[Congressional Record (Bound Edition), Volume 155 (2009), Part 14]
[Senate]
[Pages 19486-19507]
[From the U.S. Government Publishing Office, www.gpo.gov]




 ENERGY AND WATER DEVELOPMENT AND RELATED AGENCIES APPROPRIATIONS ACT, 
                            2010--Continued

  The ACTING PRESIDENT pro tempore. The Senator from Ohio is 
recognized.
  Mr. BROWN. Mr. President, 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. BROWN. Mr. President, I come to the floor today, as I will in the 
next few weeks fairly often, to share letters with my colleagues in the 
Senate and the people of this country, letters I have gotten from 
people in Ohio. I have letters today from a woman in Clermont County, 
Cincinnati; a lady in Lake County, Cleveland; a gentleman from Lake 
County also; and a gentleman from Columbus. I want to read these 
letters because this is really what the health insurance debate is all 
about. It is partly about preexisting conditions and exclusivity and 
gateway and exchange and public option--all those terms we all throw 
around. But what this debate is really about is people who are hurting 
because of the health insurance situation in this country. We know it 
is broken. We know we need to fix it. These are real people I want to 
discuss, people my office has talked to and I have talked to in some 
cases, people, for instance, like Lee Parks, whom I sat next to at 
Medworks in Cleveland this weekend. She was helping people with intake, 
people without insurance. They had some 1,500 people who came by 
without insurance. They needed dental care, eye care, medical care. 
There were several hundred volunteers, as I said, like Maria Parks and 
her husband Lee, who came and worked with us on health issues. Let me 
share some of these letters.
  This is Wes from Columbus:

       I am a 42 year old single male, small business owner. I had 
     been able to make sure that I have health insurance up until 
     March of 2007. It was then that Anthem raised my premium by 
     40 percent to $725 a month.
       I had to decide whether to pay for the insurance or to 
     continue to put money into my business. I chose the business, 
     since without it I wouldn't have had access to insurance 
     anyway. Since then I have tried to get coverage, but because 
     of my 3 spinal surgeries, 2 sinus surgeries, and a 
     prescription, NO ONE will cover me.

  He capitalizes ``no one.''

       Ohio has something called ``open enrollment'' which is a 
     joke. Each month a different insurance company has legally to 
     accept anyone who has pre-existing conditions. BUT, the way 
     they keep people away is by making the rates so high.

  We know that is what the insurance companies do. That is why we 
wanted the public option.

       In 2008 Aetna quoted me a rate of $26,000 a year for 
     coverage.


[[Page 19487]]


  This is a small business owner. He says:

       That is over half of my pre-tax income.

  He said:

       It's clear to me I will never get coverage under the 
     present system.

  Margaret, from Amelia, OH, writes:

       I am a 61-year-old woman who has oral cancer. I worked in a 
     law firm in Cincinnati for over 27 years, as the records 
     manager. I've had four recurrences of cancer, and so far have 
     been very lucky, but the doctor has said it will be back . . 
     . and will get progressively worse. I'm worried about the 
     pain, disfigurement and death, but right now--

  She has oral cancer, she says--

       I am most worried that I will be unable to work following 
     surgery or treatments and lose my job and health insurance.

  So she loses her job, she loses her insurance. We know that happens 
to so many people.

       In 4 years I will be on Medicare but the cancer is coming 
     back within months, now, not years. My husband is several 
     years older and will probably be retired before I could get 
     Medicare.

  She writes:

       Do you really want a truck driver on the road in his late 
     sixties?

  Her husband.

       I am worried that we will lose the house and everything 
     we've worked for.

  This is a letter from a woman from Lake County:

       I am 80 years old and have several health problems making 
     it necessary to take 8 prescription drugs. Last year I fell 
     into the donut hole.

  This was the President Bush privatization of Medicare. It provided a 
prescription drug benefit, sort of--a good one for some people. But it 
was a bill, as you remember, written by the drug companies and written 
by the insurance companies at the betrayal of the middle class in this 
country.
  She writes:

       I fell into the donut hole by July, and only made it 
     through the rest of the year due to the doctor giving me 
     samples. . . .
       My son had been diagnosed with rheumatoid arthritis several 
     years ago. The insurance he had with his employer agreed to 
     allow the treatments with remicade.

  Remicade is that very expensive biologic drug that costs tens of 
thousands of dollars a year for which there is no generic substitute, 
for which there is no way to get the price down.

       Then [my son] changed jobs and his new insurance would not 
     allow the remicade, but would allow the use of humira, if my 
     son would co-pay $1,000 per treatment--every other month. . . 
     . That was almost more than his salary. He is barely making 
     out.

  That is the reason we need generic biologic reform, the reason we 
need a health insurance reform plan.
  The last letter I will share today is from Thomas, from Lake County.

       My name is Tom Zidek. I work for the United Steelworkers 
     Union. Today I received information from one of the companies 
     I represent that Kaiser is requesting a 30 percent increase 
     in premiums next year.

  This company has received another quote from Anthem, and ``Anthem's 
increase will be 15 percent for next year.''
  He then goes on and tells me about his son who has Down's syndrome, 
has had open heart surgeries. His wife has cancer, and the medications 
she takes, according to Medco, cost approximately $5,000 to $6,000 a 
month.

       As I said, me and my wife have good healthcare but earlier 
     this year we were both concerned that we might lose our jobs.

  He has worked for 36 years in the steel industry. He, along with 
millions of other workers, he tells us, middle-class families, played 
by the rules, and this is what happened.
  These letters are four of hundreds that we get, many of us, every 
single day. I have had more calls and letters and e-mails this week 
about health care than any other week in my whole Senate career, my 
whole House career, for the last 18 years; more letters on health care, 
on this subject, than total letters I have gotten in any other week 
since I have been in the Congress. This is so serious. It is absolutely 
a necessity that we work on this. People who say go slow need to 
understand there are 14,000 Americans every single month losing their 
health insurance. Many of them live in my State. We need action.
  I yield the floor.
  I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DORGAN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.


                           china human rights

  Mr. DORGAN. Mr. President, I wish to make a very brief statement 
while we are awaiting Members of the Senate to come and offer 
amendments. Senator Bennett and I have been very patient. We have a 
good many amendments filed, so we are waiting for our colleagues to 
come offer those amendments on the underlying appropriations bill. But 
I wish to take a couple of minutes while we are waiting, to offer a 
brief statement.
  I am Chairman of the Congressional-Executive Commission on China. The 
Commission examines human rights and rule of law developments in China. 
I would like to talk for a moment about these issues and some 
developments in China that concern me a great deal.
  I want to discuss the increasing harassment of human rights lawyers 
in China, which this Commission had reported on in great detail. Some 
have been disbarred, and their law firms have been closed. Others have 
been physically harassed or beaten. What do these lawyers share in 
common? The tenacity and courage to take on politically sensitive 
cases.
  I wish to say a few words about China's most famous human rights 
lawyer, a very courageous man named Gao Zhisheng.
  It is 174 days now since Mr. Gao was last seen taken from his bed by 
more than 10 men. His captors, apparently the ``national defense'' unit 
of China's public security agency according to the renowned China 
expert Jerome Cohen, had threatened to kill the young lawyer during 
previous detentions that were marked by horrific torture. What was his 
transgression? Why is he in trouble with the Chinese authorities? He 
agreed to take politically sensitive cases as a lawyer, and represented 
some of the most vulnerable people in China. He sought to use the law 
in China to battle corruption, to overturn illegal property seizures, 
to expose police abuses and defend religious freedom in China.
  In October of 2005, Gao wrote an open letter to President Hu and 
Premier Wen detailing the torture of Falun Gong practitioners by 
authorities. A month later, the authorities shut down his law firm and 
revoked his license to practice law.
  In 2006, he was convicted of ``inciting subversion of state power,'' 
and was placed under ``home surveillance'' which was harsher than 
prison, for Gao and his family.
  In 2007, public security officers abducted him again. He was brutally 
tortured for 50 days. His abduction was prompted by the publication of 
an open letter he wrote to us in the U.S. Congress.
  Think of that. A lawyer in China wrote an open letter to us, Members 
of the Congress. In it, he alleged widespread human rights abuses in 
China and described the government's treatment of him and his family. 
His captors called him a traitor. They warned him he would be killed if 
he told anyone about being abducted and tortured.
  Once released, he was placed again under ``home surveillance''. His 
family faced constant police surveillance and intimidation. His 
daughter, barred from attending school, lost hope as a young girl. The 
treatment became so brutal the family finally decided that their very 
survival depended on their escaping from China.
  But Gao was too closely monitored and could not think of leaving 
without placing his family at great risk because he was monitored 24 
hours a day. He did not want to be in a situation where he would leave 
his family at even greater risk.
  So in January of this year, Gao's wife, 6-year-old son, and teenage 
daughter were smuggled out of China and into the United States. This is 
a photograph of Gao, his wife Geng He, his son, and his daughter. This 
photograph depicts a beautiful family living

[[Page 19488]]

in China, Mr. Gao and his family, a lawyer who practiced law in support 
of the most vulnerable in China. As a result, he ran afoul of the 
Chinese Government.
  Mr. Gao disappeared 174 days ago, has not been seen or heard from 
since. After his family fled China, Gao was abducted once again from 
his home and no one has seen him alive. We know his situation is 
extremely grave. I have met with his wife. I have spoken about this on 
the floor of the Senate previously. His wife came to Washington, DC, 
and was in the balcony when I and other colleagues spoke about the 
plight of Mr. Gao.
  Of course, he may have been killed. The Chinese Government has not 
let anyone know his whereabouts or given access to him despite repeated 
appeals by U.N. agencies, by our government, by foreign governments, 
NGOs, and the media. The Chinese Government has signed and ratified 
many international agreements, human rights agreements, that would 
require it to come clean about Mr. Gao.
  I have written to the Chinese Ambassador to the United States, and 
received a letter back from him that was a nonanswer. I call on the 
Ambassador again to answer the questions: Where is Mr. Gao being held? 
Is Mr. Gao alive? What is the Chinese Government doing to this poor 
soul who had previously been tortured simply because he ran afoul of 
the state by speaking out and practicing law on behalf of those who are 
vulnerable in China?
  We call on the Chinese Government to give us information about Mr. 
Gao, to allow him access to a lawyer and to his family and to publicly 
state and justify the grounds for his continued abuse. The right to 
speak freely and to challenge the government, all of these are 
enshrined in the constitution in China. Yet it appears the Chinese 
Government and the Communist Party seem intent on upholding the 
violation of these rights in the case of Mr. Gao.
  What has the Chinese Government done to Mr. Gao? How do they justify 
it? When will they allow his family to see him? The government's 
continued refusal to produce Mr. Gao makes this case resemble those of 
the ``disappeared'' in Latin American dictatorships.
  American law has the practice of habeas corpus. It is the legal 
action through which a person can seek relief from the unlawful 
detention of themselves or another. I am aware of nothing similar to 
America's habeas corpus that exists in Chinese legislation or legal 
practice. But the U.N. Convention Against Torture, which China ratified 
almost 20 years ago, obligates it to come clean about Gao.
  I urge the government of China to disclose his whereabouts and 
justify the grounds for his continued detention. Once again, this is a 
photograph of a very courageous man, a very courageous Chinese lawyer, 
who has been incarcerated and tortured and now has been apparently 
abducted, perhaps killed. We do not know. I call on the Chinese 
Government to tell us what has happened to Mr. Gao.
  Mr. Gao's family and Mr. Gao's wife continually await word now 174 
days after their father and husband--this courageous lawyer in China 
was abducted. Having been abducted before and having been tortured 
before, they worry very much about the safety of their husband and 
their father. My hope is that our government, and other governments can 
expect some word soon from the Government of China about the 
whereabouts and the well-being of Mr. Gao.
  I yield the floor and I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. CASEY. 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. DORGAN. Will the Senator yield?
  Mr. CASEY. I yield.
  Mr. DORGAN. I ask unanimous consent that morning business statements 
during the consideration of this bill be limited to 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CASEY. Mr. President, I ask unanimous consent that I be permitted 
to speak for up to 10 minutes as if in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                              Health Care

  Mr. CASEY. Mr. President, I rise to speak of an issue that has 
dominated a lot of the time and attention--appropriately so--of this 
Senate, of the Congress overall, and the American people. Of course, 
that is health care.
  We have heard so far a vigorous debate but, in my judgment, a debate 
that has not had nearly enough facts on the table. Some of those facts, 
of course, are the facts as they relate to what is in the legislation. 
Right now, what is before the Senate is one bill, the Health, 
Education, Labor, and Pensions bill, which came out of our committee. I 
am a member of that committee. It came out a few weeks ago with 13 
Democrats voting for it, 10 Republican Senators voting against it.
  We await anxiously the deliberation, further deliberation and the 
markup and the amendments which will lead to a vote in the Finance 
Committee. We do await that with a lot of anticipation. That will cause 
further debate and properly so. But I rise to speak on two or three 
topics as they relate to where we are now.
  One is the question of the ``cost of doing nothing,'' the cost of 
staying on the same road, the status quo, because that is one choice 
for the American people. The other path is the path of change and 
reform, standing and working with President Obama to create the kind of 
stability the American people should have a right to expect from their 
health care system.
  That stability should relate to and is framed by a number of 
important considerations--certainly stable cost. Too many Americans, 
even though they have coverage, see the costs going up all the time, 
and they cannot afford to pay them. Whether they are in a family or 
whether they are running a small business, we need to give them, 
through this legislation, stable costs going forward into the future.
  We also need to make sure we have stability as it relates to quality. 
Millions, tens of millions of Americans, are covered by a health care 
plan from a health insurance company but are not getting the kind of 
quality that they deserve. That is a real indictment of our system. 
Strong as it is in some other areas, it is pretty weak in some of our 
quality indicators.
  Thirdly, I think we want to make sure we ensure stable choices. The 
American people have a right to expect, at the end of the road of this 
legislation, when it is sent to the President--I sure hope we can get 
there; I think we can--that the President will be able to sign a bill 
that has a sense of stability as it relates to choices.
  Why is it the American people should not be given choices not only 
from a menu of private options but also be given the opportunity for a 
public option--not a public option that is vague and overreaching but a 
public option that has the same rules, that every insurance company has 
to develop a plan. In other words, that the plan will be solvent, that 
the plan will be self-sustaining. All those features would be part of 
the public plan.
  But the threshold question still is: Do you want change? Do you want 
to stay on the road we have been on, the status quo? I speak about the 
people of Pennsylvania, but I also know these numbers I will cite have 
a national implication as well.
  If we do nothing, if we stay on the path we are on--now it is 2009--
by 2016, according to one report, by the New America Foundation, here 
is what happens in Pennsylvania if we do nothing, if we stay on the 
road that is called the status quo, the do-nothing, let's not change 
road.
  Here is the result from page 86 of the report.

       By 2016, Pennsylvania residents will have to spend nearly 
     $27,000 or close to 52 percent of median household income to 
     buy health insurance for themselves and their families. This 
     represents a 93 percent increase over 2008 levels and the 
     sixth highest premium cost in the country.


[[Page 19489]]


  I have not found yet, and I do not think I ever will find, a family 
in Pennsylvania, rich, middle income or poor who will walk up to me and 
say: You know what, you should not do anything about health care. 
Everything is fine. We should stay on the road we are on. When it comes 
to 2016, my family and I can afford to spend 52 percent of our income 
on health care.
  I do not think we are ever going to find anyone in Pennsylvania or 
America who will be able to make that statement because no one can 
afford that.
  But make no mistake about it, that is the path we are on right now as 
it relates to the cost to families across the country. Here is another 
segment of this report on the same page--again, as it relates to 
Pennsylvania.

       People seeking family health insurance through their 
     employers in Pennsylvania will have to contribute--

  Meaning by 2016--

     more towards premiums than residents of all but one state.

  The people of Pennsylvania

     will also experience the second greatest percent change in 
     their premiums contributions nationwide. By 2016, people in 
     Pennsylvania seeking family coverage through their employer 
     will contribute almost $9,000 to the cost of the premium.

  To be exact about it, we are talking about a premium increase from 
$3,510 in 2008 to $8,830, almost $9,000, for health care. I don't think 
I will run into anybody in Pennsylvania or America who says: Let's stay 
where we are. Everything is wonderful. Don't pass any bill. Don't worry 
about getting it done. We can afford to stay on the path we are on.
  In a word, that leads to, if anything, instability for a family, the 
inability to make ends meet for a small business. That is the road we 
are on right now. At some point in this debate, there are going to be 
people in the Senate and House Members across the way who will have to 
decide which team they are on. In my judgment, there are two teams: the 
reform and change team President Obama has developed and the set of 
policies behind that or the ``let's not change, everything is OK, let's 
stay on the road we are on and let's stay with the status quo.''
  In my judgment--and I know the people of Pennsylvania pretty well--
people will support change, because the road we are on now is a road to 
ruin when it comes to our economy, when it comes to the bottom line of 
families and small businesses.
  Every week, 44,230 people lose their health insurance. That is 
unsustainable. We can do all kinds of positive things in our economy. 
We can talk about creating jobs and doing all of the actions we hope to 
do to build a strong economy, but when we are a country where 44,230 
people every week lose health insurance coverage, we are all in 
trouble.
  For Pennsylvania, between January of 2008 and December 2010, a little 
less than 3 years, 178,520 people are projected to lose health care 
coverage. Again, I don't think we can stay on the road we are on right 
now.
  Let me share some thoughts about the other debate on cost. What I 
have outlined is the cost of doing nothing. The cost of doing nothing 
is very high. In fact, it is unsustainable, if we are to have economic 
growth and families and small business stability. Two or three quick 
examples of ways the Senate HELP Committee bill, the Health Choices 
Act, helps to bend the so-called cost curve to bring costs in line over 
time.
  In 2000, the Institute of Medicine conducted a comprehensive study of 
the economic cost to society of the uninsured, arising from poor health 
and shorter lifespans. An update of that study by the New America 
Foundation estimates that the economic loss is now up to $207 billion a 
year. By contrast, the CBO recently, when analyzing the House bill, 
said that it would cost some $202 billion in 2019--not today, 2019--
less than the savings to the economy from covering the uninsured.
  The bottom line is, we are spending currently per year $207 billion 
in terms of the cost resulting from poor health and shorter lifespans. 
One doesn't have to be a math major to cost that out over 10 years. 
Just add the zero. It is entirely possible from this formulation that 
if we are losing $207 billion to poor health and shorter lifespans as a 
result of the uninsured, we are talking over 10 years about $2 trillion 
by that estimate.
  We can choose to stay on the road we are on, which means we lose more 
than $200 billion every year because of what is happening to the lives 
of people who don't have health insurance. It is not free. By one 
estimate, every person pays about $1,000 a year because others are 
uninsured. The idea that if we cover more people somehow that is going 
to cost people money, it is already costing people money today.
  I argue we should abandon the idea of doing nothing. We should 
abandon and not even discuss the idea of staying on the road we have 
been on. The road we are on right now means people in Pennsylvania will 
pay more than half their income to health care, will continue to be 
part of the loss of revenue of over $200 billion each and every year. 
And finally, small businesses won't be able to make ends meet with 
those kinds of numbers.
  We will continue to talk about costs and how we can reduce cost. That 
is an essential item and priority in this debate. But we also have to 
talk about what is happening to people right now and what is the cost 
of doing nothing. The cost of doing nothing is far too high for any 
American and, candidly, for any country to sustain. We cannot stay 
where we are now. We have to bring about change. I believe we will do 
that this year, if we choose to be on the right team in this debate.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Udall of Colorado). The clerk will call 
the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. DORGAN. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DORGAN. While we are waiting for colleagues, some of whom will be 
offering amendments, I wanted to describe briefly an amendment I am 
going to offer.
  Let me describe an executive order that was established by President 
Clinton in 1993. That executive order was titled ``Deficit Control and 
Productivity Improvement in the Administration of the Federal 
Government.'' Essentially what the President did in 1993 was require 
Federal agencies to delineate between their program costs and their 
overhead costs or general administrative costs. He wanted to begin 
cutting overhead or administrative costs.
  The first thing a business will do, by and large, to deal with a 
downturn in business, is to begin tightening their belt on 
administrative or general overhead expenditures. We can't yet do that 
with Federal agencies, because there is no distinction between program 
costs and administrative or general overhead costs. The minute you 
propose any reduction, they say: OK, what you are doing is you are 
trying to cut these programs.
  President Clinton issued an executive order in 1993 that required 
Federal agencies to separate out and report their administrative and 
general and administrative overhead expenditures versus program costs. 
Almost none of the agencies complied. So I began discussing with my 
colleague Senator Coburn legislation that we have since introduced. We 
may be an odd couple; we have different records on some issues, though 
not all. In any event, we decided to introduce legislation that would 
reinstate the requirements of the 1993 executive order, but in this 
circumstance make it stick and then, ultimately, begin a reduction in 
overhead expenditures.
  The first step of that is to get the information with each of the 
major Federal agencies on what is general and administrative overhead 
expense and what are their program expenditures.
  Let me give you some examples of administrative waste that are real 
head scratchers.
  When the Transportation Security Agency was first created some years 
ago, they had to hire airport screeners. That gave rise to some 
unbelievable

[[Page 19490]]

overhead costs in trying to recruit. We held a hearing on this. They 
had 20 recruiters begin a 7-week stay at the Wyndham Peaks Resort and 
Golden Door Spa in Telluride, CO, a luxury resort hotel with an 18-hole 
golf course. After 7 weeks, the recruiters had hired a total of 50 
people. On some days only one or two applicants showed up, but they 
hung in there. They also, as I began to investigate that, had 
recruiters show up at the Waldorf Astoria to interview people; the 
Manele Bay Hotel in Lanai, HI; Hawk's Cay Resort in the Florida Keys. 
They were recruiting people and having a grand time of it, and in the 
end they spent $700 million in this manner.
  A couple years later TSA spent $1 million on an awards banquet. They 
hired a party planner for $85,000, three balloon arches for the party 
for $1,400, seven cakes for $1,800, and $1,500 for three cheese 
platters. That is some cheese.
  I don't mean to pick on the TSA alone. For example, the Bureau of 
Indian Affairs spent $28,000 to send 14 of its most senior staffers to 
a 4-day Tony Robbins motivational seminar. Overhead? It seems to me it 
is not overhead anybody ought to be supportive of. The participants in 
that seminar were trained on how to ``shed excess weight quickly and 
enjoyably,'' and how to ``reignite the passion in your physical 
relationship.'' They were also asked to walk on hot coals with minimal 
training. The $28,000 from the Bureau of Indian Affairs could have paid 
the annual salary of a fifth grade school teacher at an Indian school.
  A week or two ago, the Bureau of the Public Debt at the Treasury 
announced it would hire a consultant to teach employees how to be funny 
in the workplace. The consultant was going to teach staff through the 
use of cartoons. I pointed out that there is very little funny to the 
taxpayers about the public debt. They scrapped that. In fact, I got a 
fairly upset letter from the cartoonist who bid the project.
  My point is, there is fat in government agencies, especially the big 
agencies that have grown and have never had to trim overhead and 
general administrative expenses.
  That brings me back to the Clinton order of 1993 that has never been 
complied with by Federal agencies, a Presidential order that directed 
certain things for which there has been no action. Senator Coburn and I 
introduced S. 948 with the objective of reviving that executive order 
and having the information by which to begin trimming back some or belt 
tightening some with the Federal agencies on overhead expenditures. I 
will not offer that bill in its entirety as an amendment to this 
legislation, but I will instead offer an amendment that represents a 
first step, which is that the Federal agencies will identify their 
overhead and general and administrative expenses, separately from 
program expenses. We need to know and should know.
  My hope is, once we do know that information, we will be able to at 
least initiate some belt tightening because with the kind of Federal 
budget deficit we have--deficits are growing; I think they are 
unsustainable and very dangerous for our country--we need to be 
tightening our belt in a wide range of areas.
  The legislation we have introduced would begin to accomplish that. 
But in order to accomplish that, the first step must be to get the 
understanding of what the separate expenditures are of general 
administrative expenses and overhead expenses. So I will be offering 
that amendment as we go along.
  We will be here apparently for a longer period of time, and at some 
appropriate moment, I will offer that amendment and hope for its 
inclusion in this legislation.
  Mr. President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER. Will the Senator withhold his request?
  Mr. DORGAN. Mr. President, I will be glad to withhold my request.
  The PRESIDING OFFICER. The Senator withholds.
  The Senator from Illinois.
  Mr. BURRIS. Mr. President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. BURRIS. Thank you, Mr. President.


                           Health Care Reform

  Mr. President, as the national debate over health care reform rages 
on, some complain about the inherent inefficiencies of government 
programs. Some are frightened by the prospect of Washington bureaucrats 
deciding what treatment people receive. But these skeptics always fail 
to mention the massive inefficiencies--and widespread denial of 
coverage--that is already present in the private market.
  Private insurance companies are accountable to two groups: their 
customers and their shareholders. The competing interests of these two 
groups make for a dangerous tightrope walk for insurers. Paying off too 
many claims, or keeping insurance premiums too low, may lower profits 
and anger investors. Paying off too few claims, or raising premiums too 
high, could cause consumers to choose a different plan--if one is 
available.
  The problem is that consumers do not have options. In the past 
decade, we have seen unprecedented consolidation in the insurance 
industry. We have seen over 400 corporate mergers involving health 
insurers over the past 13 years.
  Mr. President, 94 percent of the Nation's insurance markets are now 
considered ``highly concentrated,'' meaning they pose antitrust 
concerns. These localized monopolies stack the deck against consumers 
because there is no longer real competition or choice.
  The result? At the beginning of this decade, the five largest 
insurers increased their profit margins by at least 50 percent, and two 
of those companies increased margins by over 100 percent.
  It is not surprising that, as the cost of Medicare skyrocketed over 
the past decade, the price of health care insurance has increased at an 
even faster rate. While companies raise premiums, they also work on 
devious new ways to deny claims.
  Many insurers have created barriers to delay and limit care. 
Preauthorization requirements and burdensome, unnecessary paperwork 
mean that health care providers spend more time dealing with insurance 
industry redtape and less time treating their patients. Whole 
industries have sprung up around finding ways to deny insurance claims.
  One insurance company boasted that they are ``Managing the Spiraling 
Cost of Health Care.'' The company claims that their efforts can 
``reduce paid claims costs by up to 10% without changing benefits or 
making claim system upgrades.'' This means taking advantage of 
consumers by denying claims based on mere technicalities.
  Any of my colleagues who believe insurance companies should decide on 
treatment options has never gone through the pain of a coverage denial. 
All of the extra paperwork and administration required to deny claims 
actually costs a good bit of money. And that cost is passed directly--
it is passed directly--on to the consumer.
  What some people do not want to tell you is that government programs 
are actually much more efficient, not less. Administrative costs for 
government insurance programs, including Medicare, Medicaid, and 
TRICARE, are around 5 percent. Private costs are as high as 30 percent 
in the individual market, 23 percent in the small group market, and 
12.5 percent in the large group market.
  These numbers speak for themselves. The insurance industry has become 
distracted by their desire to maximize profits at the expense of those 
who need care. We cannot stand by and watch as the American people are 
taken advantage of, especially in a time of need when someone's health 
is on the line.
  That is why I am proud to support a public plan that will complete--
compete--with private insurers. This option would provide a low-cost 
alternative to the private market, bringing back competition and 
choice. It would press insurers to end their abusive practices and high 
profit margins, and would help eliminate redtape at the same time.

[[Page 19491]]

  No one would be forced to change insurance plans. No one would face 
higher premiums. And no one would need to fear that their coverage 
would be denied by a corporate giant for a few extra dollars' worth of 
profits. A robust public option would help make insurance available to 
those who do not have it, increase efficiencies, and reduce costs for 
every American.
  The time to act is now. We must not let another year go by without 
meaningful reform. I urge my colleagues to join me in supporting a 
strong public option. The time is now. It has been 50, 60, almost 70 
years that we have been working on this program for health insurance 
for all Americans. It is time we get it done.
  Thank you, Mr. President. I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. DODD. Mr. President, I want to take a few minutes, if I may, as 
in morning business.
  Are we in morning business?
  The PRESIDING OFFICER. We are on the bill.
  Mr. DODD. Mr. President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DODD. I thank the Presiding Officer.
  Mr. President, let me take a few minutes, if I may, on the subject 
that I know is the preoccupation of many of us, even if you are not on 
one of the committees. The discussion about health care is, obviously, 
the dominant debate that is occurring here and in our Nation. I know 
our colleague from the State of Montana, Senator Baucus, along with 
Senator Grassley, is working in the Finance Committee.
  As many of my colleagues, I know, are aware, I was asked to fill in 
for Senator Kennedy, who is struggling with his own battles with brain 
cancer, as the acting chair of the Health, Education, Labor, and 
Pensions Committee. We completed, as most of my colleagues are aware, 
our efforts about 2 weeks ago on our portion of the health care debate 
dealing with prevention, with quality, with workforce issues, with the 
fraud and abuse allegations in the Medicare, Medicaid systems, as well 
as coverage questions. The rest is left to the Finance Committee. At 
the end of that process, the goal is to marry these two pieces of 
legislation together in one bill.
  So we made that effort. We spent about 5 weeks with over 23 sessions, 
and considered nearly 300 amendments in that process. In fact, we 
agreed to about 160 of my fellow colleagues' amendments from the 
Republican side--good amendments, I might add. Some were technical, but 
many were substantive, which I think added to the value of the bill.
  While it did not turn out to be a bipartisan bill in terms of the 
votes that were cast, if you can define at least one definition of 
``bipartisan'' to be that the bill itself reflected the contribution of 
ideas from all people, then to that extent this bill is a bipartisan 
bill. But we are obviously waiting until the Finance Committee 
completes its process. I realize people want us, as they should, to 
have a deliberate process, one for which we can say at the conclusion 
we did our very best, that we evaluated the situation as well as we 
could and came up with the best ideas we could to move forward.
  It has been 70 years, as most people know, since we adopted the 
health care system we have in our country. Every President, from both 
political parties, and every Congress, since the 1940s, has grappled 
with this issue unsuccessfully. Obviously, we passed Medicare and 
Medicaid and the SCHIP program and other ideas that I think have 
contributed to a large extent to the health care system we have today. 
But certainly the overall reforms in the system to move from a sick 
care system to a truly health care system have defied resolution.
  So we are at it once again to see if we cannot defy the odds and do 
that which no other Congress and no other government has been able to 
do for more than 65 years; and that is, to come up with an answer that 
will give people primarily a sense of confidence, a sense of stability, 
to take away the uncertainty that many people feel about the present 
health care system.
  Most of us, of course, in this country have health care insurance. A 
lot of those who are insured are underinsured. They have to pay a lot 
of out-of-pocket expenses or have very high deductibles, and so a lot 
of what they may face in terms of a health care crisis has to be paid 
for out of their own pockets. Their insurance coverage does not cover 
them. Others, of course, have no insurance at all. The numbers vary, 
but I think most agree the number hovers around 45 million people who 
are uninsured. There are about 25 million or 30 million who are 
underinsured in the country.
  But, again, I state, most people have a plan they think is pretty 
good and they do not want the government or anyone else fooling around 
with it. So the first principle is to say: Leave well enough alone that 
which is working well. If you like your doctor, if you like your 
hospital, if you like your coverage, leave that alone. We are not out 
to change, nor should we, part of a health care system that works.
  What we are trying to do is fix that which does not work, that which 
is costing us more than any other nation on the face of this Earth on a 
per capita basis--some $2.5 trillion a year. How do we increase access? 
How do we improve the quality of health care? And how do we make this 
affordable so people do not end up paying more and more costs in 
premiums? Of course, how do we provide that sense of confidence, that 
sense of stability, that sense of certainty that a plan will be there, 
Lord forbid, if I need it, if my spouse, my child, or I need that kind 
of health care coverage to pay for that unexpected accident, that 
unexpected illness that could afflict every family.
  It is at that moment, that critical moment, that you want to make 
sure what you have will not put you into economic ruin, because all of 
a sudden the fine print excludes the very kind of coverage which you 
would anticipate based on the policy you have had for years. Or you 
find yourself in a situation where even if it does, it limits the 
amount you can receive to pay for that hospitalization or that care.
  Those stories go on every single day. People want that notion that: 
If you are going to change this, if you are going to reform this, the 
thing I am looking for more than anything else is that I will have the 
confidence of knowing that policy I have is not going to bankrupt me in 
costs and will be there when I need it. That, more than anything else, 
is what we are talking about.
  The problem, of course, is while we are waiting to do this--and, 
again, I emphasize that doing it right is certainly very important. I 
would like to think in our committee, while we did not get unanimous 
support at the end of it, we listened to every one of our 23 Members in 
that committee, over 5 weeks. There was extensive debate and discussion 
over all of these issues. So we have gone a long way, I think, in that 
process.
  But while we are waiting, there is a cost to all of this. Let me 
point out what has happened in terms of the numbers. Mr. President, 
14,000 people every day in our Nation lose their coverage. Again, that 
may be due to job loss, that may be because all of a sudden the plan 
they have does not cover the circumstances they are in. Since we have 
passed our bill in the HELP Committee 3 weeks ago, 182,000 of our 
fellow citizens have lost their health insurance. And 14,000 people do 
every day--again, through no fault of their own: job loss, as I say, or 
discovering that a policy did not cover the events they thought it 
covered and they find themselves in this situation.
  While we are talking about doing this slowly, and waiting a while to 
get it done, it is important, I think, for those of us here who have 
great health care coverage--if you are a Member of the Senate, if you 
are a Member of the Congress, we have a Cadillac health care plan for 
every one of us and our families, as do Federal employees. I certainly 
welcome that. It is reassuring. It certainly gives you that sense, as a 
Member of Congress, that

[[Page 19492]]

you have a stable, certain plan in place if you are unfortunate enough 
to be hit with a health care crisis.
  I merely make that point because, as I say, a lot of our fellow 
citizens do not have that same sense of certainty and that same sense 
of confidence about their health care. Of course, if they are faced 
with a health care crisis, we also know what can happen. We now know 
that 62 percent of the bankruptcies in our country that have been 
occurring over the last several years are health care crisis related. I 
might point out, which I think may surprise some people, that 75 
percent of that 62 percent are people with health insurance. It wasn't 
the person without health insurance who got caught with a tremendous 
health care cost and had no means to pay for it and thus went into 
bankruptcy. Seventy-five percent of those people actually had health 
care coverage. Fifty-four percent of the foreclosures in our Nation are 
related to a health care crisis as well. As I say, 10,000 homes today 
will receive a foreclosure notice.
  So while we are waiting here and trying to get this right--and we 
should--it is important to be mindful that while we are comfortable 
about being assured that we have the coverage, millions of our fellow 
citizens do not have that same sense of certainty and confidence they 
would like to have as well, the certainty and confidence that they are 
not going to get wiped out by rising premium costs to pay for someone 
else, despite the fact that today most families write a check for about 
$1,100 a year as part of their health insurance to cover the uninsured 
who show up in emergency rooms--the uncompensated care, as it is 
called. That is $1,100 a year, on the average, for a family, a check 
they have to write because in our country, if you show up in an 
emergency room and you need health and care, I think virtually every 
medical facility in our country takes you in and they will treat you. 
They will care for you in that moment of an emergency, but it doesn't 
come free of charge. The costs of that are borne by those who pay the 
premiums for their own coverage, and the pricetag per health insurance 
policy, on average, is $1,100 a year. That is a tax we pay today as a 
result of not having a more comprehensive health care system in our 
Nation. So those 182,000 people who have now lost their health care in 
the last 2 weeks, and the 14,000 who will lose it today, some I presume 
will show up in an emergency room because of a condition or a tragedy 
that befalls them. They will get health care under the status quo we 
have today. They will get health care, but the rest of the country will 
pay for it one way or the other. We have to change that. You cannot 
bankrupt the country by having a system that fails to provide for the 
coverage as well as the cost of these matters on the present system we 
are living under. It will not be sustainable, in my view.
  So these numbers are real. They happen every day. The longer we delay 
in getting this done, these numbers will mount. So it is important to 
not do so recklessly, to not do it at such a speed that we don't know 
what we are doing, but we need to keep in mind that as we move along in 
this process, it does not come without a cost to those out there who 
find themselves in that free-fall, that terrible feeling--that terrible 
feeling that if something happens, I can't take care of my family.
  The PRESIDING OFFICER. The Senator has reached his 10 minutes.
  Mr. DODD. If I may, I will ask unanimous consent to proceed for 1 
additional minute.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DODD. Again, there are stories of people in my State, as I know 
there are all across this country, who are losing this. I was going to 
tell the story of Mrs. Carrasco in Hartford, CT. She now skips her 
examinations, such as her colonoscopy and others things, because they 
are not paid for under her policy. Several months ago, she said she had 
an infection but didn't go to the doctor because she was afraid it 
would cost too much. Again, doesn't go and the problems can get worse.
  Another woman in Connecticut, by the name of Theresa, has a cluster 
of autoimmune disorders including rheumatoid arthritis and connective 
tissue disease. Because she doesn't have health insurance, she doesn't 
see the doctor. Those problems are going to get worse and she is going 
to show up and the cost goes up. So stability in terms of what we have, 
making sure the cost of these premiums doesn't outstrip the ability of 
working families to meet them, is certainly a great challenge before us 
as well as improving the quality of care for all Americans.
  Lastly, I would just say I spent a good part of Saturday this last 
weekend at the Manchester Memorial Hospital in Manchester, CT, looking 
at their new ICU unit as well as meeting with hospital personnel. It is 
remarkable what small hospitals do all across our country and how well 
they serve the people in keeping down costs and increasing quality. 
Many of our hospitals do. Our providers are truly good Samaritans in 
case after case after case. The nurse practitioners, the doctors, and 
others who support the health care professions do a remarkable job 
every single day. But we need more primary care physicians, we need 
more nurses, if we are going to meet the demands of a growing 
population who has coverage. But we truly need to reform this system; 
leave in place that which works, fix that which doesn't. That is the 
goal the President has laid out for us.
  That is our collective responsibility. I am confident we can do it. 
If we will sit down with each other and work through this process, we 
can achieve that result to bring that level of stability and certainty 
that people want when it comes to their health care needs.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Delaware.


                           Amendment No. 1841

  Mr. CARPER. Mr. President, I wish to return to the underlying bill. 
Senator Voinovich and I have offered an amendment, and I think it is 
No. 1841. I am not going to call up the amendment now, but I wish to 
talk a little bit about it.
  As the chairman and our colleagues know, we receive in this country 
probably 20 percent of the electricity that we consume from nuclear 
powerplants. All those nuclear powerplants were built several decades 
ago. We have about 104 in all. A number of them are 40 years old. They 
were licensed for 40 years and the utilities that own those powerplants 
have to come back to the Nuclear Regulatory Commission and ask for an 
extension, if you will, on the life of a license. They are asking for 
20-year extensions.
  The Nuclear Regulatory Commission has many jobs and one of those is 
to make sure the 104 nuclear powerplants that are in operation are 
operating safely every day. I like to say if it isn't perfect, make it 
better, to create a culture of safety and to make sure we don't have 
mistakes and errors that can cause great havoc.
  In addition to that, the Nuclear Regulatory Commission is charged 
with--these nuclear powerplants are approaching the end of their 
license, their 40-year license, and so they apply for extensions. The 
Nuclear Regulatory Commission has to go through with the utilities that 
own the plant the relicensure process. Add on to that, the Nuclear 
Regulatory Commission has now, I think, 18 applications to build 28 new 
nuclear powerplants in this country in the decades to come. Add to 
that, there are a number of new designs for nuclear powerplants that 
the Nuclear Regulatory Commission has to say grace over, to evaluate, 
to wrap their brains around and to understand how they would work and 
whether they would work safely for 40, 60 years. In short, the Nuclear 
Regulatory Commission has a lot on its operate plate, which is a good 
thing.
  Nuclear power provides, among other things, electricity for 20 
percent of our Nation's households and businesses and so forth, but it 
also provides electricity that is carbon free. The emissions from 
nuclear powerplants do not include carbon dioxide, do not include 
sulfur dioxide, do not include nitrogen dioxide, which bothers our 
breathing apparatus; does not include mercury which leads

[[Page 19493]]

to brain damage in unborn children. Nuclear powerplants don't put any 
of that into the air. They don't contribute to the problems of global 
warming.
  In order to make sure they are doing their job and the folks at 
nuclear plants and utilities are doing what they need to do to provide 
safe nuclear power, the NRC has had to hire extra people. They have 
hired, I think, in the last year or two or three, about 1,000 extra 
people. They have them spread out at different locations. The Nuclear 
Regulatory Commission is interested in trying to consolidate as many of 
those people as they can for management purposes. I think it makes a 
lot of sense. Senator George Voinovich of Ohio, who has helped me at 
one time or another, and I have helped him, to lead the Senate 
Subcommittee on Clean Air and Nuclear Safety--we believe it makes sense 
for the Nuclear Regulatory Commission to collocate many of their 
employees going forward.
  We want to make sure, and we seek to do it with the language in 
amendment No. 1841, that the NRC can use the language within the bill 
and for employee costs and other expenses to be able to get this 
collocation process underway and provide additional spaces if they are 
needed for an additional 1,000 employees. So my hope is our colleagues 
will adopt this amendment.
  I would also say the Nuclear Regulatory Commission does a competition 
with, I think, every other Federal agency. It is a competition we don't 
hear a lot about, but the competition is for the recognition of best 
federal agency to work for, best for employees, best for their 
families, and for the last two or three years, the Nuclear Regulatory 
Commission has been selected as the very best place for Federal 
employees to work. They do important work. They work hard. But they 
also work in an environment where the employees feel it is good for 
their life--not only their professional life but also their families 
too. They have asked for this help from us and Senator Voinovich and I 
are pleased to lend our support and we hope our colleagues will join us 
in supporting amendment No. 1841.
  With that being said, I note the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. DORGAN. 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. DORGAN. Mr. President, we are waiting to try to see if we can 
have a vote on an amendment that has been offered. We, again, would ask 
colleagues to come and offer their amendments. We have been patiently 
waiting, Senator Bennett and I, to see if we could get amendments 
debated and voted upon.
  I have a photograph I wish to show on another matter. I ask unanimous 
consent to speak as in morning business for 5 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                      Electrocution Deaths in Iraq

  Mr. DORGAN. Mr. President, at 8:30 p.m. on January 2 in 2008, fellow 
special forces soldiers found SSG Ryan Maseth on the floor in the 
bathroom at a security forces building in Baghdad, Iraq. His mother 
Cheryl Harris was originally told, when she was informed her son had 
died, that perhaps he had been in the shower with a radio and had been 
electrocuted. He clearly had been electrocuted when he was found 
unresponsive in January of last year.
  But Cheryl Harris, she wanted to get to the bottom of this, and she 
would not let this drop. I held two hearings on this subject. We 
discovered that Kellogg, Brown, and Root had been in charge of fixing 
widely reported problems at the shower facility where Sergeant Maseth 
had been electrocuted, and had failed miserably.
  Well, this week we obtained an inspector general's report, which 
shows that there were 230 electrical shocks of American soldiers in 
facilities in Iraq because they weren't wired properly. Kellogg, Brown, 
and Root was the contractor, and they failed miserably. In fact, they 
were awarded $83 million in award fees, bonuses, for excellent work, 
which we now know was improper. They hired third country nationals who 
could not speak good English and didn't know the standards and, in many 
cases, didn't even do basic grounding of the wiring. We know that Staff 
Sergeant Maseth was electrocuted. We know there was a young man power-
washing a Humvee who was electrocuted. We know that the U.S. Army 
criminal investigation is now investigating a number of these 
circumstances.
  But when I held the hearings, there was denial all around by Kellogg, 
Brown, and Root; no, we did great work, they said. By the Pentagon, the 
Defense Department; no, things were fine, they initially said. It turns 
out that wasn't the case. We had to ultimately get an inspector general 
to give us the facts. It is not only on this case. The same thing 
happened on contaminated water brought to the military bases in Iraq. I 
held two hearings. The Pentagon denied that KBR had provided unsafe 
water to our troops. Kellog, Brown and Root--Halliburton, rather, in 
that case, denied it. But I asked the inspector general to investigate, 
and they confirmed it. Nonpotable water that was more contaminated than 
raw water from the Euphrates was sent to our soldiers at bases in Iraq.
  These are two inspector general reports. Inspector General, U.S. 
Department of Defense. There are two of them. They tell us what has 
been the result of improper wiring of facilities in Iraq. ``In the 
remaining 9 cases,'' they say, talking about electrocutions, not about 
the 230 electrical shocks--I am talking about the nine who died. ``In 
the remaining 9 cases, we determined that individuals were killed by 
improper grounding or faulty equipment. The equipment malfunctions 
could have related to whether equipment maintenance complied with 
proper electrical standards, or whether the respective chain of command 
acted responsibly in protecting servicemembers. As of June 30, 2009, 
five of those nine cases remained under criminal investigation.''
  Until I did the hearings, these were largely unknown. Even when I did 
the hearings, KBR insisted that it had done nothing wrong.
  In the case of SSG Ryan Maseth, specifically, let me read from the IG 
report:

       An engineering evaluation of the failed pump [this is a 
     pump that serviced the building] determined that insulation 
     on the internal wires melted, causing a short to the metal 
     pump housing. Failure to ground the pump and improper 
     grounding of the building electrical system allowed the metal 
     pump housing and water distribution pipes in the building to 
     energize.

  This says this soldier was electrocuted while taking a shower because 
contractors didn't do their job. It is not me saying that. I had 
hearings in which people working for that contractor showed up at the 
witness table and said: We worked next to people who didn't know what 
they were doing, and it subjected these soldiers to great risk.
  As I indicated previously, in the Department of Defense, for this 
work, which we now know was shoddy work and improper work that put 
soldiers' lives at risk, for that work, this contractor got $83 million 
in bonus awards. It is unbelievable to me that this sort of thing goes 
on.
  I think there are some in the Pentagon, in the chain of command, and 
certainly contractors, who have a lot to answer for. This Congress 
ought to insist upon it.
  This mother of this soldier, Cheryl Harris, wasn't going to let this 
drop. Good for her. That is why I held these hearings to determine what 
is the truth, because we didn't get the truth from the people who 
talked to the mother of the soldier who died. In the hearings, 
witnesses who previously worked in Iraq told us that the KBR's wiring 
was improper. Now we get the truth from the IG report. We should not 
have to wait for the IG to confirm these things.
  I would think the U.S. Defense Department would search more 
aggressively for the truth than anyone because it was their soldiers 
who were

[[Page 19494]]

put at risk. Regrettably, the Defense Department has not pursued this 
with the zeal you would have hoped for. It doesn't matter whether it 
was the sodium dichromate case, where soldiers were exposed to the 
risks of cancer because of the water brought to the bases, which was 
more contaminated than raw water from the Euphrates. There were four or 
five cases. The contractor said it did nothing wrong in each case, and 
the Pentagon by and large said that KBR had done nothing wrong; but the 
inspector general said that the problems were real, and documented how 
the contractor had failed, and the Defense Department had failed to 
hold the contractor accountable.
  This Congress deserves better than that from the Defense Department, 
the taxpayers deserve better, and a mother such as Cheryl Harris should 
not have had to wonder whether her son was in mortal danger through the 
mere act of taking a shower.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon is recognized.


                           Health Care Reform

  Mr. WYDEN. Mr. President, I want to take a few minutes this afternoon 
to discuss the recent developments on the health care issue and 
particularly with Senator Bennett on the floor, my friend and 
colleague, and the effort to make sure health care reform is 
bipartisan. Also, Senator Baucus and Senator Grassley on the Finance 
Committee, on which I serve, are putting in killer hours now in an 
effort to come up with a bipartisan approach in the health care area.
  I wanted to take a few minutes and talk about a particularly 
important part of the health care debate, and that is what the middle 
class is looking for in terms of health care reform. I think when you 
talk about middle-class folks, most of whom have health care coverage, 
they are looking for a way to be wealthier, they are looking for a way 
to be healthier, and they want to make sure that if they leave their 
health care coverage, or their coverage leaves them, they can get 
portable coverage.
  Perhaps as much as anything, middle-class folks want choice. They 
understand--and this is a matter that Senator Bennett and I have talked 
about often--that if you are going to come up with a health care reform 
effort that is going to save money, create incentives for people to 
stay healthy and services to offer prevention, and coverage that is 
portable, you have to give everybody the chance to choose those kinds 
of health care plans and those services.
  The President, to his credit, has made the matter of guaranteeing 
choice--what I have put up here on the chart--President Obama has said 
that is one of his bedrock principles for health care reform. The 
President has said every American must have the freedom to choose their 
plan and their doctor. He clearly is on target when he talked about 
choice being one of the best ways to hold health care costs down, 
reward people for staying healthy and getting coverage that is 
portable.
  For example, every Member of Congress has the capacity to choose a 
plan that is more affordable for them. When the sign-up period comes in 
the beginning of each year, you get a menu of various health services, 
and you want to choose the one that is the most economical for you, the 
one that rewards you for staying healthy. All Members of Congress have 
the opportunity to do that. The President is absolutely right in saying 
that choice ought to be a bedrock principle of health care reform. 
Clearly, that is what middle-class folks in Colorado, Utah, and Oregon 
are looking for; they want to make sure they have choices. Frankly, 
they wish to have as many choices as we have in the Congress.
  So Americans want these kinds of choices. But for too many of our 
citizens, under the health care reform bills that are now being 
considered in the Congress, lots of people won't have the kinds of 
choices that Members of Congress have, or any choice at all. There are 
proposals in the Senate to create what is known as firewalls, to keep 
people from being able to go to what is a ``farmer's market''--they are 
called insurance exchanges--where people could get these kinds of 
choices, and these exchanges are to be created in the reform 
legislation.
  As odd as it sounds, Congress is going to be creating these insurance 
exchanges, designed to help people shop around for their insurance, but 
then limit who can shop at these exchanges. If you have coverage, for 
example, and somebody in the government says you ought to consider it 
affordable, you ought to like it, you are not going to be able to go to 
this ``farmer's market,'' this exchange, and shop for a plan that is 
better for you and your family. You aren't going to be able to enjoy 
more choices; you aren't going to be in a position to get more for your 
health care dollar. You aren't going to be able to get an affordable 
package, because only some people will be allowed at these exchanges.
  I think everybody ought to be able to shop for their health care 
insurance like Members of Congress do today, and like our esteemed 
colleague Senator Kennedy called for in a very fine essay last week.
  I have been able, working with colleagues, to come up with a way to 
do that. I call it the Free Choice proposal. Our Free Choice proposal 
lets workers who like what they have keep it. But it also lets workers 
who don't like what they have choose other plans. Half of those 
fortunate enough to have employer-sponsored insurance today don't have 
any choice of health plans at all. Think about that. Most Americans 
don't have the capacity to choose, like we can here in the Congress.
  Unfortunately, under the health care reform plans that are being 
considered in the Congress, we are still going to leave millions and 
millions of Americans without a choice of health services and health 
care plans. Under our Free Choice proposal, everybody who has employer 
coverage is going to have new choices. They can certainly keep what 
they have. But if they choose, they can take what their employer now 
pays for their insurance and go to the ``farmer's market'' and buy a 
plan that is a better fit for them and their families.
  It also gives employers more options. If the insurer isn't going to 
sell them an affordable plan, the employer could then take the whole 
group to the exchange and get a discount.
  What the distinguished Senator from Utah and I have been talking 
about these many months is something that would give more clout to 
workers and more clout to employers on day one. It would give employers 
and workers the ability to save money at the get-go, largely through an 
old-fashioned concept that is about as American as we have, which is 
choice and freedom, and the ability, when you shop wisely, to benefit 
financially and, particularly, our employer approach, where the 
employer could take the worker to the exchange on day one and get a 
discount. That the employer could get a discount is one that, in my 
view, is going to give employers the bargaining power in negotiating 
with insurers that they don't have today.
  This is a proposal we can do without making any adjustments to the 
Tax Code. The independent analysis Senator Bennett and I got a few days 
ago indicates we could save consumers $360 billion over the next 
decade. Those are savings to our people. Those are savings in the 
health care system. It is an approach that is very much in line with 
what the President has identified as a bedrock principle for health 
reform.
  I have talked about the value of choice, particularly this August in 
Colorado, North Dakota, and around the country being able to tell all 
middle-class people they are going to have more choices. But what I 
think is particularly useful about the Free Choice proposal, it is one 
of the pathways to getting more affordable coverage because once you 
have these choices, just like Members of Congress--if at the beginning 
of the year the Senator from Colorado does not like one particular 
plan, he can go to one of the other plans that is a better fit for him 
and his family. We are talking about using the same principles that 
have worked for Members of Congress for many years.

[[Page 19495]]

  I believe that middle-class folks, as they try to sort through this 
debate, are going to be looking at a handful of fairly straightforward 
principles. They are going to want to be wealthier, they are going to 
want to be healthier, they are going to want coverage they can take 
with them from job to job.
  We have had 7 million people laid off since this recession; 3 million 
of them do not have health care. What happens to them is they go into a 
program called COBRA. COBRA is the only Federal program named after a 
poisonous snake. Given how hard it is for people to afford that 
coverage and all the bureaucracy for employers and employees, we can do 
better by both workers and employers. Let's make coverage seamlessly 
portable. Senator Bennett and I have included that in our Free Choice 
proposal. On day one, more choices for the middle class. On day one, 
the opportunity to save money. If you don't like the first plan, choose 
one of the other plans. On day one, coverage that is portable. That is 
what I think middle-class folks are looking for.
  That kind of market competition is what the Congressional Budget 
Office has scored as actually producing savings in the private sector, 
not in 10 years, not in 15 years, but in a matter of 2 or 3 years. It 
actually bends the cost curve downward without exploding the debt and 
the deficit.
  I hope my colleagues on the Finance Committee and here in the Senate 
and on the HELP Committee--I had a very constructive conversation about 
the Free Choice proposal with Chairman Dodd recently. I hope colleagues 
will see this is an approach that can win bipartisan support.
  The guarantee of choice is a bedrock principle in President Obama's 
agenda. For the middle class who is asking now how this is going to 
work, this is the path that is going to let middle-class people be 
wealthier, healthier, and protected when they lose their job or if they 
want to get another opportunity. I am very hopeful that this bedrock 
principle of President Obama's agenda for fixing health care can win 
the support of colleagues on both sides of the aisle because I think 
that is the pathway to responding to the question middle-class people 
are asking all over this country today: How we are going to make this 
work for them?
  I hope colleagues who have additional questions about it will see my 
friend from Utah or me. We will be happy to discuss it with them 
further.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Utah.
  Mr. BENNETT. Mr. President, I know we are on the bill. As the manager 
on the Republican side, I want to stay on the bill, but, my colleague 
from Oregon having raised the issue with respect to the consumer choice 
and our proposal, I ask unanimous consent that I can proceed as in 
morning business in order to respond.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BENNETT. Mr. President, I am grateful to Senator Wyden for the 
leadership he showed here and the tenacity with which he has pursued 
all of these issues. As I have sat here and listened to the various 
interventions in morning business about health care, I found the common 
theme that I want to comment on with respect to it. I think Senator 
Wyden's comments helped me frame this theme.
  The theme I have heard over and over again from speakers has been: We 
can't stay where we are. And then the argument has been framed: We 
either have to move ahead with the President's program or stay where we 
are. As Senator Wyden has indicated, there are other alternatives 
besides moving ahead with the President's program and staying where we 
are.
  I would like to draw this analogy that I hope will help us understand 
at least this Republican's position. I won't try to speak for all 
members of my party, although I think many of them would be sympathetic 
with what I am about to say.
  Let's assume your neighbor's house is on fire. This is a serious 
problem. Your neighbor comes to you and says: My house is on fire. Lend 
me your garden hose so I can put the fire out.
  And you say: My garden hose isn't long enough to reach the fire.
  You don't understand, your neighbor says, my house is on fire. There 
are children in the house. There are women in the house. They will die 
if you don't put out the fire. Lend me your garden hose.
  I respond or you respond: I understand there are children in the 
house. I understand allowing the house to burn down is a tremendous 
mistake. But my garden hose won't reach. We need a different garden 
hose if we are going to put out the fire.
  No, no, no, the fire is reaching now, it is down, it has destroyed 
the top stories, it is getting down to the bottom stories; people are 
fleeing. Give me your garden hose or you are a terrible person.
  And you respond: I will be happy to give you a garden hose that would 
work, but the garden hose I have right now will not solve your problem.
  We need that kind of an understanding here.
  I am not a Republican who says: I defend the present system. I 
listened to the speeches being made about how terrible the present 
system may be, and I say I agree with them absolutely. I listened to 
the letters being read from home States that say: I was denied coverage 
by an insurance company bureaucrat. I lost my job and I lost my 
coverage. These are tragic, and I agree they are tragic, and I agree 
something ought to be done about it. It is just that, in my opinion, 
the President's garden hose will not reach. In my opinion, the 
President's garden hose will not only not put out the fire but, to 
stretch the analogy beyond all credulity, will make it worse. We heard 
about people who are being denied coverage under the present system. 
People will be denied coverage under the President's system.
  If we look at other countries that have adopted similar public plans 
of the kinds we are talking about, we are going to see people whose 
coverage is denied again and again. Indeed, the comment was made about 
Senator Kennedy and the brave battle he is putting on against his 
problem. If he lived under the single-payer coverage of other 
countries, he would be denied coverage because of his age. We don't 
want that in America. We don't want people like that to be denied 
opportunities.
  Senator Wyden and I have worked as hard as we can--back to the 
analogy--to create a garden hose that will reach, to create a garden 
hose that will, in fact, put out the fire, solve the problems, and 
change the present system.
  I thank the Senator from Oregon for making it clear that there are 
alternatives to the present system that are not necessarily the bills 
that are coming out of the two committees.
  I am not going to embarrass my friend from Oregon by insisting that 
he take the same position I take with respect to the bills that are 
coming out of the two committees, but together we have formed a 
solution that we think will solve the problem, we think will put out 
the fire, we think will turn down the cost curve. And we have now a 
growing chorus of voices of people who are saying: You know, Wyden-
Bennett looks as if it will work; why don't we try it.
  The only question I am asking here is, Why don't we try it? So far, 
neither committee has been willing to look at the details of what we 
are talking about. All we are asking is that they do so because we are 
convinced that when they do, they will come to the conclusion that our 
garden hose will, in fact, put out the fire and it will do it more 
cheaply and more efficiently than the proposals that are before us.
  Again, Mr. President, I thank my colleague from Oregon for his 
leadership and his tenacity in going forward with this proposal. I am 
honored to be associated with him in this effort. I agree with all of 
the speeches that have been made that the present system is not 
acceptable. I hope we can get together and solve the problem in a truly 
effective and bipartisan fashion.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Kaufman). The Senator from Oregon.

[[Page 19496]]


  Mr. WYDEN. Mr. President, I wish to take an additional minute. I 
thank my friend from Utah.
  What is striking about this debate is the opportunity to bring both 
sides together. As I outlined the Free Choice approach and the pathway 
to savings for middle-class folks--portable coverage, incentives for 
prevention--it could work its way into a variety of different bills 
that are being considered. Obviously, Senator Bennett and I feel very 
strongly about our legislation, the Healthy Americans Act, but I was 
very pleased with the discussion I had the other night over dinner with 
the distinguished Senator from Connecticut, the chairman of the HELP 
Committee, who has some good ideas as well.
  What I hope we will do, what Senator Bennett and I have sought to do 
lo these many months, is focus on some bedrock principles. I cited the 
three that have been important to President Obama: the question of 
holding down costs, ensuring choice, maintaining quality.
  I believe--Senator Bennett and I have worked together on this--that 
our approach with Free Choice in particular making sure we don't have 
all these firewalls that would prevent choice for millions of Americans 
would--would actually reward Americans for shopping wisely.
  I was very glad that both Chairman Baucus, who said he would look at 
our Free Choice proposal, and Chairman Dodd, the same openness at 
looking at our proposal, captured that this would be a way to carry out 
the President's agenda for addressing the questions middle-class people 
are talking about all over the country.
  Obviously, Senator Bennett and I--and I am very pleased the 
distinguished Senator from Delaware has joined us. He is certainly a 
veteran of the Senate and what it takes to come up with bipartisan 
coalitions. I am very pleased to be on the floor with two good friends 
who know a lot about health care and what it takes to build bipartisan 
coalitions.
  What I wanted to do was to say that in addition to our legislation, 
which we obviously feel strongly about, this concept of Free Choice and 
making sure you reward individuals, as we do in so many areas of 
American life, could really pay off quickly for middle-class people in 
terms of savings and access to quality health care.
  I am very hopeful that as we go into these last couple of weeks 
before the recess--and we have offered this proposal to Chairman 
Baucus, the chairman of the committee on which I serve--Democrats and 
Republicans can come together so that before the August recess, we will 
have at a minimum identified some ideas.
  Our Free Choice proposal is just one that will allow us through the 
month of August to show middle-class people that we are serious about 
their concerns.
  Right now they are trying to sort this debate out. Suffice it to say, 
they see a lot of arguing in Washington, DC. They hear a lot of the 
discussion about health care, which almost sounds like gibberish when 
you listen to all the technical lingo. If we can come back with ideas 
such as Free Choice and say: Look, middle-class people, you and your 
family can be part of a system that is very similar to what my family 
enjoys--and it has paid off for my family at the beginning of the year 
when I was choosing a plan that is more economical for me, or rewards 
prevention--then we get behind proposals that bring Democrats and 
Republicans together. I point out this is one area that the budget 
office has indicated will actually score substantial savings--not in 
10, 12, 14 years from now, but in the second year after it is fully 
implemented.
  I thank my colleague from Utah for all his support and counsel.
  I yield the floor.
  Mr. BENNETT. 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. DORGAN. 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. DORGAN. Mr. President, Senator Bennett and I are similar to the 
Maytag repairman in the old commercials, waiting for someone to come 
and offer amendments. Many have been filed. No one, apparently, has 
come to the floor to offer amendments.
  I would not be surprised if at some point down the road someone will 
say: Well, we did not get enough chance or opportunity to offer 
amendments. Of course, in these intervening hours, there has been 
plenty of opportunity for someone to show up to offer amendments.
  We had intended and hoped to have a vote at 4:30 on a relatively 
noncontroversial amendment. But for the last hour or so, we have been 
waiting, on a noncontroversial amendment, for a staff person to contact 
the Senator who is apparently not able to be contacted to tell us 
whether the Senate can vote on a noncontroversial amendment.
  Such is the life of the Senate, a place where no one has ever been 
accused of speeding. We only ask, having been here now yesterday and 
today, Senator Bennett and I only ask, having put together this bill 
that funds all of our energy and water issues, if there are Senators 
who wish to offer amendments--and many have been filed--they would come 
here and decide to offer them because we will not have floor time for 
the entire week this week. We are not going to be able to be on the 
floor. The time does not exist to allow us to be here all week.
  Those Senators who wish to offer amendments are, it seems to me, 
going to find very little sympathy from me, and I hope from other 
Members of the Senate, if they at some point down the road say: Well, 
we did not have an opportunity. They have had plenty of opportunities. 
It is they have chosen not to come to the floor to offer amendments.
  It may be they feel the amendments do not have merit or are not very 
important or whatever. But if they do have merit and are important--I 
assume some do--I would hope they would come soon and give us the 
opportunity to entertain amendments and discuss them, debate them and 
have votes on them so we can move this appropriations bill along.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island is recognized.
  Mr. WHITEHOUSE. Mr. President, I ask unanimous consent to speak as in 
morning business for up to 15 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                              Health Care

  Mr. WHITEHOUSE. I would let the distinguished floor manager and the 
distinguished Senator from Utah know that if someone does come to the 
floor and wishes to do their thing with an amendment, please feel free 
to give me the high sign and I will conclude my remarks and allow the 
business of the floor to proceed. I do not wish to keep anybody from 
offering an amendment, if they have one.
  But I did wish to take the time to talk for a minute about our health 
care system because I think people across the country are, right now, 
finding our dialogue in the Senate a bit confusing about health care, 
and they are starting to wonder what is going on. In particular, 
particularly for those who have insurance: What does this mean for me? 
Why is this important for me that the Senate be doing this work? I 
already have insurance. What do I stand to gain from all this?
  There are a great number of things Americans stand to gain from all 
this. But the issue I wish to focus on today is improvements in our 
delivery system. It is important for Americans who are listening to 
realize that the personal experiences so many of them have had are not 
unique. If you have had a loved one in the hospital and you have felt 
constrained to stay with that loved one through their illness in the 
hospital, if you have felt you could not leave them alone in that 
hospital for fear that something might go wrong, some drug might be 
misadministered, some call might go unanswered, if you feel that way, 
if you have had that experience, you are not alone.

[[Page 19497]]

  That is an extraordinarily common experience. If you have felt you 
missed an opportunity for the prevention of illness, nobody told you 
that you should have had this test, nobody told you this was a health 
consequence of something you were doing, that is an experience 
Americans have across this country.
  If you have had to ferry by hand your health records from place to 
place or if, similar to many Rhode Islanders, you have been rushed up 
for emergency specialty care in Boston and your paper records did not 
come with you and you have been in real peril in a Boston emergency 
room as they try to redo the tests they did not have access to because 
you did not have a comprehensive electronic health record, you are 
similar to many Americans.
  The consequences of that, of those problems, are renown throughout 
the health care system. The problems they cause are real ones. There 
are 100,000 Americans who die, who lose their lives every single year 
because of completely avoidable medical errors, most of them hospital-
acquired infections. That is intolerable. That is a plane crash a day. 
Yet it is the status quo in the existing health care system.
  We have the worst health care outcomes of essentially any civilized 
developed country we compete with. The worst. Even though we pay twice 
as much per person for our health care than most of them, we have worse 
outcomes. That is the status quo of our health care system. The 
Economist magazine has reported that the health information technology 
infrastructure that supports our health care sector is the worst of any 
American industry, except one, the mining industry.
  That is not very reassuring, not in an industry where the 
possibilities for technology are so great, and where at the detection 
end and where at the treatment end, we are at the technological cutting 
edge of the world, but you get back to that back office and there you 
are with that paper record and no way to cross-reference for drug 
interactions.
  We are at a primitive stage with our health information 
infrastructure. That is the status quo of our health care system. 
Everybody, I suspect, has had the experience themselves or of a loved 
one who becomes sick unexpectedly who turns to their insurance company, 
the insurance company they have been writing those big checks to year 
after year, only to find out that when you turned to that insurance 
company in your hour of need, they turned on you, they turned against 
you.
  They tried to figure out a way to get you off coverage. They tried to 
talk you out of the coverage and the treatment your doctor has 
indicated. They fought with your doctor about whether they would pay 
it. For many people, the experience is not just of being the patient, 
the experience of being the spouse or the family member or the loved 
one of the patient who has to cope, who has to become the person who 
answers the deluges of mail, who makes the call after call after call, 
who waits through dial tones and through the voice mail and the voice 
messages to try to get to somebody to approve procedures the doctor has 
said you need. That is the status quo of our health care system--
millions of Americans told by their own insurance companies: Forget it. 
We are not going to pay for the treatment your doctor says you need.
  The major reason American families go into bankruptcy right now is 
because of health care expense. It is not just the uninsured. These are 
insured families who find their coverage limits have been reached, who 
find the insurance company has found a loophole, who find they have 
exceeded, in terms of all the peripheral costs of durable medical 
equipment and other things that might not be covered, but it is more 
than they can bear to get by and they are struggling to get by and they 
are dropped into bankruptcy; the most prominent reason American 
families go into bankruptcy.
  That is the status quo of our health care system. Those can all be 
better. We can revolutionize all those areas. We can revolutionize the 
quality of care and the safety of Americans when they are in the 
hospital.
  We can improve our health care outcomes so we are the pride of 
developing nations, and not the lagger. We can improve so we do not 
have the worst health information technology of any American sector. We 
can eliminate denials of care by insurers for preexisting conditions. 
We can provide adequate supports to Americans so bankruptcy is not a 
common symptom of illness in this country.
  The problem is, if we do not do anything about those existing 
problems, they are all going to accelerate. They are all getting worse. 
What do we have to look forward to? Well, we have to look forward to a 
$35 trillion Medicare liability, and we do not have $35 trillion to 
spend.
  That is a future liability. It is coming toward us. The people who 
are going to cause it are alive right now. They are not going anywhere. 
They are getting older every day. Time is not going to stop. And they 
are getting sicker every day because it is never going to happen that 
older people are healthier than younger people.
  There is a tsunami of health care costs bearing down on us. Just the 
Medicare slice of it is a $35 trillion liability for our country, and 
we do not have the $35 trillion. So it is either going to wreck us or 
we are going to have to take some very smart, very aggressive measures 
now to reduce those costs.
  If we do nothing, a family in Rhode Island in the year 2016--that is 
not too far from now; that is 7 years from now--a family in Rhode 
Island making $52,000, which is a pretty good income, a family making 
$52,000 will spend more than half their income on health care. By as 
soon as 2016, a Rhode Island family making $52,000 will spend more than 
half their income on health care.
  We use the word ``unsustainable'' around here. We are headed to where 
it is impossible for regular families to get health care. It is bad 
enough now, and it is getting worse. We have to act to stop it from 
getting worse.
  We have pretty close to lost our car industry. People used to say: 
What is good for GM is good for America. It was the emblematic American 
company. It is gone. It is in bankruptcy, and it is gone. It is now 
coming back out of bankruptcy, but it had to be swept through a 
bankruptcy. The catastrophic effect on our country of the loss of those 
jobs in the Midwest and then through the secondary providers across the 
country is a very real problem, and it is being felt in large part 
because those cars were so burdened with health care costs.
  If you go to Starbucks, there is more health care money in your 
coffee than there is coffee bean money. In those cars, there was more 
health care money than steel. The cost of health care per car was 
greater than the cost of steel per car. It is pretty hard to compete 
with Volvos and the Lexus and cars from places where they have a 
national health care system and the price of the health care is not 
buried in the cost of the car. It put our workers at a terrible 
disadvantage. That is only getting worse, and our manufacturing sector 
has enough problems without continuing to load health care costs on to 
it. If we can't get the message from the collapse of the auto industry, 
we are missing some very loud--indeed deafening--signals.
  Our last Comptroller General warned that this health care mess will 
sink our ship of state. He phrases it as a national security issue to 
get this right. He left the job to go and spread the word around the 
country warning us of what is coming.
  Not only is it bad now, it stands to get a lot worse. Here is the 
opportunity and the tragedy of this: It is that so much of this is 
waste. One recent voice on this subject is a former Cabinet member from 
the last administration. Paul O'Neill was the Secretary of the Treasury 
of the United States. He is no fool. He is a sensible and thoughtful 
man. He ran, for years, Alcoa, one of America's biggest corporations. 
He has extreme business experience. He also ran something called the 
Pittsburgh Regional Health Initiative which looked at improving the 
quality of care of hospitals in the Pittsburgh area. He was a leader in 
all of this. He knows his

[[Page 19498]]

health care issues well. Here is what he wrote recently: There is $1 
trillion of annual waste in the health care system that is associated 
with process failures. A trillion dollars a year--even by Washington 
standards that is a big number. That is a target that is worth shooting 
for. That is a target that we shoot for hard in the legislation we are 
putting forward.
  If we take a look at the President's own Council of Economic Advisers 
recent report, on July 9, a few weeks ago, they put out the report on 
the economic case for health care reform. They looked at the health 
care system from two measures: one, if you compare to it foreign 
countries and look at their gross domestic product share and 
extrapolate from that, what we could get our costs down to if we were 
sensible and thoughtful and didn't have such a wasteful health care 
system and, second, to look at the variation among the States, from 
State to State, from region to region, even as the recent article by 
Atul Gawande said, the differences within a State, between McAllen, TX 
and El Paso, TX.
  If you look at those, that gives you another means of calculating 
what you could get the costs down to. If you could get the waste out of 
the system, efficiency improvements in the U.S. health care system 
potentially could free up resources equal to 5 percent of U.S. GDP. 
From the Council of Economic Advisers, that is over $700 billion a 
year. Maybe it is a trillion, maybe it is $700 billion. Per year that 
is a big number.
  Looking at the internal discrepancies, they note:

       [It] should be possible to cut total health expenditures by 
     about 30 percent without worsening outcomes [which] would 
     again suggest that savings on the order of 5 percent of GDP 
     could be feasible.

  Again looking at the calculation two separate ways, coming to the 
same number, $700 billion a year. The problem is, it will take some 
executive administration to get there. It is not easy. You don't just 
make your decision, flip up or down the light switch, it goes on, and 
you don't have to worry about it. This isn't like the sniper who lines 
up his shot, pulls the trigger, and the projectile goes. This is a 
problem where you are like the pilot landing in rough weather. You have 
to continue to steer through it. You have to continue to seek the 
savings. As the market adapts, you have to adapt with it. It takes 
executive leadership and administration to make this happen. That means 
the Congressional Budget Office can't score it. All they can say is 
that it promises a ``large reduction'' in American health care costs. 
But they can't score it.
  So the American public, with a lot of misinformation out there, has 
been beguiled into believing that what we are doing won't save money. 
We are determined to save money doing it. The Medicare system and the 
American health care system and the American economy will fail if we 
don't save money doing this. The target is as big as $700 billion to $1 
trillion a year.
  Our health care system has been described memorably as a ``carnival 
of waste.'' It is time to bring the carnival to an end and give 
Americans the health care they deserve.
  There are a couple of pretty sensible ways to do this. The 
administration has focused on all of them. The first is, as I said 
earlier, health information infrastructure. Why should every American 
not have an electronic health record? Why, when you go to McDonald's, 
should the checkout person have a more robust health information 
infrastructure backing them up and connecting to inventory and 
connecting to sales than your doctor does? It makes no sense. We could 
save enormous sums if we had a national health information 
infrastructure--secure, confidential, reliable, interoperable. So if 
you went to get a lab test, it went into your record. If you went to 
the emergency room, it went into your record. If you stayed at the 
hospital, it went into your record. If you saw a specialist, it went 
into your record. All of your practitioners would know what was going 
on in your care. The more complex and chronic your conditions, the more 
valuable that would be. We don't have that now. It is the worst of any 
American industry except the mining industry.
  Quality improvement: In Michigan, there was a fascinating project, 
called the Keystone Project, where they went into the intensive care 
units in Michigan--not all of them but a great number of them--with 
process reforms in the intensive care units to reduce respiratory 
problems from not being elevated, to reduce line infections from 
catheters and from blood lines. The effect of that was, in 15 months, 
to save 1,500 lives and $150 million just in one State and not even all 
the intensive care units. It proves the proposition that quality 
improvement can save money and lives.
  Prevention is obviously the same. We will be on the floor shortly to 
debate Judge Sotomayor's nomination. She has lived with diabetes since 
she was a child. She has taken good care of herself so she had not 
created a lot of cost for the health system, but many people who don't 
manage their disease well, who don't get the prevention they need, end 
up with amputations, blindness, long and unnecessary hospital stays. 
There are areas where, by investing in prevention, we can save 
fortunes.
  Why don't we do this then? Why don't we have electronic health 
records on every doctor's desk for all Americans? Why don't we have 
every intensive care unit participating in a Keystone-type quality 
initiative? Why doesn't every community health center have a robust 
diabetes prevention program? It has to do with the bizarre economics of 
our health care system. Because the same thing is true for all three 
entities. If you are a doctor and you want to put electronic health 
record systems in for your patients, if you are a hospital and you want 
to improve the quality of care in your intensive care unit and put in a 
program that will do that, if you are a community health center that 
wants to invest in prevention to help the diabetic population stay 
healthy, you face the exact same predicament: The investment you have 
to make is 100 percent out of your pocket. The risk of the investment 
is 100 percent on your neck. The administrative burden is 100 percent 
on you. The hassle of it is 100 percent yours. All of the costs are on 
the desk of the doctor, on the desk of the hospital administrator, on 
the desk of the community health center. But the benefits from the 
electronic health record, the benefits and the savings from the quality 
improvement, the savings and the benefits from the prevention don't 
find their way back to that same desk. They go off to Medicare. They go 
off to the insurance industry. They connect to the patient in better 
care, but investment doesn't get the reward.
  The basic principle of American capitalism, which is the connection 
between risk and reward, has been broken in the American health care 
system. That is one of the things we get after in this bill. We could 
have electronic health records for every American, our hospitals and 
doctors highly motivated to pursue all the quality initiatives that 
will improve the quality of our care while it lowers the cost and 
avoids unnecessary hospitalizations and delays and infections, and so 
forth, and we could have the best prevention program in the country, 
but we have to make it work for people. That is part of what we are 
about in this health care reform.
  I will continue to explain why it is important that we reform our 
health care system and what the average American will gain from it. 
Today I focused on the elements of why delivery system reform can be 
improved. But every American will see that in their lives, their 
parents' lives, and in their children's lives. When we look back to 
where we are today from where we can be and where, with President 
Obama's leadership, we will be, we will look back and ask: My God, how 
could we have been living that medieval setup? Look how good it is now.
  That is our goal. That is our purpose. That is the promise of health 
care reform.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.

[[Page 19499]]

  The assistant bill clerk proceeded to call the roll.
  Mr. VOINOVICH. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 1841

  Mr. VOINOVICH. Mr. President, since there is no further debate on 
amendment No. 1841, I ask for its adoption.
  The PRESIDING OFFICER. The question is on agreeing to amendment No. 
1841.
  The amendment (No. 1841) was agreed to.
  Mr. VOINOVICH. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. DURBIN. 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. DURBIN. Mr. President, 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, this is an important bill, the Energy and 
Water appropriations bill. It is one of the 12 or 13 appropriations 
bills we have during the course of the year to prepare for spending in 
our new fiscal year, which starts October 1. Senator Dorgan and Senator 
Bennett are shepherding this bill on the floor.
  Meanwhile, in another room, not far from here, at least six 
Senators--maybe more--are meeting trying to work out the details of a 
piece of legislation that could literally affect every person living in 
America. It is the question of health care reform. It is an interesting 
issue because it has been tried before. Previous Presidents--Theodore 
Roosevelt; Harry Truman; certainly, Bill Clinton--have tried their best 
to change the health care system in America to make it a system that is 
stable, secure, so people know what it will cost, what it will cover, 
and know, ultimately, they can have quality care available when they 
need it for themselves or their family.
  The simple fact is, in America health care has become extremely 
expensive. We spend more per person in America--twice as much per 
person--as the nearest nation on Earth. So we are spending a lot of 
money. And people see it, because the cost of health insurance premiums 
is going up much faster than their income, and they worry about it.
  Many of the folks whom I talk to back in Illinois worry whether next 
year there will be an increase in their hourly wage that will be 
completely consumed by increases in health insurance premiums. And they 
add, incidentally: Senator, that new health insurance plan is not an 
add-on. It usually covers less than the one before--the situation where 
preexisting conditions will eliminate coverage for things that are 
critically important for individuals; where folks find when they reach 
a certain age the cost of the health insurance premiums goes up so 
high.
  There are battles that go on between doctors and hospitals and 
insurance companies about whether they will actually cover something--
cases we have seen in Illinois and around the country, where folks 
thought they had some insurance and guarantee that health insurance 
covered their medical procedure only to find later it did not.
  Many people who are out of work today are realizing for the first 
time in their lives they do not have the protection of health 
insurance. Some of them, with limited savings, battered by the recent 
stock market, wonder if tomorrow's accident or diagnosis will wipe out 
everything they have ever saved. That is the reality of the uncertainty 
and instability of our health care system today. People are looking for 
stable coverage they can count on; if they get sick today, that they 
will be covered tomorrow. They can look, as well, for the kind of 
stable costs they can afford--even when they have lost a job--to make 
sure there is health insurance to protect their families. And they want 
to preserve their right to choose their doctor and hospital to give 
them the best care in this country.
  The obvious question is, can we reach that goal? And the obvious 
answer is, only with the political will of this Senate, with 
Republicans working with Democrats. I hope we can do this. I hope we 
can find a bipartisan way to this solution.
  President Obama has made it clear it is his highest priority--to 
improve health care for America and its citizens, and it is his highest 
priority when it comes to our deficit. A lot of people say: Well, if 
you are going to spend a trillion dollars on health care reform, think 
twice. Well, we should think twice because we are facing deficits and a 
national debt that has grown dramatically over the last 7 or 8 years.
  But the fact is, untouched, our health care system over the next 10 
years will cost us more than $30 trillion. If spending a half a 
trillion dollars over that period of time can change the system for the 
better, start bringing in practices that bring down overall costs, it 
is money well invested and money well spent.
  First, we have to try to wring out of the system the fraud that goes 
on. All of us know what is happening here. There are some health care 
providers in America who are capitalizing on a system that rewards 
doctors and hospitals for piling on the procedures, for piling on the 
expensive pharmaceuticals and medical devices. There is little or no 
reward for good health outcomes. The reward for a physician and someone 
who is using our system today is to do more, spend more. Well, that 
should not be our goal. Our goal should be quality health care for 
everyone. It should not be a system of fee for service that rewards and 
incentivizes spending that does not result in good health care.
  There are a lot of people who have come to the Senate in committee 
and otherwise to express their opinions about what will work and what 
will not. The Congressional Budget Office has been called on from time 
to time to ask whether these health care reform bills will actually 
save money. Testimony about the status quo is obvious. If we continue 
the way we are going, it is going to be a bad outcome. We know if we do 
not change this current system, it will become so expensive the average 
family will not be able to afford to pay the premiums. If we do not 
change the abuses in health insurance, we are all vulnerable to 
preexisting conditions and new costs and discrimination against people 
based on their gender, where they live. That has to change.
  We know there are ways to save money within our system. One of them 
relates to preventive care, wellness strategies. There is not enough of 
that today. A man by the name of Steve Burd is the CEO of Dominicks and 
Safeway, and he has a program for his management employees where he 
creates a financial incentive for them to take care of themselves and 
to get healthier. It is voluntary for those who want to participate. 
They come forward. They get examined. If they find they are overweight, 
they set a goal to reduce their weight. If they find their cholesterol 
is too high, they set a goal to reduce their cholesterol; the same 
thing with blood pressure, and the management of diabetes.
  If they meet these goals, if they show they are changing their 
lifestyles--they quit smoking; they are getting healthier--they get a 
financial reward. For the business, the reward is lower health care 
premiums.
  We need to have wellness strategies in America. Some of the problems 
we are facing are problems that will cost us dramatically in years to 
come. The incidence of diabetes among our children today is alarming. 
If it does not stop, if we will not deal with the issues of obesity and 
diabetes and other related issues, believe me, we cannot enact enough 
laws and put enough money into a health care system that does not deal 
with this.
  We also have to realize the health records and medical records need 
to be put on computers so they can be exchanged between health care 
providers. These electronic records can reduce the

[[Page 19500]]

number of mistakes that are made, improve the care that is given to 
individuals, and save us money.
  We also need to take a look at chronic diseases--I mentioned 
diabetes--and make certain there is an incentive there for wellness and 
for preventive care before people reach terrible stages in that disease 
that costs dearly and can be compromising to their health and maybe 
even their life.
  So if we can come together with a system of health care that provides 
stable coverage that you can count on, stable costs that you can 
afford, and quality that strives for excellence, and the kind of choice 
every American family wants, then the outcome of the meeting, not far 
from here, of these Senators will be one that America can cheer.
  Fortunately, the President has invested his political capital in this 
effort. He has told all of us this is the most important single thing 
he is working on and wants to achieve. He is prepared to spend his 
time, obviously, and his political capital to achieve it. It is our job 
as elected officials to respond to this national need. For many of us 
this may be a once in a political lifetime opportunity to change health 
care in America for the better.
  It is the job of those in government to consider its budgetary 
impact. But some of them are not charged with coming up with a 
solution. We have to look beyond the budget in some respects to the 
long-term benefit. The President has said we are going to pay for 
everything we do. But the long-term benefit, for example, of preventive 
care may be difficult to measure today. We know it is going to be an 
ultimate benefit to our country. Most of the savings in health care may 
not be reflected in the Federal budget. The savings will accrue to the 
people of this Nation, though, to give them the peace of mind they have 
health care they can count on that will be there when their family 
desperately needs it.
  We have to make certain this is part of our charge here, and this is 
the time to do it. I hope the Senate Finance Committee, before we leave 
in about 10 days or 11 days, can produce a bill. And I hope the House 
of Representatives can pass one, and then, when we return, we will come 
to the floor of the Senate and work together in a bipartisan fashion to 
pass it. I am certain it will require compromise by all of us. I have 
my idea of what health care reform should look like, and I am sure 
others do as well. But in the spirit of good faith, we can come 
together and make a difference and provide the kind of health care 
reform and changes that will give people peace of mind across America--
a stable and secure health care system that continues to make this 
great Nation on Earth a nation of healthy individuals and families.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Hawaii.
  Mr. REID addressed the Chair.
  The PRESIDING OFFICER. The majority leader is recognized.
  Mr. REID. Mr. President, could I ask my distinguished friend if he 
would yield for a minute to call up an amendment?
  Mr. INOUYE. Please do so.


                Amendment No. 1846 To Amendment No. 1813

  Mr. REID. Mr. President, there is an amendment at the desk, No. 1846. 
I ask it be reported.
  The PRESIDING OFFICER. The clerk will report.
  The assistant bill clerk read as follows:

       The Senator from Nevada [Mr. Reid], for himself and Mr. 
     Ensign, proposes an amendment numbered 1846 to amendment No. 
     1813.

  Mr. REID. 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 modify provisions relating to the Department of the 
                               Interior)

       Beginning on page 26, strike line 1 and all that follows 
     through page 32, line 14, and insert the following:
       Sec. 206.  Section 208(a) of the Energy and Water 
     Development Appropriations Act, 2006 (Public Law 109-103; 119 
     Stat. 2268), is amended--
       (1) in paragraph (1)--
       (A) by redesignating clauses (i) through (iv) of 
     subparagraph (B) as subclauses (I) through (IV), 
     respectively, and indenting the subclauses appropriately;
       (B) by redesignating subparagraphs (A) and (B) as clauses 
     (i) and (ii), respectively, and indenting the clauses 
     appropriately;
       (C) by striking ``(a)(1) Using'' and inserting the 
     following:
       ``(a) Action by Secretary.--
       ``(1) Provision of funds.--
       ``(A) In general.--Using'';
       (D) in subparagraph (A) (as so redesignated)--
       (i) in the matter preceding clause (i) (as so 
     redesignated), by inserting ``or the National Fish and 
     Wildlife Foundation'' after ``University of Nevada'';
       (ii) in clause (i) (as so redesignated), by striking ``, 
     Nevada; and'' and inserting a semicolon;
       (iii) in clause (ii)(IV) (as so redesignated), by striking 
     the period at the end and inserting ``; and''; and
       (iv) by adding at the end the following:
       ``(iii) to design and implement conservation and 
     stewardship measures to address impacts from activities 
     carried out--

       ``(I) under clause (i); and
       ``(II) in conjunction with willing landowners.''; and

       (E) by adding at the end the following:
       ``(B) National fish and wildlife foundation.--
       ``(i) Date of provision.--The Secretary shall provide funds 
     to the National Fish and Wildlife Foundation pursuant to 
     subparagraph (A) in an advance payment of the available 
     amount--

       ``(I) on the date of enactment of the Energy and Water 
     Development and Related Agencies Appropriations Act, 2010; or
       ``(II) as soon as practicable after that date of enactment.

       ``(ii) Requirements.--

       ``(I) In general.--Except as provided in subclause (II), 
     the funds provided under clause (i) shall be subject to the 
     National Fish and Wildlife Foundation Establishment Act (16 
     U.S.C. 3701 et seq.), in accordance with section 10(b)(1) of 
     that Act (16 U.S.C. 3709(b)(1)).
       ``(II) Exceptions.--Sections 4(e) and 10(b)(2) of the 
     National Fish and Wildlife Foundation Establishment Act (16 
     U.S.C. 3703(e), 3709(b)(2)), and the provision of subsection 
     (c)(2) of section 4 of that Act (16 U.S.C. 3703) relating to 
     subsection (e) of that section, shall not apply to the funds 
     provided under clause (i).''; and

       (2) in paragraph (2)--
       (A) in the matter preceding subparagraph (A), by striking 
     ``paragraph (1)(A)'' and all that follows through 
     ``beneficial to--'' and inserting ``paragraph (1)(A)(i), the 
     University of Nevada or the National Fish and Wildlife 
     Foundation shall make acquisitions that the University or the 
     Foundation determines to be the most beneficial to--''; and
       (B) in subparagraph (A), by striking ``paragraph (1)(B)'' 
     and inserting ``paragraph (1)(A)(ii)''.
       Sec. 207.  Section 2507(b) of the Farm Security and Rural 
     Investment Act of 2002 (43 U.S.C. 2211 note; Public Law 107-
     171) is amended--
       (1) in paragraph (1), by striking ``or'' at the end;
       (2) in paragraph (2), by striking the period at the end and 
     inserting ``; and''; and
       (3) by adding at the end the following:
       ``(3) for efforts consistent with researching, supporting, 
     and conserving fish, wildlife, plant, and habitat resources 
     in the Walker River Basin.''.
       Sec. 208. (a) Of the amounts made available under section 
     2507 of the Farm Security and Rural Investment Act of 2002 
     (43 U.S.C. 2211 note; Public Law 107-171), the Secretary of 
     the Interior, acting through the Commissioner of Reclamation, 
     shall--
       (1) provide, in accordance with section 208(a)(1)(A)(i) of 
     the Energy and Water Development Appropriations Act, 2006 
     (Public Law 109-103; 119 Stat. 2268), and subject to 
     subsection (b), $66,200,000 to establish the Walker Basin 
     Restoration Program for the primary purpose of restoring and 
     maintaining Walker Lake, a natural desert terminal lake in 
     the State of Nevada, consistent with protection of the 
     ecological health of the Walker River and the riparian and 
     watershed resources of the West, East, and Main Walker 
     Rivers; and
       (2) allocate--
       (A) acting through a nonprofit conservation organization 
     that is acting in consultation with the Truckee Meadows Water 
     Authority, $2,000,000, to remain available until expended, 
     for--
       (i) the acquisition of land surrounding Independence Lake; 
     and
       (ii) protection of the native fishery and water quality of 
     Independence Lake, as determined by the nonprofit 
     conservation organization;
       (B) $5,000,000 to provide grants of equal amounts to the 
     State of Nevada, the State of California, the Truckee Meadows 
     Water Authority, the Pyramid Lake Paiute Tribe, and the 
     Federal Watermaster of the Truckee River to implement the 
     Truckee-Carson-Pyramid Lake Water Rights Settlement Act 
     (Public Law 101-618; 104 Stat. 3289);
       (C) $1,500,000, to be divided equally by the city of 
     Fernley, Nevada, and the Pyramid Lake Paiute Tribe, for joint 
     planning and development activities for water, wastewater, 
     and sewer facilities; and

[[Page 19501]]

       (D) $1,000,000 to the United States Geological Survey to 
     design and implement, in consultation and cooperation with 
     other Federal departments and agencies, State and tribal 
     governments, and other water management and conservation 
     organizations, a water monitoring program for the Walker 
     River Basin.
       (b)(1) The amount made available under subsection (a)(1) 
     shall be--
       (A) used, consistent with the primary purpose set forth in 
     subsection (a)(1), to support efforts to preserve Walker Lake 
     while protecting agricultural, environmental, and habitat 
     interests in the Walker River Basin; and
       (B) allocated as follows:
       (i) $25,000,000 to the Walker River Irrigation District, 
     acting in accordance with an agreement between that District 
     and the National Fish and Wildlife Foundation--
       (I) to administer and manage a 3-year water leasing 
     demonstration program in the Walker River Basin to increase 
     Walker Lake inflows; and
       (II) for use in obtaining information regarding the 
     establishment, budget, and scope of a longer-term leasing 
     program.
       (ii) $25,000,000 to advance the acquisition of water and 
     related interests from willing sellers authorized by section 
     208(a)(1)(A)(i) of the Energy and Water Development 
     Appropriations Act, 2006 (Public Law 109-103; 119 Stat. 
     2268).
       (iii) $1,000,000 for activities relating to the exercise of 
     acquired option agreements and implementation of the water 
     leasing demonstration program, including but not limited to 
     the pursuit of change applications, approvals, and agreements 
     pertaining to the exercise of water rights and leases 
     acquired under the program.
       (iv) $10,000,000 for associated conservation and 
     stewardship activities, including water conservation and 
     management, watershed planning, land stewardship, habitat 
     restoration, and the establishment of a local, nonprofit 
     entity to hold and exercise water rights acquired by, and to 
     achieve the purposes of, the Walker Basin Restoration 
     Program.
       (v) $5,000,000 to the University of Nevada, Reno, and the 
     Desert Research Institute--
       (I) for additional research to supplement the water rights 
     research conducted under section 208(a)(1)(A)(ii) of the 
     Energy and Water Development Appropriations Act, 2006 (Public 
     Law 109-103; 119 Stat. 2268);
       (II) to conduct an annual evaluation of the results of the 
     activities carried out under clauses (i) and (ii); and
       (III) to support and provide information to the programs 
     described in this subparagraph and related acquisition and 
     stewardship initiatives to preserve Walker Lake and protect 
     agricultural, environmental, and habitat interests in the 
     Walker River Basin.
       (vi) $200,000 to support alternative crops and alternative 
     agricultural cooperatives programs in Lyon County, Nevada, 
     that promote water conservation in the Walker River Basin.
       (2)(A) The amount made available under subsection (a)(1) 
     shall be provided to the National Fish and Wildlife 
     Foundation--
       (i) in an advance payment of the entire amount--
       (I) on the date of enactment of this Act; or
       (II) as soon as practicable after that date of enactment; 
     and
       (ii) except as provided in subparagraph (B), subject to the 
     National Fish and Wildlife Foundation Establishment Act (16 
     U.S.C. 3701 et seq.), in accordance with section 10(b)(1) of 
     that Act (16 U.S.C. 3709(b)(1)).
       (B) Sections 4(e) and 10(b)(2) of the National Fish and 
     Wildlife Foundation Establishment Act (16 U.S.C. 3703(e), 
     3709(b)(2)), and the provision of subsection (c)(2) of 
     section 4 of that Act (16 U.S.C. 3703) relating to subsection 
     (e) of that section, shall not apply to the amount made 
     available under subsection (a)(1).

  Mr. REID. Mr. President, we all know that the most courteous man in 
the entire Senate is Senator Inouye, and I apologize for calling upon 
him for him to use his courtesy again on my behalf. I appreciate it 
very much.
  (The remarks of Mr. Inouye and Mr. Akaka are printed in today's 
Record under ``Morning Business.'')
  Mr. INOUYE. I suggest the absence of a quorum.
  The PRESIDING OFFICER. Will the Senator withhold?
  Mr. INOUYE. Yes.
  The PRESIDING OFFICER. The Senator from Arizona.


                           Amendment No. 1814

  Mr. McCAIN. Mr. President, I ask unanimous consent that the pending 
business be set aside to call up amendment No. 1814 which is at the 
desk.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report.
  The legislative clerk read as follows:

       The Senator from Arizona [Mr. McCain] proposes an amendment 
     numbered 1814 to amendment No. 1813.

  The amendment is as follows:

  (Purpose: To prohibit the use of funds to carry out any project or 
 site-specific location identified in the committee report unless the 
  project is specifically authorized or to carry out an unauthorized 
                             appropriation)

       On page 68, between lines 15 and 16, insert the following:
       Sec. __. (a) None of the funds appropriated under this Act 
     may be used to carry out--
       (1) any project or site-specific location identified in the 
     committee report accompanying this Act unless the project is 
     specifically authorized; or
       (2) an unauthorized appropriation.
       (b)(1) In this section, the term ``unauthorized 
     appropriation'' means a ``congressionally directed spending 
     item'' (as defined in rule XLIV of the Standing Rules of the 
     Senate)--
       (A) that is not specifically authorized by law or Treaty 
     stipulation (unless the appropriation has been specifically 
     authorized by an Act or resolution previously passed by the 
     Senate during the same session or proposed in pursuance of an 
     estimate submitted in accordance with law); or
       (B) the amount of which exceeds the amount specifically 
     authorized by law or Treaty stipulation (or specifically 
     authorized by an Act or resolution previously passed by the 
     Senate during the same session or proposed in pursuance of an 
     estimate submitted in accordance with law) to be 
     appropriated.
       (2) For purposes of paragraph (1), an appropriation is not 
     specifically authorized if the appropriation is restricted or 
     directed to, or authorized to be obligated or expended for 
     the benefit of, an identifiable person, program, project, 
     entity, or jurisdiction by earmarking or other specification, 
     whether by name or description, in a manner that is so 
     restricted, directed, or authorized that the appropriation 
     applies only to a single identifiable person, program, 
     project, entity, or jurisdiction, unless the identifiable 
     person, program, project, entity, or jurisdiction to which 
     the restriction, direction, or authorization applies is 
     described or otherwise clearly identified in a law or Treaty 
     stipulation (or an Act or resolution previously passed by the 
     Senate during the same session or in the estimate submitted 
     in accordance with law) that specifically provides for the 
     restriction, direction, or authorization of appropriation for 
     the person, program, project, entity, or jurisdiction.

  Mr. McCAIN. Mr. President, this amendment is very simple. It would 
prohibit funds from being spent on any of the hundreds of earmarks 
listed in the committee report that accompanies this bill--I emphasize, 
that are listed in the committee report, not part of the basic 
legislation. It would prohibit those funds from being spent on any of 
the hundreds of earmarks unless that project is specifically 
authorized.
  As we all know, committee reports do not have the force of law. They 
are meant to serve as explanatory statements for what can often be 
complicated legislative bill text. Unfortunately, around here 
Appropriations Committee reports now are treated as if they were law 
and are routinely loaded up with millions, if not billions, of dollars 
in unrequested, unauthorized, unnecessary, wasteful earmarks.
  When Congress establishes its funding priorities, it should do so 
decisively, without cause for subjective interpretation or reference to 
material outside the bill passed by Congress and signed into law by the 
President. These funding priorities should have the binding force of 
law subject only to the President's veto power. Yet here we are again, 
with a committee report that contains 622 ``congressionally directed 
spending items''--that is a great name: congressionally directed 
spending items--totaling over $985 million. None of these projects were 
requested by the administration. Many of them were not authorized or 
competitively bid in any way. No hearing was held to judge whether 
these were national priorities worthy of scarce taxpayer dollars, and 
they are in the bill for one reason and one reason only: because of the 
self-serving prerogatives of a few select Members of the Senate, almost 
all of whom serve on the Appropriations Committee. Sadly, these Members 
chose to serve their own interests over those of the American taxpayer.
  Earlier this year, in response to criticism about the number of 
earmarks in the Omnibus appropriations bill, one of the Senators stood 
on the floor and proclaimed:

       Let me say this to all the chattering class that so much 
     focuses on those little, tiny, yes, porky amendments: The 
     American people don't really care.

  If the American people don't really care, then on behalf of the 
American

[[Page 19502]]

people, I suggest we remove some of the ``little, tiny, porky'' items 
that are listed in this report. Here are just a few:
  There is $1 million for the Bayview Gas to Energy Project in Utah. My 
colleagues and people who pay attention to these processes will know 
that almost every one of these projects has a location. Again, usually 
they are located in the home State of a member of the Appropriations 
Committee. So $1 million for the Bayview Gas to Energy Project in Utah. 
I have never heard of the Bayview Gas to Energy Project. I have never 
heard a thing about it. I have never read about it. I am sure that 
maybe it is known in Utah, but I have no way of knowing whether it is a 
worthwhile project or not. The most important thing: Are there other 
gas to energy projects in other parts of the country? Maybe so. Maybe 
not. These are earmarked.
  We have $500,000 for the Ben Franklin Technology Partners in 
Pennsylvania--the Ben Franklin Technology Partners in Pennsylvania. 
From the reading of that, I have not a clue, nor would anyone else 
know, what the Ben Franklin Technology Partners is all about.
  We have $600,000 for biodiesel blending in Wisconsin; $1 million for 
the Black Hills State Heating and Cooling Plant in South Dakota; 
$250,000 for a gas heat pump cooperative training program in Nevada; 
$1.5 million for the genetic improvement of switchgrass, not in South 
Carolina but in Rhode Island; $1 million for a high-speed wind turbine 
noise model with suppression in Mississippi; $5 million for an offshore 
wind initiative in Maine; $2 million for the Algae Biofuels Research in 
Washington; $750,000 for the Algae to Ethanol Research and Evaluation 
in New Jersey; $1.2 million for the Alternative Energy School of the 
Future in Nevada--the Alternative Energy School of the Future. We have 
$6 million for the Hawaii Energy Sustainability Program, Hawaii; $6 
million for the Hawaii Renewable Energy Development Venture, Hawaii; 
$2.25 million for the Montana Bioenergy Center of Excellence, Montana; 
$10 million for the Sustainable Energy Research Center in Mississippi.
  My colleagues may get a little thread that runs through this: 
Mississippi, Nevada, South Dakota, Utah, et cetera--it goes on and on.
  We have $10 million for the Sustainable Energy Research Center, 
Mississippi; $450,000 for the Vermont Energy Investment Corporation in 
Vermont; $1.2 million for the Hydrogen Fuel Dispensing Station, West 
Virginia; $1.25 million for the Long Term Environmental and Economic 
Impacts of the Development of a Coal Liquefaction Sector in China, West 
Virginia; $1 million for the Alaska Climate Center, Alaska; $5 million 
for the Computing Capability, North Dakota; $1 million for the 
Performance Assessment Institute in Nevada; $1 million for the New 
School Green Building in New York.
  It goes on and on. There are 22 pages worth, and my colleagues might 
be interested at some of the innovative names and may be interested in 
trying to find out what those projects are. You won't find an 
explanation in the report.
  So let me be clear on one point. I don't question the merits of these 
projects. There is no way to find out what the merits are. Many of them 
may be very worthy of Federal funds. If that is the case, one should 
wonder, if they are national priorities in desperate need of scarce 
Federal funds, why they haven't been authorized by a congressional 
committee. Why haven't we had a single hearing to talk about the 
desperate need for a hydrogen fuel dispensing station in West Virginia? 
If genetically improved switchgrass was such an imperative at this time 
of economic crisis, why was the funding not requested by the 
administration?
  I just wish to point out again, contrary to popular belief, contrary 
to what members of the Appropriations Committee will continue to tell 
us, earmarking funds in an appropriations bill is not the way the 
Congress has operated historically.
  It is similar to any other evil--it has grown, grown, and grown 
larger every time, just about. After various scandals, it has leveled 
off or decreased some, but after the scandal dies down, the earmarks 
return. Yes, 9,000 of them were in the Omnibus appropriations bill and, 
of course, the stimulus package as well.
  So there was a time when earmarks were nonexistent, or at least very 
rare. Guess what. We didn't have $1.8 trillion worth of deficit for the 
year. I am proud to have served in the House with a man by the name of 
Congressman William Natcher, chairman of the House Appropriations 
Subcommittee on Labor, Health, and Human Services. He prevented 
earmarks in his committee. I am sorry there are not more William 
Natchers still in the Congress of the United States.
  Citizens Against Government Waste has tracked the growth of earmarks 
since 1991. According to Citizens Against Government Waste, in 1991, 
there were 546 earmarks, totaling $3.1 billion. In 2008, there were 
11,106 earmarks, totaling $17.2 billion. That is an increase of 337 
percent in 17 years.
  Obviously, it is not pleasant for my colleagues from the 
Appropriations Committee, and it is not particularly pleasant for some 
of my other colleagues, for me to come down here to, day after day, 
year after year, fight against these earmarks and porkbarrel projects. 
The fact is, they have bred corruption. It wasn't inadequate disclosure 
requirements that led Duke Cunningham to violate his oath of office and 
take $2.5 million in bribes in exchange for doling out $70 million to 
$80 million of taxpayers' funds to a defense contractor. It was his 
ability to freely earmark taxpayer funds without question.
  So here we are with a $1.8 trillion deficit and 22 pages of earmarks, 
most of which have a State earmark next to them so there is no 
competition, there is no revealing of the details of the project and, 
meanwhile, we have places being raided by the FBI around the country 
due to the allegations that criminal activity has taken place, which 
can be traced back to this earmark porkbarreling process.
  I don't expect to win this vote, but I intend to keep up this fight 
until such time as the American people rise and demand that we exercise 
some kind of fiscal discipline. I will tell my colleagues on the 
Appropriations Committee the reason why I think the chances are better 
and better, because they are having trouble staying in their homes, 
educating their kids, and the unemployment rate is now 9.5 percent and 
predicted to go higher.
  The present President of the United States campaigned and said he 
would change the culture in Washington. One of my deep disappointments 
is that the President has not fulfilled his commitment to go line by 
line, item by item, in every appropriations bill and not allow this 
porkbarreling earmark practice to continue. The American people will 
not stand for it forever.
  I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  Mr. BENNETT. Senator Dorgan is temporarily away.
  Mr. McCAIN. Mr. President, do we have the yeas and nays?
  The PRESIDING OFFICER. At the moment, no.
  Mr. BENNETT. I am sure there will be a sufficient second when Senator 
Dorgan has returned.
  Mr. McCAIN. I thank the Senator.
  The PRESIDING OFFICER. The Senator from Utah is recognized.
  Mr. BENNETT. Mr. President, I listened with interest to the statement 
by Senator McCain. I rise with some responses to the comments he has 
made, which I hope will clarify the situation. Senator McCain, the 
ranking member on the Armed Services Committee, serves with great 
distinction and has helped manage that bill on the floor. In the 
Defense authorization bill, which he helped manage, there are specific 
authorizations for every defense program, and there is a Defense 
authorization bill that passes every year.
  If, indeed, we had a similar situation with respect to those items 
under the jurisdiction of this appropriations bill, I would be more 
supportive of the position Senator McCain has taken with respect to the 
provisions of the bill.

[[Page 19503]]

However, this is not a defense bill and not every department 
authorizes, each and every year, the same way the Department of Defense 
does.
  Indeed, this is not the way Congress intended the Department of 
Energy to operate. When the Department of Energy was organized in 1977, 
making it one of the more recent departments, its organic statute 
provided broad authorities to support a diverse research and 
development mission with the goal of energy independence. This is not a 
project-based account and, therefore, it doesn't receive annual 
authorization.
  Recently, there has been more attention on energy, which has resulted 
in two Energy bills in the past 4 years. But you need to go back 13 
years, before the 2005 bill, to find another Energy bill passed by 
Congress. Obviously, the organic statute creating the Department 
anticipated that there would be an organic authorization for these 
items, and they would be handled in the appropriations bills. If we 
passed Senator McCain's amendment, it would eliminate any discretion of 
this subcommittee or of the Congress itself, for that matter, to make 
changes in the Department of Energy's budget priorities for spending 
plans. The Appropriations Committee would, therefore, become a 
rubberstamp for the administration's budget. Since we do not pass 
something like the Defense authorization bill, and there is no 
corresponding authorization bill for the Department of Energy, we would 
simply take the President's proposal and pass the money to support it, 
and I do not believe that is acceptable.
  Senator McCain ran through a list of projects for which he had little 
or no patience because he said he did not understand them, and they 
struck him as being projects that possibly had questionable merit. I 
have a list of projects that were funded by the administration out of 
the blanket authority the Congress gave the Secretary in what we call 
the Stimulus Act. We passed the Stimulus Act without any specific 
earmarks. We simply said: Here is your money and you get to decide how 
it is spent. Congress will not intervene. I voted against the stimulus 
bill for a variety of reasons, but we now have the announcements from 
Secretary Chu as to the specifics of the wind program funding awards.
  To quote Senator McCain in his comments about the earmarks in this 
bill: ``It may be that every one of these projects is legitimate and 
every one of them has merit.'' But this is the way the administration 
hands out money compared to the way the Congress hands out money. The 
Mountain Institute, Inc., in Morgantown, WV, overcoming barriers to 
wind development in Appalachian coal country, $99,000; the West 
Virginia Division of Energy, in Charleston, WV, overcoming the 
challenges in West Virginia, $100,000; in Austin, TX, $118,000 to fund 
solutions for wind developers and bats; for the board of trustees of 
the University of Illinois in Champaign, IL, studying ``are flying 
wildlife attracted to, or do they avoid wind turbines?''; Kansas City 
University in Manhattan, KS, the environmental impact of wind power 
development on population biology on greater prairie chickens; Texas 
Tech University in Lubbock, TX, an assessment of lesser prairie chicken 
population distribution in relation to potential wind energy 
development; Western Ecosystems Technology, Inc., in Cheyenne, WY, 
$100,000 to study greater sage and sage grass telemetry for the Simpson 
Range Resource area; finally, in Kalamazoo, MI, the Western Michigan 
University receives $99,933 to study genetic approaches to 
understanding the population level impact of wind energy development on 
migratory bats.
  These, as I say, may all be very worthwhile items. I don't think they 
are any more worthwhile items than the items we put in our bill. I say 
to those in support of the McCain amendment, if the McCain amendment 
passes, you take away from the Congress the right to determine how this 
money is spent and you turn it over to the President entirely and let 
him or his administration decide. It does not mean the money will be 
saved; it simply means the money will be spent in the way the 
administration wants it rather than in the way Members of Congress want 
it. The last time I read the Constitution, article I of the 
Constitution gives the power of the purse to the Congress and says 
Congress shall determine how much money shall be raised and how much 
money shall be spent, and that is what the Congress has done. It has 
given an organic statute to the Department of Energy, and then it 
allows the Congress, under that statute, to come up with the specifics 
of how the money is spent.
  The Senator talked about report language not being binding in the 
bill. The bill, by legislative language, incorporates the specific 
projects in the report by reference. Therefore, it does become binding.
  If we pass the amendment Senator McCain has proposed, it would have a 
devastating impact on the Department's environmental cleanup 
requirements. These are cleanup programs that receive annual 
authorization for cleaning up sites and projects under the Defense 
Authorization Act. But it also has similar authorization on sites that 
are outside the Defense Department.
  Included in this nondefense category are ongoing cleanups in the 
following places--and I will repeat that again: ongoing cleanups. These 
are not new starts or projects that have come out of nowhere; these are 
items that are going forward, that have been authorized by past 
Congresses, under the organic statute of the Department of Energy: 
Paducah, KY; Portsmouth, OH; Moab, UT; Oak Ridge National Laboratory, 
in Tennessee; Idaho National Laboratory, in Idaho; Brookhaven National 
Laboratory, in West Valley, NY; Santa Susana, in California; Hanford, 
WA; Argonne National Laboratory, in Illinois; Los Alamos National 
Laboratory, New Mexico.
  If I might focus on the one in Moab, UT, this is a cleanup of a 
uranium site, where there was a uranium plant during the boom times, 
when we were mining uranium as rapidly as we could, processing that, 
and we left behind tailings that have been judged as being damaging. 
These tailings are very close to the Colorado River. Indeed, the 
Senator's own State of Arizona is downstream from this tailing site.
  By appropriating this money in this bill in a manner that would be 
outlawed by the Senator's amendment, we are accelerating the cleanup 
process in this time of economic difficulty, adding more jobs, more 
activity, and, quite frankly, lower prices, as contractors are anxious 
to gain work and will bid lower than they would otherwise; it is the 
logical thing to do. It would be dropped from the bill if we proceeded 
with the Senator's amendment.
  For these reasons, I think the Senator's amendment would be a 
mistake. I urge my colleagues to vote it down.
  Mr. President, I yield the floor.
  Mr. AKAKA. 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.
  Mr. DORGAN. Mr. President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DORGAN. Mr. President, Senator Bennett and I have discussed the 
McCain amendment. Senator McCain has offered his amendment. I will 
speak briefly in opposition to the amendment. I believe Senator Bennett 
also has spoken. We are prepared to have a vote at 6 o'clock. I ask 
unanimous consent the Senate proceed to a vote on the McCain amendment 
at 6 o'clock. I further ask consent that no second degrees be in order.
  The PRESIDING OFFICER. Is there objection?
  Mr. DORGAN. Mr. President, let me withhold for a moment.
  I ask my unanimous consent request be considered.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. BENNETT. Mr. President, I ask for the yeas and nays on the McCain 
amendment.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.

[[Page 19504]]

  The yeas and nays were ordered.
  Mr. DORGAN. Mr. President, in response to Senator McCain's amendment, 
he has come to the floor to talk about legislative-directed spending. 
We have some disagreements on that subject. I respect the opinions of 
Senator McCain on some of these issues. I disagree, however, with the 
proposition that somehow what is in a President's budget, that is the 
recommendation of a President in the President's budget, has any 
greater import than the recommendations of Senators about what kind of 
projects have merit.
  The Constitution of this country provides that the President proposes 
and Congress disposes. The power of the purse is here. It is the 
Congress that raises the funds and it is the Congress that is 
responsible for the expenditure of those funds.
  There has been a lot of discussion about ``earmarks.'' 
Congressionally directed spending is spending that has been 
dramatically reformed. We have substantially reduced the number of 
projects in this bill.
  By the way, I indicated when I began discussing the bill that Senator 
Bennett and I have brought to the floor, talking about the number of 
earmarks the President has requested, a very large number of earmarks 
are in the President's request about what he believes we should pursue 
with respect to projects and how they should be funded. We have agreed 
with him in most cases, disagreed in a few cases, and in those areas 
where we have disagreed, we have not funded that which the President 
has requested because we didn't think it appropriate to fund it. We 
have in other cases funded other proposals that have come to us from 
Senators that have, we believe, more merit.
  I do not believe the executive branch always gets it right and the 
congressional branch or legislative branch never gets it right. I think 
somewhere between represents the best of what both can offer. That is 
why we have preserved a substantial majority of what President Obama in 
his budget to the Congress has requested.
  If you look back in history you will see there are a good many 
examples of projects that started out as legislative-directed spending, 
or funding, that have had major national implications. In 1873, 
Congress appropriated funds for the Indian police to keep order and 
prohibit illegal liquor traffic on Indian reservations. That was 
through a congressional add-on or earmark. Only later, then, were 
Indian tribal police forces and court systems authorized and included 
in the President's budget. But it was Congress that initiated the law 
enforcement approach that appropriated funds for Indian police.
  In 1883, the U.S. Navy began moving from wooden to steel ships. That 
came as a result of a decision by the Congress. The Congress said we 
want to move from wooden to steel ships. That was appropriated in the 
Naval Service Appropriations Act. It directed the Navy to construct two 
steel steam cruising vessels from funds appropriated but not required 
for repairing wooden ships.
  In 1943, the National School Lunch Program was established through a 
$50 million earmark in the 1944 Agriculture Appropriations bill. Of 
course, that turns out to have been a wonderful idea. The school lunch 
program is a remarkable success.
  In 1987, it was the Congress that earmarked funding to what was 
called gene mapping, which later became the Human Genome Project. That 
didn't come from some bureaucrat or somebody down in an executive 
agency who said, You know what we should do, let's begin mapping human 
genes. Instead, it came from here, in the Congress. In fact, former 
Senator Domenici had a lot to do with that. So Congress originated the 
Human Genome Project. Guess what. We now have the first owners manual 
for the human body. It is changing everything about medicine. That 
didn't come because somebody in the executive branch said let's do 
that. That came because someone on the floor of the Senate here said 
let's do this because it has merit.
  These are only a few examples of things that represent substantial 
progress as a result of ideas that come from the Congress. Despite what 
you hear from opponents of that sort of thing, if you got rid of all of 
the ideas that came from the Congress about how to spend money in the 
Energy and Water bill, we would still be spending the same amount of 
money because what we spend in this subcommittee is up to the 
allocation given us by the Budget Committee. The Budget Committee says 
here is what is going to be spent. That decision is made by the Senate. 
Then an appropriation, called a 302(b) allocation, I should say, goes 
to this subcommittee and that is what we allocate. That is what we 
decide we will have to spend.
  If we did not do that, then that money goes down to an agency and 
someone in the Federal agency says here is what we are going to spend 
it on. So eliminating all of the legislative-directed funding would not 
reduce the Federal budget deficit at all. I know that is claimed but it 
is simply not the case. It just is not the case.
  Let me also say the issue of legislative-directed funding is 
something we have dramatically transformed. No. 1, we have cut the 
amount of legislative-directed funding requests in half. By requests I 
am talking about those that made it into the bill. We have cut it by 
half. We got rid of half of it because I think it went way too far, so 
we cut it back by 50 percent. Second, every single request has to now 
be publicly disclosed and every single piece of legislative-directed 
funding that is in this bill is described by who asked for it, how much 
it is, and what its purpose is.
  As I indicated before, what we are doing in this bill is investing in 
improving this country's infrastructure, improving and investing in 
this country's energy future and putting people to work, doing things 
that will pay dividends for decades to come. That is what this 
subcommittee does. This is not some routine subcommittee, this is the 
subcommittee that funds the substantial amount of energy projects and 
research in this country that will have implications for decades.
  This is the subcommittee that funds all of the water projects--the 
dams, the harbors, the navigation, all of those issues that are so 
important to this country's water development and water conservation. 
So this is not some routine kind of expenditure, this is an investment 
that will create substantial jobs in the future. It will transform our 
energy future, in my judgment.
  I described earlier the importance of the national laboratories we 
fund, the science laboratories, the energy laboratories, the weapons 
laboratories that represent the repository of the most breathtaking, 
cutting-edge, world-class research in so many different areas. All of 
that is done in this subcommittee.
  I am pleased to have spent time with Senator Bennett. We Republicans 
and Democrats on this committee worked through a lot of requests, 
requests from President Obama, from his team, about how they want to 
fund a wide range of issues and requests from our colleagues.
  I would say Secretary Chu had requested a number of research hubs he 
wanted to do, kind of a transformation in the Department of Energy. We 
decided to proceed with three of those hubs. It makes sense to us to 
begin to try moving down that road in a range of areas where you 
provide real focus on specific areas of energy and research into those 
areas.
  If the McCain amendment were to be agreed to, my understanding is 
they would be considered not authorized and therefore not allowed. That 
doesn't make any sense to me. There has been, for a long period of 
time, general authorization for the programs in the Department of 
Energy. We routinely have never authorized every year that which we are 
doing here. We fund programs that generally have been ongoing within 
the larger framework of the authorization of the Department of Energy.
  I very much oppose the McCain amendment. I respect our colleague, 
Senator McCain. He is a good legislator. We have come to disagreement 
on this subject. I hope my colleagues will join myself and Senator 
Bennett in defeating the amendment.
  I yield the floor and suggest the absence of a quorum.

[[Page 19505]]

  The PRESIDING OFFICER (Mrs. Shaheen). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. DORGAN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The question is on agreeing to the amendment No. 1814.
  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), and the Senator 
from Maryland (Ms. Mikulski) are necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 25, nays 72, as follows:

                      [Rollcall Vote No. 243 Leg.]

                                YEAS--25

     Barrasso
     Bayh
     Bunning
     Burr
     Chambliss
     Coburn
     Corker
     Cornyn
     Crapo
     DeMint
     Enzi
     Feingold
     Graham
     Grassley
     Inhofe
     Isakson
     Johanns
     Kyl
     Lugar
     Martinez
     McCain
     McCaskill
     Risch
     Thune
     Vitter

                                NAYS--72

     Akaka
     Alexander
     Baucus
     Begich
     Bennet
     Bennett
     Bingaman
     Bond
     Boxer
     Brown
     Brownback
     Burris
     Cantwell
     Cardin
     Carper
     Casey
     Cochran
     Collins
     Conrad
     Dodd
     Dorgan
     Durbin
     Ensign
     Feinstein
     Franken
     Gillibrand
     Gregg
     Hagan
     Harkin
     Hatch
     Hutchison
     Inouye
     Johnson
     Kaufman
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     McConnell
     Menendez
     Merkley
     Murkowski
     Murray
     Nelson (NE)
     Nelson (FL)
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Sanders
     Schumer
     Sessions
     Shaheen
     Shelby
     Snowe
     Specter
     Stabenow
     Tester
     Udall (CO)
     Udall (NM)
     Voinovich
     Warner
     Webb
     Whitehouse
     Wicker
     Wyden

                             NOT VOTING--3

     Byrd
     Kennedy
     Mikulski
  The amendment (No. 1814) was rejected.
  Mrs. MURRAY. Madam President, I move to reconsider the vote.
  Mrs. BOXER. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                Amendment No. 1862 to Amendment No. 1813

  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. ALEXANDER. I ask unanimous consent to set aside the pending 
amendment so I may call up an amendment.
  The PRESIDING OFFICER. Is there objection?
  Mr. DORGAN. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The Senator from Tennessee has made a 
unanimous consent request. The Senator from Tennessee has the floor.
  Is there objection to the request?
  Mr. DORGAN. Reserving the right to object, has the Senator provided 
copies of the amendment to our side?
  Mr. ALEXANDER. I have provided it to the desk. I guess the answer is 
no, but I will be happy to do so.
  Mr. DORGAN. If the Senator from Tennessee will visit with me just 
briefly, I object for the moment so I may take a look at the amendment.
  The PRESIDING OFFICER. Objection is heard.
  The Senator from Tennessee still has the floor.
  Mr. ALEXANDER. Madam President, if the manager of the bill is 
congenial with my idea of going ahead and talking about the amendment 
while he considers the terms, I will see that he has a copy.
  Mr. DORGAN. Madam President, why don't we ask the Senator to proceed 
to discuss the amendment, and let's look at the language.
  Mr. ALEXANDER. I thank the Senator from North Dakota for his 
courtesy, and I will ask that my staff get copies of the amendment to 
Senator Dorgan.
  I am offering today the auto stock for every taxpayer amendment. This 
is an amendment I and a number of other Senators, including Senators 
Bennett, Kyl, and McConnell, have introduced before. It basically would 
require the Treasury to distribute to all Americans who pay taxes on 
April 15 all of the government common stock in the new General Motors 
and Chrysler within 1 year following the date of emergence of General 
Motors and Chrysler from bankruptcy proceedings. In addition, General 
Motors, we are glad to say, has now emerged from bankruptcy 
proceedings, so the amendment becomes very timely.
  The amendment would prohibit the Treasury from using any more TARP 
funds to bail out GM or Chrysler, and it would require that the 
Secretary of the Treasury and his designee have a fiduciary 
responsibility to the American taxpayer to maximize the return on their 
investment as long as the government holds stock in these companies.
  This is the best way to get the auto companies out of the hands of 
Washington bureaucrats and politicians and into the hands of the 
American people in the marketplace where the companies belong.
  There is a great deal of sentiment on the Democratic side as well as 
the Republican side about this. I know Senator Nelson of Nebraska had 
introduced legislation along the lines of finding a way to move the 
stock of auto companies out of the hands of government and into some 
other hands as quickly as possible, taking the very sensible notion 
that the job of the U.S. Government is not to operate automobile 
companies in the United States. And Senator Thune, Senator Corker, and 
Senator Johanns all have offered amendments to that effect.
  I would like to suggest to my colleagues that this amendment, which I 
hope we have a chance to consider, is the most responsible way to take 
the taxpayers' investment in General Motors and Chrysler, maximize the 
return on the investment, get it out of Washington, DC, so we 
politicians are not tempted to meddle with it, and get it back out in 
the hands of the American people in the marketplace. It will create a 
sort of ``Green Bay Packers'' fan base for Chevrolets and whatever else 
General Motors decides to produce.
  Most Americans know that in the National Football League there are a 
lot of teams who have a lot of loyalty, but the Green Bay Packers have 
more loyalty than most. One reason is that the fans own the team. In 
this case, the taxpayers would own General Motors and the taxpayers 
would own Chrysler or at least part of it. They would own 60 percent of 
General Motors and about 8 percent of Chrysler. That would give about 
120 million Americans who pay taxes on April 15 a few shares in General 
Motors and Chrysler. And it might make them a little more interested in 
the next Chevrolet, and produce a little consumer interest.
  That is not the best reason to do this. The most important reason to 
do this is that the American people, by overwhelming margins, 
understand what I think most of us understand: that the federal 
government has no business trying to run a car company. We do not know 
anything about running car companies. Yet, if we own it, we cannot keep 
our hands off of it. We have seen many examples of this on both sides 
of the aisle, I may say.
  I started giving out car czar awards a few weeks ago. I gave the 
first one to the distinguished Congressman from Massachusetts who 
called the president of General Motors and said to him: Don't close a 
warehouse in my congressional district. And, lo and behold, the 
warehouse was not closed. Well, the Congressman said he was only doing 
what any Congressman would do about a warehouse in his district. I 
think he is right about that. But the problem is, the Congressman owns 
part of the company. He happens to be the chairman of the House bailout 
committee--the Financial Services Committee--in addition to that. So it 
creates a political incestuousness that we need to end.
  Now, lest my colleagues on the other side think I am trying to pick 
on Democratic car czars, I had to give the second car czar award to 
myself because, lo and behold, General Motors

[[Page 19506]]

came around visiting the delegations of Michigan, Indiana, and, yes, 
Tennessee to try to see where they might build a plant for small cars. 
Now, what was I to do, as a Senator from Tennessee and as the Governor 
who helped recruit Saturn to Spring Hill, TN, 25 years ago? I got with 
Senator Corker, and we got with the Governor, and we had a meeting in 
my office, and we met with the General Motors executives, and we put 
our best case forward.
  Of course, we own 60 percent of the company. I counted up that there 
are about 60 committees and subcommittees in the House and the Senate 
that conceivably could have jurisdiction over General Motors and 
Chrysler and could hold hearings about the color of their cars and why 
they are buying a battery for the Chevy Volt in South Korea when they 
could be buying it from Tennessee, or why they do not make a car that 
is this big or that big or that many miles per gallon. Or what about 
the dealers? That has been a matter of great concern in the Congress. 
There is legislation pending that would overrule whatever the 
management's decision on dealers is. You name it, we have a reason to 
meddle. And most of us have been meddling.
  So what do we have here? We have these chief executives of major 
companies for which we have now paid almost $70 billion of taxpayers' 
money for 60 percent of the stock in General Motors and 8 percent in 
Chrysler. And what do these CEOs do? They are reduced to the status of 
some assistant secretary, driving their congressionally approved hybrid 
cars from Detroit to Washington to testify. They dare not fly in an 
airplane or we would want to know what kind of airplane they are flying 
in. So they come to Washington. They testify all day before the 
committee. Of course, they have to get prepared for that, which takes 
some time. Then they turn around and drive back home. My question is, 
How many cars did they design that day? How many cars did they build 
that day? How many cars did they sell that day while they are up here 
talking to all of their distinguished owners--Senators, Congressmen--
all of us who are here in Washington, DC?
  Now, we are well meaning, and they are well meaning. But my point is, 
the chief executives are never going to be able to succeed if we are 
constantly meddling in their business. So this amendment would make 
sure we move the ownership of stock from the government in Washington, 
DC, into the marketplace. Madam President, I see the manager of the 
bill. I would be glad to yield to him for a moment, if I could retain 
the floor.
  Mr. DORGAN. Madam President, if Senator Alexander would yield?
  Mr. ALEXANDER. Madam President, I would like to be able to reclaim my 
time.
  Mr. DORGAN. Yes, without the Senator losing his right to the floor. 
We think the way we would like to proceed is for the Senator from 
Tennessee to go ahead and offer his amendment and then finish his 
statement, after which we will go into a period of morning business, 
for not more than 10 minutes for each presentation. I believe Senator 
Kaufman has morning business.
  So the point is, Senator Bennett and I have discussed it, and we feel 
it appropriate for the Senator from Tennessee to offer the amendment at 
the end of his discussion, after which we will go into morning 
business.
  Mr. ALEXANDER. Madam President, I thank the Senator for his courtesy. 
And I see the Senator from Delaware. I will take just a few more 
minutes, if I may, to explain the amendment.
  So the reasons for doing this, to summarize, is that all of us seem 
to say--the President has said he does not want to micro-manage the 
auto companies. But if we own the companies, it is kind of hard for him 
not to do that. He fired the president of General Motors. His 
representatives are appointing the board. The President himself called 
the mayor of Detroit and seemed to get on the side of the issue of 
where the General Motors headquarters would be--in Warren, MI, or in 
Detroit. He has an Auto Task Force, whose business it is to pay a lot 
of attention to how these companies are running. There is a pay czar 
over in the White House whose job it is to check on the pay of certain 
executives in General Motors and Chrysler.
  It is hard for me to see how General Motors and Chrysler--with all 
they have to do and the challenges they have ahead of it--how they are 
going to compete with Honda and Nissan and Toyota and Ford, which 
posted a big profit. If General Motors is spending a large percent of 
its time responding to meddlesome questions and directives by its 
majority owner, the U.S. Government.
  I am not the only one who thinks that. According to the Nashville 
Tennessean, an AutoPacific survey reports that 81 percent of Americans 
polled ``agreed that the faster the government gets out of the 
automotive business, the better.''
  Ninety-five percent disagreed ``that the government is a good 
overseer of corporations such as General Motors and Chrysler.'' Ninety-
three percent disagreed ``that having the government in charge of (the 
two automakers) will result in cars and trucks that Americans will want 
to buy.'' According to a Rasmussen Poll done in June, 80 percent 
believe the government should sell its stake in the auto companies to 
private investors ``as soon as possible.'' According to the Wall Street 
Journal on June 18, 70 percent of those surveyed said ``they had 
concerns about federal interventions into the economy, including Mr. 
Obama's decision to take an ownership stake in General Motors Corp.''
  But I do not think that is news to any of us. I think almost every 
Member of Congress understands that General Motors and Chrysler would 
be better off if we did not own them.
  So that leaves the remaining question: What is the best way to get 
the stock from where it is in the government to where it needs to be, 
which is in the marketplace?
  There have been a variety of good proposals made. I mentioned Senator 
Nelson's proposal, Senator Corker's, and Senator Thune's. But I would 
argue that a straight, simple stock dividend, which is what I am 
proposing, is the simplest and most effective way to accomplish this 
job. It is called a ``corporate spinoff,'' in corporate terms, or a 
spinout. It is a new entity formed by a split from a larger one.
  It often happens with very large companies. It usually happens when a 
major company--in this case, the U.S. Government--has a subsidiary--in 
this case, General Motors and Chrysler--which has very little to do 
with the business of the major company. Well, surely operating a car 
company is not the main business of the U.S. Government, which has a 
lot on its plate, when we go from health care, to climate change, to 
energy, to the budget, et cetera.
  Examples of corporate spinoffs are pretty familiar to us. Procter & 
Gamble did a spinoff with Clorox in 1969. In other words, Procter & 
Gamble owned Clorox. Procter & Gamble declared a stock dividend. It 
gave its shareholders shares in Clorox, and Clorox and Procter & Gamble 
were severed. Time Warner did a spinoff with Time Warner Cable in March 
2009. Time Warner stockholders received a pro rata share of Time Warner 
Cable common share stock. That is the same idea I am proposing here 
today. Then PepsiCo did a spinoff with its restaurant business--KFC, 
Pizza Hut, and Taco Bell in 1997. This is also something familiar. 
PepsiCo shareholders each received 1 share in the new restaurant 
company for every 10 PepsiCo shares they held.
  The idea of Americans owning stock is not a new idea in the United 
States. Fifty-one percent of families hold stocks in publicly traded 
companies directly or indirectly. And many big companies have many 
shareholders.
  Several of us Congressmen and Senators were on a phone call with 
Fritz Henderson, the General Motors chief executive officer, several 
weeks ago. The question came up about, what is the government going to 
do with all this GM stock after the bankruptcy? Mr. Henderson made very 
clear that was not his decision, it was the Treasury's decision to 
make. But he said this is a ``very large amount'' of stock and that the 
orderly offering of those

[[Page 19507]]

shares to establish a market might have to be ``managed down over a 
period of years.''
  Well, if the government in Washington holds the shares of General 
Motors and Chrysler for a ``period of years,'' I cannot think of 
anything that will make it less likely that General Motors will succeed 
because we will be meddling every single day, and GM will never have 
time to design, build, and make cars. Instead, the government could 
declare a stock dividend within the next few months, which should be 
relatively easy to do because we have the names and the accounts of the 
120 million people who pay taxes on April 15. The principle here is: 
they paid for it, they might as well own it. So if the taxpayers own 
it, and that is good for them, and if getting rid of the stock from the 
government is good for the government and good for General Motors--just 
like creating a fan base of 120 million Americans who might be 
interested in the next Chevy, like Green Bay Packers fans are 
interested in the next quarterback--then, it seems to me this is a very 
wise idea.
  I have talked with a number of corporate lawyers and bankruptcy 
lawyers and securities lawyers. I have discussed it with Governors. I 
have discussed it with financial officials. And I have talked about it 
with average Americans who are not happy about the fact that the 
government owns 60 percent of General Motors. They all think this stock 
distribution is a good idea.
  I am afraid some of my colleagues think: Well, he is just making a 
point. He is just being facetious. I am not. We need to get rid of this 
stock. We almost all agree with that. It will take us years to do it if 
we sell it just in an orderly way over a period of time. The single 
best familiar way to get the stock out of the hands of the government 
and into the hands of the marketplace is a stock dividend. Give the 
stock to the people who have now paid almost $70 billion for it--the 
120 million people who pay taxes on April 15--and let's get this 
economy moving again.
  Not many weeks ago, a visiting European auto executive said to me, 
with a laugh, that he was in Washington, DC, which he referred to as 
``the new American automotive capital: Washington, DC.'' Well, it would 
be a little humorous if it were not so sad. None of us like the fact 
that we are in the situation we are in. But to give General Motors and 
Chrysler a chance to succeed, let's get our auto companies out of the 
hands of Washington, DC, and back into the marketplace. And the sooner 
the better. The amendment I offer will achieve that purpose.
  At this point, I wish to once again ask unanimous consent to set 
aside the pending amendment and call up my amendment No. 1862.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report.
  The legislative clerk read as follows:

       The Senator from Tennessee [Mr. Alexander] proposes an 
     amendment numbered 1862 to amendment No. 1813.

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

(Purpose: To limit disbursement of additional funds under the Troubled 
  Asset Relief Program to certain automobile manufacturers, to impose 
   fiduciary duties on the Secretary of the Treasury with respect to 
shareholders of such automobile manufacturers, to require the issuance 
  of shares of common stock to eligible taxpayers which represent the 
     common stock holdings of the United States Government in such 
           automobile manufacturers, and for other purposes)

       On page 68, between lines 15 and 16, insert the following:

     SEC. ___. RESTRICTIONS ON TARP EXPENDITURES FOR AUTOMOBILE 
                   MANUFACTURERS; FIDUCIARY DUTY TO TAXPAYERS; 
                   REQUIRED ISSUANCE OF COMMON STOCK TO TAXPAYERS.

       (a) Short Title.--This section may be cited as the ``Auto 
     Stock for Every Taxpayer Act''.
       (b) Prohibition on Further TARP Funds.--Notwithstanding any 
     provision of the Emergency Economic Stabilization Act of 2008 
     (12 U.S.C. 5201 et seq.) or any other provision of law, the 
     Secretary may not expend or obligate any funds made available 
     under that Act on or after the date of enactment of this Act 
     with respect to any designated automobile manufacturer.
       (c) Fiduciary Duty to Shareholders.--With respect to any 
     designated automobile manufacturer, the Secretary, and the 
     designee of the Secretary who is responsible for the exercise 
     of shareholder voting rights with respect to a designated 
     automobile manufacturer pursuant to assistance provided under 
     title I of the Emergency Economic Stabilization Act of 2008 
     (12 U.S.C. 5201 et seq.), shall have a fiduciary duty to each 
     eligible taxpayer for the maximization of the return on the 
     investment of the taxpayer under that Act, in the same 
     manner, and to the same extent that any director of an issuer 
     of securities has with respect to its shareholders under the 
     securities laws and all applicable provisions of State law.
       (d) Required Issuance of Common Stock to Eligible 
     Taxpayers.--Not later than 1 year after the emergence of any 
     designated automobile manufacturer from bankruptcy protection 
     described in subsection (f)(1)(B), the Secretary shall direct 
     the designated automobile manufacturer to issue through the 
     Secretary a certificate of common stock to each eligible 
     taxpayer, which shall represent such taxpayer's per capita 
     share of the aggregate common stock holdings of the United 
     States Government in the designated automobile manufacturer 
     on such date.
       (e) Civil Actions Authorized.--A person who is aggrieved of 
     a violation of the fiduciary duty established under 
     subsection (c) may bring a civil action in an appropriate 
     United States district court to obtain injunctive or other 
     equitable relief relating to the violation.
       (f) Definitions.--As used in this section--
       (1) the term ``designated automobile manufacturer'' means 
     an entity organized under the laws of a State, the primary 
     business of which is the manufacture of automobiles, and any 
     affiliate thereof, if such automobile manufacturer--
       (A) has received funds under the Emergency Economic 
     Stabilization Act of 2008 (12 U.S.C. 5201 et seq.), or funds 
     were obligated under that Act, before the date of enactment 
     of this Act; and
       (B) has filed for bankruptcy protection under chapter 11 of 
     title 11, United States Code, during the 90-day period 
     preceding the date of enactment of this Act;
       (2) the term ``eligible taxpayer'' means any individual 
     taxpayer who filed a Federal taxable return for taxable year 
     2008 (including any joint return) not later than the due date 
     for such return (including any extension);
       (3) the term ``Secretary'' means the Secretary of the 
     Treasury or the designee of the Secretary; and
       (4) the terms ``director'', ``issuer'', ``securities'', and 
     ``securities laws'' have the same meanings as in section 3 of 
     the Securities Exchange Act of 1934 (15 U.S.C. 78c).

  Mr. ALEXANDER. Madam President, I believe that concludes my remarks 
and I yield the floor.
  The PRESIDING OFFICER. The Senator from Delaware.
  Mr. KAUFMAN. Madam President, I ask to speak as in morning business 
for 20 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. KAUFMAN. I ask unanimous consent to be followed by Senator Brown.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________