[Congressional Record (Bound Edition), Volume 153 (2007), Part 10]
[Senate]
[Pages 14369-14374]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. WHITEHOUSE. Madam President, in the last few days, I have come to 
the floor to speak about reform of our broken health care system: how 
to make that system run better, so that tens of billions of dollars are 
not wasted every year, so we no longer lose as many as 100,000 
Americans every year to avoidable medical errors, so that we no longer 
spend vastly more of our GDP every year than any other industrialized 
nation for poorer health care outcomes.
  I believe three central things need to be reformed. One is improving 
the quality of care in ways that drive down costs. I spoke about that 
on Tuesday and used the example of an intensive care unit reform in 
Michigan that saved $165 million in 15 months and saved over 1,500-plus 
lives. We need to encourage a lot more of that. The second major reform 
we need is of health

[[Page 14370]]

information technology, and I spoke yesterday about the dire state of 
information technology in health care today-the Economist magazine 
reported that the health care industry was the worst of any American 
industry except the mining industry and the significant savings we 
could generate from expanding our use of health information technology. 
The RAND Corporation predicted that adequate health information 
technology would save us from $81 billion to $364 billion per year. We 
need desperately to capture those savings.
  Today, I want to talk about the third piece of this reform: repairing 
our health care reimbursement system, the way we pay for health care, 
so that the economic signals we send into the system produce the care 
we want. Improving quality of care will be an uphill struggle until our 
payment system rewards it. Health information technology will lag 
behind other industries until the economics of investing in it makes 
sense for participants in the health care sector.
  These problems can each be fixed, but the repair will work better if 
the three solutions proceed together, not necessarily as one, but 
staying close, because they are mutually reinforcing.
  The payment system for health care expenditures today sends all the 
wrong messages: it rewards procedures rather than prevention; it 
rewards office visits more than email contacts; it neglects best 
practices and discourages innovation. To a large degree, the system has 
been co-opted by today's unfortunate business model for health 
insurance. This is a business model which seeks first to cherry-pick 
the healthy customers and abandon the sick ones, second to try to deny 
coverage if a customer does get sick, and third to try to deny claims 
whenever their sick customer's doctor tries to send in the bills. 
Health care economics gets in the way of the change we need, gets in 
the way of improved quality of care, gets in the way of investment in 
information technology and illness prevention, and gets in the way of 
lowered costs.
  The problem is best exemplified by a tale from a book called 
``Demanding Medical Excellence'' by Michael Millenson. Northfield, MN, 
Madam President, is a town I am sure you know. It is a town of only a 
few thousand people, but it was home to four very innovative doctors at 
Family Physicians of Northfield. They discovered they could reduce the 
average treatment cost of a urinary tract infection from $133 to only 
$39, a savings of nearly 70 percent, by changing their practice 
pattern. Instead of doing an office examination, a complete urinalysis 
and culture, sensitivity studies for antibiotics, prescribing ten days 
of antibiotics, and a follow-up culture, they attained the same results 
with a phone conversation with a patient, a complete urinalysis, and a 
prescription for three days of antibiotics. But pretty soon, the Family 
Physicians at Northfield were so good at treating their patients--for 
urinary tract infections and other diagnoses--that their waiting room 
was empty. As a reward for their good work, the practice lost so much 
revenue, from never-performed lab tests and empty appointment calendars 
that, in 1995, Family Physicians of Northfield, was forced to close. 
These doctors were taught a harsh, and perverse, lesson by our present 
health care system, and that lesson is: reduce costs and improve care, 
and you will be punished.
  In Rhode Island, our hospitals are pursuing quality improvement 
projects in every intensive care unit in the state, modeled on the 
Michigan program that saved $165 million in 15 months and over 1,500 
lives as well. The Rhode Island intensive care unit program had a 
significant hurdle to overcome, however: the cost was expected to be 
$400,000 annually per intensive care unit, and the hospitals had to pay 
it. The savings were estimated to be $8 million, but those savings 
would not go back to the hospitals. The savings went to payers. So, for 
its $400,000 invested, a hospital actually stood to lose money, from 
shorter intensive care unit stays and fewer complications, so fewer 
procedures to remedy the complications. Truly pushing that quality 
envelope, and striving for zero tolerance in infections and errors, was 
against the hospital's best economic best interests. It took the 
special, collegial relationships developed within our Rhode Island 
Quality Institute to solve this payment dilemma between our hospitals 
and insurers.
  A similar analysis pertains to prevention investments. The payer has 
to shoulder 100 percent of the cost today, but the savings in 
forestalled illness might not occur for years. Maybe by then the 
customer will be some other insurer's customer, then maybe Medicare's. 
If you are the insurer, why take the chance and assume that cost, if 
the savings will not accrue to you?
  There are many ways to repair perverse incentives in the way we pay 
for health care, but one that makes sense to me and uses existing 
infrastructure would be the following. Let medical societies and 
specialty groups, who create ``best-practices'' within their specialty, 
submit those best practices--including cost-effective prevention 
programs--for approval by local health departments. If, after suitable 
administrative procedures, the best practices are approved, reward the 
effort by differentiating, in Medicare and Medicaid reimbursement 
rates, between care that follows the local best practices and care that 
does not. Reward the effort by forbidding any insurer operating in 
interstate commerce--any health insurer--from using ``utilization 
review''--that is their word for denying payment--for care that is 
delivered within these approved best practices. Require them to pay all 
those claims, in which the provider followed best practice protocols, 
within 30 days.
  The legislation I have prepared will do just that.
  This legislation sets a lot of good forces in motion. It encourages 
development and dissemination of best practices in medicine. It 
encourages doctors to follow those best practices, and discourages the 
wide and unjustifiable variations in medical treatment evident now. It 
encourages a sensible one-time debate in a professional, administrative 
forum at the time approval or amendment of the best practices is 
sought, and it discourages the wildly expensive payment battle now 
fought, claim by claim, between insurers and providers. I know from my 
experience as the insurance commissioner for Rhode Island how much time 
and money insurers and providers spend in claims administration. 
Studies have estimated that $20 billion is spent every year in this 
bitter and expanding arms race, both by insurers seeking to deny claims 
and doctors seeking to defend their claims, and every dollar of that 
fight is wasted. Doctors in Rhode Island tell me regularly that as much 
as half of their staff is engaged in this billing battle. Instead of in 
providing health care for their patients.
  My legislation will engage the medical community in a thoughtful way. 
It will bring best practices to the forefront. There is a lot of 
discussion about comparative efficiency in health care today, debates 
over which treatments and methods are most effective--this legislation 
will provide a truly meaningful forum for those discussions. An 
example: Recently, the New York Times reported on a 40-step protocol 
implemented for bypass surgery patients by Geisinger Health Systems, 
which right now can be implemented only within Geisinger hospitals. 
This bill would allow these protocols, if pursued by the local 
cardiology association and approved by the State health department, to 
get favorable reimbursement statewide. I hope this bill will help the 
health insurance industry look to a new business model where your 
insurance company is looking out for you, is your advocate when you are 
sick, reminds you when testing or prevention is appropriate, helps you 
find the best practices or care, where your insurer is your navigator 
and your adviser in the health care system instead of your adversary.
  This legislation can help repair our health care system. It puts the 
priorities and incentives in the right place so market forces are 
unleashed in our favor. It uses existing structures, just in new ways. 
It is designed and mandated to be budget neutral. And it does no harm 
if it does not work right away,

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if doctors do not take it up, if health departments will not hold the 
hearings, no harm is done But let's give it a chance to work.
  Let me close by saying how important this moment is. I serve on the 
Budget Committee and have heard the troubling facts about what the 
health care system will cost us in years to come. By the year 2050, the 
combined cost of Medicare and Medicaid will rise to eat up 22 percent 
of our gross domestic product. Further, as my friend Budget Chairman 
Conrad has noted, the 75-year net present value of the unfunded 
liabilities in Social Security and Medicare equal $38.6 trillion, and 
$33.9 trillion of this total is for Medicare alone. The health care 
system is eating up our economy, costing twice as much as the European 
Union average. There is more health care than steel in Ford cars and 
more health care than coffee beans in Starbucks coffee. It is 
significantly hampering our competitiveness. It is the number one cause 
of American family bankruptcies.
  By acting now, by acting in advance, by bringing some sensible 
economics and some sensible management and some helpful incentives to 
our health care system, we can start to grapple with its cost. And if 
we take on that fight here and now, while time is still on our side, we 
can reduce costs in the best possible way: by improving the quality of 
care, by making Americans healthier, by preventing illness before we 
have to treat it, by avoiding expensive and often fatal medical errors, 
by giving our doctors the decision support other professionals have had 
for decades, in sum, by making our health care system better. 
Considering the stakes, shame on us if we fail in that duty.
  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. REID. Madam President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                            SENATE DEMOCRATS

  Mr. REID. Madam President, Democrats earned the majority in Congress 
last year by strongly opposing the President's failed Iraq policy and 
advocating restoration of the values of working families in relation to 
our Government. The American people sent a clear message last November 
it was time to change course in Iraq. Congressional Democrats made that 
our top priority in the first day in this Congress, and have every day 
since. In less than 4 months, we have been able to send to the 
President's desk a number of things to keep our Government open; and 
that is the case literally.
  In less than 4 months, we have been able to send to the President's 
desk things he refused in years past, because now there is a 
Congressional branch he has to deal with.
  As it relates to Iraq, the President has vetoed the bill which 
reflected the wishes of the American public and many senior military 
leaders and a bipartisan majority of Congress.
  Last night we sent him another bill that doesn't go as far as I would 
like, and the majority of the Democratic Senators, and that is an 
understatement. But it does begin the process of holding the President 
and the Iraqis accountable.


                              Polling Data

  I think it is important to note how the American people feel, that 
this isn't just a bunch of politicians talking in Washington. There was 
a poll taken by the New York Times and CBS that was reported today. It 
was a very in-depth poll. When we do polls at home, those of us who 
serve in government, they do samplings of 400 to 600 people. This poll 
was twice that big. Almost 1,200 adults were sampled, so the margin of 
error was very low when this poll was done.
  Among other things, it said 61 percent of Americans say the United 
States should have stayed out of Iraq, and 76 percent say things are 
going badly there, including 47 percent who say things are going very 
badly. President Bush's approval ratings remain the lowest of his 
office in more than 6 years: 30 percent approve of the job he is doing; 
63 percent disapprove. More Americans, 27 percent, now say that 
generally things in the country are seriously offtrack. This is the 
lowest number of approval and the highest disapproval rating since 
these polls have been taken.
  Public support for the war has eroded: 61 percent say the country 
should have stayed out of Iraq; a majority, 76 percent, including 51 
percent of Republicans, say additional troops sent to Iraq this year by 
Mr. Bush either have had no impact or are making things worse. Most 
Americans support a timetable for withdrawal; 63 percent say the United 
States should set a date for withdrawing troops from Iraq sometime next 
year. The poll found Americans are more likely to trust the Democratic 
Party than the Republican Party by a significant margin. More than half 
said the Democratic Party was more likely than the Republican Party to 
make the right decisions about the war. More broadly, 53 percent of 
those polled said they have a favorable opinion of the Democratic 
Party.
  As for Mr. Bush, 23 percent approve of his handling of the situation 
in Iraq, 23 percent; 72 percent disapprove. Madam President, 25 percent 
approve of his handling of foreign policy; 65 percent disapprove. And 
27 percent approve of his handling of immigration issues, while 60 
percent disapprove.


                             Senate Agenda

  Regarding the war in Iraq, I have spoken over the last week to two 
parents in Nevada--one in Reno, one in Fernley--who have lost sons in 
Iraq. Multiply that almost 3,500 times. I can't imagine the grief and 
despair. During the last 3 days, 17 American soldiers and marines have 
been killed in Iraq, 3 days--9, 2, and 6. It is an American tragedy. As 
I said last night on this floor, we will not stop our efforts to change 
the course of this war until either enough Republicans join us with 
regard to this war to reject the President's failed policies or we get 
a new President.
  At the same time we have opposed the President's Iraq policy, we have 
moved forward on legislation that invests in our security, our economy, 
and our health. In a matter of days, we will have as law a raise in the 
minimum wage. Sixty percent of the people who draw the minimum wage in 
America are women, and for more than half those women that is the only 
money they get for their families. It was important that we raise the 
minimum wage, and we did that. It was long overdue.
  We have also provided, and will shortly have signed into law, $400 
million to ensure that States don't run out of money for the State 
Children's Health Insurance Program. In the coming weeks, we will seek 
to reauthorize this successful program that keeps millions of children 
healthy. We may not be doing much for adults in health insurance, but 
we are taking steps forward with our children.
  For 3 years we have tried to pass legislation that would give relief 
to farmers and ranchers. We have been unable to do that. The Republican 
majority has refused to allow us to do that. Disaster relief for 
farmers and ranchers, we did that. That is now going to be signed into 
law, $3 billion. Farms have gone bankrupt in the ensuing years of the 
need for this relief. I would suggest, if you look on the Internet at 
what an emergency supplemental is all about, it talks about emergencies 
that occur during the year--floods, fires, drought, hurricanes, 
tornadoes. That is why what we did last night, farm relief, $3 billion 
to help farmers and ranchers recover from drought, flood, storms, and 
other disasters is long overdue. That will be the law in a matter of 
days.
  Because of global warming, the western part of the United States has 
been swept with wildfires. In Nevada, millions of acres have burned. 
When these areas burn, we get noxious weeds that come instead of the 
plants and grasses that should be there. We are going to have in a 
short few days relief. The law has been passed, western wildfire 
relief, $465 million to help prevent and fight

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wildfires in the west and elsewhere. That is so important.
  As I understand, there has been a raging fire on the border of 
Minnesota and Canada. It has taken days to put that fire out. That is 
what we are talking about. It should have been done a long time ago. We 
have had to fight for this. I can remember going to the White House, 
being told by one of the President's assistants: Don't worry about 
that. We will do it with one of the regular bills.
  We are limited on what we can do on regular bills. This is emergency 
funding. The President has gone to New Orleans, LA, more than 20 times 
since those devastating floods that occurred there as a result of 
Hurricane Katrina. The President has talked about it but done very 
little. We did something about it. We have overcome the opposition of 
the White House, and in the bill that we passed last night, we provided 
nearly $6.3 billion to help the people of the gulf coast affected by 
Hurricanes Katrina and Rita.
  Homeland security--Senator Byrd, from his seat right here, over the 
last 5 years has offered many amendments. He wrote a book and talks in 
his book about the times he offered amendments to do something about 
homeland security. It was defeated on a straight party line basis many 
times. Last night we weren't defeated on a straight party line basis. 
We didn't get enough, but we did get a billion dollars to look at 
programs that are all so absolutely important and necessary: port 
security, $110 million; rail and mass transit security, $100 million; 
explosive detection systems for airline baggage. It is interesting with 
our airlines, you climb in one of those seats in the airplane. You are 
seated. You feel pretty comfortable about the person sitting next to 
you. But you don't know what is in the cargo of that airplane. We got 
some money for that last night, as well we should. Air cargo security, 
$80 million to inspect cargo on commercial passenger airlines; $285 
million for explosive detection systems for airline baggage. It was 
long overdue--not enough but certainly a step in the right direction.
  The Republicans had a majority of 55 to 45. They couldn't pass a 
budget because it was so skewed toward the rich, so skewed toward the 
business community and directed against working class America, they 
couldn't pass it. We have a majority, with Senator Tim Johnson being 
ill, of 50 to 49, not 55 to 45. But we passed a budget. We passed a 
balanced budget that restores fiscal discipline and puts the middle 
class first, cutting their taxes while increasing investment in 
education, veterans care, and children's health care.
  For the second year in a row, we legislated to give the hope of stem 
cell research to millions of Americans who suffer from all kinds of 
diseases. There is one Senator holding up our overriding the 
President's veto. It could be any one of these Republican Senators. We 
are at 66. We need one more to override the President's obstinance in 
the form of this veto.
  What the President has done to stifle hope for millions of Americans 
is wrong. We were at a Senate retreat. Michael J. Fox came in, someone 
whom Rush Limbaugh made fun of because he shakes when he talks. He has 
Parkinson's disease. The renown actor came up and talked to us about 
his money he has put in to find a cure for other people who have 
Parkinson's disease. He has done good work because the human genome 
project is completed, and they found the gene that causes Michael J. 
Fox's neurological problems. But he said: We need more help. Stem cell 
research would help us find out a way to attack that gene, to take care 
of that gene. But the President has stifled, stopped, slowed down the 
hope of millions of people just like Michael J. Fox.
  Several other important bills have passed and will soon be on the 
their way to the President, such as a continuing resolution. This is 
not a name I came up with, the ``do-nothing'' 109th Congress. The 
Republicans controlled by significant margins the House and the Senate, 
and they have been dubbed by historians and the press as the do-nothing 
Congress. They did less and served their constituents less days in 
actual work in the Senate and the House than in the history of the 
country. They did less and were in session less than the do-nothing 
Congress of 1948.
  One of the things they didn't do is fund the Government. They lost 
the elections last November and just left town and unfunded the 
Government. So there was a responsibility upon us, the Democrats, to 
fund the Government from February 1 to October 1. We did that. It 
wasn't easy, but we did it.
  The 9/11 Commission, the President fought it. But there was a hue and 
cry to establish an independent bipartisan commission to look at what 
happened on 9/11, what went wrong. Led by Congressman Hamilton and 
Governor Kean, this independent bipartisan commission came up with 
recommendations. We waited almost 3 years for the Republican Congress 
to do something. They did basically nothing. The 9/11 Commission, in 
fact, gave the Bush administration failing grades, Ds and Fs, in all 
that they asked Congress and the President to do. But we, the 
Democratic Congress, passed all the recommendations of the bipartisan 
9/11 Commission after they had been pushed aside for all those years. 
Now, within a matter of weeks, the House will do the same, and we will 
send this matter to the President and have him sign it.
  Ethics. The most significant ethics and lobbying reform in the 
history of our country we did as the first bill we took up. With the 
culture of corruption that existed here in Washington in the 109th 
Congress with--think about this: Am I making up a culture of 
corruption? For the first time in 130 years--approximately 130 years--
someone who was working in the White House was indicted. ``Scooter'' 
Libby was indicted and convicted. Safavian, who was head of Government 
contracting, appointed by the President and responsible for billions of 
dollars, was led away from his office in handcuffs because of 
sweetheart deals he made with Jack Abramoff and others.
  On the other side of the Capitol, in the House, the majority leader 
in the House was convicted of three ethics violations in 1 year. What 
did they do to respond to that? Changed the ethics rules. He is also 
under indictment.
  So there certainly was a culture of corruption. Staff members are 
still under investigation. Congressmen are still under investigation 
because of this culture of corruption. Members of Congress have had to 
resign or have lost their races because of being involved in unethical 
and criminal activities.
  Yes, there was a culture of corruption, and we took this up as our 
first legislative measure and passed it. The House passed it yesterday. 
We need to go to conference now and send that to the President.
  As we all know, we have begun debate on immigration reform. We are 
continuing that the week we get back. We have taken action on 7 of our 
top 10 legislative priorities we introduced on the first day of the 
110th Congress. It is tradition that the majority party introduces the 
first 10 bills. We did that. Seven of them we have passed.
  In the coming weeks, we expect to turn our attention to the remaining 
three.
  Energy. As soon as we finish immigration, we are moving to energy 
legislation. It is bipartisan. It is legislation that has been reported 
out of the Energy Committee on a bipartisan basis, legislation reported 
out of the Environment and Public Works Committee on a bipartisan 
basis, and legislation that has come from the Commerce Committee on a 
bipartisan basis.
  It is not everything I want but a great start for one of the big 
problems we have facing America today: energy.
  In the State of Nevada, my home, we have the third highest gas prices 
in the country--Nevada. In Reno, NV, gas prices are around $3.40 a 
gallon. We need to do something about it.
  The gluttony of the oil companies is unbelievable--making tens of 
billions of dollars. It is so interesting, every time at just about 
Memorial Day, when people want to travel, their refineries go down, 
they need repair. Who makes all the money? It is not the person you go 
to who pumps gas in your car or

[[Page 14373]]

even a self-service station you go to. They make pennies. They make 
less than a nickel a gallon. In Reno, NV, and other places in the 
country, you can pay $3.40 a gallon at the place you buy that gasoline, 
and that person makes almost nothing. It is made by the gluttonous oil 
companies, the refiners--record profits, of course.
  We are going to take a whack at that. I hope we can get it passed. It 
has some interesting things in it. One of the things it has is CAFE 
standards, saying automobiles in our country should be required to have 
higher mileage per gallon. We are going to try to get that done.
  The bill also includes some legislation dealing with alternative 
energy. We cannot produce our way out of the problems we have in 
America with oil. We have less than 3 percent of the oil in the world 
in America. We cannot produce our way out of our problems. We have to 
lessen our dependence on foreign oil.
  Today, in America, we will use 21 million barrels of oil. It is hard 
for me to comprehend there is that much oil in the ground, let alone 
our use of it in 1 day. We import about 65 percent of that oil. This 
oil comes from some of the worst tyrannical governments in the world. 
Much of that money is used to export communism and other bad things to 
countries, including to America.
  We must lessen our dependence on foreign oil. This administration is 
the most oil-friendly administration in the history of our country. So 
we are going to take up this legislation the second week we get back. 
The bill will dramatically increase America's renewable fuel production 
so we can begin the crucial long-term effort to reduce our dependence 
on unsustainable and volatile energy supplies I have talked about.
  The bill requires consumer appliances, buildings, lighting and, most 
importantly, vehicles to become much more energy efficient. The Federal 
Government's own energy performance will be significantly improved as 
well.
  I so appreciate Senator Bingaman, the chairman of the Energy 
Committee, and Senator Boxer, the chairman of the Environment and 
Public Works Committee, whose career has been based on things dealing 
with the environment. Senator Inouye, chairman of the Commerce 
Committee, and his right-hand person in this effort, Senator Kerry, 
have done remarkably good work.
  This legislation will address the growing threat of price gouging and 
energy market manipulation as gas prices continue to set new record 
highs almost every day.
  I have been so impressed with Maria Cantwell, the Senator from 
Washington, for her continual efforts to go after these big gluttonous 
oil companies. Her price-gouging legislation and energy market 
manipulation legislation has been, in my opinion, a picture of how we 
should legislate.
  Education. We expect to address reauthorization of the Higher 
Education Act in the next few weeks--in the next few months, probably 
more likely. I hope to do it, complete it, before our August recess.
  Since the act was last authorized in 1998, college costs have 
continued to skyrocket. A growing number of students are being priced 
out of a college education and all the doors it opens. A child's 
ability to be educated should not be dependent on how much money their 
parents have.
  I, of course, am a big fan of early childhood education. I was so 
impressed yesterday, not far from here, the conservative reporter--I 
should not say reporter--editorial writer, David Brooks, from the New 
York Times, talked about his belief of young people being educated and 
how he had become a convert and he now believes that the Government 
should be involved in getting kids educated.
  Many of those lucky enough to make it through college now begin their 
careers saddled by the weight of the money they have had to borrow. In 
Nevada, the average debt of a student is $15,000. That is unacceptable. 
It is not unusual for someone to graduate from medical school owing 
$150,000.
  Now, people say: Well, doctors make a lot of money. They do not make 
that much money. One of my friends, a prominent physician in Las 
Vegas--I do not think he will mind me mentioning his name; if he does, 
he can call me--Dr. Tony Alamo worked hard all his life--his father 
came in a boat from Cuba--believes in education. The senior Tony Alamo 
did everything he could to get his kids educated. He had a boy become a 
doctor.
  Now, young Tony is one of the lucky ones because his dad has done so 
well with the rags-to-riches story in America, and I am sure as to his 
debt, his dad could help him pay it off, if necessary. But Dr. Alamo is 
very unusual because he has parents who can help him. He has explained 
to me that when doctors graduate from medical school, they get a job, 
and a lot of jobs now are with managed care, being they are all over, 
and they are salary jobs. They have difficulty with their salary job 
paying off their loans.
  Our legislation will increase the maximum Pell grant, reduce student 
loan interest rates, expand loan forgiveness programs, and cap student 
loan payments at no more than 15 percent of their income. Our bill 
takes important steps to address this alarming and growing crisis.
  We are going to take up the next work period the Defense 
authorization bill. One of the things we talked about doing in one of 
our 10 bills is to rebuild our military. It is in a state of disarray, 
disrepair. We learned that when we found out from the Governor of 
Kansas, after that tornado, that half of the equipment of her National 
Guard was in Iraq. Could not respond to the crisis there. It is that 
way all over the country.
  Jim Webb, who is a Senator from Virginia--Jim Webb has a resume of an 
American hero because that is what he is. He is a graduate of the Naval 
Academy, fought heroically in Vietnam, earned medals for heroism, was 
badly injured. His military career ended not because he wanted it to 
but because he was hurt and had to get out.
  He believes the most important thing we can do to hold the 
President's feet to the fire in Iraq is force him to make sure our 
troops are ready to go to battle, they are trained properly, they have 
that equipment. He has an amendment we are going to work on to get in 
the Defense authorization bill.
  One of the boys killed from Nevada this past week was on his fourth 
tour of duty in Iraq. His friend said: He told me he survived four 
explosions, and he didn't think he would survive another one. He did 
not. It was an awful death. We now have two hostages, prisoners of war 
in Iraq. Remember, when they were captured, they did not know who for 
sure the three were because they knew there was a body in the Humvee. 
So I called and talked to the dad, and he prayed that his boy was not 
in the Humvee, that he was a prisoner. But it didn't work. His boy was 
incinerated in the Humvee. They could only find out who he was with 
DNA. He was on his fourth tour of duty.
  That is what Jim Webb is advocating. That is what we advocate. We are 
going to take that up in the Defense authorization bill, to make sure 
our troops have what they need. They do not have that now.
  The bill last night that we passed provides funding to ensure our 
troops, until the first of October--active and retired--get some of the 
money they need. But we have to restore and renovate what has been 
ruined and damaged in Iraq.
  Jack Reed, a graduate of West Point, believes it will take nearly 
$100 billion to bring our military up to what it should be. We are 
going to work toward that in the Defense authorization bill. That 
committee is chaired by Carl Levin. So we are going to make 
investments, critical investments to address troop readiness problems 
in the Army and Marine Corps caused by the President's flawed Iraq 
policy.
  We will take a number of steps to reconfigure our national security 
strategy to better meet the threats and challenges we face today. That 
includes returning focus to the growing and increasingly overlooked 
problems in Afghanistan and working to improve special operations 
capabilities.

[[Page 14374]]

  So once the next work session is complete, we will have taken action 
on all 10 of our day one priorities and passed most of them with 
overwhelming bipartisan support.
  Now, we have had to fight to get that support, with cloture, on many 
different issues to get to where we could have a vote. But we have made 
it, and I appreciate that help from the Republicans.
  We have also successfully addressed many crucial issues not on that 
list. The FDA reauthorization bill we passed facilitates the timely 
review of new drugs while improving the safety of the medicines 
patients take and the food we eat. We passed the Water Resources 
Development Act, known as WRDA, the first one in about 6 or 7 years. It 
will protect America's environment and keep our economy strong. We also 
passed the America COMPETES Act, which is an act to return our country 
to a position of leadership in science, research, and technology.
  I would say by far the most important fight we have taken up this 
year is our effort to oppose the President's failed Iraq policy and 
bring the war to a safe and responsible end. The next work period, as I 
have indicated, will oppose the President's failed policy regarding the 
war at every turn. The Defense authorization bill will be a major part 
of that battle. We will continue this fight every day. We have had some 
bipartisan victories this year and some tough fights as well. Progress 
especially on the war has not come easy and that is not likely to 
change. But if we continue to work in good faith, seeking 
bipartisanship at every opportunity, I have no doubt we can accomplish 
great things for the American people.
  Madam President, are we in morning business?
  The PRESIDING OFFICER. We are not.
  Mr. DORGAN. Madam President, I voted in favor of the Vitter amendment 
yesterday because I do not support a plan that tells those who came to 
this country illegally up until December 31 of last year that they are 
excused and now have legal status.
  I think that is a mistake.
  But I do want to state clearly that there are a fair number of those 
12 million people who came in here without legal authorization whose 
status must be resolved in a sensitive way. I am talking about those 
who have been here for decades, who have raised families, worked hard, 
and been model citizens. I believe we should adjust their status and 
give them an opportunity to earn citizenship.
  That same right, however, should not apply to someone who just last 
December decided that they were going to sneak into this country 
illegally.
  My understanding is that we will have additional amendments that will 
be sensitive to the need to distinguish that difference and I intend to 
support the amendments that will provide the sensitivity to those 
immigrants who have been here leading productive lives for a long 
period of time.

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