coverage needed at affordable rates and this should be our goal. ensuring that all americans have coverage, not just 16 million as the congressional budget office study indicates. everybody covered, not unsustainable government expansion. and, again, i'm calling on the white house and the democrats to scrap this unsustainable bill and sit down and let's start from scratch. according to news reports this morning, robert gibbs stated this morning -- quote -- "this is not the administration's bill, after the c.b.o. letter came out." well, where is the administration's bill? we're supposed to be enacting legislation before the end of july. where is the administration's bill? we can't afford this one.

we can't afford the one that is supposedly going to be enacted into legislation that will come to the floor of this senate. it does an injustice to our taxpayers and their children. 42% of u.s. voters are saying that cutting the deficit is the most important priority for the country. the bill is being considered tomorrow in the "help" committee. it is an extraordinarily step in the wrong direction. so, madam president, let me just say, scrap this bad bill, pay attention to the congressional budget office, understand it doesn't achieve the goal of coverage, understand that the costs would be between -- around $4 trillion over a 10-year period, for which so far there is almost no provision to pay for, and let's sit down together and work together in order to provide americans with the health care they need at a reasonable cost.

madam president, i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

mr. martinez: madam president? the presiding officer: the senator florida. mr. martinez: i ask that further proceedings under the quorum call be suspended. the presiding officer: without objection. mr. martinez: this week the senate will be considering the travel promotion act, which is an important bill for my home state of florida. every year millions of tourists travel to the united states from overseas helping our economy, generating revenues for states and communities and creating job opportunities for millions of americans. but for most of this last decade, there's been a huge drop jooff in visiters to the united states if other countries -- a huge dropoff from visitors to the united states from other countries. the united states tourism

industry has experienced 182 billion dollars in lost spending, $27 billion in lost tax receipts, and $47 billion in lost payroll, and we've also lost 245,000 jobs. one in every -- one in eight americans is directly or indirectly employed by the travel industry. the industry contributeds $115 billion in tax revenues. in florida, home to walt disney world, universal studios, and many beautiful beaches, the everglades, some of the best fishing and snorkeling in the world, and the oldest settlements in north america, the tourism industr accounts foe than 25% of all of the state sales tax collections.

last year the united states had a $633 -- had 633,000 fewer international travelers than we had in the year 2000. florida has taken a harder hit, losing $1.3 million visitors over the same period of time. numbers don't lie. our lack of attention to self-promotion is costing us money, jobs, and opportunity. it's not just that people aren't traveling much the fact is that people are traveling to some destinations other than the united states. the world competition for the travel dollar is keen. countries all over the world are doing all that they can to attract visiters to their country. we are competing in a world marketplace. this is an alarming trend that we're seeing here in the united states and it clearly hurts our economy, but it also has an impact on our image around the world. studies show that a person's opinion of our country is greatly improved when they visit our country.

we're our own best ambassadors. when fewer people visit here, there are fewer opportunities for others to so what our nation has to offer and what we're all b so increase tabout. so an increase in travel to the united states is good. one of the best ways to address this is to have campaign to promote the united states as a travel destination. this is a way of reversing this trend that we have seen. this is a way of bringing back some of the declines to a better day so that we can increase jobs and opportunities in our country. now here's an example of what other nations spend to promote themselves to the tourism market around the world. here is what we are competing against. this is what the united states is up against as we look to compete for the travel dollar. our close neighbor of mexico spends $149 million promoting travel to mexico. our next-closest neighbor, our

next close neighbor, canada, spends $58 million in travel to its destination. china spends $60 million in promoting travel to their country. us a strail spends $113 million. and the countries of the european union collectively spend $800 million on self-promotion. now, how much does the united states spend? we spend absolutely nothing. we spend nothing in promoting our tourism. for years sectors within the agriculture industry have used the so-called checkoff program to promote their products. we have heard the slogans, "pork, the other white meat." beef, it's what's for dinner. milk, it does the body good." producers kick in their own money to create a marketing campaign that benefits all producers. we need the same thing for our tourism. which is why i urge my colleagues to support moving

toward a travel promotion afnlgt it will benefit our economy, complement our nation's diplomatic efforts and perhaps most importantly it will help create new jobs. the travel promotion act will enable the united states to become its own ambassador by establishing a public-private campaign to promote tourism abroad. the campaign would be led by an nonpartisan not-profit corporation apindividuals appointed by the secretary of commerce. each would represent the various regions around the nation and bring their expertise to promoting international travel. the program will not use taxpayer money but will instead rely on user fees paid by foreign tourists and in-kind contributions from corporate partners. additionally, the act will increase coordination among the commerce, state, and homeland security departments to streamline the entry and departure procedure for our foreign tourists.

you see, not only are we not promoting ourselves, we're also doing a lot to complicate travel to our country because of those things which were done as a necessity post-9/11, we have created a lot of layers of complications for foreign travelers to visit our country. we have to continue to have the kind of protection about who visits our land and protect our homeland, but at the same time we need to use some common sense about how this is done and incorporate modern technologies to ensure that the travel experience to the united states is not cumbersome, is not complicated and it is transparent and enjoyable for those who come to visit us. in today's economy, every visitor counts. in a competitive world that we live in, every competitive dollar that can be spent out there promoting travel to the united states will inure to the benefit of the job creation we will see in places like my home state. when you consider visitors from overseas spend an estimated

$4,500 every time they visit the united states, more visitors will mean more jobs for americans at a time when unemployment continues to rise. so i truly do urge my colleagues to join me in supporting this bill as we work toward increasing our nation's presence as a tourist destination around the world. i hope that as the week unfolds that we will have an opportunity to engage in conversation and discussion and debate about this very, very important tourism bill which will help most states of this country. the fact is that we know florida to be a significant tourism destination. we're proud of that in our state. but the fact is that states around the country all can benefit and do benefit greatly from foretourists visiting our country. it is a -- foreign tourists sreuflgt our country. it is a great green way for promoting jobs and opportunities in our country and long overdue. if we're going to compete effectively with countries abroad, we must in fact also be

competitive in how we promote and advertise ourselves to the world. madam chair, i yield the floor and return the balance of my time. a senator: madam president? the presiding officer: the senator from tennessee. mr. alexander: madam president, i ask consent to speak for up to 12 minutes as if in morning business. the presiding officer: without objection. mr. alexander: thank you, madam president. madam president, i'm looking for a way to offer an amendment to the health care bill that would sentence every united states senator who votes to increase medicaid eligibility to 150% of the federal poverty level to a term of eight years as governor in his or her home state so they can have an opportunity to manage the program and to raise taxes and to find a way to pay for that sort of proposal. if we senators were to increase

medicaid in that way and go home, we would find first that medicaid is a terrible base upon which to build an improved health care system, because it is filled with lawsuits. it is filled with federal court consent decrease that sometimes are 20 and 25 years old that take away from the governor and the legislature, the authority to make decisions. it is filled with inefficiency. it is filled with delays as governors request waivers to run their systems that may take a year or more for approval from the federal government for relatively simple requests. and an intolerable waste of taxpayer money because of fraud that is documented by the general accountability office. as much as 10% of the entire program, $32 billion a year, according to the general accountability office, is fraud. that's the medicaid program. the second thing, a senator who

goes home to serve as governor for eight years would find is that increasing coverage in this way will require much higher state taxes at a time when most every state is making a massive cut in services and a few states are nearly bankrupt. for example, in my state of tennessee, if the kennedy bill were to pass, which would increase medicaid expansion by 150% and increase reimbursement rates to 110% of medicare, it would require, based on our estimates, a new state income tax of about 10% to pay for the increased costs just for our state as well as perhaps add another $500 billion or so to the federal debt. and finally, madam president, if

we were to base new coverage for the 58 million people now in medicaid and others who need insurance upon this government-run medicaid program, these americans whose -- who are the people we're talking about in this debate, who are the ones we hope will have more of the same kind of health care that the rest of us have, we would find that a large number of them would have a hard time finding a doctor, because today 40% of doctors already refuse to provide full service to medicaid patients because of the low reimbursement rates. and if we simply add more to that medicaid program, they'll have an even harder time getting service. there is a better idea, madam president. instead of expanding a failing government health care program which traps 58 million of our

poorest citizens in that government-run program that provides substandard care, the better way to extend medical care to those low-income americans now served by medicaid is to give them government tax credits or government subsidies or vouchers or money in their pockets that they can use to purchase private health insurance of their choice. that sort of option for health care reform is before the united states senate if it can only be considered. it's been offered on one hand by senator coburn and senator burr. it's been offered at the same time by senator gregg of new hampshire. it's been offered in a bipartisan way by senator wyden and senator bennett, who have offered a proposal that would basically give these dollars to the people who need help, let them buy their insurance, and according to the same

congressional budget office that said the kennedy proposal cost at least $1 trillion more, they said wyden would cost zero more. i'd like to be informed when i have a minute left. the presiding officer: without objection. the senator has five minutes remaining. mr. alexander: during the last six months the four words we've heard most in washington is more debt and washington takeover. we've seen a washington takeover of banks, insurance companies, student loans, car companies and now perhaps of health care. the president insists on a government-run insurance option as part of a health care reform plan which would inevitably lead to a washington-run health plan. why would it do that? putting a government-run and subsidized plan in competition with your private health insurance plans would be like putting an elephant in the room with some mice and saying okay, guys and gals, compete.

i think you know what would happen. the elephant would win the competition and the elephant would be your only remaining choice. as for debt, the congressional budget office, in a letter to senator kennedy, estimated that his bill, which is the only legislation that our health committee is considering, would add another $1 trillion to the deficit over the next ten years in order to cover 16 million uninsured americans, leaving 30 million uninsured. that's another $1 trillion over the next ten years that according to yesterday's "washington post," already is nearly three times as much as was spent in all of world war ii. the post said that the proposed new debt over the next ten years, before we get to the health care bill, is three times as much as we spent in world war ii. and the congressional budget office didn't even consider in this the cost of the kennedy bill proposals to expand medicaid coverage. let's talk about medicaid. every state offers it.

it provides health care in a variety of ways to low-income americans who are not eligible for medicare. the federal government pays 60% of the cost, the states pay the rest. 58 million americans are trapped in medicaid. it's the only place of any significant size where we don't have competition in our health care system. think of the elephant in the room. it was my experience as governor -- i believe it is for most governors -- that it is not only an administrative mess with substandard care -- the medicaid program -- but its costs have spiraled out of control, threatening the viability of public universities and community colleges because there's no money left for the states to support them. here's what would happen in tennessee to the ken -- if the kennedy bill passed according to state of tennessee's medicaid director. our state costs would go up $572 million if we increased coverage to 150% of federal poverty. if the fed pays for this, the

fed's costs would be $106 billion. i mean the federal budget paying for it. because the federal budget pays two-thirds, the state one-third. if the state has to also provide medicaid payments to physicians at 110% of medicare, this would add another $600 billion in costs to the state of tennessee. thus, the proposal of the abg come -- of the combination of the health and finance committee bills that are being considered would be $1.2 billion new for tennessee. if you add the federal government's increase in cost just for the tennessee people expanded -- to which the program is expanded it would be $3.3 billion. so you can see why the kennedy bill has been called so expensive. that's not all. the finance committee has been discussing turning back to the states by 2015 these increased costs, although the finance committee is talking about a smaller expansion of coverage.

so imagine a senator going home to the state of tennessee -- won't be me because i've already had the privilege of being governor. but say if one went back to be governor of tennessee, what would we find if we passed the kennedy bill as it's now proposed? we would find a bill by 2015 of $1.2 billion in today's dollars, and where would the governor get the money? well, when one governor proposed a 4% state income tax in tennessee in 2004, a 4% income tax would bring in 400 million new dollars. we need $1.2 billion under the kennedy bill to pay for the expansion of medicaid. so to raise nearly $1.2 billion, a new state income tax of more than 10% would be needed if all other services were held flat. and the governor has already said that most state functions will see a decrease in funding after the stimulus money goes

away. this same problem would be true for all states, madam president. the national governors association says that if we assumed that all individuals under 150% of poverty were covered and there's no change in reimbursement rates, the cost to the states would be $360 billion more over the next ten years. if you also increase reimbursement rate for physicians from say 72% to 83%, the governors association says the new cost is $500 billion more over ten years. then there is the fraud in the medicaid program. the government accountability office says 10% of it is fraud. $32 billion a year, about three-fourths of the amount of money we spend on prescription drugs for all seniors. then there's the problem of access of care. with 40% of doctors already not being willing to provide full service to patients who are on medicaid. so why would we expand in

government-run program when it is filled with inefficiency, delay and waste? when it would bankrupt states? when it would add hundreds of billions the dollars to the federal deficit and when it would provide substandard services when instead we could pass the coburn-burr bill or the gregg bill and give to the 58 million americans who are trapped in a failing government program the dollars they need to purchase private health insurance much like the rest of us have. madam president, i hope i can find a way to offer an amendment that would require any senator who votes for 150% increase in medicaid, who says that medicaid expansion will go to 150% of the federal poverty level will be sentenced to go home and serve for eight years as governor of his or her state so they can find out what it's like to manage such a program or to raise taxes t