quorum call:

the presiding officer: the senator from vermont. mr. sanders: i ask that the quorum call be vitiated. the presiding officer: without objection. mr. sanders: mr. president, i think most americans understand that our current health care system is disintegrating.

today 46 million americans have absolutely no health insurance and even more are underinsured with high deductibles and high copayments. at a time when 60 million people, including many with insurance, do not have access to a medical home, do not have access to a doctor of their own, close to 20,000 americans die every single year from preventable illnesses because they do not get to a doctor when they should. this is six times the number of people who died on the tragedy of 9/11, but these deaths occur every single year. mr. president, i can vividly recall talking to physicians from vermont -- and i'm sure the same is the case in delaware and every other state in this country -- who told me that

patients walked into their office very, very sick, and they said, why didn't you come in here before? you are very, very ill. and they said, well, i didn't have any insurance. i didn't want tragedy. i didn't want charity. and i just thought i would get better. and by the time people ended up walking in the door, their case -- the situation was so bad that the doctors lost those patients, people who should not have died. and this is happening close to 20,000 times every single year in this country. recently, "the boston globe" had a big story -- and this is in the state of massachusetts, which supposedly has universal health care -- and reported that patients with chronic illnesses, such as diabetes, heart disease, were not taking their medicine or not getting the treatments that they needed because they couldn't afford the 25% copay.

and massachusetts has almost everybody covered. so when we talk about the health care crisis, it's not just the number of people who have no health insurance; it is people who are underinsured. and you add that together, we have huge numbers of people who are not getting the medical care that they need, when they need it and the result is not only personal suffering; the result is, they end up going to the emergency room, costing the system far more than it should, or they end up in the hospital at highly inflated medical cost. this makes zero sense. and, it is a manifestation of a dysfunctional health care system. but in the midst of all of this, you know, somebody may say, well, you got 46 million uninsured. more underinsured people are dying. but at least we're not spending a lot of money. you know, if you bought an old, broken-down car and you started complaining that it doesn't work

well, i would say, what do you expect? you didn't spend a lot of money on your car. and people say, canada has problems. canada has problems. the u.k. has problems, france has problems. every country has problems. but the relate it, we're spend -- but the reality is, we're spending almost twice as much as any other nation per capita on health care. we should be doing far better than every other country on earth and that is not the case. the reality is that we're spending close to $2.7 trillion on health care -- that's 18% of our g.d.p. and the skyrocketing cost of health care in america is unsustainable, both from a personal point of view and a macroecomonic point of view. at the individual level, the average american today is spending about $7,900 on

-- because of medically related problems. stop and think. a million americans going bankrupt because they can't pay their medical bills. on a personal level, what does it mean? imagine dealing with scerks dealing with diabetes, dealing with heart disease, and at the same time having to stress out and worry about how you're going to pay the bill. i am not a doctor.

but i can't help but believe that it doesn't make one's recovery process any better when you're sitting around wondering whether you're going to go bankrupt. and we are the only country in the entire world -- the entire industrialized world -- where people are worrying about having to go bankrupt because they committed the crime of getting sick. this is unacceptable, and we as a nation can and must do much better than that. that's from the personal point of view. now, what about the macroecomonic point of view, the business perspective? well, we know that large corporations like general moartds, fo -- like general motors, for example, having so many economic problems, spends more on health care than they do on steel. that's a big corporation. then you have small businesses in the state of vermont and around the country who are forced to divert hard-earned profits into health coverage for their bless rather than into new

business -- for their employees, rather than into new business. and because of rising costs, it is no secret that many employers, many businesses are cutting back on the level of their coverage, passing more of the costs on to their workers. and in more and more instances, you know what employers are saying? sorry, can't do it anymore, not going to provide any health care coverage to the workers. so what we are looking at is a situation which is disastrous for millions of workers on the personal level, disastrous for our economy, making up uncompetitive with countries all over the world that have a national health care program. and there's one other point we should be noted and we don't talk about that often: nobody really knows what the exact figure is but there are some estimates that as many as

25% of american workers are staying at their jobs today. you know why they're staying at the job they're in today? it is not because they wnts to stay at that job -- they want to stay at that job. they are staying because they have a good health insurance policy which covers themselves and their families. stop and think. from an economic point of view, from a personal point of view, does it make sense that millions of people are tied to their jobs simply because they have decent health insurance policies? what sense is that? now, it is important -- and i'm sorry to say that we don't do this enough -- to ask very simple questions: how could it be that according to the oecd in 2006, the best statistics that we have, the united states at that point -- we're now spending more -- spent $6,700 per capita on health care, canada spent $3,600, france spend $3,400? france spent about one half of

what we spent per capita and most international observers say that the french system works better than our system. so as we plunge into health care reform, it seems to me the first question we ask ourselves is how do the french, among others, spend one half of what we are spending and get better outcomes than what we do? in terms of of how people feel about their own systems, according to a five-nation study in 2004, by the well-respected commonwealth fund, despite paying far more for our health care, it turns out that based on that study, americans were far more dissatisfied than the residents of australia, canada, new zealand and the u.k. about the quality of care they received. in that poll, one-third of americans told pollsters that the u.s. health care system

should be completely rebuilt, far more than the residents of other countries. does that mean to say that they don't have problems in canada or the united kingdom? of course they do. their leaders are arguing about their systems every single day. but according to these polls, more people in our own country were dissatisfied about what we are getting despite the fact that we spend in many cases twice as much as what other countries are spending. it seems to me, mr. president, that as the health care debate heats up, and we hope that more and more americans are involved in this debate, that we as a nation have got to ask two very fundamental questions. on one sense this, whole issue is enormously complicated. there are thousands of different parts to it. on the other hand, it really is not so complicated. the two basic questions are, first, number one, should all americans be entitled to health care as a right and not a privilege? which is the way in fact that

every other major country treats health care. should all americans be entitled to health care as a right? universal health care for all of our people. and that, by the way, of course, is the way we have responded for years to police protection, to education, to fire protection. we take it for granted that when you call 911 for police protection the dispatcher does not say to you, "what is your income? do you have police insurance? we can't really come because you don't have the right type of insurance to call for a police car or to call for a fire truck." and when your kid goes to school, we take it for granted that no one at the front desk of a public school says, "sorry, you can't come in. your family is not wealthy enough." what we have said for 100 years is that every kid in this country is entitled to primary and secondary school because they are americans. and we as a nation want them to get the education that they deserve. every other major country on

earth has said that about health care as well, and yet we have not. i think right now, and i think what the presidential election, last election was about was that most americans do believe that all of us are in this together and that all of us are entitled to health care as a right of being americans. now, the second question that we have to ask is if we accept that, if we assume that all americans are entitleed to health care, how do you provide that health care in a cost-effective way? there are a lot of ways that you can provide health care to all people. you can continue to throw money -- i would ask unanimous consent for five more minutes. the presiding officer: without objection. mr. sanders: you can continue to throw billions and billions of dollars into a dysfunctional system. that's one way you could do it. i don't think that makes a lot of sense. i think that the evidence suggests that if we are serious about providing quality health care to every man, woman, and

child in a cost-effective way, then our country must move to a publicly funded single-payer medicare for all approach. our current private health insurance system is the most costly, wasteful, complicated and bureaucratic in the world. the functions of a private health insurance company is not -- underline -- not to provide health care to people. it is to make as much money as possible. in fact, every dollar of health care that is denied a patient, an american is another dollar that the company makes. with 1,300 private insurance companies and thousands of different health benefit programs designed to maximize profits, private health insurance companies spend an incredible 30% of each health care dollar on administration and billing exorbitant c.e.o. compensation packages, advertising, lobbying and campaign contributions. aren't we all delighted to know

that our health care dollars are now circulating all over the halls of congress, paying outrageous sums of money to lobbyists, making sure that we do not do the right thing for the american people. public programs like medicare and medicaid and the veterans administration are administered for far, far less than private health insurance. let me just conclude, mr. president, by saying that i understand that the power of the insurance companies and the drug companies, the medical company, suppliers are so significant, so powerful that we're not going to pass a single-payer medicare. but at the very least, what polls overwhelmingly show is that the american people want a strong medicare-like public option in order to compete with the private insurance companies. that is the very least that we

can and must do for the american people. mr. president, with that, i would yield the floor. mr. inhofe: mr. president? the presiding officer: the senator from oklahoma. mr. inhofe: mr. president, i ask unanimous consent that i be recognized as if in morning business for such time as i shall consume. the presiding officer: without objection. mr. inhofe: i do have a couple of comments to make concerning the remarks by my good friend from vermont, but i will do that at the conclusion of another subject that i feel some passion about, and that has to do with the nomination of harold koh by president obama. he is a nominee for the position of legal advisor to the state department. and i understand that cloture has been filed on harold koh, and i wanted to come to register my strong opposition and assure the american people that their representatives in congress are not going to let this nominee sail through unopposed and to

let them know that there are some of us here in the senate who will require full and extensive debate before this nominee receives a vote. and i think that you -- in doing so, you almost have to ask the question as to whatever happened to the understanding we've always had in this country taos what sovereignty really means. as legal advisor to the state department, koh would be advising the straighter on the legality of united states actions in the international forum and interpreting and advocating for the international law and treaties. the significance of this position and its effect on our sovereignty and security shouldn't be understated. koh is a self-proclaimed transnationallist, adheres to this school of thought, believes that international school of law is equal to or should take

precedent over domestic law and international court rulings have equal authority to the decisions of a representative government. now that's very significant, and i know he actually believes this and he adheres to this school of thought. that international law is equal to or should be -- take precedent over domestic law. koh's transnational principles have seriously -- could have serious kpwhr*eu indications to the united states -- serious implications to the united states sovereignty in prosecution on the war on terror, gun rights, abortions and being, many other issues. koh believes a nation who goes to war should have, must have united nations security council authority, going as far as writing that the united states was part of an access -- axis of disobedience by invading iraq, or should we say by liberating iraq. in october of 2002, koh wrote -- and i'm quoting now. he said "i believe it would be a

mistake for our country to attack iraq without explicit u.n. authorization, because such an attack would violate international law." additionally he supports ratification of the international criminal court which could subject our troops to prosecution in a foreign court. implementation of this interpretation of the international law raises a number of alarming questions. if the united states is required to gain u.n. authority for military action, what punitive actions might the united states be subjected to if unilaterally uses preemptive force? would our navy seals have had to wait for authorization from the international body before rescuing the american being held hostage in the horn of africa? i think 99% of the american people said that they should have that authority and we shouldn't have to go to any kind of an international court. i don't know where this obsession has come from that nothing's good unless it's international anymore.

in 1992, george will said -- and i'm quoting now -- "there may come a time when the united states will be held hostage to the idea that the legitimacy of u.s. force is directly proportionate to the number of nations condoning it." that was back in 1992 and this is what's happening today. and i hope that day never comes. the decisions made to protect our great nation should not be made by members of an international body, but by men and women who are elected by the people of these united states. equally concerning is koh's treatment toward the department of defense's recruiting efforts. in october of 2003 -- some of us remember this -- koh led a team of yale law faculty in filing an amicus brief in support of a lawsuit against the u.s. department of defense claiming the solomon amendment was unconstitutional. the supreme court rejected koh's arguments unanimously. that's a time when there were very few things that were unanimous in the united states supreme court. he was rejected unanimously.

in writing for the court, chief skwrufrts roberts stated -- quote -- "nothing about recruiting suggests that law schools agree with any speech by recruiters and nothing in the solomon amendment restricts what the law schools may say about the military's policies." further, koh supports accession to the international criminal court, the united nations convention and the law of the sea treaty, the u.u. convention on the rights of the child, and the inter-american convention against illist sit manufacturing and trafficking of firearms. that's to thing sifta promoted by president obama. that is that we yield to an international group in terms of how we manufacture and distribute weapons in this country. all of these treaties will greatly impact the lives of everyday americans and will require the united states to alter its domestic law to meet their prospective parameters.

in 2002 koh spoke at fordham university law school on a world drowning in guns, gives you an indication of where he's coming from. his speech was published in the fordham law review. his topic was the international arms trade but as usual his analysis had serious domestic implications. koh wrote american legal scholars should pursue the analysis and development of legal and policy arguments regarding international gun controls through constitutional research on the second amendment. in other words, koh believes that the best way to regulate guns in america is through international law, through a global gun control regime. as legal advisor, koh would be in a position to pass judgment on whether a proposed treaty would raise legal issues for the united states, including issues related to the second amendment. he would, therefore, be able to endorse treaties that can be used by the courts to restrict the individual right to keep and

bear arms, an idea that he is clearly and openly in favor of. it is simply not true to say that his beliefs about gun control, as some people say, or the second amendment rights doesn't matter because he'll be in the state department advising on international law. on the contrary, he wants to use international law to restrict constitutional freedoms in this country. in his position, he will have the power to advise the administration and to testify before the senate about what reservations might be needed when ratifying a treaty to protect constitutional freedoms. however, he has a history of afrbgd indicating for treaties without conditions. he cannot be trusted to express reservations with treaties that i believe will negatively impact everyday americans. the fact that he's in the state department doesn't make him safe. it makes him more dangerous. this is exactly where, with the possible exception of the supreme court, he wants to be. this is not an accident. it is his strategy.

he realizes he cannot achieve his goals through legislation, so he has turned to international law. if he can establish that international law is binding on the united states regardless of where the senate has ratified the treaty in question, activists can avoid congress and work the issue through the courts. if you believe the second confers an individual right to bear arms on the american people, then i urge you to reaffirm that principle by voting against harold koh. if you believe that our nation should be subjected by a variety of treaties that threaten our national sovereignty and american way of life, i urge you to reaffirm those values by voting against the nominee. i mentioned several things that, national treaties that he has promoted. it's not just confined to our second amendment rights t.'s everything else. the basis of his influence in these areas is that somehow international law should have precedence over