[Congressional Record (Bound Edition), Volume 155 (2009), Part 14]
[Senate]
[Pages 18400-18429]
[From the U.S. Government Publishing Office, www.gpo.gov]




   NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2010--Continued

  The ACTING PRESIDENT pro tempore. The Senator from Arizona.
  Mr. KYL. Mr. President, I will make some brief remarks here, and at 
the conclusion we will determine whether there is an agreement on the 
other side so I can go ahead and lay down an amendment. But first I 
want to discuss what that amendment will be. It is amendment No. 1628, 
and in a moment I will seek to offer it and get it pending. It is an 
amendment I introduced with Senator Lieberman, Senator Bayh, and 
Senator McCain.
  Like other Members of this body, we have watched recent events unfold 
in Iran with great concern. This year began with talk of warming ties 
and potentially reestablishing contact with Iran; that we would no 
longer be afraid to talk to Iran and perhaps to even reach some kinds 
of agreements. In recent months, however, the Iranian regime has 
continued its support of terrorism, its illegal nuclear weapons program 
in defiance of its NPT obligations, and its engagement in violent and 
deadly repression of its own citizens.
  While the administration has made clear its intention to continue to 
pursue high-level talks with Iran, an overture which the regime has not 
seen fit to even respond, the President has indicated that the window 
for Iran to negotiate and demonstrate progress toward complying with 
its international obligations is not open indefinitely.
  I think President Obama was correct when he said:

       Iran obtaining a nuclear weapon would not only be a threat 
     to Israel and a threat to the United States, but would be 
     profoundly destabilizing in the international community as a 
     whole and could set off a nuclear arms race in the Middle 
     East that would be extraordinarily dangerous for all 
     concerned, including for Iran.

  In May, the President indicated that Iran would have until December 
to show meaningful improvement. More recently, French President Nicolas 
Sarkozy said on behalf of the G8 nations that they will give Iran until 
September 2009 to agree to negotiations with respect to its nuclear 
activities or face tougher sanctions.
  If negotiations do not prove fruitful, the United States must be 
ready to act quickly to increase pressure on Iran to end its support 
for terrorist groups and its illegal nuclear program.
  The Kyl-Lieberman amendment expresses the sense of the Senate that 
the President should sanction the Iranian Central Bank if, by December, 
Iran has not verifiably halted its uranium enrichment activities, as 
well as come into full compliance with the Nuclear Nonproliferation 
Treaty and the Additional Protocol.

       By sanctioning the Central Bank of Iran--Bank Markazi--our 
     Nation would send the message that we will use all methods at 
     our disposal to stop the spread of nuclear weapons and oppose 
     sponsors of terror.

  The case against the Iranian Central Bank is strong. It is knee-deep 
in the regime's illicit activities. Last year, Deputy Secretary of the 
Treasury Robert Kimmit revealed that between 2001 and 2006 the bank had 
moved $50 million from banks in London to Hezbollah front organizations 
in Beirut. Hezbollah, of course, is a terrorist organization.
  It also processes transactions for Iranian banks that already face 
U.S. sanctions. The Central Bank of Iran is instrumental in helping 
Iranian banks--the very ones this body voted overwhelmingly to sanction 
in 2007--to avoid sanctions. In March 2008, the Financial Crimes 
Enforcement Network of the Department of the Treasury warned financial 
institutions about the illicit behavior of the Central Bank of Iran. 
Here is what the advisory said:

       The Central Bank of Iran and Iranian commercial banks have 
     requested that their names be removed from global 
     transactions in order to make it more difficult for 
     intermediary financial institutions to determine the true 
     parties in the transaction. They have also continued to 
     provide financial services to Iranian entities designated by 
     the U.N. Security Council in its Resolutions 1737 and 1747. 
     The U.S. Department of Treasury is particularly concerned 
     that the Central Bank of Iran may be facilitating 
     transactions for sanctioned Iranian banks.

  Under U.S. law, institutions that aid entities covered by financial 
sanctions are liable to penalties. The Central Bank's activities 
clearly warrant such action, and sanctioning the bank would increase 
the effectiveness of existing measures. I urge my colleagues to support 
our amendment at such time as we are able to get a vote on it.
  The ACTING PRESIDENT pro tempore. The Senator from Connecticut.
  Mr. LIEBERMAN. Mr. President, I thank the Chair and I thank my friend 
from Arizona, Senator Kyl, for his very strong statement. I rise to 
speak in support of this bipartisan amendment which I have cosponsored 
along with Senator Kyl, Senator Bayh, and Senator McCain.
  As you know, President Obama has made a historic offer to Iran's 
leaders, inviting them to engage in direct diplomacy to resolve the 
outstanding differences between our two countries. As the President has 
repeatedly said, the door is open for the Iranians to come in out of 
the cold, if they choose to do so. It is by suspending their illicit 
nuclear activities and ending their support for terrorism that the 
Iranians have a clear path to ending their international isolation and 
taking their rightful place in the community of nations.
  Unfortunately, as Senator Kyl said, it has now been more than 3\1/2\ 
months since the formal offer of engagement was made by President 
Obama, and there has been no reply from the Iranians. Meanwhile, Iran's 
illicit nuclear activities have continued to speed forward, in 
violation of multiple U.N. Security Council resolutions. Thousands

[[Page 18401]]

of additional centrifuges are being installed, and more and more 
fissile material is being stockpiled.
  At the same time, Iran's support for terrorist proxies in Iraq, in 
Lebanon, and in the Palestinian Authority areas has continued. And, of 
course, over the past month we and the rest of the world have watched 
with horror as the Iranian regime has engaged in a brutal crackdown 
against its own people, who have sought no more than basic human 
rights.
  President Obama, together with our international allies, has been 
very clear that we will not wait indefinitely for the Iranians to 
respond to our offer of talks, nor will we enter into negotiations--if 
that is the willingness of the Iranians--that go on without end. Two 
weeks ago, at the annual G8 summit in Italy, the President joined with 
other world leaders to make clear to the Iranians that they have until 
the G20 summit in Pittsburgh, at the end of September, to return to the 
negotiating table or face the consequences.
  The amendment Senators Kyl, Bayh, McCain, and I have put forward 
would place the full weight of the U.S. Senate behind the time frame 
that the President and the G8 have articulated. Our amendment expresses 
our strong hope that Iran seizes this historic opportunity for direct 
dialogue.
  We also make clear that if the Iranians have failed to engage with us 
diplomatically by the time of that G20 summit 2 months from now, it is 
our preference that multilateral sanctions be imposed through the 
United Nations Security Council. However, the Iranian Government--the 
regime that controls the people of Iran--must also understand that the 
United States is itself prepared to put in place what Secretary of 
State Clinton a while ago referred to as crippling sanctions in the 
event that they in Tehran continue to flaunt the will of the 
international community.
  Specifically, our amendment asks the President to impose sanctions on 
the Central Bank of Iran and other banks involved in proliferation and 
terrorist activities, in the event that the Iranians haven't entered 
into negotiations that are serious by the time of the Pittsburgh summit 
or if they haven't suspended enrichment and reprocessing activities 
within 60 days of that summit.
  The Central Bank of Iran is the financial lifeline of that regime. It 
is an entity that our own Treasury Department says has engaged in 
deceptive financial practices and facilitated the efforts of other 
Iranian banks that are involved in bankrolling proliferation and 
terrorist activities to avoid international sanctions, and that have 
themselves been sanctioned by the U.N. and our Treasury Department as a 
result.
  I will say this. The idea of imposing sanctions on the Iranian 
Central Bank is not new. It has already been endorsed by a bipartisan 
majority in this Chamber. Last year, the Senate Banking Committee, 
under Chairman Dodd, adopted bipartisan legislation by a vote of 19 to 
2 to urge the President to immediately impose sanctions against the 
Central Bank. Also last year, the House of Representatives passed such 
legislation that urged immediate sanctions.
  More recently, the legislation that Senators Bayh, Kyl, and I 
introduced this spring--the Iran Refined Petroleum Sanctions Act, S. 
908--in addition to the other steps it takes--also expresses the sense 
of the Senate that the President should impose sanctions against the 
Central Bank of Iran.
  I am very grateful to report that S. 908, the Iran Refined Petroleum 
Sanctions Act, now has 67 Members of the Senate, a strong bipartisan 
group of 67, or two-thirds, as cosponsors of that legislation. These 
cosponsors range all across the ideological spectrum of Members of the 
Senate, and clearly make the point to Iran and to the rest of the world 
that whatever other differences we have, we stand together here as a 
strong majority and beyond the Senate in our concern about the nuclear 
proliferation and terror-sponsoring activities of the Iranian 
Government.
  You might say, if you are one of the 67 cosponsors of S. 908--which 
does more than this amendment does but includes it--you have already 
spoken in favor of this amendment.
  This amendment, I want to point out and make clear, in no way ties 
the President's hand in his diplomacy with Iran. That is not our 
intent. The amendment is about empowering the President, giving him 
additional leverage in his diplomacy, by endorsing the same timetable 
that came out of the G8 summit a short while ago. The effect is this, 
and I will repeat: The Iranians must appreciate that there will be 
consequences if they fail to respond to the international community's 
diplomatic initiatives; in other words, if they continue to speed their 
nuclear program forward.
  I think this amendment will send an unmistakable message to the 
fanatical regime in Tehran, in support of the G8, in support of 
President Obama: Either you can engage with the United States and the 
world community and take steps to suspend your nuclear activities or 
you can continue on your current course, in which case you will face 
the crippling sanctions this sense-of-the-Senate resolution calls for.
  I thank the Chair, and I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Arizona.
  Mr. McCAIN. Mr. President, before my colleague Senator Lieberman 
leaves the floor, I wish to thank him for this amendment. We are 
working right now to see if we can get the amendment pending and 
possibly a voice vote, because it is clear it is a very important 
amendment and one where I think we need to express very strongly the 
sense of the Senate, given the situation as it exists in Iran.
  I wish to thank Senator Lieberman, and right now it is my 
understanding that your side is checking to see if it is an agreeable 
amendment. Hopefully, we will get that decision and move forward with 
it right away on a voice vote, if that is agreeable to the Senator from 
Connecticut.
  The ACTING PRESIDENT pro tempore. The Senator from Connecticut.
  Mr. LIEBERMAN. I thank my friend from Arizona. I am encouraged by 
that. And in talking to the other cosponsors, we would be happy to have 
a voice vote. It would send a message.
  The ACTING PRESIDENT pro tempore. The Senator from Arizona.
  Mr. McCAIN. Mr. President, the amendment is straightforward and 
expresses the sense of the Senate that there should be a date certain--
and soon--by which Iran is required to end its nuclear program or face 
severe sanctions. The amendment expresses that if the Iranian regime 
has not accepted the offer of the United States of direct diplomatic 
talks by the time of the G20 summit in late September or if it has not 
suspended all of its nuclear enrichment and reprocessing activities 
within 60 days after the summit, and if the U.N. Security Council does 
not adopt new and significant and meaningful sanctions on the regime, 
the President should sanction the Central Bank of Iran.
  The situation with respect to Iran is nearing the crisis point, if it 
is not there already. We have all watched the brutal crackdown in the 
streets of Tehran and elsewhere as the Iranian regime imposed the 
results of a fraudulent election. We have been astonished by the 
courage and resolve of those Iranian citizens who have protested for 
their own inalienable rights in the face of repression. And we have 
known that, while these dramatic events have played themselves out, the 
Iranian regime has continued its enrichment of uranium, growing ever 
closer to the day on which it has a nuclear weapons capability.
  The Iranian regime has gotten away with too much for too long. Its 
illicit nuclear activities, combined with its development of 
unconventional weapons and ballistic missiles, support for Hezbollah 
and other terrorist groups, and its repeated threats against Israel and 
the United States, represent a real and growing threat to the security 
of the United States and the Middle East. It is in the interest of the 
United States, and the world's other great powers, to achieve an end to 
the Iranian nuclear program.

[[Page 18402]]

  The administration has held out an ``open hand,'' making clear that 
it intends to open direct talks with Iran. Yet 3\1/2\ months since the 
President's formal offer, the Iranian government has made no response, 
nor has it suspended its enrichment activities, as required by U.N. 
Security Council resolutions. Time is not on the side of those pushing 
the Iranians to cease these dangerous actions. Administration officials 
and others, including the French President, have stated that they will 
not wait interminably while the Iranian nuclear program proceeds.
  At the G-8 summit 2 weeks ago, the assembled leaders agreed that the 
Iranians do not have forever, and that they should return to the 
negotiating table by the time of the G-20 summit in September. This 
amendment puts the Senate on record behind that timeframe, irrespective 
of any Senator's individual view about the likelihood of agreement 
soon.
  Make no mistake: we must not wait interminably. According to the 
IAEA's latest report, Iran has increased its stockpile of low enriched 
uranium by some 60 percent in the previous 6 months, and has brought 
the number of active centrifuges above 7,000. The IAEA also reported 
that Iran denied inspectors access to the Arak heavy water reactor. As 
the threats--including to the State of Israel--continue.
  As the Secretary of State has recently articulated, should Iran 
continue to defy the international community, it must face severe 
sanctions. Should the regime not take up the historic offer extended to 
it, this resolution advocates sanctions on the Iranian Central Bank, 
the country's major connection to the international financial system. 
The U.S. Treasury Department has stated that the central bank has 
engaged in deceptive financial practices and facilitated the movement 
of funds to those involved in proliferation and terrorist activities. 
This must end, and in fact 67 Senators have cosponsored legislation--
the Iran Refined Petroleum Sanctions Act--that urges the President to 
sanction the central bank.
  By adopting this resolution, we will send an unmistakable message to 
the government of Iran that its actions are unacceptable and will 
result in real and severe consequences if continued. The administration 
has offered to talk; the ball is in the Iranian court, and if that 
regime continues down its destructive path, we have no choice but to 
impose crippling sanctions for its continued defiance.
  I urge my colleagues to support this amendment.
  Let me point out again, this amendment is a sense-of-the-Senate 
amendment, an important sense of the Senate but certainly one that 
allows the administration the latitude it needs in its handling of its 
relations with Iran.
  I yield the floor.
  Ms. STABENOW. Mr. President, I would first ask to speak as in morning 
business.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Ms. STABENOW. Mr. President, I want to recognize that tremendously 
hard work both the chair of the Armed Services Committee and ranking 
member are doing. We are very proud of the chairman, coming from 
Michigan, and of all of his excellent work in standing up for the 
troops. This bill is another example of that.
  I would like to congratulate him and the Senator from Arizona for 
working together on this very important bill.


                           Health Care Reform

  Ms. STABENOW. Mr. President, I want to speak for a moment on health 
care. We are hearing a lot, as we hear from colleagues, many 
colleagues--not every one but many colleagues on the other side of the 
aisle--about the need to be against health care reform, to be a ``no.''
  We all know that saying no to health care reform means we are going 
to have the status quo. ``No'' equals the status quo. For too many 
families, too many businesses all across this country, that is 
absolutely not acceptable.
  The status quo works, it is good--for special interests making 
profits off the current system. But it is bad for American families, 
American small businesses, American manufacturers that are trying to 
pay the bills and trying to make sure health care is available for the 
employees.
  We need change. We are here because the system, with all of its good 
parts--and there are many strengths in the American system--is also 
broken in too many cases for people. We want to build on what works and 
what is great and we want to fix what is broken.
  Right now our current health care system is bankrupting too many 
families. We know over 60 percent of bankruptcies are linked to medical 
expenses, and 75 percent of families who file bankruptcy actually have 
health insurance. Those with insurance, on average, are putting out 
medical expenses of over $18,000 when they file--even though they have 
an insurance policy.
  There are many families--we are not only talking about those who do 
not have health insurance, but those who do who find themselves in very 
difficult situations.
  I am constantly amazed when I hear the argument about: We can't do 
any kind of reform because reform means putting a bureaucrat between 
your doctor and yourself. You and your doctor can't make decisions 
about what you need for your health care.
  Do you know who stands between you and your doctor right now? An 
insurance company, an insurance company bureaucrat. Your doctors can't 
just give you whatever tests they wish. You are not able to get 
whatever care you need for your family. The first call they make is to 
the insurance company, and it decides.
  Reform is about putting health care decisions back in the hands of 
doctors and patients and being able to create a system that actually 
works for people. That is what it is all about.
  I set up online the Health Care People's Lobby for those I represent 
in the State of Michigan so they could share their stories. We have a 
lot of folks lining the halls who represent all kinds of interests, all 
kinds of special interests, and they tell us what they think should be 
happening or not happening. But in Michigan we have set up the Health 
Care People's Lobby so people can share their stories about the real 
world operating under the current system.
  If the system worked today, there would be no reason for us to be 
here. We would be working on something else. But the fact is, we are 
spending twice as much on health care as any other country and have 47 
million people at any one time who do not have health insurance. Those 
two numbers don't add up.
  On top of that, people who are currently covered are battling every 
day to try to get what they thought they were paying for or to make 
sure their family is covered or that test or procedure or medicine can 
be covered.
  One constituent of mine in Michigan, Sandra Marczewski from 
Waterford, MI, wrote to me that she and her husband have been without 
insurance for 7 months now. She writes:

       You have no idea the fear I walk around with every day.

  That is too many people in Michigan, over a million people in 
Michigan, without insurance altogether, and millions more who are 
fearful every day if they lose their job, their health care goes with 
it, for themselves and their families. People every night are putting 
the kids to bed and worrying about whether someone is going to get 
sick, saying a prayer: Please, God, don't let the kids get sick. Don't 
let me get sick. I have to be able to go to work so I can make sure we 
still have our health care.
  There are a lot of people, as I mentioned before, who make a lot of 
money off of the status quo, off of the current system. It is no 
surprise they don't want to change it. All the ads we see, all the 
things going on, all the scare tactics that are going on--and there are 
plenty of scare tactics going on right now--all of that is about trying 
to scare people and raise red flags. It is easy just to be no, no, no. 
We certainly hear that around here all the time, people who are just 
saying no to any kind of progress or change or making things better for 
people.
  The reality is, the status quo for a lot of folks means more profit, 
and

[[Page 18403]]

that is underlying a lot of the motivation of what is going on right 
now. Our job is to make sure the American people can afford health care 
and have the care they need for their families. For too many families, 
the status quo means insecurity, expenses, and fear that come along 
with not knowing whether they are going to be able to afford the health 
care they have from month to month and whether they will, in fact, even 
have health care.
  We are here because when it comes to health care, American families 
and businesses are in a serious crisis, and they are asking us for 
action. The status quo is not good enough anymore. It is not working. 
It is going to bankrupt families, businesses, and the country. High 
health care costs are causing cuts in benefits, increases in premiums, 
adding to the ranks of the uninsured at alarming rates. Even those who 
have insurance, as I indicated before, are feeling the pain of the 
current system. Every day in America families are forced to choose a 
different doctor because their health care plan was changed, because 
their employer can no longer afford the old plan they had.
  Skyrocketing health care costs make American businesses less 
competitive in the global economy. It costs us jobs, and I can speak 
directly to that coming from the great State of Michigan.
  Every day in America, families see their health care plan benefits 
eroding because they cannot keep up with high premiums, copays, and 
deductibles. Every day in America, people decide to skip a doctor visit 
and the medication and treatment they know they need because they 
cannot afford the payment--in the greatest country in the world--
because the expense is too high. Year after year, as health care costs 
increase, American families are losing the very parts of their health 
care they value most: their choice of doctor, hospital, and insurance 
plans; their choice of treatments; the security and stability that 
comes from knowing they are covered if anything goes wrong. That is 
what we are about fixing. That is what we will fix as we do health care 
reform.
  Recently, Families USA found that the average costs of family 
coverage in the workplace rose 78 percent in 7 years--78 percent. 
During those years, health insurance company profits ballooned 428 
percent. At the same time, wages went up about 15 percent. So wages go 
up 15 percent, health insurance profits go up 428 percent, and premiums 
just keep rising for businesses and individuals.
  The fact is, we cannot wait to get started on reform. The status quo 
is not acceptable and ``no'' equals the status quo. So we are here 
working with colleagues to get it done. Doing nothing is not 
acceptable.
  Recently, the nonpartisan Robert Wood Johnson Foundation released a 
report that projects if Federal reform efforts are not enacted within 
10 years, the cost of health care for businesses could double and the 
number of uninsured could rise to over 65 million people with middle-
class families being hit the hardest. The report shows if health care 
reform is not enacted, individuals and families would see health care 
costs dramatically increased.
  Total individual and family spending on premiums and out-of-pocket 
costs could increase 68 percent in the next 10 years. I cannot imagine 
68 percent out-of-pocket costs. That is if we do nothing, if we listen 
to those just saying no. Even under the best-case scenario, health care 
costs would likely increase, according to this report, at least 46 
percent. And I can tell you absolutely wages are not going to go up 46 
percent. Businesses could see their health care costs doubled within 10 
years. The report found that employer spending on premiums would more 
than double, and even in the best-case economic condition, employer 
spending on health care will rise 72 percent. The result would likely 
be far fewer Americans being able to be offered insurance or accepting 
employer-sponsored insurance. Estimates suggest a drop of 56 percent of 
Americans who are now covered by their employers, dropping from 56 to 
49 percent in 10 years.
  So there are many numbers. There are numbers that relate to the 
public programs of Medicaid and children's health insurance and the 
increased cost there as well and what will happen if we do nothing. The 
amount of uncompensated care in the health care system will increase, 
and the worst-case scenario: the total of uncompensated care could 
double.
  By the way, when we say ``uncompensated care,'' that does not mean 
somebody is not paying for it. That is why our premiums, if you have 
insurance, go up so much. It means someone can't afford to see a 
doctor, can't take their children to the doctor, so they don't get the 
tests on the front end that they need or they don't see a doctor. They 
wait until they are really sick, and then they go to the emergency 
room. They are served, as they should be, and it is the most expensive 
venue in which to do ongoing care for people. But they are served, and 
then guess what happens. Everyone who has insurance sees their rates go 
up to pay for it.
  That is what it means when we say that covering the uninsured will 
lower costs as we go out. I mean it will take time to do this, but over 
time what we are doing is working to change the way we pay for health 
care now because we pay for it in the most expensive way, by ignoring 
the problem, not focusing on health and wellness and primary care but 
waiting until people are in the worst possible situation: they go to 
the emergency room, they get care when they are sicker than they 
otherwise would be if they could see a doctor. And then we pay for it. 
That is what we want to change and will change under health care 
reform.
  So this is about many facets. We know we have a system in America 
that works for many; they are blessed. We are blessed to have health 
insurance. For the many who have insurance, it allows them to cover 
their family needs. The system works well. But for many others it does 
not. And the reality is, we all pay for a system that does not work 
effectively for everyone. We all end up paying because the reality is, 
you can say: Well, I am not going to buy a car, I do not need car 
insurance; I am not going to buy a house, I do not need house 
insurance, but sooner or later, you are going to get sick, and just 
because you don't have health insurance does not mean there is not 
going to be a cost for yourself and your family.
  We are a great country. We can do better than what we are doing 
today. We have to do better. We are working hard to have a bipartisan 
effort that will move reform forward in this country, to make a real 
difference to change the system so it works for everyone and begins to 
lower the cost over time of what is happening, the explosion in health 
care costs in this country.
  The option of saying no is not good enough. ``No'' equals the status 
quo. We just cannot have that. The public gets it. It is time for us to 
get it as well and move forward. I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Arizona is 
recognized.


                           Amendment No. 1628

  Mr. McCAIN. Mr. President, I call up the Lieberman-Kyl amendment and 
ask for its immediate consideration. It is at the desk.
  The ACTING PRESIDENT pro tempore. The clerk will report.
  The assistant bill clerk read as follows:

       The Senator from Arizona [Mr. McCain], for Mr. Kyl, for 
     himself, Mr. Lieberman, Mr. Bayh, and Mr. McCain, proposes an 
     amendment numbered 1628.

  The amendment is as follows:

(Purpose: To express the sense of the Senate on imposing sanctions with 
                respect to the Islamic Republic of Iran)

       At the end of subtitle C of title XII, add the following:

     SEC. 1232. SENSE OF THE SENATE ON IMPOSING SANCTIONS WITH 
                   RESPECT TO THE ISLAMIC REPUBLIC OF IRAN.

       (a) Findings.--The Senate makes the following findings:
       (1) The illicit nuclear activities of the Government of the 
     Islamic Republic of Iran, combined with its development of 
     unconventional weapons and ballistic missiles and support for 
     international terrorism, represent a grave threat to the 
     security of the United States and United States allies in 
     Europe, the Middle East, and around the world.

[[Page 18404]]

       (2) The United States and other responsible countries have 
     a vital interest in working together to prevent the 
     Government of the Islamic Republic of Iran from acquiring a 
     nuclear weapons capability.
       (3) As President Barack Obama said, ``Iran obtaining a 
     nuclear weapon would not only be a threat to Israel and a 
     threat to the United States, but would be profoundly 
     destabilizing in the international community as a whole and 
     could set off a nuclear arms race in the Middle East that 
     would be extraordinarily dangerous for all concerned, 
     including for Iran.''.
       (4) The International Atomic Energy Agency has repeatedly 
     called attention to the illicit nuclear activities of the 
     Islamic Republic of Iran, and, as a result, the United 
     Nations Security Council has adopted a range of sanctions 
     designed to encourage the Government of the Islamic Republic 
     of Iran to cease those activities and comply with its 
     obligations under the Treaty on Non-Proliferation of Nuclear 
     Weapons, done at Washington, London, and Moscow July 1, 1968, 
     and entered into force March 5, 1970 (commonly known as the 
     ``Nuclear Non-Proliferation Treaty'').
       (5) The Department of the Treasury has imposed sanctions on 
     several Iranian banks, including Bank Melli, Bank Saderat, 
     Bank Sepah, and Bank Mellat, for their involvement in 
     proliferation activities or support for terrorist groups.
       (6) The Central Bank of Iran, the keystone of Iran's 
     financial system and its principal remaining lifeline to the 
     international banking system, has engaged in deceptive 
     financial practices and facilitated such practices among 
     banks involved in proliferation activities or support for 
     terrorist groups, including Bank Sepah and Bank Melli, in 
     order to evade sanctions imposed by the United States and the 
     United Nations.
       (7) On April 8, 2009, the United States formally extended 
     an offer to engage in direct diplomacy with the Government of 
     the Islamic Republic of Iran through negotiations with the 
     five permanent members of the United States Security Council 
     and Germany (commonly referred to as the ``P5-plus-1 
     process''), in the hope of resolving all outstanding disputes 
     between the Islamic Republic of Iran and the United States.
       (8) The Government of the Islamic Republic of Iran has yet 
     to make a formal reply to the April 8, 2009, offer of direct 
     diplomacy by the United States or to engage in direct 
     diplomacy with the United States through the P5-plus-1 
     process.
       (9) On July 8, 2009, President Nicolas Sarkozy of France 
     warned that the Group of Eight major powers will give the 
     Islamic Republic of Iran until September 2009 to accept 
     negotiations with respect to its nuclear activities or face 
     tougher sanctions.
       (b) Sense of the Senate.--It is the sense of the Senate 
     that--
       (1) the Government of the Islamic Republic of Iran should--
       (A) seize the historic offer put forward by President 
     Barack Obama to engage in direct diplomacy with the United 
     States;
       (B) suspend all enrichment-related and reprocessing 
     activities, including research and development, and work on 
     all heavy-water related projects, including the construction 
     of a research reactor moderated by heavy water, as demanded 
     by multiple resolutions of the United Nations Security 
     Council; and
       (C) come into full compliance with the Nuclear Non-
     Proliferation Treaty, including the additional protocol to 
     the Treaty; and
       (2) the President should impose sanctions on the Central 
     Bank of Iran and any other Iranian bank engaged in 
     proliferation activities or support for terrorist groups, as 
     well as any other sanctions the President determines 
     appropriate, if--
       (A) the Government of the Islamic Republic of Iran--
       (i) has not accepted the offer by the United States to 
     engage in direct diplomacy through the P5-plus-1 process 
     before the Summit of the Group of 20 (G-20) in Pittsburgh, 
     Pennsylvania, in September 2009; or
       (ii) has not suspended all enrichment-related and 
     reprocessing activities and work on all heavy-water related 
     projects within 60 days of the conclusion of that Summit; and
       (B) the United Nations Security Council has failed to adopt 
     significant and meaningful additional sanctions on the 
     Government of the Islamic Republic of Iran.

  Mr. McCAIN. The amendment is in the name of Senators Kyl and 
Lieberman. I am calling it up on their behalf.
  The ACTING PRESIDENT pro tempore. Is there further debate? If not, 
the question is on agreeing to the amendment.
  The amendment (No. 1628) was agreed to.
  The ACTING PRESIDENT pro tempore. The Senator from Tennessee.
  Mr. ALEXANDER. I ask unanimous consent to speak as in morning 
business.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.


                           Health Care Reform

  Mr. ALEXANDER. Mr. President, I listened carefully to the Senator 
from Michigan. Republicans and I believe most Democrats want health 
care reform this year. The President said he wants health care reform 
this year. Republicans want health care reform this year. We want to 
make sure it is done right. Let me put it this way: If we were in an 
operating room and a seriously ill patient came in and we knew we had 
only one chance to save that patient's life and to make that patient 
healthy, our goal would not be to see if we could do it in the next 
week, it would be to see if we could get it right.
  So far, the proposals we have seen coming out of the committees have 
not gotten it right. One might say: Well, that is a Republican view of 
Democratic proposals. Perhaps it is. But the proposals we have seen 
coming out of the Senate HELP Committee and out of the House of 
Representatives flunk the most important test, which is cost. The most 
important test is whether Americans can afford their health care and, 
after we get through fixing it, whether they can afford their 
government. According to virtually everyone we have heard from, the 
legislation we have seen simply does not meet that test.
  In my opinion, what we should do instead is start with the framework 
of the bill sponsored by Democratic Senator Wyden and Republican 
Senator Bennett which has 14 cosponsors--8 Democrats, 6 Republicans. 
This is a different sort of framework that offers virtually every 
American coverage, does so without any Washington takeover or 
government-run programs without raising the debt one penny, according 
to the Congressional Budget Office. Remember, I said that is a 
framework. I do not agree with every single part of that bill, although 
I am a cosponsor, but it may be a much better place to start than what 
we have seen so far.
  That is not just my opinion. Lately, we have heard a lot about the 
Mayo Clinic in Rochester, MN. President Obama has talked a lot about 
the Mayo Clinic. The point is, at the Mayo Clinic and a few other 
clinics around the country, there have been significantly better 
outcomes. In other words, if you go there and come out, you are more 
likely to be well, and at a lower cost. And the question is, Why?
  The President has repeatedly pointed to the Mayo Clinic, Democratic 
Senators point to the Mayo Clinic, and Republican Senators point to the 
Mayo Clinic. Here is what the Mayo Clinic had to say on Friday about 
the legislation that is being considered in the House of 
Representatives:

       Although there are some positives in the current House Tri-
     committee bill, including insurance for all and payment 
     reform demonstration projects--the proposed legislation 
     misses the opportunity to help create higher quality, more 
     affordable health care for patients. In fact, it will do the 
     opposite.

  That is the Mayo Clinic talking.

       In general, the proposals under discussion are not patient 
     focused or results oriented. Lawmakers have failed to use a 
     fundamental lever--a change in Medicare payment policy--to 
     help drive necessary improvements in American health care. 
     Unless legislators create payment systems that pay for good 
     patient results at reasonable costs, the promise of 
     transformation in American health care will wither. The real 
     losers will be the citizens of the United States of America.

  That is the Mayo Clinic talking about the bill we are beginning to 
see in the House of Representatives.
  I think the prudent thing to do is to try to make that bill better or 
start over and certainly not try to pass a 1,000-page or 2,000-page 
bill in 1 week or 10 days without knowing what is in it, as we did with 
the stimulus bill earlier this year.
  That is not just the opinion of the Mayo Clinic. Here is a letter to 
House Members on July 16, a few days ago, from a number of clinics, 
including the Mayo Clinic. These are the Intermountain Healthcare, 
Gundersen Lutheran Health System, the Iowa Clinic, the Marshfield 
Clinic, the Rural Wisconsin Health Cooperative, ThedaCare, and 
Wisconsin Hospital Association.
  I ask unanimous consent to have this letter printed in the Record 
following my remarks.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.

[[Page 18405]]

  (See exhibit 1.)
  Mr. ALEXANDER. It goes on to say:

       On behalf of some of the nation's leaders in health care 
     delivery--

  These are the people whose hospitals we go to, whose clinics we go to 
when we are sick or when we hope to stay well--

     we write to you to comment on the House bill.

  They say:

       We applaud the Congress for working on this. However, we 
     have got significant concerns.

  They go on to say there are three of them.
  The first is about the Medicare-like public plan, as they call it, a 
public plan with rates based on Medicare. They say it will have a 
severe negative effect on their facilities, that they lose a lot of 
money every year, hundreds of millions of dollars. Because what happens 
is that Medicare, a government-run plan, pays its doctors and its 
clinics and its hospitals about 80 percent of what private insurance 
companies are paying. So roughly 177 million of us have private 
insurance of one kind or another. If a doctor sees you, he gets paid 
100 percent. But if you go to one of these clinics and hospitals, they 
are paid according to the government rate, which is roughly 80 percent 
of the private rate. These clinics say that is not sustainable for 
them, and that if that continues, some of those providers, such as the 
Mayo Clinic, will eventually be driven out of the market. What market? 
The market for Medicare patients. Those are the 45 million senior 
Americans who absolutely depend on Medicare for their service because 
for most of them, that is their only option. If that is the case, what 
that means is they will not be able to go to the Mayo Clinic or to the 
MeritCare Health System or to the Iowa Clinic or to the doctor they 
choose because that doctor will not be a part of the Medicare system 
because of low reimbursement.
  So that is the first objection these clinics make to the bill they 
see coming because the bill they see coming proposes to create another 
government-run plan with government-set rates.
  The second objection they have is geographic payment disparities. 
They say that we are a big country and there ought to be differences in 
the pay among different geographies.
  Third, and maybe this is the most important of all, that the 
President has said and many of us in the Senate have said we need to 
change the way we pay for medical care, and we ought to pay more for 
value, for quality, for results, and less for volume--in plain English, 
not how many patients a doctor can see but how many of his or her 
patients stay well or get well.
  We have talked about that for weeks here in our hearings. But what 
these respected voices in medicine are saying is that the legislation 
we see today--and understand, this is not even in a bill that has 
presented to us in the Senate yet in a way upon which we can act--does 
not meet the test for that. The legislation we have seen so far is 
running into a lot of trouble.
  David Broder, the respected columnist from the Washington Post, said 
that the plans which have been passed in a partisan way are ``badly 
flawed'' and ``overly expensive.'' I mean, the Democratic plans; we 
have Republican plans that we would like to be considered. I mentioned 
that the Wyden-Bennett plan, which is the only really bipartisan plan 
here, has not been given one bit of consideration so far in the Senate. 
And then Senator Burr and Senator Coburn have a plan, Senator Gregg has 
a plan, and Senator Hatch has a plan. We all have different ideas. As I 
said, we would like for them to be considered, today I'm talking about 
the Democratic plans that are now being considered.
  The Congressional Budget Office, of course, is the nonpartisan office 
in this Congress that we count on as an umpire to tell us what we are 
really doing. It is not supposed to have any political rhetoric. Last 
Thursday, the head of the Congressional Budget Office, Douglas 
Elmendorf was asked at a Senate Budget Committee hearing what he 
thought about the bills which had begun to emerge.
  He said:

       The legislation significantly expands the Federal 
     responsibility for health care costs.

  In other words, here we go, at a time when we are in a recession and 
where the President's proposals for other programs will add more to the 
debt in the next 10 years, three times as much as we spent in World War 
II, and we are talking about legislation that would add another $2 
trillion. We haven't dealt with cost which is where we ought to start. 
Look at the 250 million who have health care and ask the question: Can 
you afford it? Then after we get through fixing it, can you afford your 
government? And what the head of the CBO is saying, as far as the 
government goes, the answer is no.
  Then the Lewin Group, a well-respected private agency, was asked what 
would happen if we had a government-run program which many of us 
believe will lead to another Washington takeover. We are getting 
accustomed to this, Washington takeovers of banks, of insurance 
companies, of student loans, of car companies, now maybe of health 
care. The Lewin Group said 88 million people will lose their private 
employer-sponsored insurance. How could that happen? It could happen 
because a small employer or a big employer would see one of these plans 
that is beginning to come out take place. To be specific, the Senate 
HELP Committee plan says you either have to provide everybody who works 
for you insurance or pay $750. There are a lot of employers who cannot 
afford to provide everybody the kind of insurance that is envisioned. 
So they will say: OK, we will pay the $750 fine to the government. What 
happens? All those employees lose their health insurance. Where do they 
go? Into the Government plan. That is their option. Some of them may 
have a choice of other plans, but if they do have a choice and one of 
the choices is a government-run plan, it may have the same future the 
Mayo Clinic and others were saying Medicare was causing to them.
  The government will set a low price for the doctors and a low price 
for the clinics. So all these employees who now have insurance that 
they like will lose that insurance because of the passage of this bill. 
The government will set the provider rates and physician rates low, and 
so they will be part of a government plan for which many doctors and 
many hospitals and many clinics will not offer services. It is similar 
to giving somebody a bus ticket to a bus station with no busses.
  Then there are the Medicare cuts. According to the Washington Post 
last week, Medicare cuts will pay for one-half the cost of health care 
for the uninsured in one of the bills being proposed.
  If we are to find savings in Medicare and take from the 45 million 
elderly people who depend on Medicare, every bit of those savings ought 
to be put back into Medicare and not spent on some new program. I don't 
think legislation that is paid for half by Medicare cuts is going to go 
very far in this Chamber.
  Then there are the employer taxes. According to the National 
Federation of Independent Businesses, the House version has an 8-
percent Federal payroll tax. I mentioned the Senate version, a $750 
annual fine per employee, if the employer doesn't offer insurance. The 
NFIB, small businesses, estimates that will lose about 1.6 million 
jobs.
  How could that be? Well, if a small employer or even a large one has 
government-mandated costs added and they have less money, they will 
hire less employees. That is one of the options they have.
  Then there is the income surtax. There is a whole string of trouble 
for these bills. USA Today on Monday said: It is the highest tax rate 
in a quarter of a century that is proposed: A 45-percent top tax rate 
with all taxes included.
  Then rationing, there are provisions in this bill which would have 
the government make decisions about which treatment you will have and 
how long you will have to wait to see a doctor.
  Finally--I say ``finally'' because this is the subject I want to 
spend a moment on--there is the Medicaid State taxes. Sometimes this 
gets confusing.

[[Page 18406]]

Mr. President, 177 million Americans have private insurance, but a lot 
of people have government insurance now. Veterans do. Military people 
have TRICARE insurance. About 45 million older people have Medicare. 
But then there is a program called Medicaid, which is the largest 
government-run program. About 60 million people are in it now. The 
Federal Government pays about 57 percent of it, and the States pay 43 
percent. Every Governor I know--and I was once one--has struggled with 
the Medicaid Program. I once came up here in the early 1980s and asked 
President Reagan to take it all, let the Federal Government run it and 
give us Governors all of kindergarten through the 12th grade. I thought 
that would be a good swap.
  I saw a couple of Democratic Governors earlier today, and we talked 
about the story every Governor faces. If you have an extra dollar and 
you want to put it in higher education so you can improve the quality 
of the University of Colorado or Tennessee or keep tuition from going 
up, what happens to it? That dollar is stolen because it has to go in 
the increasing Medicaid cost. It is an inefficiently managed program. 
The Federal Government keeps changing the rules. The Governors have to 
get permission from Washington whenever they make minor changes. It is 
demolishing State governments right and left.
  If our real goal is to help people, then why under these new plans do 
we say to low-income people--defined as, say, a family of four who 
makes less than $32,000--your only option is going to be to go in the 
Medicaid Program under this plan. It is estimated by the Congressional 
Budget Office and others that 15 or 20 million Americans will be added 
to the 60 million in the Medicaid Program. What will they find when 
they get there? They will find that 40 percent of the doctors don't see 
Medicaid patients. When we add another 15 or 20 million people to it, 
it may be a larger number. Why don't they do see Medicaid patients? For 
the same reason the Mayo Clinic warned about this government plan in 
its letter. It is because Medicaid only pays its doctors and its 
hospitals about 72 percent of what Medicare pays.
  If you are confused by that, it works out pretty simply. Medicare 
pays 80 percent of what the private insurers pay, and Medicaid pays 
about 72 percent of what Medicare pays. If you are a doctor or a clinic 
or a hospital, you get paid about 60 percent, if you are helping a 
Medicaid patient, of what you would if you were helping one of us who 
has his or her own private health care. You can see that will be a 
pernicious trend. If we continue to dump low-income people into a 
government-run Medicaid Program, that is what will happen.
  There is another thing that happens with Medicaid. Many members of 
the committees working on this bill said: We can't let that happen. We 
can't be inhumane and just say we are out here to help people who are 
uninsured, and we are going to dump 20 million of them into a 
government-run program that doesn't have enough doctors and hospitals 
and clinics. We will have to raise what we pay to doctors and clinics. 
That sounds good, but that is very expensive, particularly for a 
program such as Medicaid that, according to the Government 
Accountability Office, $1 out of every $10 is fraudulent, is wasted. 
That is $32 billion a year. That is the program we are going to expand? 
That is the program we are going to say to low-income people: 
Congratulations, go into this program where you are not likely to find 
a doctor every time you want one, and there are a lot of hospitals and 
clinics that will not take you because we will not pay them for that.
  Because Senators and Congressmen hear that, they say: We will raise 
the rates. Here is the proposal: The proposal is, we are going to 
increase the number of people who are eligible for Medicaid by 133 to 
150 percent of the Federal poverty level. That is a substantial 
increase. Then, if we are going to do that and put many more people 
into the program, we are going to have to order an increase in what we 
pay the doctors and the clinics to serve them, maybe up to 83 or 85 
percent of the Medicare level.
  Let me talk about what that would do in one State. We called the 
State Medicaid director in Tennessee. Our program is called TennCare. 
We said: What would it cost Tennessee if we increase coverage of 
Medicaid up to 150 percent of the Federal poverty level? The answer 
came back, nearly $600 million a year. That is the State's share of the 
cost which is a little more than a third. The Federal Government's 
share is twice that. So the Federal Government is saying: That is all 
right. We know Tennessee doesn't have the money to do that, so we will 
pay it all for the first 5 years. Then, after 5 years, so the talk 
goes--and we were told, when we were working on this bill, this is an 
assumption--we will shift these costs back to Colorado, back to 
Tennessee. Back comes what in today's dollars is about $600 million to 
the State of Tennessee.
  Remember what I said. This is a program doctors don't want to go to 
because they don't get paid very well. So we will have to increase the 
amount of money we pay doctors. So if States are required to pay 
doctors and providers under the Medicaid system 110 percent of what 
Medicare is paid, that still isn't what doctors and hospitals get, if 
they see somebody with private health insurance. That is about the same 
amount of money, about $600 million added just for the State cost, 
which brings the total new state cost for paying physicians and 
hospitals more and for all the new people in the Medicaid Program to 
$1.2 billion. That is a huge amount of money.
  We throw around dollars up here and figures that make any amount of 
money seem unimaginable. What is $1 trillion, what is $10 trillion, 
what is $40 billion. We former Governors can imagine it. I figured it 
out. If in 5 years you shifted back to the State of Tennessee just its 
share of those costs from the expansion of Medicaid and paying the 
doctors and hospitals more, the bill for the State of Tennessee to pay 
the increased Medicaid costs would be an amount of money that equals a 
new 10-percent State income tax.
  The truth is, for our State--and I believe for almost every State--it 
is an amount of money that nobody has enough taxes to pay. You can run 
politicians in and out and defeat them for raising taxes all day long, 
and they still couldn't come up with ways to pay for it. In other 
words, these bills are based on a premise and assumption that will 
either bankrupt the States or, if the Federal Government says we will 
pay for it all, it will add $5, $6, $700 billion more over 10 years to 
the legislation we are considering.
  We need to think that through. Is that the best way to help people 
who are low income? I don't think so. I think there are much better 
ways. The Wyden-Bennett framework is a better way. It rearranges the 
tax deductions we have for people who have health insurance from their 
employers and it says: Let's take the available money and give the 
money to low-income people who then buy private health insurance. It 
may be a very basic plan. But at least they would have health 
insurance, and they wouldn't be stuffed in a government program 40 
percent of the doctors wouldn't see and that many of the best clinics 
and hospitals wouldn't allow them to come in.
  We have been told already by the Congressional Budget Office that 
proposal would not add a penny to the debt. Not only does it not create 
a new government program, it actually makes the Medicaid Program, 
except for Americans with Disabilities, history. In other words, if you 
are poor, you are not stuffed into a program that nobody else would 
want to join anyway. You have a chance to buy your own insurance, and 
you are not consigned to the worst run government program we have 
today.
  So there are some real possibilities with health care, and there are 
some plans on the table that will lead us in the right direction. We 
have advice from distinguished Americans with a stake in this--which is 
every single one of us--but the most distinguished are those who deal 
with it every day. The Mayo Clinic is saying the proposed legislation 
misses the opportunity to help create higher quality, more affordable

[[Page 18407]]

health care for patients. In fact, it will do the opposite.
  Shouldn't we slow down and get it right? Shouldn't we get it right? 
This is the only chance we have to do this. If we do it wrong, we will 
not be able to undo it. This is 16, 18 percent of the American economy 
we are talking about. People have tried to do it for 60 years, and they 
failed.
  The only way we will do it is if we do it together. The Democrats 
have big majorities over on that side. They do in the House. But that 
is not the way things usually happen around here. The President has 
said--and I take him at his word--and many of the leaders have said--
and I take them at their word--that we would like to get 70, 80 votes 
for the health care result. We would too.
  But in order to do that, we are going to have to do it the way we 
usually do when we have bipartisan events around here. We get some 
Democrats and some Republicans and they sit down with the President and 
they share ideas and they agree on some things. They don't just say: 
OK, here it is, and we are going to vote down almost every significant 
idea you have on the way through.
  I respect the fact that Senator Baucus is trying to do that in the 
Finance Committee, and perhaps he will succeed, working with Senator 
Grassley and others. But this is going to take some time. It cannot be 
done overnight. There are many sections to this bill. Each of them 
might be 500 pages long. They have enormous consequences to 
individuals. That is why we have all these clinics writing and saying: 
If you do it the way it looks like you are going to do it, you may 
drive us out of the business of helping Medicare patients.
  Do we really want to do that? Do we really want to say to 45 million 
Americans who depend on Medicare: We are going to pass a bill that will 
accelerate the process whereby respected clinics and the doctor you 
might choose will not see you anymore because they cannot afford to 
because the government will not pay them under the system we have?
  So I would suggest we start over, literally, conceptually; start over 
and listen to these clinics and doctors and focus on the delivery 
system and focus, first, on those 250 million Americans who already 
have health insurance and ask the question: Can they afford it? And, 
what could we do to make it possible for those Americans to afford it? 
And can we do it in a way that permits us to be able to honestly say 
when we are through that those same 250 million Americans can afford 
their government when we are through without adding to the debt?
  Then let's look at the 46 million people who are uninsured. Of 
course, we need for them to be insured. But the fact is, 11 million of 
the uninsured are already eligible for programs we already have; 10 
million or so are noncitizens--half of them legally here, half of them 
not; a large number of them are making $75,000 a year and could afford 
it but just do not buy it; and another significant number are college 
students.
  So we are going to have to go step by step by step and see in what 
low-cost way we can include a large number of these 46 million 
Americans, who are not part of the system, in the system. But that is 
the wrong place to start. That is the place to end.
  So, Mr. President, all I am saying is, on the Republican side of the 
aisle we can tell you what we are for. Some of us are for the Wyden-
Bennett bill with our Democratic colleagues. That is the only 
bipartisan bill before us today. It has not even been seriously 
considered by this body, but it is there, and it has significant 
support in the House. We have two doctors over here: Dr. Barrasso, who 
has been an orthopedic surgeon for 25 years, and Dr. Coburn from 
Oklahoma, an OB/GYN doctor. They would like to be involved in the 
process. So far their ideas are not really being adopted in the result 
we might have. We have Senator Gregg from New Hampshire, one of the 
most respected Senators, who has been a part of many bipartisan 
efforts, and he has his own bill. He would like to be more a part of 
it, but his ideas do not fit the way things are going. But the way 
things are going are too expensive for the Congressional Budget Office 
and take us in the wrong direction, according to the Mayo Clinic.
  So maybe we ought to step back and say: Well, let's listen to these 
other ideas. Let's go very carefully. Let's work with the President. 
Let's see if we can get a result. Let's keep a four-letter word out 
there that is a good word; and that is ``cost,'' and make sure we focus 
first on the 250 million Americans who have health insurance and make 
sure they can afford it; and, second, make sure when we finish fixing 
health care that those same Americans can afford their government.
  I thank the Presiding Officer, and I yield the floor.

                               Exhibit 1

                                                    July 16, 2009.
     Hon. Ron Kind,
     Longworth House Office Building,
     Washington, DC.
       Dear Congressman Kind: On behalf of some of the nation's 
     leaders in health care delivery, we write to you today to 
     comment on the House health care reform bill introduced 
     earlier this week. We would like to thank you for the 
     opportunity to comment on this legislation. We applaud the 
     Congress for its commitment to passing comprehensive health 
     care delivery system reform this year. However, we have 
     significant concerns about the current language of the bill 
     and we ask that these concerns, set forth below, be addressed 
     before the committee action is concluded.


                       Medicare-like Public Plan

       First, we are concerned that a public plan option with 
     rates based on Medicare rates will have a severe negative 
     impact on our facilities. Today, many providers suffer great 
     financial losses associated with treating Medicare patients. 
     For example, several of the systems that have signed onto 
     this letter lost hundreds of millions of dollars under 
     Medicare last year. These rates are making it increasingly 
     difficult for us to continue to treat Medicare patients. The 
     implementation of a public plan with similar rates will 
     create a financial result that will be unsustainable for even 
     the nation's most efficient, high quality providers, 
     eventually driving them out of the market. In addition, 
     should a public plan with inadequate rates be enacted, we 
     will be forced to shift additional costs to private payers, 
     which will ultimately lead to increased costs for employers 
     who maintain insurance for their employees. We believe all 
     Americans must have guaranteed portable health insurance, but 
     it is critical that we not lose sight of the need to ensure 
     adequate and equitable reimbursement.


                     Geographic Payment Disparities

       Second, our health care systems are among the most cost-
     efficient in the country in caring for Medicare patients. 
     However, many of us operate in states with some of the lowest 
     Medicare reimbursement rates in the nation. Current physician 
     payments due to geographic disparities are actually greater 
     under Medicare than under commercial insurance. This may be 
     difficult to believe, given the government's rate-setting 
     power, but flows from the fundamentally flawed payment 
     methodology. To date, health care reform proposals simply 
     continue the current payment methodology, despite the fact 
     that formula changes have been identified to address this 
     problem. We support payment changes that work to reduce 
     geographic disparities, rather than perpetuating the flaws in 
     the current payment system. While we believe that the 
     Institute of Medicine study is a good first step, we 
     encourage Congress to take this further and enact payment 
     reforms that will address the existing disparities.


                          Value Index Proposal

       Third, consistent with statements from President Obama, we 
     believe that focusing on, defining, measuring, and paying for 
     value is essential for controlling cost within the U.S. 
     health care system. The system must be reformed to compensate 
     for value instead of volume. We believe inserting a value 
     index into various aspects of the Medicare payment system 
     (e.g., physician fee schedule, hospital rates) is the means 
     to accomplish this end goal of compensating for quality 
     rather than quantity.
       We appreciate the opportunity to comment on this 
     legislation. We urge you to address the above-stated 
     concerns, which will demonstrate that Congress is serious 
     about preserving the best parts of the existing health care 
     delivery system. If we can be of assistance to you moving 
     forward, please do not hesitate to contact us.
           Sincerely,
         Everett Clinic, Gundersen Lutheran Health System, 
           HealthPartners, Intermountain Healthcare, Iowa Clinic, 
           Marshfield Clinic, Mayo Clinic.
         MeritCare Health System, Park Nicollet Health System, 
           Rural Wisconsin Health Cooperative, ThedaCare, 
           Wisconsin Hospital Association, Wisconsin Medical 
           Society.

  The PRESIDING OFFICER (Mr. Udall of Colorado). The Senator from 
Illinois.

[[Page 18408]]


  Mr. BURRIS. Mr. President, throughout this Nation's history, our 
freedom--and at times our very survival--has rested squarely on the 
shoulders of the men and women of our Armed Forces.
  As a member of the Armed Services Committee, I am proud to know many 
of these brave warfighters we have. We rely upon their training and 
discipline. We depend upon their service and their sacrifice. In 
return, we owe them nothing but the very best.
  That means keeping our commitment to every soldier, sailor, airman, 
and marine at every stage in their career--from the day they report for 
training to the day they retire and beyond.
  We can start to honor this commitment in the most basic way by 
ensuring that their facilities are safe and adequate. That is why I 
plan to offer an amendment that would help eliminate vegetative 
encroachment on training ranges. Excessive vegetation can actually 
render training grounds unusable. If a training range is heavily 
overgrown, it can lead to dangerous situations, including fires and 
obstructive lines of sight.
  In a recent study by the U.S. Army, 70 percent of the facilities 
surveyed are experiencing limitations due to uncontrolled vegetation. 
This is unacceptable. We must take action now.
  My amendment calls upon the Secretary of Defense to perform a 
comprehensive study of training ranges across every branch of the 
military. We must develop a plan to reclaim any overgrown land for its 
rightful use by our fighting men and women of America. This will help 
us ensure that we can train them adequately and safely so they can 
fully prepare for any mission they are assigned to perform.
  But we cannot stop there. Our commitment begins on the day someone 
volunteers for service in the Armed Forces. But it does not end, even 
after their service has drawn to a close. That is why I believe it is 
important to extend dislocation benefits to every servicemember, 
including those whose service is coming to an end.
  Over the course of a career in the American military, a service man 
or woman and their family may be ordered to relocate a number of 
times--moving here, moving there, this assignment, that assignment. 
Each move can be quite costly. From basic travel expenses to the 
purchase of household goods to utilities to rent, it takes a lot to 
relocate an entire family.
  Since 1955, Congress has helped members of the service defray these 
costs by paying a ``dislocation allowance'' to each person we reassign 
to a new duty station. This eases the financial burden on military 
families and means that personnel decisions can be made without fear of 
breaking the bank--at least for most servicemembers, that is.
  Unfortunately, those who retire are not covered under the current 
system, despite the fact that their final orders may require a 
permanent change of station. So after years of supporting service men 
and women when we ask them to relocate, we abandon them at the time of 
their final move. We leave them to fend for themselves, even though the 
expenses they incur will be as high as ever, and even though their 
income has been reduced to half of what they had been paid during 
Active Duty.
  So we simply cannot stand for this. We cannot allow those who have 
served us honorably to be left out in the cold at the end of their 
careers. We must offer these benefits to all Members of our Armed 
Forces, even those who have been asked to move for the last time.
  That is why I am calling for a study to examine the feasibility of 
extending the dislocation allowance to retiring servicemembers. We 
should find a way to make this work. The cost of moving demands it. Our 
servicemembers support it. And, most importantly, it is the right thing 
to do for our troops.
  Colleagues, Members of this great body, let's come together to stand 
for those who sacrifice on our behalf and protect this great country of 
ours that allows us to do what we do in America, with freedom and 
opportunity. Let's provide our men and women in uniform with the 
support they need at every stage of their careers--from the first day 
of basic training to the day they are discharged.
  Cutting down on vegetation encroachment will keep our trainees safe 
and help prepare them for years of honorable service. When that service 
ends, dislocation benefits will help them retire with some measure of 
financial security.
  So I urge my colleagues to join with me in supporting these 
initiatives I put forth. We owe our troops nothing less.
  Thank you, Mr. President. I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. REED. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  The PRESIDING OFFICER. The Senator from South Carolina.
  Mr. DeMINT. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DeMINT. Mr. President, I ask unanimous consent to speak for up to 
10 minutes as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Health Care Reform

  Mr. DeMINT. Mr. President, I wish to speak for a few minutes about 
health care and the need for health care reform in the country today. I 
think most Americans would agree we need to do everything we can to 
make affordable health insurance available to every American and, 
hopefully, that is what this health reform debate will be about.
  Unfortunately, we are seeing a pattern develop here that has been 
going on all year--since the President took office--that has many 
Americans alarmed at the rapid pace we are spending and borrowing, 
imposing new taxes, and taking over various aspects of the American 
economy. I know a lot of Americans are alarmed and some are outraged. 
More than any other comment, I am hearing Americans say: Why don't you 
slow down and read the bills before you continue the expansion of 
government.
  Now we are talking about health care, and we see that same pattern of 
crisis and rush and it ``has to be done today, hair's on fire'' type of 
mentality here in Washington so that we almost have to call this a 
``son of stimulus'' health care bill. Because certainly the last time 
the President tried to ram a massive bill through Congress before we 
had a chance to read it, we ended up with this colossal stimulus 
failure that has actually resulted in the loss of jobs in America and a 
burden of debt on our children that is almost unimaginable. It makes no 
sense for us to follow that same pattern with health care--nearly 20 
percent of our economy--to have a government takeover with a bill we 
haven't even completely seen yet, that is supposed to be passed in the 
next 2 weeks, even though the bill wouldn't take effect until 2013. 
What is the rush? The whole purpose of the Senate is to be the place 
where the legislation comes to cool down, where we deliberate, we look 
at the details. The President himself has admitted he is not aware of 
the details of the bill he is out selling every day.
  We do have serious problems in health care that we need to fix. The 
unfortunate thing is I have no confidence that the President actually 
wants to make health insurance affordable and available to all 
Americans because when he was in the Senate, Republicans proposed a 
number of alternatives that would have done that. Yet in every case--
every opportunity he had to make health insurance more available and 
affordable to Americans--he voted no. Let's review some of them, 
because I think we have to recognize that the point of this health care 
debate is not to make sure every American is insured, but to make sure 
the government is running our health care system. The most personal and 
private part of our lives they are talking about turning over to 
bureaucrats at the Federal level. This makes no sense.
  What we could do is be fair to those who don't get their health 
insurance at

[[Page 18409]]

work. If people get their health insurance at work, as we do here in 
Congress, your employer can deduct the cost of it and the employee is 
exempt from paying taxes on those benefits. That is equivalent to about 
a $5,000 a year benefit to families who get their health care or health 
insurance at work. Why can't we offer that same fairness to Americans 
who don't get their health insurance at work? It is something I 
actually proposed here in the Senate while President Obama was a 
Senator, that we would give fair tax treatment; at least let them 
deduct it from their taxes. He voted no, as did I believe every 
Democrat, and they killed the bill in the House. This was basic 
fairness to make health insurance a little more affordable to people 
who didn't get it at work. The President voted no.
  We hear a lot of talk about how we need a government plan to make the 
private plans more competitive. Why not make all the insurance 
companies compete with insurance companies all over the country instead 
of what we do now? A lot of Americans don't know that the reason we 
don't have a competitive private health insurance market is that the 
Federal Government makes it impossible. You have to buy your health 
insurance in the State where you live, so a few insurance companies 
basically have monopolies in every State of the country. What if 
someone such as myself who lived in South Carolina could look all 
across the country, find a policy I wanted at a better price, and buy 
it? Why can't we do that? Well, I proposed we do that. We introduced it 
on the Senate floor. It would have created a competitive health 
insurance market and allowed people to buy all over the country. Barack 
Obama voted no, as did all of the Democrats, to kill the bill. Now they 
are talking about: Well, we need a government option to create some 
competition, to have a real competitive market. He voted against it.
  What about allowing Americans who put money in a health savings 
account, or their employer puts it in there for them--their own money--
why not let them use that money to pay for a health insurance premium 
if they don't get it at work? It sounded like a good idea to me, to 
make it a little bit easier, a little more affordable to have your own 
health insurance, so I proposed that bill here in the Senate. Barack 
Obama voted no, as did all of the Democrats, and they killed the bill.
  What about the idea of allowing a lot of small employers--I was a 
small businessman for years. It was hard to buy health insurance as a 
small employer, but I did. It cost me a lot of money, a lot more than 
the big employers. But what about allowing a lot of small employers to 
come together and form associations and buy health insurance so they 
could offer it to their employees less expensively? Well, it is a good 
idea that was offered right here on the floor of the Senate by 
Republicans. Barack Obama voted no, as did most of the Democrats, and 
they killed the bill.
  There is a long list here I could go through, but every single bill, 
every single health reform idea that has been proposed here, the 
President, when he was in the Senate, voted against. Everything that 
would have made health insurance available and affordable to the 
average American who doesn't get their insurance at work was voted no 
by this President.
  Now he is saying, We need the government to take it over because it 
is not working. The reason it is not working is we won't let it work. 
The part of health insurance, the health care system that works the 
best today is when you have your own health insurance and you pick your 
own doctor and you and your doctor decide what kind of health care you 
are going to get. It is not a perfect system, and insurance companies 
have a lot of work to do to make things work better because I have to 
argue with them a lot myself. But the part of the health care system 
that doesn't work is the part that the government runs, Medicaid and 
Medicare, the SCHIP and TRICARE. Some of the people who get those 
benefits such as our seniors say Medicare works fine, but, 
unfortunately, doctors don't want to see them coming because Medicare 
and Medicaid don't cover the cost of even seeing a patient. So many 
physicians are closing their practices to our seniors because they have 
government health insurance. Government health care does not pay enough 
for the physician and the hospital to see the patient, so they shift 
the cost over to the private market.
  The worst part of all of these government plans is they are trillions 
of dollars in debt--debt that our children are going to have to pay 
back. These programs are broke. Yet they want to expand these programs. 
They want to take the part of health care that is not working and 
essentially force it on every American. They want every American to 
have a Medicaid plan where doctors don't want to see us coming because 
we are not paying enough of their costs.
  As I look at this whole health care reform debate--and I am glad to 
see the President out taking shots at me for saying we have to stop him 
on this, because we have been on a rampage since he took office, 
passing one government program after another, expanding spending and 
debt at levels we have never imagined in this country. It is time to 
slow down and take stock of where we are. Other countries that have to 
lend us money to keep us going are beginning to wonder, Can we pay our 
debts? We have doubled our money supply by the Federal Reserve, and 
that means big inflation, higher interest rates. Yet we are moving 
ahead with this health care plan that is going to expand our debt as a 
nation, raise taxes on small businesses that create the jobs. It looks 
as if we are going to penalize Americans who don't decide to buy health 
insurance, and we are moving again toward a government program that we 
know won't work. There is not one Federal program that has worked as 
advertised, that has worked to the budget we said it would be to. This 
week we have had announcements of what we have already passed as far as 
stimulus over the last year is going to mean trillions of dollars--
trillions of dollars--we are going to have to borrow and that our 
children are going to have to pay back.
  I appeal to my colleagues: We don't need to rush through a bill in 
the next 2 weeks before we go on our August break that affects one-
fifth--20 percent--of our total economy, that gets the government to 
effectively take over the most personal and private service that we ask 
for as Americans. We don't need to pass a bill such as that, that we 
won't even have time to read. What the President and I think a lot of 
the proponents of this bill are afraid of is if we are able to go home 
on the August break and we take this bill and we put it on the Internet 
where people can read it, and radio talk shows and bloggers all around 
the country are able to tell the American people what this bill is and 
what it will do, and get past this utopian rhetoric that we are hearing 
from the President and look at the nuts and bolts, because everything 
he is saying this bill is going to do the Congressional Budget Office 
and other experts are saying, No, it isn't going to work that way. It 
isn't going to save us money, it is going to raise our taxes, it is 
going to cost jobs in America, and it isn't going to fix health care.
  We need to go back to the basics, including some of what I have 
mentioned already, that would reform health care and make private 
health insurance work better, make it more affordable, and get it into 
the hands of more Americans. Why should we give up on freedom and move 
to a government plan when we haven't even given freedom a chance to 
work in health care?
  I know the government can't run health care and I don't want them 
running my plan. One of the best ideas I have heard in this debate is 
whatever we pass, Congressmen and Senators ought to have to take that 
health plan. I am going to have an amendment to that effect if they try 
to get this on the floor before August.
  But I appeal to my colleagues: Let's listen to the American people. 
Let's stop this rampage toward bigger and bigger government. Let's take 
our time and look at this bill and, for once, do something right. Our 
health depends on it.

[[Page 18410]]

  Thank you, Mr. President. I yield the floor.
  The PRESIDING OFFICER. The Senator from Florida is recognized.


                           Amendment No. 1515

  Mr. NELSON of Florida. Mr. President, I ask unanimous consent that 
the pending amendment be laid aside in order that I might call up 
amendment No. 1515.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The clerk will report.
  The assistant legislative clerk read as follows:

       The Senator from Florida [Mr. Nelson] proposes an amendment 
     numbered 1515.

  Mr. NELSON of Florida. Mr. President, I ask unanimous consent that 
reading of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

(Purpose: To repeal the requirement for reduction of survivor annuities 
 under the Survivor Benefit Plan by veterans' dependency and indemnity 
                             compensation)

       At the end of subtitle D of title VI, add the following:

     SEC. ___. REPEAL OF REQUIREMENT OF REDUCTION OF SBP SURVIVOR 
                   ANNUITIES BY DEPENDENCY AND INDEMNITY 
                   COMPENSATION.

       (a) Repeal.--
       (1) In general.--Subchapter II of chapter 73 of title 10, 
     United States Code, is amended as follows:
       (A) In section 1450, by striking subsection (c).
       (B) In section 1451(c)--
       (i) by striking paragraph (2); and
       (ii) by redesignating paragraphs (3) and (4) as paragraphs 
     (2) and (3), respectively.
       (2) Conforming amendments.--Such subchapter is further 
     amended as follows:
       (A) In section 1450--
       (i) by striking subsection (e);
       (ii) by striking subsection (k); and
       (iii) by striking subsection (m).
       (B) In section 1451(g)(1), by striking subparagraph (C).
       (C) In section 1452--
       (i) in subsection (f)(2), by striking ``does not apply--'' 
     and all that follows and inserting ``does not apply in the 
     case of a deduction made through administrative error.''; and
       (ii) by striking subsection (g).
       (D) In section 1455(c), by striking ``, 1450(k)(2),''.
       (b) Prohibition on Retroactive Benefits.--No benefits may 
     be paid to any person for any period before the effective 
     date provided under subsection (f) by reason of the 
     amendments made by subsection (a).
       (c) Prohibition on Recoupment of Certain Amounts Previously 
     Refunded to SBP Recipients.--A surviving spouse who is or has 
     been in receipt of an annuity under the Survivor Benefit Plan 
     under subchapter II of chapter 73 of title 10, United States 
     Code, that is in effect before the effective date provided 
     under subsection (f) and that is adjusted by reason of the 
     amendments made by subsection (a) and who has received a 
     refund of retired pay under section 1450(e) of title 10, 
     United States Code, shall not be required to repay such 
     refund to the United States.
       (d) Repeal of Authority for Optional Annuity for Dependent 
     Children.--Section 1448(d) of such title is amended--
       (1) in paragraph (1), by striking ``Except as provided in 
     paragraph (2)(B), the Secretary concerned'' and inserting 
     ``The Secretary concerned''; and
       (2) in paragraph (2)--
       (A) by striking ``Dependent children.--'' and all that 
     follows through ``In the case of a member described in 
     paragraph (1),'' and inserting ``Dependent children annuity 
     when no eligible surviving spouse.--In the case of a member 
     described in paragraph (1),''; and
       (B) by striking subparagraph (B).
       (e) Restoration of Eligibility for Previously Eligible 
     Spouses.--The Secretary of the military department concerned 
     shall restore annuity eligibility to any eligible surviving 
     spouse who, in consultation with the Secretary, previously 
     elected to transfer payment of such annuity to a surviving 
     child or children under the provisions of section 
     1448(d)(2)(B) of title 10, United States Code, as in effect 
     on the day before the effective date provided under 
     subsection (f). Such eligibility shall be restored whether or 
     not payment to such child or children subsequently was 
     terminated due to loss of dependent status or death. For the 
     purposes of this subsection, an eligible spouse includes a 
     spouse who was previously eligible for payment of such 
     annuity and is not remarried, or remarried after having 
     attained age 55, or whose second or subsequent marriage has 
     been terminated by death, divorce or annulment.
       (f) Effective Date.--The sections and the amendments made 
     by this section shall take effect on the later of--
       (1) the first day of the first month that begins after the 
     date of the enactment of this Act; or
       (2) the first day of the fiscal year that begins in the 
     calendar year in which this Act is enacted.

  Mr. NELSON of Florida. Mr. President, this is the widows and orphans 
amendment. This is the dastardly subject we have been dealing with for 
years, where there is an offset from an insurance payout, that 
servicemembers pay insurance premiums and/or retirees pay premiums, 
which is offset by Veterans Department disability compensation, which 
otherwise the veteran's surviving spouse and children would be able to, 
under existing law, be eligible for both, but there is an offset.
  This particular amendment is going to eliminate that offset. Every 
year, we come to the floor on the Defense authorization bill and we 
offer the amendment and we have an overwhelming vote in the Senate. 
Every year, it goes to conference and, for years and years, in the 
conference committee with the House, they would say you cannot pass an 
amendment that would even reduce the offset for widows and orphans. 
Only in the last couple years have we had some modest reduction of the 
offset. Then, on an earlier piece of legislation this year, we had a 
little bit more reduction of the offset. What this amendment will do is 
completely eliminate the offset.
  I wish to point out at the outset, I have a letter from the Military 
Coalition, and I ask unanimous consent it be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                       The Military Coalition,

                                    Alexandria, VA, July 15, 2009.
     Hon. Bill Nelson,
     U.S. Senate,
     Washington, DC.
       Dear Senator Nelson: The Military Coalition (TMC), a 
     consortium of nationally prominent military and veterans 
     organizations, representing more 5.5 million members plus 
     their families and survivors would like to thank you for your 
     sponsoring of Amendment No. 1515 of FY2010 NDAA (S. 1390). 
     This Amendment, like your bill, S. 535, would repeal the law 
     requiring a dollar-for-dollar deduction of VA benefits for 
     service connected deaths from the survivors' SBP annuities. 
     The elimination of this survivor benefit inequity is a top 
     legislative goal for TMC in 2009.
       We strongly believe that if military service caused a 
     member's death, the Dependency and Indemnity Compensation 
     (DIC) the VA pays the survivor should be added to the SBP 
     benefits the disabled retiree paid for, not substituted for 
     them. In the case of members who died on active duty, a 
     surviving spouse with children can avoid the dollar-for-
     dollar offset only by assigning SBP to the children. That 
     forces the spouse to give up any SBP claim after the children 
     attain their majority--leaving the spouse with only a $1,154 
     monthly annuity from the VA. Those who give their lives for 
     their country deserve fairer compensation for their surviving 
     spouses. Your amendment would also end this inequity.
       The Military Coalition again thanks you for sponsoring this 
     Amendment to restore equity to this very important survivor 
     program and encourages your colleagues vote for its passage.
           Sincerely,
       The Military Coalition:

       Air Force Association, Air Force Sergeants Association, Air 
     Force Women Officers Associated, American Logistics 
     Association, AMVETS, Army Aviation Assn. of America, Assn. of 
     Military Surgeons of the United States, Assn. of the US Army, 
     Association of the United States Navy, Commissioned Officers 
     Assn. of the US Public Health Service, Inc. CWO & WO Assn. US 
     Coast Guard, Enlisted Association of the National Guard of 
     the US, Fleet Reserve Assn., Gold Star Wives of America, 
     Inc., Iraq & Afghanistan Veterans of America, Jewish War 
     Veterans of the USA, Marine Corps League, Marine Corps 
     Reserve Association, Military Officers Assn. of America, 
     Military Order of the Purple Heart, National Association for 
     Uniformed Services, National Guard Assn. of the US, National 
     Military Family Assn., National Order of Battlefield 
     Commissions, Naval Enlisted Reserve Assn., Non Commissioned 
     Officers Assn. of the United States of America, Reserve 
     Enlisted Assn. of the US, Reserve Officers Assn., Society of 
     Medical Consultants to the Armed Forces, The Military 
     Chaplains Assn. of the USA, The Retired Enlisted Assn., USCG 
     Chief Petty Officers Assn., US Army Warrant Officers Assn., 
     Veterans of Foreign Wars of the US.

  Mr. NELSON of Florida. This letter supports this legislation. It is 
from the Military Coalition. The Military Coalition is a group of 34 
organizations, and their signatures are on the letter--alphabetically, 
from the Air Force Association all the way to the last one on

[[Page 18411]]

the list of 34, the Veterans of Foreign Wars of the United States. All 
those organizations that you would expect are in between; there are 34 
of them endorsing this amendment.
  I wish to tell you about this particular amendment. I filed this 
bill--and this is nonpartisan--years ago with Senator Sessions and 
eight other original cosponsors. It will repeal the law that takes 
almost $1,200 per month from families who have lost a loved one because 
of military service. This survivors benefit plan, otherwise known by 
its initials as SBP, is an annuity paid by the Defense Department. 
Survivors receive the benefit when either a military retiree pays a 
premium as income insurance for their survivors or when a servicemember 
dies on Active Duty.
  The other law is dependency and indemnity compensation, referred to 
by its initials DIC. It is a survivor benefit paid by the Veterans' 
Administration. Survivors receive this benefit when the military 
service caused the servicemember's death.
  What this amendment will do is fix this longstanding problem in the 
military survivor benefits system. The problem is, it requires a 
dollar-for-dollar reduction of the survivor benefits from the SBP, paid 
by the Department of Defense, offsetting against the dependents and 
indemnity compensation, DIC, paid by the Veterans' Administration.
  You know the great quote, following one of America's bloodiest wars, 
by President Lincoln in his second inaugural address--and the war was 
still raging at that point. He said that one of the greatest 
obligations in war is to ``finish the work we are in; to bind up the 
Nation's wounds; to care for him who shall have borne the battle''--in 
other words, the veterans--``and for his widow and his orphan.''
  Following Lincoln's advice to honor truly our servicemembers, they 
need to know their widows and orphans, their survivors, will be taken 
care of. We certainly agree that the U.S. Government must take care of 
our veterans, their widows, and their orphans. In keeping with that 
principle, we need to repeal this offset that denies the widows and 
orphans the annuity their deceased loved ones have earned on Active 
Duty or have purchased for them. A retired military member can purchase 
this SBP, and it is an insurance policy so their survivors will have 
income.
  Over in the Veterans' Administration, we have a law that says, if you 
are disabled a certain percentage, we are going to take care of you. 
One should not offset the other--particularly, when somebody has paid 
premiums on an insurance policy.
  Well, that dollar-for-dollar offset is what has me so agitated for a 
decade now. I have already explained that, for the survivors benefit 
plan, there are two ways to qualify: The military retiree goes out and 
voluntarily pays into an insurance program with their retirement 
income. Later, the statute was added that the survivors benefit plan is 
available to an Active-Duty servicemember if they are killed as a 
result of military service. For retirees, the SBP is an insurance 
program that protects the income of survivors; and for Active-Duty 
military members, SBP is compensation for the servicemembers' 
beneficiaries.
  On the other hand, the dependents indemnity compensation is a benefit 
payment to the survivors of a servicemember who dies from a service-
connected condition. For almost a decade, I have fought to repeal the 
law that requires the dollar-for-dollar offset of these two very 
different benefits. Back in 2005, the Senate took the step in the right 
direction and passed, by a vote of 92 to 6, my amendment to repeal that 
offset. When it got down to the conference committee, you know what 
happened. In the 2008 Defense authorization bill, we cracked the door 
to eliminating the offset. In the conference committee negotiations 
with the House, we made some progress when we got a special payment of 
$50 per month, which would now increase to $310 per month by 2017 
because of money savings found in the tobacco legislation passed 
earlier this year.
  Our efforts have been important steps in the right direction, but 
they are not enough. We must meet our obligation to the widows and 
orphans with the same sense of honor as was the service their loved 
ones had performed. We need to completely offset this SBP and DIC. We 
must continue to work to do right by all those who have given this 
Nation their all and especially for the loved ones they may leave to 
our care.
  In that letter that I have had entered into the Record, it says:

       The elimination of this survivor benefit inequity is the 
     top legislative goal for [the Military Coalition] in 2009.

  I will not take the time to read the names of the 34 organizations 
that signed the letter, but they are all fairly well known to every one 
of us.
  On February 24 of this year, during a joint session of the Congress, 
the President said:

       To keep our sacred trust with those who serve, we will 
     raise their pay, and give our veterans the expanded health 
     care and benefits they have earned.

  I say amen to that. I ask that President Obama help us end this 
injustice to widows and orphans of our Nation's heroes.
  Mr. President, may I inquire if there is someone else who wants to 
speak now, because if there would not be, I would like to speak as in 
morning business.
  Mr. McCAIN. I object. Let's dispose of the amendment.
  The PRESIDING OFFICER. The Senator from Arizona objects.
  Mr. McCAIN. I object to the Senator from Florida going into morning 
business until we dispose of the amendment. Then he can do it right 
away.
  Mr. NELSON of Florida. I merely inquired if another Senator wants to 
speak. Certainly, I would withhold asking for a unanimous consent.
  Mr. SCHUMER. Mr. President, I intend to speak on the Thune amendment 
and was scheduled to speak in the next few minutes. If it is OK with 
the floor leaders, if my colleague will speak for a brief amount of 
time, I am happy to go after him. It is up to the floor managers.
  Mr. McCAIN. Mr. President, I say to the Senator from Florida, we will 
find out if there are others who want to speak on his amendment. If 
not, we are in favor of disposing of his amendment. Part of the 
agreement we made, in order for us to proceed, was that if anyone came 
to the floor to speak on the pending amendment, that Senator would have 
priority. If it is agreeable to the Senator from Florida, the Senator 
from New York would go ahead and then we could go back to him speaking 
in morning business.
  Mr. NELSON of Florida. Of course. It is my understanding the Senator 
from South Carolina had just spoken as in morning business. That is why 
I was inquiring. I am very grateful to the ranking member of the 
committee for us to go ahead and dispose of this amendment.
  Mr. McCAIN. Why don't we wait until after the Senator from New York 
finishes, to make sure there is no one else who wants to speak on the 
amendment of the Senator from Florida.
  Mr. SCHUMER. Mr. President, if my colleague needs 5 minutes, I am 
happy to yield to him, if I would come after that. I ask unanimous 
consent that be the case.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The Senator from Florida is recognized.
  Mr. NELSON of Florida. Mr. President, I ask unanimous consent to 
speak as in morning business.
  The PRESIDING OFFICER (Mr. Kaufman). Without objection, it is so 
ordered.
  Mr. NELSON of Florida. I thank the Chair.
  (The remarks of Mr. NELSON of Florida pertaining to the introduction 
of S. 1484, S. 1485, S. 1486, and S. 1487 are located in today's Record 
under ``Statements on Introduced Bills and Joint Resolutions.'')
  Mr. REED. Mr. President, if the Senator from Florida is prepared, I 
have conferred with the ranking member, the Senator from Arizona, and 
we are prepared to voice vote the amendment.
  The PRESIDING OFFICER. Is there further debate on the amendment?

[[Page 18412]]

  If not, the question is on agreeing to the amendment.
  The amendment (No. 1515) was agreed to.
  Mr. NELSON of Florida. Mr. President, I move to reconsider the vote, 
and I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  The PRESIDING OFFICER. The Senator from New York.


                           Amendment No. 1618

  Mr. SCHUMER. Mr. President, I know we are not now on the Thune 
amendment. I know we have gone aside to other amendments and that we 
will be debating Thune tomorrow morning, but there are so many of my 
colleagues who want to speak, and I have a lot to say. So I will speak 
for 5 minutes tomorrow morning, but I will give the bulk of my speech 
this afternoon.
  Mr. President, I rise in staunch opposition to the Thune amendment. I 
believe it is a dangerous amendment that would go far beyond 
authorizing gun possession for self-defense and not only create a 
serious threat to public safety but also severely undercut American 
federalism.
  Amendment No. 1618, authored by Senator Thune, would force States and 
localities from across the Nation to permit individuals from other 
States to carry hidden and loaded handguns in public, even where the 
elected representatives of those States have chosen to bar these 
persons from possessing firearms. The legislation would require every 
State with concealed carry legislation to honor concealed carry 
licenses issued by any other State so long as they abide by the State's 
location restrictions for concealed carry.
  This amendment is a bridge too far and could endanger the safety of 
millions of Americans. Each State has carefully crafted its concealed 
carry laws in the way that makes the most sense to protect its 
citizens. It is obvious what is good for the safety of people in New 
York City or Philadelphia or Chicago or Miami or Los Angeles is not the 
same thing that is needed in rural Idaho or rural Tennessee. Yet this 
amendment, in one fell swoop, says the protections some States feel 
they need to protect law enforcement, to protect its citizenry, would 
be wiped away.
  The amendment will incite the dangerous race to the bottom in our 
Nation's gun laws. Let's examine the lineup of people who could carry 
concealed weapons in 48 States under this amendment. And I don't 
disparage each State for doing what it wants within its own borders, 
but why impose that on States outside their borders?
  Arizona law allows a concealed carry permit to be issued to an 
applicant who is a known alcoholic. So alcoholics would be in the 
lineup. They could carry a concealed weapon in States outside of 
Arizona simply because Arizona allowed them to do so.
  Texas, which is one of the top 10 sources of guns recovered in crimes 
in New York City, a city in which I reside, is obliged to issue a 
permit to a person who has been convicted repeatedly of illegally 
carrying a handgun. Therefore, we can place arms traffickers in this 
lineup.
  Mississippi law leaves access to concealed carry permits for members 
of hate groups.
  Alaska and Vermont allow adult residents of their States to carry a 
concealed weapon without a license or background check as long as they 
are allowed to possess a gun, even if they have committed violent 
misdemeanors, have committed misdemeanor sex offenses against minors or 
are dangerously mentally ill and have been voluntarily committed to a 
mental institution.
  Again, each State has its own views. The State of Vermont is a 
beautiful State. It is different from New York State in many ways, and 
the laws that fit for Vermont don't necessarily fit for New York.
  A 17-year-old Crip or Blood from New York--a member of a gang; 
dangerous, maybe violent--could head to Vermont, obtain a Vermont 
driver's license, buy a gun, and return to New York or he could buy a 
whole bunch of guns and return to New York. When law enforcement stops 
him, a loaded gun tucked in his pants or a whole bunch of guns in his 
backpack, all he would have to do is claim he is a Vermonter visiting 
New York, show his Vermont ID, and the New York Police Department would 
be unable to stop him. This runs shivers down the spines of New York 
police officers, of New York sheriffs, of New York law enforcement. And 
it doesn't just apply to New York. This could apply to any large State.
  Imagine law enforcement stopping one of these characters with a 
backpack full of guns--a known member of a major gang--and having to 
let them go. Imagine how empowered gun smugglers and traffickers would 
feel. Their business would boom. These are people who make money by 
selling guns illegally to people who are convicted felons. They could 
go to the State with the weakest laws, get a concealed carry permit--if 
that State allowed it, and in all likelihood it might--and then start 
bringing concealed guns into neighboring States and States across the 
country. Their business would boom, but our safety would be impaired. 
Imagine routine traffic stops turned into potential shootouts.
  Police officers in New York have the safety and the peace of mind in 
knowing that the only people who might legally have a gun are those who 
have been approved by the police department. That is how we do it in a 
city such as New York. We have had our problems with crime. Thank God 
it is much lower now, due to the great work of the New York City 
police. But now they would be totally unprepared, walking on tiptoe. 
And if the criminal simply said: I am from this State--wow. I shudder 
at the thought.
  Beyond the very real threat this poses to law enforcement and the 
safety of our police officers and the safety of our citizens, it would 
create a logistical nightmare. A police officer making a stop of a car 
would have to have in front of him or her the laws of all 45 States 
that now allow or whose residents would now be allowed or even whose 
people had gotten carry permits who would now be allowed to carry 
concealed weapons in New York.
  What about States rights? I have not been on the side--it is 
obvious--of the gun lobby for as many years as I have been here in the 
House and Senate. I have always believed, though, there is a right to 
bear arms and that it is unfair to say the second amendment should be 
seen through a pinhole and the first, third, fourth, fifth, sixth, 
seventh, and eighth amendments should be seen broadly. I don't think 
that is fair.
  But every amendment has limitations. Through the years when I have 
been involved in this issue, the NRA and other gun groups have argued, 
frankly, that the States ought to make their own decisions. All of a 
sudden we see a 180-degree hairpin turn. Now they are saying that the 
States cannot make their own decisions. Why is it that every other 
issue should be resolved by the States except this one? The amendment 
flies in the very face of States rights arguments and takes away 
citizens' rights to govern themselves.
  I say to my colleagues who have laws and citizenry who probably want 
the laws not drawn as tightly as my State, if you open up this door, 
one day you will regret it. Because if you say that the Federal 
Government should decide what law governs, you are taking away States' 
right to govern themselves.
  In the 1990s, after the passage of the Brady Act, the National Rifle 
Association funded multiple legal challenges to it, citing the 10th 
amendment, that the right to bear arms therefore resided in the States. 
Indeed, Mary Sue Falkner, who was then a spokesman for the NRA, said at 
the time:

       This is not a case about firearms per se, but about whether 
     the Federal Government can force States and local governments 
     against their will to carry out Federal mandates.

  Similarly, in reference to Brady, the NRA's chief lobbyist said that 
the Federal Government was getting too much involved in State affairs.
  The gun lobby's rallying cry has always been, ``Let each State 
decide.'' But with this amendment, again, a 180-degree flip.

[[Page 18413]]

  Clearly, large urban areas merit a different standard than rural 
areas. To gut the ability of local police and sheriffs to determine who 
should be able to carry a concealed weapon makes no sense. It is wrong 
to take away any State's rights to make decisions about what can make a 
resident safer. A one-size-fits-all approach to community safety leads 
us down a very precarious road.
  Make no mistake, this is a serious amendment. It is, even though not 
the intention of the author, a dangerous amendment. There will be 
needless suffering, injuries, and deaths if this amendment is agreed 
to.
  I talked to my colleague Senator Thune. We are friends. We saw each 
other in the gym this morning. He said to me: What about truckdrivers 
who have the gun in the cab of their truck and ride across State lines? 
I am sympathetic to that. I supported laws that allow police officers 
in New York to carry their gun when they cross over into New Jersey to 
shop or whatever. But you do not need this law to deal with that 
problem, because it creates so many other issues. There are ways we can 
deal with the problem that the Senator from South Dakota brought up to 
me in the gym this morning, without decimating State laws that protect 
individual safety.
  Make no mistake about it, this amendment would affect every State in 
the country, but I do not see the Governors on board. It would affect 
every city in the country. I don't see the mayors on board. It would 
affect every county in the country, but I don't see the sheriffs on 
board. It would affect every town in the country, but I don't see 
police chiefs on board.
  Before we rush to judgment, shouldn't we ask our Governors, our 
mayors, our sheriffs, our police chiefs if this will make our 
communities safer or less safe? If this will put the men and women, the 
brave men and women who defend us and protect us on police forces, in 
jeopardy? Why don't we seek their guidance?
  I urge my colleagues to give thoughtful and careful consideration to 
the consequences of the Thune amendment. I believe if they do, they 
will vote against it tomorrow at noon.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. DURBIN. Mr. President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DURBIN. I ask unanimous consent to speak as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Health Care Reform

  Mr. DURBIN. Mr. President, as we meet here today we are discussing 
the Defense authorization bill. We debate it each year. It is basically 
an authorization for the expenditure of funds in defense of America. It 
is a significant bill with a lot of different parts. I commend the 
Senators who have brought this to the floor, Senator Carl Levin, the 
chairman of the Armed Services Committee, and his Republican 
counterpart, Senator John McCain.
  I know this bill is important and I know we will be returning to 
substantive amendments on this bill very shortly. But while we have 
this break in the action, I want to address another issue which is 
being debated in almost every corridor on Capitol Hill, and that is the 
issue of health care reform. It is an interesting issue and an amazing 
challenge to this Congress, to try to grapple with the health care 
system in the most prosperous Nation on Earth.
  Despite our prosperity, we know there is something fundamentally 
flawed with our health care system. We spend more than twice as much 
per person in America on health care as any other country, and the 
results do not show that money is being well spent. Many other 
countries, spending a fraction of what the United States spends, end up 
with very different and much better results in terms of survival from 
certain diseases and illness, and mortality rates. There is something 
to be learned here about how we can be more effective in providing 
health care for our citizens and not break the bank.
  Most Americans know what I am talking about when I talk about cost, 
because they are facing cost issues every day. They know health 
insurance premiums in America in the last several years have gone up 
three times faster than the incomes and wages of Americans. We have 
learned it is not unusual for one-fourth of Americans to spend 1 out of 
every $10 in income for health insurance. Some, a smaller group but a 
significant group, spend up to $1 out of every $4 in income on health 
insurance. The number keeps going through the roof with no end in 
sight. It worries us, not just as individuals and members of families, 
but businesses that are trying to do the right thing for their 
employees and be competitive.
  It worries units of government because, whether it is your State 
government providing assistance for Medicaid or whether it is the 
Federal Government concerned about Medicare and Medicaid, the costs of 
health care are growing so quickly that they could easily put us into a 
perpetual debt situation, something we do not want to see, something we 
cannot leave to our children.
  Now we are debating in the House and in the Senate, in a variety of 
different committees, how to change this health care system. Needless 
to say, it is a contentious debate. There are a lot of different points 
of view. There are some people and companies in America that want no 
change in our health care system. Most people do. Some don't. Many of 
those who are resisting change, who are unwilling to support the 
President's efforts to move us in this direction, are the very same 
companies and people who are profiting from the current system.
  Make no mistake, when you spend billions of dollars on a system, much 
more than any other country, you are going to end up in a situation 
where many people are profiting handsomely from the current system. 
When you talk about reform--reducing the cost, reducing the payments, 
being more cost effective--these people see money going out the window, 
and they are going to fight it.
  That is what the battle is all about. We have been through it before, 
and now we have returned to it. But in addition to cost, there is also 
the issue of the availability of health insurance. This morning's 
Chicago Tribune, on the front page, told the story of a man who sadly 
is one of the victims of this situation. He lives in a suburb of 
Chicago, and he works as a doorman at one of the buildings. He had a 
bad back. He finally was told--he tried a lot of conservative 
treatment; it just did not work--you are going to have to have back 
surgery.
  So he did what he was supposed to do. He went to his insurance 
company and said: The doctor is recommending a surgery, and I want to 
know if it will be covered by my health insurance. Well, the health 
insurance company sent back to him written confirmation that the costs 
of the surgery would be covered by his health insurance. So he went 
through with the surgery and ended up incurring $148,000 in medical 
bills.
  I think you know how this story ends. They turned in the bills to the 
insurance company, and they denied them. They said: We did not really 
approve this surgery. You should have taken a more conservative 
approach to it.
  Well, he thought he had done everything he was supposed to. What 
followed was a battle with this insurance company, day after day, month 
after month, while people were saying: Send us the $148,000. This man 
of limited means was fighting to finally get this health insurance 
company to pay what they promised to pay. It took him months.
  When it was all over, Mr. Napientek, Michael Napientek, ended up with 
coverage. Had he failed to get the coverage for that surgery, it would 
have wiped out his entire life's savings. That is the reality of health 
care. That is the situation too many people find themselves in, so 
vulnerable in a situation where one medical bill denied by an insurance 
company bureaucrat can literally wipe out their life's savings.

[[Page 18414]]

  We can do better. We have to do better. That is what this debate is 
all about. First, we have to reduce the cost of health care for 
families and businesses and governments across America. There are ways 
to do that. We can lower costs to make sure every American has access 
to insurance. We can make it clear that no one can be turned down for 
insurance coverage because of a preexisting condition. We can make 
certain there is no discrimination in the premiums that are charged 
individual Americans because one is a male and another female; one is a 
certain age and another not. We can make certain there is more fairness 
in the way people are treated by these health insurance companies.
  This idea of denying coverage for preexisting conditions, imagine how 
frustrating that must be to realize that if you turned in a claim this 
year on your health insurance because you had a bad back, and you went 
to the doctor next year, when it came time for surgery they would not 
cover it.
  This happened to a friend of mine, a fellow I grew up with in East 
St. Louis, IL, in the trucking business. He not only owned the 
business, he drove the trucks. When he reached 60 years of age, his 
back was killing him. Well, at that point his company had lost its 
health insurance. Why? Because the wife of one of the employees had a 
sick baby. Her sick baby incurred a lot of medical bills, and the cost 
of health insurance went through the roof. They had to cancel the 
company's health insurance, give the employees some money, and say: 
Fend for yourself.
  He was in the same boat. He went out to get private health insurance, 
complained about a bad back. The following year when the doctor said he 
needed back surgery, he turned in a claim to his health insurance 
company, and they said: No, it is a preexisting condition. We will not 
cover your back surgery.
  Do you know what he had to do? He ended up filing a worker's 
compensation claim claiming that his back injuries had to do with 
bouncing around in a truck for 30 or 40 years, not an unreasonable 
conclusion. Do you know who he sued? He sued himself. He sued as an 
employee of the company. He sued himself as owner of the company.
  Is that crazy to reach that point? And he won, incidentally. They 
said it is subject to worker's compensation. We will pay for the 
surgery.
  He had done everything right, providing health insurance for his 
employees until he could not afford it, trying to get private insurance 
for himself at the age of 60, then turning in a claim and being turned 
down. He could have been wiped out by that surgery, just as the man on 
the front page of the Chicago Tribune.
  We are all in this vulnerable situation because the health insurance 
companies have so much power over our lives. I listen to those on the 
other side of the aisle who come--not all of them but many--every 
single day and say we do not need to change this system. Who are they 
talking to? Who are they listening to? They are not listening to people 
like these who find out every day that they do not have coverage, that 
the cost of insurance is too high, that their doctor is in a debate 
with a clerk at an insurance company over whether they are going to get 
the necessary and proper treatment for a medical condition. That is the 
reality.
  There are many ways to address this, and we should. We have to 
address it by making sure everyone has access to health insurance 
regardless of preexisting conditions, health status for a medical 
condition. We have to get rid of the so-called lifetime caps.
  Imagine that a diagnosis tomorrow that you or someone you love in 
your family has a chronic condition that is going to call for medical 
treatment for a long period of time, and then you realize there will 
come a moment when that health insurance company would say: We are out 
of here. You just broke the bank. You hit the cap on your policy.
  We have to put an end to that. We also have to limit the out-of-
pocket expenses individuals have to pay. There comes a point where 
people cannot afford this expense. We have to require equal treatment 
for men and women--Black, White, and brown, young and old, whether they 
live in a rural area or in a city.
  We have to make sure if a health insurance policy in America is 
offered, it is a good policy that covers the basic needs. There are 
policies that do not. They sell health insurance you can afford, and 
guess what. It is worthless. That is not good for America and it is not 
good for our families.
  There are ways to lower costs. We ought to be pushing for prevention. 
We ought to be trying to find ways to keep people well, incentives for 
the right conduct and healthy outcomes. Right now there is not much of 
a reward or an incentive for wellness. We also have to give support to 
small businesses. When we look at the insured in America, most of them 
are small business employees and their children. The poorest people in 
America are covered by Medicaid, the government health insurance, as 
they should be.
  Folks are fortunate, like myself, under the Federal Employees Health 
Benefits Program, and most others who have health insurance policies, 
to have coverage. But the folks in the middle who get up and go to work 
every day for the small businesses of America--and their kids--are the 
ones who do not have coverage. We can do better.
  One of the proposals before us in Congress is to make sure small 
businesses can start getting into pools where they can use that pooling 
power to reach out and have health insurance coverage that is 
affordable. That is within our reach.
  Senator Reed is on the Senate floor today. He and I were fortunate 
enough to be at lunch today when our colleague from Connecticut, Chris 
Dodd, got up and spoke about what had happened in the HELP Committee, 
the Health, Education, Labor and Pensions Committee, in preparing a 
bill on health care reform. There were 800 amendments filed. They met 
for 61 days. Some 400 amendments were considered and voted on. Over 100 
of those were from the Republican side of the aisle. They were trying 
their best to create a bipartisan compromise to get through the bill.
  But Senator Dodd came up and talked about this, not in terms of a 
specific bill and its provisions; he talked about the historic 
opportunity we have. He said for many of us, for most of us now serving 
in the Senate, this may be the only time in our political careers when 
we can change the health care system for the better; when we can make 
sure that people in America have a better chance to be able to afford 
the cost of health care.
  He certainly inspired us when he pulled out this magazine and showed 
us a picture of our colleague, Senator Teddy Kennedy, on the cover of 
Newsweek, and the quote from Ted Kennedy that says: ``We're almost 
there.''
  There is a long essay in here about Ted Kennedy's terrific public 
career and how much of it has been spent on this issue of health care; 
what it meant to him personally when his son was diagnosed with bone 
cancer and had to have his leg amputated; what he went through in a 
plane crash; when he has seen others and what they have gone through.
  Teddy Kennedy reminds us that these opportunities do not come around 
very often. There is lots we can debate and argue about, but at the end 
of the day the American people want to see the debate end. They want to 
see us acting together responsibly for health care that is centered on 
patients; to make sure they have a health insurance policy they like, 
that they can keep; to make certain they have a good strong 
confidential relationship with their doctors for themselves and their 
families; to make sure, as well, they are not excluded from coverage 
for preexisting conditions; to make sure that health insurance is going 
to be affordable; and to make sure it covers all Americans.
  We can do it. We are a great and prosperous nation. We have a 
President who is committed to it. And working with him on a bipartisan 
basis we can get this done. We can work with the health care 
professionals--the doctors, the nurses, those leading hospitals--who 
can show us the way to reduce the

[[Page 18415]]

cost of care without reducing its quality.
  This is our chance. For those who are saying no, that they want the 
status quo, they do not want to change it, only a small percentage of 
Americans agree with them. Most Americans agree what I have talked 
about today needs to be done. We have to overcome those voices of 
negativity and doubt who continue to come to the Senate floor, those 
who create fear of change.
  Let me tell you, this is a great, strong country that tackles big 
problems. We have never been assigned a bigger assignment than this 
one, health care for America. It touches all 300 million of us. We have 
to make sure it is done fairly, done effectively, and done quickly. If 
we let this drag out for months beyond this year, it is going to be 
harder and harder for us to reach our goal.
  I encourage my colleagues on both sides of the aisle to work toward 
that goal, make certain that President Obama's leadership is rewarded 
with health care reform that does make a difference.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Missouri.


                           Amendment No. 1501

  Mr. BOND. Mr. President, I rise today to discuss an amendment that I 
am cosponsoring with my friend and fellow cochair of the Senate 
National Guard Caucus, Senator Leahy. We will be introducing a 
bipartisan amendment to strengthen one of our Nation's most important 
military and civilian resources, the National Guard.
  The National Guard, as I think everybody in this body knows, has a 
long and proud history of contributing to America's military operations 
abroad while providing vital support and security to civil authorities 
at home.
  Since September 11, 2001, our citizen soldiers and airmen have taken 
on greater responsibilities and risk, from fighting in Iraq and 
Afghanistan to providing critical disaster assistance in the United 
States.
  Now we see the tremendous value of the National Guard forces every 
time we look as they confront terrorists, provide critical support in 
unique areas such as Afghanistan where the agribusiness development 
teams are working to help provide agricultural know-how and better 
income to the farmers of Afghanistan, to areas where they provide 
water, food, and health supplies to victims of natural disasters.
  Furthermore, the Guard is a tremendous value for the capability it 
provides our Nation. It provides 40 percent of the total military force 
for around 4.5 percent of the budget. In other words, the Guard 
provides tremendous bang for the buck.
  There is no doubt today we are asking more from the men and women of 
the National Guard than ever before, often at great cost to their 
families and their own lives.
  I think this means we have a heavy responsibility to support our 
citizen soldiers and airmen in their unique dual mission of developing 
military support abroad and providing homeland defense stateside.
  While serving abroad, National Guard troops serve under Air Force and 
Army Commands in what is known as title 10 status, which refers to the 
section in the U.S. Code dealing with the military. But when the Guard 
operates at home, they serve under the command and control of the 
Nation's Governors in title 32 status.
  I had the honor of serving as commander in chief of the Missouri 
National Guard for 8 years. I can tell you that Missouri has a wide 
range of natural and sometimes human disasters ranging from tornadoes 
and floods to blizzards and ice storms. I called out the Guard for 
every single one of those and several more I probably cannot even 
remember: threatened prison insurrections, other civil disobedience, to 
tracking down escapees from prison. Right after Katrina--I think it was 
about a year after Katrina--I visited Jefferson Barracks, MO, where one 
of our National Guard engineer units is stationed.
  They told me proudly that when Katrina hit, they immediately sent one 
of their National Guard battalions to Katrina. They had all the 
equipment, the high-wheeled vehicles, the communications equipment. 
They did such a wonderful job, the adjutant general of Louisiana called 
and said: You have two more battalions; send us another one. They said: 
That is where the problem comes in. We only have equipment for one out 
of three battalions. The Guard was one-third resourced. We could have 
sent them down there in tennis shoes and a taxicab, but they needed the 
equipment that an engineer battalion has to deal with the problems of 
the aftermath of the floods and the hurricane. I think there is a lot 
more we can do to make this unique arrangement work more smoothly. The 
Guard will continue to play a critical role in response to another 
natural disaster or, heaven forbid, terrorist attack. To the men and 
women of the National Guard, we say: Thank you for that support.
  But more needs to be done. The amendment we are introducing today to 
strengthen the Guard consists of two planks which are designed, first, 
to increase the Guard's voice inside the Pentagon and, second, to 
clarify how the Federal military support to civil authorities will 
occur here at home.
  We would give the Chief of the National Guard more muscle in the 
Pentagon, providing a seat for him on the Joint Chiefs of Staff. With 
40 percent of the force, one would think that big a portion of our 
total military capability would deserve to sit with the outstanding 
leaders of the Army, the Air Force, the Marines, and others who are 
there. One would think this large a segment of our force would be 
represented. When we have big decisions on the future of our resource 
allocation for the military--title X and, in this case, also title 
XXXII--they ought to be at the table.
  Last year--I thank my colleagues--we successfully authorized the 
promotion of the Chief of the National Guard to the rank of four-star 
general in last year's empowerment legislation. Additionally, this 
year's empowerment amendment will make certain that the Chief of the 
National Guard Bureau has a Vice Chief in the grade of lieutenant 
general. When you are dealing with that many problems, there is a major 
operation that needs to be handled by a deputy to the four-star Chief 
of the National Guard. It is critical to the day-to-day operations of 
the National Guard Bureau and to ensure the Guard is adequately 
represented inside the Pentagon.
  This amendment will also fill the gaps between civilian and military 
emergency response capabilities. We would give the National Guard 
Bureau, in consultation with the States' adjutant generals, budgetary 
power to identify, validate, and procure equipment essential to their 
unique domestic missions so they will be better prepared to respond to 
emergencies here at home. The next time they call for a second engineer 
battalion, I hope we have the equipment to send one to whatever State 
or maybe our own State where they are needed.
  The amendment also supports the designation of National Guard general 
officers as commanders of Army North and Air Force North commands. This 
will ensure unity of effort and of command between the National Guard 
in the 54 States and territories and the very important U.S. North 
command which protects the United States in the continental United 
States.
  Finally, our amendment gives State Governors tactical control of 
Federal troops responding to emergencies inside their State or 
territory. Time and time again, we have seen Reserve units stationed 
within close proximity to a natural or manmade disaster forced to stand 
by and watch when they could have been assisting injured victims in 
preventing loss of property. This amendment ensures that all available 
military forces be utilized as early as possible in an emergency 
situation. This way, our State leaders can act more quickly and 
decisively to mitigate disasters at home. Our citizen soldiers stand 
ready to defend the Nation, secure our homeland from natural disasters 
and terrorist attacks, and are now fighting overseas in the war on 
terror. Neither the homeland response

[[Page 18416]]

nor the Federal military support missions of the Guard are likely to 
diminish in importance at any time in the foreseeable future. In fact, 
the need for the National Guard is greater now than ever before. Now 
more than ever, as budgets are constrained and entitlements continue to 
grow at alarming rates, we should not be looking to reduce the Guard 
but, rather, fully to man and equip it.
  We have a responsibility to give the Guard the equipment, resources, 
and bureaucratic muscle they need to meet their critical dual mission. 
In order to do so, it is imperative we strengthen the decisionmaking 
capability of Guard leaders within the Department of Defense and make 
sure they are at the table.
  As one former leader of the Guard said: If you want us in on the big 
plays, at least let us in the huddle when you are planning to call 
those plays. That is what this amendment does.
  I thank my colleagues for their past support of the Guard. I join 
with Senator Leahy in asking for continued support of the National 
Guard by voting for this amendment.
  I yield the floor.


                           Amendment No. 1597

  The PRESIDING OFFICER. The Senator from Kansas.
  Mr. BROWNBACK. Mr. President, I ask unanimous consent to set aside 
the pending Thune amendment and call up my amendment No. 1597.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report.
  The assistant bill clerk read as follows:

       The Senator from Kansas [Mr. Brownback], for himself, Mr. 
     Bayh, Mr. Kyl, and Mr. Inhofe, proposes an amendment numbered 
     1597.

  Mr. BROWNBACK. I ask unanimous consent that reading of the amendment 
be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.

  (Purpose: To express the sense of the Senate that the Secretary of 
 State should redesignate North Korea as a state sponsor of terrorism)

       At the end of subtitle C of title XII, add the following:

     SEC. 1232. SENSE OF THE SENATE ON REDESIGNATION OF NORTH 
                   KOREA AS A STATE SPONSOR OF TERRORISM.

       (a) Findings.--The Senate makes the following findings:
       (1) On October 11, 2008, the Department of State removed 
     North Korea from its list of state sponsors of terrorism, on 
     which it had been placed in 1988.
       (2) North Korea was removed from that list despite its 
     refusal to account fully for its abduction of foreign 
     citizens, proliferation of nuclear and other dangerous 
     technologies and weapon systems to terrorist groups and other 
     state sponsors of terrorism, or its commission of other past 
     acts of terrorism.
       (3) On March 17, 2009, American journalists Euna Lee and 
     Laura Ling were seized near the Chinese-North Korean border 
     by agents of the North Korean government and were 
     subsequently sentenced to 12 years of hard labor in a prison 
     camp in North Korea.
       (4) On April 5, 2009, the Government of North Korea tested 
     a long-range ballistic missile in violation of United Nations 
     Security Council Resolutions 1695 and 1718.
       (5) On April 15, 2009, the Government of North Korea 
     announced it was expelling international inspectors from, and 
     recommissioning, its Yongbyon nuclear facility and ending its 
     participation in disarmament talks.
       (6) Those actions were in violation of the June 26, 2008, 
     announcement by the President of the United States that the 
     removal of North Korea from the list of state sponsors of 
     terrorism was dependent on the Government of North Korea 
     agreeing to a system to verify its declarations with respect 
     to its nuclear programs.
       (7) On May 25, 2009, the Government of North Korea 
     conducted a second illegal nuclear test, in addition to 
     conducting tests of its ballistic missile systems launched in 
     the direction of the western United States.
       (8) North Korea has failed to acknowledge or account for 
     its role in building and supplying the secret nuclear 
     facility at Al Kibar, Syria, has failed to account for all 
     remaining citizens of Japan abducted by North Korea, and, 
     according to recent reports, continues to engage in close 
     cooperation with the terrorist Iranian Revolutionary Guard 
     Corps on ballistic missile technology.
       (9) There have been recent credible reports that North 
     Korea has provided support to the terrorist group Hezbollah, 
     including by providing ballistic missile components and 
     personnel to train members of Hezbollah with respect to the 
     development of extensive underground military facilities in 
     southern Lebanon, including tunnels and bunkers.
       (10) The 2005 and 2006 Country Reports on Terrorism of the 
     Department of State state, with respect to Cuba, Iran, North 
     Korea, and Syria, ``Most worrisome is that some of these 
     countries also have the capability to manufacture WMD and 
     other destabilizing technologies that can get into the hands 
     of terrorists. The United States will continue to insist that 
     these countries end the support they give to terrorist 
     groups.''.
       (11) President Barack Obama stated that actions of the 
     Government of North Korea ``are a matter of grave concern to 
     all nations. North Korea's attempts to develop nuclear 
     weapons, as well as its ballistic missile program, constitute 
     a threat to international peace and security. By acting in 
     blatant defiance of the United Nations Security Council, 
     North Korea is directly and recklessly challenging the 
     international community. North Korea's behavior increases 
     tensions and undermines stability in Northeast Asia. Such 
     provocations will only serve to deepen North Korea's 
     isolation. It will not find international acceptance unless 
     it abandons its pursuit of weapons of mass destruction and 
     their means of delivery.''.
       (b) Sense of the Senate.--It is the sense of the Senate 
     that the Secretary of State should designate North Korea as a 
     country that has repeatedly provided support for acts of 
     international terrorism for purposes of--
       (1) section 6(j) of the Export Administration Act of 1979 
     (50 U.S.C. App. 2405(j)) (as continued in effect pursuant to 
     the International Emergency Economic Powers Act (50 U.S.C. 
     1701 et seq.));
       (2) section 40 of the Arms Export Control Act (22 U.S.C. 
     2780); and
       (3) section 620A of the Foreign Assistance Act of 1961 (22 
     U.S.C. 2371).

  Mr. BROWNBACK. Mr. President, this is a bipartisan amendment put 
forward by Senator Bayh and myself. I ask unanimous consent that 
Senators Kyl and Inhofe be added as cosponsors.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BROWNBACK. This is a bipartisan resolution and sense of the 
Senate that the administration should relist North Korea as a state 
sponsor of terrorism. As my colleagues know, the Bush administration, 
through a great deal of hoopla, listed North Korea as a state sponsor 
of terrorism. They took them off the list in spite of such terrible and 
erratic behavior as nuclear weapons, missile technology, and now taking 
U.S. citizens hostage and holding them. Nonetheless, the Bush 
administration, as part of the six-party talks, did an agreement, a 
deal to delist them as a state sponsor of terrorism. All that got us 
was more nuclear weapons, more missiles being sent off, more 
provocative action by the North Koreans, and a dismal situation.
  What we are asking with the amendment is that it is a sense of the 
Senate that North Korea should be relisted as a state sponsor of 
terrorism.
  In that regard, I wish to enter a few items in the Record to be 
printed at the end of my presentation that are currently in the news. 
This is yesterday's front page of the Washington Post where it talks 
about ``[North] Korea's Hard-Labor Camps: On the Diplomatic Back 
Burner.''
  I ask unanimous consent that this full article be printed in the 
Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (See exhibit 1.)
  Mr. BROWNBACK. That is an old story. Unfortunately, we know very well 
about the gulags that exist in North Korea and the 200,000 people we 
believe are in those. Here is today's Washington Post. This was new 
information I found shocking: North Korea building mysterious military 
ties with the military junta in Burma now taking place and the 
possibility of them giving military equipment and supplies, I suppose 
possibly even nuclear arms and missile technology, to the military 
government in Burma.
  I ask unanimous consent that this be printed in the Record at the end 
of my statement.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (See exhibit 2.)
  Mr. BROWNBACK. If that is not enough to relist them as a state 
sponsor of terrorism, I don't know what is. But there is a full record 
we can go forward with on relisting North Korea as a state sponsor of 
terrorism. At the outset, I think we ought to look at this and say this 
is an extremely tough situation for the United States. It is one on 
which we need to take aggressive

[[Page 18417]]

action to confront them on what they are doing to militarize some of 
the worst places and worst actors around the world and what North Korea 
is doing to threaten interests of the United States.
  All this is taking place while Kim Jong Il is ill. To what degree, we 
don't know for sure. A succession is being discussed. Of what nature, 
we are not sure. But clearly North Korea is doing the most provocative 
things they have probably done in the history of that provocative 
nation. It is taking place right now. We should notice it and recognize 
these are terrorist actions. We should clearly call for them to be 
relisted.
  I have, many times, spoken before regarding the long and outrageous 
list of crimes of the Kim regime. I will not go through those again at 
great length. But I will say the crimes committed by the North Korean 
regime include not only those external and diplomatic of nature--
violating agreements, treaties, conventions, and proliferating 
dangerous technologies to the world's worst actors--but the regime has 
also committed massive and unspeakable crimes against the North Korean 
people themselves who for decades have been beaten, tortured, raped, 
trafficked, starved, used as medical experiments, subjected to 
collective familial punishment, and executed in the most brutal and 
painful ways. If you want further details on that, read yesterday's 
Washington Post article.
  Hundreds of thousands languish in the gulag and concentration camps 
spread out over the entire country. All the while, the world watches 
and wrings its collective hands. As we pledged never again, we watch as 
yet again another criminal regime commits a genocide. Never again 
becomes yet again.
  I have introduced legislation to address these issues. I hope the 
Foreign Relations Committee can find time to take it up.
  The amendment before us today deals with another aspect of the North 
Korean criminal state, its longstanding and robust sponsorship of 
international terrorism. The amendment would place the Senate on record 
as standing for the proposition that North Korea's hostile and 
provocative actions will not be ignored. Indeed, they will have 
meaningful consequences under the law. This amendment, of which Senator 
Bayh is the lead cosponsor, expresses the sense of the Senate that the 
Secretary of State should redesignate North Korea as a state sponsor of 
terrorism based on its nuclear and missile proliferation, abductions, 
and material support for terrorist groups.
  On October 11, 2008, the State Department removed North Korea from 
the list of state sponsors of terrorism on which it had been placed 
since 1988. At the time, this is what President Bush said to the North 
Korean regime upon announcing that North Korea would be removed. He 
said:

       We will trust you only to the extent that you fulfill your 
     promises. If North Korea makes the wrong choices, the United 
     States will act accordingly.

  They have made the wrong choices. We should act accordingly.
  At the same time, then Candidate Obama said:

       Sanctions are a critical part of our leverage to pressure 
     North Korea to act. They should only be lifted based on North 
     Korean performance. If the North Koreans do not meet their 
     obligations, we should move quickly to reimpose sanctions 
     that have been waived and consider new restrictions going 
     forward.

  They have not lived up to their obligations. They have continued 
provocative actions. They should be relisted.
  Let's examine how well the North Korean regime has lived up to its 
commitment since being removed from the list. Since removal last 
October, the North Korean regime has done the following: launched a 
multistage ballistic missile over Japan in violation of U.N. Security 
Council sanctions; kidnapped and imprisoned two American journalists 
and sentenced them to 12 years of hard labor in a North Korean prison 
camp; pulled out of the six-party talks vowing never to return; kicked 
out international nuclear inspectors and American monitors; restarted 
its nuclear facilities; renounced the 50-year armistice with South 
Korea; detonated a second illegal nuclear weapon; launched additional 
short-range missiles; is preparing to launch long-range missiles 
capable of reaching the United States; and today news accounts are 
reporting about North Korean proliferation to the Burmese junta, 
including perhaps nuclear proliferation.
  Add to this a long history of other ongoing illicit operations that 
finance the North Korean regime's budget, including the following: 
extensive drug smuggling; massive and complex operations to counterfeit 
U.S. currency, many of which are believed to be in wide circulation; 
money laundering; terrorist threats by the regime against the United 
States, Japanese, and South Korean civilians. That is what this regime 
and group has done and is doing. That is some of what they have done 
since they were delisted from the terrorist list.
  What have we done in response? The U.N. Security Council has passed 
another sanctions resolution similar to the same resolution North Korea 
has brazenly violated to get us to this point. In 2006, the State 
Department, in its terrorism report, said this about keeping North 
Korea on the list: North Korea ``continued to maintain their ties to 
terrorist groups.''
  They said:

       Most worrisome is that some of these countries [including 
     North Korea] also have the capability to manufacture [weapons 
     of mass destruction] and other destabilizing technologies 
     that can get into the hands of terrorists.

  If that was the justification for the terror list in 2006, certainly 
North Korea's actions today fit that standard--perhaps even more so 
than back then, and I believe it is more so.
  We cannot have it both ways. If we removed North Korea from the 
terrorism list last year as a reward for its dubious cooperation on 
nuclear weapons, we would only be reversing that step by adding it back 
after the regime betrayed its commitments and followed up with hostile 
and provocative actions.
  I would also like to address this issue: It often has been raised 
with me--and the Secretary of State herself has raised this indirectly 
with me--that the multiple statutes that control the list of state 
sponsors of terrorism do not provide the legal ability for the 
Secretary of State to redesignate. I think this argument is flawed, and 
I would like to summarize that by reading the relevant portions of each 
of these acts, because here is the key point on it, that they are 
saying: Well, we have to find factual basis that is different from the 
first round for us to do that. We are going through a legal review of 
doing this. But here the state sponsor of terrorism list is controlled 
under two different acts: the Arms Export Control Act and the Foreign 
Assistance Act.
  As to countries covered by the prohibition, it says this. This is 
quoting from the Arms Export Control Act:

       The prohibitions contained in this section apply with 
     respect to a country if the Secretary of State determines 
     that the government of that country has repeatedly provided 
     support for acts of international terrorism.

  That is what it says in the Arms Export Control Act. The list I have 
just read goes through what has taken place, and they are clearly and 
repeatedly providing support for acts of international terrorism. It 
does not say anything about they cannot be relisted or we have to go 
through some elaborate finding process, that it cannot be based on 
actions they have done. These are the actions they have done in the 
last 6 months that are of public record. And it says the Secretary of 
State makes this determination and has fairly wide discretion to be 
able to do it.
  Under section 628 of the Foreign Assistance Act, it says: The United 
States shall not provide any assistance to any country if the Secretary 
of State determines that the government of that country has repeatedly 
provided support for acts of international terrorism.
  Again, the statute is very broad in its statement. It does not say 
anything about they cannot relist them. It says they can do this on the 
discretion of the Secretary of State.

[[Page 18418]]

  I do not know why we need to wait any longer, with the actions this 
government has taken and even with these most recent ones reported 
today of working with Burma or of the publicly done ones we know about 
of nuclear weapons detonation or the ones of missile technology being 
launched. Why do we need to wait longer?
  I recognize this is a sense of the Senate, so it is just a sense of 
this body. But this body has had a strong impact in prior actions when 
we took a sense-of-the-Senate resolution to list the Revolutionary 
Guard in Iran, that we believed they should be listed as a state 
sponsor of terrorism. The administration acted not long after that to 
list them as a state sponsor of terrorism.
  I believe if this body took strong action here now and said we 
believe North Korea should be relisted as a state sponsor of terrorism, 
it would send a very strong and proper signal to the administration--
not that we are doing your job, but we believe this is the case and 
this is something that is meritorious toward North Korea and its 
actions.
  That is why I urge my colleagues to support the bipartisan Bayh-
Brownback amendment and vote for this amendment to the Defense 
authorization bill.

  Mr. President, with that, I yield the floor.

                               Exhibit 1

               [From the Washington Post, July 20, 2009]

       N. Korea's Hard-Labor Camps: On the Diplomatic Back Burner

                           (By Blaine Harden)

       Seoul.--Images and accounts of the North Korean gulag 
     become sharper, more harrowing and more accessible with each 
     passing year.
       A distillation of testimony from survivors and former 
     guards, newly published by the Korean Bar Association, 
     details the daily lives of 200,000 political prisoners 
     estimated to be in the camps: Eating a diet of mostly corn 
     and salt, they lose their teeth, their gums turn black, their 
     bones weaken and, as they age, they hunch over at the waist. 
     Most work 12- to 15-hour days until they die of malnutrition-
     related illnesses, usually around the age of 50. Allowed just 
     one set of clothes, they live and die in rags, without soap, 
     socks, underclothes or sanitary napkins.
       The camps have never been visited by outsiders, so these 
     accounts cannot be independently verified. But high-
     resolution satellite photographs, now accessible to anyone 
     with an Internet connection, reveal vast labor camps in the 
     mountains of North Korea. The photographs corroborate 
     survivors' stories, showing entrances to mines where former 
     prisoners said they worked as slaves, in-camp detention 
     centers where former guards said uncooperative prisoners were 
     tortured to death and parade grounds where former prisoners 
     said they were forced to watch executions. Guard towers and 
     electrified fences surround the camps, photographs show.
       ``We have this system of slavery right under our nose,'' 
     said An Myeong Chul, a camp guard who defected to South 
     Korea. ``Human rights groups can't stop it. South Korea can't 
     stop it. The United States will have to take up this issue at 
     the negotiating table.''
       But the camps have not been discussed in meetings between 
     U.S. diplomats and North Korean officials. By exploding 
     nuclear bombs, launching missiles and cultivating a 
     reputation for hair-trigger belligerence, the government of 
     Kim Jong Il has created a permanent security flash point on 
     the Korean Peninsula--and effectively shoved the issue of 
     human rights off the negotiating table.
       ``Talking to them about the camps is something that has not 
     been possible,'' said David Straub, a senior official in the 
     State Department's office of Korean affairs during the Bush 
     and Clinton years. There have been no such meetings since 
     President Obama took office.
       ``They go nuts when you talk about it,'' said Straub, who 
     is now associate director of Korean studies at Stanford 
     University.
       Nor have the camps become much of an issue for the American 
     public, even though annotated images of them can be quickly 
     called up on Google Earth and even though they have existed 
     for half a century, 12 times as long as the Nazi 
     concentration camps and twice as long as the Soviet Gulag. 
     Although precise numbers are impossible to obtain, Western 
     governments and human groups estimate that hundreds of 
     thousands of people have died in the North Korean camps.
       North Korea officially says the camps do not exist. It 
     restricts movements of the few foreigners it allows into the 
     country and severely punishes those who sneak in. U.S. 
     reporters Laura Ling and Euna Lee were sentenced last month 
     to 12 years of hard labor, after being convicted in a closed 
     trial on charges of entering the country illegally.
       North Korea's gulag also lacks the bright light of 
     celebrity attention. No high-profile, internationally 
     recognized figure has emerged to coax Americans into 
     understanding or investing emotionally in the issue, said 
     Suzanne Scholte, a Washington-based activist who brings camp 
     survivors to the United States for speeches and marches.
       ``Tibetans have the Dalai Lama and Richard Gere, Burmese 
     have Aung San Suu Kyi, Darfurians have Mia Farrow and George 
     Clooney,'' she said. ``North Koreans have no one like that.''


                         Executions as Lessons

       Before guards shoot prisoners who have tried to escape, 
     they turn each execution into a teachable moment, according 
     to interviews with five North Koreans who said they have 
     witnessed such killings.
       Prisoners older than 16 are required to attend, and they 
     are forced to stand as close as 15 feet to the condemned, 
     according to the interviews. A prison official usually gives 
     a lecture, explaining how the Dear Leader, as Kim Jong Il is 
     known, had offered a ``chance at redemption'' through hard 
     labor.
       The condemned are hooded, and their mouths are stuffed with 
     pebbles. Three guards fire three times each, as onlookers see 
     blood spray and bodies crumple, those interviewed said.
       ``We almost experience the executions ourselves,'' said 
     Jung Gwang Il, 47, adding that he witnessed two executions as 
     an inmate at Camp 15. After three years there, Jung said, he 
     was allowed to leave in 2003. He fled to China and now lives 
     in Seoul.
       Like several former prisoners, Jung said the most arduous 
     part of his imprisonment was his pre-camp interrogation at 
     the hands of the Bowibu, the National Security Agency. After 
     eight years in a government office that handled trade with 
     China, a fellow worker accused him of being a South Korean 
     agent.
       ``They wanted me to admit to being a spy,'' Jung said. 
     ``They knocked out my front teeth with a baseball bat. They 
     fractured my skull a couple of times. I was not a spy, but I 
     admitted to being a spy after nine months of torture.''
       When he was arrested, Jung said, he weighed 167 pounds. 
     When his interrogation was finished, he said, he weighed 80 
     pounds. ``When I finally got to the camp, I actually gained 
     weight,'' said Jung, who worked summers in cornfields and 
     spent winters in the mountains felling trees.
       ``Most people die of malnutrition, accidents at work, and 
     during interrogation,'' said Jung, who has become a human 
     rights advocate in Seoul. ``It is people with perseverance 
     who survive. The ones who think about food all the time go 
     crazy. I worked hard, so guards selected me to be a leader in 
     my barracks. Then I didn't have to expend so much energy, and 
     I could get by on corn.''


                          Defectors' Accounts

       Human rights groups, lawyers committees and South Korean-
     funded think tanks have detailed what goes on in the camps 
     based on in-depth interviews with survivors and former guards 
     who trickle out of North Korea into China and find their way 
     to South Korea.
       The motives and credibility of North Korean defectors in 
     the South are not without question. They are desperate to 
     make a living. Many refuse to talk unless they are paid. 
     South Korean psychologists who debrief defectors describe 
     them as angry, distrustful and confused. But in hundreds of 
     separate interviews conducted over two decades, defectors 
     have told similar stories that paint a consistent portrait of 
     life, work, torment and death in the camps.
       The number of camps has been consolidated from 14 to about 
     five large sites, according to former officials who worked in 
     the camps. Camp 22, near the Chinese border, is 31 miles long 
     and 25 miles wide, an area larger than the city of Los 
     Angeles. As many as 50,000 prisoners are held there, a former 
     guard said.
       There is a broad consensus among researchers about how the 
     camps are run: Most North Koreans are sent there without any 
     judicial process. Many inmates die in the camps unaware of 
     the charges against them. Guilt by association is legal under 
     North Korean law, and up to three generations of a 
     wrongdoer's family are sometimes imprisoned, following a rule 
     from North Korea's founding dictator, Kim Il Sung: ``Enemies 
     of class, whoever they are, their seed must be eliminated 
     through three generations.''
       Crimes that warrant punishment in political prison camps 
     include real or suspected opposition to the government. ``The 
     camp system in its entirety can be perceived as a massive and 
     elaborate system of persecution on political grounds,'' 
     writes human rights investigator David Hawk, who has studied 
     the camps extensively. Common criminals serve time elsewhere.
       Prisoners are denied any contact with the outside world, 
     according to the Korean Bar Association's 2008 white paper on 
     human rights in North Korea. The report also found that 
     suicide is punished with longer prison terms for surviving 
     relatives; guards can beat, rape and kill prisoners with 
     impunity; when female prisoners become pregnant without 
     permission, their babies are killed.
       Most of the political camps are ``complete control 
     districts,'' which means that inmates work there until death.

[[Page 18419]]

       There is, however, a ``revolutionizing district'' at Camp 
     15, where prisoners can receive remedial indoctrination in 
     socialism. After several years, if they memorize the writings 
     of Kim Jong Il, they are released but remain monitored by 
     security officials.


                       South's Changing Response

       Since it offers a safe haven to defectors, South Korea is 
     home to scores of camp survivors. All of them have been 
     debriefed by the South Korean intelligence service, which 
     presumably knows more about the camps than any agency outside 
     of Pyongyang.
       But for nearly a decade, despite revelations in scholarly 
     reports, TV documentaries and memoirs, South Korea avoided 
     public criticism of the North's gulag. It abstained from 
     voting on U.N. resolutions that criticized North Korea's 
     record on human rights and did not mention the camps during 
     leadership summits in 2000 or 2007. Meanwhile, under a 
     ``sunshine policy'' of peaceful engagement, South Korea made 
     major economic investments in the North and gave huge, 
     unconditional annual gifts of food and fertilizer.
       The public, too, has been largely silent. ``South Koreans, 
     who publicly cherish the virtue of brotherly love, have been 
     inexplicably stuck in a deep quagmire of indifference,'' 
     according to the Korean Bar Association, which says it 
     publishes reports on human rights in North Korea to ``break 
     the stalemate.''
       Government policy changed last year under President Lee 
     Myung-bak, who has halted unconditional aid, backed U.N. 
     resolutions that criticize the North and tried to put human 
     rights on the table in dealing with Pyongyang. In response, 
     North Korea has called Lee a ``traitor,'' squeezed inter-
     Korean trade and threatened war.


                           An Enforcer's View

       An Myeong Chul was allowed to work as a guard and driver in 
     political prison camps because, he said, he came from a 
     trustworthy family. His father was a North Korean 
     intelligence agent, as were the parents of many of his fellow 
     guards.
       In his training to work in the camps, An said, he was 
     ordered, under penalty of becoming a prisoner himself, never 
     to show pity. It was permissible, he said, for bored guards 
     to beat or kill prisoners.
       ``We were taught to look at inmates as pigs,'' said An, 41, 
     adding that he worked in the camps for seven years before 
     escaping to China in 1994. He now works in a bank in Seoul.
       The rules he enforced were simple. ``If you do not meet 
     your work quota, you do not eat much,'' he said. ``You are 
     not allowed to sleep until you finish your work. If you still 
     do not finish your work, you are sent to a little prison 
     inside the camp. After three months, you leave that prison 
     dead.''
       An said the camps play a crucial role in the maintenance of 
     totalitarian rule. ``All high-ranking officials underneath 
     Kim Jong Il know that one misstep means you go to the camps, 
     along with your family,'' he said.
       Partly to assuage his guilt, An has become an activist and 
     has been talking about the camps for more than a decade. He 
     was among the first to help investigators identify camp 
     buildings using satellite images. Still, he said, nothing 
     will change in camp operations without sustained diplomatic 
     pressure, especially from the United States.


                       Inconsistent U.S. Approach

       The U.S. government has been a fickle advocate.
       In the Clinton years, high-level diplomatic contacts 
     between Washington and Pyongyang focused almost exclusively 
     on preventing the North from developing nuclear weapons and 
     expanding its ballistic missile capability.
       President George W. Bush's administration took a radically 
     different approach. It famously labeled North Korea as part 
     of an ``axis of evil,'' along with Iran and Iraq. Bush met 
     with camp survivors. For five years, U.S. diplomats refused 
     to have direct negotiations with North Korea.
       After North Korea detonated a nuclear device in 2006, the 
     Bush administration decided to talk. The negotiations, 
     however, focused exclusively on dismantling Pyongyang's 
     expanded nuclear program.
       In recent months, North Korea has reneged on its promise to 
     abandon nuclear weapons, kicked out U.N. weapons inspectors, 
     exploded a second nuclear device and created a major security 
     crisis in Northeast Asia.
       Containing that crisis has monopolized the Obama 
     administration's dealings with North Korea. The camps, for 
     the time being, are a non-issue. ``Unfortunately, until we 
     get a handle on the security threat, we can't afford to deal 
     with human rights,'' said Peter Beck, a former executive 
     director of the U.S. Committee for Human Rights in North 
     Korea.


                        A Family's Tribulations

       Kim Young Soon, once a dancer in Pyongyang, said she spent 
     eight years in Camp 15 during the 1970s. Under the guilt-by-
     association rule, she said, her four children and her parents 
     were also sentenced to hard labor there.
       At the camp, she said, her parents starved to death and her 
     eldest son drowned. Around the time of her arrest, her 
     husband was shot for trying to flee the country, as was her 
     youngest son after his release from the camp.
       It was not until 1989, more than a decade after her 
     release, that she found out why she had been imprisoned. A 
     security official told her then that she was punished because 
     she had been a friend of Kim Jong Il's first wife and that 
     she would ``never be forgiven again'' if the state suspected 
     that she had gossiped about the Dear Leader.
       She escaped to China in 2000 and now lives in Seoul. At 73, 
     she said she is furious that the outside world doesn't take 
     more interest in the camps. ``I had a friend who loved Kim 
     Jong Il, and for that the government killed my family,'' she 
     said. ``How can it be justified?''

                               Exhibit 2

               [From the Washington Post, July 21, 2009]

     Clinton: U.S. Wary of Growing Burmese, North Korean Military 
                              Cooperation

                           (By Glenn Kessler)

       Bangkok, July 21.--The Obama administration is increasingly 
     concerned that nuclear-armed North Korea is building 
     mysterious military ties with Burma, another opaque country 
     with a history of oppression, Secretary of State Hillary 
     Rodham Clinton said Tuesday.
       ``We know that there are also growing concerns about 
     military cooperation between North Korea and Burma, which we 
     take seriously'' Clinton told reporters after talks in the 
     Thai capital. ``It would be destabilizing for the region. It 
     would pose a direct threat to Burma's neighbors.''
       U.S. officials traveling with Clinton, who is in Thailand 
     to attend a regional security forum, said the concerns about 
     Burma and North Korea extend to possible nuclear cooperation. 
     North Korea has a long history of illicit missile sales and 
     proliferation, including secretly helping to build a Syrian 
     nuclear reactor that was destroyed in 2007 by Israeli jets.
       ``This is one of the areas we'd like to know about,'' said 
     one official. ``We have concerns, but our information is 
     incomplete.''
       Burma, also known as Myanmar, is regarded as one of the 
     world's most oppressive nations, run by generals who have 
     enriched themselves while much of the country remains 
     desperately poor. North Korea is an equally grim country, 
     with vast prison camps and an ailing dictator, Kim Jong Il.
       The evidence of growing Burmese-North Korean cooperation 
     since formal ties were restored in 2007 is extensive, but the 
     full extent of the military relationship is unclear.
       The nuclear connection is even murkier, but intelligence 
     agencies have tracked suspicious procurement of high-
     precision equipment from Europe, as well as the arrival in 
     Burma of North Korean officials associated with the company 
     connected to the Syria reactor, according to David Albright, 
     director of the Institute for Science and International 
     Security in Washington.
       ``Something may be going on, but no one has any proof. It 
     is a mix of suspicions and concerns,'' Albright said, adding 
     that close examination of satellite imagery of suspected 
     nuclear sites has turned up no evidence. But he said that the 
     purchases of high-precision equipment were especially 
     troubling because the equipment did not make sense for use in 
     missiles and it was shipped to educational entities that had 
     connections to Burmese nuclear experts.
       Japanese officials last month also arrested three people 
     for attempting to illegally export dual-use equipment to 
     Burma, via Malaysia, under the direction of a company 
     involved in the illicit procurement for North Korean military 
     programs.
       Moreover, Albright said, European and U.S. intelligence 
     agencies have identified people associated with Namchongang 
     Trading Corp., a North Korean company also known as NCG, as 
     working in Burma. NCG reportedly provided the critical link 
     between Pyongyang and Damascus, acquiring key materials from 
     vendors in China and probably from Europe and secretly 
     transferring them to a desert construction site near the 
     Syrian town of Kibar.
       The State Department last month cited NCG for being 
     ``involved in the purchase of aluminum tubes and other 
     equipment specifically suitable for a uranium enrichment 
     program since the late 1990s.''
       U.S. officials have observed other troubling connections. 
     The U.S. Navy last month closely tracked Kang Nam 1, a rusty 
     North Korean freighter, after the government in Pyongyang 
     tested a nuclear weapon. Although U.S. officials were never 
     completely certain the ship was headed to Burma, the ship 
     returned to North Korea after the United States, China and 
     other countries put pressure on Burma to respect a United 
     Nations resolution barring most North Korean weapons exports.
       Photographs that have emerged in recent weeks also show an 
     extensive series of 600 to 800 tunnel complexes and other 
     underground facilities built in Burma with North Korean 
     technical assistance near its new capital, Naypyidaw. North 
     Korean officials can be spotted in the photos, which were 
     taken between 2003 and 2006 and posted on the Web site of 
     YaleGlobal Online by journalist Bertil Lintner, an expert on 
     Burma.
       Burma has uranium deposits, but as a signatory to the 
     nuclear Non-Proliferation Treaty, it is required to allow 
     inspections of

[[Page 18420]]

     any nuclear facilities. Russia in 2007 agreed to help build a 
     10-megawatt light-water reactor in Burma, but little appears 
     to have come of the project.
       At the news conference, Clinton also strongly criticized 
     the Burmese government for its well-documented use of gang 
     rape as a military tactic, organized by Burmese officers, 
     against ethnic minorities. A new offensive against the Karen 
     ethnic group has sent more than 4,000 refugees fleeing across 
     the border into Thailand in recent weeks.
       ``We are deeply concerned by reports of continuing human 
     rights abuses within Burma, particularly by actions that are 
     attributed to the Burmese military concerning the 
     mistreatment and abuse of young girls,'' Clinton said.
       The Obama administration is conducting a review of its 
     Burma policy, which Clinton said has been placed on hold 
     while Washington awaits the outcome of the trial of Nobel 
     Peace Prize laureate Aung San Suu Kyi.
       ``We have made clear we expect fair treatment of Aung San 
     Suu Kyi, and we have condemned the way that she has been 
     treated by the regime in Burma, which we consider to be 
     baseless and totally unacceptable,'' Clinton said.
       The National League for Democracy, Suu Kyi's party, won a 
     landslide electoral victory in 1990, but the military 
     leadership refused to accept it. Since then, she has been 
     under house arrest for most of the time, as have hundreds of 
     her supporters.
       In May, just days before Suu Kyi's six-year term under 
     house arrest was due to expire, the government put her on 
     trial for an incident involving a U.S. citizen who swam 
     across Rangoon's Lake Inya to reach Suu Kyi's lakefront 
     bungalow and allegedly stayed there one or two nights.
       Suu Kyi was taken to Rangoon's notorious Insein Prison on 
     charges of violating the terms of her detention by hosting a 
     foreigner, which could bring a three- to five-year prison 
     term, according to Burmese opposition officials. Suu Kyi, 63, 
     is said to be in poor health and has recently been treated 
     for dehydration and low blood pressure.
       ``Our position is that we are willing to have a more 
     productive partnership with Burma if they take steps that are 
     self-evident,'' Clinton said. She called on Burmese 
     authorities to ``end the violence against their own people,'' 
     including ethnic minorities, ``end the mistreatment of Aung 
     San Suu Kyi'' and release political prisoners.

  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. REED. Mr. President, the chairman of the Foreign Relations 
Committee, Senator Kerry, is prepared to comment and speak. I ask 
unanimous consent that at the conclusion of his remarks, the Senator 
from Delaware be recognized as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Massachusetts.
  Mr. KERRY. Mr. President, obviously North Korea's actions in recent 
weeks--months, really; testing a nuclear device on May 25 and launching 
ballistic missiles on July 4--received the appropriate objection in 
many different ways of China, Japan, South Korea, the United States, 
and many other countries. Clearly, those actions threaten to undermine 
the peace and security of northeast Asia, and the U.S. response to 
those actions ought to be and, I believe, is already resolute. China 
responded very clearly. The sanctions have been toughened--individual 
sanctions for the first time. A number of steps were taken by both the 
United Nations and China. China, incidentally, has been unprecedented 
in the personalization of some of the sanctions that it has put into 
place.
  I know the Senator from Kansas cares, obviously, enormously about the 
underlying issue here. But I have to say this amendment, while well 
intended, simply does not do what it is supposed to do. It has no 
impact other than the sense of the Senate: sending a message which at 
this particular moment, frankly, works counterproductively to other 
efforts that are underway.
  Right now, the Secretary of State is meeting at ASEAN. Right now, the 
various countries involved in this delicate process are working to 
determine how to proceed forward with respect to getting back to talks 
and defusing these tensions. For the Senate just to pop on an amendment 
like this at this moment in time not only sends a signal that 
complicates that process, but I think it also, frankly, will make it 
more difficult to secure the return of two American journalists, Laura 
Ling and Euna Lee.
  It simply is an inappropriate interference without a foundation, I 
might add--without a foundation--in the law. Let me be very specific. 
When President Bush lifted the designation of terrorism--in fact, 
nothing that the Senator from Kansas has laid out here actually is 
supported either by the intelligence or by the facts. I could go 
through his amendment with specificity. Let me give an example. This is 
from the findings in his amendment:

       On March 17, 2009, American journalists . . . were seized 
     near the Chinese-North Korean border by agents. . . .

  He is citing that as a rationale for putting them back on the list. 
Well, the fact is, the families themselves, as well as the two 
journalists--but the families--have acknowledged that they, in fact, 
were arrested for illegally crossing the border. So that is 
inappropriate. But not only is it inappropriate to cite a fact that is 
not a fact, but it is not a cause for putting somebody on the terrorism 
list.
  Nowhere do any of the actions cited here fit into the statutes that 
apply to whether somebody is designated as appropriately being on the 
terrorism list. Let me be more specific about that. When President Bush 
took them off the list, here is what they said. This is the President's 
certification:

       The current intelligence assessment satisfies the second 
     statutory requirement for rescission. Following a review of 
     all available information, we see no credible evidence at 
     this time of ongoing support by the DPRK for international 
     terrorism, and we assess that the current intelligence 
     assessment, including the most recent assessment published 
     May 21, 2008, provides a sufficient basis for certification 
     by the President to Congress that North Korea has not 
     provided any support for international terrorism during the 
     preceding 6-month period.

  There is no intelligence showing to the contrary, as we come to the 
floor here today, and it is inappropriate for the Senate simply to step 
in and assert to the contrary.
  Moreover, the President said:

       Our review of intelligence community assessments indicates 
     there is no credible or sustained reporting at this time that 
     supports allegations (including as cited in recent reports by 
     the Congressional Research Service) that the DPRK has 
     provided direct or witting support for Hezbollah, Tamil 
     Tigers, or the Iranian Revolutionary Guard. Should we obtain 
     credible evidence of current DPRK support for international 
     terrorism at any time in the future, the Secretary could 
     again designate DPRK a state sponsor of terrorism.

  Well, we have not. It simply does not fit under the requirements.
  We need to use the right tools. This amendment is flawed and I am 
convinced could actually undermine what I know is going on right now in 
terms of efforts by a number of different parties to try to move this 
process forward. This is not the way a responsible Senate ought to go 
about trying to deal with an issue with this kind of diplomatic 
consequence.
  The relisting, incidentally, has no practical effect in terms of 
anything it would do with respect to our current policy other than 
raise the issue with respect to the Senate at this moment but, as I 
say, inappropriately with respect to the statutes it concerns.
  President Bush actually preserved all the existing financial 
sanctions on North Korea at the time he lifted the terror designation, 
and he kept them all in place by using other provisions of law.
  The fact is, this administration has, in fact, responded in order to 
put real costs on North Korea for its actions. We led the international 
effort at the United Nations Security Council, and we did enact 
sweeping new sanctions on North Korea, and by all accounts they are 
biting.
  The U.N. Security Council resolution 1874, passed unanimously, 
imposed the first ever comprehensive international arms embargo on 
North Korea. Those sanctions are now beginning to take effect. A North 
Korean ship suspected of carrying arms to Burma turned around after it 
was denied bunkering services in Singapore, and the Government of Burma 
itself warned that the ship would be inspected on arrival to ensure 
that it complied with the U.N. arms embargo. So that is real. That is 
happening. Significantly, China has agreed to impose sanctions both on 
North Korean companies and individuals involved in nuclear and 
ballistic missile proliferation.

[[Page 18421]]

  So the sanctions that were recently imposed by the Obama 
administration, in concert with the international community, are having 
a real impact. So I think we ought to give them time to work. I do not 
think we ought to come in here and change the dynamics that, as I say, 
I know are currently being worked on by the Secretary of State. As we 
are here in the Senate today, those meetings are taking place. It is 
better for the United States and the international community to focus 
our efforts on concrete steps rather than resort to a toothless and 
symbolic gesture. This will have no impact ultimately because we are 
still going to go down our course, but it can ripple the process which 
the administration has chosen to pursue.
  I might also point out, the President and Secretary of State have 
been closely communicating with allies and with partners in the region. 
They are currently involved in discussions with China, Russia, South 
Korea, and Japan on this issue. Even as we debate the issue here, the 
effort at the ASEAN Forum is specifically geared to try to coordinate 
our approach with our treaty allies and with others. We ought to give 
the administration the opportunity to succeed.
  Third, obviously all of us reject the recent actions taken by North 
Korea. There is no doubt about that. But it was not so long ago that we 
were actually making some progress on the denuclearization effort. And 
observers of the region--those who are expert and who follow it 
closely--are all in agreement as to the rationale which has driven 
North Korea to take some of the actions it has taken.
  I was in China about a month and a half ago. I spent some time with 
Chinese leaders on this issue because one of the tests took place while 
I was there and I saw the Chinese reaction up close and personal. I saw 
the degree to which they were truly upset by it, disturbed by it, and 
took actions to deal with it. The fact is that they explained it, as 
have others, as a reaction by North Korea to perhaps three things: No. 
1, the succession issues in North Korea itself; No. 2, the policies of 
the South Korean Government over the course of the last year or so; and 
No. 3, the fact that while they had nuclear weapons and had been 
engaged in a denuclearization discussion with the United States, most 
of the focus appeared to have shifted to Iran, and there was some sense 
that the focus should have remained where those nuclear weapons 
currently exist.
  So I believe we need to preserve diplomatic flexibility in the weeks 
and months ahead. There is an appropriate time for the administration 
to come to us. There is an appropriate way for us to deal with this 
issue, to sit down with the administration, to make it clear to them 
that we think we ought to do this, to talk with them about it, to 
engage in what the rationale might be under the law. But as I say, none 
of the reasons that are legitimate under the law for, in fact, a 
designated country as going on the terrorist list is appropriate or fit 
here. I think that is the most critical reason of all.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Delaware.
  Mr. CARPER. Mr. President, thank you very much. I thank the floor 
manager on the majority side for this unanimous consent which allows me 
to proceed now under morning business.
  I wish to say a word or two about the Defense authorization bill 
which is before us, and then I want to pivot. I will talk about the 
health of our Nation's defense, but also about the health care of our 
people.
  Let me start off by extending my thanks to the leaders of the Armed 
Services Committee, Senator Levin and Senator McCain, and their staffs 
for the good work they have done. I wish to thank Senator Reed of Rhode 
Island for his contributions as well. Standing here on the floor, I am 
looking at Senator Reed, a graduate of the Military Academy at West 
Point, and right across the aisle, at Senator McCain, a graduate of the 
Naval Academy. It is great to have that kind of experience here in the 
Senate. They are sitting on opposite sides of the aisle, coming from 
schools that are sometimes thought to be rivals, but they are able to 
work together when we need them to.
  I wish to express my thanks to the President and to the Secretary of 
Defense Bob Gates. We have learned that in the last 7 years, cost 
overruns from major weapons systems in this country grew from about $45 
million in 2001 to last year almost $300 billion, a growth over 7 years 
in cost overruns for major weapons systems in 2001 of $45 million and 
last year almost $300 billion. What we need is for the administration 
as well as the Secretary of Defense and the Joint Chiefs to say to the 
folks on the Armed Services Committee, but also to say to us in the 
Senate and in the House: These are the weapons systems we need, these 
are the threats we believe we face as a nation, and to give us some 
sense of priorities of the weapons systems we should support and fund, 
the troop levels we need and, frankly, the weapons systems we don't 
need and the troop levels we don't need.
  I was privileged to follow on the heels of the Presiding Officer, 
Senator Kaufman, about a month and a half ago to Afghanistan and 
Pakistan. He and Senator Reed, I think, led that CODEL and shared with 
us our needs in that part of the world. We need a military strategy and 
we also need a civilian strategy in Afghanistan, and I think this 
administration has given us a good two-pronged approach. We have good 
new leadership there on the military side. Basically, though, they said 
our job here is counterinsurgency. We need more troops, more trainers 
to train the Afghans and to train the military side, and then the 
civilian side. We also need mobility in terms of a lot of additional 
helicopters, about 150 new helicopters or additional ones coming in to 
provide the mobility to move our men and women all over the southern 
part of Afghanistan, and to meet the Taliban threat.
  The kind of weapon we don't use there or don't need there, I will be 
very blunt, is the F-22 which we discussed and debated here for the 
last several days, a fighter aircraft that has been around for a dozen 
or so years. We are still building more of them, but they have never 
flown a flight mission in Iraq and never flown a flight mission in 
Afghanistan either. The F-22 is limited in what it can do. It basically 
is a fighter, air-to-air combat. The Afghans, the Taliban, don't have 
fighter aircraft. In Iraq, the folks we are fighting there don't have 
aircraft. Meanwhile, we have F-15s, F-16s, F-18s. We are going to build 
2,500 F-35s, for less than half the price of the F-22, which not only 
do dog fights but can also do ground-to-air support and a variety of 
different functions that the F-22 cannot for a lot less money. The 
administration, I think wisely, said as hard as it is sometimes to stop 
the production line on aircraft, in this case the F-22, in terms of 
what is cost effective, we need to refocus on the F-35 and on 
counterinsurgency, preparing for those kinds of challenges we face. We 
voted to do that, a 58-to-40 vote. I was very pleased with the vote and 
I commend everyone who voted as they did, and, frankly, the people who 
took the opposite view. There were some tough issues to deal with, I 
know particularly from folks in whose States the aircraft are being 
produced and systems for those aircraft are being produced. I know it 
is difficult to accept. But I am encouraged by that vote.
  My hope is we will pay heed to some of the priorities sent to us by 
the Secretary of Defense, which are designed to make sure we spend 
money on weapons systems that we are likely to need in the 21st 
century--certainly in the next decade or two or three--and I think with 
today's vote, we are on a better path to do that.


                           Health Care Reform

  Sort of pivoting, if I can, after having said a word about the health 
of our Nation's defense, let me talk about the health of the people in 
our country. Some of my colleagues are probably getting tired of 
hearing me say this, but when talking about health care, I mention four 
things: No. 1, we spend more money for health care than any other 
nation on Earth. No. 2, we don't get better results. No. 3, we have 
14,000

[[Page 18422]]

people in this country today losing their health care. No. 4, some 47 
million Americans today don't have health insurance, don't have health 
care. We have to do better than this. We have to do better than this. I 
believe we can.
  There has been a big focus, as there should be, on extending health 
care coverage to 47 million folks who don't have it, and we need to 
address that, obviously. Having said that, the other concern we need to 
address is reining in the growth of health care costs. We are getting 
clobbered as a nation in terms of being able to compete with the rest 
of the world where we pay so much more money for health care than any 
other nation, and employers pay, and we are getting clobbered as a 
Federal Government with the cost of Medicare and Medicaid, and State 
governments trying to bear their share of the cost of Medicaid. They 
see enormous pressures on their State budgets.
  Over lunch today, I said to my colleagues in our caucus meeting that 
wouldn't it be great if somehow we could have our cake and eat it too. 
I said that with a piece of chocolate cake staring me right in the 
face. But as it turned out, there are delivery systems, if you will, of 
health care in this country where they are not necessarily having their 
cake and eating it too, but where they are able to provide better 
health care, better outcomes, at a lower price. Think about that: 
better health care, better outcomes, better quality of health care at a 
lower price.
  The names are beginning to become familiar to us. Some are already 
familiar: Mayo in Minnesota, and now they have an operation down in 
Florida too to see if that model will work in Florida, and it has; 
Kaiser Permanente in northern California, an outfit called 
Intermountain Health--all of these are nonprofits--Cleveland Clinic in 
Cleveland, OH, an outfit called Geisinger in Hershey, PA; there is what 
is called a health care cooperative in the State of Washington, I 
believe it is around Puget Sound, called Puget Sound Cooperative where 
they have been able to emulate this interesting result of better 
quality outcomes, better health care, lower prices.
  What we need to do is to attempt not only to extend health care 
coverage to folks who don't have it--47 million--but to rein in the 
growth of health care costs. The idea that health care costs grow at 2 
or 3 or 4 percent over the consumer price index, to continue to do that 
is going to cripple us economically and competitively as a nation. It 
is going to cripple our ability to rein in our large and growing 
deficits.
  In the last 8 years in this Nation we ran up as much new debt as we 
did in the first 208 years of our Nation's history. Think about that: 
In the last 8 years, we ran up as much new debt in this country as we 
did in our first 208 years as a nation. This year we are on track to 
have the biggest single-year deficit we have ever had. We are also in 
the worst economic downturn since the Great Depression, and we are 
trying to stimulate the economy and get it moving. I am encouraged that 
it is starting to move, but that is a huge deficit, coming on the heels 
of, frankly, 8 years where we spent like drunken sailors, and I know 
how drunken sailors spend. It is not a pretty sight, and this is, 
frankly, not a pretty sight either.
  We need to go to school on the Mayos, the Geisingers, the Cleveland 
Clinics, the Kaiser Permanentes, the Puget Sounds, the Intermountain 
Healths, and see what we can learn from them. What is their secret? How 
are they able to do this, better outcomes, less price?
  As it turns out, there are a number of things they do in common. I 
wish to mention a few of them today. Among the things they do, they 
have literally brought on to their staff the doctors at Cleveland 
Clinic, for example, who provide health care. They are on staff at the 
Cleveland Clinic. The same is true at Mayo and these other nonprofits.
  I saw an interesting special on CNN a couple of weekends ago. They 
were interviewing a number of people who worked at the Cleveland 
Clinic. They interviewed a fellow who is a doctor, a cardiologist, as I 
recall. He used to be in private practice. He said, in the old days 
when I was on my own in private practice or group practice, I got paid, 
compensated, for the number of hearts I operated on. If somebody came 
to me and they had a heart problem and it could be addressed by diet or 
exercise or medicine, he said, usually I didn't prescribe those things. 
I didn't get paid for doing that. If they needed to have a heart 
operation and we could address their problem with an operation, he 
said, I got paid for that. As a result, I was more inclined to operate 
on people's hearts than to use some approaches that were arguably more 
cost effective. He went on to say, now I work for the Cleveland Clinic. 
I am a staff doc here. I don't have to operate on people's hearts to be 
compensated. I can provide good advice, help people with their diet 
problems, their exercise problems, their weight problems. I can help 
people better understand what their opportunities are with medicine. I 
still get paid. Bingo.
  So a light went off for me. Some of us are hearing quite a bit the 
need to get away from these fee-for-service deals where we basically 
incentivize doctors, hospitals, and nurses to ask for and order more 
visits, more procedures, more MRIs, more lab tests, for imaging, more 
x-rays, because they get paid for it, because they know that by doing 
more of everything, they reduce the likelihood that they are going to 
be sued. That sort of gets us in this conundrum where we overuse health 
care. If we are going to have real success in drawing down the costs of 
health care, part of it will be addressing the issue of fee for 
service, get away from that practice, and get away from the 
overutilization of the health care we have.
  Let me mention some of the things they are doing at these five or six 
entities I mentioned, these nonprofits. Among the things they do is 
coordinate care. I use my mom as an example. My mom is now deceased. 
She lived in Florida for roughly the last 30 or so years of her life. 
She had dementia; she had congestive heart failure; she had arthritis. 
She had five doctors. The last years of her life that she was down 
there, my sister and I would go down to visit my mom about every other 
month or so. We would take turns, and we would go with our mom to visit 
her doctors. These five doctors my mom had never talked to each other. 
In fact, I don't think they knew that the other doctors existed. They 
were all in the aggregate prescribing something like 15 different kinds 
of prescription medicines. We kept them at her home in what looked like 
my dad's old fishing tackle box. It was compartmentalized with 
medicines to take before breakfast, during breakfast, after breakfast; 
before lunch, during lunch, and throughout the day. Some of those 
medicines my mom was prescribed, she didn't need to take. Somebody 
needed to know what she was taking and say, You shouldn't be taking 
these two medicines in combination; they are hurting you. We didn't 
have good coordination of care of my mom.
  One of the things these nonprofits do is coordinate the care that is 
provided to my mom or anybody's mom or dad. Another thing that would 
have been very helpful for my mom or other people in that situation is 
to have electronic health records. If my mom had an electronic health 
record such as we have in the VA and like we are developing in Delaware 
and some other States, when my mom went from doctor's office to 
doctor's office they would know in each office who else she was seeing 
and the medicines she was being prescribed, the lab tests and 
everything. They would have it right there for her when she came for 
her regular visit.
  We have a great ability to harness information technology or 
electronic health care records, which are a big part of that. Our 
nonprofits I have talked about--the half dozen or so--have that in 
common. On wellness and prevention, we know it is not just from 
nonprofits but out in California is Safeway, and these people have 
supermarkets all over America and several hundred thousand employees. 
Their health care costs from 2004 to 2008 have been level and flat. 
They have incentivized employees to do the right thing for themselves, 
in terms of holding down their weight, helping them get off tobacco, to 
fight obesity and

[[Page 18423]]

lethargy, to get off the sofa, and to eat what is right; and there are 
antismoking campaigns and all kinds of stuff. So we have a good model 
there to perform.
  It is not just the nonprofits but a lot of employers are starting to 
get into this as well.
  There are another one or two points I will mention on the nonprofits. 
On chronic disease management, such as heart disease and diabetes, I am 
told that about 80 percent of the cost of these chronic diseases can be 
controlled by four factors: diet, exercise, overweight/obesity, and 
smoking. Those four factors control about 80 percent of the cost of our 
expenditures on chronic care. If we work with those four items, we will 
help reduce the costs and provide better outcomes for people. We will 
also hold down our costs. There are a couple lessons from the 
nonprofits and others. Part of it is pharmacy--making sure people who 
need pharmaceutical medicines, small and large molecules, are taking 
those, and somebody is checking to make sure they are taking what they 
need.
  Focusing on primary care, many of those people coming out of medical 
schools want to be specialists. They are not interested in being 
primary care doctors. We need more primary care doctors. We need to 
change the incentives to get more primary care doctors, which is what 
we need. Another idea is for us to pool insurance costs. As my 
colleagues know, we have the Federal Employee Health Benefit Plan. We 
have an insurance pool where we pool all the Federal employees and 
their dependents and the retirees and their dependents into one large 
pool to purchase health insurance. They get it at a not cheap price but 
a pretty good price. One of the reasons why is, when you have a lot of 
people in the purchasing pool, you get a good variety and much better 
costs. If you think about the administrative costs for health 
insurance, as a percentage of premiums, I am told, in the Federal 
Employee Health Benefit Program, it is about 10 percent. When it comes 
to people buying individual policies and small businesses, their 
administrative costs as a percentage of premiums are about 30 percent. 
So the idea of creating large purchasing pools makes a whole lot of 
sense.
  I will close here. The idea that we would pass health care 
legislation and stop extending coverage for people who don't have it--
if that is all we do, we have failed the American people. We have to do 
at least two things. One is extend coverage but also make sure the 
coverage we extend provides better coverage, better quality outcomes 
and better health care and that we do so at a price that is diminished 
and does not continue to expand by several times the rate of inflation. 
We can do that going forward. That is what we need to do.
  My friends have been generous in allowing me to proceed. I see 
several Senators are anxious to get back into the debate.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Arizona is recognized.
  Mr. McCAIN. Mr. President, I rise in support of the amendment offered 
by the Senator from Kansas concerning North Korea.
  I must say I was entertained by the outlook--as far as North Korea's 
behavior is concerned--by the distinguished chairman of the Foreign 
Relations Committee. I can't remember when I have disagreed more.
  The State Department's 2008 Country Reports on Terrorism stated that 
``as part of the six-party talks process, the U.S. reaffirmed its 
intent to fulfill its commitment regarding the removal of the 
designation of the DPRK as a state sponsor of terrorism in parallel 
with the DPRK's actions on denuclearization and in accordance with 
criteria set forth by law.''
  They certainly haven't taken any action on denuclearization, and it 
certainly hasn't been in accordance with the criteria set forth by law.
  There was a problem with this trade, however. We delisted North 
Korea, and we got something worse than nothing. Facts are stubborn 
things. In response to our action, Pyongyang has embarked on a pattern 
of astonishing belligerence and has reversed even the previous steps it 
had taken toward the denuclearization prior to its removal from the 
terrorism list.
  A few facts. In December 2008--just 2 months after the United States 
removed Pyongyang from the list--North Korea balked at inspections of 
its nuclear facilities and ceased disablement activities at the 
Yongbyon reactor. In March, the regime seized two American journalists 
near the China-North Korean border and subsequently sentenced them to 
12 years of hard labor in the North Korean gulag. These are two 
American citizens who may have strayed over a border. Does that mean 
they are sentenced to 12 years of hard labor in the most harsh prison 
camps in the world? What are we going to do about it? It is remarkable. 
Two weeks later, it tested a long-range ballistic missile, in violation 
of U.N. Security Council resolutions, and then announced it was 
expelling international inspectors from Yongbyon, reestablishing the 
facility, and ending North Korean participation in disarmament talks. 
In May, Pyongyang conducted its second nuclear test; in June, a North 
Korean ship suspected of carrying illicit cargo departed North Korea in 
likely defiance of U.N. Security Council obligations; and earlier this 
month, Pyongyang again launched short- and medium-range missiles into 
the Sea of Japan, including on the Fourth of July.
  All these are indications that the North Koreans somehow should not 
be listed as terrorists? I think we ought to, frankly--I respect and 
appreciate my friend from Kansas. Maybe we ought to have a binding 
resolution, rather than a sense of the Senate. It is remarkable that 
these events have taken place against a backdrop of belligerence and 
intransigence by North Korea. Pyongyang has never accounted for or even 
acknowledged its role in assisting the construction of a nuclear 
reactor in Syria, which the Israelis had to bomb. Similarly, it has 
refused to provide a complete and correct declaration of its nuclear 
program. Of course, something we all know, which is one of the great 
tragedies in the history of the world, is this is a gulag of some 
200,000 people, where people are regularly beaten, starved, and 
executed. According to the Washington Post, most of them work 12- to 
15-hour days until they die of malnutrition-related illnesses, usually 
at around the age of 50. They are allowed just one set of clothes. They 
live and die in rags, without soap, socks, underclothes or sanitary 
napkins. It is a horrible story.
  It is not an accident that the average South Korean is several inches 
taller than the average North Korean. This regime may be the most 
repressive and oppressive and Orwellian in all the world today. So the 
Chinese have been serious--according to Mr. Kerry, the Senator from 
Massachusetts, the Chinese have been resolute on the issue of the ship 
inspections. The U.N. Security Council resolution calls for monitoring 
and following of the ship, and if the decision is made that they need 
to board a North Korean ship, if the North Koreans refuse, then the 
following ship cannot board but can follow them into a port, where the 
port authorities are expected to board and inspect the vessel. And then 
that violation is reported to the U.N. Security Council. That ought to 
rouse some pretty quick action. I don't share the confidence of the 
Senator from Massachusetts that if a North Korean ship goes into a port 
at Myanmar, you will see likely action, except maybe the offloading of 
whatever materials are being bought by Myanmar.
  Look, the North Koreans have clearly been engaged in selling anything 
they can to anybody who will buy it because they need the money--
whether it be drugs, counterfeit currency, nuclear technology or 
missiles. Every time we have held onto the football, like Lucy, they 
have pulled it away.
  I think this is a very modest proposal of the Senator from Kansas. I 
point out that years and years of six-party talks, different party 
talks, negotiations, conversations, individuals who have been assigned 
as chief negotiators who then end up somehow negotiating, with the end 
being further negotiations, has failed.

[[Page 18424]]

  If the North Koreans continue to test weapons, test missiles, sooner 
or later, they will match a missile with a weapon that will threaten 
the United States of America. Right now, those missiles they are 
testing go over Japanese territory. I think it is pretty obvious we are 
dealing with a regime of incredible and unbelievable cruelty and 
oppression of their own people. The newly published Korean bar 
association details the daily lives of the 200,000 political prisoners 
estimated to be in the camps. Eating a diet of mostly corn and salt, 
they lose their teeth, their gums turn black, their bones weaken and, 
as they age, they hunch over at the waist.
  This is a regime that, in any interpretation of the word, is an 
outrageous insult to the world and everything America stands for and 
believes in. I believe they will pose a direct threat, over time, to 
the security of not only Asia but the world. They were able to export 
technology all the way to Syria, obviously. Why should they not be able 
to export that to other parts of the world?
  I urge my colleagues to vote in support of the amendment by the 
Senator from Kansas, and I hope we can vote on that sooner rather than 
later.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Kansas is recognized.
  Mr. BROWNBACK. Mr. President, I ask unanimous consent to add Senator 
Bennett from Utah as a cosponsor of the amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BROWNBACK. I thank my colleague from Arizona. I think he 
understands more than anybody in this body the situation and what 
happens in a gulag-type situation. That has drawn me to the topic of 
North Korea for a couple years--the human rights abuses. Hundreds and 
thousands of North Koreans are fleeing to be able to simply get food, 
and a couple hundred thousand of them are in the gulag system. It is 
unbelievable that this can happen in 2009. We have Google Earth that 
can even show this. But we just say: OK, that is the sort of thing that 
happens there. It is mind-boggling to me that we wouldn't act 
resolutely.
  I appreciate the chairman of the Foreign Relations Committee, the 
Senator from Massachusetts, who is a distinguished Senator and is very 
bright and experienced in foreign policy. I could not disagree with him 
more about North Korea. We have had an ongoing dialog and discussion 
about this. He makes the point that we should not pop this on the bill.
  I have been trying for months for us to relist them as terrorists. 
They should not have been delisted in the first place. It was a 
terrible process move on the Bush administration to try to move the 
talks forward, saying we are going to delist you and you are going to 
do something for us. Pyongyang and Kim Jong Il said thank you very 
much, and now we are going to stick it in your face, which is what they 
have continued to do. I have listed the things, as the Senator from 
Arizona has mentioned as well.
  The thought that we are acting resolutely, to me, is an insult to the 
people in North Korea who have lived under this oppressive regime. We 
are not acting resolutely toward North Korea. We are not putting any 
sanctions on them. We have asked for international sanctions, but why 
aren't we willing to put sanctions on ourselves? If we think this is 
such a proper course to follow, and we are willing to push it on an 
international body, why wouldn't we be willing to do it ourselves? Why 
wouldn't we be willing to list them as a terror nation, as a state 
sponsor of terror? I don't understand that; why, if it is good in the 
international arena, we wouldn't do it ourselves.
  Plus, we need to have teeth into this. This is a modest--a modest--
proposal. It is a resolution, a sense of the Senate that North Korea 
should be relisted as a state sponsor of terrorism. We are not 
relisting them. That is an administration call. We are saying we, as a 
body, given the provocative actions that have taken place since they 
have been delisted clearly merits the relisting of North Korea as a 
state sponsor of terrorism. That is our opinion, and that is what we 
are saying to the administration.
  Without a foundation in the law, it is clearly--as I read 
previously--allowed for the Secretary of State to determine that the 
government of that country has repeatedly provided support for acts of 
international terrorism. That is the actual wording of the law in the 
Arms Export Control Act. Clearly, they have acted to sponsor 
international terrorism with their relation with Burma, with the 
missiles, with the nuclear weapons, and with the proliferation they 
have done and continue to do.
  He says, and is suggesting, that delisting has no practical effect. I 
believe it does have a practical effect, and it certainly does on the 
administration's stance toward North Korea and their international 
posture toward North Korea. Plus, it has a practical effect on what we 
can provide for as far as aid from the United States to North Korea. We 
shouldn't be providing aid to the North Koreans. We should provide food 
aid, if we can monitor it. We shouldn't be giving oil to the North 
Koreans. That should be limited so the administration cannot do that. 
They would not be able to if they are listed as a state sponsor of 
terrorism.
  Mr. President, it will hurt the people of North Korea and those who 
are in the North Korean gulags if we don't relist them. It recovers any 
vestige of hope they might have that at some point in time somebody of 
enough stature, such as the United States Government, is going to take 
enough notice that they are going to put pressure on the North Korean 
regime. I have talked with some people who were refuseniks in the 
Soviet Union, in a Soviet gulag during an era where we had far less 
communication capacity than we do today, and yet they were able to get 
messages at that point in time into the Soviet gulag that the Americans 
were putting pressure on the Soviet Union and the lack of human rights 
in the Soviet Union, and it gave them hope. It gave them hope in the 
Soviet gulag.
  If we can pass this, it can give people in the gulags in North Korea 
hope that somebody is at least paying enough attention to put pressure 
on this, and maybe they may be able to live longer, or actually live at 
all. It can give them hope, instead of ``abandon hope all ye who enter 
here,'' as it says at the entrance to Inferno and as it is in the gulag 
system in North Korea.
  So it is a modest resolution, and I would hope my colleagues would 
vote overwhelmingly for this resolution to relist North Korea as a 
state sponsor of terrorism.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.


                           Amendment No. 1528

  Mr. LIEBERMAN. Mr. President, I ask unanimous consent that the 
pending amendment be set aside and that amendment No. 1528 be called 
up.
  The PRESIDING OFFICER. Without objection, it is so ordered. The clerk 
will report the amendment.
  The bill clerk read as follows:

       The Senator from Connecticut [Mr. Lieberman], for himself, 
     Mr. Graham, Mr. Begich, Mr. Cornyn, Mrs. Hutchison, and Mr. 
     Thune, proposes an amendment numbered 1528.

  Mr. LIEBERMAN. Mr. President, I ask unanimous consent that further 
reading of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

    (Purpose: To provide authority to increase Army active-duty end 
  strengths for fiscal year 2010 as well as fiscal year 2011 and 2012)

       Strike section 402 and insert the following:

     SEC. 402. ADDITIONAL AUTHORITY FOR INCREASES OF ARMY ACTIVE-
                   DUTY END STRENGTHS FOR FISCAL YEARS 2010, 2011, 
                   AND 2012.

       (a) Authority to Increase army Active-Duty End Strength.--
       (1) Authority.--For each of fiscal years 2010, 2011, and 
     2012, the Secretary of Defense may, as the Secretary 
     determines necessary for the purposes specified in paragraph 
     (2), establish the active-duty end strength for the Army at a 
     number greater than the number otherwise authorized by law up 
     to the number equal to the fiscal-year 2010 baseline plus 
     30,000.
       (2) Purpose of increases.--The purposes for which an 
     increase may be made in the active duty end strength for the 
     Army under paragraph (1) are the following:

[[Page 18425]]

       (A) To increase dwell time for members of the Army on 
     active duty.
       (B) To support operational missions.
       (C) To achieve reorganizational objectives, including 
     increased unit manning, force stabilization and shaping, and 
     supporting wounded warriors.
       (b) Relationship to Presidential Waiver Authority.--Nothing 
     in this section shall be construed to limit the authority of 
     the President under section 123a of title 10, United States 
     Code, to waive any statutory end strength in a time of war or 
     national emergency.
       (c) Relationship to Other Variance Authority.--The 
     authority in subsection (a) is in addition to the authority 
     to vary authorized end strengths that is provided in 
     subsections (e) and (f) of section 115 of title 10, United 
     States Code.
       (d) Budget Treatment.--
       (1) In general.--If the Secretary of Defense increases 
     active-duty end strength for the Army for fiscal year 2010 
     under subsection (a), the Secretary may fund such an increase 
     through Department of Defense reserve funds or through an 
     emergency supplemental appropriation.
       (2) Fiscal years 2011 and 2012.--(2) If the Secretary of 
     Defense plans to increase the active-duty end strength for 
     the Army for fiscal year 2011 or 2012, the budget for the 
     Department of Defense for such fiscal year as submitted to 
     Congress shall include the amounts necessary for funding the 
     active-duty end strength for the Army in excess of the 
     fiscal-year 2010 baseline.
       (e) Definitions.--In this section:
       (1) Fiscal-year 2010 baseline.--The term ``fiscal-year 2010 
     baseline'', with respect to the Army, means the active-duty 
     end strength authorized for the Army in section 401(1).
       (2) Active-duty end strength.--The term ``active-duty end 
     strength'', with respect to the Army for a fiscal year, means 
     the strength for active duty personnel of Army as of the last 
     day of the fiscal year.

  Mr. LIEBERMAN. Mr. President, I am pleased and proud to introduce 
this amendment with a bipartisan group of cosponsors. To state it 
briefly, it extends the authorized end strength of the U.S. Army by 
30,000 over the next 3 years, effective with the commencement of fiscal 
year 2010. It doesn't mandate this increase, but it expands the 
authority of the Secretary of Defense, obviously, with the support and 
authorization of the President of the United States, the Commander in 
Chief, to extend the end strength of the U.S. Army. End strength means 
how many soldiers can the U.S. Army have. Of course, it does this to 
reduce the tremendous stress on the U.S. Army, which is carrying the 
burden of combat in two wars, in Iraq and Afghanistan today, and over 
the next year or 18 months will be in this unique position.
  Progress has been made, thank God, in Iraq, and the Iraq Security 
Forces are progressively taking over responsibility for keeping the 
security in their country. The drawdown of American soldiers is 
happening in a methodical and responsible way, and I again express my 
appreciation to President Obama that it is happening in that way. At 
the same time, we are increasing our troop presence in Afghanistan. 
Bottom line: The demand for members of the U.S. Army on the battlefield 
over the next year, 18 months, at the outside 2 years, is going up. If 
the supply remains constant, that means the stress on every soldier in 
the U.S. Army and his or her family will not be reduced. As a matter of 
fact, it will go up. The term for this--which I will get to in a 
minute--in the Army is ``dwell time.''
  This is an amendment that began with members of the Senate Armed 
Services Committee, and a comparable amendment in the House Armed 
Services Committee, recognizing, as we all do, the tremendous stress 
that our Army is under, the extraordinary job they are doing in Iraq 
and Afghanistan.
  This is really the next great generation of the American military. 
But we see in it some tough statistics: the increase in mental health 
problems, the increase in divorces of members of the service, and, 
worse, of course, the increase in suicides.
  There are many things we have supported in this Senate and the 
Congress--and the administration has--to respond to each one of those 
problems. But in a way, the most direct thing we can do is to increase 
the size of the U.S. Army so there is less pressure on every soldier in 
the Army, in this sense. Every time we add another soldier to the U.S. 
Army--and we are talking about authorization to add 30,000 more--it 
means that much more time every other member of the U.S. Army can spend 
back at base retraining, preparing and, most important of all, spending 
time with their families.
  As I know the Presiding Officer knows--and I know the President of 
the United States knows it too--the good news is that the Secretary of 
Defense, Bob Gates, who has done and is doing an extraordinary job for 
our country with, of course, the support and authorization of President 
Obama, yesterday announced that he would be temporarily increasing the 
Active-Duty end strength of the U.S. Army by 22,000 soldiers over the 
course of the next 3 years.
  I cannot sufficiently express my words of appreciation for Secretary 
Gates's decision. He acted by employing the emergency authority he has 
in an authorization of the use of force and a built-in statutory waiver 
he has up to 3 percent of existing end strength to expand the size of 
the Army. This amendment, which had been planned, and was in the 
committee before this great action by Secretary Gates yesterday, is now 
before us, and I am honored to offer this amendment with a bipartisan 
group of cosponsors who are listed on this amendment as a way to do two 
things: The first is that it literally increases from 547,000 to 
577,000-plus the authorized end strength of the U.S. Army, and to leave 
that authority there in case there is a need that Secretary Gates and 
the President see in the coming 3 years to raise the number.
  Mr. McCAIN. Mr. President, will the Senator yield for a question?
  Mr. LIEBERMAN. I will be happy to yield.
  Mr. McCAIN. It is my understanding that the amendment authorizes the 
additional forces Secretary Gates said yesterday in his speech that we 
need--or the day before yesterday. Why do we need to put this into the 
bill?
  Mr. LIEBERMAN. Two reasons. The first is that it is a bit beyond what 
Secretary Gates did. He authorized using the extraordinary powers he 
possesses as Secretary in this time of conflict up to 22,000 for the 
next 3 years. The amendment authorizes--doesn't mandate, doesn't 
appropriate--30,000 for the next 3 years. So it gives some latitude, 
depending on how conditions go in Iraq and Afghanistan, to go a bit 
further--8,000 more, if necessary, over the next 3 years.
  Second, I say to my friend from Arizona, when this amendment started, 
we didn't know Secretary Gates was going to do this. I am grateful he 
did, but this amendment now--frankly, as Secretary Gates himself said 
to me yesterday, and I appreciate it and I don't think he would mind if 
I repeated it on the Senate floor--gives the Senate and Congress the 
opportunity to essentially vindicate and support the step that the 
Secretary has made and, as he put it, send a message from the Senate to 
the members of the U.S. Army that help is on the way.
  Mr. McCAIN. And there is no doubt that the Army very badly needs the 
help now and in the foreseeable future.
  Mr. LIEBERMAN. My friend from Arizona is absolutely right. There is 
no doubt, based on the demand, certainly temporarily, over the next 18 
months, perhaps 2 years, as we are drawing down in Iraq, but not as 
rapidly as we are adding forces in Afghanistan, that there is at least 
a temporary need for more than the authorized 547,000 members of the 
U.S. Army.
  Mr. McCAIN. And if I could question the Senator further, perhaps this 
would illuminate any requirement for stop loss or for involuntary 
extensions in a combat area.
  Mr. LIEBERMAN. Absolutely. As a matter of fact, one of the reasons 
Secretary Gates gave yesterday I will read:

       The decision to eliminate the routine use of ``stop loss'' 
     authority in the Army requires a larger personnel flow for 
     each deploying unit to compensate for those whose contract 
     expires during the period of deployment.

  So, yes, this makes it possible to end the use of stop loss, which is 
essentially, in layman's terms, a way to require people to stay 
actively deployed longer than they originally were going to be 
deployed.

[[Page 18426]]


  Mr. McCAIN. I thank the Senator.
  Mr. LIEBERMAN. I thank my friend from Arizona. We have illuminated 
most of the reasons in our exchange why this amendment is important. I 
will simply add a few more things Secretary Gates said yesterday, which 
is:

       The army has reached a point of diminishing returns in 
     their multiyear program to reduce the size of its training 
     and support ``tail.''

  That is the training and support which supports the Active-Duty Army.

       The cumulative effect of these factors is that the Army 
     faces a period where its ability to continue to deploy combat 
     units at acceptable fill rates is at serious risk.

  Here is the point I just made in response to Senator McCain's 
question.

       Based on current deployment estimates, this is a temporary 
     challenge--

  A temporary point of stress. We hope and pray that is true. It 
certainly looks like it is--

     which will peak in the coming year and abate over the course 
     of the next 3 years.

  Mr. President, in addition to the Secretary of Defense, we heard from 
the Army's Chief of Staff, GEN George Casey, and Secretary of the Army 
Pete Geren, who have been advocates within the Pentagon for this 
increase in end strength, and I thank them for that. Admiral Mullen, 
Chairman of the Joint Chiefs, told our Armed Services Committee earlier 
this year that the light at the end of the tunnel, as he put it, is 
still more than 2 years away, and that is only if everything goes 
according to plan, which in combat, obviously, often does not.
  Again, I say this is an authorization; it is not a mandate. I will 
add that Secretary Gates announced yesterday that he will find a way to 
fund the additional troops in this year and fiscal year 2010--the one 
that begins October 1--by reprogramming other funds appropriated to the 
Pentagon for fiscal year 2011, which is the budget that will be 
presented to us next year, if it is probable that the Department of 
Defense will require funding as part of its normal operations, and more 
likely as part of the OCO fund--the overseas contingency operation 
fund--which supports our presence in Iraq and Afghanistan.
  I cannot say enough, I know all of us in the Senate believe we cannot 
say enough, in gratitude to the members of the U.S. Army who are 
leading the battle for us against the Islamic extremists and terrorists 
who attacked us on 9/11/01. We owe them a debt we can never fully 
repay.
  One thing we can do, that Secretary Gates did yesterday and the 
Senate can do in this amendment, is to send a message to our troops in 
the field that help is on the way in the most consequential way, which 
is additional members of the Army.
  I ask that when the vote be taken, it be taken by the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  Mr. LIEBERMAN. Again I say to my colleagues I am doing that, although 
I expect there will be very strong support for this, because I believe 
it is the most visible way for this Senate to send the message to the 
U.S. Army of appreciation and gratitude, to them and their families, 
that help is on the way.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Michigan is recognized.
  Mr. LEVIN. Mr. President, let me commend Senator Lieberman and others 
who support this amendment. We in the Armed Services Committee are very 
supportive of previous increases; indeed, we led the way on some of 
them. Because of the stress on the Army and the number of commitments 
which had been made in Iraq and Afghanistan, we must give the kind of 
support to our troops they deserve and the American people want us to 
give.
  One of the ways we can reduce some of the stress is by increasing the 
end strength so the dwell time is more sufficient and there are other 
positive spinoffs as well from this kind of increase in the authorized 
end strength.
  The Secretary made a very powerful speech the other day when he 
called for an increase of 22,000, I believe, in the end strength. That 
end strength is temporary, it is almost as large as this--not quite; 
this is 30,000, but this is surely in the ballpark. It is appropriate. 
It is authority, it is not mandatory, and I think it is a very positive 
signal to send to our men and women in uniform and to their families. I 
very much support the amendment.
  The PRESIDING OFFICER. The Senator from Connecticut is recognized.
  Mr. LIEBERMAN. Mr. President, briefly I thank Senator Levin, the 
chairman of the Armed Services Committee, not just for his strong 
statement of support now but for the support he has given during our 
committee's deliberations to the goal of achieving an increase in Army 
end strength.
  I yield the floor.
  Mr. CARDIN. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. CARDIN. Mr. President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Begich). Without objection, it is so 
ordered.


                           Amendment No. 1475

  Mr. CARDIN. Mr. President, I am going to talk about an amendment we 
have not yet cleared unanimous consent for it to be brought up. I am 
hopeful that will come. But in order to advance the issue, I intend to 
talk about my amendment, No. 1475, without offering it at this time. I 
think it is an appropriate amendment to talk about at this point 
following Senator Lieberman's amendment because his amendment deals 
with increasing our forces.
  One of the reasons it is important to do that is the stress that the 
restricted numbers provide on our military personnel. Senator Lieberman 
mentioned, and I will repeat, the number of suicides and attempted 
suicides by our young men and women serving in the military has 
increased and one of the reasons, frankly, is that the repeated 
deployments and the length of the deployments have added to the stress 
of our servicemen.
  Health experts agree that there is most likely a combination of 
factors leading to this increase in suicides. Many of these factors are 
simply the results of the prolonged conflict that our Nation finds 
itself in, including multiple deployments, extended separations from 
family and loved ones, and the overwhelming stress of combat 
experiences; each placing a unique and tremendous strain on the men and 
women of our all-volunteer force.
  But while Congress has recognized these strains, and acted to help 
provide relief by increasing the size of our forces and thereby 
reducing the number and frequency of deployments, we cannot as easily 
remedy the stress or mental trauma created by combat experience.
  For those who have had to witness the ugliness and devastation of war 
first-hand, they have encountered something very unnatural for the 
human mind to comprehend or accept. For these service members, 
recovering from these experiences involves a long and arduous journey 
in learning to identify, control and cope with a wide array of 
emotions. And this learning process is often only accomplished with the 
guidance and management of highly trained mental or behavioral health 
specialists.
  In this light, we in Congress have acted to increase funding for more 
mental health providers and improved access for our troops and their 
families, and we have sharpened the focus of the military on addressing 
these care needs. That is very positive and has had a very positive 
effect.
  What we must now focus on, and direct the military's attention to, is 
the potentially harmful practice of administering antidepressants to a 
population that frequently moves throughout a theater of war and is 
therefore susceptible to gaps in mental health management. We are not 
certain they are getting the follow-up care they need.
  A 2007 report by the Army's fifth Mental Health Advisory Team 
indicated that, according to an anonymous

[[Page 18427]]

survey of U.S. troops, about 12 percent of combat troops in Iraq, and 
17 percent of combat troops in Afghanistan, are taking prescription 
antidepressants or sleeping pills to help them cope with this stress. 
This equates to roughly 20,000 troops on such medications in theatre 
right now.
  What I find particularly troubling, when reviewing these figures, is 
that the Pentagon has yet to establish an official clearinghouse that 
accurately tracks this kind of data. In fact, the Army's best reported 
estimate can only tell us that the authorized or prescribed drug use by 
troops in Iraq and Afghanistan is believed to be evenly split between 
antidepressants--mainly selective serotonin reuptake inhibitors, or 
SSRIs--and prescription sleeping pills. My amendment would provide us 
with the information so we know what is happening with the use of these 
drugs.
  Providing that this best estimate contains some degree of accuracy, 
it is important for us to also recognize that many of these same 
antidepressants, after strong urging by the FDA, recently expanded 
their warning labels to state that young adults--ages 18-24 years old--
may be at an elevated risk of suicidal thoughts and behavior while 
using the medication. This same age group--18-24 years old--represents 
41 percent of our military forces serving on the front lines in Iraq 
and Afghanistan.
  While keeping this warning label in mind, it is imperative that my 
colleagues understand that nearly 40 percent of Army suicide victims in 
2006 and 2007 are believed to have taken some type of antidepressant 
drugs--and overwhelmingly these SSRIs. And as I mentioned at the 
beginning of this statement, the number of Army suicides reported each 
month are outpacing each preceding month.
  This class of antidepressants--these SSRIs--are unlike most earlier 
classes of psychiatric medications in that they were, from their 
inception, specifically designed for use as an antidepressant --that 
is, they were engineered to target a particular process in the brain 
that plays a significant role in depression and other anxiety 
disorders. More significantly, however, these SSRIs are unlike most 
other antidepressant medications because they are still allowed by 
Department of Defense policy to be prescribed to service members while 
they are deployed and directly engaged in overseas operations.
  Now, to be fair, there is widespread consensus in the community of 
professional mental health providers, and empirical evidence to 
support, that SSRIs do offer significant benefit for the treatment of 
posttraumatic stress and some forms of depression. And although there 
are some side effects, they are reportedly much milder and shorter in 
duration than other antidepressants. Additionally, SSRIs are also 
believed to potentially prevent, or at least some believe, lesson the 
more harmful long-term effects of posttraumatic stress disorder.
  My concern, however, and hopefully that of my Senate colleagues, is 
not the long-term efficacy of these SSRIs, but more pointedly the 
volume and manner in which these drugs are being administered to our 
service men and women overseas.
  You see, unlike medications that work on an as-needed basis, SSRIs 
only begin to work after having been taken every day--at a specific 
dosage--for a significant period of time. This frequently translates to 
a 3 to 6 week latency period before the therapeutic effect materializes 
and patients begin to feel improvement. In light of the population I 
have been discussing, there are two very readily apparent problems with 
this shortcoming--first, is that service members serving in forward 
operating areas, such as Afghanistan and Iraq, are quite frequently 
subject to moving between bases or into other areas--some so remote 
that there may be no trained mental health provider available to 
administer the treatment and to make sure it is effective.
  Second, and more importantly, is that this initial period is when 
patients, particularly younger patients, often suffer an escalation in 
the severity of depression and/or anxiety.
  In essence, DOD may be prescribing SSRIs to its service members, 
without the assurance that they will remain in a capacity to be 
observed by a highly trained mental health provider. Worse yet, these 
same patients may very likely find themselves ordered off to conduct 
combat operations during this same latency period.
  Let's return our focus back to the alarming increase in the number of 
military and veteran suicides reported in 2008 and 2009.
  At what point do we step forward to direct that action be taken by 
DOD to capture, track and report this data? And at what point do we 
ensure that DOD is properly prescribing, dispensing and administering 
these drugs to our troops without having in place the necessary 
controls and or patient management practices?
  As a first step in this direction, the amendment I intend to 
introduce will accomplish a better understanding as to the potential 
magnitude of this issue. This amendment directs the Department of 
Defense to capture, at a macro level--at a macro level, not individual 
information, without divulging or violating any protected patient 
health information--the volume and types of antidepressants, 
psychotropics or antianxiety drugs being prescribed to our men and 
women serving in Iraq and Afghanistan. It will also require DOD, 
beginning in June of 2010 and then annually thereafter through 2015, to 
report to Congress an accurate percentage of those troops currently and 
previously deployed to Iraq and Afghanistan since 2005 who have been 
prescribed these types of drugs.
  I wish to reiterate that this measure specifically directs the 
disclosure of this information by DOD to be done in such a way as to 
not violate the individual patient privacy rights of our service men or 
women as defined by HIPAA.
  This legislation further directs DOD to contact the National 
Institute of Mental Health and provide any and all data as determined 
necessary by the Institute to conduct a scientific peer reviewable 
study to determine whether these types of prescriptions, and/or the 
method in which they are being prescribed and administered by DOD, are 
in any way contributing to the rising number of suicides by 
servicemembers or Iraq or Afghanistan veterans.
  I want to specifically address one issue I have heard from some who 
express concern about this amendment by saying it would stigmatize, in 
the eyes of our troops, those seeking mental health care. Nothing could 
be further from what this amendment does. This amendment would collect 
information in an anonymous manner, and it will be invisible to the 
servicemembers serving on the front line.
  The men and women serving in our military, and equally so their 
families, deserve our utmost assurance that we are doing everything in 
our power to see that our Nation's warfighters are provided the best 
medical care available. An integral part of our commitment must also be 
to ensure that these service men and women volunteering to serve our 
Nation are not being exposed to what may potentially endanger them when 
they seek medical care and mental health service.
  This amendment is very simple. It asks us to gather information so we 
can make a judgment in a macro sense, without violating the individual 
privacy of our service men and women. It allows us to gather the 
information, to have the best information. This Congress has a proud 
record of providing the necessary resources for the health care of our 
warriors and their families.
  This amendment will complement that by making sure that we have the 
analytical tools to make sure we are providing the right type of mental 
health services to our service men and women who are in theater. It 
gets us the information in order to judge what is being done today.
  I would hope my colleagues would agree that we would want to have 
this information, and I hope at a later time I will have the 
opportunity to actually offer the amendment.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Michigan.
  Mr. LEVIN. First of all, let me commend the Senator from Maryland on

[[Page 18428]]

his amendment. I support it. I hope it can be cleared or placed in 
order so that we can adopt it on a rollcall if it cannot be cleared.


                           Amendment No. 1528

  I ask unanimous consent that we now proceed to a vote on the 
Lieberman amendment, a rollcall vote on the Lieberman amendment.
  Mr. McCAIN. I ask for the yeas and nays.
  The PRESIDING OFFICER. The question is on agreeing to the amendment. 
The yeas and nays have been ordered. The clerk will call the roll.
  The bill clerk called the roll.
  Mr. DURBIN. I announce that the Senator from West Virginia (Mr. 
Byrd), the Senator from Massachusetts (Mr. Kennedy), the Senator from 
Maryland (Ms. Mikulski), the Senator from Pennsylvania (Mr. Specter), 
and the Senator from Virginia (Mr. Webb) are necessarily absent.
  Mr. KYL. The following Senator is necessarily absent: the Senator 
from Idaho (Mr. Crapo).
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 93, nays 1, as follows:

                      [Rollcall Vote No. 236 Leg.]

                                YEAS--93

     Akaka
     Alexander
     Barrasso
     Baucus
     Bayh
     Begich
     Bennet
     Bennett
     Bingaman
     Bond
     Boxer
     Brown
     Brownback
     Bunning
     Burr
     Burris
     Cantwell
     Cardin
     Carper
     Casey
     Chambliss
     Coburn
     Cochran
     Collins
     Conrad
     Corker
     Cornyn
     DeMint
     Dodd
     Dorgan
     Durbin
     Ensign
     Enzi
     Feinstein
     Franken
     Gillibrand
     Graham
     Grassley
     Gregg
     Hagan
     Harkin
     Hatch
     Hutchison
     Inhofe
     Inouye
     Isakson
     Johanns
     Johnson
     Kaufman
     Kerry
     Klobuchar
     Kohl
     Kyl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     Martinez
     McCain
     McCaskill
     McConnell
     Menendez
     Merkley
     Murkowski
     Murray
     Nelson (NE)
     Nelson (FL)
     Pryor
     Reed
     Reid
     Risch
     Roberts
     Rockefeller
     Sanders
     Schumer
     Sessions
     Shaheen
     Shelby
     Snowe
     Stabenow
     Tester
     Thune
     Udall (CO)
     Udall (NM)
     Vitter
     Voinovich
     Warner
     Whitehouse
     Wicker
     Wyden

                                NAYS--1

       
     Feingold
       

                             NOT VOTING--6

     Byrd
     Crapo
     Kennedy
     Mikulski
     Specter
     Webb
  The amendment (No. 1528) was agreed to.
  Mr. LEVIN. I move to reconsider the vote, and I move to lay that 
motion on the table.
  The motion to lay on the table was agreed to.
  The PRESIDING OFFICER. The Senator from Michigan.
  Mr. LEVIN. Mr. President, I ask unanimous consent that Senator Leahy 
be added as a cosponsor on the amendment which we just adopted, the 
Lieberman amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 1688

  Ms. SNOWE. Mr. President, as ranking member of the Senate Committee 
on Small Business and Entrepreneurship, I rise in support of this vital 
amendment in order to correct disparities among the Small Business 
Administration's, SBA, small business contracting programs. Building on 
my efforts to bring true parity to the programs, this amendment will 
create a more equitable and flexible method for Federal agencies to 
fairly allocate Federal procurement dollars to small business 
contractors across the Nation. Earlier this year, I offered an 
amendment, cosponsored by my colleague from Maine, Senator Collins, to 
create parity as part of S. 454, the Weapon Systems Acquisition Reform 
Act of 2009. Unfortunately, that amendment was not accepted.
  For years it has been unclear to the acquisition community what, if 
any, is the true order of preference when determining which small 
business contracting program is at the top of the agency's priority 
list. The SBA's regulations state that there is parity among the 
programs, and this had been the general practice in effect until two 
Government Accountability Office decisions were released on September 
19, 2008, and May 4, 2009.
  The decisions stated that the Historically Underutilized Business 
Zone--HUBZone--program had preference over all other small business 
contracting programs. While the interpretation benefits HUBZone 
businesses, it comes at the expense of other vital small business 
contracting programs. This targeted amendment provides equity for the 
SBA's small business contracting programs.
  The amendment provides Federal agencies with the necessary 
flexibility to satisfy their government-wide statutory small business 
contracting goals. This amendment makes clear to purchasing agencies 
that contracting officers may award contracts to HUBZone, service-
disabled veterans, 8(a), or women-owned firms with equal deference to 
each program. It would provide these agencies with the ability to 
achieve their goaling requirements equally through an award to a 
HUBZone firm, a service-disabled veteran-owned small business, and a 
small business participating in the 8(a) business development program. 
And of course this list will also include women-owned small businesses 
once the women's procurement program is fully implemented by the SBA.
  In addition, this amendment brings the SBA's contracting programs 
closer to true parity by giving HUBZones a subcontracting goal. 
HUBZones are the only small business contracting program without a 
subcontracting goal. In addition, the amendment authorizes mentor 
protege programs modeled after those used in the 8(a) program for 
HUBZones, service-disabled veteran and women-owned firms.
  The essence of true parity is where each program has an equal chance 
of competing and being selected for an award. During these difficult 
economic times, it is imperative that small business contractors 
possess an equal opportunity to compete for federal contracts on the 
same playing field with each other.
  I urge my colleagues on both sides of the aisle to support this 
amendment.


                           amendment no. 1500

  Mr. GRASSLEY. Mr. President, I rise today to support the section 1072 
of S. 1390, National Defense Authorization Act of 2010. This section 
authorizes the Comptroller General of the United States to assess 
military whistleblower protections.
  As everyone knows, I strongly believe whistleblowers play an 
important role in the accountability of all government. This should 
also be true for the men and women who wear uniforms and serve in the 
Armed Forces.
  In 1988, Congress passed legislation that gave members of the armed 
services unique whistleblower protections. Despite this military 
whistleblower law, I have concerns that military whistleblowers could 
be underserved by the regulations and processes created by the 
Department of Defense, DOD, and the DOD, Office of Inspector General, 
OIG.
  During the course of my own investigation of several military 
whistleblower cases, I learned some matters which may question how 
effectively military whistleblower reprisal cases are handled by the 
DOD and DOD OIG. The Government Accountability Office, GAO, has noted 
in its past work that the effectiveness of the Federal protection for 
military whistleblowers rests principally on a two-stage process of 
investigation and administrative review. The first stage involves a 
DOD, service, or guard inspector general's investigation of the 
specific facts and interpretation of issues associated with a 
whistleblower reprisal allegation. In the second stage of the 
investigation/administrative review process, the DOD OIG reviews and 
approves the findings of the service or guard inspectors general. This 
review is designed to provide assurance that the findings and 
recommendations in a report were made in compliance with applicable 
investigatory guidelines and meet legal sufficiency. The second stage 
of this procedure is crucial for the military whistleblower process to 
work as intended.
  In addition to the tasking included in S. 1390, the military 
whistleblower reprisal appeal process should be examined by the GAO as 
well. The military

[[Page 18429]]

whistleblower law, 10 USC Sec.  1034, gives the Boards for the 
Correction of Military Records--BCMR--of each armed service the appeal 
authority in these often unique and complex matters. I believe the 
report requested by the underlying bill is important and I support its 
inclusion. However, it is important for the GAO to also study the 
effectiveness of the BCMR appeal process to ensure military 
whistleblowers are afforded a fair administrative process to combat 
reprisal.
  Last year, I first introduced the idea of a GAO military 
whistleblower study when I requested this work of the Acting 
Comptroller General Gene L. Dodaro in a letter dated July 18, 2008. I 
followed up on my letter to the GAO with a legislative proposal through 
a filed amendment to the Defense Department appropriations bill for 
2009 which instructed the GAO to conduct a comprehensive analysis of 
this issue. Unfortunately, that amendment did not make it through the 
legislative process. I thank Chairman Levin and Ranking Member McCain 
for including this sensible military whistleblower study in the current 
bill.
  Accordingly, I offer this latest amendment to include a review and 
analysis of the military whistleblower reprisal appeals heard by the 
Boards for the Correction of Military Records.
  Mr. DURBIN. Mr. President, the National Defense Authorization Act for 
Fiscal Year 2010 authorizes almost $680 billion for the Department of 
Defense and the national security programs of the Department of Energy.
  The bill provides pay and health care to servicemembers and their 
families; funds troops with the equipment and resources they need to 
fight and provide security; strengthens our ability to train foreign 
militaries and protect against IEDs and rogue nuclear threats; and 
terminates questionable weapons programs.
  It also includes legislation to complete the James A. Lovell Federal 
Health Care Center in Illinois.
  It gives the VA and the Navy the authority they need to finalize a 
model partnership between the North Chicago VA Medical Center and the 
Naval Health Clinic Great Lakes.
  This is a model that the Departments hope can be replicated around 
the country.
  Combining separate Federal hospitals will provide better care for our 
servicemembers and veterans while saving valuable taxpayer dollars.
  Given the conflicts we face abroad, this bill provides the right 
amount to spend in support of our troops. Today, the United States is 
the world's leader in defense spending. Last year, U.S. military 
spending accounted for almost half of the world's total military 
spending. We spend more than the next 46 countries combined. U.S. 
military spending, combined with that of our close allies, makes up 72 
percent of all military spending in the world. Our defense budget is 
six times larger than China's and 100 times larger than Iran's.
  These funds make good on a promise to our men and women in our 
military. Our troops continue to do everything we ask of them in the 
wars in Iraq and Afghanistan. These conflicts have taken an 
extraordinary toll on servicemembers and their families that we cannot 
forget.
  The Armed Forces, particularly the Army and the Marine Corps, will 
continue to be heavily stressed, even as we start to redeploy our 
forces from Iraq. Servicemembers still do not have enough dwell time 
between deployments and the Army has seen a troubling rise in the 
number of suicides. These are indications of the strain that multiple 
and continued deployments are taking on the force. The President 
requested increasing the size of the Army to 547,400 soldiers and 
increasing the Marine Corps to 202,100 Marines, while preventing cuts 
in Navy and Air Force personnel. This bill supports the President's 
request. It also authorizes an additional 30,000 soldiers in 2011 and 
2012, should the Secretary of Defense believe such troops are 
necessary. Additional soldiers and marines will help ease the burdens 
caused by multiple deployments.
  More personnel will give each service more breathing room to care for 
its wounded warriors. Others can continue the fight while injured and 
ill servicemembers can recover in wounded transition units.
  This legislation creates a task force to assess the policies and 
programs that support the care and transition of recovering wounded and 
seriously ill members of the Armed Forces. The task force will consider 
whether servicemembers have sufficient access to care for posttraumatic 
stress disorder and traumatic brain injury, the signature injury of the 
wars. It will look at how well we help injured warriors transition from 
the Department of Defense to the Department of Veterans Affairs.
  The task force will also review the support available to family 
caregivers as they care for recovering injured and seriously ill 
members of the Armed Forces. For every servicemember successfully 
recovering from a serious injury or illness, there is often a family 
member who has put the brakes on his or her life to care for that 
person.
  Last week, my office received a call from the family of Jordan Hoyt, 
a soldier from Barry, IL. He was seriously injured in Afghanistan and 
is receiving care at Walter Reed Army Medical Center here in 
Washington. His wife Haley has moved to Washington to be near Jordan 
while he goes through months of surgery and rehabilitation. She has 
brought with her their infant child, who was born while Jordan was away 
serving his country. Haley is from Quincy. She has left her family 
behind to help Jordan recover from his injury. She has also delayed her 
educational plans to study criminal justice. Haley is 19 years old. 
After Jordan leaves Walter Reed, the couple will return to Quincy to 
live with her mother, who has already provided them with incredible 
support. While taking care of wounded servicemembers is our basic 
responsibility, we also need to support the families whose lives have 
been up-ended by the wars. I commend the committee for including this 
task force to look at the needs of family caregivers.
  This President inherited many challenges at home and abroad, 
including two wars and a challenging situation in Pakistan. This bill 
supports President Obama's new direction in addressing these 
priorities. In June, our military redeployed from Iraq's cities under 
the Status of Forces Agreement concluded by the government of Iraq and 
the previous administration. The Iraqis must continue to take 
responsibility for their own future.
  I commend the President's increased focus on defense and development 
in Afghanistan; preventing the reemergence of the Taliban and al-Qaida; 
and strengthening economic, agricultural, educational, and democratic 
development. These goals are important to development in Afghanistan, 
but they are essential to our military's strategy. I support the 
National Defense Authorization Act and commend Chairman Levin and 
Senator McCain for their leadership.
  Almost 3,000 soldiers from the Illinois Army National Guard are 
currently deployed to Afghanistan. Members of the Illinois Guard's 33rd 
Infantry Brigade Combat Team are helping train the Afghan National 
Police and providing force protection at military bases. It has been a 
difficult deployment, with many casualties. Gen William Enyart, the 
Adjutant General of Illinois, has had to attend the funerals of too 
many of his soldiers. He sent me an article he had written this spring. 
Why do the young soldiers serve, he asked? This is what he wrote. They 
serve because:

       They are our kids, they are our protectors. They are what 
     stand between us and chaos. They don't have to be asked to 
     serve. They don't have to be asked to go into danger. They do 
     it, not out of hate, not out of vengeance, but out of love. 
     Love of family, love of community, love of fellow soldier.

  I think he is right. Members of the Armed Forces and their families 
make these sacrifices to keep our country safe. We owe them much in 
return. This bill takes one step by providing them the resources they 
need. I ask my colleagues to support this legislation and to send it to 
the President for his signature.

                          ____________________