[Congressional Record (Bound Edition), Volume 155 (2009), Part 14]
[Senate]
[Pages 19480-19486]
[From the U.S. Government Publishing Office, www.gpo.gov]




 ENERGY AND WATER DEVELOPMENT AND RELATED AGENCIES APPROPRIATIONS ACT, 
                                  2010

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of H.R. 3183, which the clerk will report.
  The assistant legislative clerk read as follows:

       A bill (H.R. 3183) making appropriations for energy and 
     water development and related agencies for the fiscal year 
     ending September 30, 2010, and for other purposes.

  Pending:

       Dorgan amendment No. 1813, in the nature of a substitute.

  The PRESIDING OFFICER. The Senator from North Dakota.
  Mr. DORGAN. Madam President, this legislation comes from the 
Appropriations Energy and Water Subcommittee. It has passed through the 
full Appropriations Committee and reported to the floor of the Senate. 
This is another one of our appropriations bills that we very much hope 
we can get done, have a conference with the House, and send to the 
President for signature. Regular order for this bill has not happened 
for a couple of years, which is a failure of the Congress and the White 
House because of the way things developed in the last few years. We 
need to change that.
  I thank Senators Inouye and Cochran, the chairman and vice chairman 
of the full committee. They have made a decision that they want to 
drive these individual appropriations bills through the process, get 
them conferenced, then send them to the White House to sign them into 
law. That is the way they should be done.

[[Page 19481]]

  We have put together legislation that we think is a good bill. It 
funds all of the energy functions across the country, including 
programs attached to the Energy Department. It funds all of the water 
policy issues across the country, all the projects that are ongoing. It 
is a very important bill. If we think of the subject of energy and 
water, there is not much more controversial or important at this point 
than those two subjects.
  This bill is 1.8 percent under the President's budget request and 1.4 
percent over the amount spent in the previous fiscal year. This is a 
fairly conservative, austere bill we have put together. We have tried 
to make the best case we can for the best investments for the future.
  The other thing that is important to understand is that, at a time 
when our country is in a deep recession, funding water projects and 
energy projects provides a way of putting people to work and creating 
jobs. At the end, rather than only spending and having the money 
disappear, we have invested and we have returns on those investments in 
the form of water and energy projects that will benefit the country for 
many years.
  Yesterday, I talked for a moment about the Department of Energy's 
national laboratories. We fund a lot of issues in this appropriations 
subcommittee, including all of our science, energy, and weapons 
laboratories. I am so proud of those laboratories. They remind us of 
the old Bell Laboratories, where so much good research and scientific 
inquiry occurred. The Bell Labs are now largely gone. The laboratories 
that we have--the science, energy and weapons labs--are the repository 
of the most important research that goes on in this country.
  I believe it was in the last fiscal year that Los Alamos in New 
Mexico announced it had completed work on what is called the 
Roadrunner, which is the most powerful computer in the world. That most 
powerful computer does not exist somewhere else, it exists here at Los 
Alamos Laboratory.
  It is a computer that has met the speed of what is called a petaflop. 
That sounds like a foreign language.
  Let me start first by talking about a teraflop. A teraflop is 
something where a computer can do 1 trillion discrete functions per 
second. In 1997, we reached that standard of a teraflop, 1 trillion 
functions per second. Ten years later, the amount of space for the 
hardware to do what was called a teraflop was a very large home 
essentially. That is the amount of space it took for the hardware. The 
amount of energy it took to run all that computer power was the amount 
of energy it took to supply hundreds and hundreds of homes. Then, 10 
years later, a teraflop, the same 1 trillion functions per second, 
could be provided with the energy equivalent of a 60-watt lightbulb on 
equipment the size of a very small token.
  Now we are not talking about 1 trillion functions per second or a 
teraflop. We are talking about a computing standard called a petaflop. 
The Roadrunner achieved it. A petaflop is 1,000 trillion functions per 
second. It is so powerful and unbelievable, it is almost hard to 
describe. I asked a scientist: What does it mean that you can do 1,000 
trillion functions per second? He said: As an example, they are using 
them on stockpile stewardship and weapons issues. There are something 
like 1 or 2 billion synapses in the brain that communicate with each 
other. This is the first computer that has the capability and the power 
to analyze what these billion synapses of the brain are doing in 
communicating in order to produce something from one's eye called 
vision. We understand we can see. We just don't understand how it is 
all possible. Yet the development of very powerful computers like the 
Roadrunner, the world's most powerful computer in this country, allows 
us to do almost unbelievable things in science and research and 
inquiry. Is that an investment in the country, in the future? Yes, it 
is a big investment, an investment that will pay dividends for decades 
to come.
  I point that out to say that we have brought a bill to the floor that 
deals with so many important energy and water issues. It attempts to 
accelerate research into renewable energy for programs like wind and 
solar and biomass. It attempts to evaluate how, through science and 
research, we can understand our ability to continue to use our most 
abundant resource: coal. We understand we will have to have a lower 
carbon future and capture carbon and sequester it or use it for 
beneficial use. The way we will do that is by investing in the kind of 
research and inquiry that will unlock the mystery of doing that. I am 
convinced we will. This is the legislation in which we make those 
investments.
  Senator Bennett has no doubt had the experience I have had because we 
lead the committee that funds all of this. I have had people from all 
around the country come to my office breathless about the silver bullet 
they have now patented that will solve all of our problems in energy, 
either the newest form of energy or the newest approach to capture 
carbon. They come in breathless. By the time they are finished talking, 
we are out of breath because they are so excited about what they are 
doing.
  We have a guy who was a witness at a hearing on the beneficial use of 
carbon so that we can continue to use coal and not severely impact our 
environment. He has developed and patented an approach by which he 
takes the effluent coming out of the stack of a coal-fired generating 
plant and doesn't separate the CO2. Through chemicals, he 
mineralizes it and creates a product that is equivalent and harder than 
and better than concrete. Is that the silver bullet? I don't know. But 
he made a strong and interesting case before the committee that this 
will dramatically advance our ability to use coal in the future while 
at the same time protecting our environment.
  Senator Bennett and I, in this legislation, provide the investment 
funds necessary to begin to scale up and demonstrate new approaches and 
new patents and new technologies in so many of these areas. Why is all 
this important? We are unbelievably dependent on foreign oil. Almost 70 
percent of the oil we use comes from outside of our country. That makes 
us vulnerable from a national security and an energy security 
standpoint. The country knows we have to move off that dramatic 
dependency and find ways to produce more here. That means more of all 
kinds of energy. That is what we support in this legislation. We 
produce, we conserve. We provide greater efficiency for virtually 
everything we use every day, as we use energy in our daily lives.
  Then, in addition to that large area of energy, which we will 
describe in greater detail as we have amendments to the bill, all of 
the water projects in this country, through the Army Corps of Engineers 
and the Bureau of Reclamation, are projects that are making life better 
for people, providing access to clean water and the storage of water.
  We understand how controversial water is, but we also understand that 
water is essential to economic growth and human health. To monitor and 
conserve water resources and make the best use of all of those 
resources is exactly what we are trying to do with this legislation.
  I won't describe more except to say this legislation includes the 
President's recommendations, his wide range of earmarks, and what the 
White House would like to be funded in water projects. We respect that 
and have accepted most of what the President has recommended for 
specific project requests. We have added some, while eliminating some 
of the President's, that we believe have higher value for various 
States based on information we have gleaned.
  We will have amendments. I think there are already a couple dozen 
amendments filed. Some say the Congress should not have any imprint on 
what should be funded here, let's just let the White House tell us what 
they want funded.
  Well, that does not make a whole lot of sense because the folks in 
this Chamber are elected by their constituents and perhaps have the 
best sense of what kinds of water projects will best

[[Page 19482]]

meet the needs of their region or their State. But, as I said, we 
respect the President's views, and we have funded most of the specific 
projects he has asked us to fund and made some modifications where we 
think appropriate and where we think it will improve the legislation.
  I say on behalf of myself and Senator Bennett, we were here 
yesterday, and we did not have amendments offered. We had some filed 
but not offered. It is a quarter to 12 today, and we will be here all 
day. We very much hope, if people have amendments, they will come to 
the floor of the Senate, offer them, and debate them so we can proceed. 
So we are here. We very much would like to finish this bill by tomorrow 
evening--perhaps this evening, if people would be as optimistic as we 
are. But we would like people to come and offer amendments as soon as 
possible.
  Madam President, I do not know whether Senator Bennett wishes to 
speak. Well, I believe we have someone who wishes to offer an 
amendment. We appreciate Senator Voinovich coming to the Chamber.
  The PRESIDING OFFICER. The Senator from Ohio.


                Amendment No. 1841 to Amendment No. 1813

  Mr. VOINOVICH. Madam President, I ask that the Voinovich-Carper 
amendment No. 1841 be called up.
  The PRESIDING OFFICER. The clerk will report.
  The assistant legislative clerk read as follows:

       The Senator from Ohio [Mr. Voinovich], for himself and Mr. 
     Carper, proposes an amendment numbered 1841 to amendment No. 
     1813.

  Mr. VOINOVICH. Madam 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 clarify the authority of the Nuclear Regulatory Commission 
regarding the acquisition and lease of certain additional office space)

       On page 63, after line 23, add the following:

     SEC. 3__. AUTHORITY OF NUCLEAR REGULATORY COMMISSION.

       The Nuclear Regulatory Commission may use funds made 
     available for the necessary expenses of the Nuclear 
     Regulatory Commission for the acquisition and lease of 
     additional office space provided by the General Services 
     Administration in accordance with the fourth and fifth 
     provisos in the matter under the heading ``salaries and 
     expenses'' under the heading ``Nuclear Regulatory 
     Commission'' under the heading ``INDEPENDENT AGENCIES'' of 
     title IV of division C of the Omnibus Appropriations Act, 
     2009 (Public Law 111-8; 123 Stat. 629).

  Mr. VOINOVICH. Madam President, I thank Chairman Dorgan and Ranking 
Member Bennett for allowing me to bring this amendment to the floor.
  This bipartisan amendment renews authorization granted to the Nuclear 
Regulatory Commission and the General Services Administration in the 
fiscal year 2009 Omnibus appropriations bill that allows GSA to acquire 
additional permanent office space near the Nuclear Regulatory 
Commission headquarters location in Rockville, MD. We need to renew 
this authorization in the fiscal year 2010 appropriations because the 
current lease negotiations will likely extend beyond September 30, the 
end of fiscal year 2009.
  This is a fairly straightforward and simple amendment, but I want to 
take this opportunity to underscore the importance of the original 
intent of the authorizing language.
  Having served as either the chair or ranking on the Clean Air and 
Nuclear Safety Subcommittee for the past 8 years side by side with my 
good friend, the senior Senator from Delaware, I take great pride in 
the fact that the NRC has become one of the best regulatory agencies in 
the world.
  Senator Carper and I, together with other members on the Environment 
and Public Works Committee, have worked hard to provide the NRC with 
the necessary resources to do its job; that is, ensuring safe operation 
of the 104 operating nuclear powerplants while conducting licensing 
reviews of the 17 applications for construction and operation of 26 new 
reactors. That may sound like some new information, and it is. We have 
17 applications filed with the Nuclear Regulatory Commission for 
construction and operation of 26 new reactors.
  With three pieces of legislation included in the Energy Policy Act of 
2005, we were able to help NRC hire more than 1,000 new workers and 
rehire retirees in the last 4 years to meet the increasing demand. The 
rehiring was to train new people who are being brought on board.
  Now we need to follow through and provide NRC with adequate, 
colocated headquarters office space to ensure maximum efficiency and 
effectiveness. I must say that the subcommittee has looked at this over 
and over again, and we have concluded that it is very necessary to have 
them have space in the same vicinity so they can more adequately and 
more efficiently run the operation.
  Lately, we have been hearing a lot about how we need to increase the 
use of nuclear energy if we are to achieve our energy independence, 
reduce greenhouse gases, and create jobs. I would point out that the 
NRC is at the center of all of this in the midst of reviewing those 17 
applications for 26 new reactors.
  Providing NRC with the tools necessary to achieve regulatory 
stability, efficiency, and effectiveness not only makes sense, it is 
the job of Congress. I urge my colleagues to vote for this amendment.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Utah.
  Mr. BENNETT. Madam President, I am in favor of the Voinovich 
amendment. To use the language of the cloakroom, it has not yet been 
hotlined. I do not know of any objection to it, and at least on this 
side, we will do what we can to get it hotlined, get it cleared, so it 
can be adopted, I would hope by voice vote, as quickly as possible. But 
because it has not been hotlined on our side, I would suspect the vote 
will probably take place this afternoon, if that is acceptable to the 
chairman.
  There has been, as Senator Voinovich has pointed out, a significant 
increase in the NRC workload, and GSA has been in negotiations with NRC 
to construct additional building space next to the existing NRC 
headquarters. The negotiations may extend beyond the end of this fiscal 
year, with the lease award occurring in 2010. So in order to anticipate 
that, the NRC and GSA agreed that the language should be continued in 
the fiscal year 2010 appropriations for the NRC. That will facilitate 
the procurement process and protect the government from any protests 
after a contract is awarded. This would mean the NRC could continue the 
current procurement without interruption. For those reasons, I think we 
should facilitate this.
  With that, Madam President, I yield the floor.
  I suggest the absence of a quorum.
  Mr. DORGAN. Madam President, if the Senator would withhold?
  Mr. BENNETT. Madam President, I will withhold the suggestion of an 
absence of a quorum.
  Mr. DORGAN. Madam President, I, too, rise in support of the amendment 
offered by Senator Voinovich. It is a good amendment. In fact, it would 
extend authority we have previously carried in this legislation in 
fiscal years 2008 and 2009. So I believe we would be able to clear this 
amendment by voice vote, but it has to be hotlined, I think. So my 
expectation is we will be able to clear this amendment at some point 
after lunch today.
  Madam 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. UDALL of New Mexico. Madam President, I ask unanimous consent 
that the order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. UDALL of New Mexico. Madam President, I ask unanimous consent to 
speak as in morning business for 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. UDALL of New Mexico. Madam President, as to the bill that is 
before the Congress, I heard Chairman Dorgan mention Los Alamos 
National Laboratory and the Roadrunner computer.

[[Page 19483]]

I thank him for his attention to the two national laboratories in my 
State, Los Alamos and Sandia. This computer, the Roadrunner computer, 
is a very important computer in dealing with issues such as climate 
change, national security, and other scientific research. I applaud his 
efforts in moving us forward, and also Ranking Member Bennett. I 
applaud them both for their leadership.


                              Health Care

  Madam President, if you follow the debate in Washington about health 
reform, it is easy to get the wrong idea. The press likes to cover what 
we are doing out here as if it is a game of chess--one side wins by 
passing health care reform; the other side wins by blocking it.
  I understand that somebody will disagree with whatever plan we 
produce to reform health care. That is democracy. Some Members of this 
body might decide they have to vote no on health reform. But let's be 
clear on one thing: If we fail to pass a health reform plan, nobody 
wins. If we keep the status quo, all of our constituents will be worse 
off.
  The health care debate can get complicated. Both sides have a list of 
numbers a mile long that are supposed to explain the problem and the 
possible solutions. But these numbers do not tell the whole story. For 
example, we know that 22,000 Americans die each year because they do 
not have health insurance. But that is only part of the story because 
every one of those 22,000 is a unique and irreplaceable individual--
somebody's mother, somebody's son. Numbers cannot convey the injustice 
of it all, the needless pain for families and friends. Every year, this 
country produces 22,000 unnecessary stories of loss and suffering--
22,000 stories that could go unwritten if we act now. These stories are 
everywhere we look, if we look.
  Last week, I got a short note from a man in Pena Blanca, NM. The man 
wrote:

       My wife and I have been self employed craftsmen for 25 
     years. We never made enough money for health insurance. My 
     wife now has terminal colon cancer. If she could have had a 
     colonoscopy at 50 [years old] she would not be dying at 54. 
     My heart is broken.

  All this woman needed was the simple preventive care that should be 
available to every American--care that costs little and saves lives. 
But our system did not provide that, and now she is dying. If we do not 
get health care legislation passed, thousands of women like my 
constituent in Pena Blanca will not get their colonoscopies and 
thousands more hearts will be broken like her husband's. I do not care 
where you stand in this body, that is not a victory for anybody.
  Another thing we talk about in Washington is ``preexisting 
conditions'' reform. It sounds as if it should be something 
complicated, something most Americans do not quite understand. But my 
constituents know exactly what a preexisting condition is. It is the 
heart attack from 10 years ago that prevents dad from getting insurance 
through his job. It is mom's age. It is the fact that Sarah from down 
the street might get pregnant--a fact that forces her to pay more for 
insurance than her male coworkers.
  I have held a number of townhalls on health care reform in New 
Mexico, and everywhere I go I hear stories.
  A couple of weeks ago, I heard a story about a constituent who had 
come to my office for some casework a few years ago. This is one of 
those people whom you would expect to do great things. He works an 
incredibly technical job at Los Alamos National Laboratory. Until 
recently, he thought his knowledge and hard work would get him through 
any crisis. Then John began suffering from a host of unexplained 
neurological problems. The problems got so bad that he was actually 
relieved when a doctor told him about a tumor in his brain. He chuckles 
when he remembers that day. He was so relieved to know what was wrong 
with him, and his doctor said something could be done.
  But John's insurance company had other ideas. Months went by, and 
John was not approved for the operation his doctor recommended. Only 
just recently was he approved for the procedure he needs. But now he 
has other problems. His medical leave is about to run out, and he does 
not know what to do. If he loses his job, he loses his insurance. And 
if he loses that, he could lose everything. He will become just another 
American whose preexisting condition prevents him from getting health 
care.
  John was supposed to be one of the lucky ones. Before he began having 
problems, he assumed he was one of the 55 percent of New Mexicans who 
have adequate health insurance. But John was just one illness away from 
the edge. And he is not alone. If we do not act, millions of Americans 
will fall off the edge in the coming years. I do not care how you feel 
about the President's health care plan, that is not a victory.
  Because John cannot work, he could lose his health insurance. But you 
do not have to lose your insurance to lose everything.
  When I was back in New Mexico over the Fourth of July recess, I 
stopped at a local TV station for an interview. I went to the front 
desk to check in and introduced myself to the woman sitting there. It 
was like I had touched a nerve.
  ``Senator Udall,'' she said, ``I need your help.''
  This woman works full time and she has health insurance through her 
work. Not too long ago, her doctor told her she needs cataract surgery 
or she will lose her sight. On Monday, before I met her, she was 
scheduled to get that surgery. Then, days before her appointment, she 
was informed that the deductible would be more than $2,200, not 
including the cost of any followup care. Like many Americans, she has 
been struggling to make ends meet in this economy. She cannot spare 
$2,200 from her paycheck, so she canceled her operation. Now she is 
afraid she will lose her sight and she doesn't know what to do. So when 
a Senator walked through the door, she asked me for help.
  We can help this woman. She shouldn't have to choose between paying 
her rent and keeping her sight. Nobody should. And we can make it so. 
We can create a system where people can find and afford to pay for 
quality health insurance that provides the care they need. We can 
create a system where people do not have to worry that they are one 
layoff away from losing their insurance or one medical emergency away 
from losing everything. We can guarantee quality affordable health 
insurance to every American. If we don't--if we miss this opportunity--
this is not a victory of one political party over another; it is a 
massive loss for all of us and for everybody we represent. It would be 
a national disgrace.
  We are better than this. We can pass something that helps every 
American. We can declare victory not over the other political party but 
over the status quo. I hope we do so.
  Thank you, Madam President.
  I note the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. KOHL. Madam President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. KOHL. Madam President, I ask unanimous consent to speak as in 
morning business for 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. KOHL. Madam President, I rise today to talk about our effort to 
achieve comprehensive health care reform. Most people agree that 
reforming our health care system is a necessity and that we cannot 
afford to wait another 10 or 20 years until health care costs consume 
the American economy as well as the budgets of most American families. 
However, as urgent as this issue is, we must approach every aspect of 
health care reform thoughtfully and not rush to complete what might be 
one of the most important legislative initiatives any of us will ever 
work on during our time here.
  As the HELP Committee and the Finance Committee release their 
proposals for health reform, we know we cannot consider a bill that 
does not control costs. Controlling costs is an

[[Page 19484]]

enormous priority. I believe it is as important as ensuring universal 
coverage, because if we provide universal coverage without controlling 
costs, the result would be financial catastrophe for our Nation.
  I want to be clear that lowering costs does not mean limiting access 
to care, although opponents of health care reform will try to convince 
the American people that it does. These political talking points are a 
distraction at a time when we are trying to expand access to health 
care. No one will be forced to change their health plan, their doctor, 
or their hospital if they like what they have now. Health care reform 
will provide coverage to those who do not have it today, and it must 
lower costs for both families and businesses.
  One key component to cutting costs is to eliminate unnecessary 
testing and overtreatment. If we can do that, then our health care 
system and America's patients will be in better shape. We can move in 
this direction if the Federal Government starts paying for value of 
care, not volume. As it stands, the Medicare reimbursement system 
provides perverse incentives. Currently, geographic areas that provide 
the most inefficient care oftentimes get the highest reimbursements. We 
need to ensure that all health care systems provide better care in a 
more efficient way and reward those systems that already do so; 
otherwise, we will never get costs under control.
  As chairman of the Aging Committee, I am familiar with many of the 
health care issues that affect seniors as well as all Americans. In 
this capacity, I have been pushing for health reform to include 
improvements to our long-term care system. Our Nation's population is 
aging at a record rate, and with every passing year more elderly 
Americans find themselves in need of long-term care. Most of us will at 
some point struggle with the high and rising costs of caring for a 
loved one. These too are costs we must get under control as part of 
health care reform, and I applaud Chairman Kennedy for including the 
CLASS Act in the HELP Committee bill. This bill will provide new 
funding for long-term care through a voluntary social insurance 
program.
  We can also get long-term care costs under control by promoting a 
move toward home and community-based long-term care services in 
Medicaid. These programs break away from a ``one size fits all'' 
approach, offering flexibility and choices tailored to an individual's 
needs. Even better, they save a lot of money that would otherwise be 
spent on nursing home care. Senators Kerry, Grassley, and Cantwell all 
have good ideas in this area that I hope will be considered.
  We must also protect those consumers who are making an effort to plan 
for the costs of their own long-term care in advance. In recent years, 
long-term care insurance has gained popularity. Over 40 States have 
initiated programs to encourage residents to buy long-term care 
insurance in an attempt to ease the burden of Medicaid costs on State 
budgets. I believe we have a duty to make sure these policies, which 
may span several decades, are financially viable.
  Many long-term care insurance companies have been raising their 
policyholders' monthly premiums, which can be devastating for older 
persons who are living on a fixed income. Until we can guarantee that 
consumers have strong protections, that carriers will not deny 
legitimate claims, and that premiums will not skyrocket down the road, 
long-term care insurance is not ready to be a major part of the health 
care reform solution.
  The funding of care is not our only concern. It has been 22 years 
since we raised the standard of care in nursing homes, and quality 
improvements are long overdue. Every year, as part of our Medicare and 
Medicaid reimbursement system, our government collects information 
about all 16,000 nursing homes across the country. We should make this 
information available to consumers so they can judge a home's track 
record of care for themselves before deciding where to place a loved 
one. We should make nursing homes safer by instituting a comprehensive 
background check system for long-term care workers. Pilot programs have 
shown that this would keep thousands of predators out of our nursing 
homes where they can cause, and do cause, terrible physical, financial, 
and emotional harm to residents and their families.
  The truth is that while there are some hot button issues that divide 
us and while there is seemingly endless ground to cover, there is a lot 
about improving health care we do agree on. We all recognize the need 
to bolster the ranks of those who provide care. As America ages, we 
will face a severe shortage of workers who are equipped to manage 
seniors' unique health needs. It is important to expand the training 
and education for licensed health professionals, direct care workers, 
and family caregivers, and I applaud the HELP Committee for recognizing 
this need in their bill.
  We agree that America's health systems should expand the use of 
health information technology, which has been shown to save lives by 
reducing medical errors and save money by promoting efficiency in 
testing and communication. We agree that those who have suffered from a 
health problem in their past should not be denied insurance that will 
protect them for the future by ensuring that these individuals with 
preexisting conditions can purchase coverage.
  We also agree that we should do everything we can to remove fraud, 
waste, and abuse from the system. We must employ a vigorous health care 
fraud enforcement program that will protect policyholders, businesses, 
and taxpayers.
  We agree that we should work to provide appropriate care at the end 
of life. We need to break down the barriers to advance planning and 
encourage Americans to talk with their doctors about end-of-life care 
long before such choices must be made.
  Finally, we agree that we have a lot to gain if we get this done in a 
thoughtful, deliberate way. We can do this right and we must do this 
soon because so many Americans are depending upon us.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. THUNE. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. THUNE. Madam President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. THUNE. Madam President, I think the American people are beginning 
to react in a negative way to what they perceive to be happening in 
Washington, DC, today with regard to the debate about health care, the 
debate about new energy taxes in the form of a cap-and-trade program. 
Of course, we know there are a lot of questions about whether there was 
any value in the trillion dollar stimulus bill that passed earlier this 
year, which was supposed to keep unemployment below 8 percent, and now 
in many States it is well into the double digits and continues to go 
north from there.
  They have seen a lot of government spending with the stimulus, a 
takeover of many industries, whether it is auto manufacturing, 
financial services, or insurance companies in this country. They have 
seen the cap-and-trade bill, which passed the House of Representatives, 
which they know--there are debates about how much, but they know it 
will increase what they pay for energy in this country. And now we are 
having this discussion about the government taking over one-sixth of 
the American economy in the form of health care.
  I think what we are starting to see is that the American people, as 
they engage in these issues, are becoming increasingly concerned about 
the level of government expansion and intervention in the marketplace, 
and the amount of new taxation and new borrowing and spending that is 
going on in Washington, DC, at a time when the American people are 
being, by virtue of

[[Page 19485]]

the fact that they have to live within a balanced budget, required to 
make hard choices in their daily lives. They see a disconnect between 
what they are experiencing in their family lives and what is happening 
in Washington, DC, where there continues to be this pattern of new 
taxes, spending and borrowing.
  Logic would dictate, I think, when you are in a recession, you should 
not raise taxes. The worst thing to do in a recession is raise taxes 
and actually crush any economic recovery that might occur because, as 
we all know, what helps create jobs is small business. If small 
businesses are faced with higher taxes, they have less to invest in new 
equipment and in hiring new employees.
  The other thing I think logic dictates is that when you are running 
trillion dollar deficits as far as the eye can see, you should not be 
piling more debt upon future generations. It seems as if everything we 
are talking about these days is an expansion of government in 
Washington, at greater additional costs to the American people, either 
in the form of higher taxes or increased borrowing from future 
generations, neither of which is something I think most Americans would 
acknowledge we ought to be doing when you have an economy in a 
recession and trillion dollar deficits as far as the eye can see.
  The current health care debate is a good example of something about 
which people have reservations and concerns, because they see the 
attempt by the Federal Government to take over one-sixth of the 
American economy, to essentially nationalize it--whatever you want to 
call it. In any event, it will mean greater government intervention and 
greater government involvement and an expansion of government in 
Washington, DC. I think they are starting to react in a negative way 
against that, and more and more members in Congress, in the House and 
Senate, are hearing that.
  I think that is why it is becoming increasingly difficult now to move 
in the quick way in which the Democratic leadership in the House and 
Senate wanted to in order to enact some form of health care reform 
before the August break.
  The way I view this issue is that we ought to look at starting over. 
Clearly, what has been proposed and rolled out so far is not working. 
It is not working in terms of winning the minds of the American people, 
in terms, in Washington, DC, of putting together what ought to be a 
bipartisan solution to probably one of the biggest challenges and 
crises facing the American people and our economy.
  So far, we have seen a bill being debated at the committee level in 
the House of Representatives, and perhaps scheduled for the floor--if 
not this week, when we get back--and we have seen action by the HELP 
Committee in the Senate on a bill that, by CBO's estimate, is about a 
trillion dollars in new costs. Somehow, it will have to be paid for.
  It seems as if we ought to push the reset button and figure out, OK, 
how can we do this in a way that achieves savings to the American 
people and the health care costs in this country, as opposed to 
actually adding new costs by increasing government spending in 
Washington, DC, expanding the size of government, and putting the 
government in the way of--I guess intervening in that fundamental 
relationship between physicians and patients.
  There are a number of things that are, in my view, wrong with the 
current plan, the plan that passed the HELP Committee in the Senate, as 
well as the one currently being considered in the House of 
Representatives. The first fundamental test it flunks is that it 
doesn't do anything to reduce costs. To me, reform ought to be finding 
efficiencies, streamlining, looking at ways of doing things in a less 
costly way to achieve savings. We know that is not the case with the 
bill that passed the HELP Committee in the Senate, and we know the 
House of Representatives, in their bill, according to the most recent 
Congressional Budget Office estimates, also does nothing to find 
savings or achieve any sort of savings as a result of all these changes 
being proposed. So it flunks the first fundamental test of reform; that 
is, it does nothing to reduce costs.
  Secondly, it does cut payments, reimbursements, under Medicare to 
providers, whether it is hospitals, whether it is the cost of 
pharmaceuticals. All of these things in this country that add to the 
overall cost of health care are obviously going to take a nick in this. 
We don't want to see the health care currently provided under Medicare 
to American senior citizens somehow be hurt by the fact that they are 
trying to find money to pay for this whole new expansion of government 
health care in this country. So you have the issue of cuts to 
reimbursements currently under Medicare, which very likely would impact 
the delivery of care, the quality of care for America's seniors.
  The third thing, and another big problem, is that it adds new 
Medicaid costs to our States. States currently are participants. 
Medicaid is a shared program between the Federal and State governments, 
and there is talk about a significant expansion, the size of the 
Medicaid Program, which obviously costs the Federal taxpayers a lot 
more money. But it also passes on an incredible new and costly mandate 
to State governments. Many States are figuring that out and are 
starting to react to it.
  My State of South Dakota is a good case in point. Our State 
legislature, Governor, and people who looked at this have concluded it 
would cost South Dakota an additional $45 million a year in Medicaid 
costs, which may not sound like a lot of money in Washington, DC, but 
in a State such as South Dakota, where there is a requirement to 
balance the budget every year, that represents a lot of money. 
Obviously, it will have to be paid for somehow. When you get to the 
larger States, the numbers increase in multiples.
  You are talking about new taxes on States, in addition to the new 
taxes being talked about in Washington, DC, to pay for all this. You 
have new Federal and State taxes, again, at a time when already many 
State governments and budgets are strapped and they are trying to 
figure out how to balance their budgets currently.
  Another reason why the current plan is such a big problem, and why we 
need to start over and hit the reset button, is because you are going 
to have a lot of people who are going to lose employer-provided 
insurance. Most of the studies conclude--and the House bill is a good 
example--that about 83 million people would lose their private health 
insurance under the bill that is under consideration in the House of 
Representatives. There are other studies that have been done. This was 
a Congressional Budget Office estimate. Other studies suggest that the 
number of people who could lose insurance on some of these plans under 
consideration in Congress could be in the 120 million range.
  If you consider that we have 177 million people today who get their 
insurance through their employer, that is a significant number of 
people who are going to lose their privately provided health insurance 
and be pushed into a government plan.
  That brings me to the next point of why the current health care plan 
being debated is the wrong direction in which to head and creates 
problems; that is, you are going to have more people going into the 
government-run plan--literally millions of people, the ones who are 
going to lose their insurance in the private marketplace. They are 
going to be pushed into a government-run plan. Obviously, there are a 
lot of people who would like to see that. I don't happen to be one of 
them. We ought to preserve what is best about the market and 
competition we have and allow people to have more choices. We don't 
want to, by default, shove more and more people into a government-run 
plan, when there are opportunities out there available to them today 
where they can get their health care coverage and insurance in the 
private marketplace. That is a much better model and has worked very 
well for a long time.
  That isn't to say there are not things we can do better. I don't know 
of any Senator on either side of the aisle who doesn't acknowledge that 
there are

[[Page 19486]]

things we need to do to reform health care in this country, to get 
costs under control, provide access to more people. But certainly 
taking away private coverage and pushing people into a government-run 
plan is not a reform of the health care system that makes sense to me 
or, I argue, most Americans, especially when it will cost trillions of 
dollars to do it.
  As I said, I think most people look at reform as something that would 
actually reduce or somehow eliminate costs or create greater 
efficiencies and savings in the health care system in this country. You 
have a lot of people who will lose private insurance, and millions of 
Americans would be pushed into a government-run program.
  As I said before, another big problem with this idea is that for 
employers, during a recession, it imposes new taxes and fines, both of 
which would be very costly, and both of which would deprive them of the 
opportunity, as the economy hopefully starts to recover, to hire new 
people, create new jobs, which is what small businesses do best. They 
are the economic engine of this country. We are talking about imposing 
new taxes and fines on them, at great cost, and so that takes away a 
lot of the resources, as they generate revenue that they can be able to 
devote or allocate toward capital investment or hiring more people. 
They are going to be paying fines and taxes to the Federal Government 
to underwrite this new expansion of government in Washington, DC.
  Logic would dictate, and history would suggest, that the worst thing 
you can do in the middle of an economic recession is to raise taxes on 
the job creators in the economy. Raising taxes on small businesses is a 
bad idea. In fact, the House bill that is under consideration, with the 
surcharges and increased taxes, would actually increase marginal income 
tax rates from the top rate today of about 35 percent to about 37 
percent. Think about that. The size of the increase in marginal income 
tax rates that would occur in State and Federal marginal tax rates, 
under the plan under consideration in the House of Representatives, and 
how that would impact the economy, would be the largest tax increase we 
have seen since the end of World War II.
  Frankly, if you think about most Americans and most small businesses, 
when you start paying half, or 50 cents out of every dollar, in taxes, 
you are getting to a point where it is going to be very difficult for 
these businesses which might say: Why should I continue to try to 
create jobs and provide health care coverage for my employees, when the 
government takes more and more of the profits I make in this business? 
I think that is the risk we run with the job creators, the small 
businesses, which are the economic engine and create as many as two-
thirds to three-quarters of all of the jobs in our economy, in a 
recession. When you put new taxes and fines on them, you are layering 
them and burdening them with more costs that will make it very 
difficult for them to lead us out of the recession and start to expand 
the economy and create jobs. Intuitively it makes no sense for us to 
head in this direction.
  Finally, I think the last problem--and, as I said, there are many 
with the current health care proposals--is we will have to start 
dealing with the lines and the rationing that so often occurs when we 
see a system such as they have in Europe or the Canadian system. Some 
here actually believe that is the best way to do this. They believe in 
a single-payer system. They believe we ought to nationalize our health 
care system in this country. Inevitably, what we will end up with is 
people ending up in lines. We will have government making decisions 
about what procedures will be covered, what the reimbursement will be 
for this procedure, that procedure. It is a disaster and a train wreck 
in the making, and it is a direction I don't think we ought to go.
  These are all issues that I think point to the need for us to hit 
that reset button and to sit down and actually figure out what can we 
agree upon that will be a bipartisan solution to the challenge of 
increasing costs and a lack of access for millions of Americans.
  That being said, we have a large number of proposals out there which, 
I submit, we ought to be able to debate. As the HELP Committee and the 
Finance Committee go through their deliberations, there are many things 
that have bipartisan support in the Congress for which we could get big 
majorities and which would address the fundamental issues of access to 
health care and cost of health care but none of which are being 
considered because right now the only plan out there is the one that 
has been written by the Democratic leadership, which consists of this 
government plan or this government takeover of the health care system.
  We believe the principles in this debate ought to continue to 
maintain: People ought to be able to keep their health care; it ought 
to be health care they can afford; it ought to provide choices; and it 
ought to be patient centered.
  I yield the floor.

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