quorum call: the presiding officer: the senator from kansas.

mr. roberts: i ask unanimous consent the call of the quorum be dispensed. .the presiding officer: without objection, so ordered. mr. roberts: mr. president, i ask unanimous consent i may proceed for about 12 or 13 minutes as if in morning business. the presiding officer: without objection, so ordered. mr. roberts: i thank the president. mr. president, i rise today to talk about health care reform. what else, in regard to the interest of the american people and what we are doing here. as the republican leader, senator mcconnell has pointed out, the disiefe desire for heae reform on both sides of the aisle unites this chamber across both political and geographic boundaries. our system of health care produces some of the best care in the world and it is the driver of a substantial share of the medical innovations that wiped out diseases, improved our comfort and extended our time on this earth. however, this system

is not truly accessible to everybody. that's the problem, and that's what this entire debate boils down to. your ability to have access to a doctor, to go see the doctor of your choice when you need to see that doctor. solving his this problem of access is exceedingly complicated partly because it evidences itself in so many diverse ways all across the country. so many different geographical areas. for example, in our rural areas in kansas, we are struggling with attracting and retaining doctors and keeping the doors open to our hospitals, to our pharmacies and clinics. we talk about recruiting athletes, the business of recruiting doctors and health care professionals is equally as competitive. in urban areas like kansas city and wichita, our providers face very different challenges that are just as daunting and which

threaten patients' ability to access health care. on top of that, although some 250 million americans have health insurance, somewhere in the neighborhood of 27 to 47 million, depending on who you're counting and who's talking, they do not. and that makes accessing health care expensive and very challenging for them. in addition, the government-run medicare program which is on the verge of bankruptcy, by the way, does not pay doctors and pharmacists and ambulance drivers and nurse clinicians -- pardon me -- clinical lab folks and home health care providers, almost every health care provider that you can name. they don't pay them enough to cover their costs unless these providers have a nonmedicare patient population from which to recoup their losses, they cannot stay in business and their patients lose out de facto rationing of health care.

now, as a member of both the finance and health committees and the cochair of the senate rural health care caucus, i am able to participate and have been participating along with staff in this complex and very difficult effort. we must reform our health care system into one that guarantees meaningful access for all americans and guarantees that patient-doctor relationship. however, this effort to date has been a tale of rhetoric versus that of reality. the promise of cooperation contrasted with the unfortunate real fact of parsonship, something i do not like to say. let me explain. president obama, who ran as a postpartisan candidate, has made many overtures to republicans emphasizing for this desire for this process to be partisan just met with some members of our leadership and obviously the leadership on the other side of

the aisle as of today. others in the senate have declared their goal to be a bill that attracts upwards of 70 votes. is that possible? i would hope so. could be. that would be a tremendous victory for the senate of the united states and the american people. but the reality is something really very different. today in the "help" committee -- health, education, labor and pensions, the "help" committee -- we have begun the process of walking through a 615-page bill that we are scheduled to mark up next tuesday. this bill does not have one single republican contribution as far as i can tell. moreover, it is incomplete with many details missing. for example, the small detail of how much it will cost. there's no cost estimate to this bill. 615 pages just going through it as of today, going to try to mark it up next tuesday. come on now, that's not the way

we should be doing business. the finance committee has conducted a parallel, and i think, quite frankly, a better process so far, and i'd like to thank chairman baucus, ranking member grassley, their staffs for their efforts, but we still have not seen a detailed proposal or cost estimates, and we are being pushed to mark something up in the next few weeks as well. i want everyone to understand why process is important. health care reform is important, to be sure. getting things done obviously that is important. but so is process. it's not because i do not want health care reform or any member in this body, i don't think, is in a position to say that they do not want health care reform. i want every single kansan, every single american to be able to see the doctor of their choice when they want to, especially when they have to. and i speak today because this health care reform bill will likely involve one of the

biggest, most important votes that i or any one of my colleagues cast during the time that we are privileged to serve in the senate of the united states. this health care reform bill will affect the lives of every single american. it will reform a system that drives one-sixth of our economy over 16 million american jobs. it will have consequences for medical science and innovation that improves the lives of not only those of us in this great country but all across the world. when people are really sick, they come to the united states. and it will spend upwards of $2 trillion -- $2 trillion -- that our children and grandchildren will have to someday repay. if we are going to do this, we cannot afford to get it wrong. for this reason, i initiated a letter just about a week ago on behalf of all my republican colleagues on the senate finance committee, on the "help" committee, and i asked the chairman of those respective

committees, the distinguished chairman, senator dodd, who is now serving in senator kennedy's absence to give this process the time and the careful consideration that it deserves. that was the message of the letter: give us the time and the very careful consideration that this vital issue does deserve. it seems to me that our requests have been extremely reasonable. first, please provide us with your detailed plan with enough time for us to read it, to understand it and get feedback from our constituents back home to people that the bill will affect. we've done this in the finance committee. goodness knows, i don't know how many panels we have had, how many walk-throughs, how many slide presentations. boy, that's tough in the afternoon to turn lights off with senators trying to pay attention. and fact after fact after fact and suggestion after suggestion after suggestion and policy

objective after policy objective on each day as we go through the legislative smock, if you will, to try to get there from here. our requests, again, i think -- i want to say it again, first, we should provide -- you should provide us with your detailed plan with enough time to read it, understand it, get feedback from our constituents back home, the people the bill will affect. the reason i said that twice is that every day we had one of these slide shows, every day we had a power point, every day we got more information, my office would send it back to the providers of health care in kansas, much in the same fashion as many members of the committee would send it to their people and say, hey, is this going to work? these are the people who actually do provide the health care. now, i know the argument that you can say, well, wait a minute, we need to cut out fraud, waste, and abuse.

and we need to be much more cost-conscious. and we need better practices in regards to better medical practices. and we need a lot of things to either suggest to or to incentivize or to mandate that the health care providers do. but in the end result, if that person is sick, they're going to have to see a doctor and they're going to have to see a nurse and they're going to have to see some health care provider. so in the end result, we better at least be doing something that the providers say, yes, this makes common sense or you're going to see either one of two things. you're going to see a political revolt. and they say, no, we're not going to go down that road. or else you're going to see a continuation and rationing where providers say, no, i'm not going to take part anymore in the medicare program because i'm not getting reimbursed up to cost. and in that regard, then, you see rationing. you can have the best government program in the world, the best government card in the world and it can guarantee all swords of things. but if you can't provide a

doctor that really provides it or a home health care provider that will provide that or any provider that will provide that, well, where are you? second, i'd like to see provided the cost estimates from the congressional budget office and the joint tax committee. just let us know how much all of this is going to cost. that's extremely important. we're hearing anything, $1 trillion to $2 trillion. then lastly, how will it be paid for? i know we're into an era now where basically we have the printing presses rolling. we have an economic recovery act and we have many facets of that. we have the stimulus, we had the omnibus. we had the president's budget. and we had tarp. and we had four different other acronyms under tarp. and we didn't worry too much about the pay fors and who was going to pay for it. we let the printing presses roll because nobody wanted to see economic armageddon. could we have done it better? i think so. but that's yesterday's decision.

so we should identify how this will be paid for or are we not going to pay for it? are we simply going to go ahead? there has been some discussion about some aspects of it that you would not pay for. there are other aspects that we need to go into because they involve probable tax increases. and now is not the time to be increasing taxes especially on the small business community, despite the need for health care reform. now, i think asking for these details is absolutely fair. i think it's necessary under the circumstances. in fact, i would be ignoring my responsibilities to my constituents in kansas if i did not demand these conditions be met. every single republican member of the finance committee and health committees signed the letter. every single one expressed the desire to work with our colleagues to achieve bipartisan health care reform. that brings me back to today's

"help" committee walking through 615 pages of an incomplete draft, the rushed health and finance markup schedule tuesday and then in about a week or two and the arbitrary floor debate headlines that we hear from leadership. and i just hope that our letter will slow this hurried dash to an imaginary finish line, slow it down. slow it down. i know it's extremely important that we pass good health care reform legislation. it is also extremely important to prevent bad legislation from passing and get it -- get america saddled it w it for about 20, 25 years. i often wish at the end of every committee room, if in fact the bill gets to committee, the committee of jurisdiction and we could hold appropriate hearings, we would hold a sign which says "do no harm."

right below it, perhaps we could say whoa until everybody can slow down and agree with regard to process and cost and specifics of the bill and trying to work together to get a good product. there's no reason why the senate should rush through a bill that has this much at stake. so time out, mr. president. time out. time. slow down. give us the details. that's all we're asking for. the people of this great nation deserve nothing less. let's get health care reform and let's get it right. thank you, mr. president. i yield back.

the presiding officer: the senator from kansas. mr. roberts: mr. president, it occurs to me after a careful look around the system that a quorum is not present and i would suggest a quorum is not present. the presiding officer: the clerk will call the roll. quorum call:

mr. barrasso: mr. president? the presiding officer: the senator from south dakota. price barrasso i ask unanimous consent the call of the quorum be dispensed. .the presiding officer: without objection, so ordered. mr. thune: i ask unanimous consent i be allowed to speak as if in morning business. the presiding officer: without objection, the quorum call is dispensed with. the senator is recognized. mr. thune: thank you, mr. president. mr. president, there is a disturbing pattern that is emerging in washington, d.c.,

which i don't think is being lost on the american people. we've seen since the beginning of this year with the new administration coming to power, the new congress taking control of the leadership in both the house and the senate, an enormous, unprecedented amount of spending, borrowing, and taxing and i think that the -- to bear that out, i guess this piece of information has been used before -- if you look at the numbers, you have to go back a long ways in american history, back to the foundation of our country, back to 1789 and take it up through today, 2009, 220 years of american history, the total amount of debt that has been accumulated over that period of time, literally since the presidency of george washington through the presidency of george bush will be equaled in the next five years. we will double the amount of

federal debt, public debt, in this country in the next five years. mr. president, we will triple it in 10 years. we are borrowing and spending money around here on a spree that literally is without precedent in american history and i think it should be of concern to all americans for the obvious reason: they've got a share of that debt. in fact, according to "usa today" if you just take the amount of debt accumulated since of beginning of this year with the passage of the stimulus bill, with the new appropriations bill that passed, 8.3% increase over the previous year which was twice the rate of inflation and all the other spending that's going on with the various bailout programs and what not, the average family's share of the debt this year alone is $55,000. average share, family share of the federal debt, $55,000 per

family in debt accumulated just since the beginning of this calendar year. so, mr. president, the amount of borrowing is without precedent. the amount of spending that is being done is without precedent and all under the guise of "this is an emergency," and we've get to react this way. but i think as more of this spending and more of this debt accumulates the american people become more convinced the spending isn't solving the problem it was supposed to solve which was we are going do create jobs, we're going to get the committee growing and expanding and we haven't seen any of those effects but what we have seen, of course, is more debt, more interest, and a bill that we're going to happened to future generations that is not fair to them because we shouldn't be penalizing future generations and punish them because we haven't been able to live within our means. now, the most recent response to that by the administration was yesterday they came out and announced that they're going to implement pay-go so we're going

to have pay-go regulations, or pay-go policies now if place with respect to the federal budget and the way we operate here in congress and, incidentally, even when pay-go was in effect it was in the very effective because much of the budget, much of the spending that kurs here in washington was outside the realm, or outside the net of pay-go and, in fact, if you look at what pay-go does in terms of its design, it exempts all discretionary spending, would allow all current entitlement programs like social security, medicare and medicaid, to continue to grow on autopilot. it affects only new entitlements or tax cuts that could be created in the future and allows expiring entitlement programs to be extended without offsets but not expiring tax cuts. so it's clearly bias in favor of higher spending and higher taxes. in fact, if it does not apply to discretionary spending, and if,

in fact, it does not in a meaningful way apply to entitlement reform -- in other words, it simply puts sort of a cap on how much entitlements can grow but doesn't get at the issue of them growing unabated it simply is one thing: that is, a statutory excuse to raise taxes. that's essentially what pay-go is. now, the new administration came out with the news bulletin yesterday this was somehow a bold new step and that they're going to really attack and take on this deficit and this debt we have. of course, what they didn't tell you is that the sort of expression that we use in my part of the country is it's like closing the barn door after the horse is already out of the barn. because you've already got all this spending this year that wasn't covered by pay-go. the stimulus bill which was80