a recent new yorker magazine article showcased the mayo clinic in the contests of health care's costs problem. according to an author, a physician, we're in a battle for the soul of american medicine. on one side is a fragmented volume-driven model that too often crosses into profiteering. there are good parts, believe me. i know this. i live in minnesota. we have to maintain those. but we have to fix this broken cost structure. on the other side, you see this model offered by mayo and other institutions across the country

where doctors collaborate to provide the best, most efficient care for their parents. patient. on one side it is financially and morale unsustainable. on the other side is a new direction that promises to cub b costs and it is time to choose sides. for the sake of fiscal health and the sake of millions struggling to afford the care they need i urge my colleagues to choose the ladder. yesterday, i met with a bipartisan group of senators. i have to tell you i still have hope we're going to get this done. i have hope there will be bipartisan support for this. the things i am talking about today -- cost reduction, putting incentives in place -- this isn't is democratic issue or republican issue. this is an american issue. this is an american cause that we can find a uniquely american solution to this problem so that we can reduce costs and make health care better quality. and i can tell you, having spent the entire life, my life, in the

state of minnesota having a daughter born very sick, couldn't even swallow when she was born i know we can get high quality health care at lower cost. they do it every day in my state. we can do it in the rest of the country. thank you, madam president. i yield the floor. mr. kyl: madam president? the presiding officer: the senator from arizona. mr. kyl: thank you, madam president. when it comes to health care, republicans want reform that respects patient freedom and choice and maintain the doctor-patient relationship. we believe doctors, not washington, shaw should tailor e car. washington, d.c. would dispolice millions of americans who are happy with their current health insurance. federal bureaucracies are not known for being efficient, innovative or hassle free. on wednesday, the majority bhip said -- and i quote -- "those who come to the floor of the senate defending the health insurance companies and saying

they want no change in health care system have to defend the indefensible." well, who, exactly, has come to the floor and said that? who on the senate, in the senate, has come to the floor and said they want no change? i know of no one who has done that. this is a strawman argument usually made when you can't win an argument on the merits but it has become the familiar refrain from friends on the other side of the aisle. they present a false choice between doing what they want and doing nothing. they don't want to listen to republican ideas they accuse us of wanting to doing in and it happened with the stimulus bill and now health care. republicans want health care reform. i've said this repeatedly. so has senator mcconnell. i have noted that there are abundant problems in our current system that are routine visits to the doctor can be surprisingly expensive. too many people have to go without basic care for a host of

reasons, whether they're unemployed, work if a business without health care or perhaps have a preexisting condition. the task before us is to ensure that all americans have access to quality health care without degrading the quality of care for anyone. in other words, those who are happy with their care and that is the majority of americans, don't want to have to sacrifice their care in order to take care of the problem of those who are having issues. and i do mean by "access to care," rather, i don't mean by "access to care," access to a government waiting list. there are two ways to approach health care reform while trying to keep costs in line. one, which president obama says he rejects, is to create a competitive marketplace in which consumers get to pick the plan that works the best for their families. competition helps the consumer. the more competition, the better. and this concept does not include a washington-run plan.

the other is for the government to ration care deciding what treatments to get and which medication you can have. yes, you can cut costs this way but it is in the right. and it's not what americans want. nor is it what physicians want. the american medical association, an organization of 250,000 of america's physicians said in a recent statement, "it does not believe creating creating a public health insurance option for nondisabled individuals under the age of 65 is the best way to expand health insurance coverage and lower costs." i agree. the doctors, those who provide the care, are concerned about what a washington-run health care would mean for their patients and for the uninsured americans who need to get in to see them. republicans have been discussing the state of health care in canada and the united kingdom because those countries have government-run health care and delay or deny treatment for citizens to keep costs under control. the canadian and british

governments created the systems with good intentions but government-run care is not serving their citizens' need and we don't need to replicate their problems in the united states. in canada, claude, chair of the commission which recommended the quebec establish a government-run system in the 1960's declared last year the system is in "crisis," his words. private clinics are opening all over canada at the rate of one per week to treat those who are on waiting lists at the public hospitals. many canadians who have the resources to get out of the bureaucratic government have chosen to do so. as the republican leader pointed out, britain's national institute for health and clinical excellence, the entity responsible for setting guidelines on pharmaceuticals and treatment for british patients denied parents in that country access to four kidney cancer drugs with the potential to lengthen the patients' lives

explaining it this way -- and i quote -- "although these treatments are clinically effective, regrettably the cost is such that they are not a cost effective use of resources." a chilling statement, indeed. the stories of parents being denied treatment by their governments are real. president obama and some of my colleagues in the senate, like the majority whip, have argued that a "public" or a government-run option can compete with other insurers and this government-run option would be the only -- excuse me would be only one choice of many the my question is: why is it needed? what will it do? government-run health care would crowd out other insurers, quickly becoming a monopoly. and i cited the statistics from the louen group which made the point. someone who has insurance throughout his or her company could be forced into the government's plan if the employer decides it is simpler and cheaper to pay a fine to the

government and eliminate its coverage. the company might say, why bother with the paperwork and administration when we can just pay a fine and tell people to get on to the government insurance roles? and as i said that's what health experts say will happen. the louen group has estimated 119 million people will be shifted great a private plan to a government plan if it's created. that would affect two-thirds of the 170 million americans who currently have private insurance, all but ending private insurance in america. president obama said recently, if we don't get this done this year, we're not going to get it done. why is that if why does that have to be so? could it be because the president would prefer that we rush a bill through before americans get a chance to absorb what washington-run health care would mean for their families? if this is worth doing, it's worth doing right. it's worth taking the time to do it right. americans are compassionate and we want coverage for our

neighbors just as much as we want it for or our families but i will tell you my constituents worry about the cost and they don't want the federal government to cover others at their spend. both in -- at their expense in the form of cost and rationed care. so a question for the program is: how much will it cost? who is going to pay it? another question: what's going to be the effect on seniors who are in medicare? do they have anything to worry about? my answer do that is, absolutely, because some of the conversation has to do with "reforming" the way our seniors get their cost. we haven't heard much about the exact price of government-run health care. but we know the cost will be extremely high and we won't spend enough to ensure that all americans get the care they need. so when we talk about beginning to be more concerned about the cost than quality of care as the

institute in bin that i quoted just said, we get into a situation where we are going to be having to ration care and that is something that neither our seniors nor families with coverage today want at all. we need a real marketplace of openings. and choice. and freedom. they should be guiding principles for the reform we all want. i reiterate, republicans and democrats want reforms in our health care system. there are people who need coverage. we all understand there are ways we can save money. the question is, do we do this through more government criminal? more government bureaucracy? government-run insurance companies? fines on employers? or raising taxes in order to add 40 million or 50 million more to insurance roles? or achieve the results through removing barriers to competition which currently exist and republicans have noted a whole

series of laws right now that could either be reformed or repealed in order to allow more competition, in order to reduce prices for those already in the market and give patients more choice. i don't know why the resistance to this insurance reform. i don't know of anybody that likes the way insurance companies always do their business. i know i don't. why not reform and enable those who would do it the way people want to have products that could be offered to the public and which presumably the public would buy if they're concerned about the way their insurance is currently being offered? so this is not a matter of one side wanting reform and the other side not. it's a matter of different approaches to it. for my constituents, madam president, i can tell you they are concerned about what they have, they're concerned about what they're going to have to pay and as much as they want to help other people have the same kind of coverage they do, they don't want it at the expense of their families by

having care rationed to them and their families as a result of the fact that it would cost more money than we are countrily paying. madam president, i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: quorum call:

mr. brown: madam president? the presiding officer: the senator from ohio. mr. brown: thank you, madam president. i ask unanimous consent to -- the quorum call be dispensed with. the presiding officer: without objection. mr. brown: thank you, madam president. in my state of ohio, especially states like michigan, indiana, pennsylvania. middle class families are facing a new wave of job losses. 400,000 ohioans are employed directly or indirectly because

of the auto industry. the auto industry crisis is a crisis he especially in my state and in michigan and the other states in the region. as congress works to help the industry through the difficult times, the industry must do all it can to keep the jobs at home. it was welcome news when g.m. announced that rather than start more small-car production in china and mexico, which they have done in the past, that they would open a new small-car manufacturing plant somewhere in one of these auto states. this crisis, though, as congress works -- this crisis has hit home in my state, especially in mansfield where g.m. has one of its best stamping plants. workers at this happen plant were asked to make concessions over the past two years, and they did. they were asked to produce in an exceptionally efficient manner, and they now rank at or near the top across a range of peformance standards. mansfield -- the mansfield g.m.

fisher body stamping plant played by the rules, did all that was expected of them, and they made it to the top, literally to the top of g.m.'s stamping plants. yet, g.m. has decided to close this facility. g.m.'s facility not to include the mansfield stamping plant in the new g.m., this new coming out of bankruptcy company, one they say is focused on building fuel-efficient cars for the 21st century, that decision is troubling. it's more than troubling to employees or to members of this community, the mansfield community and to me. yesterday i met with g.m. officials who were direct and polite and are trying to do their best. met with g.m. officials to try to understand their decision. i've not convinced this -- i'm not convinced this makes sense for the new g.m. to close this mansfield fisher body stamping plant: i know it doesn't make sense for ohio. g.m.'s score card shows the mansfield plant has met nearly 100% of its targets. it has productivity rate of 94%. according to