every single day -- members continue to make every single day, we diminish ourselves as much as we diminish their service. senator ted kennedy has long been a leader on this issue. i know he want to sea legs passed to end the ban -- to sea legs passed to end the ban. i will do all i can to support those efforts. we will see justice -- not just in the military but also for gay and lesbian families. last week, president obama took a first step toward ending inequality of gay an and lesbian families for benefits for federal employees. same sex pans can be included in the federal long-term care insurance program. now, any employee will be able to use sick leave to care for a same-sex partner. just as an low can make, take

tyke off to care for an opposite sex spouse. i applaud the president for being -- beginning to tear down the inequities. while this executive order represents an important initial step there is so much more to be done, mr. president. the u.s. government is far behind the private sector on this front. large number of fortune 500 companies already offer comprehensive benefits to sakes-sex couples. they have done so for many years. sometimes more than a decade ago. this allowed them to compete for the best and brightest, attracting talented professionals regardless of sexual orientation or gender identity. we make sure the federal government is able to compete for the same talented people. i'm proud to support a bill that

would extend additional benefits to the domestic partners of federal workers. this legislation introduced by my friend chairman lieberman and ranking member collins extends the full range of benefits to these couples including access to the same federal health and retirement plan currently available to the recognized spouses of government workers. as the free market has shown, extending these benefits to same-sex pans is not only the right thing to do but it also makes good business sense. i know this week many pride events an the country mean a lot of different things for people in the gay, lesbian and transgender community. some, it has a chance to reflect on the progress made by this community and to organize for the future. for others, it is an opportunity

to reflect and to honor those who have lost to aids. and still to others, it is a chance to feel safer, to feel empowered, to celebrate being part of being something bigger than themselves and to be reminded everyone should be proud of who they are. however, each of us celebrate gay and lesbian pride month we must remember the journey toward equality is far from over. just as the empansmation proclamation took this country on a path toward racial equality and women suffrage paveed the way for gender equality that refrain throughout the history will be taken up again. the struggle for equality will not be easy and it never has been but if we keep at it we

will get there. thank you, mr. president. i yield the floor. thank you, mr. president. a senator: mr. president? the presiding officer: the senator from wyoming is recognized. mr. enzi: might i inquire what the status is? the presiding officer: we are in executive nomination of harold koh. mr. enzi: are there time restrictions? the presiding officer: we're in postcloture which requires debate on the pending matter. mr. enzi: mr. president, i'd ask unanimous consent i be allowed to speak as if in morning business for such time as i might consume. the presiding officer: without objection, so ordered. mr. enzi: thank you, mr. president. i rise today to speak on the need to reform our nation's health care system.

if we're to be successful we must undertake this effort with the greatest of care and deliberation. when it comes to health care reform we've started down this road before. last congress i proposed legislation called ten steps to transform health care in america in an effort to provide a blueprint from which we could begin to address the challenge of improving our health care system. i might mention that the way that came about is that senator kennedy was the chairman of thee health, education, labor and pensions committee and i was ranking member and he and i worked together on a number of bills. in fact, have quite a record for being able to work in a bipartisan way to get bills completed. we were very busy on the higher education act and other education issues so i kind of took some leadership in the health area and we talked about principles that we wanted to achieve and then i collected ideas from both sides of the

aisle and put together this package of ten steps that would transform health care in america. as a blueprint to improve and address this challenge of improving our health care system. so it isn't something that he or i just started working on. after i introduced the bill i took my message of america hrk directly to the people -- health care reform directly to the people in my state traveling 1,200 miles and held a series of events in march of last year to provide the people of wyoming with a chance to see what i was working on and to voice their concerns with our current system. everywhere i went i her the same message repeated over and over again: that's that people want change. they want a system that will provide them with a health care system that's affordable, more available, and easier for them to access. simply put, the people of wyoming, like people all across the country, want more choices and more k control over their

health care. that was the goal of my ten steps bill drafted with the aim of living the playing field in tax treatment of health insurance. it was intended to provide a helping hand to low-income americans in the form of subsidies that would ensure access to quality, affordable health insurance. as i traveled through the state i also heard from members of the small business community of my state. they made it very clear that they wanted greater equity and access to a plan that would allow cross-state pooling so they could band together with small business owners and other states and get better rates on their health insurance that they provide their employees. in the end, no matter who i spoke with, they all had one message they wanted me to bring to the senate: keep costs down and under control. there have to be limits. that's why as the only accountant in the senate and on the budget committee i was and

remain you have concerned with the effect any health reform proposal will have on our federal budget. both in the short and the long term. i can't be the only one who heard those things when i was back home. i feel my experience on the road was very similar to almost every one of my colleagues. last year, whether they were campaigning for themselves or for other members of our party, we logged on a lot of travel miles. we met with and spoke to people from all walks of life who came from every imaginable background. some were from large cities and towns with large populations and others came from the smaller cities, actually call them very small towns with fewer people and resources. whoever we spoke to, and wherever we were, we all her the same concerns: we need a better health care system. and we need it now.

in response, i was pleased to join with several of my colleagues as we continued to work on health care reform this year. as the ranking member on the health, education, labor and pensions committee and in my service on the senate finance committee and in my service on the budget committee i have been working to facilitate a constructive dialogue with my colleagues on both committees. i've also met with the president and administration officials on numerous occasions so we could chair ideas on how to best craft a strong, bipartisan bill. as the debate on health care reform proceeds i top to stand ready to work on this critical issue. this is likely to be the most important legislation that we will ever work on as members of the senate. no matter how terms we serve. how well we handle this crucial issue will have an impact not just today but for many

tomorrows and countless years to come. if we fail to provide the change that's needed, it may be a long time before the senate will ever try to do this again. i'm convinced we have a perfect storm before us as we face this issue. the time is right. the political winds are with us. and we have the support and encouragement of the current administration and the people of the nation to get something done. that's why a good bill and a bipartisan effort are well within our gaps. our -- within our grasp. if we are to do the work before us and do it well we cannot have one side or the other try to grab the reins and lead the effort exclusively in their direction. the american people are looking for us to solve the problem. and they want to know that we wrote this bill together, amended it together, and, most importantly, finished it

together. they know that no one side has all the answers. so they do expect this to put partisanship aside. this is too important an issue not to follow a path that will produce a bill that will have the support of 75 or 80 members of the senate. i have every belief we can do that. and that's why i'm so strongly committed to bringing massive change to the policies laid out in the recently filed kennedy bill. i'll continue to try to bring what change in the work being done by health, education, labor and pensions committee and in the finance committee. let me be very clear about what i believe we can do if we put partisanship aside and work together. we can draft a good bipartisan bill that will drew a large majority to its side. we can get it done this year. last week, the help committee began to work up a very flawed piece of legislation. i understand the difficult circumstances that brought

senator dodd to chair this extraordinarily complex bill and i appreciate senator dodd's willingness to take on the task because he also chairs the bang been. chairs -- he also chairs the banking committee but the legislation is broken. it's too costly. and it's incomplete. of course, we're promised we will get the other pie pieces oe bill. arguments show that in the race to revamp our health care system this bill was a false start. in order to get this right, we should slow down and in some areas, we need to start over. this shouldn't be a matter of speed. to stay with the analogy of health care, no one guess to a doctor or a surgeon based on how fast they can operate or conduct an examination. it never matters how long it

takes. all that matters is that they get it right. we should do the same. i'm not suggesting that we come up with a new process to develop this legislation. all i'm saying is we need to make better use of the one we already have in place, the way we have always done things in the senate when we want to mak sure that we get it done right. for instance, it wasn't all that long ago that we had to do something about our nation's pensions system. we worked together. we talked about what we had to do, together. and then we came up with a way to get there -- together. the result was a bill that, when it came to the floor, was over 1,000 pages long, had the involvement of do committees. the same two committees we are talking about with health care -- health, education, labor and pensions committee and the finance committee. those two committees came together on a bill, over 1,000

pages. when it came to the floor we already had an agreement between the two committee members which were taken to the leaders which meant we had an agreement with everybody in the chamber that there would be one hour of debate, two amendmements, and a final vote. i asked the parliamentarian when the last time, when the last time was there was a bill of that complexity with that kind of an agreement before we debated it and that person said "not in my lifetime." that's what's possible and here if we work together. that's what we did with the nation's pension system. of course i think we're talking about the pension benefit guarantee situation being short a drastic $24 billion. well, that doesn't look like much money anymore, does it? no, we're talking about some errors on this one that is over $58 billion. that wasn't so long ago.

now we worked together and talked about what we had to do together and we came up with it together. the result was a bill with only two amendments offered because the agreement on both the illness and the remedy was so strong. as we prepared to begin the markup of this bill last week, we received a troubling preliminary analysis from the congressional budget office and the joint committee on taxation regarding the cost and coverage figures asoabted with the legislation. in its review of the proposal, the congressional budget office found that enacting the proposal would result in an increase in spending of about $1.3 trillion, with a net increase in the federal budget deficits of about $1 trillion over the 2010 to 2019 period. now, this cost estimate did not include the promised significant expansion of medicaid or other

options for subsidizing coverage of those with income below 150% of the poverty level. as the markup continues, we'll be asking the congressional budget office for an official analysis of the impact of the addition of such a policy on the federal budget committee. i'd say, this morning we talked about long-term care and we're having a lot more seniors move into the category where they'll be taking long-term care, and we have a proposal before us that we'll debate when we get back, but senator -- the senator from new hampshire, senator gregg, who is the ranking member on the finance committee, pointed out that the only part of the bill that gets scored are the premiums people would pay in over that first 10 years for their long-term care, which comes to about $59 billion, which shows a surplus of $59 billion. but what it doesn't take into consideration is the obligation to those people that are paying in those premiums that they will

get long-term care, and the expected cost of that long-term care to those people paying in that $59 billion is $2. -- is $2 trillion. the proposed payment doesn't match the proposed cost, and it won't be sustainable beyond the ten years when you're just taking the premiums. once the people start taking long-term care, we have another federal government program with a budget deficit. now, about the same time that we received news about the preliminary analysis of the kennedy bill last week, we got word that the committee was postponing its markup on the legislation after a report surfaced that the congressional budget office was preparing a report that projected an increase to the federal budget of $1.6 trillion over the next 10 years. all of this was on the heels of president obama's speech last week at the american medical association at which he said --

quote -- "health care reform must be and will be deficit-neutral in the next decade." end quote. the bill we have before us misses the target of this committee commitment by more than $1 trillion. still the bill is missing language in three key areas. i'd like to take a few moments to speak about our nation's deficit and our overall fiscal and economic condition. my concern about the runaway spending in the kennedy bill -- i should call it the kennedy staff bill because i'm not sure that -- i know that the senator, had he been able to work with me, would have come up with some different conclusions on the bill. my concern with the runaway spending in the kennedy staff bill is not simply a concern that it breaks faith with the president's health care reform commitments; remembe rather, i'y troubled the direction this bill would take us during a truly perilous fiscal age.

i was elected in 1966. in my first years we moved toward a period of surpluses. nearly 13 years later our fiscal deficit for this fiscal year -- this fiscal year -- exceeds $1.84 trillion, and our national debt exceeds $11.4 trillion. that's bad. people are starting to take notice, and that, unfortunately, includes our creditors. add to this the losses to our gross domestic product, and an unemployment rate that's heading towards 10%, and the news is worse. again, what i say is there have to be limited. people have them in their families, municipalities have them, most states have them. the federal government doesn't. according to the federal reserve, the level of debt-to-g.d.p. ratio is

estimated to reach the highest levels it has been since immediately after the second world war, and the increasing spread between short-term and long-term treasuries is evidence that global investors -- global investors -- are increasingly concerned about our nation's level of debt and the real potential for future inflation. in recent weeks, treasury secretary geithner traveled to china to attempt to ease growing concerns about our ability to pay off our growing debts. when geithner told an audience of chinese students at beijing university that -- quote -- "chinese assets are very safe," end quote, the reports are that this statement drew loud laughter. it really is not a laughing matter for us. it is serious. tough action, not -- quote -- "i'll tell you what you want to hear speeches" -- is what we need. on the state and local front,

our economic indicators are equally troubling. on thursday, the rockefeller institute on government issued a report on state personal income tax revenues for 2009. they're falling fast. 34 of the 37 states in the saw declines in tax revenues indicating that it will be increasingly more difficult than expected for states to close their widening budget gaps. i can hear calls for more bailouts, but my question is: who's going to bail out the federal government? these numbers provide the critical backdrop as we consider the new deficit spending included in the keening did i staff bill. recently federal chairman bernanke stated that -- quote -- "achieving fiscal sustainability requires that spending and deficits be well-controlled" -- end quote. he then went on to note that, "unless we demonstrate a strong commitment to fiscal sustainability in the longer term, we will have neither

financial stability nor economic growth." for these reasons, the kennedy proposal requires an entire rewrite with respect to its impact on our federal budget deficit. just as troubling as this bill's impact on the deficit is its failure to help tens of millions of americans get the health insurance they need. the congressional budget office estimates that if enacted, this bill would only provide health insurance for one-third of the nation's uninsured. let's seekers $1 trillion-- -- let's see, $1 trillion for 16 million people. this number falls far short of the president's stated goal of -- quote -- "quality, affordable health insurance for all americans." in his recent letter to chairman kennedy and baucus. the c.b.o. projects that about 10 million individuals who would be covered through our employers' plan under current law would not have access to

that coverage under that legislation. this figure breaks president obama's often-repeated promise during both the 2008 campaign and since taking office that under his health care plan -- and i quote -- "if you like your health care plan, you'll be able to keep your health care plan, period. no one will take it away, no matter what." period, end of quote. under the kennedy plan, that promise rings hollow for millions of americans, and that's simply unacceptable. i know that the president has already scheduled an event on one of the networks to push his health care ideas. when it airs, i'm sure we'll hear him repeat this line over and over, that if you like the health care plan you already have, you can keep it. if he makes that promise again, every time we hear him say that, we should remind ourselves that the white house has already admitted that such statements aren't to be taken literally.

i think that means they aren't true. i can't recall ever hearing something like that from the white house, but those are their words. maybe they should be applied to an old presentation that none of it should be taken literally. i know one thing that can be taken literally, and we ought to give it straight to the american people, and that is, under the proposals being rolled out, you won't be able to keep the care you have right now. washington bureaucrats will be able to deny you and your family the care you need, and that you fully deserve. unfortunately, that's not the only thing that we're in denial about. we're also in denial when this comes to the cost of the democrats' health care plan and our ability to work our way out of a hole of debt that only promises to grow deeper and derm for a long time and for many years to come. a lot of times we've talked about how we're spend our kids' and our grandkids' money.

i really feel compelled to point out that we're already spending our seniors' money. why is that? well, i see -- normally what happens in this country is that little bit that's taken -- a bunch that's taken out of your check for social security, that's matched by the employer, that amount of money each month has always gone to pay the seniors that are retired, to pay their pension, and to have a little bit of surplus. but you know what? it isn't doing that anymore. we're having to take money out of the trust fund now to supplement that to be able to pay the people that are retired right now, and we aren't even to the baby boomers yet. we've got a problem. and, unfortunately, that's not the only thing we're in denial about. so having shown the devastating impact of the kennedy bill on the federal deficit and the failure of the kennedy bill to provide adequate access to health coverage for millions of

americans, i'd like to turn briefly to one of the three foundational principles of my 10-step plan: namely, improving the quality of care. on this plan, i think the kennedy plan again fails to live up to the promise laid out by president obama to improve patient safety and quality of care. that's very important. to improve patient safety and quality of care. i'm deeply troubled by the real possibility that the comparative effectiveness research that's mentioned in the bill, that's been debated in the committee, that's been held intact in there, will be used as a cost-containment measure to ration care under this legislation. the result would be that for millions of americans, a federal bureaucrat would dirk tate the type of care they -- dictate the type of care they receive and interfere with the doctor-patient relationship. as the kennedy bill proceeds through congress, i'll fight to strip those provisions that will delay and deny needed health

coverage to americans. i spoke at length in committee about the truly horrible stories of rationing care that we hear about from the united kingdom, and i'll continue to speak out to make sure that type of socialized care is not imported to the united states. finally, i am deeply troubled a number of other policies advanced in the bill. i believe that the community rating provisions will result in skyrocketing premium costs for younger americans, and i'll troubled with that the bill does not provide incentives to encourage individuals to make healthier choices. yeah, there are a lot of choices that we can make that would improve our health, and not preventive stuff. it is stuff we can do ourselves. so as we proceed in the second week of the hem help committee markup, we're still -- as we proceed in the second week of the "help" committee markup, we're still missing stuff. there's a manned on employers to

provide insurance and a provision for follow-on biologics. it should be fairly simple to take care of, but it hasn't been, and that's troubling. it is obviously very difficult to comment on these provisions until they're released. proponents of the government-run option, including the president, consistently argue that a public plan is necessary to keep the insurance companies honest and thto foster competition. with respect to provisions dealing with preexisting conditions, rate bans and other reforms, we're all committed to taking action to keep the insurers honest. and to make sure that people with preexisting and chronic diseases can get insurance. the creation of a new government program at a time when the experts and the medicare trustees tell us that medicare stands on the brink of insolvency does nothing to foster honesty. it fosters fiscal irresponsibility. we are borrowing to pay for the government-run programs we have now. if you already have trouble

maying your mortgage payment, why would you go out and buy a boat and an r.v.? with respect to the notion that we will be fostering competition with the creation of a government-run health plan, i think the public is growing tired of the government intervention in our day-to-day lives. first there was our involvement in the mortgage system. then in our banking system. then we got more involved in our nation's auto motive industry. it is certainly more than a possibility that the government has taken on more than it can handle. we're certainly operating at more than the maximum capacity already. having government take over our nation's health care system may be the last straw. think about that. think about all the things that just this year the government has decided to take over, and the comments i get at home and the other places i've traveled across the united states is doesn't the government have a little bit of trouble running government? there's certainly a role for government as aon