north carolina republican senator richard byrd that's expected around 4:30 eastern. now live senate coverage right here on c-span2. the presiding officer: the senate will come to order. the chaplain, dr. barry c. black, will lead the senate in prayer. the chaplain: let us pray. our fathers' god to you the author of liberty, we lift this

prayer. long may our land be bright with freedom's holy light. protect us by your might, great god our king. lord, it's so easy for us to forget your gracious providence that sustained our nation's founders law bitter adversity. how easily we forget and assume that our might, wisdom, and ingenuity alone produced this land we love. remind our lawmakers each day that they are helpless without you. may they not wait for calamities

to fall before they acknowledge their dependence upon you. lord, deliver them from the pride which believes that they alone can solve the problems that beset our nation. quicken their minds to seek your wisdom and return them to that noble dependence on you that enabled our forebears to persevere and win against good odds. we pray in your sovereign name, amen.

the presiding officer: please join me in reciting the pledge of allegiance to the flag. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the presiding officer: the clerk will read a communication to the senate. the clerk: washington, d.c., june 9, 2009. to the senate: under the provisions of rule 1, paragraph 3, of the standing rules of the senate, i hereby appoint the honorable roland burris, a senator from the state of illinois, to perform the duties of the chair. signed: robert c. byrd, president pro tempore. ^ mr. reid: mr. president, following the remarks of the leaders the senate will be in morning business for one hour with senators allowed to speak for up to ten minutes and the majority controls the first 30

minutes and the republicans control the second 30 minutes. then the senate will resume consideration of h.r. 1256, family smoking prevention and tobacco control act. last night, cloture was invoked on that matter and we also agreed last night that we would have a vote in relation to the burr substitute amendment at 4:30 p.m. today and i hope we can reach an agreement to consider other amendments prior to the vote in relation to the burr amendment. senators will be notified if any other votes are scheduled. staff is working now trying to come up with a list of amendments we can vote on. the senate will recess from 12:30 until 2:15 for caucus luncheons. mr. president, h.r. 31 is at the desk and it is my understanding it is due for a second reading. the presiding officer: the clerk will read the bill for the second time. the clerk: h.r. 31, to provide for the recognition of the lumbee tribe of north carolina and for other purposes.

mr. reid: i object to further proceedings at this time. the presiding officer: the objection having be heard the bill will be placed on the calendar under rule 14. mr. mcconnell: mr. president? the presiding officer: the republican leader. mr. mcconnell: mr. president, when it comes to health care americans are looking for answers. they don't understand why basic medical procedures are so expensive. they don't understand why millions of americans have to go without basic care in a nation as prosperous as our own and many are worried about losing the care they have and like. so the need for health care reform is not in question. all of us want reform. the question is: what kind of reform will we deliver? and two very different

approaches are now beginning to come into view. according to one approach, the government plays the dominant role by getting into -- into the health care business and leverages taxpayers' money to muscle everybody else out of the way. under this approach the vast majority of americans who like the health care they have, risk losing it when a government-run system takes over. the other approach is to find ways of controlling costs such as discouraging the junk lawsuits that drive up the cost of practicing medicine and limit access to places -- and access to care in places like rural kentucky. lifting barriers that currently diminish effectiveness of prevention and wellness programs shown to reduce health care costs like quitting smoking, fighting obesity and making early diagnosis. and, finally, letting small businesses pool resources to lower health insurance without imposing new taxes that kill

jobs. this second approach acknowledges that government already plays a major role in the health care system and that it will continue to play a role in any solution that we devise. but this approach is also based on the principle that government can't be the solution. americans want options. not a government-run plan that drives every private health plan out of business and forces people to give up the care they currently have and like. the secretary of health and human services acknowledged this concern about a health care monopoly when describing those parts of the country where certain private health plans already have a monopoly. she said "in many areas of the country the private market is monopolized by one carrier. you don't have a choice for consumers." what we know in any kind of market is a monopoly doesn't give much incentive for other innovation or cost effective strategies. well, mr. president, if that's true of private health plan then

it would be especially true of a government-run health plan. if a government-run plan came into being, concerns about a monopoly wouldn't just be regional but national. another problem of the government plan is a feature too common in nations that adopted one. many of these nations have established so-called government boards as part of their government health plans that end up determining which benefits are covered and which benefits aren't covered. our former colleague and the president's first choice for health and human services secretary, tom daschle, envisioned a board in his widely cited book on the topic. "the federal health board," he writes, would promote high-value medical care by recommending coverage of those drugs and procedures backed by solid evidence. now, mr. president, what this means is the federal government would start telling americans what drugs they can and cannot have. we know this because that's

exactly what is happening in countries that have adopted the government boards. they have categorically denied cutting-edge treatments either because the treatments cost too much or someone in the government decided the patients who needed it were either too old or too sick to be worth the effort. when these countries enacted health boards i'm sure the intention was not to delay and deny care but that is exactly what government boards are doing. the writer and commentator, virginia pastral who has written for the "new york times" and "wall street journal" recently wrote an confident her first-hand experience with breast cancer and the ability to treat it successfully with a drug here in the united states. she says the availability of the drug increased her chances of survival from a coin flip, from a mere coin flip, to 95%. a year after beginning treatments she wrote that she had no signs of cancer.

none. in the same article, she points out that the situation is far different in new zealand. a government board there decided that this drug shouldn't be made available to some cancer paints in that country -- cancer patients in that country. as one cancer doctor in new zealand put it, new zealand is a great tourist destination but options for cancer treatment are not attractive. bureaucrats in new zealand finally allowed coverage for the drug due in part to a public outcry over the limited availability of the drug. new zealanders have been denied access to drugs that are proven effective in reducing the risk of heart disease and strokes. according to an article from 2006 in the new zealand medical journal, the restrictions placed on statins by new zealand's government board significantly hampered the preventive approach to heart disease. as the authors of the article put it, it is probably that this

one decision has caused more harm and premature death to new zealand patients than any of the other maneuvers. now, americans want health care reforeign minister but they don't want re -- health care reform but they don't want reform that destroys care. they don't want a government bureaucrat making arbitrary decisions about which drugs you can or cannot take for an illness. and they don't what to be told they have to give up the care they already have. americans don't want a government-run health plan. and they certainly don't want a government board to dictate their health care coverage. they want real reform that solves the problems they face without sacrificing the benefits they enjoy. mr. president, i yield the floor. mr. durbin: i ask unanimous consent to speak as if in morning business for 15 minutes. the presiding officer: under the previous order, the leadership time is reserved.

under the previous order there will now be a period of morning business for up to one hour with senators permitted to speak for up to ten minutes each with the time equally divided and controlled between the two leaders or their designees with the majority controlling the first half, the republicans controlling the second half. the senator from illinois. mr. durbin: i renew my that that request to speak in morning business for 15 minutes. the presiding officer: without objection, so ordered. mr. durbin: for the last month the republican leader from kentucky has come to the floor and argued that we should not move detainees currently in guantanamo, into the united states, even for trial. luckily, the president and the attorney general have the head of the joint military chiefs of staff have come to the conclusion that it's in the best interests of the united states' safety and security that one of these notorious terrorists be brought to the united states for trial. and so it has been announced today that mr. ahmaz ghalani is

being brought to the united states, to new york, for trial. luckily this administration is not following the advice and counsel of senator mcconnell and some on his side. it is time for this man to face a trial. what is he being charged with? he's being charged as one of those involved in the 1998 embassy attacks in africa. this tanzania national has been held in cuba since september of 2006. he was captured by our forces, and others, in pakistan, in 2004 and transported to guantanamo. he is being charged with his involvement in the 1998 bombings of u.s. embassies in east africa which killed 224 people, including 12 americans.

the position being taken by the republicans in the senate is that this man should not be brought to the united states for trial. i think they're wrong. i think it's time that he answer for the crimes that are being charged against him. 12 americans died. as a result of what we believe was his conduct. he needs to be held accountable. this argument that he can't be brought to the united states and tried would virtually allow this map to escape the punishment for the crime that we believe he committed. republicans' position that he should not be brought to the united states because somehow if he is being held in a prison in the united states it's a danger to the rest of us? that just cannot be supported in fact. there are 327 convicted terrorists presently being held in u.s. prisons and not one has escaped. in super max facilities, no one has evers scaipped. foevers -- ever escaped and

for the republicans to argument we cannot bring this man to trial it leaves him in a position where we may lose our ability to prosecute him. speedy trial requirements of our constitution and the laws of the united states could virtually end up in the united states being unable to prosecute this man if the republican position on guantanamo detainees is followed. general colin powell is right, guantanamo needs to be closed. it is a recruiting tool for al qaeda. we know that these individuals can be brought to the united states and tried and safely imprisoned. we've never had an escape from a supermax facility. and we know that to turn these prisoners over to some other country runs the risk that they will be released. dangerous people who threaten the united states should be dealt with by our constitution and laws. the administration has made the right decision that this man be

brought to trial in the united states, held accountable for any wrongdoing on his part that led to the deaths of so many hundreds of innocent people at our embassies in africa. mr. president, i ask that my next statement be placed in a separate part of the record. i ask consent. the presiding officer: so ordered. mr. durbin: mr. president, this morning we heard the republican leader come to the floor again -- this is not the first time -- to address the health care situation in america. i read his previous speech and i listened to his speech today. it is clear to me that he does not believe that we are facing a crisis when it comes to health care. i think we are. i think it is a serious crisis. it is a crisis where 47 million americans have no health insurance. imagine, if you will, being a parent, having children with no health insurance coverage. imagine yourself in a position where an accident or a diagnosis

in a doctor's office could literally mean you'd lose every penny you ever saved in your life for expensive medical care when you don't have health insurance. imagine that as a crisis that affects americans, too many of them today. and then imagine those who have health insurance and worry that tomorrow the cost will go up to the point where they can't afford it, that there will be medical procedures necessary uncovered by the health insurance. cost is an issue. it is an issue which is driving us to look at reform of the health care system. now, i heard senator mcconnell this morning, and what he is arguing about, frankly, is not even in the debate here on capitol hill. he said repeatedly -- he said it yesterday, said it again today -- that our debate over health care reform means that americans run the risk of losing their health insurance that they

want. exactly the opposite is true. what president obama has said and what we are saying is that if you have good health insurance, you can keep it. if you like the health insurance you have, you can keep it. no one has ever argued the opposite position which the senator from kentucky referred to this morning. he also spent a lot of time talking about government-run health care plans. it's interesting that he would raise that as an issue when we're not suggesting a government-centered health insurance reform. we think it should be a patient-centered health insurance reform. but we also know that when you ask americans across the board, families and patients, what do you think about the health care system in america? what are its greatest shortcomings in the current health care system? you know what the number one saepbs. stph* almost 48.9% say not having health insurance.

43% say the greatest shortcoming is dealing with health insurance companies. 30.9%, inflexibility of health care plans. 30.9%, insurance companies refusal to cover preexisting conditions. when the senator from kentucky comes to the floor and argues against changing the current situation, he is arguing for allowing these health insurance companies to continue to dominate. and as long as they dominate, americans and their families will be vulnerable, vulnerable to increases in cost that they cannot manage, vulnerable to new policies with more exclusions, vulnerable to preexisting conditions not being covered. that is the vulnerability of americans today that we have to seriously address. the senator from kentucky argues that we don't want a canadian plan. we don't want a british plan. we don't want a new zealand plan. he's right. we want an american approach, an

american approach that combines private health insurance companies when they're held to standards that are fair to american families, but also holds open the option that we will have a plan which is run by the government as an option, a voluntary option for people to choose. if they like what they have in their current plan, they can keep it. if they want to prove to another private health insurance plan, they can do so. if they want to choose a government plan, they can do that as well. now, according to the senator from kentucky, if the government's involved in it, it must be bad. tell that to 40 million americans under medicare. people, many of whom never had health insurance in their life and now have the protection of medicare. medicare's worked for senior citizens and the disabled for a long, long period of time. the senator from kentucky should also tell the people in the veterans administration that when the government's involved, it doesn't work. they know better. veterans and their families across america know that our

veterans health care system provides quality care for them. we entrust to them, the men and women who risk their life for america and came home injured, and we know that they're going to get quality care. so to argue that if there's any government involvement in all in health care, it's to the detriment of america argues against medicare, argues against the veterans administration. the senator went on to say that, if the government gets involved, the delays will just be intolerable. we don't want delays. we want timely treatment of people. if a doctor believes that either i or my family members need to have surgical procedure, some help, some diagnostic test, we want it done in a timely fashion. what the senator from kentucky, the republican leader ignores, is that there are delays within the current system. an article in "business week" highlights the case of a woman in new york -- susan -- who called for an annual mammogram

appointment in april knowing she would have to wait six weeks. in 2007, her first scan at the end of may wasn't clear. a follow-up scan detected an abnormality which the doctor wanted to address with a needle biopsy, an outpatient procedure. the first available date was mid-august, more than two months later. this lady, who had an abnormality in her mammogram, was forced to wait months under the current system, the current private health insurance system. we have a similar problem in chicago in cook county, illinois. at the local public hospital, wait times for specialty services can range from six months to one or two years, under the current system. so we know that when it comes to delays, unfortunately, they are occurring in the current system that we have. we also know that for a lot of people this current system has become just unaffordable and intolerable. when i think back of one of my

friends in springfield, doug mayol, he tells the story. he ounce a -- owns a small business in springfield, a shop that sells cards and gifts. his only worker has medicare coverage, but doug has to buy private health insurance. unfortunately, you see, doug has a problem. he was diagnosed many years ago -- 30 years ago, in fact -- with congenital heart valve defect. he has no symptoms. without regular health care, he runs the risk of developing serious problems. in the year 2001, doug, in springfield, illinois, paid $200 a month for health insurance. 2001. by 2005, even though he had not turned in any claims, his cost of health insurance was up to $400 a month. the next year, when he turned 50 years of age, the rate nearly doubled to $750 a month. he made some changes in coverage so he'd pay more out of pocket,

choose a small network of providers, have a higher deductible, got his premium down to $650 a month. this man owns a small shop. he sells greeting cards. he was up to $650 a month. two years later his deductible jumped over $1,000 a month. again he made some changes by opgt for the highest possible deductible, he was able to bring his premiums down to $880 a month. he's paying 300% more than he paid for health coverage eight years ago and getting a lot less for it. he isn't a costly patient. his valve condition is a seupl tow mattic. he never filed a claim. with his high deductible, his insurance rarely kicks in. here's the problem. because of his high detkeublgt and because of the expense of his health insurance, he's afraid to go to the doctor. it will create another red flag for the health insurance company to raise premiums even more.

it's unfair to him. doug mayol working in springfield, illinois, as a small business owner, insurance company never paid a claim, to watch his costs explode from $200 a month to $1,000 a month in just a few years. sadly, if we follow the advice of the senator from kentucky, it will just go the worse. president obama has challenged us to take this on. this is not easy, believe me. there are health insurance companies who are going to fight us every step of the way. any time we step in to try to protect doug and other families to make insurance affordable and to make sure it's quality, they're going to argue it's too much government, just like you heard from the senator from kentucky this morning. what he had to say is what we hear from the health insurance companies. leave it alone. leave the system alone. can we afford for doug mayol and the millions of americans to leave this alone? we have to make sure that we

move toward a situation that recognizes we face a crisis. it's a crisis in cost and a crisis when it comes to the availability of health insurance. we have to hold the health insurance companies accountable to provide us affordable quality care. we have to change the system so that we have early detection of problems, preventive care. we've got to wring some of the cost out of the system. one of the persons who made a comment on this regularly that i respect very much is a doctor in boston named atule gawandi. he recently in an article in "the new yorker" talked about the disparity of costs around the united states for medicare. it is clear in some parts of the country -- and he was speaking of mcallen, texas -- the cost for medicare patients are dramatically higher than other places. we can bring costs down to a reasonable level and try to take control of a system that's currently out of control. but we can't do it if every day we are reminded of problems that

don't exist. and that's what we've heard from the other side of the aisle. they're arguing that we want to take away people's health insurance. absolutely false. we've said if you like your health insurance, you can keep it. they're arguing that we want the government to take over the health care system. i haven't run into anybody who suggested that. what we want to do is have private health insurance and have a public option, which the senator from new york is going to address in just a moment as i close here. this is an important debate for every single american. it is time for us to put together a reform that assures quality affordable health care for all americans. mr. president, i yield the floor. mr. schumer: mr. president? the presiding officer: the senator from new york. mr. schumer: thank you. first let me thank my friend and colleague from illinois for his strong and forceful words, meaningful, bringing it home, as he always does, in a very strong and good way about individuals and how they are affected.

i'd like to talk a little bit about where we're at in health care and where we have to go. let me just say, mr. president, that about ten years ago -- i can't remember the exact time -- there was a, one of the major issues we faced was called the patient bill of rights. people felt, doctors felt, patients felt, everyone felt that h.m.o.'s were taking undue advantage of them. doctors, a patient needed desperately a prescription. they'd call up some accountant in a faraway city, couldn't get approval and the patient wouldn't get the medicine. it sort of hit home. there was a movie called "as good as it gets." it had jack ni coleson and can't remember the name of the woman who was the star in there as well. and the family couldn't get the health care they needed because

the h.m.o. turned them down. and i believe it was her child who was really hurting. and when she and jack nicholson made remarks about how somebody has to keep an eye on these h.m.o.s in theaters across america, the audience got up and cheered. that's again what we're talking about here today when we talk about public option. every one of us has a friend, a family member, or maybe it's ourselves who has experienced the basic intransigence of insurance companies in providing, even when you have a package of benefits, in providing the kind of care you or a loved one, a member of your family, needs. it's clear in america that the insurance companies -- and they're doing their job, maximizi t