[Congressional Record (Bound Edition), Volume 154 (2008), Part 2]
[Senate]
[Pages 2712-2717]
[From the U.S. Government Publishing Office, www.gpo.gov]




  REQUIRING A REPORT SETTING FORTH THE GLOBAL STRATEGY OF THE UNITED 
  STATES TO COMBAT AND DEFEAT AL QAEDA AND ITS AFFILIATES--MOTION TO 
                                PROCEED

  The PRESIDING OFFICER. Under the previous order, pursuant to rule 
XXII, the Chair lays before the Senate the pending cloture motion, 
which the clerk will report.
  The assistant legislative clerk read as follows:

                             Cloture Motion

       We, the undersigned Senators, in accordance with the 
     provisions of rule XXII of the Standing Rules of the Senate, 
     hereby move to bring to a close debate on the motion to 
     proceed to Calendar No. 576, S. 2634, global strategy report.
         Russell D. Feingold, Edward M. Kennedy, Patrick J. Leahy, 
           Robert Menendez, Ron Wyden, Sherrod Brown, Richard 
           Durbin, Bernard Sanders, Patty Murray, Joseph R. Biden, 
           Jr., Frank R. Lautenberg, Christopher J. Dodd, John D. 
           Rockefeller, Amy Klobuchar, Charles E. Schumer, Tom 
           Harkin, Barbara Boxer.

  The PRESIDING OFFICER. By unanimous consent, the mandatory quorum 
call is waived.
  The question is, Is it the sense of the Senate that the debate on the 
motion to proceed to S. 2634, a bill to require a report setting forth 
the global strategy of the United States to combat and defeat al-Qaida 
and its affiliates, shall be brought to a close?
  The yeas and nays are mandatory under the rule.
  The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from West Virginia (Mr. 
Byrd), the Senator from New York (Mrs. Clinton), the Senator from 
Massachusetts (Mr. Kennedy), and the Senator from Illinois (Mr. Obama) 
are necessarily absent.
  Mr. KYL. The following Senators are necessarily absent: the Senator 
from Missouri (Mr. Bond), the Senator from Minnesota (Mr. Coleman), the 
Senator from Texas (Mr. Cornyn), and the Senator from Arizona (Mr. 
McCain).
  Further, if present and voting, the Senator from Minnesota (Mr. 
Coleman) and the Senator from Texas (Mr. Cornyn) would have voted: 
``yea.''
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The yeas and nays resulted--yeas 89, nays 3, as follows:

                      [Rollcall Vote No. 34 Leg.]

                                YEAS--89

     Akaka
     Alexander
     Allard
     Baucus
     Bayh
     Bennett
     Biden
     Bingaman
     Boxer
     Brown
     Brownback
     Bunning
     Burr
     Cantwell
     Cardin
     Carper
     Casey
     Chambliss
     Coburn
     Cochran
     Collins
     Conrad
     Corker
     Craig
     Crapo
     DeMint
     Dodd
     Dole
     Domenici
     Dorgan
     Durbin
     Ensign
     Feingold
     Feinstein
     Graham
     Grassley
     Gregg
     Harkin
     Hatch
     Hutchison
     Inhofe
     Inouye
     Isakson
     Johnson
     Kerry
     Klobuchar
     Kohl
     Kyl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     Martinez
     McCaskill
     McConnell
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Sessions
     Shelby
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Sununu
     Tester
     Thune
     Vitter
     Voinovich
     Warner
     Webb
     Whitehouse
     Wicker
     Wyden

                                NAYS--3

     Barrasso
     Enzi
     Hagel

                             NOT VOTING--8

     Bond
     Byrd
     Clinton
     Coleman
     Cornyn
     Kennedy
     McCain
     Obama
  The PRESIDING OFFICER. On this vote, the yeas are 89, the nays are 3. 
Three-fifths of the Senators duly chosen and sworn having voted in the 
affirmative, the motion is agreed to.
  The PRESIDING OFFICER. The Senator from Colorado.
  Mr. ALLARD. Mr. President, I was scheduled to speak at 6:30. We had a 
vote at 6:30. It is my understanding that I now have the floor to speak 
on the bill on which we just voted.
  The PRESIDING OFFICER (Mr. Casey). The Senator is recognized.
  Mr. ALLARD. I rise to discuss the war in Iraq and specifically the 
legislation at hand which directs the President to transition the 
mission of U.S. forces in Iraq.
  The Senate has voted on this same issue on four separate occasions in 
this session alone. Not one of those times did the measure receive even 
one-third of the Senate's support. Nonetheless, here we are again 
debating the policies of the war.
  Let me be clear. There is certainly nothing wrong with openly 
debating those policies. It is our responsibility as Members of this 
body to discuss thoroughly what is arguably the most important and 
defining issue of our day. In fact, I find it highly curious there was 
an attempt to castigate those who voted for this debate and who wanted 
the full 30 hours to talk about this vital issue. Some in this body 
seem to have perhaps been a little too clever and tried to summon as 
much outrage against debating this matter as they were prepared to use 
in support of debate.
  I do question exactly what those in support of this bill hoped to 
realistically accomplish with this debate and this legislation before 
us given the gains that have been made through the surge strategy. Last 
May when the surge was being implemented, only 29 Senators voted for 
similar legislation. Undoubtedly, much has changed for the better since 
that point. Violence in Iraq is down 60 percent since the start of the 
surge and 80 percent in and around Iraq. There has been a 30-percent 
increase since June in insurgent weapon caches discovered. Economic 
improvements continue. Oil production is constantly increasing, up 50 
percent from this time last year. And oil revenues are nearly double 
what they were last year. In Baghdad alone, 21 new health clinics 
opened this year, 1,885 new schools have been built, and another 1,604 
have been refurbished throughout Iraq.
  Because of reconstruction and rebuilding, electricity demand is up 25 
percent. A year ago, it would have been laughable to suggest that Anbar 
Province be transferred to Iraqi control. But that will happen in May. 
When this occurs, Anbar will be 10 out of 18 provinces under full Iraqi 
control.
  The city of Ramadi in Anbar was once one of the most dangerous cities 
in Iraq. It is now one of its safest following the surge. The number of 
U.S. combat battalions operating in Ramadi has decreased from five to 
two in less than a year.
  An Army combat brigade that has been stationed in Ramadi for over a 
year is scheduled to leave the area in March and is not scheduled to be 
replaced. The United States is on pace to

[[Page 2713]]

transfer control of all Iraqi provinces by the end of the year.
  The surge strategy is brilliant in its simplicity: Exert our military 
forces to quell insurgent violence in order to create an environment 
suitable for fostering and sustaining a legitimate government capable 
of governing its citizens. Real political progress will only be reached 
when Iraqis feel secure, and the results of the surge are proving this 
to be exactly the case.
  Thus far the surge is producing its intended results by eliminating 
terrorists, interrupting communications between insurgents in many 
areas in Iraq, and ensuring safety for the people which, in turn, 
allows far broader, far greater cooperation and association with the 
United States.
  Only with these security improvements do Iraqis have a reasonable 
chance of finding a political solution. This strategy is convincing 
many Iraqis to abandon terrorist methods and turn against groups such 
as al-Qaida.
  Our efforts are reuniting torn communities and enabling political 
process. Obviously, this Nation would have been better served had the 
surge strategy been implemented earlier. But the ability to criticize 
strategy is not the same as the ability to strategize.
  So I applaud those who did finally implement the surge strategy and 
congratulate them on their vision. As we know, Iraq must stand up 
before we can stand down. Again, David Petraeus has stated there cannot 
be solely a military solution to violence without political action. And 
he is absolutely correct in his assertion.
  In recent weeks, Iraqis have made tremendous political strides under 
what are still difficult and onerous conditions and as a result 
increased security in their nation. February 13 saw the Council of 
Representatives pass three key pieces of legislation: amnesty for Sunni 
security detainees, a provincial powers law, and a budget.
  Debaathification reform was enacted last month as well.
  Let's talk about those political accomplishments. The general amnesty 
law passed by the Shiite-majority Parliament sets the guidelines in 
providing amnesty for thousands of detainees held in Iraq detention 
facilities. This helps to remove one of the greatest stumbling blocks 
to reconciliation between Sunnis and Shiites.
  The Iraqi Parliament has also passed the provincial powers law which 
outlines the balance of authorities between the central and local 
governments while also specifying that provincial elections be held on 
October 1 of this year. The Iraqi Parliament approved a $48 billion 
budget, representing a step toward Iraq using its own resources to 
provide for security and infrastructure reconstruction. This Sunni-Shia 
compromise budget allows the Kurds a larger share of the budget, which 
is 17 percent. Iraqi oil revenues have soared with the rise of global 
prices, and Iraqi production has increased due to gains in security. 
The money is now going to the provinces on a regular basis where it 
will fund urgently needed reconstruction and humanitarian relief. The 
Iraqi Government is now providing the kind of services that give the 
Iraqi people a stake in their own success.
  Finally, the President's council approved the law of accountability 
and justice on February 3, 2008. This law could allow thousands of 
former Ba'ath party officials to return to Government jobs and receive 
pensions, helping the reconciliation process and stimulating the 
economy. In addition, even more groundbreaking legislation is slated 
for consideration in the very near future. These initiatives include a 
hydrocarbons law to determine the level of control allocated to the 
central Government as well as an election law that is being drafted 
currently by the Prime Minister's office. While the job is far from 
over and much work is still required, these recent accomplishments on 
the political and economic fronts continue to gather momentum and show 
important signs of progress and create reasons for optimism. There is 
much criticism of flaws in the Iraqi Government's processes and 
outcomes, but any Member of this body who considers throwing stones in 
that direction should first glance at any newspaper, news show, citizen 
rally, or public opinion poll, and reflect on who among us is producing 
perfect and flawless legislation.
  Even the media, which has often been one-sided on the war, has for 
several months now been forced to report that the surge and coalition 
efforts have been succeeding. Let's look at some of the headlines:
  The Washington Post, February 23, 2007, ``Sadr Extends Truce in 
Iraq''; the Los Angeles Times, February 22, 2008, ``U.S. Micro-Loan 
Effort Yields Big Results in Iraqi Province''; the Colorado Springs 
Gazette, February 18, 2008, ``Baghdad Neighborhood is a Model of 
Progress''; Reuters, February 16 of this year, ``Attacks in Baghdad 
Fall 80 Percent''; Reuters, a February 13 article, ``Iraq Lawmakers 
Pass Key Budget and Amnesty Laws''; Reuters on January 17 of 2008, 
``Iraqi Forces Could Control All Provinces This Year''; even the New 
York Times, February 14, 2008, ``Making (Some) Progress in Iraq''; the 
Washington Post on February 10, 2008, ``Diary of an Insurgent in 
Retreat: Al-Qaeda in Iraq Figure Lists Woes''; the AP, February 2, 
2008, ``Lynch: US Surge Tipped Scales in Iraq''; an AP article on 
January 21, 2008, ``U.N. Envoy Applauds Cut in Iraqi Violence''; the 
Winston-Salem Journal, February 12, 2008, ``Iraq is Much Changed Since 
Surge Started One Year Ago''; Tacoma News Tribune, February 14, 2008, 
``Iraq Reaches Benchmark for Healing.''
  Coalition success is being seen all over Iraq. It is being reported. 
The only people who seem to refuse to see it or admit we are winning in 
Iraq are my colleagues on the other side of the aisle who continue time 
and again to bring this issue to the floor claiming that the surge has 
not worked and urging immediate troop withdrawal. Certain Members of 
Congress continue to deny that any progress has been made. Earlier this 
month the Speaker of the House described the surge as a failure. 
Opponents long criticized the administration for not sending more 
troops to Iraq. But when this strategy was installed, it was also 
attacked as opponents declared that this effort was essentially too 
little, too late. When the surge began to show great military success, 
it faded from the floor of this body.
  That is why we welcome the chance to spend 30 hours on this topic. It 
is a shame that now, when both military and political success is being 
realized, we are only debating whether to retreat. If that is the 
ground the majority wishes to stand on, so be it.
  For a moment let's consider the severity of the issue at hand. We are 
debating whether to deploy our forces which would essentially concede 
the country to whatever group eventually gains control that would 
likely plunge the country into further unrest and chaos. It seems we 
are acting under the assumption that if we get all of our forces out, 
we can slam the door behind us and all will be fine. This policy fails 
to lend any consideration to what would certainly be dire consequences 
that would ensue as a result of our Nation abandoning Iraq at this 
critical juncture. To do this would simply be irresponsible and 
shortsighted. Iraq is the pivotal front in our global war on terror. To 
intentionally abandon our progress and lose the battle would surely 
cause irrevocable harm to our efforts to secure our Nation. Osama bin 
Laden had referred to Iraq as the central front in the war against 
America and the West. Al-Qaida in Iraq shares this view of the 
situation. Leaving prematurely would only strengthen al-Qaida and 
enable terrorists to set up training camps in Iraq and plot further 
attacks on the United States.
  The National Intelligence Council stated:

       If such a rapid withdrawal were to take place, we judge 
     that al Qaeda in Iraq would attempt to use parts of the 
     country--particularly al-Anbar province--to plan increased 
     attacks in and outside Iraq.

  By passing this legislation, we would be running away from a war from 
the floor of the Senate. When has it ever been sound policy for 
legislators to micromanage a war from Washington? I don't ever recall 
in our history this tactic being successful in achieving our

[[Page 2714]]

strategic goals. In fact, let me remind our colleagues, we have seen 
terrible results from political motives being placed above military 
necessity. Installing an artificial deadline is not what we need. It is 
not what is good for the Nation. It is not good for the future of Iraq 
and the long-term stability of that region. We have heard from our 
military intelligence professionals who have warned about the possible 
consequences of hasty withdrawal and the potentially catastrophic 
results that may ensue. We should also listen to our folks on the 
ground. I have heard time and time again from our service men and women 
from all branches of the military who have returned from Iraq that 
progress is being made, and they are proud of the contributions they 
are making to this Nation and to the long-term stability of Iraq and 
the Middle East.
  In my lifetime I have witnessed few events that compare to the joy 
and jubilation that accompany the homecoming of a military unit. When I 
have seen a brigade return home to Fort Carson or a wing to Peterson 
Air Force base, there are no words to describe the sheer emotion of 
seeing families returned to loved ones and friends. However, 
redeploying our forces at this point is not the proper course of action 
and not in the best interests of our Nation. Our military does not 
exist just to come marching home, and our military understands this. 
They exist to fight our enemies and secure our vital national 
interests. Removing Saddam Hussein from power was in our national 
interest. Stability in the Middle East is in our national interest. 
Securing Iraq from terrorist control is in our national interest. 
Pandering speeches about bringing the troops home that strive for mere 
political points and fail to acknowledge strategic realities are not in 
our national interest.
  We still have a job that needs to be completed. We still have work to 
do. When the time is right, we will redeploy responsibly. The Iraqi 
Government is making progress. We are beginning to be able to stand 
down to a greater extent than we have in the past. General Petraeus and 
Ambassador Crocker will return to Washington and report on the progress 
in Iraq in April. We owe to it our men and women in harm's way to 
listen to the experts and make our decisions off of their findings.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wisconsin.
  Mr. FEINGOLD. Mr. President, I am pleased the Senate has voted 
overwhelmingly to allow some debate of the Feingold-Reid al-Qaida bill, 
but it is pretty clear to everyone that this body still doesn't fully 
understand and is not ready to address head on the threat posed by al-
Qaida. As was made clear during debate on the Iraq redeployment 
legislation, too many Members confuse the war in Iraq with the fight 
against al-Qaida. That is true of the administration too. While it is 
focused on Iraq, al-Qaida has reconstituted itself along the 
Afghanistan-Pakistan border. Don't take my word for it. Listen to our 
intelligence community.
  Early this month, the Director of National Intelligence testified 
before Congress that the central leadership based in the border area of 
Pakistan is al-Qaida's most dangerous component. A few months ago, the 
DNI again repeated the intelligence community's assessment that over 
the last few years ``Al Qaeda's central leadership has been able to 
regenerate the core operational capabilities needed to conduct attacks 
in the Homeland''--our homeland, Mr. President, the United States of 
America.
  The DNI also testified that al-Qaida ``is improving the last key 
aspect of its ability to attack the U.S.: the identification, training, 
and positioning of operatives for an attack in the Homeland.''
  Meanwhile, the Federally Administered Tribal Areas in Pakistan is 
serving as a staging ground for al-Qaida in support of the Taliban and 
providing it with a base similar to the one it used to have across the 
border in Afghanistan. The Chairman of the Joint Chiefs of Staff, ADM 
Mike Mullen, testified recently that ``the most likely near term attack 
on the United States will come from Al Qaeda via'' its safe havens in 
Pakistan--not in Iraq, in Pakistan. Over the past year, we have seen an 
unprecedented rise in suicide bombings in Pakistan. The Taliban is 
gaining ground in Afghanistan. While we may be sending an additional 
3,200 marines to Afghanistan in the near future, we have been fighting 
for far too long there with too few soldiers and too few reconstruction 
funds.
  With the Joint Chiefs of Staff saying in ``Iraq we do what we must 
and in Afghanistan we do what we can,'' it is no wonder that 
Afghanistan is teetering on the edge. Let me remind my colleagues that 
it was from Afghanistan--Afghanistan, not Iraq--that the 9/11 attacks 
were planned. And it was under the Taliban regime, which is once again 
gaining ground, that al-Qaida was able to flourish so freely.
  Al-Qaida affiliates from Africa to Southeast Asia pose a significant 
terrorist threat. While we have been so myopically fixated on Iraq, the 
threat from an al-Qaida affiliate in north Africa has grown and now, 
according to the DNI's testimony, ``represents a significant threat to 
the United States and European interests in the region.'' Since its 
merger with al-Qaida in September 2006, it has expanded its targets to 
include the United States, the United Nations, and other interests. And 
it likely got a further boost when al-Qaida leadership announced last 
November that the Libyan Islamic Fighting Group united with al-Qaida 
under AQIM's leadership. Its possible reach covers Tunisia, Morocco, 
Nigeria, Mauritania, Libya, and other countries. Meanwhile, it is using 
deadly tactics that suggest it is acquiring knowledge from the war in 
Iraq. That is right. The war in Iraq may be being used as a training 
ground by forces that wish to do us harm. Another way of saying it is, 
our troops are being used as a way to train people to give them the 
skills to launch attacks in other places.
  Al-Qaida has affiliates around the world--in Saudi Arabia, the United 
Arab Emirates, Yemen, Lebanon, where al-Qaida poses a growing threat, 
the Horn of Africa, and Southeast Asia. We cannot ignore the rest of 
the world to focus solely on Iraq. Al-Qaida is and will continue to be 
a global terrorist organization with dangerous affiliates around the 
world. We are watching al-Qaida strengthen and develop its affiliates 
around the world while we remain bogged down in Iraq.
  We need a robust military presence and an effective reconstruction 
program in Afghanistan. We need to build strong partnerships where al-
Qaida and its affiliates are operating--across north Africa, in 
Southeast Asia, and along the border between Afghanistan and Pakistan, 
and we need to address the root causes of the terrorist threat, not 
just rely on military power to get the job done.
  We can start doing that by passing S. 2634. This bill requires the 
administration to provide Congress with a report outlining a 
comprehensive global strategy to defeat al-Qaida and its affiliates. 
The strategy must ensure U.S. resources and assets are targeted 
appropriately to meet the regional and country-specific threats we 
face, and that troop deployments do not overstretch our military.
  Who could oppose a commonsense bill such as this? Well, as I noted 
earlier, the administration actually issued a veto threat for this 
bill. That threat makes the baffling argument that preparing a report 
on the threat of al-Qaida may somehow ``inhibit the President's 
constitutional authority as Commander in Chief.'' That is not all. The 
administration also argues that preparing a plan that prioritizes 
operations against al-Qaida would tie the hands of commanders.
  This is just plain double-talk. We are trying to help our commanders 
and the rest of our Government to properly dedicate their resources to 
our most pressing national security concern. This bill does not tell 
our commanders how to carry out any operations; it merely requires a 
report. The Congress has a constitutional responsibility, in 
collaboration with the President, to determine what are our national 
security priorities. That is what we should be

[[Page 2715]]

doing. That is what this bill would do. Unless the President has 
completely abandoned the idea of civilian control of the military, and 
of the shared responsibilities between the legislative and executive 
branches, then he should have no objection to my bill.
  The administration does say that it ``supports the bill's goals and 
intent, with regard to updating and informing Congress and the American 
people on the strategy to combat terrorism.'' I guess that is good 
news. But then it cites two documents it has already prepared on this 
topic. One is the September 2006 National Strategy for Combating 
Terrorism, which sets broad goals but does not include the detail 
called for in our bill about how limited resources will be allocated to 
achieve this strategic vision. That 2006 document also does not 
prioritize the geographic--country and region-specific--threats we face 
from AQ and its affiliates, which is essential because how else--how 
else, Mr. President--will we know where to focus our resources?
  The other document cited by the administration is the National 
Implementation Plan. I am a member of both the Senate Intelligence and 
Foreign Relations Committees, and I am not even allowed to see that 
document. The administration will not even share it with the full 
Intelligence Committee. So the idea this document is an acceptable 
substitute for what is called for in the Feingold-Reid bill is absurd.
  The administration suggests our bill limits the President's authority 
to withhold information. Now, I agree we need to protect classified 
information, and there is nothing in my bill--nothing--that would 
prevent the addition of a classified annex. Much of our strategic 
planning, however, is not classified, consistent with our country's 
belief in open government and accountability.
  The American people deserve to be told, to the extent possible 
without divulging classified information, what their government is 
doing to protect them. The President's veto threat is further evidence 
of his unwillingness to be straight with the American people about the 
fact that the war in Iraq is actually undermining our national 
security. The President's current strategy is to prioritize operations 
in Iraq, even to the detriment of operations in Afghanistan against 
those who attacked us on 9/11.
  Now, that does not make sense. It has to change, and we have to 
change it today by passing this Feingold-Reid bill, refocusing our 
attention and resources on al-Qaida.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from North Carolina.


                           Health Care Reform

  Mr. BURR. Mr. President, one of the most pressing issues in America 
today is: What will Congress do to address health care? The American 
people deserve a 21st century health care system--not just a delivery 
system of doctors and hospitals but a system that is integrated, one 
that recognizes society has changed.
  This body, several years ago, extended a new benefit to Medicare, 
where we covered prescription drugs in a health care delivery system 
that was created in the 1960s, when drugs were not a common treatment 
for disease. It took us until the 21st century to recognize that if we 
would enhance the benefit so we could match the disease with some of 
the breakthroughs, that the outcome was different, that Americans 
actually got better, that the cost actually went down because we 
eliminated the number of incidents.
  America's health is at risk. When I say America's health is at risk, 
I am talking about the physical health and the economic health of this 
country. It is impossible to believe that unless you transform health 
care so it works for everybody in this country that American business 
can be competitive in a global marketplace that is not coming, that we 
are part of today.
  Now, Republicans want to propose to this body and to America one main 
goal. That goal is that we are committed--Republicans are committed--to 
providing every American with genuine access to quality, affordable 
health care that protects the sacred doctor-patient relationship. This 
is what everybody thinks of when they think of a health care plan: 
health care coverage that recognizes them as an individual and coverage 
they need to provide security for their family.
  Let me restate it. We are committed to providing every American with 
genuine access to quality, affordable health care that protects the 
sacred doctor-patient relationship. Nothing else should get between 
that. It should not be determined based upon an arbitrary third-party 
reimburser or the Federal Government. The reality is, when we provide 
every American with this opportunity, we have a system that functions 
like the marketplace is designed.
  How do we get there? No. 1: access and choice. All Americans have a 
right to choose their doctor, to choose their hospital, and, I believe, 
to choose the health care plan they want, and, more importantly, they 
deserve. No Washington, DC, bureaucrat should deny that right.
  Americans like choice. We know that. Americans do not like to have 
one choice. They like multiple choices. As a matter of fact, when you 
have one, you really do not have a choice. Some politicians want to 
give America one choice. It is the debate potentially of this next 
election cycle.
  Let me teach America a new word. It is called ``universal control.'' 
Universal control: when one entity is in charge of the only choice, and 
now they control how they provide that; they control what it looks 
like; they control where you get it; they control what the cost is. All 
of a sudden, this innovative, creative health care system we have had 
in America--that has not worked for everybody because our target has 
not been to make sure every American is covered--all of a sudden it 
totally breaks down.
  Well, one health care package, one set of doctors, one set of 
treatments, one set of prescriptions is not what America is looking 
for. America is looking for choice. North Carolinians do not want one 
choice, and they certainly do not want bureaucrats in Washington, DC, 
defining what their choices are going to be.
  A majority of Americans are willing to pay a little bit more to have 
more choices. I strongly believe doctors and patients--not lawyers and 
bureaucrats--should have the power to make health care decisions.
  The challenge is that Americans believe that is the most important 
thing. Clearly, access to health care is directly dependent upon cost. 
Americans must have access and choice, but they also have to have 
affordable coverage. Republicans believe the best health care in the 
world is worthless if Americans cannot afford it, and I think we would 
all agree.
  It would drive down costs by giving Americans control over their own 
health care choices, making sure patients have the information they 
need to make good decisions, guaranteeing vigorous competition that 
benefits patients, and holding the entire health care system 
accountable to the patients' needs.
  You see, in many cases we have used Government as the accountability 
measure. We miss the boat. The accountability measure is making sure 
patients hold the system, patients hold the doctors, patients hold the 
hospitals accountable; more importantly, patients hold the insurers 
accountable.
  This belief that a patient cannot negotiate with an insurer--well, 
quite frankly, these days are over. We need to drive down costs. We 
need to give Americans control over their own health care choices. We 
need to make sure patients have the information they need to make good 
choices--the right choices for them, for their family, for their age, 
for their illness or their health conditions, and, more importantly, 
for their income, guaranteeing vigorous competition that benefits 
patients. The focus here is on patients, holding the entire health care 
system accountable to patients' needs.
  I would suggest if health care could be more like a television--with 
a television, you have real competition. You have a choice of over the 
air, you have a choice of basic, you have a choice of cable, you have a 
choice of cable with

[[Page 2716]]

premiums, and you have a choice of DirectTV. In fact, with television, 
you know exactly what comes with each option. You know exactly how much 
it costs, and you know you get what you pay for. That can be the only 
reason that on-demand sports has become so popular. It is because when 
you want to watch a sporting event, and you see exactly what the cost 
is, you can make a calculation as an individual as to whether that is 
worth it to you. Americans should have all the competition, the choice, 
the control, and the information they need when it comes to health care 
decisions. So affordable coverage.
  Let me tell you a story. My oldest son is now 23. Shortly before he 
became 22, I was notified by the Office of Personnel Management in 
Washington that in the Federal Government, regardless of where you were 
in the Federal Government, your children, when they turned the age of 
22, even if they were in school--which mine were--had to be dropped 
from your health insurance.
  Now, forget the fact--I can see the Presiding Officer is struggling 
with this. That does not save any money. You are exactly right. You are 
taking the healthiest of America, and you are taking them out of the 
risk pool that helps hold down the risk for us older guys who are more 
susceptible to disease. But somewhere the Federal Government got this 
idea that they are going to save money by dropping people when they 
become 22 years old--the healthiest of the American population.
  So I went through the realization that this is actually going to 
happen. There is no way you can change it. So I called OPM to say: 
Surely, you have negotiated coverage for our children. I would like 
something that resembles the plan I had with Blue Cross Blue Shield. 
They quoted me the exact same plan: $5,400 a year. Twenty-two years 
old, healthy as a bull, still in college, and all of a sudden, as a 
parent, I was strapped with the decision that for him to have coverage 
it was going to cost $5,400. If it was his decision alone, he would 
have said: No way. Affordability was not met from the standpoint of 
what he was getting in coverage for what it was costing.
  I did not stop there. I picked up the phone. I called the university 
he was at and found out a local insurer, insurance agent, had 
negotiated with Blue Cross Blue Shield coverage for kids who fell into 
this situation where they did not have insurance. I described to him 
the plan. He quoted me the exact same plan that as a Member of the 
Senate I had, which, before, my son was covered under, with the same 
deductible, the same copay, the same limits--the exact same plan. But 
this was negotiated by an independent insurance agent in Chapel Hill, 
NC, against the same Blue Cross Blue Shield that the Federal 
Government, representing 1.3 million employees, negotiated with; and on 
behalf of my son, he negotiated a cost of $1,500 per year--$1,500 
versus $5,400, a fairly significant savings.
  We sit here and wonder: What can the American people do with the 
right information relative to the decisions they have to make as it 
relates to health care coverage? If it is that difficult to figure out 
how to have the coverage you need at the cost you can afford, envision 
how difficult it is for a patient without information to decide what 
type of chemotherapy they are going to take, when all of a sudden the 
doctor walks in and says: You have cancer and you are going to die 
without treatment. This is a difficult thing without the ability to go 
out and search for the information.
  The third item is quality care and prevention. Here is a unique word 
in health care, ``prevention.'' It is something that probably for 
decades we should have incorporated into the coverage each of us has. 
We believe in strengthening health care by providing consistent, 
dependable quality and promoting the principles of prevention. What is 
prevention? Let's change our habits. Let's educate ourselves. Let's do 
the things that keep us healthy. And let's actually pay annually to let 
somebody go in and see the doctor and make sure there is not a health 
condition they have that could be prevented, early, without the 
incidence of an inpatient stay in the hospital.
  We will harness the powerful promise of advanced research and modern 
technology to create innovative new treatments and breakthrough cures, 
promote wellness, and empower consumers with accurate, comprehensive 
information on quality health care that is available for them.
  Choice, information: I believe strengthening health care by providing 
consistent, dependable quality and promoting prevention is absolutely 
essential.
  Creating innovative new treatments and breakthrough cures: Let me ask 
my colleagues, if innovation didn't take place, what would the 
diabetics do today, those who currently have a diabetic pump that is 
implanted in their side, that automatically reads their blood sugar 24 
hours a day, administers the insulin when they need it. No longer do 
they go through a finger prick. No longer do they get an inconsistent 
reading. No longer do they inject themselves later than they need to 
keep a balance. Why is that important? Because for somebody with 
diabetes who can constantly maintain their blood sugar at the right 
level, it means none of the horrors we heard about and saw and that 
many families lived with before when the management was not as precise. 
The result was, eventually they began to go blind, eventually began to 
have a toe, two toes, all their toes, a foot, a leg amputated because 
of the effects of diabetes. Forget the number of times the person might 
have been admitted to the hospital to get their blood sugar in balance 
so they could at least delay the deterioration. Now technology allows a 
diabetic to insert a pump and to keep a constant read and a constant 
regulation of their blood sugar. The net result is the system saves a 
tremendous amount of money. The individual saves a tremendous amount of 
money. The individual's quality of life is that much better.
  For a student who had diabetes, the likelihood was that they would 
never play organized sports because the demands on an athlete mean they 
have a blood sugar spike that is incredible, and without the ability to 
regulate that, it was impossible. Now kids are playing soccer at every 
age and running around with a pump that is automatically reading their 
blood sugar.
  How about for some of us who are a little bit older and we probably 
are susceptible--because we haven't done everything we should do 
regarding healthy habits, we are susceptible to high cholesterol. Where 
would we be without the pharmaceuticals' breakthrough of cholesterol 
drugs? I will tell my colleagues where we would be. We would be funding 
$8,000-plus bypass surgeries at an alarming rate that would bankrupt 
the system, both public and private. But today we have this little pill 
we can take. It doesn't take the place of exercise, it doesn't take the 
place of diet, but it certainly enhances our chances that we are not 
going to be selected to have bypass surgery, open-heart surgery; that 
we are not going to have the recovery time, the loss of productivity at 
work because innovation allowed us now to inject in that quality arena 
a different outcome based upon innovation.
  We want to promote wellness. We want to empower consumers with 
accurate, comprehensive information. The United States has the best 
health care system in the world. I will tell my colleagues, North 
Carolina is a big reason as to why health care is so good. We need to 
make sure quality stays high while improving the access. Congress needs 
to foster--not hinder--research and development of treatments and 
cures.
  I just mentioned prevention and wellness. Those words need to be the 
first thing Americans think about when they think ``health care'' or 
when they think ``doctors.'' Prevention and wellness. Doctors should be 
paid to help people stay healthy instead of just paying them to treat 
individuals who are sick.
  My final thought for this section: Patients should have as much 
information prior to using doctors and hospitals as they do prior to 
buying cars. What a novel idea. The Centers for

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Medicare and Medicaid Services is starting to provide quality, Web-
based information about nursing homes and hospitals. The initiative 
needs to keep growing so all patients have the ability to research all 
aspects of health care. That happens in real time at the tips of our 
fingers. Access and choice, affordable coverage, quality care and 
prevention.
  The fourth piece--and we shouldn't be shocked because this is 
America--personal ownership and security. But this is something our 
system has never incorporated. We believe Americans should own and 
control their health care coverage and should have the freedom and the 
flexibility to take it with them when they change jobs, just like a 
401(k).
  Hard-working Americans deserve the peace of mind to know the care 
they need will be the care they receive and that their financial 
security will be protected from catastrophic events.
  Americans will achieve this security and will receive better care if 
the health care system is highly personalized and guarantees patient 
control. What does that mean? With the right information, with the 
right resources, any American should have the ability to construct a 
health care plan that meets their age, their health, their income, and 
have the financial security of knowing they are covered. Some might 
call this ala carte, the ability to construct something that meets--for 
those of us who are over a certain age, we have probably already been 
instructed by our spouses that we have had all the children we are 
going to have. That is a little tough in this body because we have had 
some Members who had them at quite a late stage in life. But I fall 
into that category. I can't buy health insurance coverage that doesn't 
come with maternity coverage. I pay for it knowing I am never going to 
use it.
  Now, maybe I am helping to subsidize somebody else. But while we are 
here talking about every American being insured, the reason we are here 
is because that subsidy is going on today. It goes on in every company. 
In goes on with everybody who pays out of pocket. It is something that 
happens to each of us who have health insurance, and it is triggered by 
somebody who receives a service in health care and either won't or 
can't pay. So to recover the cost of the delivery of that benefit, 
hospitals, doctors, every delivery point in health care does what they 
call cost-shift. They charge that cost of delivering that service over 
to the people who have coverage or who can pay.
  When all of a sudden you have a goal and a commitment that every 
American is insured, the cost-shift goes away. What is the score on 
that? It is $200 billion a year. So that is $200 billion that today 
does not go to the delivery of one ounce of care. It is shifted to 
people who can pay or who are covered. All of a sudden now we know the 
answer to why health care increases at double-digit rates of inflation 
on an annual basis. It is because as the pool of uninsured continues to 
grow, the amount of cost-shift continues to grow, and the cost-shift is 
directly dumped on those companies that provide coverage for their 
employees, for us as individuals if we go to the marketplace and we buy 
coverage or to us who pay out of pocket when we access health care 
because it is shifted evenly across the system.
  Forget the fact that if we adopt this, if we achieve it, that, one, 
we have a more manageable system--a system, quite honestly, that 
incorporates access and choice, affordability, quality and prevention 
and wellness, personal ownership, and the security of knowing you have 
coverage. We drive the costs down for every American.
  The goal is to continue to have the best health care system in the 
world, to continue to drive innovation and medical breakthroughs, and 
to do it in a way that brings the overall cost of health care down. If 
we can begin to see the trend line on inflation and health care begin 
to go south, it is amazing what type of an incentive it will be to 
individuals who now engage in the prevention and wellness section and 
begin to look at ways that they can control the cost of their health 
care because it is now theirs, they own it, they have constructed it, 
they can change it as they need to, and--oh, yes, by the way, to 
accomplish this, we have to have 50 States that have high-risk pools 
that take those individuals with preexisting conditions, and we 
collectively buy their cost of insurance down to an equal amount for 
those of us who are healthy. A lot of States around the country 
currently do it. Mine just happened to pass it last year. We are late 
coming to the game. But the reality is that all 50 States should and 
will and have to do it if we want the system to work.
  There is a way to maintain the highest level of care in the world, 
the highest commitment to innovation and breakthroughs, to look down 
the road and know we are going to cure things tomorrow, that today 
there is only one outcome and it is to live. If we don't change and 
transform our health care system and begin to promote prevention and 
wellness and to drive the costs down, the first thing that will leave 
is innovation, the innovation that treats many of us today in a totally 
different way, with a multitude of options we never had. If, in fact, 
we don't begin to change this, the system will reflect one choice, one 
doctor, one hospital, one delivery port.
  I challenge my colleagues today that is universal control, control 
where one entity--the Federal Government--dictates where we go, who we 
see, what they are reimbursed for delivering the service, and the 
outcome will be the lack of innovation, the lack of breakthroughs, and 
no reason for the American people to make healthy choices and to engage 
in prevention and wellness.
  That is where we are. I hope my colleagues on both sides of the aisle 
will engage and encourage our leadership to have a healthy debate on 
health care. I haven't locked in to any prescribed legislation tonight. 
It is the principles of the Republican Conference that I am here to 
present and will continue to come back to the Senate floor to present. 
I encourage my colleagues on both sides of the aisle: let's come to the 
floor. Bring your legislation. Let's examine it, let's debate it, let's 
let America see it. Let them be the judge. At the end of the day, it is 
the American people who will influence where this debate goes, and that 
is exactly who should influence it. They are the patients of the future 
health care system.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Colorado is recognized.

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