[Congressional Record Volume 157, Number 54 (Wednesday, April 13, 2011)]
[Senate]
[Pages S2439-S2442]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         CONTINUING RESOLUTION

  Mr. WHITEHOUSE. Mr. President, later this week, we will consider a 
spending measure to fund the United States Government through the 
remaining 6 months of this fiscal year. While the majority leader is on 
the Senate floor, I want to thank him, as well as Appropriations 
Chairman Inouye and Senator Patty Murray, for their hard work in 
negotiating an end to the budget stalemate and preventing the 
threatened government shutdown.
  The battle over that spending measure brightly illuminated the 
contrast between the priorities of the two parties. The priorities of 
the House Republicans, I believe, are completely upside-down. In the 
debate over the spending bill, they fought to cut programs that helped 
the middle class and for extreme tea party policy riders that had 
nothing to do with the budget. These included a prohibition on funding 
for women's health and eliminating the Environmental Protection 
Agency's ability to protect us against carbon and other pollution.
  At the same time, the House Republicans refused to even consider 
raising revenue by closing tax loopholes, for instance--not one. They 
refused to entertain ending even one corporate tax giveaway or one 
special treatment for wealthy taxpayers.
  If that debate didn't make the contrast between the two parties 
crystal clear, the House Republican budget for 2012--the so-called Ryan 
budget--sure did. In his budget, Congressman Ryan proposes privatizing 
Medicare and requiring seniors to pay the majority of their health 
expenses with their own money. They would get a voucher, which actually 
would go to the insurance company, and the difference would be up to 
them. In the same document in which Congressman Ryan would decimate 
Medicare, he would cut taxes for millionaires and billionaires by 
trillions of dollars.
  Now, one major factor that contributed to our budget deficit is the 
economic crisis that we recently weathered. It is amazing the amnesia 
we can have in Washington. We are not even through the recession that 
has been so painful for so many families in Rhode Island, and yet we 
seem to have forgotten that economic crisis. Well, those of us who were 
here ought to remember the desperate urgency that was displayed by 
Treasury Secretary Hank Paulson and Federal Reserve Chairman Ben 
Bernanke as they, having looked into the economic abyss, came to this 
building--to the LBJ Room right here in the Senate--to plead with us 
for help to save the world economy. These are not two easy men to 
frighten, and they were very frightened.
  We are now past the worst depths of the financial and economic 
crises, and as this chart shows, the economic recovery measured in jobs 
is proceeding, although all too tentatively and all too slowly in Rhode 
Island. We are still at 12 percent unemployment in the Providence 
metropolitan area and over 11 percent statewide. Now that we are 
finally creating jobs--but very few compared to the job losses of the 
crisis--now that we are finally at least on the good side of the 
equation, House Republicans have proposed yanking government support 
for the recovery and jeopardizing many of the jobs that are on this 
chart.
  Their spending proposal, H.R. 1, would have cut spending so severely 
that former McCain Presidential campaign economic adviser Mark Zandi 
estimated it would cost as many as 700,000 jobs.
  Just look at our job gains: For February, 222,000; for January, 
68,000; for December, 167,000; and for November, 128,000. We would wipe 
out months and months of job gains with a 700,000 job loss.
  Goldman Sachs, the Wall Street investment bank, said this bill--H.R. 
1--could reduce the growth in our annual gross domestic product by two 
full percentage points over the rest of the year. We were only 
expecting about three percentage points of growth, so to knock off two 
of them is a big hit on jobs.
  So I will begin by pointing out that as we deal with the debt and 
deficit, we cannot forget about jobs. It is growth, ultimately, and a 
recovering economy that will help reduce our national debt.
  As you will recall, the Republicans also resisted any efforts to 
close any corporate tax loopholes. Corporations, our Republican friends 
contend, are overtaxed, and any closing of a loophole would amount to 
an unacceptable tax hike. So let's look for a minute at the actual 
state of things. Let's look at the facts for a minute.
  This is the actual state of corporate tax payments in America. In 
1935, for every $1 an American individual contributed to our revenues, 
American corporations also contributed $1. By 1948, American 
individuals were contributing $2 for every $1 that corporate America 
contributed. By 1971, it broke through 3 to 1. In 1981, it broke 
through 4 to 1. And in 2009, we broke through 6 to 1, with American 
individual taxpayers contributing every year to our annual revenues six 
times as much as American corporations.
  So we have gone, in a lot of people's lifetimes--you have to be 
pretty old, but there are plenty of people who remember 1935--from, 
basically, even-Steven between corporate America and individual 
Americans, with individual Americans carrying six times the tax burden 
of corporate America. So when people say how overtaxed corporate 
America is, it is worth looking at this history of ever-diminishing 
corporate contributions to our Nation's revenues.
  Let's look now at one of the factors that is driving the erosion of 
corporate tax revenues. This is an interesting house--a building 
located down in the Cayman Islands. It is not particularly large, kind 
of nondescript. Our Budget Committee chairman, Kent Conrad, uses this 
photograph quite often.
  This building may not look like a beehive of economic activity, but 
over 18,000 corporations claim they are doing business in this 
building. That is correct; 18,000 corporations claim to be doing 
business in that little building. It gives a whole new meaning to the 
phrase ``small business'' when you think of trying to pack 18,000 
corporations into that little structure.
  Well, as Chairman Conrad has pointed out, the only business being 
done in that building is funny business or monkey business with the Tax 
Code. Tax gimmickry. This nonsense is estimated to cost America as much 
as $100 billion every year. For every one of those dollars lost to the 
tax cheaters, honest taxpaying Americans and honest taxpaying 
corporations have to pay an extra dollar or more to make up the 
difference.
  Now, let's go to another building that has a tax story to tell. This 
is the Helmsley Building in New York City. It is a nice-looking place. 
The building is big enough to have its own Zip Code. That means the IRS 
reports of tax information by Zip Code can tell us a lot about this 
building. Here is what this building tells us from actual tax filings 
and actual tax payments.
  The well-off and very successful, indeed, admirable occupants of that 
building paid a lower tax rate than the average New York City janitor. 
The average tax rate of a New York City janitor is 24.9 percent. The 
average tax rate of a New York City security guard--I am sure the 
Helmsley Building has security guards--is 23.8 percent. But the average 
tax rate actually paid by the occupants, the successful, capable, but 
well-compensated occupants of that building, is 14.7 percent, about 
three-fifths of the rate that their janitors and security guards are 
likely paying.
  So that seems as though it must be extraordinary, but, believe it or 
not, that is no fluke. The IRS reports the tax rate that is actually 
paid by the highest earning 400 Americans. They have to go back a few 
years to do the calculations, but here is their most recent 
information, and the story is the same. The highest earning 400 
Americans each earned on average more than $344 million--more than $1/3 
billion in 1 year--and the average tax rate those 400 high-income 
earners actually paid was 16.7 percent.

[[Page S2440]]

  I applaud their success. It is the American dream writ large when 
somebody can make $1/3 billion in a single year. But when they only pay 
16.7 percent, it makes you wonder. You might wonder, for instance, at 
what wage level does a regular single working person start paying 16.7 
percent in total Federal taxes? If you are a single filer without 
deductions, you hit 16.7 percent of your salary going to the Federal 
Government in taxes at $18,650 in salary.
  So what does that equate to for jobs? The Bureau of Labor Statistics 
calculates that in my home State, in the Providence labor market, a 
hospital orderly is paid on average $29,000 a year. That means that the 
400 biggest income earners in America, each earning on average $1/3 
billion, are paying the same tax rate as the hospital orderly pushing 
that cart down the linoleum hallways of the Rhode Island Hospital at 2 
o'clock in the morning. That is the way the code actually works. There 
are a lot of people in between that and making what a hospital orderly 
makes, and they pay a lot more in taxes than 16.7 percent. But when you 
get to the very high end, when you get to the occupants of the Helmsley 
Building, when you get to the people making $1/3 billion a year, those 
tax rates actually paid go down to the point where they are paying the 
same rate as the janitor--less than the janitor--and the same rate as 
the hospital orderly.
  I have heard my colleagues say that rates go up the higher income you 
pay, and nominally they do. But when you look at what is actually paid, 
when you look at what goes through our contorted Tax Code system, out 
the back end come these extraordinarily low actual tax payment rates 
for the most well-off and well-compensated Americans.
  If you go to the corporate Tax Code, that makes little more sense. 
Decades of lobbyists have carved our corporate Tax Code into a Swiss 
cheese of tax loopholes, of tax earmarks for the rich and powerful. The 
result? We have a nominal corporate tax rate of 35 percent. But here is 
what the New York Times reported recently. General Electric, one of the 
Nation's largest corporations, made profits of over $14 billion last 
year and paid no U.S. taxes--none. Indeed, it actually received a $3.2 
billion refund from the American taxpayer.
  I read recently that Goldman Sachs in 2008 reportedly paid income 
tax, Federal tax, of 1 percent. Maybe those were 1-year anomalies, but 
if you look at a previous analysis by the New York Times, of 5 years of 
corporate tax returns, consolidated, that analysis found that 
Prudential Financial only paid 7.6 percent--less than our hospital 
orderly; Yahoo, 7 percent; Southwest Airlines, 6.3 percent; Boeing, 4.5 
percent; and what looks to be our tax avoidance champion, on $11.3 
billion of income, the Carnival Cruise Corporation paid less than 1.1 
percent in Federal taxes averaged over those 5 years. One recent paper 
actually calculated Carnival Cruise Lines' effective tax rate at 0.7 
percent on $11.3 billion in income. Carnival Lines doesn't just take 
you for a cruise, they are taking all of us for a ride. Good, honest 
CVS, a corporation in my home State, pays full freight. Why should they 
pay 30 times the tax rate of Carnival Cruise Lines? It makes no sense.
  But wait, there is more. Don't forget that we make the American 
taxpayer subsidize big oil to the tune of at least $3 trillion a year, 
and big oil has made $1 trillion in profits this decade. They hardly 
need to raid the pockets of the American taxpayer, but on an effective 
tax rate basis, the petroleum-gas industry pays the lowest rate of any 
industry.
  I think these are all noteworthy landmarks of where we are in our 
budget and debt and deficit discussion. But the big landmark, what I 
call the Mount Everest of landmarks that casts its shadow over the 
entire budget discussion, is health care. Representative Ryan's health 
care budget proposal is radical and would create terrible harm for 
seniors. But I do agree with Representative Ryan on his statement that 
says the following:

       If you want to be honest with the fiscal problem and the 
     debt, it really is a health care problem.

  He is right, and the landmark feature of this landmark problem is 
this: The health care cost problem is a health care system problem. Our 
national health care costs are exploding. The health care system is 
driving up the costs of Medicare. The health care system is driving up 
the costs of Medicaid. The health care system is driving up the costs 
of private insurance--of BlueCross, of United. The health care system 
is driving up the cost of the military's TRICARE system and the VA 
system. No one is exempt. It doesn't matter who your insurer is, the 
health care system is what is driving the costs in public and in 
private programs alike.
  We have to address the health care system problem if we are going to 
get our health care costs under control. Simply going after one manner 
of payment, such as the Medicare system, misses the real target and 
will cause us to fail at our endeavor.
  Instead of tackling this vital problem of the underlying growth in 
health care costs, the Ryan budget would end Medicare as we know it. 
Just look at these numbers. I was born in 1955. It was at $12 billion, 
the entire national health care system. By 1979, it was up to $219 
billion; by 1987, $512 billion; by 1992, $849 billion; and from 1992 to 
2009, it has soared to $2.5 trillion. This is a rocket every insurer is 
on, and you can't just throw the Medicare people off of their health 
care and pretend you are going to do anything about bringing down that 
accelerating curve. But instead of tackling the underlying growth, the 
Ryan budget would end Medicare as we know it. That would be a tragedy 
and a mistake.
  Medicare, along with Social Security, is one of the most successful 
programs for human well-being in the history of the world. It allows 
tens of millions of older Americans to enjoy their golden years with 
minimal concern about paying for health care. Paired with Social 
Security, Medicare guarantees American seniors the freedom to retire 
without fear of privation or destitution. As with Social Security, 
American workers pay for this privilege through payroll taxes, and they 
have a right to the retirement benefits that they have been promised 
and that they have earned.
  The House Republican budget drafted by Mr. Ryan would break our 
pledge with Americans who have been paying Medicare payroll taxes by 
ending Medicare as we know it and replacing the single-payer system 
with vouchers for private care that will not come close to paying the 
full cost of insurance. Indeed, that may be an understatement. 
According to the nonpartisan Congressional Budget Office, the Ryan plan 
would leave the average senior with over $12,500 in out-of-pocket 
expenditures that they would have to pay by 2022. That is nearly as 
much as the average Rhode Islander gets from Social Security now.
  The current Medicare system is projected to cover 68 percent of a 
senior's health care costs in 2012, and the Ryan plan would only cover 
25 percent. Three-quarters of a senior's health care responsibility 
would be on them, and Medicare would only pick up 25 percent. That is 
an unaffordable and a indefensible burden that destroys the freedom and 
the security Medicare provides to seniors and provides to their 
children as well.
  Don't forget that we all enjoy the freedom of knowing our parents 
will be taken care of no matter how dread the disease they suffer, and 
we do not have to compromise our choices in life in order to hedge 
against the fear that our parents will suffer such an indignity, such a 
terrible result. It helps all Americans to have that freedom in our 
seniors' hands, to have that fear lifted from their and our hearts.
  The Ryan plan is 180 degrees from where we should be on health care 
reform. It would greatly increase costs. Costs go up because of how 
inefficient private insurance is--for the average senior, from a 
projected $14,770 under current policy to $20,510, a 39-percent 
increase in the underlying cost--in other words, a huge giveaway to the 
private health insurance industry that would get these vouchers. It 
would ignore the potential for tremendous savings in delivery system 
reform and saddle seniors with enormous out-of-pocket expenses.
  As I said, rising Medicare costs are not driven by Medicare. Every 
insurer has their costs going up like a rocket on that chart I showed. 
We have to get at the problem of the underlying cause.

[[Page S2441]]

  How do we do this? We actually have a pretty good health care toolbox 
that has five major tools in it. One is quality improvement. Quality 
improvement saves the cost of errors, of missed diagnosis, of 
disjointed care, and so forth. For example, hospital-acquired 
infections alone cost about $2.5 billion every year, and they are 
virtually entirely avoidable. They should be and could be ``never'' 
events. That alone would save $2.5 billion, and quality improvement can 
extend far beyond just the realm of hospital-acquired infections.
  Two is prevention programs. Prevention programs avoid the cost of 
getting sick in the first place. More than 90 percent of cervical 
cancer is curable if the disease is detected early through Pap smears. 
Three, you pay doctors for better outcomes rather than for ordering 
more and more tests and procedures. That will save money while 
improving outcomes for Americans.
  Four is a robust health information infrastructure which will save 
billions of dollars a year and open exciting new industries once it 
takes life. We are approaching that tipping point now, I am glad to 
say.
  Finally, five, the administrative costs of our health care system are 
grotesque. The insurance industry has developed a massive bureaucracy 
to delay and deny payments to doctors and hospitals. So the doctors and 
the hospitals have had to fight back and hire their own billing 
departments and their own consultants.
  I visited, a little while ago, our little Cranston, RI, community 
health center. They told me there that half their staff is dedicated 
not to providing health care but to fighting to get paid. On top of 
dedicating 50 percent of their staff to trying to get paid, they have 
to spend another $200,000 a year on fancy consultants. All of that, the 
entire war over payments between insurers and hospitals, adds zero 
health care value.
  We have heard that on the private insurance side, anywhere from 15 to 
30 percent of the health insurance dollar gets burned up in 
administrative costs. We know we can do better because the cost of 
administering Medicare is closer to 2 percent of program expenditures.
  So you add up all of this, all those five strategies, the numbers are 
enormous. The President's Council of Economic Advisers has stated that 
5 percent of GDP can be taken out of our health care system costs 
without hurting the health care we receive. That is about $700 billion 
a year.
  The New England Health Care Institute says it is $850 billion a year. 
The well-regarded Lewin Group has estimated the probable savings at $1 
trillion a year, a figure that is echoed by former Bush Treasury 
Secretary O'Neill.
  Those are very big numbers, but not only are they big numbers, they 
represent results that are a win-win. Remember the five strategies: 
higher quality care with less errors and infections; prevented 
illnesses so you do not get sick in the first place; secure, complete 
health records that are there when you need them electronically, so 
your doctors, your lab, your pharmacy, your hospital, your specialists 
all know what everybody else is doing; payments to doctors and 
hospitals based on keeping you well and getting you well, rather than 
on giving you more procedures and more tests; and, finally, not so much 
of that infuriating insurance company bureaucracy hassling both 
patients and doctors.
  Those are not bad outcomes even without the savings. So what do we 
draw from this if we keep all these landmarks in mind, landmarks of 
where we are as we approach this budget debate? Well, our colleagues on 
the other side, particularly our House Republican colleagues, say they 
are determined to reduce our annual deficit on our national debt. That 
is their top priority.
  But they only want to seem to address 12 percent of the budget, the 
nonsecurity discretionary spending, and examine no savings at all on 
the revenue side. If we are serious about deficit and debt reduction, 
why risk destroying 700,000 jobs, when job destruction only adds to the 
deficit and to our debt through lost economic activity and lost 
revenue?
  If we are serious about deficit and debt reduction, why is there not 
one corporate tax loophole--not one--on the chopping block? Why is the 
entire Tax Code off limits in this discussion as it burns up 6 billion 
hours that Americans spend every year--6 billion hours that Americans 
spend every year--complying with its contorted requirements.
  Why must that hospital orderly, pushing his or her cart down the 
linoleum hallway at midnight, pay a higher tax rate than some of the 
most fortunate and able Americans making hundreds of millions of 
dollars each in a single year? If we are serious about this, if 
deficits and debt are the most important thing we face, why no 
discussion of corporate America's ever-diminishing contribution as a 
share of our Nation's revenue? Should that not be something we at least 
consider?
  If we are serious, why is there no plan for even one of the 18,000 
corporations in that phony-baloney headquarters in the Cayman Islands 
to pay its proper taxes? If we are serious, why is there so much pure 
political nonsense about ObamaCare and socialized medicine, instead of 
a mature discussion about using and improving the tools in the health 
care bill to address our grave national health care system problem.
  Why has Representative Ryan proposed taking a sledgehammer to 
Medicare, instead of making thoughtful and efficient investments to 
improve the way we deliver health care?
  It seems to me that until one corporate tax loophole is on the table, 
until one subsidy to big oil is on the table, until one subsidy to big 
agribusiness is on the table, until we are even beginning to talk about 
billionaires contributing Federal revenue beyond the share of their 
income that hospital orderlies contribute, until we are not so casual 
about threatening 700,000 jobs and perhaps $20 billion in related tax 
revenue that job loss would cause, until then, it is still politics as 
usual and it is not a sincere desire to tackle our debt.
  I have always found that you get a better read looking what people 
actually do, rather than just believing whatever they say. If you look 
at what Republicans made their priorities on the CR debate and in the 
Ryan budget, look at what they do. It is the same old Republican 
agenda: attacking programs that help the poor, attacking women's right 
to choose, attacking national voluntary service, helping polluters get 
around public health measures, reducing the share of revenues paid by 
corporations, and very high-income individuals. It is the same old 
song.
  Most important, the problem is that if you go that road, it is not 
adequate to meet the serious problems at hand. We need to look 
throughout the budget and across all our opportunities to bring down 
our Nation's deficits and to bring down our Nation's debt. Everyone 
needs to participate, including our corporate community, including our 
wealthiest, most talented and most fortunate, everyone. We cannot--we 
simply will not--get out of the debt and deficit problem we have if we 
put the whole load of that on the backs of the American middle class.
  I look forward in the months ahead to a serious, fair, and sensible 
discussion, a mature discussion of how to reduce our deficits and our 
debt.
  I yield the floor.
  Mrs. FEINSTEIN. Mr. President, I wish to speak to the war on women's 
health and Planned Parenthood.
  To be clear, to end Federal funding for Planned Parenthood is to stop 
providing critical health care to millions of Americans, the majority 
of them who are poor and simply cannot afford services anywhere else.
  This effort will strip the poor and middle classes of their right to 
preventive healthcare.
  Through 800 nationwide locations, Planned Parenthood provides cancer 
screening, HIV and STD tests, contraceptives, education and 
empowerment.
  Planned Parenthood estimates it prevents over 620,000 unintended 
pregnancies and 220,000 abortions each year.
  Seventy-five percent of its clients are at or below the poverty line. 
Abortions account for just 3 percent of its overall activities.
  What House Republicans seem to have forgotten is that by existing 
law, taxpayer funding cannot be used for abortions except in cases of 
rape, incest, or if the woman's life is in danger.
  A ban on Federal spending for abortions has been in place since 1976. 
That is 35 years this ban has been in place.

[[Page S2442]]

  Yet today House Republicans continue to try to strip Planned 
Parenthood of its Federal funding and continue to use this issue as a 
bargaining chip in a debate over the budget.
  But the vote the Senate will have to take is clearly not about the 
budget, it is a war on women's health. This effort would essentially 
turn back the clock on women's health.
  I said this last week, and I will say it again. This is simply an 
opportunity for the right wing in the House to really sock it to 
American women.
  Let's talk about the facts.
  Over 90 percent of care provided by Planned Parenthood is preventive. 
Planned Parenthood provides care to almost 3 million patients 
nationwide every year, many of whom have no other place to go.
  Only 3 percent of Planned Parenthood's total services are abortion 
services. And that 3 percent is not made up of Federal funds.
  Every year, Planned Parenthood provides affordable contraception for 
nearly 2.5 million patients, nearly 1 million cervical cancer screens, 
830,000 breast exams, and 4 million tests and treatments for sexually 
transmitted infections, including half a million HIV tests.
  These critical preventive services include annual exams, flu 
vaccines, smoking cessation, and well baby care.
  Planned Parenthood helped to prevent 612,000 unintended pregnancies 
in 2009 alone. Every dollar invested in helping women avoid unintended 
pregnancies saves $4 in public funds.
  And House Republicans want to eliminate Federal funding for this 
program?
  These cuts are biased, politically motivated, and hurts women--
particularly low-income women.
  Seventy-five percent of Planned Parenthood's clients have incomes at 
or below 150 percent of the Federal poverty level.
  In California alone, Planned Parenthood serves over 750,000 patients, 
over 680,000 of them through federal funds.
  This program is necessary, effective, and oftentimes a last resort.
  Let me share a story from one woman from my home State of California.
  Mary couldn't afford annual visits to her regular OB/GYN office 
during college. So a friend suggested she visit Planned Parenthood for 
a free exam.
  Mary said, ``After some hesitation I went. Thank god that I did. 
During my visit they found that I had the first signs of cervical 
cancer. I was 19 and terrified.
  ``The staff at Planned Parenthood was so supportive and 
understanding. One doctor in particular was amazing, I wish I could 
find her and thank her personally. She went out of her way to call and 
check up on me once a week until I had recovered completely from the 
procedure that got rid of the cancerous cells.''
  Six years later, Mary is still healthy and still so grateful for the 
excellent and compassionate care she received at Planned Parenthood.
  There are thousands of other stories like Mary's. I have heard from 
these young women who went to Planned Parenthood for STD screening and 
birth control, when they had no other place to go.
  I have heard from women pleading with me to preserve Federal funding 
to Planned Parenthood; telling me that the cancer screenings they 
received saved their lives.
  The House Republicans also want to defund the Affordable Care Act, 
and block critical consumer protections in the law.
  This too targets women. House Republicans want to go back to the days 
where women could be denied insurance coverage for the ``preexisting 
condition'' of being pregnant.
  They want to reinstate gender rating, where insurance companies 
charge women higher premiums simply because of gender.
  House Republicans want to remove maternity care as an essential 
health benefit. Currently only 12 percent of health plans in the 
individual market offer any maternity coverage.
  So you see, defunding Planned Parenthood and the Affordable Care Act 
is not about reducing the deficit or balancing the budget. It is about 
harming women.
  We need to look carefully at our spending and we need to make cuts, 
but not at the expense of the women in our country.
  It is a shame that the budget debate has turned into an ideological 
war.
  It is a shame that funding for health care and family planning is 
considered ``government waste'' by some Republicans.
  When in reality, it is an ideological assault on women's health. I do 
not support any cuts that harm women and children.
  I urge my colleagues return to the issue at hand so we can seriously 
discuss the Federal deficit, absent an ideological agenda.

                          ____________________