[Congressional Record (Bound Edition), Volume 155 (2009), Part 11]
[Senate]
[Pages 15200-15211]
[From the U.S. Government Publishing Office, www.gpo.gov]




       TRAVEL PROMOTION ACT OF 2009--MOTION TO PROCEED--Continued

  The ACTING PRESIDENT pro tempore. The Senator from North Dakota is 
recognized.
  Mr. DORGAN. Mr. President, just prior to lunch, we had a vote on a 
cloture motion. The vote was 90 to 3. It was not some significant piece 
of public policy that will shake the Earth, it was a vote on the 
question of whether we could actually proceed to something called the 
Travel Promotion Act.
  For those who do not know how the Senate works, you have to have a 
motion to proceed. Normally, a motion to proceed to a bill such as this 
would be done by unanimous consent and take just a nanosecond, no 
problem, a motion to proceed approved, proceed then to the bill, have a 
debate on the bill, and then vote on the bill.
  But this is something called the Travel Promotion Act, which I will 
describe. It is bipartisan. I have offered it along with Senator John 
Ensign, a Republican from Nevada. The two of us, along with many other 
cosponsors, Republicans and Democrats in the Senate, believe this is an 
important piece

[[Page 15201]]

of legislation for the Senate and for the Congress to pass. Despite 
that, we had to have a vote this morning on the motion to proceed: 
Shall we proceed to this? A cloture motion had to be filed. It took 2 
days to ripen, and then we had a vote. It was 90 to 3. The answer was 
yes by 90 to 3. And now we have 30 hours postcloture that we have to 
wait until we can get to the bill. And then have another cloture motion 
filed. It is the most unbelievable, Byzantine example of how this place 
has sort of fallen off the rails--requiring cloture motions to be filed 
on things that then get a 90-to-3 vote, and then there is a requirement 
that we have to spend the next 30 hours waiting until we can actually 
get to the bill. Unbelievable. But it is an example of what has 
happened here. And the minority is requiring this of every single piece 
of legislation. It is a way to require the Senate to walk through wet 
cement and make almost no progress at all. I guess when you get nothing 
done and then you are able to boast that nothing has happened, maybe 
some people feel good. It does not make me feel very good.
  But having complained about it, now let me at least describe what 
this bill is. We will get to the bill this week. It will have taken a 
difficult route to get there. Judging by the 90-to-3 vote, I assume 
ultimately, when the Senate passes this legislation, we will have very 
strong support because it is a bipartisan piece of legislation.
  I am told Senator Ensign has had to leave today as a result of a 
family matter. I think Senator Martinez will be coming to the floor, 
who is also a cosponsor of this legislation. I appreciate very much 
working with Senator Ensign and Senator Martinez; on this side, Senator 
Reid, the majority leader, a strong cosponsor, and so many others as 
well.
  Let me describe what this issue is. The fact is, there is an effort 
to attract international tourism around this world. Why is that the 
case? Because international tourists; that is, people who visit other 
countries, spend a lot of money and create a lot of jobs. They support 
airlines, support hotels, support recreation facilities and theme 
parks. Plus, they have a chance to understand a little about that 
country before they go back home. So many countries around the world 
are very actively engaged in saying: Come to our country. They have 
very aggressive, very sophisticated promotion campaigns saying: Come to 
our country. We do not, but they do.
  Here is an example of India: One special reason to visit India in 
2009. Anytime is a good time to visit the land of Taj. But there is no 
time like now. Incredible India.
  Well, India is very interested, very promotional, saying: Come to 
India.
  But it is not just India. Here is Ireland, big promotional campaign: 
Go where Ireland takes you.
  A beautiful photograph of the majesty of Ireland.
  An example of Australia: Looking for an experience to remember? 
Arrived. Departed. An adventure we will never forget. Go find yourself 
in Australia.
  All over the world we have campaigns now, very aggressive campaigns, 
saying: Come to Italy. Vacation in Italy. Come to Great Britain. Come 
to Spain. See the wonders of Spain.
  Why are countries doing that? Well, it is interesting. The average 
international traveler spends about $4,500 on an overseas trip. When 
they go to a country, they spend money. This creates jobs. So countries 
are aware of that, and they are very active in trying to encourage 
travelers to come to their country. Not so with our country so much 
since 9/11/2001. In fact, it is interesting that in 2008 we had 633,000 
fewer people come to this country from overseas than we had in 2000. 
Let me say that again. In 2008, 633,000 fewer people from overseas came 
to visit our country than in the year 2000. In fact, here is an example 
of what is happening around the world: visitors to the United States--
this is 2000 to 2008--a 3-percent decrease; visitors to other countries 
in international travel, a 40-percent increase. The fact is that we are 
losing ground and losing shares of the international travelers' tourism 
dollars and the ability also to explain to them a bit, by having them 
see this country, what America is all about.
  Well, why is that happening? Headlines like this post-9/11/2001. We 
are very concerned about people coming into this country, and we 
tightened the visa requirements so that there were long lines and very 
long waits in order to try to come to this country. Here are some of 
the headlines:
  Sydney Morning Herald: ``Coming to America is not easy.''
  The Guardian: ``America--more hassle than it's worth?''
  The Sunday Times in London: ``Travel to America? No thanks.''
  Look, the fact is, we want to change that.
  This legislation is bipartisan. A group of us Republicans and 
Democrats who want to create jobs in this country and want to attract 
international tourism to this country want to change this perception 
that somehow international travelers are not welcome here.
  So here is what we believe. We believe that to have people come to 
this country is to see its wonders. It is the only one like it on the 
face of this planet. It is an extraordinary place. There is so much to 
see and so much to do. And when we have done polling, and so on, when 
international travelers leave this country, they have an unbelievably 
positive impression of the United States of America, and that is very 
important. At a time when there has been so much discussion about our 
country going it alone and doing this or that, we have suffered some in 
international areas. But the fact is, inviting international tourism to 
our country is job creating, it produces a boost to our economy, but it 
also allows people to come here and understand what this country is 
about and inevitably leave with a great impression.
  Here is what we do with this piece of legislation. We set up a 
nationally coordinated travel promotion program. I might say that if 
somebody says: Well, you are going to set up something new, well, you 
know what, the Congressional Budget Office has a score for this. They 
have to decide what everything costs or what the consequences of 
everything will be.
  This is one of the few pieces of legislation to be brought to the 
floor of the Senate that the Congressional Budget Office estimates 
would actually reduce the budget deficit by half a trillion dollars 
over the next 10 years. Let me say that again. This is one of the few 
pieces of legislation you are going to get a chance to vote on that 
reduces the Federal budget deficit by $425 million in the next 10 
years.
  How does it do that? Well, the fact is, it creates a private-public 
partnership and it establishes a corporation for travel promotion which 
will be an independent nonprofit corporation governed by an 11-member 
board of directors appointed by the Secretary of Commerce. It also 
creates an Office of Travel Promotion in the Department of Commerce to 
develop programs to increase the number of international visitors to 
our country. It sets up a travel promotion fund, and that is financed 
by a private-public matching program. The Federal contributions will be 
financed by a $10 fee paid by foreign travelers from visa waiver 
countries, and it will be collected in the electronic system for travel 
authorizations which already exists.
  Let me make the point that many other countries do exactly this. It 
does not in any way retard international travel. Australia charges a 
$37 departure fee; Guatemala, $30; Mexico, $11 to $38; Thailand, a $14 
departure fee. And the list goes on. We are suggesting a very modest 
$10 fee for international travelers, from the visa waiver countries, 
and that will finance this piece of legislation that we have had now to 
file a cloture motion on on the motion to proceed to this issue and for 
which there was a 90-to-3 vote, an affirmative vote.
  Here is some discussion about our legislation.
  I introduced this in the last session of the Congress. We had over 50 
cosponsors, Republicans and Democrats. We have reintroduced it now with 
wide bipartisan cosponsorship.
  The Detroit Free Press says:

       Doesn't it make sense to encourage, at no cost to 
     taxpayers, foreign visitors to come

[[Page 15202]]

     here and leave us with some money? There's no good reason not 
     to pass this bill.

  The Dallas Morning News says:

       The Travel Promotion Act is a sensible first step toward 
     putting the welcome mat back on America's doorstep.

  The Orlando Sentinel says:

       Our position, charging international travelers $10 to pay 
     for the promotion, makes sense.

  The Los Angeles Times:

       Considering that the U.S. spends hundreds of millions of 
     dollars on public diplomacy with dubious results, and nearly 
     nothing on promoting tourism, it might do well to invest a 
     little money in wooing travelers.

  The list goes on of newspapers that have endorsed the legislation.
  This has been a pretty difficult decade for our country in many ways. 
Our country was attacked on 9/11/2001. Several thousand innocent 
Americans were killed by terrorists. Following that, we suffered a 
recession almost immediately, then a war in Afghanistan, and then a 
long protracted war in Iraq that cost an enormous amount of money and 
was very controversial all around the world. It has been a very 
difficult decade.
  As I indicated when I started, 8 years later, we have so many fewer 
visitors coming to the United States. I think during part of this 
decade there was a notion by some that we were not welcoming visitors 
to the United States; we did not want them to come here very much.
  That was not true, but I think that was a sense of some: You want to 
come to the United States, get in line, it is going to take a long time 
to get a visa. Why? Because we are concerned. We are screening 
everybody. We are doing all of these kinds of things. Well, the fact 
is, no one ever intended to decide we were not going to welcome people 
to this country. By far, the most effective way to describe to the 
world what America is about and the unbelievable values that exist and 
the openness and the wonders of this great democracy, by far, the best 
way to do that is to say to people from around the world: Come here. 
Vacation here. You are welcome here. We want you here, to experience 
and visit America and some of the best attractions and some of the best 
people and be a part of what we are and then go home and remember what 
the United States is about.
  So that is what we are trying to do. It has been too long, but 
finally we are now putting together a piece of legislation that says: 
We are not willing to go through another 8 or 10 years like the last 8 
or 10 years where our share of international tourism dramatically 
decreased.
  We want the next 8 or 10 years to show a substantial increase in 
people from around the world coming to visit America. And the fact is, 
it will create substantial numbers of jobs. That is important. I mean, 
as you know, we ran into a financial ditch, have an economic crisis of 
sorts. The number of unemployed Americans rises every month, and we are 
hoping that turns around soon. But in the meantime, this is something 
constructive and positive and concrete we can do to try to boost this 
economy. It does not even cost money. This will save almost half a 
trillion dollars in the next 10 years by reducing the Federal deficit.
  Again, I wish some of my colleagues were not deciding to see if they 
could run everybody through the traps for the next few days before we 
get to what I think will be a very positive vote on a very constructive 
idea that will benefit this country. But if it takes 4 days or 2 days 
or 1 day, whatever the moment, I think most of us will feel as if we 
have done something good for the country.
  In the midst of all of the other very controversial issues and very 
important issues, some of which are urgent, the questions of: How do 
you rein in increasing health care costs? What do you do about a 
country that is 70 percent dependent on oil that comes from foreign 
countries? What do you do about the issue of protecting our climate and 
climate change? How do you deal with the Federal budget deficit that 
seems galloping out of control? There are all these big issues.
  In the middle of all that--all of which, in my judgment, we are 
required to address in order to put America on a different course 
toward a better future--in the middle of all that, this piece of 
legislation, the Travel Promotion Act of 2009, might be one small 
glimmer--just one small bit of hope--for more bipartisanship rather 
than less. Because this piece of legislation is so persuasive about the 
interests of this country, we have Republicans and Democrats who have 
come together to say: Let's do this. Let's do this in the interest of 
this country's economic future.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. ROBERTS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. ROBERTS. Mr. President, I ask unanimous consent that I may 
proceed for approximately 16 minutes as in morning business.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. ROBERTS. I thank the distinguished Acting President pro tempore.


                           Health Care Reform

  Mr. President, last week, I came to the Senate floor to talk about 
the flawed process of our current attempts to reform the health care 
system in this country and the urgent need to fix those flaws.
  Those efforts included a letter--my letter--which every Republican 
member of the Finance Committee and the HELP Committee--Health, 
Education, Labor, and Pensions Committee--signed requesting some very 
reasonable steps to be taken by Chairman Baucus, Chairman Kennedy, and 
Senator Dodd, who is standing in for our friend and colleague, Senator 
Kennedy.
  We asked the chairmen to release the details of their plans to reform 
health care. We asked them to do so in a timely manner to allow us time 
to read and understand the policies and to get reactions from our 
constituents, i.e., the people who will benefit or will not benefit, 
not to mention the providers of health care. We asked them to give us 
the estimates of how much their plans would cost and how it would 
impact everyday Americans. Finally, we asked them to identify how they 
intended to pay for these plans.
  It was my sincere hope that by receiving this information we could 
better participate in the quest to ensure that every American--every 
American--has meaningful access to health care, not to mention patient 
choice.
  Well, unfortunately, the health care reform process has been so 
corrupted by artificial timelines and a ``hurry up'' and a ``riding 
hell for leather'' mentality that it threatens to destroy a health care 
system that has served most Americans very well.
  The American health care system represents one-sixth of our economy, 
which has been repeated many times on this Senate floor, offers health 
insurance coverage to 250 million Americans, and employs over 16 
million people. It leads the world in medical innovations that save 
lives inside as well as far outside our borders. So this actually is an 
international health care bill.
  President Obama has recognized that most people are happy with their 
health care. Obviously, they would like some changes, some reforms. But 
he has repeatedly assured them: If you like what you have, you can keep 
it.
  Well, because changes to this system have the potential to impact 
every single American citizen and citizens of other nations, it seems 
to me we must ensure we protect the best of its features when we 
consider changes to shore up its deficiencies.
  Careful consideration is required. That is why we ask for more 
details. That is why we ask for more time. To date, our requests for 
more information have not been met, and I think I am starting to 
understand why.
  Yesterday afternoon, the Congressional Budget Office, the CBO, 
released its first preliminary analysis of the bill we are scheduled to 
begin marking up

[[Page 15203]]

in the HELP Committee tomorrow. Let me repeat this: Yesterday 
afternoon--less than 24 hours--if you are a HELP Committee staffer, you 
are looking at your watch, and you are wondering how come you do not 
have more time--the Congressional Budget Office released its first 
preliminary analysis of the bill that we are scheduled to begin marking 
up tomorrow.
  I said in my previous speech, maybe we need a ``process czar,'' a 
``fair play czar'' around here. We have 25 czars in the Obama 
administration. Maybe we need a czar around here to at least be fair, 
give us more time, give us more consideration, let us know what we are 
going to be voting on.
  Before I talk about the results of the CBO's analysis of the Kennedy-
Dodd legislation, I need to point out this analysis is incomplete. It 
is incomplete because, despite our persistent requests for more 
information from our Democratic colleagues and friends, one day before 
the markup of possibly the most important health care bill ever to 
cross the Senate floor, they have not released the complete 
legislation.
  In fact, even when the HELP Committee begins our markup tomorrow, we 
will not have a complete picture of what we are marking up. The most 
contentious components of the bill will not be released until sometime 
on Thursday morning--leaving us around 30 hours to digest these 
significant policies, vet them with our people back home, take the 
specifics back home to the health care providers and every constituent 
who certainly is interested and wants to know the details, and then 
file amendments to see if we can do better, see if we can actually 
correct some things we think are headed in the wrong direction.
  I said it is hard to digest all of this in 30 hours. This is not 
digestion, this is not indigestion--this is heartburn. It may develop 
into a malady much more serious than that.
  Most egregious perhaps is the fact that we will most likely be 
considering these major reforms without any idea of how much they will 
cost or how they will affect the current system. But, as I said, I am 
starting to wonder whether that is not part of the plan, which leads me 
back to yesterday's CBO release analyzing the cost and effect of just 
one of the six titles to the Kennedy-Dodd health care reform bill--and 
an incomplete title at that.
  According to CBO, the incomplete sections of title I will cost $1 
trillion--$1 trillion. That is just for one incomplete title of this 
bill. What will we get for this staggering investment, for a title with 
a purpose ostensibly to expand health care coverage to the estimated 47 
million Americans currently lacking insurance?
  According to CBO, we will only cover 16 million more Americans. Let 
me say that again. According to CBO, we will only cover 16 million more 
Americans. That does not seem like a very good return for a bill that 
seeks to cover three times that many people.
  Instead of extending health insurance to 47 million uninsured, we are 
leaving tens of millions still uncovered. And the CBO says that figure 
is around 37 million people. So you can see we have some flaws in this 
approach on this bill.
  In addition, CBO says that 15 million people would lose their 
employer-sponsored insurance and another 8 million--again, this is the 
CBO analysis--would lose coverage from their current source.
  Whom are we going to trust around here? At least when we asked the 
CBO to give some specifics, they are providing some specifics; that is, 
15 million people would lose their employer-sponsored insurance and 
another 8 million would lose coverage from their current source. That 
is 23 million people. That is a lot of folks. As I said, President 
Obama has consistently promised: If you like the health insurance plan 
you have, you can keep it. Not those 23 million.
  Under the Kennedy-Dodd bill, 23 million Americans who may like what 
they have cannot, in fact, keep it--again, according to the CBO, 
nonpartisan.
  I cannot even imagine how much more this bill will cost taxpayers 
when CBO figures in the rest of the initiatives my friends across the 
aisle wish to add. I am positive, under the complete plan by my 
colleagues, millions more Americans will not be able to keep the 
insurance they like.
  That is because in addition to the plans that have already been 
released, they want to establish a new government-run, taxpayer-
financed insurance plan that is estimated to replace private insurance 
for over 100 million Americans. They want an expansion of Medicaid for 
everyone up to 150 percent of the Federal poverty level. They want to 
enact dozens upon dozens of new programs.
  For example, title III of this bill includes--listen to this--a $10 
billion per-year-cost in mandatory spending--mandatory spending; this 
is on the appropriators' side--for something called a Prevention and 
Public Health trust fund for the Appropriations Subcommittee on Health, 
with very little, if any, direction on what the money would be used 
for.
  This is unprecedented and amounts, in my view, to a slush fund, 
regardless of any description.
  Another section provides an unknown amount of money--``such sums as 
may be necessary''--to fund something called a community makeover--
excuse me--a community transformation grant to build grocery stores, 
sidewalks, and jungle gyms.
  Sidewalks, jungle gyms, grocery stores? This is a health care bill, 
not a rural development bill. I am shocked by the numbers that have 
come out so far, and they are just the beginning.
  Well, come to think of it, maybe it is related to health care. Maybe 
if you build a better sidewalk, people could walk on that sidewalk, 
pass the jungle gym, exercise on the jungle gym, go to the grocery 
store, have mandates to buy nothing but fruits and vegetables, come 
back past the jungle gym, exercise some more, and since the sidewalk is 
fixed, they could go home, and we would help cure the obesity factor we 
face today. Maybe that is the tie. Maybe that is the tie.
  I am shocked, as I said, by the numbers.
  One independent group--now listen again to this; you have to listen 
to this--the group called HSI Network in Minnesota has estimated that 
the cost of the Kennedy-Dodd bill in its entirety could be $4 
trillion--$4 trillion. The Lewin Group has estimated that up to 119 
million Americans could lose their private insurance coverage under a 
government-run plan.
  I am willing to bet the American public will be as shocked as I am 
once they understand what has been lurking, lurking, lurking under the 
banner of reform. The refusal to release information such as this until 
the very last possible minute, under an unjustifiably accelerated 
timeline, leaving no time for Senators, let alone the American public, 
to examine the merits of this plan, makes me think the ``health care 
emperor has no clothes.''
  Let me repeat what the CBO has said. Sixteen million Americans newly 
insured--a good thing--but 37 million Americans still not insured. 
Twenty-three million Americans lose what they have for $1 trillion. 
This is the wrong direction. This is the wrong direction. We ought to 
say: ``Whoa.'' Put a sign up in both committee rooms that says: 
``Whoa,'' and put a sign underneath it that says: ``Do no harm.''
  To add to this concern I have and the frustration I have in regard to 
health care reform, CongressDaily reported Tuesday, June 16--that is 
today--that CBO scored a recent version of the Senate Finance 
Committee--this is Finance, this is not Health. This is not the one I 
am talking about; this is the Finance Committee, and I have the 
privilege of serving on both--that their overall proposal is at $1.5 
trillion over 10 years, not $1 trillion, according to several sources. 
This is a typical news story. The committee's timeline to release and 
mark up the legislation could slip on the news. Senate Finance Chairman 
Max Baucus cautioned today the CBO numbers, which he did not confirm, 
were on a bill that is about 2 weeks old and the bill has evolved since 
then. The chairman indicated it is unlikely he will release a draft of 
his committee's bill Wednesday, as he previously estimated--that is 
tomorrow.

[[Page 15204]]

The high score could add more credence to an insurance co-op proposal 
offered by Senate Budget Chairman Kent Conrad as an alternative.
  So we don't know. Is it $1.5 trillion or is it $1 trillion? We don't 
know. And if an offhand comment, which may or may not be private, but I 
don't think anymore anything should be private in regard to health care 
reform--the chairman indicated, I think, it was a comment in response 
to Senator Snowe, who said, How do we vote for this bill in committee 
if we don't know how much it costs and how it is going to merge with 
the Health Committee's bill. Basically the answer coming back, as 
everybody knows is, This bill isn't going to be written here, this bill 
isn't going to be written in committee; it is going to be written in 
conference. It is called ``trust me.''
  I don't see how we can have much trust when ``the emperor has no 
clothes.''
  I yield the floor.
  Mr. CASEY. Mr. President, first, I ask unanimous consent to be 
permitted to speak as in morning business.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. CASEY. I also ask unanimous consent to be permitted to speak for 
what I hope will be 20 minutes.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. CASEY. Finally, I will have two separate subject matters I wish 
to cover.
  Mr. President, I didn't plan on responding to my colleague from 
Kansas, and I won't today, but I still think on health care we have a 
long way to go. There is still a lot of work to be done in the 
committee I am a member of, the Health, Education, Labor and Pensions 
Committee, and an awful lot of work to do still in the Finance 
Committee. So we will leave that for another day. But in a general 
sense, I think what we are all trying to do--I know my colleagues on 
the Democratic side are trying to do this--is to make sure that at the 
end of this debate, the bill that emerges from the Congress has a 
couple of basic principles. One is it gives people choice in their 
health care. If you like what you have, you get to keep it, and if you 
don't like what you have, you have a choice; and that the bill also 
reflects a cost reduction which is essential if we are going to move 
forward; and finally, that we provide the kind of quality, affordable 
health care that every American has a right to expect that we would try 
to provide in this bill.
  If we keep that in mind, I think we can get to the right place. We 
have an awful lot of work to do, and I think there are some conclusory 
statements that have been made in the last couple of days which don't 
reflect the reality, which is we have a lot of proposals, we have draft 
bills, but we don't have a final product yet, so we have a way to go.


                           Iranian Elections

  Mr. President, the first subject I wish to discuss is the Iranian 
elections. I wish to convey some brief remarks on the remarkable events 
we have been witnessing unfolding in Iran in the last couple of days. 
It is too soon to tell what will happen. We do not know if Iran's 
brittle theocratic regime will hear out the voices of reform emanating 
in such powerful fashion from the streets of Iran today. We do not know 
if a credible investigation of serious electoral irregularities will 
occur, but I am confident that the events of this past weekend will be 
recorded in the history books as a major milestone for the democratic 
aspirations of the Iranian people. While the hard-liners who continue 
to rule Iran today may further entrench their power in the coming days, 
they are only planting the seeds for their ultimate defeat by their 
response to the democratic voices with the kind of force and 
suppression we have seen play out on television.
  It is a promising sign that Iran's supreme leader has called upon the 
all-powerful Guardian Council to review the electoral results and 
assess the claims of serious irregularities, including vote rigging and 
ballot fraud, in the national election. However, we should not get our 
hopes raised that justice is imminent.
  In the last Iranian Presidential election in 2005, there were also 
serious questions of fraud raised after Mr. Ahmadinejad came out of 
nowhere to win the Presidency following a runoff vote. Yet the final 
results of that investigation were never published, and thereafter Mr. 
Ahmadinejad's declared victory stood firm. Because of that precedent, I 
am skeptical that the Iranian regime will engage in an honest review of 
this election count.
  President Obama and his senior national security team have refrained 
from extensive commentary on the election in recent days. That is as it 
should be. The U.S. Government should not give the Iranian regime any 
flimsy rationales for further crackdown on protestors and reformist 
leaders. However, administration officials, led by Vice President 
Biden, have made clear that the strategy of diplomatic engagement with 
Iran's leadership to bring a peaceful resolution of Iran's nuclear 
program will continue, regardless of who may comprise that leadership 
or how they may have assumed power. That, I believe, is the right 
strategy. We must deal with Iran as it is, not as we may wish it to be. 
For far too long, the United States deprived itself of the power of its 
diplomacy on the mistaken insistence that Iran agree to a set of 
preconditions before talks could even commence. Talking to your enemy 
can never be viewed as a concession. The United States spoke to the 
Soviet Union during the worst excesses of the Cold War, but diplomacy 
cannot be the only option that the United States pursues with Iran. The 
President knows this and has reaffirmed that other options are open to 
the United States on multiple occasions.
  Any effective strategy toward Iran must offer the regime a clear 
choice when it comes to its nuclear program, and here is the choice; it 
is either one or the other. Come into compliance with the multiple 
United Nations Security Council resolutions and reap the benefits of 
economic engagement and warmer diplomatic ties, choice No. 1. Or choice 
No. 2 for the Iranian regime: Face continued economic sanctions and 
international isolation that will steadily worsen if Iran continues to 
engage in illicit nuclear activities. It is either one or the other, 
and the regime has a choice to make before the world. Effective 
diplomacy is successful if it can fully convey that choice to the 
decisionmakers in Iran.
  The Congress can also play a useful role here in elucidating the 
consequences Iran faces when it makes its choice on its nuclear 
program. Some might call it the ``good cop, bad cop'' strategy; I 
simply prefer to call it diplomatic leverage that our negotiators can 
employ if and when they do sit down at the table with Iranian 
representatives.
  For those reasons, I am proud to have joined my colleague Sam 
Brownback in introducing the Iran Sanctions Enabling Act. This 
legislation would authorize State and local governments as they see 
appropriate to direct divestment from, and prevent future investment 
in, companies that hold investments of $20 million or more in Iran's 
energy sector.
  There is a growing divestment movement across the country in response 
to Iran's accelerating nuclear program, its support of Hamas and 
Hezbollah, and hateful statements against Israel perpetrated by its 
President and others in Iran's senior leadership. Unfortunately, the 
Federal courts have ruled that divestment actions undertaken against a 
single nation may not predict the President's constitutional authority 
to enjoy exclusive authority over our Nation's diplomatic relations; 
thus, State and local governments undertake divestment measures with 
some legal jeopardy. The Justice Department has taken legal action 
against State and local governments in cases involving other nations. 
This act, the Iran Sanctions Enabling Act, protects the rights of State 
and local governments to ensure that their pension funds and other 
investment funds are not invested in companies that do business with a 
regime such as Iran. It is carefully targeted to focus only on 
financial ties with Iran's energy sector,

[[Page 15205]]

to hit Iran where it is economically most vulnerable.
  The bill includes a sunset provision to lift this authorization once 
the President certifies that Iran has ceased providing support for acts 
of international terrorism and has ceased the pursuit of weapons of 
mass destruction. I am proud to have assumed the lead Democratic role 
on this legislation, taking over for President Obama, then Senator 
Obama, who served in the lead role when he was in the Congress.
  Secondly, let me also take a brief moment to comment on the Iran 
Refined Petroleum Sanctions Act of which I am proud to be a cosponsor 
with the majority of the Senate. The bill would clarify existing legal 
ambiguity by authorizing the President to sanction foreign firms 
involved in supplying Iran with refined gasoline and/or assisting Iran 
with increasing its refining capacity.
  Iran is forced to import as much as 40 percent of its annual gasoline 
consumption due to the fact that much of its refining infrastructure 
was destroyed during the Iran-Iraq war in the 1980s. Economic sanctions 
in place since then have limited outside foreign investment. Targeting 
Iranian gasoline consumption is a promising venue for increasing our 
leverage on Iran's leadership. The Iranian people, I believe, may 
question why the regime prioritizes a nuclear program condemned by the 
international community at the cost of serious gasoline shortages in 
Iran.
  The images in recent days have been stirring. Just yesterday we 
witnessed a procession of hundreds of thousands of Iranians, both young 
people dressed in modern attire and elderly women wearing traditional 
veils, marching in silence throughout downtown Teheran. Indeed, 
whenever a chant or shout emerged from the crowd, it was quickly hushed 
by the crowd, seeking to avoid any provocation for the riot police 
standing watch to move and break up the march. It is easy to forget, 
with all the incendiary rhetoric from leaders such as Mr. Ahmadinejad, 
that the Iranian people remain fundamentally pro-American and envy our 
democracy and personal liberties.
  This week is a dark moment for the Iranian people as their legitimate 
aspirations for greater reform have been apparently sidetracked by the 
regime. But I am optimistic on their future and look forward to the day 
that the United States and Iran can once again be at peace and enjoy 
mutual respect for and with one another.
  Mr. President, I would inquire as to the time remaining.
  The ACTING PRESIDENT pro tempore. The Senator has used 11 minutes.
  Mr. CASEY. So I have more time than I thought I did. That is good 
news.


                 American Recovery and Reinvestment Act

  Mr. President, I wish to move to a second topic in the remaining time 
I have with regard to the American Recovery and Reinvestment Act, but 
especially in regard to some of the attacks that have been leveled in 
recent days.
  In just over 100 days now, the Recovery and Reinvestment Act is 
already at work doing many things, such as providing immediate relief 
for hard-hit communities and families; secondly, creating and saving 
jobs; and thirdly, jump-starting thousands of shovel-ready projects 
across America. Our economic problems were not created in 100 days and 
they will not be solved in 100 days or even in a little more than 100 
days. But thanks to the Recovery Act, we are meeting the greatest 
economic challenge in a generation head on.
  There are early signs of progress across the country. Just a couple 
of examples of immediate relief measures under the act are providing 
stability for hard-hit families.
  First, the Make Work Pay tax credit has increased take-home pay for 
95 percent of working families; 95 percent of working families in 
America are benefiting from that. I note that in Pennsylvania the 
number is 4.8 million households are benefiting from that tax credit. 
Second, unemployment benefits have increased by $25 a week. Third, 
COBRA health insurance premiums have been cut by 65 percent. Fifty-four 
million older citizens across the country have received $250 in 
emergency relief checks in the mail. Finally, in this section, food 
assistance benefits have increased by 13 percent, just when vulnerable 
Americans need them.
  Tax credit and other Recovery Act incentives are starting to drive 
new consumer spending and creating new product demand. Energy 
efficiency and renewable energy tax credits are providing fresh 
opportunities for manufacturers and contractors that make or install 
green products. And the $8,000 first-time home buyer tax credit is 
proving to be a bright spot for the hard-hit housing industry.
  The Recovery Act aid to State governments is helping to protect 
critical safety net programs and saving teaching and law enforcement 
jobs. Over half of the States have qualified for the State fiscal 
stabilization funds that are saving teaching jobs and improving 
education.
  State governments are making up shortfalls in Medicaid funds, thanks 
to the Recovery Act.
  Infrastructure improvement projects funded by the Recovery Act are 
bringing new jobs to hard-hit communities.
  Over 20,000 Recovery Act projects across the country have been 
approved already. In Pennsylvania, just two quick examples: $725 
million for highway projects has been allocated and $600,000 for 
airport grants.
  The Recovery Act commitments to develop and commercialize new 
technologies that will be the foundation of the new economy are 
starting to boost confidence and spur some private sector investment 
across the country.
  Businesses are converting crisis to opportunity because of the 
promise they see with the Recovery Act. The Recovery Act is already 
making life a little easier for families and businesses like these, and 
work is just getting started.
  Last week, President Obama and Vice President Biden announced the 
Roadmap to Recovery, 10 new major projects that will define the next 3 
months of the Recovery Act. Here is what the 10 are: help 1,129 health 
centers in 50 States and 8 territories provide expanded service to 
approximately 300,000 patients; begin work on 107 national parks; start 
rehabilitation and improvement projects at 98 airports and over 1,500 
highway locations throughout the country; fund 135,000 education jobs, 
including teachers, principals, and support staff; begin improvements 
at 90 veterans medical centers across 38 States; hire or keep on the 
job approximately 5,000 law enforcement officers; start 200 new waste 
and water systems projects in rural America; begin or accelerate 
cleanup work at 20 Superfund sites from the National Priority List; 
create 125,000 summer youth jobs; finally, begin 2,300 construction and 
rehabilitation projects at 359 military facilities across the country.
  Billions of dollars in Recovery Act programs that will shape the 
economy of the 21st century will launch in the weeks and months ahead--
for example, $8 billion for high-speed rail; $4.7 billion to connect 
more Americans to broadband Internet; $4.5 billion to make a nationwide 
smart energy grid a reality; $800 million to accelerate the use of 
biofuels and bring them to market; and $300 million to expand the 
Nation's fleet of alternative-fuel vehicles through the Clean Cities 
Program.
  These investments will get our economy moving today in a way that 
will change our economy for tomorrow. The road to recovery is long and 
our economic problems won't be solved overnight, but with every dollar 
invested and every project started under the Recovery Act, we are 
getting one step closer.
  I will conclude with one further comment. Just as was the case when 
we voted on the Recovery Act, it was a choice between are you for the 
Recovery Act or for the status quo? Fortunately, enough of us voted for 
it so we could jump-start the economy, get it out of the ditch and back 
on the road to recovery. We still have a long way to go, and there is a 
lot more work to do, but so far the news is positive in communities 
across the Commonwealth of Pennsylvania and I know in your home State 
of Illinois, Mr. President, and across the country.

[[Page 15206]]

  With that, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Arkansas is 
recognized.
  Mrs. LINCOLN. Mr. President, I ask unanimous consent to speak as in 
morning business.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mrs. LINCOLN. Mr. President, I wish to applaud my colleague from 
Pennsylvania because he shared not only our dreams for the recovery--
or, as we call it in Arkansas, the ``jump-start'' bill--but, more 
importantly, not just our dreams but the things that are actively 
happening in our States, the great things, whether it is highway 
projects or for us in Arkansas the new market tax credits, which have 
been a tremendous boost for capital infusion into small businesses and 
for entrepreneurs. We can also look at the SBA 7(a) Loan Program, which 
is tremendous for small businesses. Education alone--I met with 
principals and administrators last week when I was home, talking about 
the opportunities for education and the infusion of resources coming 
from the Recovery Act, along with water projects and broadband. The 
Senator from Pennsylvania did an excellent job in mentioning those and, 
most importantly, focusing on the fact that this will help us get our 
country and our economy back on track and get Americans back to work or 
keep them in the jobs they are clinging to. I appreciate him coming to 
the floor and mentioning some of that, all of which many of us have 
been seeing as we travel home to our States over the weekend or during 
the breaks.
  Mr. CASEY. I thank the Senator.
  (The remarks of Mrs. LINCOLN pertaining to the submission of S. Res. 
186 are located in today's Record under ``Submissions of Concurrent and 
Senate Resolutions.'')
  The ACTING PRESIDENT pro tempore. The Senator from Virginia is 
recognized.


                        Systemic Risk Regulation

  Mr. WARNER. Mr. President, I rise today to discuss the state of our 
financial system and to provide some thoughts on systemic risk 
regulation, as we set about crafting an overall reform to our financial 
regulatory approach.
  Yesterday, Treasure Secretary Timothy Geithner and the Director of 
the National Economic Council, Lawrence Summers, published an editorial 
in the Washington Post laying out the broad outline of their proposal 
for regulatory reform. I share their views on how we arrived at this 
moment. I share the broader goals they discussed and look forward to 
working with the administration on comprehensive and timely regulatory 
reform. However, I wish to speak today about one area where I disagree, 
and that is how to address systemic risk.
  Let me step back for a moment.
  In the past 2 years we have witnessed events that have shaken our 
financial system to its core, altered our markets in ways that we still 
struggle to understand, and imposed costs that will burden our economy 
and our taxpayers for decades to come. We have grown numb to the news, 
but let me briefly recount these events.
  The investment banking sector that built our capital markets has 
collapsed. Two of our largest investment banks have failed. Another has 
merged with a commercial bank to avoid failure. Two others became 
commercial banking organizations.
  Our residential mortgage finance sector has collapsed. The largest 
mortgage banks in the country have failed. Our two largest savings and 
loan associations have failed. Our two largest housing GSEs are 
operating under Federal Government conservatorship.
  Our commercial banking sector has avoided collapse only through the 
infusion of hundreds of billions of dollars in equity support from the 
U.S. Treasury and massive liquidity support from the FDIC and the 
Federal Reserve. And despite these interventions, some of our largest 
commercial banks continue to face an uncertain future and dozens of 
smaller commercial banks have failed. Our insurance sector has been 
badly damaged. The largest insurance organization in the United States 
has been nationalized to avoid collapse. Other major insurers have 
received billions of dollars from the Treasury.
  The magnitude of the events of the past 2 years strains 
comprehension. I believe what we have seen over the last couple years 
is the equivalent, in economic terms, of the 100-year flood. Millions 
of families and retirees have lost their financial security. Millions 
of people are out of work. Each day, we read about more layoffs, more 
losses, more bankruptcies, and more bank failures. We call this a 
financial crisis, but for the American people it is a very personal 
crisis of lost homes, derailed careers, forgone education, deferred 
retirement, communities less cared for, and at its core, the confidence 
of the American people has been shaken.
  This crisis has uncovered the flaws of our current regulatory model 
and has revealed a shadow financial system which lies beyond the 
current regulatory structure.
  We all share the hope that we will soon return to healthy, 
competitive financial markets and a vibrant economy. We have seen some 
positive signs that markets are stabilizing. But for our long-term 
prosperity, we do need a new model. What has happened to our financial 
system and our economy should not have happened. We must find and adopt 
reforms that will ensure that it never happens again.
  We cannot shrink from the needed reform because it will be difficult 
or because some will oppose it. Right now there is a lack of faith in 
our system or its long term prospects. You can see that in our bond 
markets. We are not turning to the financial sector as a source of 
positive innovation so that the broader economy can grow. You can see 
that in the lack of credit in our markets, and the jobs lost every 
month.
  To innovate and create jobs, not only in the financial system but 
across our whole economy, we do need comprehensive reform. Quality will 
attract capital, but only change will restore the quality of our 
markets.
  This is the fundamental challenge facing the Banking Committee, of 
which I am a new member. However, before I joined this Banking 
Committee, before I joined this August body, I did spend 20 years in 
the private sector around the financial system, taking companies 
public, looking at and learning about the markets. So I came to this 
body, I believe, with some background. But only since that time have I 
learned how complex the problems and the challenges are of trying to 
get financial reregulation or financial reform right.
  Since joining the Banking Committee, I have been working to educate 
myself, meeting with a range of experts to learn more about the issues 
and to collect their thoughts on potential solutions to financial 
reregulation. There are a number of things we must do, including 
providing full regulatory coverage for all markets, ending too big to 
fail with a robust resolution authority, and ending regulatory 
arbitrage.
  Today I would like to speak about one issue I discussed at length 
with these experts--systemic risk regulation. I hope, in the coming 
days, to come back to the floor and discuss other parts of securities 
and banking regulation.
  ``Systemic risk'' is a term that, quite candidly, probably most of us 
even around the financial markets had not even heard of or thought very 
much about until the last couple years. Obviously, systemic risk is not 
the only area we need to address, but it is an area in which the 
current system has unequivocally failed.
  Systemic risk is a tricky concept. Systemic risk is not a specific 
kind of risk at all. It is a catchall phrase that includes risks of all 
kinds, united only by the possibility that if left uncontrolled, they 
could have consequences for entire markets or even our entire financial 
system. Counterparty exposures can present systemic risk. So can 
interest rate shifts. So can bad laws and regulations. Because they 
come in all shapes and sizes, we should not expect to control systemic 
risks with a rigid, one-size-fits-all approach.
  Our current system has failed to provide checks and balances and has 
replaced healthy competition with a system where a handful of firms are 
called

[[Page 15207]]

too large to fail, and these so-called too-large-to-fail firms can 
threaten the safety of the entire system and, unfortunately, enjoy an 
implicit or even now even more explicit government guarantee that 
destroys any notion of market competition.
  Secretary Geithner and Professor Summers have proposed empowering the 
Federal Reserve to manage systemic risk. But as I have discussed this 
approach with a number of experts, they have raised a number what of 
what I think are very serious and legitimate concerns.
  My primary concern with placing this added new responsibility with 
the Federal Reserve is structural. There are already tensions between 
the Federal Reserve's responsibilities for the conduct of monetary 
policy and its responsibilities for bank supervision. No less an 
authority on this matter than Paul Volcker told the Joint Economic 
Committee last year that broadening the Federal Reserve's 
responsibilities ``would be a way of destroying the Federal Reserve in 
the long run, because it does need independence.'' Adding this 
additional responsibility on the Federal Reserve, I believe, is a step 
too far.
  My other concern is rooted in the governing philosophy of this 
country, which I think has, quite honestly, served us well. That 
philosophy is that too much economic power placed in one place puts our 
system of government at risk.
  Our Founding Fathers opposed that concentration of power, economic or 
otherwise, and favored a system of checks and balances. Thomas 
Jefferson famously wrote that ``[t]he Central Bank is an institution of 
the most deadly hostility existing against the principles and form of 
our Constitution.'' That is why America, unlike so many European 
countries, never created a single, all-powerful national bank. We have, 
consequently, even since that time, resisted creating that all-powerful 
central bank. The experience of countries which have concentrated too 
much power in one entity I think should serve as cautionary tales.
  Also, we should not ignore that the Fed has had some responsibility 
for systemic risk regulation under the current structure. Over the 
course of the past year, we have seen the Federal Reserve and the 
Treasury strike private deals with our largest and most powerful 
financial institutions--deals that might have protected the 
shareholders and creditors of those banks, but, consequently, by those 
actions, put smaller and less powerful and often better run 
institutions at a competitive disadvantage and undermining the long-
term vitality of our financial system.
  An old African proverb says that when elephants dance, the grass gets 
trampled. We have a trampled grass problem at this point, and I don't 
think we can solve it with bigger elephants, whether those bigger 
elephants are regulators or institutions. If we do not give the Federal 
Reserve the responsibility for systemic risk regulation, what should we 
do instead?
  I believe the answer to this question has two parts. The first part 
is that many systemic risks already lie squarely within the 
responsibilities of the day-to-day financial regulators. We did not 
just discover systemic risks. We have been discovering them for 
generations. We have passed laws to deal with them, and we have 
entrusted those laws to the administration of substantial regulatory 
agencies.
  We need to make sure our current regulators, the folks who, for the 
most of the last century, have done their jobs well, have clear 
missions, including managing risks within their regulated institutions 
and markets, and we must ensure that these regulators do their jobs.
  But that is only half the problem. Even if we get the day-to-day 
prudential regulator to be more efficient in evaluating particular 
institutions' risk profile, we have to recognize that some part of 
systemic risk may lay outside of the regulator's day-to-day 
responsibilities and actually fall between the cracks of our existing 
regulatory system.
  Working with folks across the financial spectrum, they have suggested 
the creation of a systemic risk council. I don't mean to claim on this 
floor that a systemic risk council is a silver bullet, but it avoids 
the pitfalls of entrusting the systemic risk responsibility in one 
agency that already has responsibilities and can be a potential source 
of conflict. Instead, a council can see across the horizon and gather 
all the information and expertise can flow to it, thereby addressing 
our stovepipe problem of our various regulatory agencies and making 
sure, as well, by having this council, it would have the intrinsic 
conflicts that would come if you also have to have responsibility for 
monetary policy. Making sure we have this council would also avoid the 
very real challenge of regulatory capture. Let me briefly outline this 
concept.
  Our belief would be the systemic risk council would consist of the 
Treasury Secretary, the Chairman of the Federal Reserve, and the heads 
of the major financial regulatory agencies. It would be charged with 
the responsibility for working to improve our understanding and control 
of systemic risks and, in a narrow set of circumstances or emergencies, 
it would have the ability to act.
  People would say: What does this look like? It builds on the model of 
the President's working group on financial markets. The idea is, the 
systemic risk council would have an independent chair appointed by the 
President and approved by the Congress and supported by a permanent 
staff. The best analogy of the systemic risk council might be the 
resemblance it might bear to the National Transportation Safety Board 
or the National Security Council. Just as the NTSB leaves rulemaking on 
a day-to-day basis to the FAA, the systemic risk council would leave 
most of the day-to-day rulemaking to the financial regulatory agency.
  I understand criticism of the council's approach today is we don't 
just want a debating society at moments of crisis. That is why it needs 
this independent chair, independent staff, and resources. We must 
ensure it could act.
  It would have the authority to review every bit of information that 
the individual, prudential, day-to-day Federal regulatory agencies 
possess, to require those agencies to collect information from the 
institutions they regulate.
  It would also have, as I mentioned, an independent staff capable of 
analyzing this data, understanding how the pieces of the regulatory 
system work together, and then at that council level, at that staff 
level, feed that information up to the council so it could identify 
weaknesses or gaps within our system or potential systemic risks that 
might be arising outside the purview of the independent Federal 
regulatory agency.
  The council would also have the authority to require the financial 
regulators to develop clear, written plans for dealing with potential 
financial crises. In effect, it would have the potential to ask any 
institution to come forward with a winddown resolution plan for its 
particular circumstances. These plans would be created in advance of 
any crisis, maintained and even simulated from time to time to make 
sure they are adequate.
  Again, if we put in place these kinds of credible plans to handle the 
potential failure of every systemically important financial 
institution, then we will no longer have the excuse that we have 
constantly heard over the last few months: Gosh, it is tough we have to 
put up this much public money to support this institution, but it is 
too big to fail.
  As we have seen time and again in this crisis, because we didn't have 
these plans in place, unfortunately, the American taxpayers have taken 
on unfounded, quite honestly, financial risk in shoring up these 
institutions.
  Because a systemic risk council would not directly interact with our 
major financial institutions on a day-to-day basis, it would be less 
prone to capture than the financial regulatory agencies. During normal 
times, the council could help to determine how to regulate new products 
and markets in order to minimize regulatory gaps, regulatory arbitrage, 
and the blind spots that currently exist in our system. As we know at 
this point, too many of

[[Page 15208]]

those blind spots exist and have allowed the creation of some of the 
financial products that led to the financial meltdown we have seen.
  The council will not identify firms that are too big or too large to 
fail but instead will work to prevent firms from becoming too large to 
fail. It would do this specifically in two ways.
  First, it would have the authority to establish systemwide, 
counterparty exposure limits, increased capital requirements, reduced 
leverage, and strengthened risk management requirements--all of these, 
in effect, to put not an absolute prescription but at least barriers on 
those institutions that choose to get so large that they might 
potentially fall into that ``too big to fail'' category.
  Second, it would ensure that the resolution authority would be able 
to resolve any institution that got to that size and then potentially 
posed a systemic risk.
  In a crisis, the council could work with its member organizations to 
promote coordinated and comprehensive responses. The systemic risk 
council's responsibilities would be clear and focused. Systemic risk 
would be its only job.
  Using a council, prudential regulators would remain empowered and 
responsible for systemic risks that arose in their jurisdiction. If 
they encountered a risk that extended beyond their authority they could 
go to the council to ensure coordinated and comprehensive action. On 
top of that, if the evidence of risk is spread across different 
agencies like pieces of a puzzle, the council would have the 
information and expertise to spot it, and the ability to coordinate 
action in order to address it.
  What I am proposing today boils down to a simple, commonsense idea. 
If we want to do something constructive about systemic risk, we should 
create a mechanism that can help ensure our regulators do their jobs on 
a day-to-day basis, avoid conflicts of interest, and fully leverage our 
existing regulatory resources to promote the proactive identification 
and control of systemic risks.
  Let me acknowledge at the outset that there are many details that 
still need to be worked out, and I will, as I mentioned, have a series 
of other ideas of how we can modernize our financial system in the 
coming weeks ahead. But I believe the general approach I have outlined 
today, in terms of a systemic risk council, hopefully, will spark the 
debate so we do not simply default to further empowering an already 
extraordinarily important and critical institution, in terms of the 
Federal Reserve, without a thorough debate about this issue.
  The ACTING PRESIDENT pro tempore. The Senator from Arizona.


                              Health Care

  Mr. KYL. Mr. President, the problems with the current state of health 
care in America are well known. Republicans do not need to be convinced 
of a case for reform. We hear from our constituents who have concerns 
about their own health care dilemmas and those of their neighbors and 
we all agree the millions of uninsured Americans need access to high-
quality health care. But though we all agree on the need for reform, we 
have disagreements on how best to accomplish our goals.
  Republicans favor a patient-centered approach that allows individuals 
to choose their own insurance, keep it if they like it, and never have 
to get permission from a Washington bureaucrat to get the test or 
treatment their doctor says they need. President Obama wants Congress 
to pass a sweeping new Washington-run health care system that we 
believe would jeopardize the care most Americans already have. Such a 
system would likely lead to the collapse of private insurance and 
replace it with an enormous Washington bureaucracy that would ration 
health care for all Americans.
  I have discussed my concerns that Washington-run health care would 
diminish Americans' access to quality care, lead to denials, shortages, 
and long delays for treatment, and would give power to Washington to 
dictate what medications and procedures Americans could get and when 
they could get them. It is already in the works.
  A recent National Institutes of Health project description states:

       Cost-effectiveness research will provide accurate and 
     objective information to guide future policies that support 
     the allocation of health resources for the treatment of acute 
     and chronic conditions.

  ``Allocation of health resources'' is a euphemism for rationing--
denying care based on cost. To that end, Senator McConnell and I have 
introduced legislation that would bar the Federal Government from using 
comparative effective research to delay or deny care to anyone. That is 
a bare minimum that we should do to prevent rationing of care. Our 
bill, incidentally, is endorsed by the American Medical Association.
  Mr. President, government-run and rationed approaches have caused 
much pain to people in other countries--in Canada, for example. In an 
article for the Manhattan Institute's City Journal, Dr. David Gratzer 
wrote of the long waits that Canadians endure for just about any 
procedure or diagnostic test: seniors who lay on stretchers for 5 days 
in a hospital waiting room; a 3-year wait list for a hernia operation; 
a 2-year delay for sleep apnea treatment; a year-long delay for a hip 
replacement, and so on.
  It is one thing for Washington to take over car companies. Getting it 
wrong there usually would not lead to life-or-death problems. But it is 
an entirely different matter to allow Washington to go into business as 
the Nation's health care provider. Who is going to protect you when 
they get it wrong? To whom are you going to appeal?
  In his health care speeches, President Obama has stressed that if you 
like your current health care, you can keep it if you don't want to get 
on the Washington-run plan. That sounds all well and good, but it would 
not play out that way, according to health experts.
  The Lewin Group produced a study that shows, if enacted, the 
President's public option--the government-run insurance company--would 
displace 119 million happily insured Americans. Their companies could 
take the easy route and simply pay a fine, tell their employees to sign 
up for Washington-run health care, even if they do not want it. How 
does that square with the President's assurances that patients will get 
to keep what they have?
  Most insured Americans like their coverage. A May 14 Rasmussen poll 
shows that 70 percent of Americans rated their coverage as excellent--
70 percent. Another 23 percent rated it as fair. So most folks are 
happy with their current insurance and would not appreciate being 
pushed into Washington's health care bureaucracy, with all of its 
complex rules and hours of waiting on hold and webs of impenetrable 
bureaucracy.
  Then there is the matter of cost. How much will it cost to add 47 
million people to the health care rolls? Who will pay? To not know the 
answers to these questions is to be fiscally irresponsible. Yet we 
don't even have precise estimates from the Congressional Budget Office 
whose responsibility it is to tell Congress how much legislation will 
cost the taxpayers. The preliminary estimate of the Congressional 
Budget Office shows that only a part of the Health, Education, Labor 
and Pensions Committee bill will cost $1 trillion, but it only reduces 
the number of uninsured by 16 million people--$1 trillion for 16 
million people. The remainder of the bill, by the way, has not even 
been scored.
  My math shows that is $62,250 per person, and that only covers about 
one-third of the 47 million who are said to lack insurance. It doesn't 
take into account the estimated 119 million insureds who will be 
switched from the private coverage they currently have to the 
government program. So what will the total cost be?
  Mr. President, there is another concern that hasn't been much 
discussed but needs to be raised. It is a major concern for America's 
seniors. Over the weekend, the administration proposed trimming 
Medicare's budget to pay for this new public plan. This is exactly the 
wrong thing to do and can only

[[Page 15209]]

mean one thing: rationing and waiting lists for America's seniors. 
Seniors want Congress to strengthen Medicare, make it more efficient 
and, importantly, make it solvent. They want it to serve as intended--
to pay for the health care of seniors. They do not want its resources 
drained to pay for a massive new plan for the 47 million uninsured, 
plus the 119 million currently insured but soon to be displaced into 
the government system.
  Seniors rightly ask: Won't the new demands for care greatly diminish 
the quality of care seniors now receive and lead to dangerous waits for 
tests and treatment?
  President Obama has acknowledged that Medicare's promises of 
treatment are financially unsustainable. We learned recently that 
Medicare's liability; that is, the amount of benefits promised that are 
not covered by taxes, is $38 trillion over the next 75 years. One 
lesson we can draw from Medicare's financial troubles--and veterans 
health care, for that matter--is that health care plans run by 
Washington bureaucrats are not very efficient or cost effective. They 
have no incentive to be. In fact, the economic principle of ``the 
tragedy of the commons'' applies. Since the money doesn't belong to any 
one individual or group, no incentive exists to be cost efficient, to 
eliminate waste, or to streamline the bureaucracy.
  Another way to say it is: Who washes their rent-a-car?
  Mr. President, seniors and veterans, private insurance holders, small 
businesses, and employers that insure their workers, the uninsured--in 
fact, all Americans--should be given the chance to review, discuss, and 
provide feedback on any legislation as important as this health care 
reform. It will affect the way we all get our health care.
  I look forward to an ongoing dialogue about the health care reform 
that we all want, but we must not rush to churn out and then hastily 
pass a plan that will lead to rationing and the displacement of 
millions from the insurance they currently enjoy. It is of paramount 
importance that the principles of quality care, choice, freedom, and 
putting patients first triumph in the reform we all want.
  Mr. President, I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. SANDERS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. SANDERS. Mr. President, I think virtually everybody in our 
country understands that America is in the midst of a major health care 
crisis. We have 46 million Americans without any health insurance. We 
have even more who are underinsured, and we have, in addition to all of 
that, some 60 million Americans--20 percent of our population--who do 
not have access to a doctor on a regular basis. The result of that 
particular fact is that we lose over 18,000 Americans every year, 
Americans who die needlessly--who should not die--because they do not 
go to the doctor when they should and get the treatment they need. That 
is six times every single year the number of people we lost on 9/11--
people who should not die because they do not have access to a doctor.
  Mr. President, in the midst of this horrendous lack of coverage--
unique, I should mention, among major nations on Earth--the United 
States spends far more per capita on health care than any other nation, 
and those costs continue to soar. So when people make international 
comparisons of the United States with other nations on how well or not 
well we are doing--and that is good to do--we should always remember we 
are spending almost twice as much per capita on health care as any 
other country. There is certainly something wrong and dysfunctional 
about a system which spends so much and yet leaves so many people 
uninsured, underinsured, or without access to a doctor or a dentist or 
other preventive health care.
  At $2.4 trillion and 18 percent of our gross domestic product, the 
skyrocketing cost of health care in this country is unsustainable both 
from a personal point of view--the needs of individual Americans--and 
also from a macroeconomic perspective of what is happening to our 
entire economy. At the individual level, the average American today 
spends about $7,900 per year on health care. Can you believe that? 
Close to $8,000 per person on health care?
  We all know folks who are out there making $20,000, $25,000, or 
$30,000 a year, and we are spending, on average, almost $8,000 per 
person.
  Despite that huge outlay--unprecedented in the world--a recent study 
found that medical problems contributed to 62 percent of all 
bankruptcies in 2007. I should add that most of the people who went 
bankrupt had health insurance. They had health insurance. But what they 
had was inadequate health insurance.
  From a business perspective--as opposed to the needs of an 
individual--General Motors spends more money on health care per 
automobile than they do on steel--more money on health care than on 
steel--which might lead us to understand why they are where they are 
today.
  Small business owners in the State of Vermont and around this country 
are forced to divert hard-earned profits into health coverage for their 
employees rather than new business investments. Many small businesses 
are trying to do the right thing for their employees, spending more 
than they have for health coverage so they do not have the money 
available to make the investments they need to make their businesses 
grow. The result of that, of course, is as a result of soaring health 
care costs--going up 10, 15, 20 percent a year--many small- and medium-
size businesses are cutting back drastically on their level of health 
care coverage or, in some cases, they are doing away with it entirely.
  More and more businesses in America are simply saying: I cannot 
afford to provide health insurance to my workers. Despite all of that--
that we spend almost twice as much per person on health care as any 
other country--people will say: Since you spend all that money, the 
results must be great. But that is not the case. The bottom line is we 
get poor value for what we spend.
  According to the World Health Organization, the United States ranks 
37th in terms of health system performance. We are far behind many 
other countries in terms of such important indices as infant mortality, 
life expectancy, and preventable deaths.
  So we are spending almost double what any other country on Earth is 
spending. We have 46 million without any health insurance, we have more 
who are underinsured, we have thousands who die because they cannot get 
to a doctor, and then in many other health care outcomes we are behind 
many other countries around the world--some of which are spending far 
less per person than we are spending.
  It seems to me, as the health care debate in Congress heats up, we as 
a nation have to ask two fundamental questions. Different people will 
have different answers to them, but here are the two questions I think 
we have to ask: First, as a nation, should all Americans be entitled to 
health care as a right? That is the first question.
  Honest people will have differences of opinion. Some people will say: 
You know what. Some people have big cars, some people have small cars. 
Some people have big houses, some people have small houses. Some people 
have good health insurance, some people have no health insurance. That 
is the way life goes. Some people hold that view.
  I do not. I think in America we should understand that every single 
person should be entitled to quality, comprehensive, affordable health 
care. In fact, I think most Americans believe the same thing.
  Second, if we are to provide quality health care to every man, woman, 
and child in this country, how do we do it in a way that does not 
bankrupt the Nation? How do we do it in a cost-effective way? Those are 
the two questions that we have to ask ourselves.

[[Page 15210]]

  I think the answer to the first question is pretty clear and, in 
fact, it is one of the reasons Barack Obama was elected President of 
the United States. Most Americans do believe all of us should have 
health care and nobody should be left out of the system. We have a hard 
time understanding that Joe Smith who works for one company has good 
health care, and his neighbor, Mary Evans, who works for another 
company, does not have any health insurance at all. What sense is that?
  I think as a nation we are coming to understand all of our people are 
entitled to health care as a right, as Americans, and the challenge we 
face is how do we do it in a cost-effective way. In that regard, I 
think--and I obviously speak just for myself--the evidence is 
overwhelming that we must end the private insurance company domination 
of health care in our country and move toward a publicly funded, 
single-payer, Medicare-for-all approach. I think the evidence is 
overwhelming that if you want universal, comprehensive, quality health 
care for all people, that is actually the only way you can do it.
  Our current private health insurance system is the most costly, 
wasteful, complicated, and bureaucratic in the world. Just today--not 
yesterday, just today--I spoke to an individual who has a law degree, a 
very smart guy. His wife has a Ph.D. They went through the Federal 
employee benefit package. Between a Ph.D. and a lawyer, they spent 
hours trying to figure out what particular program could work best for 
them.
  All over America, people are spending countless hours trying to 
figure out: Is it this program? Is it that program? I am young; I might 
not get sick but, you know, I have a history of cancer in my family. 
Should I get comprehensive? Should I get a high deductible? If I am a 
small business I can only negotiate this, if I am General Motors I can 
self insure. What should I do?
  The answer is, there are 1,300 separate private insurance companies 
in America peddling thousands and thousands of different plans. Let's 
be very clear, if in fact, anybody has not caught on yet; the function 
of a private health insurance company is not to provide health care. It 
is to make as much money as possible. That is what its reason for 
existence is about.
  In fact, when a private health insurance company denies health care, 
it makes more money. In fact, the record is pretty clear that private 
health insurance companies have given bonuses to people, their own 
employees, who are successful in throwing people off of the insurance 
policy because those people were running up high health care costs. 
Thus, we have the insane phenomenon of something called a preexisting 
condition.
  What a term that is, preexisting condition--meaning a person cannot 
get coverage for the illness they need to be covered for most. The 
person who had cancer 3 years ago and is worried about a recurrence of 
cancer--sorry, we can't provide insurance to you.
  Then you have other circumstances where somebody gets really sick, 
runs up a high medical bill, and the insurance company says: Oh, we 
don't want to continue your policy because we had to pay out so much 
money. We want to go to some young guy who can run the marathon and 
promises us never to get sick. Those are the guys we want to cover.
  This is an insane system. It is a wasteful system. It is a 
bureaucratic system. How many people are spending half their lives on 
the telephone, arguing with insurance companies to cover the claims 
they thought they were covered for? So people on one end of the phone 
are spending huge amounts of time and money doing that, and at the 
other end of the phone we are paying someone to tell us we don't have 
coverage for what we thought we did have coverage.
  With thousands of different health benefit programs designed to 
maximize profits, not provide health care, private health insurance 
companies spend an incredible 30 percent of each health care dollar on 
administration and billing, exorbitant CEO compensation packages, 
advertising, lobbying, and campaign contributions.
  One of the lovely things the insurance companies do and the 
pharmaceutical companies do is, after they rip you off and they make 
huge profits, they take some of that money to hire all these fancy guys 
in Washington, DC, to protect the status quo.
  The bottom line is--and all of the evidence makes this clear--public 
programs such as Medicare, Medicaid, the SCHIP Program, and the 
Veterans' Administration are administered for far less money than are 
private health insurance companies.
  In recent years, while we have experienced an acute shortage of 
primary health care doctors, nurses, and dentists, we are paying for a 
huge increase in health care bureaucrats and bill collectors. Here is 
the insanity, the dysfunctionality of the current system: We do not 
have enough primary health care doctors, we don't have enough dentists, 
we do not have enough nurses, we do not have enough medical personnel--
we don't have enough of those people, but over the last three decades 
we have seen an explosion in the number of health care bureaucrats and 
people who are bill collectors.
  To my mind, I would rather see somebody hired who can help somebody 
get well or prevent disease, not somebody on the telephone billing or 
arguing about what we owe or do not owe. The fact is, over the last 
three decades the number of administrative personnel has grown by 25 
times the numbers of physicians--25 times more bureaucrats than 
physicians. We do not need health care bureaucrats pushing paper. We 
need primary health care doctors delivering babies, taking care of the 
elderly, and taking care of those people who are sick.
  Not surprisingly, while health care costs are soaring, so are the 
profits of private health insurance companies. From 2003 to 2007, the 
combined profits of the Nation's major health insurance companies 
increased by 170 percent. Health care costs are soaring, profits of the 
health insurance companies are also soaring, and while more and more 
Americans are losing their jobs and health insurance, the top 
executives in the industry are receiving lavish compensation packages. 
It is not just William McGuire, the former head of United Health, who 
several years ago accumulated stock options worth an estimated $1.6 
billion.
  OK, $1.6 billion a few years ago for the CEO of United Health and we 
do not have enough money to provide health care to people who are 
uninsured? It is not just the head of Cigna, Edward Hanway, who made 
more than $120 million in the last 5 years. The fact is, CEO 
compensation for the top private health insurance companies now 
averages over $14 million apiece.
  Moving toward a national health insurance program which provides 
cost-effective, universal, comprehensive, and quality health care for 
all will not be easy. It is the major political struggle that we face 
right now. The powerful special interests--and they are all over 
Capitol Hill. The lobbyists are here. In the midst of the recession, I 
would suggest that while unemployment in general is soaring, my strong 
guess is that unemployment for health care lobbyists and pharmaceutical 
industry lobbyists is going down. Those guys have plenty of work, and 
they are making plenty of money. I am quite confident that those 
lobbyists will wage an all-out fight to make sure we maintain the 
current dysfunctional system which enables them, the insurance 
companies and the drug companies, to make millions and billions of 
dollars in profits.
  In recent years they have spent hundreds of millions on lobbying, 
campaign contributions, and advertising with unlimited resources. We 
have no reason to believe they will not continue to spend as much as 
they need. But at the end of the day, as difficult as it may be, the 
fight for a national health care program will prevail. Decade after 
decade, all over this country people fought for a civil rights movement 
which said we will judge human beings not on their color but on their 
character, who they are as a human being. The struggle for women's 
rights went on decade after decade before women had the right to vote 
or had a seat at the table.

[[Page 15211]]

  In my view, the struggle for health care is the civil rights struggle 
of today, and I believe 30 years from now, 50 years from now, people 
will look back and say: I don't believe there was a time in America 
where people who got sick couldn't find a doctor, where people went 
bankrupt because they committed the crime of being sick or having 
cancer. I do not believe that.
  Our job is to bring that day when every American has health care as a 
right in a comprehensive, cost-effective manner. Our job is to make 
that day come sooner rather than later. If we work together and if we 
have the courage to stand up to the big money interests who want to 
maintain the status quo, we, in fact, can do that.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Alabama is 
recognized.

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