' and 
``Support for Health Overhaul Wanes'' be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

             [From the Wall Street Journal, Dec. 17, 2009]

                Democrats' Blues Grow Deeper in New Poll

                          (By Peter Wallsten)

       Washington.--Less than a year after Inauguration Day, 
     support for the Democratic Party continues to slump, amid a 
     difficult economy and a wave of public discontent, according 
     to a new Wall Street Journal/NBC News poll.
       The findings underscored how dramatically the political 
     landscape has changed during the Obama administration's first 
     year. In January, despite the recession and financial crisis, 
     voters expressed optimism about the future, the new president 
     enjoyed soaring approval ratings, and congressional leaders 
     promised to swiftly pass his ambitious agenda.
       In December's survey, for the first time, less than half of 
     Americans approved of the job President Barack Obama was 
     doing, marking a steeper first-year fall for this president 
     than his recent predecessors.
       Also for the first time this year, the electorate was split 
     when asked which party it wanted to see in charge after the 
     2010 elections. For months, a clear plurality favored 
     Democratic control.
       The survey suggests that public discontent with Mr. Obama 
     and his party is being driven by an unusually grim view of 
     the country's status and future prospects.
       A majority of Americans believe the U.S. is in decline. And 
     a plurality now say the U.S. will be surpassed by China in 20 
     years as the top power.
       Democrats' problems seem in part linked to their ambitious 
     health-care plan, billed as the signature achievement of Mr. 
     Obama's first year. Now, for the first time, more people said 
     they would prefer Congress did nothing on health care than 
     who wanted to see the overhaul enacted.
       ``For Democrats, the red flags are flying at full mast,'' 
     said Democratic pollster Peter Hart, who conducted the survey 
     with Republican pollster Bill Mclnturff. ``What we don't know 
     for certain is: Have we reached a bottoming-out point?''
       The biggest worry for Democrats is that the findings could 
     set the stage for gains by Republican candidates in next 
     year's elections. Support from independents for the president 
     and his party continues to dwindle. In addition, voters 
     intending to back Republicans expressed far more interest in 
     the 2010 races than those planning to vote for Democrats, 
     illustrating how disappointment on the left over attempts by 
     party leaders to compromise on health care and other issues 
     is damping enthusiasm among core party voters.
       But public displeasure with Democrats wasn't translating 
     directly into warmth for Republicans. Twenty-eight percent of 
     voters expressed positive feelings about the GOP--a number 
     that has remained constant through the Democrats' decline 
     over the summer and fall. Only 5% said their feelings toward 
     the Republicans were ``very positive.''
       And in one arena, Afghanistan, Mr. Obama appeared to have 
     some success in winning support for his planned troop surge. 
     Liberals remain largely opposed to the strategy, but in fewer 
     numbers compared with before Mr. Obama made his case in a 
     speech at West Point. Overall, by 44% to 41%, a plurality 
     believe his strategy is the right approach.
       Still, the survey paints a decidedly gloomy picture for 
     Democrats, who appear to be bearing the brunt of public 
     unease as unemployment has risen from 7.6% to 10% since Mr. 
     Obama took office. Just 35% of voters said they felt 
     positively about the Democratic Party, a 14-point slide since 
     February. Ten percent felt ``very positive.''
       ``Overall, it's just a depressing time right now,'' said 
     Mike Ashmore, 23 years old, of Lansdale, Pa., an independent 
     who supported Mr. Obama last year but now complained about 
     the president's lack of action on jobs.
       Julie Edwards, 52, an aircraft technician for Boeing Co. in 
     Mesa, Ariz., said she voted Democratic in the past two 
     elections but wasn't sure how she would vote next time. She 
     wondered why Wall Street firms were bailed out when average 
     Americans needed help. ``We can bail out Wall Street, but 
     everybody else has to suffer in spades for it,'' she said.
       Democratic leaders, while bracing for losses next year, 
     have argued that unlike the 1994 elections, in which 
     Republicans gained 54 seats and took the House majority, 
     Democrats would survive 2010 in part because they are taking 
     steps to avoid that possibility. Republicans must gain 41 
     seats to take control.
       House Speaker Nancy Pelosi said Wednesday that Democrats 
     ``fully intend to be in the majority'' after November 2010, 
     and she was now shifting to ``campaign mode'' to help 
     candidates. Party officials are leaning on a number of 
     longtime colleagues to fight for their seats rather than 
     retire.
       The Journal/NBC survey found Ms. Pelosi's presence on the 
     campaign trail could do more harm than good. Fifty-two 
     percent said they would be less likely to vote for a 
     candidate who agreed with the speaker almost all the time, 
     compared with 42% who felt that way about candidates siding 
     with Republican leaders.
       For Mr. Obama, who has relied on his personal popularity to 
     retain the clout he needs to enact his legislative agenda, 
     the survey pointed to troubling signs.
       A majority for the first time disapproved of his handling 
     of the economy. And the public's personal affection for the 
     president, a consistent strong suit, has begun to fray. Fifty 
     percent now feel positive about him, six points lower than in 
     October and an 18-point drop since his early weeks in office.
       Democrats' troubles can be attributed in part to changing 
     feelings among some core supporters. A third of voters 34 and 
     under, a group that turned out heavily for Democrats last 
     year, feel negative toward the Democratic Party. And just 38% 
     of Hispanics feel positive, down sharply from 60% in 
     February.
       The survey, which was conducted Dec. 11-14, has a margin of 
     error of 3.1 percentage points.
                                  ____


             [From the Wall Street Journal, Dec. 17, 2009]

                   Support for Health Overhaul Wanes

                            (By Janet Adamy)

       The public is turning against an overhaul of the health-
     care system, complicating Democrats' effort to pass a 
     sweeping bill in the Senate.
       More Americans now believe it is better to keep the current 
     health system than to pass President Barack Obama's plan, 
     according to a new Wall Street Journal/NBC News poll. The 
     findings mark a shift from the fall, when the overhaul 
     enjoyed a slight edge over the status quo. They could make it 
     more difficult to get wavering lawmakers on board as the 
     Senate prepares to vote on the measure as soon as next week. 
     Some Democrats expect support will rebound if they can pass a 
     bill quickly and start selling it.
       According to the poll, 44% of Americans said it is better 
     to pass no plan at all, compared with 41% of Americans who 
     said it's better to pass the plan. In early October, 45% of 
     respondents preferred passing a bill, while 39% preferred 
     passing no bill. Uninsured people were among those who have 
     grown less supportive of the plan.
       In seeking support for his top domestic priority, Mr. Obama 
     has said the status quo wasn't acceptable because insurance 
     premiums were rising sharply and government insurance 
     programs were headed toward insolvency. Republicans have 
     argued that many Americans could be worse off, particularly 
     the elderly, because the legislation contained hundreds of 
     billions of dollars in cuts to health-care providers through 
     Medicare. The legislation would extend health-insurance 
     coverage to at least 30 million more Americans by widening 
     the Medicaid federal-state insurance program for the poor and 
     providing subsidies to lower earners to help them buy 
     coverage.
       The idea of creating a government-run health-insurance 
     option still enjoys considerable support. Democrats dropped 
     the idea from the Senate version of the health bill. When 
     asked what they thought of removing the public option, 45% of 
     respondents said that wasn't acceptable, while 42% called it 
     acceptable.
       Respondents also favored letting people buy into Medicare 
     starting at age 55, another idea Democrats abandoned to win 
     the support of centrists needed to pass the bill in the 
     Senate.
       Democrats ``clearly have irritated their own base in a way 
     that has dropped their enthusiasm for their own plan,'' said 
     Bill Mclnturff, a Republican pollster who conducted the Wall 
     Street Journal/NBC News poll with Democratic pollster Peter 
     Hart.
       In September, 81% of liberal Democrats thought the health 
     plan was a good idea, and 6% thought it was a bad idea. In 
     the most recent survey, 66% of liberal Democrats called it a 
     good idea, while 13% called it a bad idea. House Speaker 
     Nancy Pelosi suggested the decline in support for the health 
     legislation was due to ``mischaracterization'' by opponents. 
     She predicted views would turn around when the House and 
     Senate coalesced around a single bill and the president began 
     selling it to the public. ``It's very hard to merchandise 
     health care until you have a bill,'' she said.

  Mr. McCONNELL. Madam President, I say to my friend from Arizona, with 
reference to the issue of the process, it

[[Page S13348]]

has been a bit of a charade--in fact, a whole charade. We have been out 
here for 2 weeks on the amendment process. We have had 21 votes, many 
of them have been side-by-sides, in order to cover the majority against 
the potential downside of voting to cut Medicare and voting to raise 
taxes.
  But there is no serious effort to engage in any kind of genuine 
amendment process, such as the Senator from Arizona and I have been 
involved in here for quite a while. Then the bill, which we are 
actually only allowed to have about two votes a day on, is not the real 
bill. The real bill--we know the core of it, but there are a lot of 
things around the edges being slipped in and slipped out, and they want 
to jam the public before Christmas, as the Senator from Arizona 
indicated.
  How arrogant is that? They think: We know better than you, we know 
better than the Republicans, and we know better than the public. Why 
don't all of you--the Republicans and the public--sit down and shut up 
and leave it to us and we will take care of it before Christmas.
  Mr. ALEXANDER. I say to the Republican leader and the Senator from 
Kentucky, I believe there is another bit of history being made. This 
process is historic in its arrogance. This isn't very hard to 
understand. The proposal is to take 17 percent of our economy, 
affecting 300 million Americans, and nothing could be more personal, as 
the Republican leader has said, than our health care.
  But now we don't have the bill. We do not have the bill. It is being 
written in secret in another room. If there is any part of this debate 
that went through to every single household in America, I believe it 
was when the Finance Committee voted down a motion--the Democrats voted 
down a motion that the bill should be on the Web for 72 hours so that 
the American people could see the text, know what it costs, and know 
how it affects them.
  Eight Democratic Senators wrote the Democratic leader and said they 
want to insist that they know what the text is, and that they have the 
official score from the Congressional Budget Office, and that they have 
it for 72 hours before we move to vote.
  We don't have the bill. We don't have the official score from the 
CBO. Seventy-two hours is three more days, and even though eight 
Democratic Senators and all the Republican Senators said we want to 
know what it costs, know what it is, and how it affects us, they want 
to run it through before Christmas.
  Mr. McCAIN. May I mention to my colleague that maybe the reason why 
they don't want it to be online for 72 hours is because when they 
examined what we have--on page 324 in this bill is an $8 billion tax on 
individuals who have nongovernment approved plans. On page 348 is a $28 
billion tax on businesses that cannot afford to offer insurance to 
their employees. On page 1979: Raises an almost $150 billion tax on 
many middle-class workers using so-called Cadillac health insurance 
plans. Page 1997: Will cost families and individuals an additional $5 
billion by prohibiting the use of savings set aside for health care 
expenses through health savings accounts. Page 2010: Will make the cost 
of lifesaving medicine more expensive by taxing pharmaceutical research 
firms an additional $22 billion. The list goes on and on, including on 
page 2040: Increasing Medicare payroll taxes by $53.8 billion.
  That may be a reason why it is going to be difficult for them to win 
passage of this after 72 hours of examining this bill.
  Mr. McCONNELL. It makes this bill, in addition to all of the other 
problems, a job killer. With unemployment at 10 percent, there is a big 
tax increase on a variety of different Americans, as Senator McCain 
pointed out, in addition to all of its other problems--substantive 
problems, process problems. It is a job killer in the middle of a very 
difficult recession.
  Mr. COBURN. I say to my colleagues that one of the things President 
Obama said he wanted to have was transparency. There has been no 
transparency in the process. That is why at least if there is not going 
to be transparency in the process, we ought to at least have it 
transparent to the American people for 72 hours. This is a quote from 
the chairman of the Finance Committee:

       I think it is impossible to certify that any Senator will 
     fully understand.

  We are going to have a 2,000-plus page bill, and the chairman of the 
Finance Committee says he thinks it is going to be impossible to 
certify that any Senator will fully understand this bill. That is the 
best reason I know not to pass this bill, because if we don't 
understand it, you can bet the American people aren't going to 
understand it.
  Mr. McCAIN. When more Americans begin to understand it, they don't 
want it. That is thanks to the efforts made all over this country to 
educate the American people about what the impact of the bill will be.
  Mr. BARRASSO. Following along what the Senators are saying, that is 
why the support of the American people for the bill is at an all-time 
low. It is at the lowest level of support ever. According to this NBC 
poll, fewer than one out of three Americans support this bill. They 
don't know all that is in it, but they don't like what they see so far, 
because they believe, in overwhelming numbers, that the cost of their 
own care will go up, that this will add to the deficit, it will hurt 
the economy, and their health care would actually be better if we pass 
nothing.
  So why would the American people support a bill that is going to cost 
them more personally and when their health care will get worse? That is 
not the value the American people have ever wanted.
  That is what I hear from patients at home, and it is what I hear on 
telephone town meetings. That is what we are hearing in all of our 
States. This is what the American people continue to say: Do not pass 
this bill.
  As our leader said, we do need health care reform, and Dr. Coburn 
certainly knows that. But it is not this reform that we need.
  Mr. ALEXANDER. We come to the floor every day and point out the 
problems with the bill. We don't have a bill now, we can't read it, and 
we don't know how much it costs or how much it affects the American 
people. It raises taxes and premiums. It will increase the debt, 
because it doesn't include things such as the physicians Medicare 
reimbursement. It cuts Medicare by $1 trillion over 10 years once it is 
fully implemented.
  We point out what we think should be done. My colleagues have talked 
about it many times. Instead of wheeling in another 2,000-page bill, we 
should focus on the goal of reducing costs, and we should take several 
steps toward doing that. The Senator from Arizona talks about one of 
those things, which is reducing the number of junk lawsuits against 
doctors. I don't think that is in the bill, unless it is secretly being 
added in the back room today.
  Mr. McCAIN. Well, I don't think that is being added today. Again, I 
also point out that Americans are now against passage of this 
legislation. But in that polling data, it is very interesting, also, 
the majority of seniors, by much larger numbers--the actual 
beneficiaries of Medicare--are turning against it, and the intensity of 
Americans against it--which is harder to gauge in a poll--is 
incredible.
  If the responses that our efforts are getting are anything close to 
indicative of the mood of the American people, and the intensity of it, 
it is probably as great as I have ever seen in the years that I have 
had the privilege of serving in the Congress of the United States.
  This polling data says more Americans now believe it is better to 
keep the current health system than to pass President Obama's plan. 
That is a message being sent, and the intensity is higher than any I 
have ever observed in my years of service. I thank them for that.
  There is a chance that we can stop this, and we start in January. We 
would be willing to come back and sit down and negotiate, with the C-
SPAN cameras on--as the President said or committed he would do as a 
candidate. We would sit down together here, at the White House, or 
anywhere, and we can fix this system that we all know needs fixing.
  As the Senator from Oklahoma said, it is the cost that has to be 
addressed, not the quality.
  Mr. COBURN. I want to bring up an example. We are going to see this 
time and time again if the bill goes through. We had the U.S. 
Preventive Health Task Force put out a recommendation on breast cancer 
screening through

[[Page S13349]]

mammography on the basis of cost. They said it is not cost effective to 
screen women under 50 with mammograms, because you have to screen 1,900 
before you find 1 breast cancer. On cost, they are right; but over 50, 
you have to screen 1,470.

  So what we had was a decision made on cost, not on quality, not on 
patients, but based on cost. We fixed that as part of an amendment to 
this bill. We actually fixed that. There are three different agencies 
within this bill that are going to do the same thing. Every time they 
make a ruling based on cost, not on clinical outcomes and what is best 
for patients, are we going to fix it? No. We are transferring the care 
of the American patient to three bureaucracies within the Federal 
Government, and they are going to decide what you have to do. If you 
think about it, this week the wife of a Member of this body was 
diagnosed with breast cancer. She was diagnosed through a mammogram. 
Under that task force's recommendation, she would not have gotten that 
mammogram.
  Mr. McCAIN. I ask the Senator from Oklahoma, would that aspect of 
this bill come to light if it hadn't been for the recommendation that 
was made by another similarly acting policymaking body? In other words, 
that is what triggered the investigation of what was in this bill, 
which would have had exactly the same effect. So if we hadn't had that 
information of a recommendation by another government policymaking 
bureaucracy, we would not have known about this until the bill would 
have taken effect.
  Mr. COBURN. So there is no transparency. What we do know is that we 
are going to have three organizations, the Medicare Advisory 
Commission, the Cost Comparative Effectiveness Panel, and the U.S. 
Preventive Health Task Force that will tell everybody in America what 
they are going to receive.
  Mr. McCAIN. This example wouldn't have been known if it hadn't been 
for the actions of the bureaucracy. Doesn't that bring into question 
what else is buried in this 2,000-page piece of legislation?
  Mr. COBURN. What are the unintended consequences of this that they 
don't know? What we do know is there are 70 new Government programs 
that will require over 20,000 new Federal employees, and there are 
1,690 different times when the Secretary of HHS will write rules and 
regulations about your health care in America--the Secretary, not your 
doctor; your doctor isn't going to write the regulations. The Secretary 
of HHS is going to write the rules.
  Mr. McCAIN. Let me point out again that we don't know what the CBO 
estimate is, because we know the majority leader keeps bouncing 
proposals back and forth to CBO. That is why we haven't had CBO 
information now for many days. But there is the Commission for Medicare 
and Medicaid, which clearly points out that this legislation would 
increase taxes dramatically, increase costs dramatically, decrease 
care, and it would have the effect of forcing people not only out of 
the system, but even if they are in the Medicare system, they would not 
have physicians to provide the care, because more and more physicians 
would fail to treat Medicare patients.
  Mr. COBURN. So we go back to the 72 hours. We are going to get a new 
bill, but we will not have the opportunity to amend it. We are not 
going to be able to read it and study it, nor are the American people. 
What do you think the outcome of that will be?
  Mr. McCAIN. I think we know what the outcome will be. We will either 
be able to reflect the feelings and intense feelings of the majority of 
the American people about this legislation and say let's go back to 
square one and all commit to a bipartisan approach to this issue or we 
will see jammed through on Christmas Eve legislation that will have the 
most far-reaching effects and devastating effects, I think, not only on 
our ability to provide much-needed medical care to all of our citizens, 
but also an impact that would be devastating on the debt and deficit, 
upon which we have laid an unconscionable burden already.
  We have two choices--to go back to the beginning and enact many 
reforms we can agree on--and there are many we could agree on 
immediately on a bipartisan basis; as the Senator from Tennessee 
pointed out, there has never been a fundamental reform made in modern 
history that was not bipartisan--or we are going to see jammed through, 
over the objections of a majority of Americans, legislation that they 
have never seen, read, or understand.
  That is the choice we have. That is what it is boiling down to. I 
think that, frankly, the American people should be heard, not a 
majority over on the other side.
  Mr. BARRASSO. The American people are saying: Don't cut my Medicare, 
don't raise my taxes, don't make things worse than they are right now, 
and this bill cuts Medicare, raises taxes, and for people depending on 
a health care system in this country this makes things worse.
  Mr. McCAIN. By the way, could I mention, if you live long enough, all 
things can happen. I now find myself in complete agreement with Dr. 
Howard Dean, who says we should stop this bill in its tracks; we should 
go back to the beginning and have an overall bipartisan agreement. Dr. 
Dean, I am with you.
  The PRESIDING OFFICER (Mr. Bennet). The Senator's time has expired.
  The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, I ask unanimous consent that I may speak 
up to 20 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SPECTER. Mr. President, I have sought recognition to comment 
about the Patient Protection and Affordable Care Act. It has been an 
extraordinary legislative process with a good bit of the calendar year 
2009 taken up with very intensive work to try to pass health care 
reform. At the moment, there is still some doubt as to what will happen 
with the bill. The Congressional Budget Office has not yet submitted a 
report on the so-called managers' package.
  There are still some concerns being expressed by some Senators. I can 
understand the frustration that some have had as we have moved away 
from a public option. I have been an advocate of a robust public option 
and think it ought to be part of the legislation.
  The public option is what it says. It is an option. There have been 
efforts made to demagog the issue by saying it is a takeover by the 
Federal Government. It is not. The private insurance industry remains 
in the field, and this is one option.
  As President Obama has put it, it is an option to try to keep the 
private insurance companies honest. We have seen, in the past several 
months, very large increases in premiums for small business. The 
reports have been that those increases in premiums have come from Wall 
Street pressure on the insurance companies to try to increase their 
profits before there is legislation. The public option would be a 
forceful factor dealing there.
  When the objections were raised to the public option and in an effort 
to find 60 votes--it is difficult when you have no help at all from the 
Republican side of the aisle, illustrated by the performance just put 
on with their prepared colloquy--it is not easy to find everyone in 
agreement. Then there was an effort to move to expand Medicare. I think 
that is a fallback position that would have been very helpful.
  There are some who are contending that people who are disappointed 
with the lack of a public option and disappointed from the retreat of 
expanding Medicare say we ought to start over and begin again. I can 
understand that frustration.
  My own view, after thinking it through very carefully, is we ought to 
proceed and do as much as we can this year, realizing that some of the 
tough legislative achievements take a period of time to accomplish. But 
the Civil Rights Act of 1957 was necessary, although it did not go as 
far as people would have liked then, to get the Civil Rights Act of 
1964. Again, it did not go as far as people would have liked, but we 
did find the Voting Rights Act of 1965. We have to find times when we 
have to build incrementally on these matters.
  I have been in the Senate following the elections of 1980, and I have 
seen matters take a very substantial period of time. While it is not on 
the subject, we were trying to provide more than 100,000 jobs in 
Pennsylvania by deepening the channel. The authorization

[[Page S13350]]

came in 1983. It took until 1992 to get the Corps of Engineers to agree 
on funding. Now it has $77 million. We are still in court, but it is 
going to move forward. I do not expect health care legislation to take 
that kind of a long term, but it is a matter which does take some time.
  It is my hope we will yet improve this bill. It is my hope that when 
the bill goes to conference, we will find a way, perhaps, even to bring 
back the public option in a refined sense. The public option is in the 
House bill.
  One Republican Senator has stated opposition on the ground that there 
has not been time enough to review the bill. It is complicated. I think 
there has been time enough to review the bill. But I respect the view 
of the Senator on the other side of the aisle. When the bill goes to 
conference, that Senator will have an opportunity to review the bill 
further. That Senator has shown some inclination to support the bill, 
having voted it out of the Finance Committee.
  Another Republican Senator has commented that the bill has been very 
greatly improved, not sufficiently for the taste of that Senator, but 
perhaps we will find a way to improve the bill. We still do have a 
bicameral legislature. We do have the House of Representatives which 
has the public option.
  Comments were made about the fall of the expansion of Medicare on the 
ground it was considered in too brief a period of time, not enough time 
to digest it, not enough time to think through. We will have, in the 
month of January, some time to consider that further, and in conference 
we may well find we are able to improve the bill. We cannot get to 
conference unless we pass the bill out of the Senate.
  I was asked yesterday how will I respond to my constituents if we 
have the bill which has had so much taken from it. I said: A more 
relevant question or an equally relevant question is how will I respond 
to my 12 million constituents in Pennsylvania if we go home with 
nothing. If we have 80 percent accomplished, then that is a starting 
achievement.
  It may well be it will take the campaign in 2010. If this Congress 
will not pass a bill with a robust public option, it could well be a 
campaign issue.
  I believe my colleagues on the other side of the aisle may well be 
misreading the American people. I believe the American people do want 
health reform. It does take time for the American people to understand 
the ramifications of it. But this may well be a campaign issue in 2010. 
The 112th Congress may have a different view as to how we ought to 
proceed.
  During the month of August, when I was making the rounds of town 
meetings in Pennsylvania, in accordance with my habit to cover almost 
every county almost every year, when I got to the first town meeting, 
the second Tuesday in August, the first week we were in recess, I found 
instead of the customary 85 or 100 people, more than 1,000 people and 
3 national television sound trucks--CNN, MSNBC, and FOX. There were a 
lot of vituperative statements. One man approached me apoplectic and 
said the Lord was going to stand before me. I think he got mixed up. I 
think he meant to say I was going to stand before the Lord. Senators 
are reputed to have power but not quite that much power. I think the 
public tenor is considerably more favorable to health care insurance 
today than it was then. After the 2010 election, it may be 
substantially more favorable.

  We have to move ahead with building blocks, and we do have a chance 
to improve the bill in conference.
  I point to the provisions of the bill as to what we have. We have 
very significant insurance reforms. We have eliminating discrimination 
based on preexisting conditions. We have new health insurance 
exchanges. We have an elimination of a cap. We cover many of the 
uninsured, expanding to some 33 million additional people. We have 
substantial more small business assistance, preventive care, increased 
health workforce. We have improvements in the health delivery system. 
We have fiscal responsibility that this bill will not add to the 
deficit but will, in fact, reduce the deficit in the first decade by 
some $120 billion and in the second decade by some $650 billion.
  We have a provision I have pressed in earlier legislation, S. 914, to 
provide for transformational medicine.
  During my tenure as chairman of the Appropriations Subcommittee on 
Health and Human Services, I took the lead, with the concurrence of 
Senator Harkin, who was then in the minority, to increase NIH funding 
from $12 billion to $30 billion and then in the stimulus package to add 
$10 billion more. There has been a gap on what we call transformational 
medicine, going from the so-called bench in the laboratory to the 
bedside. While I have not seen the final version of the managers' 
packet, I am informed that provision will be a part of the bill.
  We have very important measures for preventive care, for annual 
exams, which will cut off many chronic illnesses which are so 
debilitating and so expensive.
  I have pressed an amendment, which is pending, to have mandatory jail 
sentences for at least 6 months for someone convicted of $100,000 or 
more of Medicare or Medicaid fraud. Jail sentences are a real 
deterrent. The experience I had as Philadelphia's DA showed me that 
when you have a fine, that is added onto the cost of doing business and 
is passed on to the consumers.
  I ask unanimous consent to have printed in the Record a statement of 
the provisions which I briefly summarized which are very favorable in 
this bill and a statement of testimony at a Criminal Justice 
Subcommittee to show the value of deterrence.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

      Provisions in the Patient Protection and Affordable Care Act


                       General Insurance Reforms

       Insurance companies will be barred from discriminating 
     based on pre-existing conditions, health status, and gender.
       New health insurance Exchanges will make coverage 
     affordable and accessible for individuals and small 
     businesses.


                               Uninsured

       With a reported 47 million people without health insurance 
     the status quo is not acceptable. Additionally, there are 
     millions more Americans who are underinsured, with health 
     insurance that is inadequate to cover their needs.
       In 2007, 1,206,115 Pennsylvanians under age 65 were 
     uninsured for the entire year, which is 11.3 percent of the 
     under 65 population.
       The analysis found that the legislation would extend 
     coverage to 33 million more Americans, bringing the 
     percentage of Americans with health insurance to 93%.
       The bill covers 10% more Americans with only a 0.7 percent 
     increase in spending--a change of only 0.1% of GDP in 2019.


                       Small Business Assistance

       In the current health insurance market small business are 
     at a distinct disadvantage in providing health insurance to 
     their employees. In a recent study it was found that 58 
     percent of small employers do not offer health insurance, 
     with nearly 50 percent stating that they can't afford it.
       The Patient Protection and Affordable Care Act address 
     health insurance problems facing small businesses by 
     providing more health plan choices, fairness in the 
     marketplace and improving affordability with tax credits.


                           Preventative Care

       The Patient Protection and Affordable Care Act will 
     eliminate co-pays and deductibles for recommended preventive 
     care, provide individuals with the information they need to 
     make healthy decisions, improve education on disease 
     prevention and public health, and invest in a national 
     prevention and public health strategy.


                       Increase Health Workforce

       Currently, 65 million Americans live in communities where 
     they cannot easily access a primary care provider, and an 
     additional 16,500 practitioners are required to meet their 
     needs. The Patient Protection and Affordable Care Act will 
     address shortages in primary care and other areas of practice 
     by making necessary investments in our nation's health care 
     workforce.


               Improvements in the Health Delivery System

       The legislation we are considering will establish an 
     Independent Medicare Advisory Board to present Congress with 
     proposals to reduce cost growth and improve quality for 
     Medicare beneficiaries. In years when Medicare costs are 
     projected to be unsustainable, Board proposals will take 
     effect unless an alternative is adopted by Congress. This 
     type of reform is necessary to ensure the financial future of 
     Medicare.
       Preventable hospital readmissions diminish quality and 
     efficiency in the health care system. Nearly 20 percent of 
     Medicare patients who are discharged from the hospital are 
     readmitted with 30 days. The Medicare Payment Advisory 
     Commission (MedPAC) estimates that Medicare spent $12 billion 
     on potentially preventable hospital readmissions in 2005, 
     which would be more than $15 billion today.

[[Page S13351]]

       The bill also begins the payment system reform of bundling 
     Medicare provider payments as a lump sum fee--instead of 
     paying a fee for each service--encourages care coordination 
     and streamlining. It removes the incentive to generate 
     additional services for added reimbursement.


                         Fiscal Responsibility

       The legislation is fully paid for and reduces the deficit 
     in the next ten years and beyond.
       The revenue provisions in the bill focus on paying for 
     reform within the health care system.


                          The Cost of Inaction

       In 2000, family health insurance purchased through an 
     employer cost $6,438 and consumed 13 percent of median family 
     income. In 2008, the same family health insurance cost 
     $12,680, a 97 percent increase over the 2000 cost, consuming 
     approximately 21 percent of median family income. In 2016, 
     the same insurance is projected to cost $24,291, nearly 
     double the 2008 cost, which will consume 45 percent of 
     projected median family income.
                                  ____

       Let's kind of go back to (inaudible). Can you--each one of 
     you, starting with Mr. Perkins, talk about kind of what's 
     the--the impact of criminal prosecutions and prison time 
     versus civil actions and fines.
       KEVIN PERKINS, Assistant Director, FBI: Yes, Senator. The--
     it's really a combination of both. We, obviously, are very 
     successful in the health care fraud side, where we have civil 
     remedies that we utilize each day in our investigations 
     there. But again, I'm a--I'm a very strong proponent of 
     criminal prosecutions that involve serious jail sentences for 
     white-collar criminals. That is a huge deterrent.
       I've seen it over the years, and I--I know--I know that, 
     from my own personal experience, going and interviewing 
     individuals who are--who--white-collar criminals who have 
     been--or are doing jail time, going and talking to them on 
     various occasions--it's--it's a huge deterrent. It's--it's 
     something that we have to have, going forward, to make this 
     work.
       KAUFMAN: Mr. Khuzami.
       ROBERT KHUZAMI, Director, Securities and Exchange 
     Commissions Division of Enforcement: (Inaudible), yes, but 
     there's--there's no deterrent that's a substitute for jail 
     time. I miss the cooperation tools, and I--I miss the 
     sentencing guidelines even more. But there is a very 
     significant role for the civil regulators as well, simply 
     because: Because of the standard of proof of beyond a 
     reasonable doubt and the necessity of convincing 12 jurors of 
     the--of the guilt of someone, the criminal authorities, by 
     definition, cannot and should not capture the whole field of 
     wrongdoing.
       And so what you'll often see is criminal authorities 
     focused on the core wrongdoers, and we may cast a wider net--
     because we have a lower standard of proof--cast a wider net 
     amongst those involved in the wrongdoing as well. And in 
     particular, there's lots of wrongdoing that goes on that 
     doesn't rise to the level of criminal intent, all sorts of 
     activity across regulated broker-dealers and investment 
     advisors and others where, if you can at least make it 
     unprofitable--so that they have to give back the money they 
     wrongfully got, pay a penalty, perhaps suffer time out or 
     lose their license--that, too, has a significant impact.
       KAUFMAN: Mr. Breuer.
       LANNY BREUER, Assistant Attorney General: Senator, 
     obviously, as Rob (ph) says: A comprehensive approach is 
     essential. Civil remedies are essential. But I've had many 
     years in the private practice, and I've had many years when I 
     represented individuals, and I can tell you, Senator: In a 
     white-collar case--I've been in the conference room with my 
     clients--there is nothing--there is nothing like an 
     individual--who feels as if he or she has been sort of the 
     center of their community, is well-respected and has had a 
     comfortable life--realizing that they're facing jail time. 
     The terror in their eyes is like nothing else, and there's 
     simply no deterrent like it.
       KAUFMAN: You know, I think I know the answer to this, but I 
     think it'd be good to be on the record, and starting with 
     you, Mr. Breuer. Why don't--why haven't we seen more, you 
     know, board room prosecutions?

   Mr. SPECTER. Mr. President, how much time do I have remaining?
  The PRESIDING OFFICER. The Senator has 7 minutes remaining.
  Mr. SPECTER. I thank the Chair.
  Mr. President, there is another very important aspect, in my opinion, 
of the Senate enacting legislation on this bill; that is, we were sent 
to Washington to govern. What we have seen in the recent past has been 
staggering partisan politics. Partisan politics became a blood sport in 
Washington, DC. It is a blood sport on the floor of the Senate. It 
pervades the entire town.
  The point from the Republican side of the aisle has been very clear; 
that is, to make this President Obama's Waterloo, to make this ``break 
President Obama.''
  I saw the ramifications when we took up the stimulus package earlier 
this year. There were only three Republicans--Senator Snowe, Senator 
Collins, and myself--who would even talk to the Democrats. There was a 
determination to look ahead to the 2012 elections on the Presidency 
even before the ink was dry on the oath of office taken by President 
Obama on January 20. This was the second week of February, the week of 
February 6, as I recall, just a couple weeks, and already the plans 
were for the next election.
  As I reviewed the matter, it seemed to me we were on the brink of 
going into a 1929 Depression. The 1929 Depression was very hard on the 
Specter family, living in Wichita, KS, at the time. Both of my parents 
were immigrants. In the mid-1930s, the family moved from Wichita to 
Philadelphia to live with my father's sister. That is what happened in 
the Depression--you moved in with relatives because there were no jobs.

  I sided with supporting the stimulus package and played a key role in 
having that enacted. And the political consequences on a personal level 
are not something to be discussed on this floor at this time, but the 
conduct of partisanship on the stimulus package is directly relevant to 
what we are doing here today, and that is that we are being 
stonewalled.
  I think it is harder for a Republican to stand up on health care 
reform and join the Democrats today than it was in January and in 
February when three of us did so. And if I were on the other side of 
the aisle today, I would be supporting health care reform. I would be 
supporting, and perhaps, if I were on the other side of the aisle 
today, I could bring somebody with me. I don't know. That is entirely 
speculative.
  Without revealing any more of the confidence which went on inside of 
the Republican caucus, when I talk about a Republican Senator's 
statement that this should be the Waterloo of President Obama and this 
should break him, those are matters in the public record. But the 
pressure over there in the Republican caucus is absolutely intense, and 
we were sent here to govern.
  In the Democratic caucus--and the Presiding Officer, the 
distinguished Senator from Colorado, was there on Monday evening--when 
my turn came to speak, I said: I have two sentences. And may the record 
show a smile on the face of the Presiding Officer. I said: I have two 
sentences. One sentence is, the bill is a great deal better than the 
current system, and the second sentence is, we should not let 
obstructionism prevent us from governing. And that is why I crossed the 
aisle to make the 60th vote. I was very surprised to see in the public 
record--been in the newspapers--that everybody stood up and applauded, 
and I read in one of the Hill newspapers today that you could hear the 
applause down the corridor. So they knew what was going on. Well, that 
is the role, it seems to me, of a Senator. We are facing a situation 
where, if defeated, it will have a significant impact on the tenure of 
President Obama.
  We had a meeting on Tuesday--2 days ago--in the Executive Office 
Building, and it was a rather remarkable setting. There was a large 
rectangular table, and in the center on each side--one side was 
President Obama, the other side was Vice President Biden, and almost 
all of the 60 Senators were present. I think Senator Byrd couldn't be 
there because of his ailment, but I believe everybody else was present. 
During the course of that session, the President expressed himself--and 
this has also been publicized--that if action was not taken now, it 
would discourage anyone from the foreseeable future--any President--
from undertaking health care reform if now, with both Houses and 60 
Members of the Democratic Party, you can't get it through the Senate 
and get it conferenced and get it enacted.
  Some of those who were most vocal in favor of the public option urged 
those in the caucus who disagreed to reconsider their position, and I 
would renew that request that they reconsider their position. The 
people who would classify themselves as most progressive in the 
Democratic caucus have swallowed hard and have announced publicly that 
they would support this bill even though it doesn't have a robust 
public option, doesn't have the Medicare expansion. And that may shift 
yet.
  It is fair and accurate to say there are more pressing problems 
confronting the United States today than at any time in our history, 
and we have

[[Page S13352]]

to finish health care next year to move ahead to jobs. We have the 
issues of global warming and climate control, and we have the problems 
with the Mideast peace process and the difficulties in Iran and North 
Korea and Afghanistan. We need a strong President, and we need a 
Congress which has the courage to act and the tenacity and willingness 
to confront tough problems. We need to show the American people that it 
is not all gridlock here, that it is not all desperate, desolate 
partisan politics.
  So my vote will be in favor of the bill. Although I am, frankly, 
disappointed and I share the frustration expressed by many people who 
say go back and start again, this is a significant step forward. We 
have a great chance to improve it in conference, and beyond that there 
will be another Congress. And with the analogy of civil rights 
legislation, we can get the public option and get greater public 
involvement for the benefit of the American people.
  I thank the Chair, and I yield the floor.
  Mr. President, in the absence of any other Senator seeking 
recognition, I ask unanimous consent to speak up to 3 minutes on 
another subject.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                         Americans Held By Iran

  Mr. SPECTER. Mr. President, there has been wide publicity given to 
three young Americans who were taken into custody by Iran and the 
recent reports that they are going to be tried in an Iranian court. 
Senator Casey and I, in the Senate, introduced a resolution urging the 
Iranians to release those three young Americans--Congresswoman Allyson 
Schwartz, on the House side, did so in the past--and it is my hope Iran 
will change its view.
  I was talking to the Syrian Ambassador yesterday, who advised me that 
when the five British citizens were taken into custody by Iran, the 
Government of Great Britain made a request of the Syrian Government to 
use their good offices to secure the release of the five British 
citizens. That request was made via Syria, and they were released.
  I have written to and contacted the State Department since that 
meeting yesterday afternoon to find out what is the status of U.S. 
activity because if we have not asked the Syrians for help, my view is 
that we should. It would be my hope that with the very difficult 
problems facing the United States in Iran, that Iran would relinquish 
the custody of those three young Americans and release them to their 
family and friends, especially at this time of the year.
  I have been an advocate of dialog with Iran for years. I have tried 
to go to Iran since 1989, when the Iran-Iraq war ended. Senator Shelby 
and I got to Iraq and met Saddam Hussein, but as yet we have not had an 
interparliamentary exchange, which I have sought for a long time with 
the Iranians.
  It would be my hope that Iran, for humanitarian reasons, would 
release these people and that we would exercise our best efforts--the 
U.S. Government working through Syria or whatever other channel we can 
find--to secure their release.
  Mr. President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. DURBIN. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER (Mr. Kirk). Without objection, it is so 
ordered.
  Mr. DURBIN. Mr. President, before the Senate now is an issue of 
funding our military, the Department of Defense appropriations bill. 
This is a bill that is critically important because it provides the 
funding our men and women in uniform now risking their lives while we 
meet in the safety of our businesses and offices and homes in America, 
it funds their needs to make sure they will be safe to perform their 
missions effectively and come home. Without fail, every year this bill 
comes before the Senate and is a consensus bipartisan bill.
  Regardless of our debates over foreign policy, we all want the men 
and women in uniform to know we stand behind them. As a consequence, 
this bill usually passes with an overwhelming number. I asked how this 
bill fared in the House of Representatives when it was considered 
yesterday. The vote was 395 to 34. There were 164 Republicans who voted 
yes on this bill. It was clearly an overwhelmingly positive bipartisan 
vote. There is no reason it would not be the same in the Senate.
  But there is a problem. The problem is this: Tomorrow the funding for 
our troops runs out. It is the end of our continuing resolution in 
funding. We are not going to leave them high and dry, but we are going 
to leave them uncertain if we don't act decisively and quickly. Why 
would we do this to them?
  Military families across America, as we go into the holiday season, I 
am sure, are saddened by the absence of their loved ones who may be in 
Iraq or Afghanistan, saddened by a separation from children and other 
loved ones they would like to avoid in their lifetime but they have 
offered it up for this great country. With this kind of uncertainty and 
sadness and emotion, why would we be uncertain when it comes to funding 
our troops?
  Here is where we are: We offered this yesterday. We said: Let's vote 
for it. Let's vote for our troops and get this behind us so the 
Department of Defense appropriations bill was clear.
  The other side of the aisle said: No. We want you to go through all 
of the hurdles that you have to go through under the procedures of the 
Senate for the most controversial bills. We want you to file a cloture 
motion which would put an end to a filibuster. We want you to fill the 
tree with amendments so that this bill isn't assaulted.
  Believe me, the terminology would lose most people, including many 
Senators, but the bottom line is this: Instead of just doing what we 
know needs to be done and what should be done, Republicans have 
insisted we delay this process for at least 2 days.
  Why? Why would we want to delay funding our troops in the middle of a 
war? Why would we want to say to our troops that the military pay raise 
they were counting on so their families can get by back home, and for 
those stationed in the United States, make sure that they have what 
they need, why would we say to them that we are going to raise a 
question as to whether we are going to put $29.2 billion into the 
defense health program, the health program for our military members and 
their families?
  Why would the Republicans insist on delaying a vote for $472 million 
for family advocacy programs for military families who are separated, 
many of whom are going through extraordinary stress because of the 
separation? Why would they want to delay a pay raise for the military? 
Why would they want to delay $154 billion for equipment and training 
for our military?
  I don't understand it. It would seem to me that we ought to come 
together by noon today and say: Let's do this. Let's not waste another 
minute in terms of helping our troops and showing them we stand behind 
them. But, no, the decision has been made on the other side of the 
aisle that we are going to delay this matter until tomorrow.
  They say in politics, for every decision there is a real reason and a 
good reason. There may be some good reason they are giving on the other 
side of the aisle for delaying funding our troops, but the real reason 
is their hope that they can stop health care reform in the Senate. That 
is what is behind this. The lengths to which those on the other side of 
the aisle will go was demonstrated yesterday.
  We had a defining moment when the leadership on the Senate Republican 
side insisted, through Senator Coburn of Oklahoma, that an 800-page 
amendment be read by the clerk. It is the right of a Senator to ask for 
that. It is an archaic right because people don't sit here hanging on 
every word to understand an amendment. That never happens. It didn't 
happen yesterday. But the clerk started reading.
  Almost 2 hours into it, it was pretty clear that it would take 10 
hours to finish this 800-page amendment, despite the best efforts of 
the clerk's office. Why did the Senate Republican leadership want to 
take 10 hours out of a day for something that was meaningless--the 
reading, word by word, line by line, page by page, of an 800-page 
amendment? To stop debate on health care reform.

[[Page S13353]]

  During that period, no one could debate it. No one could amend it. 
The Republicans have conceded that they are finished with the debate 
and amendment phase of health care reform. They have decided now that 
the only thing they could possibly do is to delay everything the Senate 
can consider in the hopes that maybe we get tangled up with our desire 
personally to be home with our families during the holidays and would 
not do our duty here.
  They are wrong. We are determined to do this. We are determined 
because health care reform for this country is so absolutely essential. 
The Presiding Officer has an awesome assignment, succeeding the late 
Senator Ted Kennedy whom he counted as a close friend and served as a 
member of his staff.
  In our cloakroom is a cover of Time magazine where Senator Kennedy is 
looking out with that smile on his face saying: We are almost there. It 
was an article he wrote before he died about health care reform. He, 
more than any person in the Senate, had the authority to speak to it. 
Senator Kirk told us in a meeting of our caucus the other day that it 
was 40 years ago when Senator Kennedy took to the floor as a young man 
and talked about the priority of health care reform. Forty years, when 
you think about it, 40 years of waiting for this moment to vote on 
health care reform. If he were here today--and I wish to God he were--
he would be back there at that desk--that was Kennedy's spot--
thundering in this Senate Chamber about this historic opportunity and 
how if it costs us Christmas Eve or costs us Christmas Day or even 
more, we cannot let down the people of this country.
  I see the polls. This complicated issue of health care reform has a 
lot of people confused and even worried. They have heard some of the 
wild charges on the other side. At one point they were arguing about 
death panels; that ultimately the government was going to decide 
whether people would live or die. That was one of the cruelest 
distortions in this debate.
  The actual issue was raised by Senator Johnny Isakson, who is a 
Republican of Georgia, whom I thought raised a serious and important 
consideration and one that all of us, though we might not want to, 
should reflect on. He said every person under Medicare ought to have a 
compensated, paid-for visit to a doctor if they want, voluntarily, to 
talk about end-of-life treatment. There is hardly a family in America 
who doesn't contemplate that possibility, doesn't have a husband say to 
a wife: Honey, I don't want any of that extraordinary stuff. Don't keep 
me on life support.
  What Senator Isakson wanted to do was to give Medicare patients an 
opportunity to sit down with a doctor and say: What instruction should 
I leave? If this is what I believe, whom should I tell? That was a 
humane, thoughtful amendment. But the critics of health care reform 
twisted and distorted it into a death panel that was going to tell 
Grannie: We are going to pull the plug.
  Sad. It was sad, when Senator Isakson offered such a good-faith 
amendment, to have it distorted. It is no wonder if the critics of 
health care reform would go to those extremes to try to defeat this 
bill, why other extreme things have been said about it. If you listened 
on the floor of the Senate over the last several weeks while we have 
debated health care reform and listened to the speeches from the other 
side of the aisle, you would believe that this bill is going to destroy 
Medicare. Many Republican Senators who historically did not support 
Medicare and wanted to privatize Medicare are now its most fervent 
champions. You might question their sincerity. We don't do that in the 
Senate because we don't question motives of people. But I will question 
their accuracy.

  This bill, which is over 2,000 pages, knows the future of Medicare is 
important to all of us. If we do nothing today, Medicare will go broke 
in 8 years. We would not be bringing in enough money from payroll taxes 
to pay the Medicare services we promised in 8 years. That is a fact. 
But this bill is going to change it. This bill will add 10 years of 
solvency to Medicare. I wish it were more, but it is a step in the 
right direction to say to those receiving Medicare and those about to 
go into Medicare: This important program will be there when you need 
it; 10 years of added solvency in Medicare; Medicare on sound financial 
footing for 10 more years because of this bill.
  There is something else it does. At the end of our conference between 
the House and Senate on health care reform, we are going to take care 
of a problem in Medicare. It is a serious problem. When we passed the 
Medicare prescription drug program, there wasn't enough money to fund 
it. They created this strange situation where if you were seriously ill 
under Medicare and receiving medication, this Medicare Part D plan 
would pay for prescription drugs up to a certain limit and then stop.
  In the midst of a new calendar year, some could find several months 
into that year that Medicare Part D was not paying for any more 
prescription drugs. You would be responsible personally to pay for 
them. After you had paid a certain amount of money, the Part D coverage 
would kick in again. It was known euphemistically as the doughnut hole, 
that gap in coverage in Medicare Part D. When this is over, this health 
care reform is going to fill that gap, close that doughnut hole, give 
to 45 million Americans under Medicare the peace of mind of knowing 
that their prescription drugs will be paid for and they will not find 
themselves exhausting savings or going without it when it comes to 
basic medication.
  That is why this bill is important. That is why some of the things 
that have been said in the debate are so misleading.
  There is something else this bill does which we ought to take pride 
in as Senators. Most civilized and developed countries in the world 
have a health care system that protects their people. We are the only 
developed country on Earth where a person can die because they don't 
have health insurance. We are the only one.
  You might say: Senator Durbin, aren't you getting a little carried 
away? Well, 45,000 people a year do. Let me give you an illustration: 
What if you had a $5,000 copay on your health insurance and you didn't 
have $5,000 and the doctor says: I am a little bit worried about some 
of the things you tell me, Senator. I think you need a colonoscopy.
  That is something I can understand because my mother had colon 
cancer. I am very careful about this. I have a history in my family.
  But if you had a policy that said the first $5,000 you have to pay 
for and went out and asked how much a colonoscopy cost, you would find 
in many places it is $3,000. There have been cases--a man from Illinois 
wrote me. He said: I didn't have the $3,000 so I skipped the 
colonoscopy.
  Without health insurance, without coverage, without enough money to 
pay for that basic test, this individual is running the risk of 
developing a serious cancer that could claim his life or at least cost 
a fortune to take care of. That is what inadequate health insurance 
does to you. That is what no health insurance does to you.

  At the end of the day, this bill will say, for the first time in the 
history of this great Nation, 94 percent of the people will have health 
insurance. Thirty million people today who have no health insurance 
will have it when it is over. Fifteen million will go into Medicaid 
because they are in low-income categories.
  I met one of those people when I was back in my home State of 
Illinois. Her name is Judie. She works at a motel in Marion, IL. She is 
a hostess in the morning for their free continental breakfast--a sweet 
lady with a big smile on her face, in her early sixties.
  She came up to me and said: Senator, I am not sure this health care 
reform is good for me.
  I said: Judie, do you have health insurance?
  She said: No, I've never had health insurance, and I'm a few years 
away from Medicare.
  I said: If you don't mind telling me, how much money do you make?
  She said: Well, they've cut our hours here at the motel because of 
the economy. I work about 30 hours a week now, and I make about $8 an 
hour. And she said: There isn't a person here you're looking at, 
working on this motel staff, who has health insurance.
  I said: So does that mean your income each year is about $12,000?
  She said: Well, I guess. It's the only job I have. I get by on it.

[[Page S13354]]

  I cannot imagine how.
  She said: I get by on it.
  I checked into it, and I saw her the next morning before I checked 
out, and I said: Judie, under this bill we have, because you make less 
than $14,000 a year as an individual, you will qualify for Medicaid. 
For the first time in your life, you will have health insurance under 
an Illinois State Medicaid Program that you won't have to pay for 
because you are in a low-income category.
  Well, she said: That's great because I have diabetes.
  Think about that: age 60, no health insurance, low income, no doctor 
regularly available to her.
  And she said: And I've had a few lumps I would like to get checked 
out too.
  I thought: This poor lady. She is a classic illustration of what we 
are talking about in this bill. She is not lazy. She is a hard-working 
person. She gets up every day at the crack of dawn to be there to make 
sure people feel right at home at that motel, and she has no health 
insurance.
  Ninety-four percent of the people in this country will have health 
insurance--people like Judie, who, for the first time in her life, will 
have health insurance. Is that worth something? Is it worth something 
in America for us to take pride in the fact that we are expanding the 
peace of mind which some of us take for granted of having health 
insurance coverage?
  I think it is worth a lot. I think it is important for us and the 
critics to step up and acknowledge they have never come forward with a 
single proposal to deal with that issue--not one. We have never heard 
from the Republican side of the aisle how they would cover 94 percent 
of the people in America. They have never put together a comprehensive 
health insurance plan. They have never talked about submitting it to 
the Congressional Budget Office to make sure it does as promised, as we 
have.
  They come to the floor with criticisms of what we are trying to do. 
It is their right as Senators to do that. But it is also our right to 
ask them the basic question: Does the fact that you do not have a 
Republican health care reform bill mean that you like the current 
system, that you do not want to change it? That is one conclusion.
  The other conclusion is: This is hard work. Writing a bill that does 
this takes a lot of time and effort, and they have not put in that hard 
work. So they come emptyhanded to the floor with good speeches and good 
graphs and good press releases, but without good amendments to take 
care of the basic problems.
  There is one other element in this health care reform bill too. How 
many times have you met somebody in your family or at work or through a 
friend who told you about a battle they had with a health insurance 
company when somebody got sick in their family? I have run into it a 
lot. A few years back, when I was a Congressman, in Springfield, they 
had a unique program where the Sangamon County State Medical Society 
would invite Members of Congress to accompany doctors on their rounds 
in a hospital.
  The first time I was invited to do that, I called back and said: 
You've got to be wrong. You don't want me walking into a patient's room 
where you are talking about their private health situation.
  They said: No, no, we ask permission. And it is interesting, people 
are bored in the hospital, and they are amused by politicians. So would 
you please come?
  So I accompanied a doctor on his rounds. He was examining a nice lady 
in my hometown of Springfield, IL, who was suffering from vertigo, who 
had come to the hospital, and as a result of an x-ray, they discovered 
she had a tumor--a brain tumor--that needed to be removed. She lived by 
herself. She was falling down at home. He wanted to operate on her on 
Monday. This was a Friday. He wanted to keep her in the hospital 
because he was afraid if she went home she might fall, hurt herself, 
and he wanted her ready for surgery on Monday.
  But before he could say to her: Be prepared to stay over the weekend, 
he had to call her health insurance company. I stood next to this 
doctor at the nurses station in St. John's Hospital in Springfield, IL, 
as this doctor was arguing with a clerk at a health insurance company 
somewhere in a distant location about why this woman needed to stay in 
the hospital, and the clerk was saying: No, we are not going to pay for 
it. Send her home. Bring her back on Monday for the surgery.
  He said: I'm not going to do that.
  The clerk said: Well, we're not paying for it.
  He hung up the phone and turned to me and said: She's staying in the 
hospital. We'll fight this out later on.
  Fight it out--those battles, those fights take place every day across 
America.
  I have told the story on the floor here about a friend of mine--a 
great friend of mine--whom I have known since he was a young man. He is 
a baseball coach at Southern Illinois University. His name is Danny 
Callahan. Danny has been battling cancer for years. Danny is a young 
guy. He has a young family and a good wife, and he is a terrific guy 
from a great family. He has been battling cancer--chemo, radiation, 
even surgery, removing part of his jaw and trying to stop this advance 
of cancer.
  His oncologist came up with a drug that is working. It is called 
Avastin. This drug is experimental. It works on some cancers. It is 
certified to work on them. But they found it works on others in an off-
label application. The oncologist wrote to the health insurance company 
and said: This is working. We have stopped the spread of his cancer. We 
want to keep using this drug. And they said: No. It costs $12,000 a 
month, and we won't pay for it.
  What is he going to do? You do not make a fortune as a baseball coach 
at Southern Illinois University. His family pitched in, borrowed some 
money to cover a month of treatment. He is going to have a trial in St. 
Louis at Barnes Hospital, connected with Washington University there. 
He is trying his best to keep this going, but he is battling this 
insurance company that said no.
  This bill gives people whom I have described a fighting chance. It 
gives them a chance to fight against the discriminatory, wrong 
decisions of health insurance companies. Is that worth anything? Is it 
worth it? I have yet to see an amendment from the other side of the 
aisle that does this.
  We used to call this a Patients' Bill of Rights, and it used to be a 
bipartisan issue. Senator John McCain joined with Senator Kennedy and 
the two of them worked on this, saying that patients in America should 
have the right to fight insurance companies that turn them down because 
of preexisting conditions, that turn them down because the cost of care 
is so high, that turn them down because they have lost their job or 
turn them down because their child reaches the age of 24. This bill 
provides protections for those people.

  So when people say: I heard Governor Dean--I like him; Howard is a 
friend of mine; former Governor of Vermont; former head of the 
Democratic National Committee--wrote a big article in the Washington 
Post this morning and said: Vote against this bill. It is not 
everything I want it to be.
  Well, Governor Dean, it is not everything I want it to be either. But 
how could we in good conscience explain to 30 million Americans who 
would have health insurance for the first time in their life--such as 
Judie down in Marion, IL--``Judie, I am sorry, we won't be able to get 
you health insurance this time around. We couldn't get everything we 
wanted.'' That is not a very compelling argument, from my point of 
view.
  How do we say to people who want to have a fighting chance against 
insurance companies that say no--and will have the legal right to do 
that--``I am sorry, you are just going to have to continue to do your 
best fighting these clerks at health insurance companies who say no 
because this bill does not have everything in it that we want.''
  You learn in this business of life and politics that concessions and 
compromise are critical parts of achieving a goal. Within the 
Democratic Caucus there are conservative and liberal or progressive 
members, and we have to find that sweet spot, that middle ground, where 
they come together. I think we have, and I am sorry we do not have any 
Republican support for this.
  It is a fact, though, we have spent an entire year debating health 
care reform on Capitol Hill, and the sum total of Republican support 
for health care reform by vote comes down to two. One

[[Page S13355]]

Republican Congressman from the State of Louisiana voted for the House 
bill, and one Republican Senator, Ms. Snowe of Maine, voted for a 
version of health care reform in the Senate Finance Committee. Not a 
single vote beyond those two in support of health care reform.
  In fact, some take great pride in the fact that they are never going 
to vote for health care reform until it comes down exactly as they want 
it. We have invited them into conversation. In fact, my friend, the 
Senator from Iowa, who is on the floor here today, was part of a 
conversation with Senator Baucus and four other Members of the Senate 
that went on, I am told, for weeks, if not months, in an effort to find 
bipartisan, common ground, and they could not. I am sorry they did not. 
It would have been a better day if we had a real bipartisan effort 
before us. But I thank the Senator from Iowa for his genuine heartfelt 
efforts in trying.
  But we come here today without a Republican alternative to health 
care reform. We come here today facing the reality that if we fail this 
time, we will not address health care reform, I am afraid, in my 
political lifetime or in the lifetime of many people following this 
debate. It took 16 years since President Clinton last offered an effort 
to try. If we wait another 16 or 20 years, I cannot imagine what is 
going to happen.
  We know what is going to happen to health insurance premiums. Ten 
years ago, for a family of four, the average cost of their family 
health insurance premium was $6,000 a year--$500 a month. Pretty steep, 
right? The average cost today, for a family of four, for their family 
health insurance premium: $12,000 a year. It has doubled in a 10-year 
period of time, and it is going up so fast that it will double in the 
next 7 or 8 years to $24,000 a year.
  Imagine working and earning $2,000 a month just to pay for your 
health insurance premium. That is it. Imagine how meager that coverage 
is going be because each year you know what happens. The cost goes up 
and coverage goes down. What will it be 10 years from now? If you talk 
to people who are negotiating for contracts, such as labor unions, all 
they talk about is health insurance. They do not talk about wage 
increases. They talk about health insurance. Those are the issues that 
break down the negotiations and end up in work stoppages and strikes, 
it has become that contentious and that difficult.
  Are we going to accept that? Is that the best we can do in America? I 
do not think so. Are we going to accept a strategy which says: We are 
going to slow down the business of the Senate to a crawl, or stop it, 
as they tried yesterday, in an effort to defeat even having a vote on 
health care reform?
  Don't we owe the people of this country, at the end of this debate, a 
vote on health care reform? Shouldn't it be in a timely fashion?
  Shouldn't we first pass this bill that funds our troops that is 
sitting on the floor here that passed the House 395 to 34? Why would we 
delay that funding of our troops in the midst of a war? Why don't we do 
that today before we break for lunch and say to our troops: ``We took 
care of you.''
  I might add, in here there is a provision that extends unemployment 
benefits. Is there any doubt on the other side of the aisle that they 
will vote to extend unemployment benefits in the midst of a recession? 
The last vote we had was 97 to 0 on the floor of the Senate to extend 
unemployment benefits, and that was a few weeks back. I assume 
Republican Senators feel as Democratic Senators do, that in the midst 
of a recession, in the midst of the holiday season, we owe it to these 
families to try to help them out.
  How could we in good conscience go home and celebrate Christmas or 
Hanukkah or whatever our holiday might be and say we want to be in the 
comfort and love of our families, to sit and have a glorious Christmas 
morning before the tree, and enjoy the blessings of this great Nation 
and the blessings of life, and then turn down the unemployed when it 
comes to their benefits? We could not do that in good conscience.
  Why don't we do that today? Why do we wait until tomorrow? Why don't 
we say: Regardless of what your strategy is on health care reform, 
let's not shortchange the troops. Let's not leave them with any 
uncertainty. Let's not leave those unemployed with uncertainty as to 
whether they are going to get benefits they come to expect and deserve. 
I hope we can.
  Mr. President, I ask unanimous consent to have printed in the Record 
a recent article published in the New York Times relating to the trauma 
of joblessness in the United States.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                [From the New York Times, Dec. 14, 2009]

               Poll Reveals Trauma of Joblessness in U.S.

                 (By Michael Luo and Megan Thee-Brenan)

       More than half of the nation's unemployed workers have 
     borrowed money from friends or relatives since losing their 
     jobs. An equal number have cut back on doctor visits or 
     medical treatments because they are out of work.
       Almost half have suffered from depression or anxiety. About 
     4 in 10 parents have noticed behavioral changes in their 
     children that they attribute to their difficulties in finding 
     work.
       Joblessness has wreaked financial and emotional havoc on 
     the lives of many of those out of work, according to a New 
     York Times/CBS News poll of unemployed adults, causing major 
     life changes, mental health issues and trouble maintaining 
     even basic necessities.
       The results of the poll, which surveyed 708 unemployed 
     adults from Dec. 5 to Dec. 10 and has a margin of sampling 
     error of plus or minus four percentage points, help to lay 
     bare the depth of the trauma experienced by millions across 
     the country who are out of work as the jobless rate hovers at 
     10 percent and, in particular, as the ranks of the long-term 
     unemployed soar.
       Roughly half of the respondents described the recession as 
     a hardship that had caused fundamental changes in their 
     lives. Generally, those who have been out of work longer 
     reported experiencing more acute financial and emotional 
     effects.
       ``I lost my job in March, and from there on, everything 
     went downhill,'' said Vicky Newton, 38, of Mount Pleasant, 
     Mich., a single mother who had been a customer-service 
     representative in an insurance agency.
       ``After struggling and struggling and not being able to pay 
     my house payments or my other bills, I finally sucked up my 
     pride,'' she said in an interview after the poll was 
     conducted. ``I got food stamps just to help feed my 
     daughter.''
       Over the summer, she abandoned her home in Flint, Mich., 
     after she started receiving foreclosure notices. She now 
     lives 90 minutes away, in a rental house owned by her father.
       With unemployment driving foreclosures nationwide, a 
     quarter of those polled said they had either lost their home 
     or been threatened with foreclosure or eviction for not 
     paying their mortgage or rent. About a quarter, like Ms. 
     Newton, have received food stamps. More than half said they 
     had cut back on both luxuries and necessities in their 
     spending. Seven in 10 rated their family's financial 
     situation as fairly bad or very bad.
       But the impact on their lives was not limited to the 
     difficulty in paying bills. Almost half said unemployment had 
     led to more conflicts or arguments with family members and 
     friends; 55 percent have suffered from insomnia.
       ``Everything gets touched,'' said Colleen Klemm, 51, of 
     North Lake, Wis., who lost her job as a manager at a 
     landscaping company last November. ``All your relationships 
     are touched by it. You're never your normal happy-go-lucky 
     person. Your countenance, your self-esteem goes. You think, 
     `I'm not employable.' ''
       A quarter of those who experienced anxiety or depression 
     said they had gone to see a mental health professional. Women 
     were significantly more likely than men to acknowledge 
     emotional issues.
       Tammy Linville, 29, of Louisville, Ky., said she lost her 
     job as a clerical worker for the Census Bureau a year and a 
     half ago. She began seeing a therapist for depression every 
     week through Medicaid but recently has not been able to go 
     because her car broke down and she cannot afford to fix it.
       Her partner works at the Ford plant in the area, but his 
     schedule has been sporadic. They have two small children and 
     at this point, she said, they are ``saving quarters for 
     diapers.''
       ``Every time I think about money, I shut down because there 
     is none,'' Ms. Linville said. ``I get major panic attacks. I 
     just don't know what we're going to do.''
       Nearly half of the adults surveyed admitted to feeling 
     embarrassed or ashamed most of the time or sometimes as a 
     result of being out of work. Perhaps unsurprisingly, given 
     the traditional image of men as breadwinners, men were 
     significantly more likely than women to report feeling 
     ashamed most of the time.
       There was a pervasive sense from the poll that the American 
     dream had been upended for many. Nearly half of those polled 
     said they felt in danger of falling out of their social 
     class, with those out of work six months or more feeling 
     especially vulnerable. Working-class respondents felt at risk 
     in the greatest numbers.
       Nearly half of respondents said they did not have health 
     insurance, with the vast majority citing job loss as a 
     reason, a notable

[[Page S13356]]

     finding given the tug of war in Congress over a health care 
     overhaul. The poll offered a glimpse of the potential ripple 
     effect of having no coverage. More than half characterized 
     the cost of basic medical care as a hardship.
       Many in the ranks of the unemployed appear to be rethinking 
     their career and life choices. Just over 4o percent said they 
     had moved or considered moving to another part of the state 
     or country where there were more jobs. More than two-thirds 
     of respondents had considered changing their career or field, 
     and 44 percent of those surveyed had pursued job retraining 
     or other educational opportunities.
       Joe Whitlow, 31, of Nashville, worked as a mechanic until a 
     repair shop he was running with a friend finally petered out 
     in August. He had contemplated going back to school before, 
     but the potential loss in income always deterred him. Now he 
     is enrolled at a local community college, planning to study 
     accounting.
       ``When everything went bad, not that I didn't have a 
     choice, but it made the choice easier,'' Mr. Whitlow said.
       The poll also shed light on the formal and informal safety 
     nets that the jobless have relied upon. More than half said 
     they were receiving or had received unemployment benefits. 
     But 61 percent of those receiving benefits said the amount 
     was not enough to cover basic necessities.
       Meanwhile, a fifth said they had received food from a 
     nonprofit organization or religious institution. Among those 
     with a working spouse, half said their spouse had taken on 
     additional hours or another job to help make ends meet.
       Even those who have stayed employed have not escaped the 
     recession's bite. According to a New York Times/CBS News 
     nationwide poll conducted at the same time as the poll of 
     unemployed adults, about 3 in 10 people said that in the past 
     year, as a result of bad economic conditions, their pay had 
     been cut.
       In terms of casting blame for the high unemployment rate, 
     26 percent of unemployed adults cited former President George 
     W. Bush; 12 percent pointed the finger at banks; 8 percent 
     highlighted jobs going overseas and the same number blamed 
     politicians. Only 3 percent blamed President Obama.
       Those out of work were split, however, on the president's 
     handling of job creation, with 47 percent expressing approval 
     and 44 percent disapproval.
       Unemployed Americans are divided over what the future holds 
     for the job market: 39 percent anticipate improvement, 36 
     percent expect it will stay the same, and 22 percent say it 
     will get worse.

  Mr. DURBIN. Mr. President, I am going to close by saying that for 
those who wonder if it makes any difference whether we move forward on 
the issue of helping the unemployed, they should read this article I 
have put in the Record. People across this country are not only worried 
about getting a job and taking care of their families, it has reached a 
point where it is dramatic. Some of them are making critical life 
decisions, spending their savings, with no health insurance to cover 
themselves or their kids.
  I will ask the Republicans, who will follow me: Please, regardless of 
how long you want to talk today, agree with us that we should move 
quickly to fund our troops, send the money for those members of the 
military and their families to give them peace of mind we stand behind 
them. Do not make them part of any political delay and strategy that 
leaves uncertainty. Let's do it today. Let's not wait until the money 
runs out tomorrow.
  Let's fund our unemployment benefits too. Let's give these families, 
who through no fault of their own are out of work, the peace of mind of 
knowing that as we go home for Christmas, they will at least have a 
Christmas which has, even if it is small, an unemployment check.

  The PRESIDING OFFICER (Mr. Burris). The Senator from Iowa is 
recognized.
  Mr. GRASSLEY. Mr. President, I ask unanimous consent to speak as in 
morning business for 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                          Biodiesel Tax Credit

  Mr. GRASSLEY. Mr. President, I rise on the issue of jobs and 10 
percent unemployment and to tell my fellow Senators what we can do to 
preserve maybe 25,000 jobs in an industry that, by the end of the 
month, will be otherwise shut down because Congress is not taking 
action. The main point of my remarks is, if we don't extend the 
biodiesel tax credit by the end of the month, these jobs will be lost.
  My point is 23,000 jobs will be lost. In fact, right now, on December 
17, companies are making plans to shut down these operations by the end 
of the year.
  Everybody knows our unemployment rate is 10 percent. Everybody knows 
the President has spent a great deal of time, over the last 2 or 3 
weeks, talking about creating jobs and getting us out of the recession. 
But we have to remember that for those without work, this is not just a 
recession, it is a depression.
  We all agree we should take whatever action is necessary to jump-
start our economy and get people back to work. President Obama and Vice 
President Biden have been talking for months about the need to create 
green jobs. Well, green jobs, purple jobs, whatever kind of jobs, jobs 
are jobs. I don't object to the creation of green jobs. In fact, what I 
am talking about is some of these green jobs.
  President Obama has held three public events in recent days to 
highlight his concern about the economy and the need to create jobs. 
Yesterday, the administration apparently announced billions more in tax 
credits for renewable energy and energy conservation efforts. I will 
bet when I look at that list I am going to support most of those 
because I believe a national energy policy involves capturing whatever 
we can of petroleum and fossil fuels we have available for a short 
period of time because we are never going to get rid of them in the 
short term. We need conservation, and we need renewable and alternative 
energy. Those three things make a comprehensive energy program. 
Obviously, if I am for that comprehensive energy program, I am for 
renewable energy and alternative energy.
  It seems as if nearly everyone, in fact, in the administration is 
touting the benefits of green jobs and a clean energy economy and I am 
doing that right now myself. It is astonishing, though, with all this 
talk about green jobs and clean energy that this Congress right now 
seems to be heading for the holidays while thousands of green energy 
workers will receive pink slips and furloughs.
  On December 31 of this year, the current biodiesel tax credit will 
expire. The biodiesel tax credit provides a $1-per-gallon credit for 
biodiesel made from soybean oil and yellow grease and animal fats. The 
tax credit is essential in maintaining the competitiveness of this 
clean-burning, domestically produced green fuel and the jobs that are 
connected with it.
  The tax credit exists for a commonsense reason and something we have 
been using for a long period of time: to offset the higher cost of 
producing biodiesel--or I could just as well insert the word 
``ethanol''--compared to petroleum diesel. Without the tax credit, 
petroleum marketers will be unwilling to purchase the more expensive 
biodiesel and demand will vanish. From this standpoint of the tax 
credit, I hope everybody remembers that whether it is wind, ethanol, 
solar, biodiesel, biomass, or geothermal, it takes tax credits to get 
these programs off the ground. Right now, wind energy is a big industry 
in my State, not only from the production standpoint but from the 
standpoint of manufacturing of components because, in 1992, I got a 
wind energy tax credit passed; otherwise, we would not have wind energy 
and everybody touts wind energy today. It is a little bit like the very 
infant biodiesel industry we have. One might not think biofuels are an 
infant industry because ethanol has been around for 30 years, but 
biodiesel is about where ethanol was 30 years ago. So we want to help 
move this industry along so eventually it can stand on its own legs. 
That is the motive behind all these tax credits, to get an infant 
industry started and then they stand on their own.
  In 2008, getting back to the jobs in this industry, biodiesel 
supported 51,000 green jobs. Because of the downturn in the economy and 
the credit crisis, the biodiesel industry has already shed 29,000 green 
jobs. So now what about the rest of those jobs? That is what my remarks 
are all about, and that is what getting the tax credit renewed before 
the end of the year is all about. Because the industry is currently 
operating at just around 15 percent of capacity. Without an extension 
of the tax credit, all U.S. biodiesel production will grind to a halt. 
Plants will be shuttered and workers will be let go.
  No one should be surprised by the upcoming expiration of this tax 
credit. It was extended most recently in October 2008. So we have known 
for 14 months; hence, nobody should be surprised that it would need to 
be extended by the end of this year.

[[Page S13357]]

  The Senate has been in session nearly continuously for months. 
Earlier this year, Senator Cantwell and I introduced a bill to extend 
the tax credit for 5 years and change it to a production tax credit. 
There is no excuse for inaction on this credit. The Democratic 
leadership is content to leave without doing the necessary work on 
extenders, believing they can extend the tax provisions retroactively 
sometime early next year. Retroactivity does work a lot of times on tax 
extenders that are not extended at the end of the year and extended to 
be made retroactive. But retroactivity in the case of the biodiesel 
market doesn't help bring it from grinding to a halt on January 1, 
2010, because without the incentive, the biodiesel will cost much more 
than petroleum diesel.
  While the House and Senate dither, thousands will lose their jobs, 
but demand for dirty, imported petroleum diesel, however, will 
continue. Investments in the domestic renewable fuels industry will 
lose value and possibly disappear--quite to the contrary of what I said 
in my remarks of yesterday, the President announcing various tax 
credits. So this one has been on the books. All it has to be is 
reauthorized.
  It is too bad that among all the talk of green jobs and the clean 
energy economy, Congress is unable to pass a simple extension of an 
existing tax credit. Once again, the actions of the majority do not 
match their words. For all the talk, they will have failed all those in 
the biodiesel industry working today to reduce our dependence upon 
foreign oil if we leave without extending this critical tax credit 
before the end of the year.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Texas is recognized.
  Mr. CORNYN. Mr. President, we have conferred with the other side of 
the aisle, and I think we have reached an agreement. I ask unanimous 
consent to be allowed to speak for up to 10 minutes, and then I believe 
two Senators from the other side of the aisle would like to speak for 
up to 10 minutes each.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CORNYN. Mr. President, it just shows we can do some things in a 
bipartisan way around here still, albeit small things.
  We are talking about the Defense appropriations bill. I think it is 
important to point out that the majority leader has waited until the 
very last minute to bring up this very important bill, which I am sure 
will pass by a large majority, but it was 2 months ago that the fiscal 
year ended. The majority leader has now left us here 8 days before 
Christmas with a lot on our plate, a lot yet to do, and, of course, 
threatening to keep Congress here through Christmas--certainly up to 
Christmas. I would not say we are happy to be here, but this is a great 
responsibility. These are important issues, and none of us is going to 
shy away from dealing with these issues, albeit 8 days before 
Christmas.
  It is also appropriate to talk about Christmas because this bill not 
only funds our troops, it is a Christmas tree on which Members of 
Congress have hung nice shiny little ornaments, provisions that have 
nothing to do with funding our troops and the Defense appropriations 
bill. As a matter of fact, this bill would actually create new 
entitlement spending programs--that is what some of these little shiny 
ornaments are--rather than fix the ones we have. It is significant. We 
are talking about our troops. At the same time, we are talking more 
generally about health care, because under Federal law TRICARE, which 
handles the reimbursement rates for health care for our troops and 
their families, is required under Federal law to follow Medicare 
reimbursement rates.
  We know that under the underlying health care bill we will be 
considering up until Christmas, it looks like there are actually going 
to be $500 billion in cuts to Medicare. The concern is, if access to 
care is jeopardized for Medicare beneficiaries, which we know it will 
be for at least some--particularly Medicare Advantage beneficiaries--
then cuts to TRICARE reimbursement rates could follow.
  We also know this bill includes a 2-month bandaid for the Medicare 
reimbursement rate for doctors, the so-called doc fix. This is the 
sustainable growth rate formula which has never worked since Congress 
passed it in 1997. It shows Congress makes assumptions--this one back 
in 1997--that we are going to cut Medicare, and in this particular 
instance Medicare reimbursement rates for doctors and that somehow that 
will not have a negative impact on people's ability to find a doctor 
who will see them.
  I know in Travis County in Austin, TX, at last report, only 17 
percent of doctors will see a new Medicare patient, and it is even 
worse for Medicaid, which pays less than Medicare. So we know the cuts 
the underlying health care bill will make to Medicare are going to have 
a negative impact on access to care for many of our seniors, and 
because TRICARE rates are linked to Medicare rates under Federal law, 
they could well jeopardize our troops' and their dependents' access to 
care as well.
  This experience we have had since 1997 under the Balanced Budget Act 
with the sustainable growth rate which, unless Congress acts, will 
actually cut reimbursement rates for doctors by 23 percent--and this 
bill provides a 2-month--a 2-month--fix--these assumptions have never 
worked. Yet this health care bill, at least the 2,074-page version--we 
have yet to see the Reid substitute, which will appear, I am sure, 
miraculously sometime around Saturday as the majority leader tries to 
cram this bill through before Christmas--we know it contains or will 
contain many other assumptions, such as this SGR formula that will 
prove unenforceable and will never work. Yet those will be used by the 
Congressional Budget Office to provide a cost estimate or score which 
may meet the demands of politics today but which will bear no 
relationship whatsoever to the ultimate costs. And the American people 
understand that. They understand the budget gimmicks of having a 10-
year program and not implementing it until year 4 but starting the 
taxes to pay for it on day one. They understand that, and that is why 
they don't trust the Congress to be honest and transparent when it 
comes to spending their money--because of their unfortunate experience.

  I also want to focus on other promises the President has made about 
health care reform which bear on the process by which health care 
reform and these bills are being considered--unfortunately, ways in 
which the Reid bill breaks those promises. This is one we have talked 
about before, but I think it bears repeating because the American 
people want us to read the bills before we vote on them. They want to 
be able to read the bills and to have them posted on the Internet so 
they can understand how this legislation will impact them and their 
families.
  Here is what the President said:

       I'm going to have all the negotiations [the health care 
     negotiations] around a big table. We'll have negotiations 
     televised on C-SPAN, so that people can see who is making 
     arguments on behalf of their constituents and who is making 
     arguments on behalf of the drug companies or the insurance 
     companies.

  I see one of our colleagues on the floor, who is a chief proponent of 
an amendment that had to do with drug pricing. We all know it is the 
worst-kept secret in Washington, DC, that the drug companies have cut a 
special deal behind closed doors--not around a big round table on C-
SPAN but behind closed doors--and many of us don't know the exact terms 
of this deal. We do know that while the big drug companies may be 
protected, the American people are not at the table while special 
interests are cutting deals that have not yet fully come to the light 
of day. I think this is a tragedy. There is no reason the President's 
promise cannot be kept, other than to try to run something by Congress 
and the American people before they have had a full opportunity to read 
it and understand what is in it.
  This is exactly the kind of cynical act that breeds public skepticism 
about Congress and their elected representatives. We are elected by the 
people in our States to use our best judgment on their behalf, listen 
to them, and ask: What do you think about this? Tell me, as your 
elected representative, how do you think I should vote on these 
important issues? If we hide the substance of these cooked-up deals 
behind closed doors from the American people, no wonder the 
congressional approval

[[Page S13358]]

rating is so low. Unfortunately, promises such as this which are broken 
by the Reid bill do nothing but breed skepticism or cynicism on behalf 
of the American people.
  The Washington Post reported last October that the first Reid bill 
was written in secret and ``behind closed doors.'' That is the 2,074-
page bill we have seen stacked up on our tables. That bill, with 
sleight of hand, will be swept off the table and a new one will 
miraculously appear sometime on Saturday. That is the bill we are going 
to be asked to pass by Christmas--again, without anybody knowing what 
exactly is in it.
  Of course, there is speculation among the press corps and the 
political class in Washington as to whether the majority leader will be 
able to get 60 votes on a bill. People are saying: Yes, I think he will 
get 60 votes. Others say: No, he is missing a few votes; he is not 
quite there yet. And we are talking about a bill most of us haven't 
even seen. How in the world can anybody tell their constituents they 
are for the bill or against the bill before they have had a chance to 
read it? It is mind-boggling. Yet we know these closed-door meetings 
are still going on--8 days before Christmas--to work on perhaps a new 
2,000-page Reid bill.
  I know some of our colleagues were irritated with our colleague from 
Oklahoma, who asked that the Sanders amendment be read before we 
actually considered it. Only in Washington, DC, would people be mad 
about knowing what is in a bill or an amendment before we are asked to 
vote on it. The American people want to know. They are being excluded, 
as are many of the rest of us who don't get to know what is being 
cooked up behind closed doors.
  We know these private meetings continue. The President has had 
meetings with our Democratic colleagues from which Republicans have 
been excluded. We don't know what kinds of agreements or discussions 
were occurring behind those closed doors. Certainly, no C-SPAN cameras 
were allowed.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. CORNYN. I ask unanimous consent for 2 more minutes.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. CORNYN. Mr. President, we need to have every single Senator look 
at what is in these bills before we are asked to vote on them.
  Let me close on one last issue. The President has also said:

       First, I will not sign a plan that adds one dime to our 
     deficits--either now or in the future. Period.

  Unfortunately, because of this cynical attitude of Washington and of 
the political class in Washington toward the public generally, 74 
percent of voters said they don't believe that. Seventy-four percent of 
voters, including 82 percent of Independents, are saying: We don't 
believe the President of the United States when he says the bill will 
not add one dime to the deficit.
  One reason they might think that is because of what this Reid bill--
at least the 2,000-page variety--says. The Chief Actuary for CMS says 
that pledge is ``unrealistic and doubtful.'' David Broder, one of the 
deans of the Washington press corps, said:

       These bills, as they stand now, are budget-busters.

  I don't know what it is going to take before Congress wakes up and 
listens to our constituents and the American people. I guess it is 
going to take another election in 2010 or in 2012 where the American 
people get to hold us accountable because in the end the American 
people will get the kind of Congress they want and the kind of Congress 
they deserve. I hope it will be the kind of Congress that embraces the 
transparency pledges the President has made and, in reality, lets the 
American people know what we are doing here and asks whether they 
approve.
  Mr. President, I thank the Chair and yield the floor.
  The PRESIDING OFFICER. The Senator from North Dakota is recognized.
  Mr. DORGAN. Mr. President, it is interesting to listen to the 
discussion on the floor of the Senate. We hear a lot about what is 
wrong these days. For a moment, let me say that there is a lot right in 
this country as well.
  We are in a deep economic recession. I understand that. This is the 
deepest recession we have seen since the Great Depression. It is a 
difficult circumstance. But this country has been in tough 
circumstances before. The American people are a resilient bunch; they 
pull themselves up and move forward.
  I understand the angst and the concern across this country. I 
understand the debate in the Chamber about what is wrong. I would be 
the first to say I don't think either political party is a great 
bargain sometimes. Both of them have their faults.
  I think of that Ogden Nash poem that goes like this:

     He drinks because she [scolds],
     He thinks she [scolds] because he drinks,
     She thinks while neither will admit what's
     [really] true that he's a [drunk] and she's a shrew.

  Both political parties, it seems to me, have faults, but both 
political parties have also contributed to the well-being of this 
country.
  When I hear people say nothing works in America--I answered phones at 
the front desk yesterday for a while to hear from callers calling in 
about various things. I heard it on many occasions because a lot of 
people on the radio and on TV are saying nothing works in America and 
there is nothing the Federal Government has ever done that works.
  The Internet--what a wonderful invention in the life of our planet. 
Yes, that was created by the Federal Government. Going way back, we 
brought electricity to America's farms and unleashed a barrage of 
productivity in American agriculture. When you drive around with a 
locator on the dashboard of your car, that is a GPS satellite--that is 
the government as well. The Interstate Highway System that connects 
America--when you drive down big roads that are connecting all of 
America, that is the Interstate Highway System, suggested by President 
Dwight D. Eisenhower. What a remarkable thing.

  I also think of the story I read a while back about those two little 
creatures that are crawling around the planet Mars, one called Spirit 
and one called Opportunity. Five years ago, our country sent both of 
them to land on the surface of Mars. They landed 1 week apart. They are 
dune buggy-sized mechanical creatures on the surface of Mars. We sent 
them up by a rocket. They landed encased in a shroud, and they bounced 
and the shroud opened up and these dune buggy-sized vehicles began 
driving on the surface of Mars. They were expected to last 90 days. 
Five years later, Spirit and Opportunity have been driving on the 
surface of Mars collecting samples. One of them--I believe Spirit--had 
an arm that looked as if it was arthritic, so it was hanging at an 
angle, almost like a salute. The wheel broke, and so they were dragging 
the wheel and creating a trench. The arm reached back, and the 
scientist--it takes 9 minutes to send up a signal--the scientist had 
the arm reach back and dig into the trench so they could get better 
samples on the surface of Mars. These dune buggies were running on the 
surface of Mars. Yes, that is the Federal Government and all the 
contractors.
  When somebody said to me that the Federal Government has never done 
anything right, I said: If you ever get to the Moon, just check the 
boot prints. They are not Chinese or Russian; they are made by an 
American astronaut--the one who planted the American flag there.
  There is plenty wrong in this country, to be sure, but there is a lot 
right about this country.
  About 9 years ago, at the start of this decade, our country had a 
budget surplus. Poor Alan Greenspan, the Chairman of the Federal 
Reserve Board, wasn't able to sleep. He was worried that we were going 
to pay down the debt too quickly. I assured him he ought to go to sleep 
peacefully because that is not a problem.
  President Bush came to town and said: We are going to do very big tax 
cuts because it is estimated that we are going to have very big 
surpluses. I was one on the floor who said maybe we ought not do that. 
Let's be a little conservative. These surpluses don't exist for the 
next 10 years yet. They existed that year for the first time in a long 
time in the year 2000--a budget surplus. President Bush said: No, we 
are going to begin very large tax cuts right now in anticipation of 
these surpluses in the future. Some of us said:

[[Page S13359]]

Be careful. The wealthiest Americans got very large tax cuts, 
especially.
  Almost immediately, this country went into a recession, and 6 months 
after that, this country was hit with 9/11, an unbelievable terrorist 
attack. Almost immediately, we went into the country of Afghanistan to 
go after Osama bin Laden. Then, very quickly, we invaded Iraq. We were 
at war for the rest of the decade without paying for one penny of it. 
Not a penny was paid for those wars or the increased funding to deal 
with terrorist attacks.
  Some of us went to the floor of the Senate and said: Let's begin to 
try to pay for some of this. Why should we send our men and women to 
war and decide we won't ask anybody to pay for it? They thought we will 
just have the kids and grandkids pay the cost. The President said: If 
you add this to the bill to pay for it, I will veto the bill. So here 
we are.
  Then we see, at exactly the same time, regulators coming to town 
boasting that they were willing to be willfully blind and they would 
not look or see and they would not care. We had a bunch of big high 
fliers create unbelievably exotic financial industries, such as credit 
default swaps and liars loans for mortgages, and they steered this 
country right into a ditch while the people at the top were making a 
lot of money, causing economic havoc the likes of which we have not 
seen since the 1930s. Our revenue at the Federal Government dropped 
$400 billion because of the deep recession. Expenditures for 
unemployment, food stamps, and so on, which are caused to go up during 
recessions, increased substantially, and we have very serious economic 
problems. There is no question about that. I can recite the problems as 
well as anybody. But let's also, from time to time, recite the strength 
of this country. It requires leadership from all of us to put this 
country back on track. I am convinced we can. I am convinced we will do 
that. We need a little cooperation here and there. There is not much 
these days. But I am convinced all of us want the same thing for this 
great country, and perhaps we can come together even if we have 
different views of how to get to that common destination. I am 
convinced one of these days we will make some progress and put America 
first.

  I wished to come today to talk about something that is happening half 
away around the world in Copenhagen. That is the issue of climate 
change and energy. Even as leaders around the world gather in 
Copenhagen to talk about climate change, I wish to talk about the 
energy legislation that addresses the issue of climate change. The 
energy legislation that was passed by the Senate Energy and Natural 
Resources Committee earlier this year is a real energy policy that also 
protects the planet by reducing greenhouse gas emissions.
  We are not going to reduce greenhouse gas emissions because somebody 
signs a paper. We have a lot of environmental laws. Mexico is a good 
example. They have a lot of environmental laws on the books. They are 
just not enforced. Signing a paper is not going to mean much unless you 
have an agreement that makes sense for the planet and an agreement that 
is enforced and an agreement that is agreed to by virtually all the 
countries that are emitting a great deal of carbon.
  I will tell you what will make a big difference; that is, for the 
Congress to pass the Senate Energy legislation, which truly does move 
us in the direction of addressing climate change.
  That energy policy, by the way, is not some secretive policy. This 
past June we passed an energy bill out of the Senate Energy and Natural 
Resources Committee that does all the things I think we need to--or 
virtually all the things--address the issue of climate change and a 
lower carbon future. But it was not brought to the floor of the Senate 
or the House of Representatives because we are told energy legislation 
must be married or merged with climate change. I do not agree with 
that. We are going to have wasted a year, in my judgment, in which we 
could have debated the energy legislation on the floor of the Senate, 
and passed it into law by the signature of the President. This energy 
legislation maximizes the use of renewable energy, such as the building 
of the interstate transmission capability that would allow us to 
maximize renewable energy. The energy legislation would also establish 
a renewable electricity standard, the first one in the history of this 
country. The energy legislation would also retrofit buildings to make 
them more energy efficient, which would increase energy savings. I also 
offered an amendment to this legislation, that would also give us the 
ability to reduce our dependence on foreign oil by opening oil and gas 
production in the eastern Gulf of Mexico.
  All these issues are in an energy bill that passed the Senate Energy 
and Natural Resources Committee on a bipartisan vote. Yet the benefits 
to this country from those energy policies that make a lot of sense, 
will not be available during this year, because those who are pushing 
for climate change legislation here say you have to do energy and 
climate change together.
  I say this: I hope when we turn the corner and start a new year, that 
an energy bill that is bipartisan--Mr. President, I had indicated I 
wished to take 20 minutes today. I ask consent for the 10 additional 
minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DORGAN. Mr. President, the legislation that exists and is ready, 
in my judgment, could be signed by the President and already moving 
this country down the road. The deliverable for the President to go to 
Copenhagen could have been: Look what we have done in energy policy; we 
have taken the significant step in the right direction. Yet we are told 
that energy legislation has to move with climate change legislation.
  I am not opposed to a lower carbon future. I am not opposed to trying 
to do something on climate change legislation. I have indicated I am 
not supportive of the trade piece of cap and trade. I have no interest 
in consigning to Wall Street the opportunity to have a $1 trillion 
carbon securities market that they could trade on Monday and Tuesday, 
and then they can tell us on Wednesday and Thursday how much we are 
going to pay for our energy. I have no interest in creating a carbon 
securities market.
  There are a lot of things we can do, especially an energy policy at 
the front end--and I hope early next year--we will advance this 
country's energy security, No. 1, and advance this country's movement 
toward a lower carbon future.
  I wish to put up a couple charts as I describe this. We must reduce 
our dependence on foreign energy, especially foreign oil. Seventy 
percent of the oil we use comes from off our shores. We sink straws in 
the planet and suck oil out. We suck out 85 million barrels a day, and 
one-fourth has to come to this country because of our appetite for oil.
  You know what, when 70 percent of it comes from other countries--many 
that do not like us very much--that means we have an energy security 
problem. This Energy bill I have described, that has been out of the 
Energy Committee since June, and was passed on a bipartisan vote, 
reduces our dependence on foreign oil, increases domestic production, 
establishes a renewable electricity standard, and creates a 
transmission superhighway. By the way, in the last 9 years, we have 
laid 11,000 miles of natural gas pipeline in this country--11,000 
miles. Do you know how many miles we have laid of high-voltage 
transmission lines interstate? Mr. President, 668. On this bill, I 
worked on the transmission piece with Senator Jeff Bingaman and others 
and we solved the issue of transmission.
  We can get about the business of building an interstate highway of 
transmission lines so you can produce electricity where the Sun shines 
and the wind blows, put it on a wire and move it to where it is needed 
in the load centers.
  This is not rocket science. This is rather simple. We already passed 
a bipartisan bill out of committee to do this. Electrification and 
diversification of our vehicle fleet is in the bill. The legislation 
also enhances energy efficiency in a wide range of areas, it expands 
clean energy technology, and the training of an energy workforce for 
tomorrow.
  Every one of us gets up in the morning and the first thing we do is 
flick a switch and all of a sudden there is light. Then many decide to 
plug in a coffee maker or turn on the stove, turn on the radio, turn on 
the television set,

[[Page S13360]]

get in the car, put in a key, the engine turns on--all of this is 
because of energy, and that is before you get to work. No one even 
thinks about the role energy plays in our life. That is why it is 
important for us to understand we have a very serious energy security 
issue in this country. No. 2, we have a serious issue of the need to 
construct new kinds of energy and also to use the existing energy 
differently or produce energy differently and reduce carbon emissions.
  I chair the committee that funds most of our energy projects. I chair 
the Senate Energy and Water Appropriations Subcommittee. It funds the 
energy and water issues, obviously. There is a lot going on, for 
example, that I think is so exciting that can unlock our opportunity to 
continue to use coal. Some say you cannot use coal. Of course, you can. 
Our science and our technology can clearly decarbonize the use of coal, 
which is our most abundant resource. Why would we not want to use coal 
in the future?
  There are unbelievable things going on Dr. Craig Venter, a scientist 
not far from here, is working on this issue: developing synthetic 
microbes that underground would turn coal into methane. These microbes 
would consume the coal and turn it into methane. Pretty interesting to 
me.
  There is a guy in California who has an idea, a patented idea I don't 
know if it works, but they insist it is the silver bullet. He takes the 
entire flue gas from a coal plant and he mineralizes it through some 
patented process he has. It does not separate CO2. It 
mineralizes all of it and turns it into a product that is harder than 
concrete and more valuable than concrete and produces, as a result, the 
cost of carbon at almost near zero. Maybe that is the silver bullet. I 
don't know. There are dozens of examples like it that are very exciting 
and very interesting.

  I started algae research after it had been discontinued for 15 
years--single-cell pond scum, that green scum on the pond out on the 
farm--algae. You take the CO2 that is released from a coal 
plant, feed it to an algae farm and grow algae. It increases its bulk 
in hours. Then you can harvest the algae and produce diesel fuel. Get 
rid of the CO2 and produce a fuel. That is called value 
added. That is called beneficial use of carbon.
  There are others now--Dr. Craig Venter is involved in this, along 
with Exxon--who have projects in which they create algae that excretes 
lipids directly. Instead of harvesting algae and destroying it for the 
purpose of acquiring a diesel fuel, it excretes lipids directly which, 
with very little manipulation, is a fuel.
  One of the scientists with the Sandia National Laboratory talked 
about the development of a solar heat engine in which you put 
CO2 on one side and water on the other and you fracture the 
molecules and thermochemically recombine them and you have methanol--
water, CO2, develop a fuel.
  All these ideas are opportunities for us to continue to use coal and 
at the same time reduce our greenhouse gas emissions.
  My point is, I think we ought to be doing a lot of everything with 
respect to producing a better energy future for this country and with 
respect to reducing the carbon in our future. I am not somebody who is 
a naysayer about climate change at all. I expect to be a part of 
discussions about how to reduce carbon in our future. But I do believe 
it will be a profound mistake if we do not advance the very policies we 
have the opportunity to advance in the Congress, in the Senate, the 
very policies that move us in the direction of reducing carbon and 
making us more energy secure.
  To date, what we have had is all this breathlessness about you have 
to do a climate change bill right now and you cannot take up energy 
legislation until you take up climate change legislation. You know 
what, I do not agree.
  I hope that high on the list of the agenda next year for this 
Congress is to say: We have a serious energy security problem and we 
have a serious issue with respect to carbon. Let's deal with both. If 
anybody believes this country can continue to have a 70-percent 
addiction for oil from foreign countries, they are dreaming. That is 
not something that will be sustainable in the long term. It undermines 
this country's economy to have that kind of addiction to foreign oil.
  So how do we address this issue and fix it? We address it with 
thoughtful policies inside this country--to increase efficiency, 
increase conservation, increase production, and increase production in 
the right way that protects our planet. All these things are possible.
  I guess I have spoken six or eight times on the Senate floor about 
these issues, not that anybody is listening so much I guess. But it is 
all health care all the time right now. Health care is not unimportant. 
I happen to think among the first things on the agenda is, A, financial 
reform which restores confidence. That was important because a bunch of 
high fliers steered this country into the ditch. We have to make sure 
people think that will not happen again; then, second, restarting the 
economic engine and putting people to work--jobs; third, dealing with 
energy which has to do with the very security of virtually everything 
we do to create jobs in this country. All these are important issues.
  My hope is, when the calendar turns and January comes, we will have 
the opportunity to grab and seize the progress that was made in the 
Senate Energy and Natural Resources Committee, now nearly 6 months ago, 
to do the right thing for this country and to do the right thing to 
address climate change at the same time.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington is recognized.
  Mrs. MURRAY. Mr. President, I come to the floor on behalf of over 
10,000 constituents from my home State of Washington who have sent me 
letters and e-mails over the past 6 months to tell me their stories and 
their struggles with our health care system.
  I come to the floor on behalf of the thousands who do not have the 
time or who do not have the resources to write to me and ask for help 
but who are struggling as well.
  I come to the floor on behalf of small business owners, parents, 
senior citizens, and people with preexisting conditions, people with 
insurance whose premiums are skyrocketing, and people without insurance 
who spend their nights praying they do not have an accident or fall 
ill.
  These people are all worried about keeping their jobs or making a 
mortgage payment and for whom the cost of getting sick today or being 
dropped from their health care plan or opening their mail to see 
another premium increase is too much to bear. Those are the people who 
deserve a real debate and a real plan, not distortions or silly 
distractions, such as conversations about how many pages are in this 
health care bill. What is more important than the number of pages in 
this health care bill is the help within those pages for businesses and 
families across this country.
  I have watched, day after day, as our colleagues on the other side of 
the aisle have come down to this floor. They have made outrageous 
claims. They have handed out reams of paper and stacked copies of the 
Senate bill on top of copies of the House bill to try and turn a 
serious debate into a sideshow. But if my colleagues on the other side 
want to focus on pages, fine, let's focus on pages.
  Beside me is a photo of a woman named Doreen Kelsey. In front of 
Doreen is a stack of papers. Those are hundreds upon hundreds of pages 
of forms and rejection letters and appeals and denials from her 
insurance company. These are pages that have taken hours and hours to 
fill out and that have stood between Doreen's husband and the care he 
desperately needed.

  I met Doreen at a roundtable I hosted in August in Spokane, WA, in my 
State. Doreen told me she is self-employed and isn't able to purchase 
her own health insurance because she has a preexisting condition. Now, 
luckily, she and her family have health insurance coverage through her 
husband Tony's employer. She told me she and Tony thought their family 
had good insurance coverage. But when he asked for a colonoscopy, they 
soon discovered the lengths to which insurance companies will go to 
deny, to delay, and to dispute the care families such as the Kelseys 
assumed were included in their coverage.
  Their insurance carrier told them before they would pay for this 
preventive care, it would have to be approved by a primary care 
physician. After being delayed for more than a month because of

[[Page S13361]]

that requirement--and this whole stack of papers here--the colonoscopy 
ultimately confirmed their fears, and he was diagnosed with stage 4 
colon cancer. With that diagnosis in hand, the Kelseys were determined 
to beat this terrible disease together, but rather than focusing on 
fighting cancer they were forced to fight their insurance company.
  Doreen told me although they had faithfully paid their premiums 
throughout their entire working lives, now that Tony desperately needed 
lifesaving treatment, he was in a constant struggle of paperwork with 
his insurance company to pay for even routine care. They weren't asking 
for anything new, they weren't asking for anything experimental, they 
were just asking for the care that a lifetime of paid premiums should 
have entitled them to.
  The Kelseys assumed what most Americans do when they are paying for 
good health insurance. They assumed that while their insurance was 
expensive, it would be there for them when they needed it. Well, Doreen 
and her family, like many other American families and businesses, have 
come to find out that in our current health care insurance system, 
stability is sometimes nothing more than an illusion.
  With each procedure and each battle, the Kelseys faced a new fight--
more paperwork stacked on more paperwork, another appeal and another 
appeal. At one point, Doreen told me she had to appeal all the way to 
the State insurance regulator just to get a corrected explanation of 
benefits form--paperwork--from her insurance company. She told me they 
had to borrow thousands of dollars to pay doctors while their claims 
were tied up in what seemed like an endless appeal process--paperwork.
  The Kelseys' insurance now costs more than their mortgage, and they 
are constantly worried that Tony's employer will drop that coverage. 
But, thankfully, she told me Tony is working hard and successfully 
battling his cancer. In the meantime, Doreen has successfully been 
battling her insurance company. But this isn't how our system should 
work. When we pass the Senate's health care reform bill we are 
debating, it will not be.
  Let me tell everyone--and the Kelseys--how our bill will help them. 
First of all, our bill ends insurance company discrimination for 
preexisting conditions, so Doreen will be able to purchase insurance on 
her own and not have to rely on her husband's employer. Doreen would 
also have access to a number of different plans through an exchange 
that we are setting up where insurance companies, for the first time, 
would have to compete for her business. Our plan would inject 
competition into the insurance market, and we know that will lower 
costs and give families such as Doreen's more choices.
  Our plan also makes it illegal for insurance companies to drop people 
when they get sick, so Doreen and Tony wouldn't have to worry about 
losing their coverage at the moment they need it the most. Since we 
know that preventive care is critical to saving lives and saving money 
on health care costs in the long term, our bill ensures free preventive 
services under all insurance plans.
  Our plan invests in prevention and in public health to encourage 
innovations in health care that prevent illness and disease before they 
require more costly treatment. It would have allowed Tony to get a 
colonoscopy when he first needed it so he could get his treatment 
started sooner.
  Mr. President, we also know families deserve the security and 
stability of knowing that if they or their loved one do get sick, they 
will not be forced into bankruptcy to pay for the cost. Our bill 
restricts the arbitrary limits that insurance companies currently place 
on the amount of coverage families receive. It caps the total amount 
that insurance companies can make people pay out of pocket on copays 
and deductibles. And it eliminates the lifetime limits insurance 
companies can impose on coverage.
  In addition to putting in place those important consumer protections 
that would help people such as Doreen and Tony, it will give families 
the stability and security they deserve and lower the cost of care so 
Americans such as Tony and Doreen would not have coverage that costs as 
much or more than their mortgage. We do that by putting in place 
premium rate reviews to track increases and crack down on excessive 
insurance company overhead costs.
  When our bill passes--and I am confident it will, despite the delay 
and the delay and the delay that we are seeing on the other side of the 
aisle--insurance companies will no longer be able to hike up Doreen's 
premiums to pay for a bureaucracy they will then put to work battling 
her claims.
  We also provide sliding scale premium tax credits--tax credits--for 
families who still can't afford coverage, which would help 450,000 
people in my home State of Washington get the coverage they need.
  Mr. President, the bill before us today--which some of my colleagues 
have sitting on their desks and they bring out here on a daily basis to 
show us the pages--will help families such as the Kelseys. That is what 
is within the pages of the bill they keep throwing at us. So I think, 
rather than talking about the number of pages in the bill, our 
colleagues on the other side of the aisle might actually want to talk 
about what is in the bill because right now, instead of debating the 
merits of bringing down costs or protecting families from losing the 
coverage when they get sick, our colleagues are actually spending time 
complaining this bill has too many pages.
  I ask the Presiding Officer and my colleagues on the other side of 
the aisle to take a look at this photo of Doreen sitting next to 
hundreds and hundreds of pages of correspondence and appeals and fights 
with her insurance company. These are the pages we ought to be talking 
about. These are the pages that impact people's lives, and the Kelseys 
are the people we ought to be talking about.
  So when my colleagues come down here and complain about the number of 
pages in our health reform bill--those pages that will help our 
families and businesses lower costs--I want them to think about the 
number of pages right here in front of Doreen. These are pages that 
have caused the Kelseys unimaginable heartache, and these are the pages 
that have come between them and the health care they paid for.
  These are the numbers we ought to be focusing on--the 14,000 people 
who are losing coverage every day. These are the numbers we ought to be 
focusing on--the 51 million people who have no insurance. Those are the 
numbers we ought to be focusing on, not the number of pages in the 
bill.
  Mr. President, we have to end the politics, end the delay and the 
partisanship. We need to end this obstruction because that is what the 
Kelseys faced every day, delay and obstruction. They are facing it 
again on the floor of the Senate. It is time for us to come together on 
this important bill and bring our businesses and our families the 
insurance reform they have been asking for. I hope that is what 
Americans will remember at the end of the day, that the pages in this 
bill are going to change their lives so they don't have to fight their 
insurance companies again.
  Mr. President, we are here today in the Senate--nobody on the floor, 
just me talking about what we ought to be doing, and you in the Chair, 
waiting. Why? Because we have a Defense appropriations bill in front of 
the Senate. It is a Defense appropriations bill that needs to be passed 
by the end of this year. It needs to be passed so we can get back on 
the floor and pass our health care reform bill.
  Some people on the other side of the aisle have decided that delaying 
this Defense bill will somehow help them delay this from ever being 
passed--the health care bill that would help Doreen and her family. 
Well, Mr. President, it isn't just about making a political point. What 
we are doing is having our soldiers--who are serving on the ground in 
Iraq, in Afghanistan, around the globe and here in our country--wonder 
what they are going to get for Christmas--a delay from the Senate?
  The bill in front of us provides a 3.4-percent military pay increase. 
This is an All-Volunteer Force we have out there working for us. Many 
of them are away from their families this Christmas. They do not want 
to hear that the Senate is delaying passing this important bill that 
will give them the security they need because of political obstruction 
in order to delay a health care bill.

[[Page S13362]]

  This Defense bill is critically important. It has very important 
support for our military and their families. It has passed through this 
Senate before, and we are ready now to make the final trip to the White 
House, which needs to be done, by the way, by tomorrow. So I hope our 
colleagues will not continue to delay. I hope they will allow us to 
move to final passage on this bill so our men and women who are serving 
us in the military and around the globe know there is a Senate who is 
working for them.
  I have heard some of them on the other side complain that some things 
were added to the Senate Defense bill--that also need to be done by the 
end of the year, besides the Defense bill--such as making sure our 
families, whose benefits are running out for unemployment, or COBRA for 
health care insurance, get a 2-month extension. So should our Christmas 
present to them be: Sorry, you aren't going to get your small little 
help as we end this year. We want to keep that going for another 3 
months during one of the worst economic times we have seen. So, of 
course, we put it in this bill.
  Because of the obstruction on the other side, we can't get it through 
in a timely fashion. It has to be done by the end of this year. We are 
doing the right thing for our families. We are doing the right thing 
for our military by putting it in this bill and getting it done and to 
the President so we can finish our work.
  Mr. President, these are all critical issues. We are all tired. We 
have been here day after day after day. It is time to get this done. 
Let me tell you why. Because Doreen and her husband are facing piles 
and piles of paperwork to care for her husband. They are fighting their 
insurance company. And all we have to do is put these bills in front of 
us, get them done, and provide some relief for America. I hope that is 
what we focus on, Mr. President. I hope we stop the deny and delay and 
obstruction that the Kelseys have had to fight with their insurance 
company. Let's move these bills and go home to our families for 
Christmas.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Udall of New Mexico). The Senator from 
Illinois is recognized.
  Mr. BURRIS. Mr. President, I also would like to make a few comments 
on the issue that is pending before this body and which has been 
debated and debated and debated, discussed and discussed and discussed. 
It is time to bring it to a meaningful and final conclusion.
  As I address this Chamber today, we stand on the cusp of history. For 
many years, we have known that the American health care system is badly 
broken. Now, after nearly a century of debate, after 100 years of delay 
and false starts, this body is on the verge of laying the issue of 
health reform to a rest.
  This bill represents the culmination of decades of hard work. Its 
course has been shaped by 11 Presidents and countless Members of the 
House and Senate. It has taken a long and winding path to reach this 
point. This legislation is a product of compromise and consensus, of 
give and take on both sides. It is not perfect; by no means is it 
perfect. But here we stand.
  We have come further than any Congress in history on this issue. We 
have worked hard to craft a measure that can accomplish the goals of 
reform without alienating those whose support we need to pass this 
bill. Without a commitment to certain ideals, this bill would be empty 
and ineffective. But without a willingness to work together and achieve 
compromise, this bill can never become a political reality.
  As responsible legislators, this is the fine line we must always 
walk. It is never easy. I applaud my colleagues for the fine work they 
have done at every step along the way. Still, not everyone is 
satisfied, so the work goes on. It is the genius of our Founding 
Fathers and the rules of this body that allow one Senator to keep 
debate alive so we can work, debate, write, rewrite legislation 
together. One Senator can do that under the rules of this body.
  Some have suggested that we kill this legislation and start over. 
They suggest that we stop and come up with something new. They say 
without perfection we should give up on reform altogether.
  I have spoken on the Senate floor, Mr. President. You know what my 
position has been. But giving up on this issue is not an option. So as 
my colleagues and I continue to move forward from here, I would like to 
make one thing very clear. After 100 years of debate, we have come too 
far and worked too hard to turn back now. Too many Americans are 
counting on us to make a decision on their behalf. They need it now. 
They don't need it tomorrow or next week or next month or next year or 
never--they need it now. Killing the bill would ignore those who look 
to us for help in their time of crisis. We cannot abandon them at this 
time. Leaving tens of millions of people without any health coverage at 
all is also unacceptable.
  To all those who believe we should kill this bill I would say this: I 
understand their frustration, the impulse to say enough is enough. But 
our vote in this body on this bill is not the end of a path for this 
sweeping legislation, only a door to the next step of conference.
  I have not yet seen the details of the legislation. I have not yet 
seen the CBO score. I have not yet seen the provisions that will earn 
my vote; namely, cost containment, competition, and accountability. It 
is only through keeping this legislation alive that we can continue our 
work to make this a more perfect document. I say we must continue to 
work on this document we have before us. We cannot kill this 
legislation and start over. We must keep working through this 
legislation, keeping it alive so we can continue--continue--to make 
this document what we want it to be. That is what we must do.
  I yield the floor.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. KAUFMAN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. KAUFMAN. Mr. President, I speak today about the need for urgent 
action on the Defense appropriations bill. I shouldn't have to speak 
about urgent action on the Defense appropriations bill because this is 
the one area that is so important to the country and on which we should 
always operate as quickly as we can. I urge my colleagues on the other 
side of the aisle to stop their attempts to derail the health care bill 
and allow the Defense appropriations bill to move forward.
  As always, I respect that my colleagues have different views. We have 
different views on all kinds of issues. We have all kinds of 
substantive differences. I am one of the people in this body who 
believe there are basic differences, and a lot of them are not 
political, they are about basic differences that separate us from being 
Democrats and Republicans. We can disagree on tactics and on 
principles, but I know my colleagues on the other side of the aisle 
support our troops, and the support of our troops should never be a 
partisan issue.
  This bill funds more than $100 billion for operations, maintenance 
requirements, and military personnel requirements for our armed action 
in Afghanistan and Iraq. It provides more than $23 billion for 
equipment critical for protecting the brave men and women in uniform--
and they are brave men and women and they deserve this. I know the 
other side of the aisle agrees with that. That is why we should move 
ahead on this bill. It funds more than $150 billion for the training of 
our troops, critical to our success. It is incumbent upon the Congress 
to ensure that our troops in Afghanistan, Iraq, and throughout the 
world have the resources they need to be safe, secure, and effective in 
the war zone.
  This bill has been operated and worked on by both parties. It puts 
our troops first, with the necessary equipment and improved benefits 
for the military and their families. This isn't just about our troops; 
this is about the brave men and women who remain at home, the families 
who need the benefits--again, issues I know my colleagues on the other 
side of the aisle agree with. They deserve our support and they deserve 
it now.
  In addition to providing a 3.4-percent pay increase for our troops, 
it also improves military health care and research, including for the 
very important psychological health, which is especially important, 
given the startling

[[Page S13363]]

rates of post-traumatic stress disorder. Everybody knows we must train 
and equip our troops, our men and women going into battle, but it is 
equally important--and everyone agrees with this, too--it is equally 
important to care for the troops and their families after they return 
home. That is what this bill does.
  This bill is necessary, as it demonstrates solidarity with the troops 
and gratitude for the sacrifices they make on our behalf. It is an 
investment in our military, in our security, and in our future. That is 
why our House colleagues overwhelmingly agreed to it yesterday by a 
vote of 395 to 34 and why we must end these partisan delays to move 
this bill forward.
  It is critical we pass the bill, and there is no good reason why our 
troops and military families should have to wait--especially in this 
holiday season--while the other side of the aisle is playing politics.
  I support conducting a real debate on Afghanistan with a host of 
other military issues, but the current debate is not about substance, 
it is about politics. Our troops should come first and they deserve 
better. We should pass this bill without delay to give the military and 
their families the funding they need to do their jobs and to protect 
our Nation.
  Thank you. I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Webb). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. KAUFMAN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. KAUFMAN. Mr. President, I ask unanimous consent to speak as in 
morning business for 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Health Care Fraud

  Mr. KAUFMAN. Mr. President, I rise to discuss health care fraud. 
Earlier this month, I introduced, along with Senators Leahy, Specter, 
Kohl, Schumer, and Klobuchar, an amendment that will protect our 
increased national investment in the health of Americans by improving 
fraud enforcement. Everyone believes in fraud enforcement, and this 
amendment does that.
  It is no secret fraud represents one of the fastest growing and most 
costly forms of crime in America today. In no small part, our current 
economic crisis can be linked to financial fraud, starting with 
unchecked mortgage fraud generated by loan originators, through 
securities fraud that hastened the eventual market crash and maximized 
its impact on Main Street and average American investors.
  In response, this body passed the Fraud Enforcement Recovery Act, 
FERA, which directed critical resources and tools to antifinancial 
fraud efforts.
  FERA was passed in response to an unprecedented financial crisis, but 
Americans should expect Congress to do more than simply react to crises 
after their most destructive impacts have already been felt. We owe it 
to our constituents to identify and address problems when they arise so 
we can prevent disaster rather than just trying to figure out how to 
clean up after it happens.
  In undertaking comprehensive health care reform, we must be proactive 
in combating health care fraud and abuse.
  It is hard to believe, but each year criminals drain between $72 
billion and $220 billion--that is billion dollars--between $72 billion 
and $220 billion from private and public health care plans through 
fraud, increasing the costs of medical care and health insurance and 
undermining public trust in our health care system. We not only lose 
the money, we lose the trust people have for the system that the system 
works.

  We pay these costs as taxpayers and through higher health insurance 
premiums. This amendment will provide needed tools to reduce those 
costs through effective investigation, prosecution, and punishment of 
health care fraud.
  It is pretty clear that as we take steps to increase the number of 
Americans who are covered by health insurance and to improve the health 
care system for everyone, we must also ensure that law enforcement has 
the tools it needs to stop health care fraud.
  The Finance and HELP Committees, as well as leadership, have worked 
long and hard to find ways to fight fraud and bend the cost curve down. 
They have done a great job. However, there is more work to be done, and 
this amendment is an important additional step.
  This amendment makes straightforward but critical improvements to the 
Federal Sentencing Guidelines, to health care fraud statutes, and to 
forfeiture, money laundering, and obstruction statutes, all of which 
would strengthen prosecutors' ability to combat health care fraud.
  First, this amendment directs a significant increase in the Federal 
Sentencing Guidelines for large-scale health care fraud offenses.
  It is really kind of strange, but despite the enormous losses in many 
health care fraud cases, analysis from the U.S. Sentencing Commission 
suggests that health care fraud offenders often receive shorter 
sentences than other white-collar offenders in cases with similar loss 
amounts. So people basically feel you can do health care fraud and get 
away with it and you will not pay a major price. According to 
statements from cooperating health care fraud defendants, many 
criminals are drawn to health care fraud because of this low risk-to-
reward ratio.
  As we have an incredible expansion of health care that will go 
forward, with more funds, we know criminals out there think this is 
easy. They think: I can go out and commit fraud. It is a very complex 
process, but I commit the fraud. My chances of getting caught are not 
that great, but even more, I have an added bonus that, if I get caught, 
I will not get much of a penalty.
  That is why we need to ensure these offenders are punished not only 
commensurate with the costs they impose upon our health care system but 
also at a level that will offer a real deterrence. These folks believe 
they can engage in health care fraud and even if they get caught they 
will not have much of a penalty. Our amendment directs changes in the 
sentencing guidelines that, as a practical matter, amount to between 20 
and 50 percent for health care crooks stealing over $1 million.
  In addition, the amendment updates the definition of ``health care 
fraud offense'' in the Federal Criminal Code to include violations of 
the antikickback statute, the Food, Drug, and Cosmetic Act, and certain 
provisions of ERISA.
  These changes will allow the full range of law enforcement tools to 
be used against all health care fraud.
  The amendment also provides the Department of Justice with subpoena 
authority for investigations conducted pursuant to the Civil Rights for 
Institutionalized Persons Act, also known as CRIPA.
  It is hard to believe, but under current law the Department of 
Justice must rely upon the cooperation of the nursing homes, mental 
health institutions, facilities for persons with disabilities, and 
residential schools for children with disabilities that are the targets 
of CRIPA investigations. You can figure out that in most cases these 
targets will cooperate, but sometimes they may not. The current lack of 
subpoena authority puts vulnerable victims at needless risk.
  Finally, the amendment corrects an apparent drafting error by 
providing that obstruction of criminal investigations involving 
administrative subpoenas under HIPPA--the Health Insurance Portability 
and Accountability Act of 1996--should be treated in the same manner as 
obstruction of criminal investigations involving grand jury subpoenas.
  As we consider and debate meaningful health care reform, we must 
ensure criminals who engage in health care fraud, and those who think 
about doing so, understand two things: If they engage in health care 
fraud, they are going to be faced with swift prosecution by more 
prosecutors and more folks who enforce the law, and when they are found 
guilty, they will face substantial punishment.
  These commonsense provisions should be a central part of health care 
reform. I urge my colleagues to support this amendment.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Texas is recognized.
  Mrs. HUTCHISON. Mr. President, I ask unanimous consent to speak as in 
morning business for up to 10 minutes.

[[Page S13364]]

  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Health Care Reform

  Mrs. HUTCHISON. Mr. President, I rise today to speak about the health 
care bill that is pending. The Department of Defense bill is also 
pending. It is the business we have on the floor today. I have no doubt 
that at the appropriate time there will be a vote in support of funding 
our troops. I know that may come on Saturday after the time for debate 
has run out.
  I want to talk about the health care issue because it is the reason 
we have been here for really most of the last month--voting every 
Friday, Saturday, and Sunday--is to talk about the health care bill, 
debate the health care bill, ensure the American people know what is in 
this health care bill, and ensure people start looking at the effect it 
is going to have on their businesses and their families. I can't think 
of anything we have ever voted on in this body since I have been here 
that will affect people's lives in such a personal way.
  I have tried to look at what is good in the bill, and then I look at 
what I don't like in the bill, and I have to say the scale is very 
heavily tilted toward what I don't like.
  In fact, I had a tele-townhall meeting, which is a new capability we 
have to talk to people. It is a wonderful way to be able to reach out 
in your State to people who are interested in asking questions and 
actually call them and let them ask their question. At all times during 
the tele-townhall I had last night, there were over 6,000 people who 
were in and out of that tele-townhall meeting. I was very pleased 
because every single question was a real question, a real person. One 
man who called is on kidney dialysis treatments. He has very high drug 
costs and high expenses. Then we had people on Medicare asking how the 
cuts in Medicare would affect their treatment and their care. Then we 
had small businesspeople who are scared to death of having more 
burdens, more taxes, and more mandates on their small businesses. Some 
were almost screaming into the phone: But don't people realize how hard 
it is to make ends meet right now for small business? Don't you all 
realize we are trying to stay afloat while we are in one of the worst 
recessions of our lifetime?
  Of course, I assured them I do understand that. That is why I am 
trying to amend this bill, trying to change it, trying to encourage my 
colleagues on the other side of the aisle that we should really start 
over and try to have a health care reform bill that does three basic 
things.
  We want a bill that actually lowers the cost of health care. Right 
now, the bill before us will increase the cost of health care. The cost 
of the bill that is before us today, if you start with when the bill 
takes effect, which is 2014, and you go 10 years out, you are looking 
at $2.5 trillion in costs.
  We have a debt of $12 trillion in America right now. Those numbers 
are staggering. We used to be worried about $12 billion, $15 billion, 
and $100 billion; now we are talking about trillions of dollars. We are 
talking about $12 trillion in debt right now. The idea that we would 
put $2.5 trillion more in this health care bill, which mandates taxes, 
to offset some of it, to businesses, employers, and families, is 
unthinkable. It is unthinkable in good times, but in the bad times we 
have now, it is absolutely unthinkable. Here we are now talking about 
this bill that will increase the debt and increase taxes and mandates.
  In talking with the people of Texas, I did a little poll on the tele-
townhall. I said: Register in, punch 1 for yes, 2 for no, and 3 for 
undecided. I asked: Do you support the bill that is before us today? If 
you say yes, press 1; no, press 2. Eighty-one percent instantly started 
registering against this bill.
  I was listening to my colleague, Senator Barrasso of Wyoming. He also 
had a tele-townhall meeting for Wyoming. Many Senators are doing this 
now. He had a couple of thousand people on the call. Ninety-three 
percent who registered on the poll were against this bill. My colleague 
from Nebraska, Senator Johanns, said the polls in Nebraska are 
overwhelmingly against this bill.
  People are listening to the debate, reading the newspapers, getting 
every bit of information they can, listening to the tele-townhall 
conference calls, they are asking their questions, and in unprecedented 
numbers they are registering their interest and their overwhelming 
rejection of this bill.
  I talked about what is in this bill and what we could have. Instead 
of $100 billion in new taxes, which would start next month, we could 
step back and say we are not going to put new taxes on businesses and 
families and companies before the bill even takes effect. In fact, 
Senator Thune and I had a motion that was rejected on the floor. It was 
tabled yesterday afternoon. It would have done exactly that. Very 
simply, if the bill is going to pass, at least don't start the taxes 
until there is some program available that is as a result of the bill. 
It is very simple and clear. That was our motion, and it was tabled, 
with only 41 Senators saying yes, so we lost the motion.
  It is of great concern to us that the tax increases in this bill 
start next month--we will have over $100 billion in new taxes starting 
next month--and that the 40-percent excise tax on premium health care 
coverage policies takes effect in 2013 but the bill doesn't take effect 
until 2014.
  That is the bill we are debating today, which an overwhelming number 
of American people are rejecting. They don't want taxes, mandates, and 
they don't want the government to step between them and their doctors. 
They want the physician-patient relationship that is the hallmark of 
American health care. It is what makes us different from most other 
countries in the world--that we don't have government standing in the 
way and most of our private plans don't say: No, you can't have this 
treatment because you are too old or you are not fit enough, or having 
the government say: Here is who is qualified for this procedure. That 
is not the health care we have known in America.
  We are for health care reform that lowers the cost of health care in 
our country, and more people will have affordable options. There is a 
part of this bill that could provide that. It doesn't mean a government 
takeover. We don't need a government takeover. That is why you have all 
the taxes and mandates, because it will cost so much that taxes and 
mandates are the way the majority is putting forward to pay for this 
expensive government takeover.
  Why not have the health care exchange without all the mandates so 
there would be a free market on the exchange with no cost that would 
allow people to have choices? The insurance companies would come 
forward and there would be high-deductible plans for people who wanted 
high-deductible plans, and there would be low-deductible plans that 
would be more expensive, but some people would prefer to have that. You 
could make your choices among the plans that would be put on an 
exchange that would be open, transparent, and competitive. You would 
have bigger risk pools and, therefore, lower premiums would be the 
result.
  Talking about what Republicans wish to see in health care reform and 
asking the majority if we could stop going through every weekend with 
one vote on Friday, one vote on Saturday, one vote on Sunday so that we 
are not able to do anything with our families during this holiday 
season, instead why don't we step back and say we will come back after 
Christmas or whenever the majority wishes to come back and say: Let's 
sit down in a bipartisan way, and let's have three principles in a 
health care reform bill. No. 1, we would lower the cost with the 
exchange, bigger risk pools, lower costs. No. 2, how about tax credits 
for every individual or family who would buy their own policies because 
they don't have access through an employer or if they are going to go 
on this exchange that would not cost anything, they would be able to 
have a tax credit to buy their own health care coverage. That would 
increase the number of people insured in our country, much larger than 
we are looking at today with a big government-run plan, which is said 
to increase the number of insured 31 million, but leave 24 million 
uninsured. We could get 31 million with the free market working.
  No. 3, what about medical malpractice reform? We could take $54 
billion out of the cost of health care by having frivolous lawsuits 
curbed with some kind of reasonable limits on damages or attorneys fees 
that would allow

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people to get some compensation for a transgression, but not something 
that is going to raise the cost of premiums so high for doctors and 
hospitals that they have to order more medical tests and that raises 
the cost of health care across the board.
  Those would be the principles we could support. Let's start again 
after Christmastime and do a rational proposal that the American people 
would accept.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mrs. HUTCHISON. I yield the floor.
  The PRESIDING OFFICER. The Senator from Florida.
  Mr. NELSON of Florida. Mr. President, is it any wonder that people 
are responding negatively when asked, Do you support health care, when 
they have been bombarded with millions of dollars of TV advertisements 
that are not telling what this health care bill does?
  Is it any wonder when they hear comments such as this health care 
bill will not save the American consuming public on their health 
insurance premiums? What does it do?
  Can you believe that it is not going to allow insurance companies to 
cancel your policies?
  Can you believe that it is not going to let an insurance company come 
up with some kind of fictitious excuse that you have had a skin rash 
and, therefore, you have a preexisting condition and they are not going 
to insure you?
  Can you believe that it is going to bring in 3l million new people 
who are going to have health insurance who did not have health 
insurance before, and that all the rest of us paid for when they showed 
up at the emergency room?
  Can you believe that this health care bill is going to bring down the 
cost of Medicare over the course of time and is going to save Medicare 
instead of Medicare running out of funds in about 6 or 7 years?
  Can you believe that by creating a health insurance exchange for the 
private marketplace for private health insurance companies to compete 
for that available exchange of people who want to buy health insurance 
there, it is going to bring down their health insurance premiums from 
what they would otherwise pay?
  You probably say it is hard for me to believe that because of all the 
negative I have heard. But that is exactly what the experts tell us 
this bill is going to do. And, oh, by the way, it is going to do one 
more thing. Over 10 years, this bill is going to reduce the deficit by 
$130 billion. Can you believe that? Not if you have been listening to 
all the stuff that has been thrown around about how bad the bill is. 
But that is the tactic. That is the tactic of ``in your face,'' ``oh, 
ain't it awful.'' It is time the real story gets out.
  You know what will happen? When this bill is passed and it is finally 
signed into law by the President, then the real story is going to get 
out and people will know. In the meantime, I wish that in the Senate we 
could have closed the doughnut hole. The doughnut hole is the gap in 
coverage for Medicare recipients where they have to continue to pay 
premiums for Medicare but they receive no drug coverage whatsoever.
  Under current law, a Medicare beneficiary will pay up to $310 for 
their drugs, which is the deductible, and then they pay 25 percent of 
their drugs up until they have paid out a total out of their pocket of 
$940. Above that, they hit the dread doughnut hole and they continue to 
pay premiums, but they receive no help from Medicare for their drugs 
all the way up to a much higher level. There are 3.5 million people who 
hit that dread doughnut hole.
  Each year, because of the formulas, the doughnut hole grows bigger 
and it is compounded by higher and rising drug prices. We have seen 
that the pharmaceutical industry has raised their prices 9 percent. 
These out-of-control increases in prescription costs are hurting our 
folks and especially seniors on fixed incomes.
  It is no secret that I wanted to fill the doughnut hole. It is not 
going to happen. But what is going to happen when this gets into 
conference with the House of Representatives--in fact, there has been a 
commitment by the majority leader, there has been a commitment and a 
statement by AARP, which has a significant interest in this 
legislation, there was a pledge on this floor by Senators Reid, Baucus, 
and Dodd to close the doughnut hole. I suspect that what has happened 
is, they have gotten the agreement of the pharmaceutical industry to 
help them close that doughnut hole once we get into the conference 
committee with the House of Representatives.
  But first, we have to get the bill out of here. That means we have to 
stand up and push back all of this nonsense and misinformation that is 
coming about this bill.
  What does it do, to recapitulate. It lowers the cost of Medicare over 
time. It gives a reduction of the Federal deficit. It allows insurance 
for people who do not have it to be available and affordable and they 
cannot cancel or use some flimsy excuse to cancel. It will utilize the 
private marketplace in which to make this happen. This is an American 
story, and it is going to be an American success story.
  Mr. President, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. CORNYN. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER (Mr. Begich). Without objection, it is so 
ordered.
  Mr. CORNYN. Mr. President, as I contemplate the task ahead of us 
between now and Christmas to consider this huge change--some might say 
radical change--in our health care system, I am reminded of an oath 
that doctors take called the Hippocratic oath, which basically is, 
first, do no harm. In other words, you don't want to kill the patient 
when you are trying to cure them of cancer. You don't want to disable a 
patient, make their condition actually worse than trying to help them. 
I think it would be advisable if Congress took a Hippocratic oath, and 
nowhere is that more appropriate than when talking about health care.
  We ought to make sure whatever we do, we don't make things worse. Yet 
the underlying health care bill, the Reid bill, makes things worse. I 
will talk about that in detail.
  We all agree health care reform is needed. Some of us have different 
ideas about what reform should look like. We know health care premiums 
have more than doubled in the last 10 years for American families and 
that health care costs typically rise at two or three times the rate of 
wage growth. We also know this is all unsustainable. We can't keep 
doing what we are doing. Republicans and Democrats agree on the nature 
of the problem. The question is, What is the cure? What are we going to 
do to make it better? Are we, perhaps, due to inadvertence or 
unintended consequences, actually going to make things worse than they 
are now?
  The Reid bill, the health care bill that will be considered along 
with a substitute that has been negotiated behind closed doors and 
which we haven't seen, the basic Reid bill would actually increase 
premiums by $2,100 for American families purchasing insurance on their 
own.
  I would like to recall the words of President Obama as he was 
describing his bill. He said:

       I have made a solemn pledge that I will sign a universal 
     health care bill into law by the end of my first term as 
     president that will cover every American and cut the cost of 
     a typical family's premium by up to $2,500.

  Yet this bill breaks President Obama's pledge because for an average 
American family buying their insurance on their own, it would raise 
their premiums by $2,100. According to the CBO and the Joint Committee 
on Taxation, all of the new taxes--the tax on health benefits, if you 
have so-called Cadillac plans. I had three firefighters from Texas in 
my office 2 days who said: Please don't let them tax our health care 
plans. We have negotiated those in lieu of wage increases. We accepted 
lower wages because we wanted a better health care plan. Now you are 
going to tax our health care plan. That is just not right.
  We know those taxes on medical devices, on health insurance, whatever 
they may be--on prescription drugs--eventually will find their way back 
to the consumer. It is sheer fantasy to think these companies are just 
going to absorb those taxes and those cuts and they would not have an 
impact on

[[Page S13366]]

the price to the consumer. That is why rather than bending the cost 
curve down, making health care more affordable, this will actually make 
it worse.
  A new independent study by Oliver Wyman found that the Reid bill 
would actually increase insurance premiums for people with insurance. 
Again, I thought the purpose of health care reform was to bring costs 
down through managed care, medical homes, accountable care 
organizations, delivery reform, medical liability reform, parity of tax 
treatment, increased competition across State lines. Those are the 
kinds of things this bill does not do which would actually have some 
hope of bending the cost curve down for the average American family.
  This study by Oliver Wyman found that the Reid bill would actually 
make people's insurance premiums go up. This study said premiums would 
go up by 54 percent--in my State of Texas, by 61 percent--for Americans 
purchasing health insurance on their own. In other words, it is not 
employer provided. They would have to go out in the marketplace, if you 
are a small business man or woman, and buy insurance or if you are an 
individual buying health insurance, this will make your premiums go up 
by 61 percent in Texas and 54 percent across the Nation. So an average 
family of four in Houston would see their premiums more than double to 
$1,352 a month.
  Is that the kind of health care reform we thought we were signing on 
to when we engaged in this debate? It certainly isn't what I call 
health reform. This is not what my constituents in Texas call health 
reform, to double the premiums for an average family of four in 
Houston. That just makes things worse. Premiums could go up 20 percent 
higher for small businesses struggling to provide benefits for their 
employees.
  The worst part about this is that these kinds of so-called reforms 
have been tried before. They failed miserably. For example, in New 
Jersey and New York, both tried the kinds of mandates, community 
ratings, guaranteed issue--these other things that sound a little 
arcane but which have had the impact of skyrocketing premiums in those 
States and causing insurance companies to leave the market. Rather than 
bearing these financial and regulatory burdens, many of them say: We 
are out of here--leaving people with less choice and higher premiums.
  Then there is the Medicaid-Medicare cost shift. For example, Medicare 
pays about 80 percent of what private insurance does to a doctor or a 
hospital, Medicaid even less. So these providers have to make it up 
somewhere else. What they end up doing is charging more to people with 
insurance. That is what the cost shift is all about. According to one 
study, that cost shift means higher premiums of about $1,800 a year for 
the average family. About half of that comes from Medicaid alone. Yet 
the Reid bill includes the biggest expansion of Medicaid since the 
program was created in 1965. And lest we forget, Medicaid is a joint 
Federal-State program. By expanding the coverage of Medicaid, we are 
basically imposing an unfunded mandate on the States.
  In my State, a State of 24 million people, this Medicaid expansion 
will result in a $20 billion unfunded mandate imposed on State 
taxpayers that the Federal Government is not going to help them out 
with, $20 billion over 10 years.
  The American people intuitively know all of this. A new Washington 
Post-ABC poll came out this week that found that most Americans, 53 
percent, believe Washington's health care bill will actually increase 
their costs. Small businesses know this is true. According to a letter 
I received from the National Federation of Independent Business:

       The Patient Protection and Affordable Care Act, which is 
     short on savings and long on costs, is the wrong reform at 
     the wrong time and will increase health care costs and the 
     cost of doing business.

  Why in the world would we impose additional costs on small businesses 
at the same time we are trying to get small businesses to create jobs 
to try to get our economy to come back? We know that small businesses 
are the engine of job creation. Now we are just going to impose more 
costs, more higher premiums on them. What is that going to do? That 
will discourage them from keeping employees they have in a tough 
economy and perhaps not hiring new people, when we want to do 
everything we can to bring down the 10 percent unemployment rate.
  In Houston, TX, according to one small business owner:

       The proposed health care bill is going to have a negative 
     impact on my business because the cost of employee health 
     insurance will go up. I don't believe what some are saying 
     that the costs will go down. This bill does not make economic 
     commonsense.

  One thing about common sense is, as you find out the older you get, 
it is not too common. This bill simply defies the explanation that some 
have given to it that it will actually make things better rather not 
worse. My constituents, small business owners, everyone understands 
that the pressures put on premiums and costs is going to make things 
worse.
  Here is a chart that shows that from the time this bill is passed 
until 2016, we will see a huge increase in premiums for businesses and 
individuals as well--large businesses, small businesses, individuals. 
Americans know this is going to make an unsustainable status quo even 
worse. Yet the President and the majority----
  The PRESIDING OFFICER. The time of the Senator has expired.

  Mr. CORNYN. I ask unanimous consent for an additional 2 minutes.
  The PRESIDING OFFICER. In my capacity as a Senator from Alaska, I 
object.
  Mr. CORNYN. I thank the Senator for his courtesy.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. CORNYN. Mr. President, I ask unanimous consent to speak for an 
additional 5 minutes.
  The PRESIDING OFFICER. In my capacity as a Senator from Alaska, I 
object.
  Mr. CORNYN. Mr. President, may I inquire of the Chair, is it the 
intent of the Presiding Officer to prevent any Senator from speaking on 
the floor on this important bill? I am looking around. I don't see any 
other Senator waiting to speak. I simply would like an explanation of 
the Chair's ruling.
  The PRESIDING OFFICER. I release my objection.
  Mr. CORNYN. Mr. President, the Congressional Budget Office has said--
this, of course, is the nonpartisan office which is tasked with the job 
of scoring or determining the cost of these bills before us--the CBO 
has opined that the Reid bill will result in 90 percent of Americans 
seeing the same unsustainable premium increases as they currently do 
year after year or, in some cases, even higher. If we are going to 
spend $2.5 trillion over 10 years, if we are going to cut Medicare by 
half a trillion dollars, if we are going to raise taxes by another half 
a trillion just to have no impact for 90 percent of Americans and for 
the others to actually see premiums go up, it strikes me that this is a 
solution in search of a problem.
  The problem is, we know the premiums are too high, costs are too 
high, and we need a better answer than is being proposed by the Reid 
bill.
  The Congressional Budget Office estimates that families who get their 
health care through small businesses or large employers will see their 
premiums go up under this bill. The new ideas we have seen offered by 
our friends on the other side are designed to score political points 
but are not aimed at solving problems.
  For example, one of our colleagues, the Senator from Arkansas, 
offered an amendment to cap compensation for insurance executives and 
argued that it would actually lower premiums somehow miraculously. We 
asked the Congressional Budget Office whether that would have any 
impact on premiums. It said the impact would be negligible. So what is 
the point?
  We have heard a lot about repealing the antitrust exemption for 
health insurers. The CBO said while that may be a feel-good sort of 
provision, that it would actually make premiums higher and make things 
worse.
  The CBO concluded that by enacting the legislation, it would have no 
significant impact on the premiums that private insurers would charge 
for health insurance. They also noted that to the extent insurers would 
become subjected to additional litigation, their costs and their 
premiums charged to consumers might increase.
  We have also heard from some of our colleagues about their cost 
containment ideas, a group of Democratic Senators who offered an 
amendment. I

[[Page S13367]]

think it does have some good ideas in it, but it only saves $200 
million, not an insignificant amount of money, but in a $2.5 trillion 
bill?
  So the bottom line is, this bill spends $2.5 trillion to increase 
premiums or, at best, maintain the status quo. That is not health care 
reform. We should reject this bill and start over with a step-by-step 
approach that will actually solve the problems confronting the American 
people.
  We should not accept, no matter what the crush is before the 
Christmas holidays--these last 8 days of this year--we should not 
accept a bill that cuts $\1/2\ trillion from Medicare, which cuts 
benefits from Medicare Advantage beneficiaries--one-half million of 
whom live in Texas; there are 11 million total--we should not accept a 
bill that raises premiums for many Americans, and we should not accept 
a bill that puts crushing new taxes on small businesses when 
unemployment is at 10 percent.
  I yield the floor and I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ROCKEFELLER. Mr. President, I rise with my colleagues, Senator 
Lieberman and Senator Whitehouse--who are on their way to the Chamber--
to discuss an amendment to strengthen and improve the independent 
Medicare advisory board included in the underlying bill.
  I firmly believe creating an independent authority to help Congress 
make informed decisions about reimbursing Medicare, getting away from a 
fee-for-service system, and making it based upon the cost which is 
incurred--but also the quality which now has to be required: evidence-
based outcomes--that is the direction Medicare, all of health care, has 
to go.
  These are not just cost decisions but quality decisions. I think it 
is critical to sustaining our program and the promise we made to 
millions of seniors that we would do right by them and still keep 
Medicare affordable, keep the trust fund solvent. It is meant to go 
broke in 2017. That does not help hospitals, doctors, Medicare 
beneficiaries, or anybody else. So we have to keep that in mind as we 
talk about this issue.
  I applaud Leader Reid for his bold leadership in including this 
advisory board in his underlying bill. It is a very strong step 
forward.
  In their May report this year, the Medicare trustees determined, if 
we do nothing, the Medicare trust fund will basically go insolvent in 
2017. In health care terms, that is like next February.
  It is abundantly clear if we fail to put Medicare on a path of fiscal 
sustainability, this incredible program--and the security it means for 
seniors in my State of West Virginia and in the Presiding Officer's 
State of Alaska and people everywhere; and the disabled, who are, 
unfortunately, often forgotten--it will be in tremendous danger. We 
cannot allow that to happen.
  So what does this amendment do? If we are serious about protecting 
Medicare's future, we have to be serious how we handle Medicare, how we 
allocate it, and use it as a reimbursement and quality tool. So this 
amendment includes a number of changes to do exactly that.
  The most important change: This amendment eliminates a significant 
loophole in the underlying bill; that is, it eliminates the carve-out 
which was created by some for hospitals and other providers. I repeat, 
it eliminates the carve-out.
  The carve-out now comprises about 60 percent of all Medicare. So it 
is a sham. It has to go or else Medicare is in deep trouble. I wish to 
talk about this a little bit.
  We protect the board's integrity. In fact, we give the board 
integrity and we give them authority. Congress, right now, has the sole 
authority to change Medicare's cost curve. Yet as the ranks of 
lobbyists grow and prey upon Members of the House and Senate--it is 
amazing the relationship between how the cost of Medicare grows and 
their activities.
  Let's be quite honest about it. This is not a politic thing to say, 
but it is the truth. Probably about 12 percent of the Congress 
understands health care down to the wee depth that is needed to be able 
to decide on the reimbursement procedures, the quality outcomes 
procedures, which we use to reimburse Medicare providers. This means we 
have made a lot of mistakes, the cost of Medicare has gone out of 
control, and we provide Medicare reimbursement unevenly and unfairly. 
People complain when they should not; do not complain when they should.
  You have to understand, Medicare is such a powerful force it drives 
prices and it drives policies in health care for years and years to 
come all across the span of health care. It is the elephant in the 
room.
  Power represents an opportunity. Medicare's force and clout can also 
be harnessed in a direction to improve our health care system, improve 
efficiency. That is why I am adamantly opposed to the carve-out for 
hospitals and other providers because it weaves special-interest 
treatment into the very fabric of a board created to remove them from 
the process.
  MedPAC was created by a Republican Congress in 1997. It, in theory, 
decides how Medicare reimbursement is going to be updated on an annual 
basis. The fact is, it has no power to do any such thing. That has to 
be changed.
  Is this a significant change? Yes, it is. Is it just like people 
changing their lives in various ways all across America because they 
are facing situations which they have not faced before? People do not 
have work; people have anxiety over all kinds of subjects; they have 
anxiety over health care, and they should have anxiety over health care 
because, particularly if you are a senior, the Medicare trust fund is 
running out on us.
  So the only way you can do that, in my judgment, is to get away from 
fee for service; that is, you provide the service, and whatever it is, 
I will pay you the fee. It is simple. It is what we have used. It is 
what has gotten us in trouble because we do not insist upon experts 
making these decisions and on demanding evidence-based outcomes in the 
way hospitals, doctors, and others are reimbursed under Medicare. 
Medicare is taxpayers' money. It is not a frivolous matter.
  As was the intent of my original policy, it is time to change the 
equation and put expert evidence and advice at the forefront of health 
care decisionmaking. It is time to take the special interests out of 
the process and create an independent, politically insulated entity 
with its sole job to be to protect Medicare's long-term quality and 
solvency. I am sure many will come and object to that, saying we should 
do that in Congress, but I repeat: Is Congress qualified? Does it have 
the knowledge to the depth that it can make a decision on how much 
providers should be reimbursed? My answer is some do, most don't and, 
therefore, the cost of Medicare keeps rising and the system is more 
endangered.

  I have no doubt that a strong independent Medicare advisory board 
would be a powerful cornerstone for meaningful health reform in all of 
the right directions, but if we want the board to succeed, it needs the 
tools for both Medicare reform and genuine private sector cost 
containment.
  Congress cannot do this on its own. We have proven ourselves 
incapable of making efficient, consistent decisions about Medicare's 
future, which now amounts to a crisis. We cannot continue standing in 
the way of progress. I urge my colleagues to join me in support of this 
truly transformative policy.
  I simply repeat: If we are going to make it in health care, if we are 
going to make it in Medicare, if we are going to preserve the trust 
fund, we have to change the way we do business. People may not like 
that. People will complain about it. People will complain if we do 
nothing. People will complain if we do everything. People complain. 
That is the nature of it. That doesn't matter. What matters is that we 
do the right thing; that we bend the cost curve by making accurate 
decisions; that we are tough in our decisionmaking; and that is what 
this board--and Congress will have a chance to review it but cannot 
override it except by a very substantial vote--and that is what the 
Medicare advisory board is all about. It is the answer to Medicare's 
future, in this Senator's judgment.

[[Page S13368]]

  The security this policy provides for our seniors is too important. 
We need to fight for them, always. We need to protect them. We need to 
protect the solvency of the trust fund, and we need to make sure 
seniors are getting the best possible care. The day has ended when 
people can submit a bill and say: I did this and, therefore, pay me 
that. That is our system now. It is the wrong system. It has gotten us 
into trouble. It is not good for health care, and it is very bad for 
the solvency of the trust fund.
  I see my distinguished colleague Senator Lieberman has arrived. He 
and I have been working on this for some time together, I am proud to 
say.
  I thank the Chair. I say to my colleagues the full text of the 
amendment, No. 3240, is printed in the Record of Tuesday, December 15.
  The PRESIDING OFFICER (Mr. Franken). The Senator from Connecticut is 
recognized.
  Mr. LIEBERMAN. I thank the Chair.
  Mr. President, I am honored to stand and speak on behalf of this 
amendment which I have filed with Senator Rockefeller and Senator 
Whitehouse, and I thank them for their leadership.
  I wish to speak for a few moments about it. It is not a 
noncontroversial amendment, but I think it redeems one of the two 
central promises or goals of this bill. The fact is that a lot of the 
current health care reform debate in fact is focused on issues that are 
not central to two big goals that I think most of us share, which are, 
first, to expand the number of people who have health insurance 
coverage in our country; secondly, to lower the costs, because the 
costs continue to go up way beyond the rate of general inflation in our 
country, and that has a very burdensome effect on millions of 
individuals, families, businesses, our government--indeed, our entire 
economy.
  This amendment focuses on the second of those two big shared goals, 
which is containing the increases in health care costs. It has become a 
mantra around here--but it is never bad to repeat a mantra--which is 
that national health expenditures in our country are now well over $2 
trillion. It is hard to imagine that amount of money, but let me try to 
get inside it.
  We spend twice as much per person on health care as the average 
developed country in the world, but I am afraid we are not receiving as 
a country the best value for our health care spending. The fact is that 
the United States provides some of the best health care in the world, 
but we don't provide it to all of our people and we don't provide it 
efficiently. Medicare and Medicaid account for over 20 percent of the 
Federal budget and over 27 percent of national health expenditures. 
These two programs are expected to rise to equal 20 percent or one-
fifth of our gross domestic product by 2050.
  Here is the animating, motivating fact that brings Senator 
Rockefeller, Senator Whitehouse, and me together to file this 
amendment: The Medicare trust fund, which provides Medicare benefits to 
approximately 37 million senior Americans that they depend on, that 
they have depended on in a way that has helped to extend their lives as 
average life expectancy goes up, the Medicare trust fund is expected to 
be insolvent, out of money, bankrupt, by 2017--unable to pay the bills 
by 2017. That is 8 years from now. It is to prevent that unacceptable 
result that my colleagues and I come forth to file this amendment to 
make sure that by then--we have done a lot of things, but one of them 
is to make the delivery of health care more efficient, the delivery of 
health care to seniors through Medicare more efficient, so they can 
look forward with confidence to having Medicare coverage throughout the 
rest of their lives.
  As we all know, it is not just the ones on Medicare now; the baby 
boomers are coming of age to get on Medicare, and that will add 
enormously to its responsibilities.
  I would say that Senators Reid, Baucus, Dodd, and Harkin did a superb 
job, a very good job, with the Patient Protection and Affordable Care 
Act, the underlying bill, to reduce health care spending and 
particularly to do so while expanding coverage for 30 million more 
Americans, which is the second great goal that I believe we all share. 
While these numbers are encouraging, Senators Rockefeller, Whitehouse, 
and I think we can and should do more, and that is the cost containment 
numbers.
  My colleagues introduced earlier this year the MedPAC Reform Act, 
which created an independent authority, a separate nonpartisan body, to 
make critical health care cost decisions or make recommendations about 
them. In the current Senate health care reform bill, their idea appears 
centrally as the independent Medicare advisory board. It will bring 
together a panel of experts whose mission it will be to extend the 
solvency of the Medicare trust fund by seeking out new efficiencies, 
new cost containments, and improving the quality of care delivered by 
Medicare in the private sector. The board will have the authority to 
make recommendations to the President and Congress to reduce Medicare 
spending in particular ways. Those recommendations will be fast tracked 
through Congress with strict requirements for the committees of 
jurisdiction to review them, report the recommendations to the full 
Congress, and then be subject, those recommendations, to limited floor 
debate, limited by the underlying legislation. If Congress does not 
pass the advisory board's recommendations or adopt other proposals that 
produce an equivalent amount of savings, the Secretary of Health and 
Human Services will be required to implement the board's original 
recommendations.
  As Senator Rockefeller said--this is the second time today I have 
said this--earlier today the Homeland Security Governmental Affairs 
Committee held a hearing on efforts to establish a commission to begin 
to turn around the exploding national debt we have. Part of the reason 
we do that and part of the reason this independent board outside of 
Congress is being created is that we haven't proven ourselves capable 
of controlling costs because we find it a lot easier to say yes to 
people, for good reasons, for humane reasons, but don't find it so easy 
to pay for the resulting costs of our affirmative answers to their 
requests.

  The CBO has estimated that the advisory board in the current bill 
will save $23 billion in the next 10 years. The Obama administration 
and dozens of respected economists have said that the creation of this 
board is instrumental in lowering costs and literally saving Medicare 
from bankruptcy. The amendment I have filed with Senators Rockefeller 
and Whitehouse, I am convinced--certainly our intention is to make this 
independent board stronger so it will result in larger savings and 
contain more costs over the long run.
  There are six provisions in the amendment that I want to denote, 
describe briefly. First, this amendment will extend the board's 
authority to cover hospitals and hospices; sensitive, I know, but the 
board must have the authority to consider the entire breadth of 
Medicare expenditures in making its recommendations to Congress to 
maximize savings for the government, for taxpayers and, most of all, 
for the beneficiaries of Medicare so the program is still there to help 
them.
  Second, our amendment makes it easier for the board to make 
recommendations in the years beyond 2019 than the underlying bill does 
so that it can continue to monitor Medicare over the longer term and 
ensure its long-term solvency. We want those on Medicare now, and those 
coming on Medicare, to be able to depend on it over the course of their 
lives.
  Third, this amendment will raise the amount of savings the board must 
meet in years where Medicare growth exceeds the target growth rate set 
in the law, in the proposal.
  Fourth, we move up the time of implementation of the board's 
recommendations by 2 months to minimize, frankly, the influence of 
interest groups who will be in the normal course of the process 
fighting to stop these cost-effective recommendations.
  Fifth, the amendment allows the board to offer recommendations in 
years where the Medicare growth rate does not outpace the target growth 
rate. The goal of this provision is to be clear that the purpose of the 
board is not just to contain costs beyond a certain standard but also 
to search out constantly for inefficiencies, for waste, for the 
expenditure of Medicare dollars that is not actually benefiting 
Medicare recipients.
  Finally, our amendment clarifies that the purpose of the board is not 
just to contain costs within Medicare but to look more broadly at 
health

[[Page S13369]]

care spending outside of these publicly supported programs. That is 
very significant. It will provide an opportunity for broad savings in 
health care and health insurance for pretty much everybody in our 
country.
  I am proud to join today with my friends, Senators Rockefeller and 
Whitehouse, to announce the filing of our amendment. These six 
provisions will make this advisory board stronger and reduce costs.
  While we disagree on some aspects of health care reform, I hope we 
can agree across party lines that health care spending is out of 
control, and that we can contain it in a way that doesn't threaten 
access or benefits. We must preserve and extend Medicare for future 
generations, and we must ensure that the new private market we are 
creating in health care reform is one where health care quality and 
efficiency justifies the cost.
  The PRESIDING OFFICER. The Senator has spoken for 10 minutes.
  Mr. LIEBERMAN. I wonder if I could ask unanimous consent for an 
additional moment.
  The PRESIDING OFFICER. In my capacity as a Senator from Minnesota, I 
object.
  Mr. LIEBERMAN. Really. OK. I won't take it personally.
  I thank the Chair.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. McCAIN. Mr. President, I ask unanimous consent that the Senator 
from Rhode Island be recognized for 10 minutes followed by the Senator 
from Michigan, the distinguished chairman of the Armed Services 
Committee who will be speaking on the bill, and that I be recognized to 
follow him.
  The PRESIDING OFFICER. Is there objection?
  Mr. LEVIN. No objection. I assume that is for 10 minutes each?
  The PRESIDING OFFICER. Is that for 10 minutes each?
  Mr. McCAIN. Yes. I have been around here 20-some years. It is the 
first time I have ever seen a Member denied an extra minute or two to 
finish his remarks. I must say that I don't know what is happening here 
in this body, but I think it is wrong.
  It is fine with me that it be 10 minutes.
  I will tell you, I have never seen a Member denied an extra minute or 
so, as the Chair just did.
  Mr. LEVIN. If the Senator will yield, I don't object to the unanimous 
consent request on that condition. I think the same occurred earlier 
this afternoon for reasons that have to do with trying to get this bill 
going.
  Mr. McCAIN. I haven't seen it before. I don't like it, and I think it 
harms the comity of the Senate not to allow a Member at least a minute. 
I am sure the time is urgent, but I doubt if it is that urgent.
  I renew my unanimous consent that the Senator from Rhode Island be 
recognized for 10 minutes, the Senator from Michigan for 10 minutes, 
and then that I be recognized for 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Rhode Island is recognized.
  Mr. WHITEHOUSE. Mr. President, I know the Senators have been waiting 
longer than I have. It is a personal courtesy from them to me to allow 
me to join Senator Rockefeller and Senator Lieberman as a cosponsor and 
have our remarks follow in series. I am grateful to both of them.
  I am here to speak in support of the amendment offered by Senators 
Rockefeller, Lieberman, and myself, which would strengthen the 
provisions of the reform bill creating a nonpartisan group of experts 
to put the brakes on out-of-control medical spending.
  One of the first things we can count on in terms of this amendment 
being one to protect Medicare beneficiaries is that the prime sponsor 
is Senator Rockefeller, a man who has dedicated his career since long 
before I was here--even during his days in West Virginia--to looking 
out for seniors and for the disabled and, since he has been in the 
Senate, looking out for Medicare. That is a credential that deserves 
great respect with respect to this amendment.
  One of the most persistent concerns in this health care debate is, of 
course, cost control. I have spoken many times on the floor about the 
overriding importance of cost containment for the future of health care 
and especially the need for innovative delivery system reforms, which 
can be driven by the way you pay providers.
  Our Republican attackers complain that Democrats on the bill are just 
doing more of our usual taxing and spending and that we won't impose 
any discipline on the system. Mr. President, as somebody who has worked 
for years on health care delivery system reform, I can tell you that is 
simply not true. This bill undertakes the most comprehensive redesign 
of our chaotic, wasteful system ever attempted.
  One leading health economist and expert in cost containment, MIT 
professor Jonathan Gruber, recently wrote of the Senate Democrats' 
efforts in this bill that he couldn't ``think of a thing to try that 
they didn't try. They really made the best effort anyone has ever made. 
Everything is in here. . . . You couldn't have done better than they 
are doing.''
  Many critics talk about cost control as if it were just a matter of 
political will, that Congress can come here and cut costs by flipping a 
switch. Well, that may be true if you want to cut benefits for the 
elderly and disabled or if you want to throw the elderly and disabled 
off of coverage or if you want to pay doctors even less for treating 
Medicare patients. But those would be brutal, callous cuts that would 
create human misery and suffering. Better to tackle the waste in the 
system, the $700 billion annually in excess costs found by President 
Obama's Council of Economic Advisers--a number that may actually be as 
high as over $1 trillion every year, according to the Lewin Group and 
to George Bush's former Secretary of the Treasury, Paul O'Neill.
  By this method, you save money by improving the quality and 
efficiency of care; by tackling the multiple sources of waste and 
inefficiency in the system; by improving quality and access to care and 
giving doctors, hospitals, employers, and employees all the correct 
financial incentives to adopt healthy, cost-saving, efficient 
practices. The complexity of getting those incentives right, aligned 
with top-flight health care, versus the power of the interest groups 
that are involved, has historically paralyzed Congress.
  History teaches that the significant national dialog and debate we 
are now having about health care is a momentary exception rather than 
the general rule. It is possible this debate will usher in a sustained 
period of focus on health reform, but the steepening fall of our health 
care system toward catastrophe should counsel us to protect against 
that congressional institutional paralysis.
  This independent, nonpartisan board of experts to help control costs 
in a way that is smart, humane, and not all politics, is important. The 
independent Medicare advisory board will force Congress to act by 
issuing recommendations to reduce cost and increase efficiency that 
will automatically go into effect if Congress does what we so often do 
around here--nothing. If Congress can agree to different ideas, it can 
change the board's recommendations, but we still have to reduce 
Medicare costs by a minimum savings target. In other words, the board 
will force Congress to engage thoughtfully and for the public good on 
the most important fiscal and health issue our Nation faces.
  Senator Rockefeller's amendment strengthens this board in several 
important ways: It expands the circumstances in which the board's 
recommendations go into effect when Congress does nothing. It raises 
the maximum level of savings that the board's recommendations must 
achieve. It ensures all providers of health care services, including 
large hospitals, are equally responsible for bringing down Medicare 
costs. It empowers the board to issue recommendations for improving 
Medicare over the long term, even in years where spending is under 
control.
  My colleagues on the other side of the aisle have depicted the board 
as a frightening, Orwellian, all-powerful dictator that will cut 
Medicare benefits. Hogwash. The bill specifically prohibits the board 
from doing anything to increase premiums, ration care, restrict 
benefits, or modify eligibility.
  The facts no longer seem to matter to our friends on the other side. 
They have called this group the ``rationing

[[Page S13370]]

commission.'' If you look at page 1004, lines 3 and 4, it says this:

       The proposal shall not include any recommendation to ration 
     health care.

  You are entitled to your own opinion--and we all have one--but not 
your own facts.
  It is actually that kind of demagoguery about Medicare that proves 
the case for creating the board. Thoughtful, smart, technically expert 
people under congressional oversight but protected from these partisan 
spasms of congressional vitriol, passion, and folly will make careful 
and consistent decisions for all of our benefits, without diminishing 
the power of the American people and their elected representatives, so 
that we can preserve and protect Medicare.
  I urge my colleagues to support Senator Rockefeller's amendment, in 
which Senator Lieberman and I have so proudly joined him.
  I yield the floor with my thanks to the Senator from Michigan for 
being so gracious in allowing me to join my colleagues in sequence on 
the bill.
  The PRESIDING OFFICER. The Senator from Michigan is recognized.
  Mr. LEVIN. Mr. President, I wish to speak for the few minutes we have 
this afternoon in support of the appropriations bill that is before us, 
the Defense appropriations bill.
  Senator McCain and I and other members of the Armed Services 
Committee have spent a lot of time each year authorizing important 
programs to support our troops, protect our troops, and support their 
families in a whole host of ways. Hopefully, it will authorize funds 
that can help us succeed in Afghanistan and Iraq. That bill is now law, 
and in front of us is an appropriations bill that contains most of 
those same provisions--not all but most of the same provisions.
  It is critically important that this appropriations bill be passed. 
There are differences in this body and between this body and the House 
of Representatives about the policies that are involved in the war in 
Afghanistan and the war in Iraq. That is normal. That is the way it 
should be. We can have democratic debates inside this great democracy 
of ours. We don't have to agree, and we don't on many of the policies 
involved in these two war efforts. Where I believe this body is 
unanimous is that we are determined to support our troops when they are 
in the field regardless of whether we agree with the particular 
strategy they are supporting or whether we happen to have supported 
their mission.
  It has been the tradition of the Congress, once a decision has been 
democratically arrived at to send troops to the field, that we support 
those troops. This appropriations bill has critically important 
provisions in it to support our troops. I believe there is unanimity 
and consensus in this body on those provisions. I will focus on a few 
of those provisions.
  We have added significant funds. One example is the so-called Mine 
Resistant Ambush Protected Vehicles or MRAP. These are life-and-death 
matters we are talking about. These vehicles are a perfect example of 
that. The faster we can get the advanced MRAPs to the field in 
Afghanistan, the more we can get to the field in Afghanistan, the fewer 
Americans are going to be killed in Afghanistan. So we have funds in 
here--more than actually were requested--to send over 6,600 new MRAP 
vehicles, all-terrain vehicles that can function better there than the 
ones we sent to Iraq. These all-terrain vehicles have been designed and 
developed in record time in order to get them to our troops. We should 
be acting in record time on this appropriations bill, and there are 
many reasons for that. Surely, getting more MRAPs more quickly into the 
field is one of those reasons.
  We have an organization called the Joint IED Defeat Organization 
whose sole purpose and mission is to come up with the strategies and 
technologies to defeat these IEDs, these improvised explosive devices 
that are killing our troops. In order to defeat these devices or train 
our troops who are deployed there in how to identify and protect 
themselves against IEDs, we have $1.8 billion in this appropriations 
bill for that organization. They have a laser mission to defeat the 
IEDs. We have to get this money to them.
  This bill needs to be signed. The President has to sign it--and he 
will--so we can get these funds as quickly as possible to our troops. 
We need to adopt this appropriations bill.
  We have pay raises and health programs in the bill. We add $1.3 
billion more than the President requested for the Defense Health 
Program. This covers shortfalls in private sector care, increases funds 
for medical research, including what is called TBI, which are the brain 
injuries, as well as PTSD, which has so afflicted our troops in these 
wars. We add additional funds for those programs. The quicker the bill 
is signed, the faster those funds get appropriated and spent, the 
better off our wounded warriors who suffer from TBI and from 
psychological health problems are going to be.
  In Afghanistan now, one of the key issues is going to be whether we 
can get the Afghan troops trained quickly enough, supported quickly 
enough, given the equipment they need so they, hopefully earlier rather 
than later, can join with us, partner with us, and take responsibility 
for their own security. Regardless of people's differences over the 
policies and strategies in Afghanistan, I believe there is a consensus 
in this body--no matter what the vote ends up being on the bill, 
whether people vote for the bill or against the bill, I would think all 
of us believe we must quickly provide funds to train, support, and 
sustain the Afghan security forces. We want to fund that effort in this 
bill at $6.6 billion.
  Counternarcotics in Afghanistan. We all know the narcotics industry 
in Afghanistan is being used to support the Taliban. We want to 
continue efforts to train Afghan counternarcotics forces and support 
U.S. counternarcotics and interdiction activities in Afghanistan, so 
$300 million in this bill is going to do that.
  We have a fund called the Commander's Emergency Response Program or 
CERP. That fund has been used to great advantage. This bill provides 
$1.2 billion for that Commander's Emergency Response Program; $1 
billion of that is for that program in Afghanistan and $200 million of 
the CERP program in Iraq. This represents about twice as much CERP 
funding for Afghanistan as we had in fiscal year 2009.
  Those CERP funds are able to provide very quickly support and 
economic development village by village. Our commanders are able, 
without going through a whole lot of red tape, to make relatively small 
investments in things which make a difference, in terms of the security 
of our troops and the betterment of the lives of the Afghans. It has 
had a huge, positive impact in terms of the perception of the Afghan 
community about us, satisfying them that we are there for their 
benefit, not just for our benefit. We are not occupying Afghanistan. 
When we leave Afghanistan, we want to leave Afghanistan in better shape 
than we found it. The CERP funds are a major contribution to that goal.
  One of the things we have authorized in the bill, which Senator 
McCain and I and members of the Armed Services Committee have brought 
to this body, was adopted by this body, and signed into law, was the 
authorization to use those CERP funds to help reintegrate, where we 
can, Afghan Taliban fighters into Afghan society--those who will 
renounce violence against the Government of Afghanistan and make a 
commitment to participate in civilian life. We are able to actually 
have the funds that are so essential to make that program work. We do 
not yet have a program in place. That is being worked on as we speak. 
But these funds need to be available to support that program of 
reintegration of Afghans, those low-level Taliban people who are with 
the Taliban not for any ideological reason but because they get some 
pay from the Taliban. Not all the members of the Taliban fall into that 
category. But for the ones who do, this funding becomes critical.
  Mr. President, I will only take a few minutes more, but I did want to 
highlight a few additional points that I believe my colleagues should 
know about.
  The first area pertains to three initiatives that originated in the 
Defense authorization bill that relate to the continuing fight against 
al-Qaida and associated terrorist organizations.
  The bill includes nearly all of the $1.6 billion the administration 
requested for the coalition support fund, which is used to reimburse 
key partner nations, particularly Pakistan, for support provided to the 
United States in Operation Enduring Freedom and Overseas Contingency 
Operations.

[[Page S13371]]

  It includes $350 million in fiscal year 2010, the full amount 
authorized, for the train and equip program to build the capacity of 
foreign militaries to conduct counterterrorism operations and support 
military or stabilization operations in which the U.S. participates. As 
clarified in the fiscal year 2010 NDAA, this authority can be used to 
build the capacity of ISAF coalition partners to prepare their training 
teams and special operations forces to be available for use in 
Afghanistan.
  The bill also provides the full $100 million authorized for the 
authority to transfer funds from DOD to the State Department to support 
State's security and stabilization assistance programs.
  The other area pertains to missile defense.
  The bill before us provides important funding for ballistic missile 
defense programs. It supports the decisions made by Secretary Gates and 
President Obama to restructure the missile defense program with a 
greater focus on regional missile defense against existing missile 
threats. These changes include the termination of the Multiple Kill 
Vehicle Program and the Kinetic Energy Interceptor Program, and cancel 
procurement of additional airborne laser aircraft. This defense 
appropriations act also supports the decision to cap deployment of the 
ground-based midcourse defense system at 30 operational ground-based 
interceptors in Alaska and California, rather than the 44 previously 
planned for deployment.
  The bill supports funding for alternative missile defense systems in 
Europe, to defend against current and future Iranian ballistic 
missiles.
  It also includes an additional $57 million, above the budget request 
of $169 million, to procure more standard Missile-3 interceptors for 
our Aegis ballistic missile defense system. This type of interceptor 
will be at the heart of the new missile defense plan for Europe. The 
amendment also provides the full $1.1 billion requested for the 
terminal high altitude area defense, THAAD, system, which is another 
key element of our regional missile defense capabilities.
  I believe my 10 minutes is up. I thank my good friend from Arizona, 
Senator McCain, for allowing me to go first. The order of priority was 
that he go immediately after someone speaking on this side. But as 
always, his courtesy shines through to me, and I very much appreciate 
it.
  I yield the floor.
  The PRESIDING OFFICER (Mrs. Shaheen). The Senator from Arizona is 
recognized.
  Mr. McCAIN. Madam President, I thank my friend from Michigan. I thank 
him for his leadership of the Armed Services Committee.
  The train is about to leave the station on the last of the 
appropriations bills for 2010 and, unfortunately, nothing has changed. 
Everything is the same--earmarking, porkbarrel, excessive and 
unnecessary spending. Billions in wasteful earmarks again have found 
their way into this bill which could otherwise be spent for the 
priorities that our men and women, our military leaders, as well as the 
Secretary of Defense, has asked for.
  There is in this bill--here we go again: an appropriations bill 
loaded up with earmarks--a 523-page explanatory statement for 1,720 
earmarks totaling $4.3 billion. Let's do some simple math: $4.3 billion 
in pork, $2.5 billion in unauthorized and unrequested C-17s; $500 
million in unrequested and unwanted funding for the Joint Strike 
Fighter alternative engine; and a Presidential helicopter. That is $7.3 
billion that neither the military nor the Defense Department requested 
and does not need--$7.3 billion.
  Some people say that is not a lot of money. It is enough to keep the 
State of Arizonas budget requirements fulfilled for 10 months. States 
across America are facing great difficulties, as we know, and an 
additional $7.3 billion would not be so bad.
  I wish to say, again, this process of earmarking breeds corruption. 
That is why we have former Members of Congress in Federal prison. It 
was not inadequate disclosure requirements that led Duke Cunningham to 
violate his oath of office and take $2.5 million in bribes in exchange 
for doling out $70 million to $80 million of the taxpayers' funds to a 
defense contractor. It was his ability to freely earmark taxpayer funds 
without question.
  I wish to point out, again, the President pledged during the campaign 
he would work to eliminate earmarks. The President, last March, when we 
had an omnibus spending bill, said they would not do it anymore. In 
September, the President spoke in Phoenix, AZ, to the Veterans of 
Foreign Wars. In that speech, the President's words were quite 
compelling about waste and porkbarrel spending in Defense bills. In 
that speech, the President promised--promised--an end to ``special 
interests and their exotic projects'' and reaffirmed he was leading the 
charge to kill off programs such as the F-22, the second engine for the 
Joint Strike Fighter, and the outrageously expensive Presidential 
helicopter.
  The President went on to say:

       If a project doesn't support our troops, we will not fund 
     it. If a system doesn't perform well, we will terminate it. 
     And if Congress sends me a bill loaded with that kind of 
     waste, I will veto it. We will do right by our troops and 
     taxpayers.

  Mr. President, I can tell you, the President of the United States, 
that meets your criteria with over $7 billion of unnecessary, unwanted 
spending. Will the President veto this bill? Not a chance. Not a 
chance. But the American people are going to demand this obscene 
process stop. The American people are going to demand it be stopped, 
wasting $7 billion of their tax dollars on wasteful and earmark 
spending. I am confident they are aware. They are aware we are spending 
$7.6 million to fund research in Montana on hypersonic wind tunnels, 
called MARIAH. This self-licking ice cream cone has been earmarked and 
unrequested since 1998. The Air Force lost interest in 2004, so the 
appropriators moved it to the Army. The Army has no requirement for 
this capability and published a report in 2005 stating their 
disinterest in the program. In summary, we spent $70 million for some 
hypersonic wind tunnels nobody wants--$70 million. Unless we demand and 
receive change, there will be more millions in it next year.
  There is $5 million going to the battleship USS Missouri Memorial 
Association; $18.9 million for a center at the University of 
Massachusetts ``dedicated to educating the general public, students, 
teachers, new Senators, and Senate staff about the role and importance 
of the Senate.'' What does that have to do with defending this Nation? 
What does that have to do with providing the men and women who are 
risking their lives, as we speak, with the equipment they need? Madam 
President, $18.9 million to educate the public about the importance of 
the Senate? Give me a break.
  There is $9.5 million going to the University of Hawaii for a program 
called the Panoramic Survey Telescope and Raid Response System. The 
list goes on and on. The Air Force is paying for this, and the Air 
Force will not be allowed to be getting much in return, since it will 
only be allowed to use the telescope 5 percent of the time. In other 
words, in dollar figures, the Air Force pays $10 million to the 
university and receives $500,000 in return.
  What is more, the Air Force has not, in the 9-year life of this 
earmark, requested a single dollar for this program. Since 2001, the 
Air Force has been forced to spend more than $75 million of its budget 
allocation on a program it does not want.
  I ask unanimous consent to have printed in the Record these other 
porkbarrel earmark programs, such as $1.2 million for the American 
Museum of Natural History Infectious Disease Research.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

       $7.6 million to fund research in Montana on hypersonic wind 
     tunnels, called MARIAH. This self-licking ice cream cone has 
     been with us, earmarked and unrequested, since 1998. The Air 
     Force, leader in hypersonic testing and technology, lost 
     interest in 2004, so appropriators moved the program to the 
     Army. The Army has no official requirement for this 
     capability and published a report in 2005 stating their 
     disinterest in the program. To date, the Army has no plans to 
     fund the MARIAH wind tunnel effort, as they have stated in 
     their budget documents. But that hasn't kept Congress from 
     pouring more than $70 million into it, with no discernable 
     return. One group has made out particularly well in the deal, 
     however. Of course, I'm referring to lobbyists, including 
     Gage LLC, whose CEO, coincidentally, had been a senior 
     staffer to an appropriator from Montana.

[[Page S13372]]

       $5 million to the battleship USS Missouri Memorial 
     Association. This is a private organization which owns and 
     operates this battleship as a museum in Pearl Harbor. I am 
     aware that the Association plans to put the Missouri in dry-
     dock and refurbish it, and also aware that it was not part of 
     the donation agreement that the Defense Department would pay 
     for required maintenance.
       $20 million for the National WWII Museum in New Orleans, to 
     help pay for the construction of new facilities as part of a 
     $300 million expansion. This privately funded museum opened 
     in 2000 and, through the help of the Louisiana delegation, 
     has already received $13 million in Department of Defense 
     funds tucked into previous appropriations bills. This earmark 
     has no benefit to the United States military and will be paid 
     at the expense of equipment and training for our troops, 
     something few WWII veterans would support.
       $14.8 million for five different earmarks pertaining to 
     nano-tube research. Of the 1,720 earmarks in this bill, 
     hundreds are for high-tech research or devices. I ask my 
     colleagues whether they are capable of weighing the merits of 
     specific technologies that they fund in this bill. The answer 
     is they are not.
       $18.9 million for a center at the University of 
     Massachusetts ``dedicated to educating the general public, 
     students, teachers, new Senators, and Senate staff about the 
     role and importance of the Senate.'' This center was neither 
     requested in the President's budget nor authorized by 
     Congress.
       $9.5 million to the University of Hawaii for a program 
     called the Panoramic Survey Telescope and Raid Response 
     System (Pan-STARRS). On the surface, this program seems like 
     a reasonable need for the Air Force as a part of its Space 
     Situational Awareness efforts. Unfortunately, the Air Force 
     won't be getting much return on this investment, since it 
     will only be allowed to use the telescope 5 percent of the 
     time. In dollar figures, the Air Force pays $10 million to 
     the University and receives $500,000 in return. What's more, 
     the Air Force has not, in the nine-year life of this earmark, 
     requested a single dollar for this program. So, since 2001, 
     the Air Force has been forced to spend more than $75 million 
     of its budget allocation on a program it doesn't want--but 
     might be able to use--only to be denied use 95% of the time.
       $500,000 for the Brown Tree Snake Program.
       $1.8 million to renovate and upgrade the Historical Fort 
     Hamilton Community Club in the New York City area.
       $1.6 million to study human genetics at the Maine Institute 
     for Human Genetics and Health in Brewer, Maine.
       $3.5 million for a Micro-algae Biofuel Project in Hawaii.
       $5 million for the Presidio Heritage Center, a museum, in 
     San Francisco.
       $1.6 million for the Center for Space Entrepreneurship.
       $2 million for National Initiatives for Applications of 
     Multifunctional Materials.
       $1.6 million for a Virtual Business Accelerator for the 
     Silicon Prairie.
       $7.8 million to develop key technologies needed for long 
     term operations in ``near space'' conditions for the Orion 
     High Altitude Long Endurance Risk Reduction Effort, Aurora 
     Flight Sciences in Columbus, Mississippi.
       $2.4 million for Fusion Goggle System.
       $800,000 for ``Advanced Tactical Laser Flashlight'' in 
     Wyandotte, MI.
       $2 million for Cedars-Sinai Medical Center's Operating Room 
     of the Future, Los Angeles, California.
       $4.8 million for New Vaccines to Fight Respiratory Disease 
     and Central Nervous Disorders at the Iowa State University.
       $720,000 to survey epidemiologic health for the University 
     of Iowa.
       $3 million for the New Jersey Technology Center.
       $1.2 million for American Museum of Natural History 
     Infectious Disease Research.
       $1.6 million for Army Plant Vaccine Development Program.
       $1.4 million for Flight/Hangar Deck Cleaner.
       $4 million for the Hampton University Proton Cancer 
     Treatment Initiative.
       $10 million for the Hawaii Technology Development Venture.
       $3.9 million for Intelligent Decision Exploration.
       $12 million for Laser Phalanx.
       $2.4 million for Marine Mammal Awareness Alert and Response 
     Systems.
       $2 million for a Marine Mammal Detection System.
       $2.3 million for Marine Species.
       $1.2 million for the Maritime Directed Energy Test and 
     Evaluation Center.
       $3.2 million for a National Functional Genomics Center 
     Collaborating Site.
       $2.4 million for NAVAIR High Fidelity Oceanographic 
     Library.
       $2 million for Non Traditional Ballistic Fiber and Fabric 
     Weaving Application for Force Protection.
       $4 million for Smart Instrument Development for the 
     Magdalena Ridge Observatory.
       $2 million for underwater imaging and Communications Using 
     Lasers.
       $800,000 for Unmanned Undersea Vehicle Submerged Long Range 
     Positioning.
       $2.4 million for an Unmanned Vehicle Sensor Optimization 
     Technologies Program.
       $8 million to study oceans at the Center for Excellence for 
     Research in Ocean Sciences.
       $2 million for an Advanced Laboratory for Information 
     Integration in Hawaii.
       $2 million for PaintShield for Protecting People from 
     Microbial Threats.
       $3.2 million for Playas Training and Research Center.
       $1.2 million for Progressive Research for Sustainable 
     Manufacturing.
       $1.6 million for Protective Self-Decontaminating Surfaces.
       $1.5 million for the Institute for the ``Advancement of 
     Bloodless Medicine'' for the Englewood Hospital in Englewood, 
     New Jersey.
       $1.2 million for the Model for Green Laboratories and Clean 
     Rooms Project.
       $1.6 million for the Maine Center for Toxicology and 
     Environmental Health at the University of Southern Maine in 
     Portland, Maine.
       $6 million to study the molecular signatures in tumors for 
     the National Functional Genomics Center.
       $1.6 million for Multi-Dose Closed Loop pH Monitoring 
     System for Platelets at Blood Cell Storage Inc., Seattle, 
     Washington.
       $4.8 million for the National Oncogenomics and Molecular 
     Imaging Center in Detroit, Michigan.
       $800,000 for the Natural Gas Firetube Boiler Demonstration, 
     Rock Island Arsenal, Illinois.
       $5.8 million for the Rock Island Arsenal Roof Replacement, 
     Rock Island, Illinois.
       $800,000 for Near Infrared Spectroscopy Military Personnel 
     Assessment at the University Community Hospital, Tampa, 
     Florida.
       $4.2 million for the Nicholson Center for Surgical 
     Advancement Medical Robotics and Simulation in Central 
     Florida.

  Mr. McCAIN. Madam President, the list goes on and on: $2 million for 
the Cedars-Sinai Medical Center's operating room of the future in Los 
Angeles, CA. That is the second earmark I have seen. The other one is 
for irritable bowel syndrome. Now we have the operating room of the 
future. Remarkable.
  There is $2.3 million for marine species; $2 million for a marine 
mammal detection system. There is a threat. Also, $2.4 million for 
marine mammal awareness alert and response system. The list goes on and 
on.
  I know my time is near to expire.
  Here we are with a deficit of $1.4 trillion for this year, a debt of 
over $12 trillion, unemployment at 10 percent, 900,000 families lost 
their homes in 2008, and we are spending over $7 billion on earmarks, 
porkbarrel projects the Department of Defense neither needed nor wants, 
and there are programs not fully funded because of this that are vital 
to defending the lives of the men and women who are serving in the 
military.
  Again, this appropriations bill is a disgrace.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Mr. KERRY. Madam President, I rise to speak on something else, but I 
will say very quickly, I have listened to colleagues on the other side 
of the aisle lamenting where we are today. It has been 11 months since 
a new President was inaugurated and, obviously, everybody understands 
this is not a mess he created. The last 8 years of the stewardship of 
this country, where there was never one appropriations bill vetoed in 
that entire time, is an extraordinary story of public negligence and 
even malfeasance.
  We are where we are. We are creating jobs. The economy is turning 
around. We had the least loss in the last 11 months. We are beginning 
to see those changes. We will ultimately have the strength in our 
economy to deal with this deficit.


                        Tribute to David McKean

  Madam President, I rise for a different reason right now. It is a 
bittersweet privilege for me to speak about my friend and my counselor, 
David McKean, staff director of the Foreign Relations Committee, who is 
leaving the Senate at the end of this month to become the chief 
executive officer of the John F. Kennedy Library Foundation.
  I have enjoyed the benefit of David's advice for almost 20 years now. 
He will be sorely missed. My only consolation is, this son of 
Massachusetts will again be able to vote for me.
  He has been a part of my life in the Senate since 1987, when I was a 
freshman and he was a younger and idealistic legislative assistant. 
Over the years, I have drawn significantly on his knowledge and his 
skills. He leaves the Senate now to continue in public life, but he 
leaves it a little bit older but still idealistic and young at heart.
  When he came to our office, he had already made a mark. He had 
graduated magna cum laude from Harvard College and received a law 
degree from

[[Page S13373]]

Duke University and a master's degree from the Fletcher School of Law 
and Diplomacy. He also taught English at the Waterford Kamhlaba School 
in Swaziland, Africa. But he was a crusading soul deeply interested in 
public policy, with a zeal for investigations and an instinct to hold 
Washington accountable. He was looking for a place to put all those 
interests to work in the Senate, and he found it.
  But he also found something more, I might add--much more--that summer 
of 1987. There was a young Kellogg fellow from the University of 
Pennsylvania working in my office at that time. Her name was Kathleen 
Kaye. She was extraordinarily smart and committed. David did not fail 
to notice those qualities and a lot more. Their marriage and their 
three wonderful children, who I am pleased to say are with us right 
now, Shaw, Christian, and Kaye, are a tribute and more to the 
relationship they share.
  David has devoted his career to public service. After 5 years of 
working in my office, he moved across the Capitol as chief of staff to 
another member of the Massachusetts delegation, Representative Joe 
Kennedy. He later became special counsel at the Commodity Futures 
Trading Commission before returning home to the Senate as deputy chief 
counsel at the Governmental Affairs Committee and staff director of the 
Permanent Subcommittee on Investigations.
  I failed to mention that before going to the Permanent Subcommittee, 
he worked with my staff early in his career in helping to develop one 
of the great investigative efforts in the Senate in recent memory, 
which was the BCCI investigation. That wound up on the cover of Time 
magazine and was a seminal report--one of the best reports I have seen 
in the 26 years I have been here.
  In 1999, I was lucky to entice him to come back to my office as chief 
of staff. It turned out to be his longest tenure in any of those public 
jobs so far. Earlier this year, when I became chairman of the Foreign 
Relations Committee, he became the staff director.
  David is the ultimate team builder and a magnet for great talent, so 
he would be the first to tell you that his success did not come single-
handedly. But it is clear David played the essential role in turning 
2009 into a stellar year for the committee and for its new chairman. 
Under his guidance, we conducted 125 hearings on topics ranging from 
Afghanistan to Zimbabwe. We secured passage of the Enhanced Partnership 
with Pakistan Act, and we won approval of legislation bringing far-
reaching reform to our foreign assistance program. He has worked 
tirelessly with the committee members and the White House over the past 
year, and our record is a testament to his determination and skill. I 
think our committee has succeeded in going through the nominations of 
more people and passing them more rapidly to the floor than any other 
in the Senate, and I congratulate him for that effort.
  Somehow, during his career of service, he has found time to indulge 
in his passion for history and scholarship. He is the author of a 
highly acclaimed biography of Tommy Corcoran, the ultimate Washington 
insider. He also wrote a biography of Clark Clifford, which was a New 
York Times ``notable book of the year,'' and he is the coauthor of 
``The Great Decision,'' which skillfully, and perhaps surprisingly, 
transformed the story behind the Supreme Court's landmark Marbury v. 
Madison case into what the Washington Post called ``a political 
thriller.''
  As those of you in this body know, we are--all of us--really only as 
capable or competent as our staff. Over the years, I have depended on 
David McKean at every stage. He has been the consummate adviser--
trustworthy, loyal, unafraid of speaking up when I was about to veer 
off in the wrong direction--which, clearly, was very seldom indeed. 
Never was he more valuable to me than in the immediate aftermath of the 
2004 Presidential election. Forty-eight hours after an election night--
and early morning and early afternoon--that didn't end up the way that 
I had hoped it might, I returned to the Senate for a vote. Back to 
work. I don't remember what the vote was about, but I do remember that 
David was there with a plan to get us through the day and the next 2 
years. I will miss that wisdom and guidance.
  Our loss is the Kennedy Library's gain. In some ways, I think 
something like the Kennedy Library is the perfect place for this man 
who is at heart a scholar and an intellectual. But the Kennedy Library 
is particularly well-suited to David because it is a place Jackie 
Kennedy hoped would help turn history into advocacy and activism, and I 
have no doubt David's vision and experience will help to ensure that 
the legacy of President Kennedy endures to inspire future generations.
  Madam President, I want to close by simply saying that my colleagues 
and I are grateful for David's distinguished service. I will personally 
miss him very much. I wish him, Kathleen, and their children my very 
best as they return home to Massachusetts to start this next special 
chapter in David's career in public service.
  I yield the floor, and I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Ms. STABENOW. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Ms. STABENOW. Madam President, I ask unanimous consent that at 5:30 
p.m. today, the majority leader be recognized to make a motion to 
recess until 12:01 a.m.
  Mr. SESSIONS. I object.
  The PRESIDING OFFICER. Objection is heard.
  Mr. SESSIONS. Reserving the right to object, if I might, if the 
Senator would propose her request again.
  Ms. STABENOW. Madam President, I ask unanimous consent that at 5:30 
p.m. today, the majority leader be recognized to make a motion to 
recess until 12:01 a.m.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Ms. STABENOW. Madam President, I rise to speak about the position we 
find ourselves in as we come to the end of the year. Despite the 
incredible successes we have had with the recovery act and equal pay 
and the Children's Health Insurance Program and so many other areas 
where we have been focused and working hard to make a difference, every 
step of the way, as with the current bill, we have been faced with 
stalling tactics, objections, and filibusters. Now with the very 
important Department of Defense funding bill, we are in a filibuster 
again. I had to make the motion I offered because we will have to come 
in at 1 o'clock in the morning and have a vote to stop a filibuster. 
That is what this is all about, filibustering a bill that has a pay 
raise in it for our troops, that has help for military families, that 
has the funding for the next year--we are in the middle of two wars--
essential funding that is needed to support our military. As our 
Presiding Officer knows, having been a leader on this as well, we also 
have placed into this bill provisions that are incredibly important for 
families, extending unemployment insurance for families across the 
country who find themselves in a situation not of their making where 
their job has gone away or they have been laid off because the company 
can't continue to employ them, maybe because of rising health care 
costs, which is certainly part of the equation. People are finding 
themselves in a situation where due to nothing they have done other 
than be a good citizen, care for their kids and follow the rules, they 
are without employment. We have this year extended unemployment 
insurance--and I am so grateful that President Obama has been willing 
to do this, has helped to lead this in the recovery act and then again 
as we ended a filibuster, a month-long filibuster in October, brought 
that to an end in November to extend unemployment insurance. We find 
ourselves again, because of the unemployment situation, even though we 
see it getting a little bit better, with a long way to go. We are 
moving in the right direction, but we have a long way to go. This bill 
would extend for 2 months unemployment insurance that is critical for 
families. It would also extend help with health insurance. We are 
debating the larger health reform bill to create a way for families to 
be able to afford insurance and for us to bring down costs over the 
long run for businesses and for families.

[[Page S13374]]

  This bill in front of us that is being filibustered by the 
Republicans would extend help for health care, for health insurance, 
for COBRA payments--a program put in place that made a lot of sense. If 
you lose your job, you could pay on your own to continue the coverage. 
But it is incredibly expensive.
  So recognizing that, and recognizing how tough it is when you lose 
your job and you are in a situation--it is either savings or 
unemployment insurance or both--and you are trying to make the mortgage 
payment and care for the kids and put food on the table and pay the 
electric bill and all of the other things, and then to add a several 
hundred or several thousand dollar payment for COBRA on top of that has 
not been realistic for families. So we have placed a 65-percent 
subsidy, to help families get through this tough time, for health 
insurance. We also have assistance for food for families who, right 
now, again, have never had to ask for help before in their lives but 
now have a situation where they cannot put adequate food on the table 
for their children.
  This bill is very important, and what we have in front of us, 
unfortunately, is another filibuster, another objection--like we have 
seen all year--to stop us from moving forward to fund our military, to 
support our troops with a pay raise, to help military families, and 
then to do a number of other things that are critical to do in the 
short run until we get into the new year and are able to focus more 
broadly on these things.
  As the Presiding Officer knows, this is not the first time this has 
happened. We have had from the party of no 98 different objections this 
year. This is a record, a world's record I think: 98 different times 
that we have seen them objecting, filibustering, having stalling 
tactics to moving forward on things that ought to be bipartisan.
  These are not Democratic issues when somebody has lost their job or 
when a small business needs help or needs health insurance they can 
afford or when a family finds themselves in a situation where they need 
to be able to have help to continue their health insurance or put food 
on the table. This is not a Democratic idea or a Republican idea, this 
is American.
  We have Democrats, Republicans, Independents, people who do not have 
a party, people who are not active politically, people who vote, people 
who do not vote. They are losing their jobs. They expect us to get it. 
They expect us to have a sense of urgency around here.
  The troops who are serving us right now, who are in tougher times 
than we will ever face, are not saying what matters is whether you are 
Democrat or Republican as to whether we fund the troops and fund the 
Department of Defense and give them a pay raise they have earned and 
need or to help their families. They are saying: Come on. Come 
together. Solve problems. Get things done.
  But yet, over and over--and we find ourselves tonight where we are 
going to be stopping a filibuster at 1 o'clock in the morning on a bill 
to fund the Department of Defense, on a bill that would help families 
get through the holiday season, keep a roof over their head, pay their 
heating bills, and keep food on the table.
  To dramatize this even more, it is stunning to think about the fact 
that out of the 40 weeks we have been in session this year--40 weeks--
for 36 of those weeks, we have had filibusters or stalling tactics, 
objections to amendments or objections to bills being put on the floor. 
That means only 4 weeks out of the entire year we have been in a 
situation where the Republicans have not been saying no, have not been 
stalling on things that are incredibly important.
  Even with all of this, by any objective measure, there has been more 
accomplished this year than in any other time since the Great 
Depression. We need to be accomplishing more and faster because people 
have a tremendous sense of urgency about what is happening in their 
lives right now. So we need to be acting. Think of what we could have 
gotten done. We have all the things that have gotten done and have been 
addressed. Think about what we could have gotten done if we did not 
have 36 weeks of filibusters that we had to deal with and objections we 
had to deal with.
  I hope, as we are going through this new year, there will be a sense 
that it is time to get things together here and work for the common 
good and put people back to work and tackle their health care costs and 
make sure people can afford to have health insurance.
  Let me close by sharing a story from Annette from Lake Orion, MI. She 
says:

       After a successful 21-year journalism career, I was laid 
     off in May when my newspaper closed. I will turn 60 in 
     October and am a 12-year survivor of breast cancer. My 
     husband, who is 62, is on my health insurance.
       Thankfully, the federal government is helping [us] pay for 
     our COBRA, which would be more than $800 a month.
       Senator, we're not pleading poverty. But it's easy to see 
     the dilemma of many Americans in our shoes: Risk going 
     without health insurance, you risk bankruptcy if someone gets 
     sick. Pay the current price, and watch your life savings, 
     which were supposed to support you in [your] old age, dwindle 
     down.
       Don't listen to those screaming to maintain the status quo; 
     it doesn't work for too many Americans.

  We have story after story where people are facing an early 
retirement--not by choice--dipping into retirement savings to try to 
keep their health care going. Young people, old people need us to act 
now, and I am urging Congress to act now.
  The PRESIDING OFFICER. The Senator's time has expired.
  Ms. STABENOW. I thank the Chair.
  The PRESIDING OFFICER. The Senator from Alabama.
  Mr. SESSIONS. Madam President, it is very distressing that Senator 
Stabenow could not finish her remarks and that other Senators such as 
Senator Whitehouse and Senator Levin and Senator Lieberman have been 
shorted of time. Why? Because, for some reason, the majority leader 
feels we should not go past 5:30 tonight.
  This is a defense bill, and it is important. We need to be talking 
about the good things that are in it and the things that have been 
added to it that are not so good. I do not think working a few extra 
hours is going to hurt anybody.
  I hear colleagues complain that they cannot work a weekend, they 
cannot work up to Christmas, they cannot work at night. Well, what 
about our men and women who are serving in Iraq and Afghanistan 7 days 
a week, 12 hours a day, Christmas and holidays? They are away from 
their families so I do not have any sympathy for any Member of the 
Senate who feels this is too hard for them. Also, I do not appreciate 
the fact that we are shut off from debate tonight to be able to talk 
about this issue that is before us. I see no reason for that to have to 
occur.
  I object to the health care bill. The American people object to the 
health care bill--sixty-one percent say no. But we are supposed to now 
agree and go along with the majority? And if we do not, we are some 
sort of obstructionists? I do not think so. I believe I am representing 
my constituency. I believe I am representing the best interests of the 
United States of America. I do not believe this health care bill is 
part of that.
  With regard to the armed services bill--I am a member of the Armed 
Services Committee, and I have been a Member for 12 years; I have been 
to Iraq six times and Afghanistan six times--I believe it is great we 
can give our soldiers a pay raise and support them. A lot of things in 
the bill are good. There are some that are cut too much, but there are 
a lot of things that are good, and I wish to vote for the bill. But 
this defense bill has $18 billion in unrelated spending items attached 
it: increased unemployment, COBRA, food stamps, and loan subsidies for 
businesses.
  Two things strike me about this. First, these new expenditures are 
not paid for. They are not within the budget. They are above the 
budget. What does that mean? Well, the budget itself has us in deficit. 
So if it is not paid for in the budget resolution, every penny of this 
$18 billion goes straight to the debt of the United States of America. 
We need to stop this.
  Second, why did they put this kind of spending on the defense bill? 
Because they want to come down here and say: Anybody who is not willing 
to go along with this scheme to pad $18 billion straight to the debt of 
the United States of America--anybody who objects does not love our 
soldiers.
  That is wrong, and people are getting tired of that. This is how the 
debt of this country is surging out of control.

[[Page S13375]]

This Congress is irresponsible in our spending. We have increased the 
debt the likes of which this Nation has never seen, and we are spending 
as if it is going out of style.
  I would point out one matter here about the interest we pay on the 
debt. In 2008, the annual deficit was $450 billion--at that time, the 
largest ever. This past year, the deficit for the fiscal year ending 
September 30 was $1,400 billion, $1.4 trillion. This puts us on the 
map, according to the Congressional Budget Office, to double the entire 
debt of America in 5 years, and triple it in 10. Unbelievable.
  This is a kind of gimmick--attaching unpaid for, nonbudgeted items to 
the defense bill, then trying to force it through, so we cannot do 
anything about it. They snicker, I am sure, in their self-confident way 
that: We got 'em. If they object to the bill, we will say they don't 
love our soldiers, they don't support America's defense.
  I am getting tired of it. I think the American people are getting 
tired of it. I saw a poll where the most popular party in America today 
is the tea party--more than Republicans or Democrats.
  Somebody said: Well, $18 billion, Sessions, that is not too much 
money. But it is done on bill after bill. This is not the only bill 
that has these kinds of gimmicks in it. Let me show you. I figured this 
out one day. I put together a chart here a little bit hastily: Baseline 
Increases: A Destructive Pattern.
  When we increase funding in these bills above the budgeted amount and 
increase the debt, people like to think: Well, it is just $18 billion. 
That is not much.
  Look how that works when you do it over a period of ten years. So 
let's say next year, we go over $18 billion. This adds another $18 
billion to the national debt. Well, that is not so much. But wait, it 
is a lot. The State of Alabama's general fund budget is $2 billion. Do 
not tell me $18 billion in one bill, on top of this defense bill, is 
not a lot of money. It is a huge amount of money.
  But it does not work that way. This $18 billion tends to go into the 
baseline, so the next year, when they talk about increasing the budget, 
they pad it by another $18 billion. It is not just $18 billion the next 
year, you see. It is $18 billion on top of what was pumped into the 
baseline the year before, and that totals out to $36 billion. Then the 
next year, it is $36 billion, plus $18 billion more. And the next year, 
it is $54 billion, plus $18 billion more. The next year it is $72 
billion, plus $18 billion. The next year, it is $90 billion, plus $18 
billion. And the next years, it is $108 billion, $126 billion, $144 
billion, and $162 billion if you pad the budget. And this bill is just 
1 of 13 accounts: Defense. We have 13 different spending bills. How 
much is that? It is $900 billion in additional deficits, just because 
of our inability, our unwillingness, to stay by the numbers that we 
voted on as our budget limit.

  The budget itself, as presented by the President and passed by the 
Democratic majority, put us on a road to having $1.4 trillion in 
deficit last year, and it looks as though this year we are going to 
have a another $1.4 trillion deficit. But just this one little gimmick, 
if it is replicated each year, can add almost $1 trillion more to the 
debt of America over ten years. That is why we are concerned about it.
  By the way, when we talk about the scheme that puts us on the road, 
according to the Congressional Budget Office, to tripling the debt of 
America by 2019, that does not include the health care bill. The health 
care bill has not passed. This outlook only includes the things that 
are in law now. So how much more would those figures be if the debt 
goes up?
  I will point to one last thing about the overall financial status of 
this country: the interest we pay on that debt. This chart shows it.
  Last year, this Nation paid $170 billion in interest on the 
borrowings we have as a nation. In that 1 year it was $170 billion. 
That is a lot of money. As I said, not counting the State education 
budget, for all the other matters of our State of 4.6 million people--
which is almost one-fiftieth of the Nation's population, an average-
sized State--our general fund is $2 billion. However, $170 billion is 
how much we paid in interest last year. According to the Congressional 
Budget Office, those numbers will increase to where in 2019, as a 
result of surging debt, $799 billion will be added to our debt because 
of interest we must pay; $799 billion just in that 1 year. That is more 
than the whole defense budget. That is more than the whole U.S. 
discretionary budget from not too long ago. That is a huge amount of 
money. It is going to crowd out spending for schools, for highways, for 
health care, and for other projects.
  I am very upset about it. We cannot continue. The President has said 
this is an unsustainable course. Every economist we talk to says it is 
an unsustainable course.
  But how do we get there? We get there by taking a Defense bill and 
tacking on $18 billion worth of unfunded spending. Every penny of that 
gets added to the debt.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. SESSIONS. I thank the Chair.
  I urge my colleagues to send this bill back and reform it so we can 
have a clean Defense bill. We need to take these unpaid matters out and 
make sure they are paid for.
  I thank the Chair and yield the floor.
  Mr. JOHNSON. Madam President, I rise today to recognize this 
incredible opportunity to dramatically improve the health of our 
Nation. Americans face out-of-control health care costs, great 
inequalities in access to care, eroding benefits, and the ever-
increasing threat of losing their health insurance. While it is no easy 
task to fix a system that is both very complex and very troubled, we 
cannot fail to act.
  I wish today to highlight the challenges faced by approximately 12 
million Americans who buy health insurance in the individual market. 
Many farming and ranching families in South Dakota are forced to 
purchase from this market, where they all too often wind up 
underinsured with coverage that costs too much and provides too little.
  South Dakotans have contacted me directly to report health insurance 
discrimination that results in increased premiums, refusal of coverage 
for necessary treatments, and denial of coverage. I have even heard 
complaints from people who work in the insurance industry, like Pam 
from Sioux Falls, SD. She shared with me the serious barriers people 
encounter when looking for health insurance on the individual market. 
``There are huge loopholes in the individual market. People who are not 
healthy cannot get insurance. We turn people away every day and they 
want to buy health insurance.''
  Insurance companies increase their profits by selling to individuals 
who will pay premiums but rarely use their benefits, and by avoiding 
individuals who have health issues. This cherry-picking leaves millions 
of Americans without access to affordable health insurance coverage. 
And when families go without health insurance, they receive less 
preventive care and often must undergo more costly medical treatment 
when illness progresses undetected. This uncompensated care for the 
uninsured drives health care costs up for all of us.
  Those who buy insurance on the individual market pay top dollar for 
very limited coverage. They will benefit immensely from health reform. 
The Patient Protection and Affordable Care Act will increase the 
insurance options in the individual market and address injurious 
insurance industry practices that limit access to care. Immediately 
after enactment, a new program will be created to provide affordable 
coverage to Americans with preexisting conditions until insurance 
industry reforms are fully implemented. The legislation will also form 
health insurance exchanges in every State through which those limited 
to the individual market will have access to affordable and meaningful 
coverage. The exchange will provide easy-to-understand information on 
various health insurance plans, help people find the right coverage to 
meet their needs, and provide tax credits to significantly reduce the 
cost of purchasing that coverage.
  Pam says, ``People who want to buy individual insurance should be 
able to, regardless of their health status.'' I couldn't agree more. 
The Patient Protection and Affordable Care Act will ensure that no 
American is denied coverage because of their medical history, and it 
will provide the security of meaningful, affordable health care 
coverage for all.

[[Page S13376]]

  Mr. JOHNSON. Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. REID. First of all, Madam President, I apologize to everyone. I 
indicated to both the majority and the minority that we would be here 
at 5:30, but I had some things that came up, and I simply could not be 
here.

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