quorum call:

a senator: mr. president? the presiding officer: the senator from tennessee. mr. alexander: thank you, mr. president. today in the "help" committee -- the presiding officer: senate is in a quorum call. mr. alexander: thank you, mr. president. i ask that the quorum call be vitiated. the presiding officer: without objection. mr. alexander: thank you. today in the health and education and labor and pensions committee in the senate, after several days of discussions, we are beginning to work on the health reform legislation that was proposed by our chairman, senator kennedy. as we begin our work today, i want to suggest that we put aside the legislation that we're working on and that we start over, because the kennedy bill we're dealing with is so flawed and expensive that it cannot be

fixed. and there are better proposals available for us to work on, proposals advanced by senator burr, by senator coburn. there's a bipartisan proposal that senator wyden and senator bennett have offered, and senator hatch, a former chairman of the committee, is working with a number of senators on a proposal that seems to me to be a much better base for beginning. as we go to work on health care reform, these are the things that we should keep in mind. we would want to be able to say to the american people that we're interested in all 300 million of you, not just the 47 million uninsured. that our goal is to provide for each one of you a health care plan that you can afford, a plan in which you and your doctor, not washington, d.c., makes the decisions. a plan that emphasizes prevention and wellness. we want to give low-income

americans the same cientd kind f health plan that most americans already have. we don't want -- we do not want to make it harder for american businesses to compete in the world marketplace by adding to their costs. and we do want a plan that your children and your grandchildren can afford so that they're not saddled with a massive debt that devalues the dollars they earn and the quality of their lives. and as the president has repeatedly said, the best way for us to realize all those objectives is to fashion this health care reform in a truly bipartisan way. mr. president, the bill we're marking up today in the health care committee is not ready to be considered. we don't have the details of the bill. we don't know the costs of the bill. even though the president just within the last few days has

said that pay-as-you-go is important. if we're going to spend a dollar, he said, we ought to raise a dollar. or he might have said raise taxes a dollar. that's what the president said. so surely we are not going to mark up a bill or finish marking it up until we know whether or not we're going to have to save a dollar or tax dollar or how many dollars we'll have to save or tax in order to pass the bill. but this we do know about the regulation that our committee is considering. we do know that it leaves 30 million of the 47 million americans who are uninsured today -- there are 47 million americans uninsured today. it leaves 30 million of them i will uninsured. we know that it expands one failing government program -- medicaid -- and creates another, putting washington in between you and your doctor. it reduces the ability of employers to give incentives for

wellness and prevention. it doesn't increase it, it reduces it. it freezes 58 million low-income americans into a medicaid program that offers sporadic, substandard care. it's so expensive it will literally bankrupt states, and our government accountability office has told us it wastes $1 for every $10 it spends. that's $32 billion a year, three-fourths as much as we spend on all the prescription drugs for senior americans. and, according to unbiased government officials, its addition to the national debt are astronomical. the congressional budget office told us yesterday that the kennedy bill so far as it's written will add $1 trillion to the debt over the next 10 years, and that doesn't include medicaid expansion or the expansion of reimbursements for doctors seeing medicaid

patients. it doesn't include the government health insurance option. it doesn't include the employer mandate. the baucus bill, we are told -- according to press results -- in the finance committee may cost $1.5 trillion over the next ten years. an independent study released yesterday says the kennedy bill may mean $4 trillion. the national government association says that medicaid itself will add a half trillion dollars to the state costs -- to the state costs over the next 10 years if reimbursement rates are increased, as they are proposed to be increased. this is on top of what the "washington post" said earlier this week is a set of proposals by the obama administration that would add nearly three times as much to the national debt over the next 10 years as we spent in all of world war ii.

and this bill, mr. president, i'm sorry to say, is absolutely not a bipartisan bill. we're having a bipartisan discussion. we're all very friendly and civil to one another. chris dodd is doing a tremendous job of sitting in for senator kennedy. we all like him. but we know what a bipartisan bill is. it's when 15 or 20 of us from different sides of the aisle sit around a table and start from scratch and take our best ideas and put it together and get 60 or 70 or 75 votes or something. we've done it much times on energy, on intelligence, but we're not doing it on this. we're presented with a bill last thursday -- or some of a bill -- and told this is how it is. we'll have a lot of discussion about it. but this is the way we're going to it. wend to start over. if we did start over, we should be able to agree that every american should be covered. we should be able to agree that it should be at a cost that each

american could afford. we should be able to agree at that preexisting conditions don't disqualify you and that prevention and wellness is encouraged. we should be able to agree that low-income individuals have the same choices -- same opportunities for health insurance that the rest of us do. and we should be able to agree that americans should have choices. now, all of those things we ought to be able to agree, if we were starting from scratch. and if we do all those things, mr. president, why do we need to create a so-called government-run insurance plan? that is the big difference of opinion we have in the committee. and i believe on the senate floor. a government-run insurance plan inevitably leads to a washington takeover of which we're having far too many these days. washington takeovers of banks, washington takeovers of insurance companies, washington takeovers of student loans, washington takeover of car

companies. why do we need a washington takeover of our health system? and why would a government-run insurance plan thread a washington takeover? well -- plan lead tow a washington takeover? well, think of it this way. it's like putting an elephant in a room of mice. after a little while only the elephant would be left. the elephant would be your only choice. and we have a very good example of what that elephant can look like. we call it medicaid, a program that every start has, that the federal government -- that every state has, that the federal government pace most for and it provides low-income health care to most americans, those who are not on medicaid. i would like to may find a way to require every senator who votes foreclosure spangdzing medicaid coverage to be required to go home and serve as governor of his or her home state for

eight years and try to manage and pay for a medicaid barack obama that's expanded -- to pay for a medicaid program that's expanded. the only way you could like the medicaid program is if you've been in washington a long time and you don't have to manage and pay for it and get your health care from it. let me be very specific. the medicaid program -- and i dealt with this for eight years as governor myself -- it's filled with lawsuits. it's riddled with federal court consent decrees from 25 years ago that restrict the ability of legislators to make improvements. it's filled with inefficiency and delays. it will take a governor a year to get permission from washington to do something 38 other states are doing. as i mentioned earlier, it has intolerable waste of taxpayer dollars. the general accounting office says $32 billion every year are wasted in the medicaid programs, 10% of all the money that's

appropriated to it. second -- the second thing wrong with medicaid, it would require higher state taxes at a time bh states are making massive cuts in services and are very nearly bankrupt. the state of tennessee by my own calculations, i believe it would require a 10% new state income tax by the year 2015 if the senate were to take the kennedy bill and the baucus draft and enact them today? why would it do do that? the state director of medicaid in our state says if we increase medicaid coverage to 150% of the federal poverty level that costs the state of tennessee $572 million. if the federal government pays for that, the bill for the federal government for that increase is $1.6 billion just for the tennesseans covered. if we also increase the pay for medicaid providers to 110% of

what medicare pays physicians, that would add another $600 million in tennessee, because tennessee medicaid pays physicians 70% of what medicare pays physicians, and medicare pays physicians 80% of what private pay pays physicians. so the increase costs just for tennessee of the medicaid expansion in the kennedy bill is $1.2 billion, according to our state medicaid directors. if the federal government has to pay the whole thing, it's $3.5 billion. then they're talking in the finance committee about shifting those costs back after five years to the state. so here comes a $1.2 billion bill to whomever is governor of tennessee in 2015. last time, just to put this in perspective, they tried to pass an income tax in tennessee. it took a 4% income tax to produce $400 million a year.

we're talking about finding $1.2 billion a year. the national governors association said increasing the federal poverty level to 150% would increase the cost to $360 billion over ten years in all the states, increases in medicare reimbursement would bring that total to $500 billion in all the states. that's on top of the $1 trillion that the congressional budget office has said that senator kennedy's bill already costs. one of the effects on this is it would absolutely destroy our public colleges and universities across the country. it's already damaging them because governors and legislators are finding they barely have enough money to keep up with increasing medicaid costs. they have nothing left for colleges, universities. and so the quality of the universities goes down and the tuition at the universities goes up. finally senators serving as governor of their home states trying to manage an expanded medicaid program would find that most of the people -- maybe a

majority debaters would find a hard time getting service. today 40% of doctors nationally don't provide full service to medicaid patients because of the low reimbursement rates. so, mr. president any version of the bill we're considering will explode in complexity and astronomical spending and will never succeed. there is a better way. there are several better ways. instead of stuffing low-income americans into one failing government health care program -- medicaid -- that now provides substandard care and creating a new government-run insurance program, why don't we give low-income americans government grants or subsidies so they can purchase private insurance as is provided by the wyden-bennett bill, for example, which has a cost of zero to the taxpayers according to the congressional budget office. or the coburn-burr bill. or the senator gregg bill.

or the bill that senator hatch is working on with senator cornyn and others. those are the way to meet our objectives. is here are our objectives once more, mr. president. we want to provide health coverage to 300 million americans, not just to the 47 million uninsured. we want for you a health care plan that you can afford. we want for you a plan in which you and your doctor make the decisions, not washington, d.c. we want a plan that emphasizes prevention and wellness. we want a plan that gives low-income americans more of the same opportunities and choices for health care that most americans already have. and we want a plan that doesn't make it harder for american businesses to compete in the world marketplace by adding to their costs. we want in the end a program, a health care program that your grandchildren and your children can afford and doesn't keep

trillions of dollars of new debt upon them, that devalues the dollars that they eventually will earn and the quality of their lives. and as the president has repeatedly said, the best way to do that is to do it in a bipartisan way. but in order to do that, mr. president, we need to put aside the bill that we're working on today in the health committee and start over again in a truly bipartisan way to meet those objectives. i thank the president. i yield the floor. mr. president, i notice the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

mr. specter: mr. president? the presiding officer: the senator from pennsylvania. mr. specter: i ask consent that further proceedings under the quorum call be terminated.

the presiding officer: without objection, so ordered. mr. specter: mr. president, i have sought recognition to comment on the forthcoming proceedings on the confirmation of judge sotomayor for the supreme court of the united states. judge sotomayor comes to this position but with an extraordinary record. her academic standing at princeton was summa cum laude, a graduate of the yale law school, where she was a member of the board of editors. then in her practice, she was an assistant district attorney in manhattan, a position which gives very extensive experience in many important facets of the law, something i know from my own experience years ago as an assistant district attorney. then she was in private practice

on -- with a very prestigious new york law firm. then served on the united states district court. and more recently on the court of appeals for the second circuit. the hearings will give judge sotomayor an opportunity to respond to a number of issues which have been raised about her background. i think that chairman leahy was correct in moving the hearing date so that the confirmation process could be concluded in time for judge sotomayor, if confirmed, to sit with the court during september when the court will decide what cases it will hear. a great deal of the important work of the supreme court of the united states is decided on what cases they decide not to hear.

and perhaps that in some ways is as important as the cases they do hear. the cases they do decide. that it is during that period of time when the decision is made on a grant of certiorari with four justices deciding what cases to hear where the presence of a new justice could be very, very important. the confirmation hearings at an early stage will give judge sotomayor an opportunity to respond to many questions which are highly publicized. it's a very noteworthy matter when a nominee is being considered for the supreme court, and there is a lot of publicity, and some of it is controversial. as a matter of fairness, the

earlier a nominee can have the opportunity to respond to those issues, there is a question been raised about her decision on the new haven firefighters case. well, the nuances of affirmative action don't lend themselves too well to brief newspaper articles or sound bites on the talk shows. they're made for a supreme court hearing. or her decision on property rights following the kelo decision has been subjected to certain comment. there again, the nuances really require a hearing. her statement about a wise latino woman has been widely commented upon. and there again, she ought to have an opportunity to speak to those issues. there have been some questions raised about her decisions under the second amendment, membership

in the elysian grove and a lot of speculation. so let's bring on the hearings where there will be an opportunity for judge sotomayor to present her views. based on what i have studied and her opinions and an extensive meeting which i had with her, she is a powerful intellect and prospectively she is likely to be able to have good comments. but that's what the confirming process is all about. so let us move forward on it to the july hearing date so that we can consider her nomination and she can have an opportunity to respond to those issues. there have been contrary views

about the value of confirmation hearings. there are some who say that they've really outlived their usefulness, pointing historically to the fact that prior to 1955 or thereabouts there were very few confirmation hearings, only when there were some extraordinary question, and that in recent decades the confirmation hearings have been extensive. having participated in some 11 of these confirmation hearings, it is my judgment that they are very worthwhile from many'nt points of view. it presents an opportunity to have a public focus on the appropriate role of the supreme court. a lot of very major questions about the respective roles on

separation of powers between the courts and congress on fact finding and on the record. important questions on the relative authority of the executive versus the court on the issues of detention and the habeas corpus. important issues on the relative rules of the congress versus the executive as exemplified by the conflict between the foreign intelligence surveillance act and the powers of the president under article 2 of the constitution as commander in chief. there are also hearings where it's quite a public focus on a civics lesson as to what the court does, and public attention is focused on the court. my preference would be, as i've noted on legislation i've

introduced which has been passed out of the judiciary committee to have the proceedings of the supreme court televised under certain circumstances. that has not yet been approved. but i think the day will come when supreme court hearings will be televised. i think they could be televised without having showboating, real insight by the public as to what happens by the supreme court of the united states. just as hearings of the house of representatives and the united states senate are televised. there are a lot of quorum calls but there are debates that go on here for the public to see,. and at least the confirmation hearings does bring the role of the court into focused hearings. and i think to a ver