mr. kyl: mr. president, i've been talking about health care reform being urgently needed. mine is satisfied with the status quo. we have all heard unfortunate stories of americans who cope with health insurance. all americans deserve access to high quality health care. in a country as innovative and prosperous as ours we can achieve that goal. republicans believe we can do so by putting patients first. we believe americans should be trusted with their own money to make wise decisions about the health care plan that best fits their family's needs. we do do not believe forcing everyone into a one-size-fits-all washington-run system as the president wants to is the solution to our health care problems. indeed, we believe a washington takeover would create a whole new set of problems, the likes of which are experienced every day in countries like canada and great britain. president obama often says that if you're insured and you like your current health care, you

can keep it. but as i pointed out several times, the president's plan would in fact force millions of americans into the government system by providing incentives for their employers to eliminate their coverage p. government-run health care systems in canada and great britain have over and over again failed the very patients they were created to serve. access to doctors, tests, treatments, and medications is limited. patients wait through painful months and years to get the treatment they need. the longer they wairkts the more their conditions worsen. medications are sometimes unavailable, or the government may refuse to pay for them despite the "guarantee" of universal coverage to all. innovation and new medical technologies are not encouraged because they would lead to higher costs. patients deal with bureaucratic hassles as they try to wade themselves through the rules. americans want health care reform, but they don't want to experience the rationing and the

ordeals that a government system would create. as opposition to this public option idea -- or washington takeover -- grows, some democrats in the senate have been trying to disguise this takeover with a new name and they've come up with the idea of calling it a health insurance co-op. this started with a very good idea -- an idea from the senator from north dakota -- but it has evolved into simply another name for a government-run insurance company. as we all know, a co-op, in its pure form, is a business controlled by its own members. co-ops form when communities unite to solve a common problem oir exchange goods or services. in arizona we have more than 100 co-ops all across the state. some communities use them to get fresh food, electricity, hardware, heating fuel, or create credit unions. a bloated washington-run health care bureaucracy forced upon the public is not a co-op.

as michael leavitt has written in a soon-to-be published fox news articles, "a co-op that would be federally controlled, federally funded, and federally staffed sounds like the public option meets the new general motors." well, mr. president, in the era of the gm takeover, as we know, washington controls the purse strings, pays the bills, dick taits the rules. the same would be true of a washington health care co-op. as leavitt put it, washington health care would result in americans be co-opt rather than being given a co-op. americans are concerned about the cost of the bills being imposed on the other side. an estimate shows that the bill in the "help" committee -- health, education, labor, and pensions -- or the draft bill crate creteed by the senior senators from massachusetts and connecticut -- that's the piece of legislation we're talking about -- would cost $1 trillion

over the course of 10 years. but only would reduce the number of uninsured by 16 million people. so $1 trillion would bring 16 million people into the insured status. for those that would be newly covered, the cost would be $65,185 per person. for ten years of coverage. that's only a preliminary estimate for part of the plan. of course, a preliminary estimate does not tell the whole story. what would it cost to cover the remaining 31 million who are thought not to have insurance? or the millions who would be displaced from current private coverage with their employer into the public plan? remember, indicated that private employers would have no incentive to keep those people on their own rolls when it would be much cheaper to have them go to the so-called government option. the bill also provides subsidies for families whose incomes reach 500% of the poverty line.

500% of poverty, which gets you close to $100,000, as i recall. mr. president, the first question one has to ask in these circumstances, how do we pay for all of this? and who will pay? we're all familiar with the huge expenditures of this government since the beginning of the year on the so-called stimulus package, the so-called omnibus bill, the budget that's been provided, and now the supplemental that we'll probably be taking up tomorrow, all of which adds trillions of dollars in more debt, more debt than all of the other presidents and congresses of the united states put together -- in fact, double that and that's how much debt is created in just one budget of president obama. and now we add on top of all that $1 trillion, $2 trillion, who knows how much, to try to find coverage for about 45 million people.

we haven't got the answers to the questions yet of how we would pay for it, who would pay for it, but we've seen proposals that range from taxes on beer and soda to juice, salty foods, eliminating comartable tax deductions, w we've even heard about a value-added tax that would tax everyone regardless of income. would there be anything left that the federal government does not tax at the end of this? well, the "help" committee would also establish a new what's called prevention and public health investment fund. we don't know all the details yet but what we've hearted is that it would direct billions of dollars to the government to do healthy things -- like what? like building sidewalks and establishing new government-subsidized farmer markets. the side to encourage healthier livlifestyles. well, i suppose that creating sidewalks so people can jog on sidewalks creates healthy lifestyles. i was just at at farmers s.

market this weekend. i didn't notice any federal subsidies and i'm sure the vegetables there are good for everybody and it would be nice to have more farmers' markets. but should the government be spending a lost money on things like that in the guise of trying to provide healthier americans so that we have less costly insurance? i don't know, encouraging healthier lifestyles is fine but i don't think this is the kind of health care reform that the american people had this mind. it's also indicative of a very wasteful and inefficient system whiforts a run by the -- whenever it's run by the federal government here in washington. we all believe that families who can't afford insurance should be helped. there are ways to do that. the poorest americans are already eligible for medicaid, and we should see to it that medicaid and medicare -- the health care program for seniors -- are strong and that everyone who is eligible signs up for them. one of the reasons there are so many uninured is that many of the people who are eligible for medicaid or private insurance haven't signed up. we can get them signinged up for

that, and that leads to another question about washington-one health care. will increased demands for government health care diminish the quality of care that is now received by america's seniors? medicare? that's an important question for seniors to contemplate. they want congress to find ways to ensure that medicare is solvent. they don't want us to divert the program's resorrieses into massive new entitlement for everyone. yet we all know, as the president himself has said, that medicare is not solvent. it is not sustainable. now we're going to add additional burdens and expect that there won't be any negative impacts on america's seniors. i find that hard to believe. i haven't read anything in the congressional budget office's preliminary report that makes me more optimistic about this. the preliminary numbers should make us even more wary of adding a new government program. finally, we're told that we must hurry up and pass the health care reform that president obama wants right away for the sake of the economy. the president pitched the same argument to congress as he

pushed us to pat pass the stimulus, which was packed with debt and weight, the detail denf which are coming to light -- the details of which now are coming to light by a report by senator coburn. the bulk of the money that we passed for stimulus should simply not be spent. that will not be efficiently spending taxpayer dollars. i argued at the time that rush rushing to borrow money to pass such an expensive and complex bill was irresponsible and a disservice to taxpayers. economists insisted that if congress passed the stimulus lurks unimloirmt would peak at 8%. well, four months later, unemployment has now reached 9.4%, and here we are again being pressured to hurry up and spend another $1 trillion of the taxpayers'. republicans will not be rushed into passing the democrats' health care bill. we're going to ask the tough questions. i think our constituents deserve answers to to questions.

based upon the track record so farks i wouldn't say that the experts who have told us don't worry about the cost, everything will be fine, have not guessed right, as the vice president said last sunday. i don't think that our constituents want us to hurry it. i think they want us to do it right. we want real reform, not more deficits, government waste, and unsustainable programs. so as we reform health care, we need an approach that makes sure that the patients come first and that no government bureaucrat stands in the way of the doctors prescribing the medications and treevments that their patients need. the success of america is largely due to the individual freedom that we all enjoy. and individual freedom triumphs when the doctor-patient relationship remains free of government intervention. we must continue our great tradition, as we pursue the health care reforms we all want. mr. president, leet me just conclude by -- let me just conclude by comment on a piece of legislation that senator mcconnell and i introduced.

i'd love to have every one of my colleagues cosponsor this legislation. i'm hoping that we can get it adopted very soon, before we take up health care reform, because it will inform us as to how we should deal with health care reform on the one hand what could be the most important -- on what could be the most important issue that americans find in this whole issue. americans want their fellow citizens to be insured and they want costs to be kept in check so that they can afford insurance. they want both of those things. but they don't want their care, the care that they, according to public opinion surveys, that they believe in and they like -- they don't want that care interfered with in order to achieve these other two goals. one of the things they're most fearful of is that their care will be rationed. when we talk about saving money in medicare in order to pay for insuring more americans, seniors rightly question whether or not some of the care that they've been getting is going to be denied them or that they will be delayed in getting that care.

one of the ways that that could be accomplished is by using something that the congress has already passed compared comparative effectiveness research. that stimulus bill that i've talked of earlier appropriated $1.1 billion to conduct comparative effectiveness research. it really wasn't necessary because it's done in the private sector all the time. hospitals, medical schools, associations, groups of people who want to find out which treatment is best for the most people conduct this kind of research all the time. is drugs "x" or drug "y" better to treat people when they have a certain condition? and they run tests to see how the different medications perform and then give the results to physicians who then use the information in prescribing to their patients. and it's a way that we have found that we can provide better-quality care for more people and sometimes by the way we can save money as well.

but the point of it is not to try to figure out how to cut costs so that we can deny certain care to people and, therefore, not have the cost of providing it. unfortunately, that is one of the purposes to which this research could be put, and it has been acknowledged by people both within the administration and without the acting head of the national institutes of health, for example, talked about using this research for allocation of treatments. allocation of treatments is another way of saying rationing. you decide which treatments to allocate and which ones not to. this is the way it's done in great britain and canada. they don't have enough money to pay for all the health care physicians prescribe, and so they delay some of the care until it's not needed anymore or the person dies, or they deny it. for example, one of the policies was not to prescribe a -- well, the doctor prescribes the drug, but not to fill the prescription

for an eye condition until the patient was blind in one eye. and then you could get the drug. americans don't want that. they don't want to have to suffer in that way when the medicines are available to treat them. and what the government agency in great britain has said is, look, we don't have enough money to give you all the care that your doctor says you need. we're going to have to make tough choices. we understand that won't please everyone. but there is no other way to use the limited dollars that we have to provide this free care to everybody within the country. what we're saying is that we don't want american to get to that point where you have to ration the health care. in great britain, they have a term called -- which stands for quality-adjusted life years,

quay. what they have said is a person's life is worth about $40,000. a year of your life, i think it comes out to about $125 a day. and. if the health care that the doctor has prescribed costs more than that, then in most case you you don't -- in most cases you don't get it. even though the doctor says you need it and he's willing to prescribe it and help you with the procedure or treatment or taking the drug. i would hate to get to that point in the united states where we have an agency that says how much we think your life is worth every day -- $125 -- and says, well, if the prescription of the doctor costs more than that, you're out of luck. we're not going to pay for it. incidentally, the national health care system in great britain has an acronym for that agency, it's nice. i think it's the national institute of care.

"nice." nice. not so nice when you don't get the care your doctor thinks you need. what we have said is the government can't use this research, this comparative-effectiveness research, for the purpose of denying you care. obviously it can be used for the purpose for which it was originally intended, namely, to figure out which treatments and prescriptions are best. but it cannot be used to deny treatment or service. we obviously make an exception for the f.d.a., which has the bill in the food and drug administration which can say a certain drug is dangerous to your health. obviously that would be exempted from this prohibition. otherwise we say you can't ration health care with comparative-effectiveness research. the bill pending before the "help" committee actually creates an agency to use this research for that purpose. so there is a blatant attempt in the "help" committee to use this research to ration care. our legislation would stop that.

and we think we ought to pass it now to instruct the "help" committee that we don't want that to happen. in the finance committee, it's more indirect. a private entity would conduct the research, but there's nothing to prevent the federal government from using the results of the research to delay or deny your care, to ration care. so for the bills that are being written in both committees, our legislation would provide direction that americans are not -- whatever other reform we have, americans are not going to have to worry about somebody getting in between their doctor and themselves. when the doctor says i think you need this particular treatment, if their insurance provides for that. if not, there are other ways you can get the treatment. if it's a government program like medicare, you'll be able to get the treatment. the government is not going to inject itself in between you and your physician and say that you can't have that because it's too expensive. that's all our legislation does. and i would hope that my colleagues would be willing to support that legislation to give direction to the two committees

to ensure that they don't, in their zeal to cut costs, write legislation that would have the effect of rationing health care. mr. president, there are a lot of other concerns that we have in putting this legislation together. concerns about government-run insurance company to compete with the private insurance companies. a requirement that all employers provide health care, which, of course, would substantially add to their costs and might result in their hiring fewer people or paying the people that they do hire less money. there are a lot of different concerns that we have. in my mind, the most serious one is this concern about rationing. everybody would like to lower costs, but the one way we can't lower costs is by having the united states government tell you that you can't get medical care that your doctor says you need. let me just conclude with this point. if you'll think back, think back, mr. president, just 100 years ago to the year 1908.

how much health care could you buy at the turn of the last century, say, in the year 1900 and 1908. the answer is not very much. think back about 40 years before that when president lincoln was assassinated and the kind of treatment that he got. it almost seems barbaric in our modern way of looking at things that there wasn't really anything available to save his life. now think of the incredible inventions and breakthroughs in medical science in the last 100 years, in the last 50 years, in the last 10 years. things have been invented -- new medications, new pharmaceutical drugs, medical devices, new kinds of surgery, ways of treating all kinds of conditions have evolved so rapidly that we are extraordinarily fortunate to be able to buy all of this health care. and so when people say we're spending too much on health care, i'm not sure that's

totally correct. to the extent that there are more efficiencies in the system that can be brought to bear, of course we want to do things to incent those incentives. that's what some of the republican proposals would do. but what we don't want to do is to put a government bureaucrat in between you and this incredible new medicine that's being invented every day. we should be glad that we can spend more on health care if it's much better health care. as one of the ex-tpherts this area said, in -- experts in this area said, in 1980, if you had a heart attack, after five years your chances of survival are about 60%. if you have that same heart attack today, your chance of survival is about 90%. so from 60% to 90% survival in just a few years based upon new medical breakthroughs. it costs a little more money. and the question is would you rather have 1980's health care at 1980's prices or health care

that's available today at today's prices? and i submit that almost all of us, when we're thinking about a loved one in our family, would say i want the very best there is, the very best that we can get. that's why republicans say we want insurance to be affordable for everyone so that at least, if nothing else, for that catastrophic event in your life, like a heart attack, for example, you will have all of the latest health care that america has available. and it will be paid for so that you will have high-quality care. and some of these other countries, they say we're sorry. we can't afford that. we can't afford to spend money on all these new breakthroughs. we're basically stuck with what we can afford back in 1980, for example. and good luck, we know that's not going to help you all that much with your illness, but that's all we can afford to pay. that's what we're trying to avoid, mr. president. we're trying to take a very small step first and say that at a minimum, nothing in this

legislation would allow the government to use comparative-effectiveness research to ration our care. i don't think that's too much to ask. and i would ask all of my colleagues to join senator mcconnell and me in sponsoring that legislation and seeing to it that we can get it passed for the benefit of our families and our constituents. mr. president, i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

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