profit-focused. when you read what percentage one insurance company or two insurance companies have of a market in each state, you know that robust competition is missing from the health care market. and that is why so many people are worried about the future of the plans that they now have. the public plan is not about government-controlled health care, socialism or any of the buzzwords that have been tossed around as part of this debate. i ask my colleagues: do they consider medicare socialist? would they like to abolish medicare? probably some of them would. but medicare -- hello, my friends -- is a government-run plan. it is very popular with the american people. very few propose eliminating medicare. so let's be real here.

the public option is about offering americans a choice in the market that far too often offers them none. i'll tell you the choices too many americans face: whether to pay for health insurance or health care or to pay for other necessities of life, because health care has become so expensive. that's not a choice anyone should have to make. and maybe that explains why the american people don't agree with the critics of the public plan. half of all americans think the government plan will provide better health care coverage than private insurance companies, and a significantly lower percentage disagree with that statement. let's be clear, a public plan may not have special built-in advantages. it would be a coverage option that would compete on an equal footing alongside private insurance plans in the market for individual and small business coverage. if a level playing field exists,

then private insurers will have to compete based on quality of care and pricing instead of just competing for the healthiest consumers. in this way, a public plan will accomplish many of our most important goals. it will not waste money on costs incidental to providing health care. it will not focus on profits at the expense of the best health outcomes. instead it will spend money on improving health delivery and on trying innovative technologies and systems in order to save -- save -- money. it will force many insurers that have been shielded and protected from competition for far too long to compete with the plan that provides comprehensive care at an affordable rate. it will, most importantly, give all americans a choice. in fact, i think the thing that really scares opponents of the public option is choice.

then the curtain might be pulled back on their friends at the insurance companies and americans will finally see the hidden costs that have caused their premiums to skyrocket, the wasteful spending that does not improve health outcomes and the protection from competition that has been offered to private insurers over the last decade. to truly reform our health care system, congress must pass legislation that includes a public option and a fig leaf public plan is no plan at all, and i will not settle for such a fig leaf. it is important to remember how we arrived here. for a long time, when thinking hypothetically about health care reform, many in this country suggested we move to a single-payer -- a senator: i would note for

the senator from new york that he has used ten minutes. mr. schumer: i thank you, mr. president. i ask unanimous consent i be given five more. the presiding officer: without objection, so ordered. mr. schumer: the republicans rejected the single-payer plan. and so at the onset of this debate, we met them halfway with a framework that continues to largely rely on private insurers. so then we said if we're going to continue rely mostly on private insurance, can we at least introduce greater competition into the market by having a public plan as one option. the republicans, most at least -- just about all, i think -- rejected that too. we said, well, what if we insured that -- what if we insured that the public plan had to adhere to the same rules as private insurers? thus, guaranteeing a level playing field. the republicans here in the senate -- not in the country -- but the republicans here in the

senate still said no, even a level playing field. so, some democrats came up with a new idea. what if we relied on a co-op model that has served rural states well? in a good-faith attempt to consider this idea, i proposed some ideas for ensuring that co-ops could do the job of keeping private insurers honest. yesterday senator conrad indicated he could go along with many of these proposals. but senator conrad has never been the problem here. he's been well open to negotiating on how to make a co-op plan have the kind of clout to go up against the private insurance companies, be available to all americans, be able to bargain with the providers and be ready to go on day one to compete with the large nationwide insurance companies. senator conrad has always been willing to entertain all of that. he has been a good-faith negotiator with the best

interests at heart. it has been those on the other side of the aisle who have not been willing to negotiate. and so i'm losing confidence that senate republicans will ever agree to the types of changes to a co-op to make it a viable alternative, a viable substitute to a traditional public plan that is nationwide and available to everybody, that can go up against the private insurers and go up against the suppliers in buying power and that is formulated so that it hits the ground running on day one of the insurance exchange. we can only bend so much to try to win over opponents of health care reform. we cannot bend so far that we break. we cannot say we're putting something else out there and not have it do the job because of public option is what really

does the job. we must not let the scare mongering about the possible consequences of a public option deter us from doing what the american people overwhelmingly want and need. it is time to put the health needs of the american people -- not the insurance companies -- first. it is time to move past the partisan bickering and make sure that the health care reform passed by congress includes a real public option. it is the right thing. it is the smart thing. and it is what the american people want and they deserve. mr. president, i yield back the floor. a senator: mr. president? the presiding officer: the senator from south carolina. a senator: i ask unanimous consent to speak for 15 minutes. the presiding officer: is there objection? without objection, so ordered. mr. demint: thank you, mr. president. it seems that you're always stuck with listening to me. i apologize for that. i want to respond to my

colleague's grand design of our new health care system in just a moment, but i'd like to back up a little bit and discuss health care and some other things in context. there's no question in anyone's mind that these are difficult times for america. millions are unemployed and the unemployment rate continues to climb. our economy has been in decline for a number of months, and our military is strained all around the world at a time when our enemies seem to be gaining strength and increasing in numbers. back here at home, our spending and borrowing and debt are out of control in this massive government spending plan we call the stimulus has yet to show any results. we see government intervention in the many areas of our economy. and to the banks, the financial markets, the takeover of fannie

mae and freddie mac, takeover of large insurance companies, our auto industry. you know, people back home and all around the country are alarmed. and as i heard someone say last week, they tried to explain to me they're alarmed, and they threw up their hands and they just said "i'm outraged out," and couldn't speak any more. my question for my colleagues today: is this a good time to create another government program? the answer on the other side is obviously been yes. yesterday they all voted, i believe, to get the federal government in the tourism business, to close off debate and pass a plan that would get the federal government to promote tourism in america all over the world. i think it's like $400 million. in today's terms, a small amount of money. but the tourism industry, while

hurting because of the economy, is certainly not in collapse and need of a government bailout. the tourism industry spent billions of dollars on advertising last years. and it's not as if the rest of the world does not know we're here. the problem with tourism in america can be laid at the feet at an inept government. if you ask people abroad why they're not coming here in such numbers as they have in the past, we find the statistics show that we are the most unwelcoming at our customs office in the lines to get through to america. if you want to have a business convention or trade show in america, it's very likely that you cannot get the visas for your customers to come here, so many of these conventions and trade shows have had to move overseas. the problem with getting people here is what the government is not doing well. we don't need to get the government in the tourism business.

i have plants back home, such as bmw, who would like to bring people from their headquarters in germany over here to train the american workforce, but they found it's easier just to send our people over there because it's so hard to get their people to come here. they could come here and stay in our hotels and eat at our restaurants and improve our economy. but instead an inept government causes us to cause americans to stay in their hotels, eat in their restaurants and rent their cars. it's just illogical for us to create a federal tourism agency a la fannie mae, a new government-sponsored entity that is going to help promote tourism. it is this same kind of logic we're now using for health care. we're saying we have a crisis in health care, so, therefore, the government needs to get more involved and to take over various aspects of the health

care industry, such as was just described by my colleague from new york. but if we look at this situation a little more clearly, we'll see that it's the government that's causing most of our problems in not allowing free-market health care system to work. let's just look at this a little bit closer, because there's a whole lot of misinformation that was just shared on the floor here today. let's look at health care coverage in america. you've got about 60% now that are in employer-sponsored plans and almost another 10% who have purchased their own insurance on the individual market. so we have about 70% of people with private insurance. you've got about 25% medicare-medicaid and another 4% or so that are in military

plans. so you've got between 25% and 30% of americans who are now in a government health plan. and my colleague from new york was just bragging about how well the government health plans work of medicare. certainly if you have medicare and you can get a doctor to see you, it works just fine. but the problem is, is every dollar that's come in for medicare since its inception has been spent. the 2.5% that comes out of every paycheck has not been saved by our senior citizens to pay for their health care. it's been spent, and there is absolutely no money in this system to take care of america's baby boomers. this works like a government plan that my colleague was just bragging about. it has trillions of dollars of unfunded debt that will fall on the heads of our children and grandchildren. trillions of dollars that we have no idea how we're going to pay for. in medicare, is hopelessly in

debt at the state and the federal level. even worse is this problem, and let's keep looking at government versus private plans. i think most people in america woblt best situation in health care is to have a health care -- health insurance policy so you can pick your own doctor and decide with your doctor what kind of health care you're going to get. no plan is perfect. there are always problems in health care. it's very complex. but you have here about 70% of people who are in that situation, but every year their insurance costs more money. my colleague was saying that that is caused by private insurance, but let's find out the truth here. every year these government plans pay physicians and hospitals less. they pay a physician less than their cost to see a patient. and i have doctors i know back in south carolina in rural

areas. they have to close their practice to new medicare and medicaid patients because once over 60% of their patients are medicaid or medicare they can no longer make a living. you know how these costs are picked up? the hospitals and dockets who take medicare and medicaid have to charge private insurers more money every year because every year the government pays doctors less. that's why fewer and fewer of our best and brightest students are going to medical school and that we're headed for a real position shortage in this country not because of private health insurance, but because of the government plans. we've got about 16% who have no coverage in our country today. those are the ones that we say we're concerned with right now. the government requires hospitals to provide them service whether they have any insurance or money anyway. and where do these costs go? they're transferred to those who have private insurance.

so every year the inept government is transferring huge amounts of cost over to those employers and those individuals who are buying private health insurance and now my colleagues are trying to say this is what's failing us. we need to expand this part of the health care market, the part that's not paying doctors and hospitals to see patients, the part that's trillions of dollars in debt and the part that's already beginning to ration health care for those who are under those plans. if you want to know how the public option's going to work, i'd just encourage you to drop by a social security office, take a number an sit town and wait for them to get to you or maybe go to a veterans hospital or another government service. did we really want the government involved with health care? health care's the most personal and private service that we have as americans. do we want to turn health care over to the most impersonal,

most bureaucratic, the most wasteful and in many cases the most corrupt aspect of our society? what we do need to do is look at how we can get these private plans in the hands of those who have no insurance. that is something that we can do and we can do it for a lot less than the current administration is talking about. but before we talk about how we're going to get these insured, let's look at who they are. because this is being misrepresented to exaggerate the problem to create a crisis so that we can justify another government takeover over another area of our economy. we say we have about 46 million uninsured in america. here's how that breaks down. you've got about 6.4 million who actually have medicaid today but they're under counted in the census.

we have another 4.3 million who are eligible for medicaid or schip or another government program, but they haven't signed up for it. we need to make more of an effort to get people to sign up for the programs they're eligible for. you've got about 9.3 who are noncitizens. many of those are illegal in the country and the taxpayer should not be paying for their health care. we've got about 10% who have incomes of 300% or more over poverty and they're just not buying health care. an i've had some of those work for me when i was in business. i would offer to pay -- most of oir insurance. i'd pay $500 a month and they would pay $50 and some people turn it down because they don't want to pay $50. some people don't want to buy insurance. we have some people between 18 and 34 years old who don't have insurance and 10.6 million who are uninsured. and if we look at this, at least half of these should not be

subsidized by any type of government plan that are not already eligible for a plan or not citizens of our country. we could look at 20 million to 25 million. now, i want to make clear if there is one person in america who doesn't have access to good health care, that is a crisis to them. and we need to do everything we can to make sure that we are fair and affordable health care policies are available to every american. that's my goal. that's the goal of the republican party. and this week, this afternoon, as a matter of fact, i'm going to introduce a plan that will solve the problem at a fraction of the cost of what the democrats and president obama are proposing. in various ways their plan is to expand the government option whether it's a government health plan or government mandated plan on the private insurance market. one way or another, they want to expand government rather than expand private insurance.

and i know this for a fact. this is my fifth year in the senate. i've introduced a lot of resolutions that would help these people get insurance and every time my democrat colleagues have voted it down. we've had proposals for association health plans that would allow small businesses to come together and buy insurance at a lower price to offer their employees. they voted it down. i had a proposal that i introduced called health care choice that would do just what my colleague from new york was talking about is break up that single-state monopoly of a few health care plans. my plan would allow an american to buy health insurance from any state in the country. wherever a plan is registered, certified by that state, someone in south carolina could buy it from arizona or colorado, mr. president, and that's how most industries work in america. if i want to go across the line and buy a car in north carolina, i'm not prohibited to do that. but i can't do it if it's a

health insurance plan. so we allow those quasi-monopolies to develop in every state. i would develop a plan that would allow americans to buy -- the freedom to buy health insurance in any state in the country and to a person the democrats voted it down. now, i introduced a plan that would allow people to use what they have in a health savings account to pay for a health insurance premium. common sense, right? they voted it down. the fact is this: the people who want to expand the government option do not want these people to have private insurance because they believe in government and they do not believe that the private market can keep itself accountable. but the problems we have with the private market now can be attributed to a large degree to the government not paying its share of the cost, to the government having policies that keep quasi-monopolies in every state. i had a proposal that would allow individuals to deduct the cost of their health insurance just like we allow employers.

the democrats to a person voted it down. folks, you don't have to look far to understand what's going on here. the people who like taking over general motors an fannie mae and freddie mac want these government programs to be expanded all the way around this circle. this is something we've got to stop. and we can do it very simply if we use fairness and freedom here. so my plea to all americans, and particularly my colleagues, before we give up on freedom in the health care area, let's let it work and that's what my proposal is. this afternoon i'm going to introduce a plan that tells every american if you like the plan you have, whether it be medicare or medicaid or an employer plan or a military plan, you keep it. we're not going to mess with it. but if you have no coverage at all, or if you're buying your policy on your own on the open

market, we're going to for the first time treat you fairly and give you the same tax break that we give people in the employer-sponsored plan. this plan does this: if you're a family, we're going to give you a certificate for $5,000 a year to buy health insurance. if you're an individual, we'll give you $2,000 a year to buy health insurance. now some will scream and say, you can't get a good policy for that, and you can because i bought it for my adult children who aged out of my plan. and my plan also includes the option for an individual to buy health insurance in any state so we'll increase competition and lower the price. the plan also allows an employer to put money in the health savings account for you that you can use to pay for your health care or to pay for your -- the premium to support you to buy additional coverage with your health insurance. we have a provision that deals with lawsuit abuse and we have a provision that funds high-risk

pools for states so that people who have high risk conditions, uninsurable conditions, preexisting conditions can buy insurance that they can afford at state level. so the estimates are by the heritage foundation that within five years more than 20 million of these uninsured, most of them, will have private insurance plans. because they can't use their health care certificate unless they use it to buy health insurance. now, just ask my colleagues this: if we had the option to get everyone in an individual or employer plan or expand these government plans, which aren't paying their way, which are transferring costs to other people, which are hopelessly in debt, which way do we go? but we can fund my plan without one additional dollar of taxpayer money because the estimates are over the next 10 years that getting these people insured with private policies,

giving them a $5,000 a year health care certificate will cost about $700 billion. if that number sounds familiar, that's about how much money we've got outstanding with the bailout money we call tarp here in this congress. instead of them bringing this money back and spending it on something else, my proposal pays for my plan by recapturing this tarp money. so as this bailout money comes back over the next five years, it can pay to give every american access to a plan that they can afford and own and keep. it's basically no additional cost to the taxpayer at this point over what we're already committed for for the bailout. the choice really belongs to americans. are we going to buy this idea that a government option is really going to give us more choice, more quality, more

personal attention, it will attract more physicians into the profession? any thinking american knows that isn't going to happen. the ideal plans are those that when an individual has a plan that they reasoned can keep, they -- they own and can keep, they pick their own doctor and the doctor and patient decide what health care they're going to get. this is within our reach. we don't need massive government takeover of health care in order to make health care accessible to every american. let's not buy this idea that we're in such a crisis that we have to rush over the next couple of months to create another government program, another government takeover when we see what happens to government-run health plans right in front of our eyes. it won't work. we can't afford it. they're going to end up rationing care. they're going to take employer plans irrespective of what they say. if you have a low-cost government option that doesn't pay interests enough to see you,

you're going to see employers dropping their health plans and you will end up in the lap of the government whether you like it or not. let's not give up on freedom. let's look at the facts. have we seen any government program during your lifetime or mine that has actually done what it said it was going to do at the cost they said it would be done at? and you know that's not true. social security, so important to seniors, a promise we must keep, hopelessly in debt because this government has spent every dime that americans have put in it and there's not a dime in the social security account to pay future benefits. the same with medicare, trillions of dollars. this is a commonsense solution that every american can see. if we don't listen to the misrepresentation that's we're starting to hear in this body. -- misrepresentations that we're starting to hear in this body. every american with a policy they can own and keep is

available to us within our reach without any government takeover of health care. we just have to believe that what made america great can make a health care work and that is freedom. thank you, mr. president. i yield back and note the absence of a quorum. the presiding officer: withhold the quorum call? mr. demint: i withhold. no quorum. a senator: mr. president? the presiding officer: the senator from texas. mr. cornyn: thank you, mr. president. i thank my colleague. mr. president, i rise to speak on the nomination of harold koh whom the president nominated to be legal adviser at the state department. this is a relatively obscure, but very important position at state department and the legal adviser operates frequently behind-the-scenes but on such important issues as international relation, national security, and in other areas. one area that's very important

is that the real leel adviser is the -- the legal adviser is often the last word of state department on questions regarding treaty interpretation, that is, international agreements between countries. a legal adviser often gives legal advice to the secretary of state and the president of the united states during important negotiations with other nations. we also know that from experience the legal adviser can be a very important voice in diplomatic circles especially if he or she views america's obligations to other nations and multilateral organizations in a particular way, particularly if they have strong views. professor koh has an impressive academic resume and a professional background. he's an accomplished lawyer and a scholar in the field of international law. nevertheless i do not believe that professor koh