senate will come to order. the chaplain, dr. barry black, will lead the senate in prayer. the chaplain: let us pray. almighty god, eternal and unchangeable, we pray for this

nation, its people, and its institutions in these challenging times. if we have forsaken you, don't abandon us. if we have sinned, forgive us. if we have been mistaken, correct us. let your grace be sufficient for all our needs. lord, lift the efforts of this body into the higher reaches of your kingdom, guiding and strengthening our senators in the discharge of their duties. bless their work, as you strengthen them by your spirit to honor you.

we pray in your great 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 17, 2009. to the senate: under the provisions of rule 1, paragraph 3, of the standing rules of the senate, i hereby appoint the honorable tom udall, a senator from the state of new mexico, to perform the duties of the chair. signed: robert c. byrd, president pro tempore. mr. reid: mr. president?

the presiding officer: the majority leader. mr. reid: following leader remarks, we'll be in a period of morning business for an hour, senators will be allowed to speak for up to 10 minutes each. the republicans will control the first half, the majority will control the second 30 minutes. following morning business, the senate will resume the motion to proceed to the travel promotion act, postcloture. following adoption of that motion to proceed to travel bill later this afternoon we'll turn to the consideration of the emergency supplemental appropriations conference report. mr. president, i'm disappointed that we are again wasting time on a heavily bipartisan bill, the travel promotion act. wide support by both the democrats and republicans. but the republicans forced us to have a vote on cloture to allow us to get on the bill. all the republicans voted for it. they're filibustering things that they even agree with, just to stall for time. now, mr. president, this is 30

hours we could use on a lot of good things. i don't know what would be the rationale for wasting this time. maybe they don't want president obama to complete more legislation through us. it's beyond my ability to comprehend why we would waste this time. now, mr. president, it's been written and talked about that this is the most accomplished congress since the first year of the roosevelt administration. now, mr. president, i don't have before me all the things we've done, but i'm going to try to recall some of the things that we've done here. we passed the lands bill, the most significant environmental legislation in more than a quarter of a century, creating more than 2 million acres of wilderness, 1,000 miles of scenic rivers, hundreds of miles of trails and many other good

things in this very important legislation. we passed the lilly ledbetter legislation equalizing pay between men and women. we passed the children's health insurance program which had been vetoed by president bush on several occasions. now more than 14 million children can go to the doctor when they're suck or hurt. we passed the economic recovery package. 25% of that money is owvment the rest is coming. we passed, mr. president, the omnibus spending bill, very important legislation that had been held up by the bush administration. we spent $1.2 trillion within a period of three weeks of the people's money. why did we do that? we did it, mr. president, because mark zandi, among others, senator mccain's chief economic advisor, republican economist, democratic economists told us that we had to do this to stop a worldwide depression, and we've done that. as chairman bernanke said, the

crops have been planted and the shoots are now appearing out of the ground. we, mr. president, went on to pass a procurement bill, extremely important, to rein in the excessive expenses of what has taken place with -- in years past with the pentagon, overspending money that we give them. that is, something is supposed to cost this much and winds up costing twice that much. we, mr. president, were able to pass national service legislation, allowing 750,000 people in america to be involved in public service, dealing with the environment, health care, the poor. and during the 7,000 hours that they volunteer, they get a small stipend. when they finish, they get an amount of known help with their college education. credit card legislation, so important, and we finally were able to do it, after years of talking about doing it, we did

it to stop the ripoff of these credit card companies and what they were doing to hurt americans, all americans. we passed tobacco legislation. mr. president, i can remember when i was working here in the capitol of the united states going to law school, the surgeon general came out with the first report that smoking was bad for you. some people thought that was the case, but the surgeon general of the united states said it'll kill. we've been trying ever since then-tothen to get control of t. after all those years, we do it. mr. president, we have been able to work on many earpiec other pf legislation. legislation passed to address people trying to take advantage of people in foreclosure on the one hand distress. we passed a lot of housing

legislation that will allow people to stay in their homes. we've done a pretty good job of that. we're now, mr. president, arriving at a point where we're going to pass the supplemental appropriations bill, very important to fund our troops. the last time we'll have to do this because president obama is honest with his budgettings budgeting. the cost of his war is in his budget. for the eight years that president bush was in office, it was never in his office. it's interesting to note there, all but five republicans in the house of representatives voted against funding the troops yesterday. it'll be interesting to see what happens here. wheare my republican colleagues going to join with us to fund the troops? i hope so. i certainly hope soavment so, mr. president, we've accomplished a lot more than what i've just outlined but we've done it by reaching out to the republicans. mr. president, we've got an lot

of help from the republicans. but we've gotten enough to pats bills. -- but we've gotten enough to pats bills. the economic recovery package -- we needed two. and none -- neither one of the two would give us 60 votes, so we got three and we got three. i appreciate very much the courage of senators specter, snowe, and collins in doing that. tbas good for their states and t was good for their states and our country. we have reached out to the republicans time and time again. now, mr. president, we began this year dedicated to delivering the change the american people demanded in november. we began this congress committed ting life better not the -- committed to making life better for the american people. but they also demanded something more. they said that we, their leaders, should not be unlegitimacy to work together -- unwilling to work tosmght the challenges we face left no one unscathed. we're all in this hole together. the only way we climb out of this hole is by doing so

together. when the "people" spoke last year they gave us, above all, a maintained fomandate for bipart. i wrote a letter saying one of the best ways to lift up our exphi to keep down health care costs. almost 50 million americans have no health care. the problem grows worse every day. every day more americans go tbrupt or lose their homes just trying to stay healthy. even those fortunate enough to have insurance pay a hidden tax to cover those who don't. what does that mean? mr. president, the 50 million people when they get sick or hurt go to the nearest emergency room. that emergency room may be across the street, it may be 50 miles from where they are, but that's where they go. that increases the cost to everyone of their health insurance policy and increases the cost of the doctor bills that we get, the hospital bills we get and indigent taxes.

so if your family has health care, you pay at least $1,000 more than you would if all other families had health care n that letter i expressed my sincere thoasincerehope that republicank with us. i asked for their hope. i knew we would disagree at tiessments i told them i looked forward to working with them to help struggling americans. in had letter i especially asked our republican colleagues to focus on the concrete and critical crisis that affects children, families, and small businesses every day. a parent who cannot take a child to the doctor because insurance doesn't exist or is prohibitively expense six a family lives one accident or illness away from financial ruin. a small business that lays off employees because they can't afford skyrocketing health care premiums. we hear those stories every time

we time we go home. i ask that letter that we used short and valuable time we have to work together rather than against eesm other. i wish i could say republicans answered those words with deed of equal good faith, but how they responded regarding health care -- they've taken the hand we extended across the aisle, nope l. nope. have they taken the seed we offered at the negotiation table? no. have they engaged in productive debate about health care? no. have they shown that they're just as interested in working with each other rather than against each other? no. have they told us a single thing they're for rather than what they're against? it's always what they're against. in fact, "no" is all we hear from the republicans these days instead of debating facts, the republicans have committed themselves to a strategy of

misinformation and mi misrepresentation. mr. president, we have different priorities. we're committed to lowering the high cost health care, ensuring every american has access to quality, affordable care and letting people choose their own doctor, hospitals and health plans. we're committed to protecting existing coverage when it is good, improving it when it is not and guaranteeing health care for the millions, including 9 million children, who have none. doing nothing, i don't believe, is an option, mr. president. because the costs of doing nothing are too great. we must pass health care reform this year. as we said at the start of the year, the start of this work period, at the start of this debate, we'll continue doing our best to work with republicans and pass a bipartisan bill. in spite of the past, i remain optimistic that both republicans and democrats recognize how urgent this health care debate

is. the health of our citizens and our economy are at stake and neither will be able to recover if we wait. as important as bipartisanship it, it is not critical as helping the nearly 50 million americans who have nowhere to turn and the other 20 million who have bad insurance. and the rest of america who are paying at least $1,000 more for their insurance policy as a result of people having no insurance. as i said in my letter this april, in order for this bipartisan process to take root, republicans must demonstrate a sincere interest in legislationing. i hope they do soavment because one way or another we're going to get health care done. thank you, mr. president. mr. mcconnell: mr. president, earlier this year the new

administration proposed an economic stimulus bill that was meant to lift the economy at a time of massive job losses and widespread economic hardship. not only was the bill enormously complex, it was also one of the costliest piece of legislation ever proposed. and yet, those who put it together insisted that it be rushed to a vote. their reason, of course, the economic downturn was just too dire to wait. trust us, they said. it's responsible, it's needed, and it will work. and so this incredibly complex, enormously expensive bill which was introduced on january 26 was passed less than three weeks later, just 24 hours -- 24 hours, mr. president -- after all of its details had been disclosed to the public for review. at the time i argued that spending this much borrowed money in the middle of a recession on a bill that had

been rushed to the floor was extremely irresponsible. at a time when millions are struggling just to make ends meet, washington had no business borrowing hundreds of billions of dollars to pay for government golf carts and a.t.v. trails in the name of economic stimulus. this week senator coburn has categoried some of the other outrageous contained in this bill. here are just a few. the town of union, new york, received a $578,000 grant that it didn't request for a homeless problem it claims it does not have. florida is planning to spend $3.4 million in stimulus money to build a 13-foot turtle tunnel at lake jackson. that's more than $225 million per foot. this one takes the cake. in north carolina, $40,232 in

federal stimulus money will pay for the salary -- the salary -- of someone whose job is to lobby for more stimulus money. $40,234 just to pay someone to lobby for more stimulus money. this would be comical if it weren't so maddening, and if these projects hadn't been sold to the american people as the answer to our economic problems, and if the administration hasn't assured us that it would make every cent -- make sure every cent of this money was spent efficiently and without waste. but that was then. the administration had promised since january that it would keep an eye on how sprerbs tax dollars were spent, but in january it was already admitting that funds were being wasted and people being scammed n. january and february administration economists took to the talk shows promising that the

stimulus would create 3 million to 4 million jobs. they said that if we passed the stimulus, the unemployment rate would be about 8%. but just a few months later, with job losses continuing to mount, the administration admits that their early predictions were simply a guess and that they guessed wrong. today the unemployment rate stands at 9.4%. and just yesterday the administration said it expects unemployment to climb even higher. $1 trillion, they said, was absolutely necessary to jump-start the economy and which was put on a fast track by an eager-to-please democratic-led congress is now being called a very bad guess by the very people who proposed it. and now they're asking us to do it again *fplt only this time it's even more than $1 trillion, and the consequences could be far worse. the early estimates we're

getting for the health care proposal we've seen is that just a portion of it -- just a portion of it -- will be $1.3 trillion. this figure, staggering in itself, doesn't even account for the money that would be needed to pay for expanding medicaid and creating a new government-run plan. and no one can tell us where any of this money will come from. yet, just like the stimulus, we're being told in a most urgent tone that this government takeover of health care is absolutely necessary and that we have to approve it as soon as possible, without review, without knowing the full cost and without knowing how it will affect people's lives. once again, it's rush and spend and rush and spend, in a tidal wave of debt. everyone in america knows that health care reform is needed in this country, but they want us to do it right.

they don't want a blind rush to spend trillions -- trillions -- of dollars in the hope that the administration gets it right. during the debate over the stimulus, we were told that we had to pass it right away, with just 24 hours review or $42 billion an hour for the sake of the economy. now we're being told we need to approve a parcular set of health care reforms for the sake of the economy, but we have no bill. we have no idea of its total cost. and yet, it's rush, rush, rush. we've heard all this before. we've made this mistake already. americans won't be rushed into another one. americans do want health care reform, but they want the right reform, not a government takeover disguised as a reform that takes away the care they

have, replaces it with something worse and costs untold trillions that they and their grandchildren will have to pay through higher taxes and even more debt. the administration admits it made a mistake on its predictions about the stimulus. we shouldn't make the same mistake again when it comes to health care. mr. president, i yield the floor. the presiding officer: under the previous order, the leadership time be reserved. under the previous order, there will now be a period of morning business for one hour with senators permitted to speak for up to ten minutes each, with the time equally divided and controlled between the two lease or their designees. with the republicans controlling the first half and the majority controlling the final half. mr. mccain: mr. president? the presiding officer: the senator from arizona. mr. mccain: mr. president, as we all know, health care dominates the agenda and the

thoughts and efforts of the congress of the united states, and it has to be addressed. and it is an historic opportunity to achieve the health reforms that americans need today more than ever. we need fundamental reforms, reforms that not only help people get affordable health care coverage, but reforms that bring down the costs of health care. given the enormous costs associated with the bill that's been proposed, i called on the other side to scrap the bill and start from scratch. we've got to get it right. it shouldn't be a partisan process that forces a bad bill through committee. in starting over, we must address the fundamental components of health care reform, including the major drivers of increasing health care costs. one of the main factors keeping health care cost trends too high is defensive medicine. ask any doctor, ask any

practitioner, they order additional procedures for fear of litigation, which drives up the medical malpractice insurance costs faced by so many in the medical profession. medical liability insurance is a direct result of out of control lawsuits that force physicians to practice defensive medicine to avoid baseless liability lawsuits. any legislation reforming our health care system is incomplete if it doesn't address this important issue. a 2003h&hs report estimated the cost of defensive medicine to be between $70 billion and $126 billion a year. now put that in the light, mr. president, of the report that's in "the washington post" this morning. it says "obama's health plan tphaoepdz spending controls,

c.b.o. says." it goes on to say "whaoeupl president obama's plan to expand coverage to the uninsured is likely to dig the nation deeper into debt unless policy-makers adopt painful control on spending such as sharp reductions to doctors, hospitals and other providers at other measures. mr. president, here is a way to save about $100 billion a year. $100 billion a year, because if it were updated, the cost estimate would likely increase to $180 billion a year. where is it in this bill? it's nowhere. nowhere, and that's a testimony to the trial lawyers of america. on monday, before a receptive crowd at the american medical association, the president stuck his toe in the medical liability reform waters by acknowledging

that medical liability reform is real. but the president took caps on noneconomic damages off the table by saying -- quote -- "don't get too excited yet. just hold on to your horses here, guys. i want to be honest with you. i'm not afrbgd -- advocating caps on malpractice awards. this all but ensures that meaningful reform won't happen. today "the wall street journal" stated in an opinion piece -- quote -- "president obama mentioned the medical liability problem, and we suppose this is progress. but mr. obama's call might have had more credibility had he not specifically ruled out the one policy top deter frivolous suits. without caps on medical malpractice awards, the lottery will continue. interestingly, mr. president, my neighbor in the state of california addressed this precise problem in 1975 that

passing legislation that capped jury awards for noneconomic damages such as pain and suffering for medical malpractice lawsuits. not only does this cap reduce the amount of damages, but it has had the effect of deterring lawsuits. malpractice filings have fallen in almost every county in california. according to a 2004 rand study, this has led to awards in medical malpractice lawsuits being 30% less than other states. such a cap is sure to also lead to lower medical malpractice insurance rates. not only do you have a reduction in suits itself, reduction in awards, but you can imagine the costs that have been saved because the doctors no longer feel compelled to practice defensive medicine. thereby, prescribing unnecessary and unneeded tests and procedures simply to protect

themselves in court from medical malpractice. there are plenty of ideas that should be considered including caps on nondamages, health courts, national standards of care are just a few thoughtful concepts. we have demonstrable success stories that capping noneconomic damages brings down the cost of malpractice insurance. california and texas both have reformed malpractice to stem the tide of doctors leaving their states. there's also intriguing ideas involving health courts, courts focused only on health disputes, with specially trained judges having expertise in health court adjudication to make injury compensation decisions. some have also pushed for a concept establishing a national standard of care. the concept envisions establishing specific clinical practice guidelines that doctors

would be required to follow and enforce by the department of health and human services. this approach might reduce liability concerns. these are but three examples that can be considered on both sides of the aisle, and there are other ideas that we would be well served to continue. when health care costs are said to be driven up by over $100 billion and up to 40% of medical liability lawsuits being entimer groundless, don't you think the other side would have some provision in their bill to address this fundamental problem? maybe even a modest provision. i'm here to tell you that the other side has yet to suggest any provision to suggest medical malpractice reforms. shocking? it should be addressed and must be addressed as part of real health reform.

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