[Congressional Record (Bound Edition), Volume 159 (2013), Part 3]
[Senate]
[Pages 3322-3324]
[From the U.S. Government Publishing Office, www.gpo.gov]




                          CONTRASTING BUDGETS

  Mr. DURBIN. Mr. President, this is a historic week because we will 
see congressional presentations of the congressional budgets, and I 
believe we will see stark contrasts.
  Congressman Ryan of Wisconsin--nearby my home State of Illinois--is 
going to prepare and present to the Republicans in the House of 
Representatives a budget that he says will bring our overall Federal 
budget into balance over 10 years. It is a daunting task, and I commend 
him for his effort. I also have to say that we have been there before. 
We have heard this budget before. We know what it contains. There are 
several elements in the Ryan budget--as some have announced in 
advance--that repeat the mistakes of his earlier budgets, and some of 
them are grievous.
  We understand we need entitlement reform to make sure important 
programs such as Social Security, Medicare, and Medicaid continue for 
years to come. We understand there will be some hard choices associated 
with efforts to make these programs more solvent.
  The Ryan approach continues to have something called premium support. 
What it boils down to is this: In the outyears, Congressman Ryan and 
the House Republicans want to offer seniors across America less money 
to pay for their Medicare insurance. They want to privatize the 
Medicare insurance system.
  Our side of the aisle--both in the House and the Senate--is dedicated 
to

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some basic principles. One of the first is to make sure men and women 
across America who are from working families have a fighting chance, to 
make sure the Tax Code is responsive to their needs, to make sure the 
programs they count on will be there when they need them.
  Every hour of every day most American workers in States such as 
Massachusetts and Illinois pay into our Social Security and Medicare 
system with the belief that when the time comes for retirement, Social 
Security and Medicare will be there. Unfortunately, what Congressman 
Ryan is proposing is to really break that promise and to say to seniors 
across America: You can pay into it for a lifetime, but when the time 
comes and you really need Medicare and health insurance during your 
retirement, you probably won't be able to afford it. You won't be able 
to come up with the premiums.
  What good is a Medicare system that a worker has paid into for a 
lifetime if it cannot provide the basic protections they will need 
during retirement? They can balance the books--at the cost of coverage 
and the cost of the Medicare promise that has been made for 
generations.
  Therein lies the real crux of the difference between Democrats and 
Republicans when we look at these entitlement programs. We know that 
reform is necessary, but reform should be based on best medical 
practices, on reducing the obvious waste in the Medicaid Program, and 
not on penalizing seniors who are on a fixed income who cannot afford 
increasingly high Medicare premiums. That is the Paul Ryan approach--
privatizing Medicare. It is not a good approach for America. That is 
the real difference.
  Of course, there is this dedication on the part of Congressman Ryan 
to reduce the tax rates for the wealthiest people in America. Those 
rates, after the fiscal cliff negotiation, go as high as 39 percent on 
the highest income. Paul Ryan's budget wants to bring them down to 25 
percent, which is a dramatic decline in the income tax rate for the 
wealthiest Americans. How will he achieve this? He says he will achieve 
it by changing the Tax Code to bring the rate down to 25 percent. I sat 
through the negotiations in the Bowles-Simpson Commission and other 
places, and the math does not work. If they are going to try to bring 
down the income tax rate for the wealthiest to 25 percent, sadly, they 
will eliminate the most basic income tax deductions for working and 
middle-income families across America. That is the reality; otherwise, 
they cannot reach that number.
  We have to look at this. If the Paul Ryan budget means the wealthiest 
Americans get a tax cut while working families see a tax increase and 
if the Paul Ryan budget means Medicare will be fiscally solvent but 
unaffordable for most working Americans, this is a budget we need to 
reject out of hand.
  We will see that budget in its entirety today, and by tomorrow the 
Democratic alternative here in the Senate, which has been worked on and 
prepared by Senator Patty Murray of Washington and her colleagues in 
the Senate Budget Committee, will be presented as well, and it will be 
a stark contrast. What Senator Murray and the Senate Budget Committee 
will produce is a balanced approach that says: Yes, there will be 
deficit reduction, but it will be the right way. We need to make sure 
we have revenues coming from those who can afford to pay in the highest 
income categories. Yes, we need spending cuts, and they will continue. 
We need entitlement reform that is thoughtful and sensitive. We need 
reform that really makes sure these programs are here for generations 
to come.
  I think America will applaud the efforts on the Senate side. I think 
they will have many questions to ask on the House side, and then the 
debate begins. Those of us on the Appropriations Committee wait for 
this to be completed because the budget resolution is basically our 
blueprint for what we can achieve during the remainder of the year and 
for the next budget year that starts October 1.
  There are a couple of things that are part of the budget process that 
I will address very quickly.


                             Sequestration

  I am very concerned about the impact of sequestration on health care. 
Reporters in Illinois asked me over the weekend: What is the big deal? 
Sequestration came and life didn't end. It seems as though we are going 
on in a normal way.
  Unfortunately, they overlooked some obvious impacts. For example, 
community health centers are the frontline for primary health care 
across America. I visit them and always leave with a sense of hope and 
a positive feeling. The community health centers in Chicago and across 
Illinois are quality medical institutions. They serve people with 
limited insurance or no insurance, and they serve them in the most 
professional way. I have said with confidence that if I happen to get 
sick someday or someone in my family did, I would feel confident 
walking into these community health centers--they are that good.
  Some 22 million people in more than 9,000 locations across America 
rely on them. As the point of care for uninsured and low-income people, 
community health centers provide preventive services that help avoid 
expensive procedures and emergency room visits.
  At a time when 30 million new Americans are about to get health 
insurance so they can afford to get care, these across-the-board cuts 
are taking $115 million out of community health centers this year 
alone. Nationally, almost 900,000 patients will lose access. Community 
health center funding in Illinois will be cut by $6.2 million. Erie 
Family Health Center in Chicago is one of the best. They will do their 
best to protect clinical care, but the wraparound services that make 
Erie so effective, not to mention cost-effective, will be reduced.
  Now is not the time to cut community health center funding. Instead, 
we should expand the centers so hard-working and low-income families 
get the care they need.
  Regardless of where someone lives or where they go to see the doctor, 
the $1.6 billion cut to the National Institutes of Health threatens all 
of us. And that is what these cuts are going to do to medical 
research--cutting $1.6 billion from the National Institutes of Health. 
I have always said that I will take this issue to any corner of 
America, any group--liberal or conservative, young or old--and make my 
case that investment in health care research is one of the most 
important investments our government makes. When we shortchange medical 
research, we shortchange our future.
  Great medical care is only as good as the science behind it. Drugs 
and devices work only as well as our understanding of the medical 
conditions they are treating. Our country is rich with promising 
research. We lead the world and should be proud of it. We have the 
bright minds, the curious scientists, and the innovative labs. Today 
countless people are engaged in work that will lead to better 
treatments for arthritis, Alzheimer's, AIDS, diabetes, cancer, and the 
list goes on.
  Biomedical research supported by the NIH has established America as 
the leader in the world, and we are right on the verge of making life-
changing discoveries through this research. But sequestration--which is 
now in place-- will have a ripple effect that could curb medical 
discoveries and weaken the economies across the country.
  Dr. Francis Collins, Director of the NIH, says there is no question 
that sequestration will slow the development of an influenza vaccine 
and cancer research.
  Eli Zerhouni, head of NIH under President George W. Bush, said:

       We are going to maim our innovation capabilities if we do 
     these abrupt deep cuts at NIH. It will impact science for 
     generations to come.

  Right now, when so much good research is moving us forward, we should 
be doubling down on medical education, innovation, and infrastructure. 
Cutting back on NIH and biomedical research is so shortsighted. Medical 
research saves lives, keeps America's place as a leader in science and 
medicine, and it generates economic growth. Frankly, these cuts shake 
the

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confidence of people in this field. Trying to decide whether they 
should dedicate their lives to medical research with the uncertainty of 
sequestration and budget cuts is unfair.
  For over a century, NIH-supported scientists have led the way for 
important breakthroughs to improve health and save lives through the 
discovery of things such as the MRI, extending the life expectancy for 
people with cystic fibrosis, revolutionizing our thinking about cancer, 
improving our understanding of stroke and heart disease, and creating 
new vaccines that save lives.
  President Obama has called on congressional leaders to come together 
to create an alternative to the sequestration. A balanced mix of 
smarter spending cuts and revenue from closing loopholes that benefit 
higher income individuals will mean we can keep our commitment to 
medical research.
  This week we are going to start the debate on the continuing 
resolution. One of the early amendments that is likely to be offered 
will be by Senator Harkin, who chairs the Labor, Health and Human 
Services Subcommittee in Appropriations. I have spoken to Senator 
Harkin. He is determined to do everything he can to give the Senate the 
opportunity to continue to cut the deficit but to do it in a way that 
will not make dramatic negative cuts in medical research.
  I hope we can get a bipartisan consensus. Diseases and the threats of 
ill health strike all of us regardless of party affiliation. We should 
come together on a bipartisan basis to support increasing medical 
research and maintaining America's lead in the world.
  I yield the floor and 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. CORNYN. 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.

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