percentage rate counted on a simple interest bases with no other fees and charges for overdraft. we believe that by using a line of credit product which is formally recognized as a loan, and thus subject to all of the federal lending disclosure requirements, the cost of the consumer is both fully disclosed and properly proportional to the amount that the overdraft account by. at penn fed with post-transaction smallest to largest. we provide separate mail notification for each overdraft so that our mirrors are carefully aware of the status of their account. we believe that rapid notification is important to those members so that they can pay off their overdraft as quickly as possible. inshore would have attempted to craft a product that is truly consumer friendly. we would make note of the fact that we have not received a single complaint from our membership regarding the order in which we process items in

over 20 is. nevertheless, there are mbs who do not choose to opt in. and there are those who cannot qualify for a line of credit. these numbers are not allowed to overdraft their account with a limited exception of an off-line edit on 10 debit process. in those instances we do charge a 30-dollar fee. . . the product we created is called warriors advantage.

it waives the checking account fees for insufficient funds for up to two occurrences in any rolling three-month period. importantly, this program is separate and distinct from our overdraft line of credit and goes beyond the minimum requirements of the proposed legislation. under this program a military member with overdraft protection can use all of the money available in their checking account plus their line of credit and still have two additional instances of return items every 90 days with no fee or charges beyond the interest on their loan. our research indicated that this program would result in just over 98% of our military members with checking accounts never experiencing a fee. the warriors advantage program represents only a beginning for us. we intend to extend this program to our entire membership and we're already at work on our next version which we hope to roll out in the summer of 2010. so thank you very much for this opportunity to testify. we are indebted to you for the work that you're doing on behalf of the american consumer.

>> mr. pollack, we thank you very much. mr. kerry, we welcome you to the committee. i want to point out and i say this to you because it's oftentimes we have these discussions and hearings and people like citibank and others are the subject of our concerns to put it mildly. but i'd like to reflect it here that citi, overdraft fees from atm and point of sale, pin transactions and debit transactions -- when they are not sufficient funds and they count, not sufficient to the account, real time posting of debit and atm transactions are part of city's program. we compliment citi. we often berate you for what you're doing doing but i want to compliment you when you do something right. >> thank you very much for the opportunity. >> there's still other things i want you to do. i don't want you off the hook. >> i understand. thank you for the opportunity to talk about the bill and offer some recommendations for improving the choice with

overdrafts. you know, we've heard today the policies that some of the banks employ implying their overdraft protection particularly with atm and debit transactions can be very confusing, frustrating and often expensive for consumers. especially, for those people who don't manage their daily finances that closely. there are many stories we all heard where a consumer incurred an unexpected fee for a transaction that could easily have been avoided had there been better information at the point of sale. it's the $5 cup of coffee that ends up costing 40 bucks after the overdraft fee is slapped on. so at the outset it's important for me to be clear and, senator, i think you made it very clear is that at citi we help customers avoid overdraft fees. we have never authorized, never authorized atm or debit transactions if we know the money is not there. and, therefore, we do not charge an overdraft fee when a customer attempts such a transaction. moreover, through incentive

programs with our personal bankers we encourage our customers at the account opening and throughout their relationship with us to link a savings account or a line of credit for potential overdrafts and avoid either an overdraft fee or a bounced check fee. this practice is one of the best ways to reduce the risk and the costs of overdrafts. separately, we do allow overdrafts for checks and ach transactions. we do this because the situation is very different. with checks and ach transactions customers have the sole control over the transactions. we cannot know what amount they're writing on the check or exactly when the check was written. in those cases we mitigate risk for our customers and ourselves by allowing customers a cushion to cover a small overdraft. further, in order to avoid large overdraft situations, citi will not authorize a payment beyond a reasonable amount. today, fewer than 20% of citibank customers are charged

even one overdraft fee a year. of those only few are charged more than once annually. we think the reason for this is because we decline atm and debit transactions when the funds are not available. while we have concerns with aspects of the bill we fully support the goal of protecting consumers from unnecessary overdraft fees. we support the additional efforts to improve consumer awareness regarding overdraft protection and alternative payment options. moreover we believe banks should have more transparency so the consumers can better manage their own money. we believe in the importance of giving consumers the ability to make choices based upon their individual circumstances as they manage their finances from one day to the next. that is why we believe there are opportunities for reform to provide consumers with even greater choice and control related to overdraft fees. of course, most consumers do not overdraft and never will. still consumers may not fully understand the effect of opting

into or out of overdraft coverage. it will have over them in time. and they will find themselves in a circumstance where they wish they could proceed with a specific transaction even if they know they would be charged a fee. i'm not referring to the $5 cup of coffee that ends up costing $40. rather, it's about something -- it's about someone being stranded without cash in a foreign country and bebe able to access $100 from an atm even if it costs them $130. having previously opted out would eliminate the flexibility. so it's our position that consumers should be given the choice of opting in at the point of sale. the choice and control should lie squarely in the hands of the informed consumer. so consumers should be alerted at the atm or debit terminal that the transaction will overdraft their account and they should be able to choose at that moment whether or not they want to incur the fee. and have it go forward with the transaction.

and in the absence of the choice, perhaps the transaction should be denied. understandably updating the technology to provide such transparency will take time and it will be incumbent upon the merchants, the networks and the banks to help create this functionality at the point of transaction. with this point of transaction approach, all the issues in the bill about how many fees can be allowed, whether those fees are reasonable, exactly when the customer should be notified and the other concerning policy and business implications of those points all become moot. informed consumers can decide whether a fee is too high or being charged too often based on their personal needs. in short, consumers need to decide. as i've noted we agree with the overriding goals of the bill. however, we have some important points of concern in the current bill that should be addressed, some i've noted here and more in detail in my submission. i thank you very much for the opportunity to participate. >> thank you very much. very creative thoughts. i appreciate that. how are you doing this afternoon.

good to have you with us here as well mr. calhoun. we thank you for coming before the committee. >> good to be here, chairman dodd, and members of the committee. thank you for your leadership in protecting consumers, especially, enacting the card act recently and thank you for inviting us to testify today. nearly five years ago, federal regulators studied overdraft fees and found serious problems. they issued joint guidance advising banks to consider prohibiting overdraft fees on debit cards and to limit the fees. had this guidance be enforced we would not be here today discussing the explosion in the amount and frequency of these fees. instead, the regulators chose to not enforce the guidance and in the intervening years, american families have lost an additional $70 billion. current overdraft practices are a pipeline out of the pockets of american families.

federal regulators have the present authority and duty to stop this abuse. their hands are on the valve to cut off the siphoning of consumers money but they refuse to cut it off. i'm going to focus my comments on overdraft fees on debit cards as this is the largest and fastest growing source of overdraft fees. overdraft fees on debit cards are abusive and should be prohibited. it's a penalty fee totally unrelated to the cost and the bank can stop the act by doing as citi does, just declining the transaction and there is no nsf fee for the customer, for the consumer, when that is done. that's like a town with an intersection with a green traffic light and then the town opposes a high fine on travelers who enter the intersection. today, banks manipulate bank accounts to generate fees and then impose these high penalties. there are lower costs

alternatives that i mentioned today but these abusive high fees are driving them out of the market. several banks have discontinued alternative products like lines of credit because of the revenue from high overdraft fees. overdraft fees are turning debit cards into high cost credit cards without the protection of the card act. these fees cause immense damage to families, more than 27 million families pay over five overdraft fees a year. it is taking families out of the financial mainstream as we run into counselors who feel that they cannot tell families to get a bank account because these overdraft fees drive them into financial hold they can't get out of. these abusive overdraft fees also harm the banking industry in our overall economy. they disadvantage responsible programs who don't charge these fees.

and it turns our banks into a competition of who can enroll the most customers in overdraft programs and then deplete their accounts rather than which bank can offer sustainable credit and fair financial services. one testimonial from a banker for overdraft programs went on to say, quote, if i had two more products like this, i could quit making loans all together. we praise the reforms that are set out in senate bill 1799. it imposes critical limits on the amounts and number of fees. in contrast the recent consent rule is too little too late. there was consent on credit cards before the card act. but that did not solve the problem. substantive protections were needed. again, overdraft abuses demonstrate the need for consumer financial protection agency. if overdraft abuses had been a primary focus of an agency, they

would he not have developed in the way they have. there's a need for an agency that can act quickly and respond to new problems and a consumer financial protection agency focused on consumer protection is best suited to do this. it is said to whom much is given much is required. the american taxpayers have given hundreds of billions of dollars to the big banks. and taxpayers will pay for this for many years. it is not too much to expect that the recipients of this aid will use it to restore the american economy that they helped bring down and at the very least, that these banks will not in return sieffon away families hard earned dollars hurting fought only those families but also the many businesses in dire need of the boost those dollars would provide if available to purchase useful goods and services. we again call on the financial regulators and especially the occ which oversees the biggest

overdraft forms and to issue regulations with substantive protections for american families. we also urge congress to enact substantive overdraft reform closing the gap in the card act and putting an end to these abusive practices. thank you. >> thank you very much, mr. calhoun. and again, i thank for all of your participation and your thoughts have been decree constructive and helpful. i want to begin with you, mr. livieri. i was curious -- and you and i talked about this. you talk about this week that went by between the time you actually wrote that check for $200 and only had $197.80 or close to 80 cents in your account so you had $2.17 of an overdraw on that account. if you had -- would you have continued to use your debit card to make additional purchases had

you been notified right away? >> definitely not. definitely not. >> the point -- i think you told me at one point that actually in the notice you received the post mark on the notice -- >> the notice was -- the notice was given to me on the 18th. and the postmark was the 24th. then they sent me another one on the 16th and the postmark was the 22nd. so i didn't know that i was overdrawn. as soon as they told me i was overdrawn, 10 minutes later a half hour later i brought down money and everything was fine. >> it was six days that they took notice they notified you. i hate to ask you this, you've told me this so i know the answer. you had enough money in your own accounts to more than cover these things. you weren't short that amount that was in the bank you. weren't aware of the limited amount. >> i didn't have it in their bank. i had another bank which was close by. >> you're a multiple banker.

>> i didn't have it in their bank but it was down the street a couple blocks. as soon as they told me that the -- that the thing was overdrawn, i just went and got the money and brought down cash to them. so it wasn't a serious problem. before this, on many occasions 'cause i was with this bank for 10 years, when i did something and a lot of times it was their mistake, but if it wasn't, they would -- as soon as you put your card in and you put your pin number and so forth, it would say insufficient funds, go see your banker. it didn't this time. nothing. like everything was fine. we're only talking $10.60. $30 and $20. that's all the things were for. it's not a serious amount. the only thing was the serious amount was the $35 to get $10.60. >> so the technology existed in your bank where actually the machine notified you of insufficient funds. >> sure. >> that's interesting. well, let me ask the panel if i

could, mr. carey in his testimony talked about the frustration that consumers expressed centered around atm and debit transactions where the overdraft and coverage fees could have been avoided if the customer had only known that the atm point of sale that the transaction would result in a fee. in our bill, by the way, we ask for a study at this to look at this particular point. we've already accommodated your interest to some degree and recognize although you hear from mr. livieri actually the technology existed at his bank in an earlier time where they were able to notify him instantaneously whether the amount was -- it was an inadequate amount of funds to cover that particular transaction. but you make a good point and as i say, we're evaluating it through a study. but even if the technology were readily available at a reasonable cost, overdraft coverage fees should still be reasonable in proportion. you got $2.17. you get a $35 fee.

it seems to me that if someone was overdrawn by $500 or $250, having an overdraft fee that would somehow be proportional to the amount of the overdraft would be more reasonable to me at least. but the idea that even in a few cents where a person -- literally, the examples, plenty of this, a cup of coffee, young people particularly that are more inclined to use that card more frequently and they have small transactions where each transaction is at $35. or gets doubled that amount. it doesn't seem at least in the interim before we get to the point of transaction that what we're trying to do here should be adopted rather than wait for all of that to occur. >> senator, i guess the question is directed at me so i'll give it a shot. >> you made the point. >> i made the point. that's fair. at citi at this point if you didn't -- if you were to go and buy that $4 cup of coffee and you did not have $4 in your account, we wouldn't authorize the transaction.

basically the transaction wouldn't go through and the customer would have this decision to pull out another means of basically paying for it. >> yeah. >> and what we're essentially saying is, that's what ought to happen until the technology is there at any point of sale is to simply deny the transaction in its entirety. and have the customer go someplace else or use some other mechanism to pay for it. >> right. >> and that way when you do that, when the customer literally -- when this technology gets built and it's not that far away because it can be done and it already is in the atms as we've heard is you can make the decision about whether or not you want to incur the fee. do i want this or do i not want this. no, i don't want the fee. i'm willing to go someplace else to do that and that's where the real choice is. my concern is that if we give a choice in a static environment where i open a account two years ago and i opted into this thing and i had no idea that i would be incurring this fee, that's the problem.

now, you asked about the reasonableness of fees. and, you know, it's a slippery slope. my concern about it is, certainly in the debit and the atm space establishing limits and establishing those -- what's reasonable or not, i think that's worth discussing. but i think when we start talking about people writing checks and bouncing checks and the banks offering the service for overdrafts rather than having a check bounce, that's good thing. >> but my point, i guess, i want to make in the absence of these other matters being adopted, i want to determine whether or not you felt it was reasonable are bill. i'm not asking you every dotted i and crossed t. >> what i would suggest is that the transaction should simply be denied. >> yes. >> may i ask other people on the panel. >> when banks talk about overdraft fees being set high to serve as a deterrent.

if they wanted to deter overdrafting they would deny transactions on debit cards at the atm. >> you anticipated my next question. the gao found that the average noninterest fees including overdraft fees increased by 10% or more since the year 2000. >> uh-huh. >> so how is the imposition of these fees as a determent show if increasing revenue coming to these banks as fees. >> right. we've been surveying the largest banks overdraft fees for the last several years. every time we go back and look, the fees have gone up. more banks are charging tiered fees so the second and third and fourth overdraft is even more expensive and now they're starting to add sustained overdraft fees so you can get charged $35 immediately if you don't pay the bank back in a few days. it's another $35. some banks charge an $8 per day sustained overdraft fee. i heard from a young fellow in indiana this summer. he's just out of high school working a minimum wage job.

he made a $10 math error on his bank account. he had four debit transactions that overdrew his account. his bank charged $35 for each of them. he rushed down and deposited $100. that was sucked out to pay the overdraft fees so he was still overdrawn. and they charged $8 a day. by the time this young kid's family got in touch with me, he was $500 in the hole. that's not a deterrent. that's not a service. that's a debt trap. >> yeah. anyone else want to comment on this before i turn to senator reed? senator brown, excuse me. anybody else who wants to comment on this? >> if i may add, that is what the practice was not many years ago. and that was the big selling point, in fact, of debit cards was that they had a limit. they were different from credit cards. >> yeah. >> and again, what these

overdraft programs have done particularly with debit cards is they have turned debit cards into extraordinarily high cost credit cards. >> that's a very good point. >> with none of the substantive protections. the card act limits the number of fees and it's patterned similar to what you have in 1799 and requires that those fees be required reasonable, proportional and they be consented to. if you're going to require that for a credit card, it seems like you need at least those protections in a noncredit situation. >> thank you. senator brown? >> thank you, mr. chairman. and thank you, senator reed. a question for mr. calhoun and a question for mr. pollack. the american bankers association say that consumers appreciate having overdraft protection. that it's a service that their customers -- their members customers want. why are your survey findings so different, mr. calhoun, from what the american bankers association tell us?

>> well, as many surveys it depends what you ask and to whom you ask it. our survey was done by an independent group, a larger sample nationwide, more than 2,000 respondents. and people want to know what it will cost them. and when they're told $35, it's a whole different kettle of fish. the other main thing is, that for people who want it covered, there is an alternative both a line of credit which the typical charge -- if you use overdraft protection from a line of credit, is less than a dollar for an overdraft versus $35. or they used to regularly offer linking as some still do. linking your debit cards to your savings and some charge and impose a $1 fee each time you access it. banks are discontinuing those programs because the regulators have allowed these abusive products to drive out the good ones. so you can have -- it's not an

either/or. if somebody truly wants coverage for overdraft they can have it and on a fair basis that's profitable to banks. >> so 5 or 10 years ago it'd be much more likely for a bank to have to set up a situation that the account -- the overdraft if you will would be money taken out of my savings account. there would be a link and the bank would do that automatically. i would get the statement that they had done that and that's much less common than it was five years ago. >> if you go in, many banks no longer do and they discourage it and point people toward the high fee programs. >> mr. pollack, at the pentagon credit union where you work, do your customers complain that you decline these debt transactions? do you hear discussions from customers about this after they see how your system works? >> actually, we do not.

we share the view and we think our members do as well that citibank does. they'd prefer not to have money out of their accounts and get $20 or $5 for a cup of coffee. and so we have had no complaints. >> you don't have the technology mr. carey talked about that someone is notified that they would be overdrawn but still has the option to be overdrawn and pay the fee in case of emergency? you don't have that technology i assume yet? >> that's correct. and we reject if you do not have available funds. >> do most -- would you know if most credit unions around the country have the policy that you have or do credit -- or other credit unions more likely to mimic pentagon credit union or are they likely to mimic some banks that do this? >> it's probably 50/50.

roughly. >> is it the larger credit unions likely to do it? the smaller ones? >> the larger ones are less likely to charge a fee in this -- in the house meeting, the second largest credit union showed up, which is north carolina state employees, they do not charge fees either. so i think the larger credit unions are more apt to have programs similar to ours or similar to citi's. >> okay. thank you. thank you, mr. chairman. >> thank you very much, senator. senator reed? >> thank you very much, mr. chairman. and thank you for your witnesses, for your wonderful testimony. let me ask mr. carey, you have initiated these steps with respect to your policies as a result of any type of regulatory suggestion or is this just

something that you think is good business? >> this is something -- this has been our practice really since we invented the atm. and that we've never done anything -- >> be careful because somebody invented the internet and got in a lot of trouble. >> i don't think there's much dispute around this one as i think about the other one. it's basically -- essentially been our practice that the funds aren't there and the transaction doesn't go forward. >> well, the majority of banks both large and medium and all sizes charge these fees. and i guess my point is that do regulators ever look at you and say, that's great or do they in any way sort of try to suggest what a good fee structure would be with respect to consumers or they just remain aloof. >> i think your first point i have yet to be in a meeting with a regulator where they said everything i've ever done is really good and pat me on the head because i think that's not their job.

you know, both through their compliance oversight as well as the safety and soundness oversight that they challenge us on all sorts of issues about how we're -- how we're approaching specific things. i have not had specific conversations around our practices with respect to debit and atm. but nor would i expect to have them because i think it's fought a big -- it's not a driver of consumer complaints. they're not surprised that the coffee that they bought, in fact, cost them 40 bucks. and with respect to, you know, ach and checks, our customers like the fact that we can cover off a transaction that's important to them rather than bouncing the check and then having them face a return a bounced check fee from a vendor and all the flow-down problems that come from it. >> thank you. there's, you know, some evidence, though, i think, mr. calhoun, that consumers

would rather be denied in some cases, particularly debit cards, than to have automatic fees. is that your findings? ..

>> it's not only have they failed to address this problem, they have actively condoned the development of these overdraft programs as you are questioning was considering. >> also, the comptroller of the currency has set a set of guidelines in order for which banks process payments. and none of those criteria at any consumer protection. it talks about deteriorating miss use of the account if the bank ledger overdraw. you haven't misused anything. you have been invited to do that. none of the occ guidelines about the ordering of payments says that consumers shouldn't be charged extra fees because it's been manipulated. so the regulators have really

failed to curb this practice, as the fees went up, overdraft became more pervasive, more transactions became covered by it, and more money went out of people's pockets. >> and that is from your perspective, consistent across the board, not just the occ but other -- >> it's the federal reserve that writes the rules that implement the federal banking credit laws. and we have been urging them for years to require banks to comply with truth in lending, when they extend credit through letting you borrow from the bank. and in docket after docket, the federal reserve has failed to do that. they have written truth in saving act rules, they've added rules to rate each. they have failed to provide a basic set of comparable protections to overdraft lending at every other creditor has to comply with.

mr. paul, you point out in your testimony that essentially that's what you do voluntarily, that because you treat -- because of your practices, if someone has overdraft protection, you are consistent with all the lending laws, is that correct? >> yes, sir. , that is correct. >> yes, i know seen as an impediment? >> to the contrary. we are doing quite well. >> and mr. carey, just to qualify, you don't charge vcs, etc., with respect to checks, you do charge those, and unlike mr. polis organization, you don't do it to an overdraft. you do it automatically? >> know, as i said in my testimony, we have programs similar to what pin fed has, which an account opening and throughout the opening there's an opportunity to link a line of

credit. and customers can move those funds back and forth and make sure that they have the appropriate coverage here so we do have all those things. and at those point-of-sale money can literally move over and cover those particular transactions. soleus is to have the same capability. what i was focusing on was if someone just simply didn't opt in to the programs, in the current environment we simply wouldn't authorize the transaction. if there were no funds there. >> well, yes, mr. livieri, thank you. >> it has been my policy, then quite a while, but i remember having a credit card, or debit card, whatever. you put it in a machine and you say you want to hundred dollars or whatever. then it says the fee will be $18. do you want to continue? if you say no, the transaction is no envoy. that's okay. as long as you know what's it going to cost you if you wanted

to do it if you don't want you just can't know and forget about that in doing it without knowing what they will charge, that is a horse from a different garage. >> i couldn't say it any better. [laughter] >> and i then remembered. horse from a different garage. that's a new one. a garage from a different color i guess. >> mr. chairman, thank you. >> thank you very much, senator reed. good questions. let me pick up on the point that senator reed was making. it was, for many, many years the federal reserve, it is the federal reserve that has the primary responsibility, or has had primary response billy in this area. of consumer protection. they have been aware of the abuse of overdraft for a long time. in fact, it interagency guidance in 2005 call for overdraft coverage programs quote abusive and misleading. that's four years ago. that their words to describe going back in 2005.

over the past several years the federal reserve has issued modest role after martial. i am pleased to see what they have done. i don't want anyone to leave the room and think we're not grateful. i would love to be convinced it would have happened in the absence of introducing legislation in this regard and absence of the financial regulatory reform that is out there. as i say, i have a lot of respect for ben bernanke. i don't say that likely pickiest and a i do welcome these changes. are the sufficient rule change is going to be adequate enough, and doesn't it -- let me take advantage of the panel here. again, i say this not because it should be punitive or adversarial, but merely so to complete the entire picture. if we're looking at creating stability and safety and soundness and financial institutions, which we all want. at the same time, it's very,

very important that people like mr. livieri, a hard-working guy, ran his own business for 50 years, goes in, does a simple transaction and ends up paying $140 for a $2.17 overdraft. if this were a bizarre exception, i wouldn't have him here. he wouldn't come here. mistakes happen but unfortunately, this happens with great regular. the idea that the real organization of the process, instead of me going through the process, look, all of you know interested in the senator will. did it out of committee, dated on the floor of the united states senate, go through a week or two, maybe if i'm lucky here without a whole lot of other things being added to. to have the president of the united states signed into law in order to get some changes, the federal reserve four years ago called abusive, called abusive and misleading, seems to me it cries out for a different

process. that would allow an agency with responsibility of confirmation by the senate, appointed by the president, to watch out what happens to the mr. livieri of the world. i shouldn't have to go through this process on every matter like this but this ought to be delegated to a responsible regulatory body to provide the kind of protection. the great depression we came up with a federal deposit insurance corporation. we didn't require a piece of legislation every time a bank failed to make sure the depositors in those banks were going to have their money protected. the securities and exchange commission, we guaranteed if you bought a share of stock you were going to be deceived and defrauded. i do say, that still goes on. bernie madoff case, but nonetheless. now there is a bill in cars every time some action occurs out there. should we did in the 21st century given all the wonderful technologies that exist today, they can conform consumers of what's going on. i apologize for the length of this question. this is a further example of

instead of waiting around and hoping and praying, despite years of a knowledge of the problems existing, waiting for a bill to get passed by congress, we would have responsible people that a responsible register with body making these decisions. doesn't cry out for indie pendant consumer -- your lawnmower breaks today, you call somebody and say the board is not there. who can help me out to get my money back from a faulty product that i got sold. a consumer product. who do you call? when all of a sudden you are mr. livieri you get taken to the claire for 140 bucks for $2.17 transaction. who does he call? call your senator. called the senator. you shouldn't have to call your senator. >> and if he calls the bank regulatory agency, they will tell him this didn't violate any rule that this didn't violate any law that they can charge any amount that any number of the. they can charge you over and over for the same overdraft, that there are no limits on what the banks can do in this area.

and you are correct, the consumer protection finance agency would be very important to keep this kind of abusive practice from getting out of hand. >> mr. pollack, i did mean to draw you in this. you're in the business of financial services that in the reaction to this? >> at pfc we believe that the cfpa is a good idea. we think that the belly of an agency to focus solely on consumer protection will make that agency more effective. the fact of the matter is today that regulators have a very difficult job and have to cover a lot of ground. and i don't think that anybody in any of the regulatory agencies was trying to do a bad job. i don't think that at all. i simply think that when you're trying to cover a lot of ground, you can't do as well as when you are focused on one sole area. so we believe strongly that the

cfpa is a beneficial event for the american consumer. >> mr. carey i will invite you any comment you would like to make i would invite you even as a private individual. >> i think the best thing i could say is clearly there is an opportunity to improve consumer protection. whether it is through the cfpa or whether it is enhancing the authorities. senator, you probably know that better than i do. but really what you're describing here, deserve attention. and if anything is done by the rigatoni agencies in the question has to be asked, why not. >> mr. calhoun, we know where you stand on this. you have already spoken on. do you want to make additional comments? senator merkley, i didn't see you jump in a room. i will let you jump in here.

>> well, i want to ask a question, and i apologize that i had to leave and come back. so if this has been answered you can just indicate me to check the record if you will. but i use a debit card, a visa debit card for just about, just about everything i am purchasing. and i try to keep up out of nowhere about this issue of overdraft. but how difficult would it be to have a system in which i could be given a real-time choice of whether or not the fi have, in fact, if i am in fact depleting my fund with a transition and i am buying a newspaper in airport? how difficult would be to give a real-time warning and allow me to just do i wish to have an overdraft and pay a fee for that, or simply not do the transaction? >> why did you start, john?

>> right now the technology, the technology is there. i mean, but it is not capable of being done now. in other words, it's not like we have two invent a new idea. it's the technology in there. the processes are not. and that requires the cooperation of merchants, requires merchants a bank and requires the cooperation of the networks to get that done. so it isn't there today, but for example, is your own atm. and it should be your own, you are on us or your home atm. about having a capability if you do this, you're going to be overdrawn, would you like to go forward with a fee? so it's not that far away, but there has to be the incentive to be able to basically go out and build it. and part of that, and that is the point i have been trying to make is, until that is there,

then perhaps the transaction should be approved. is simply flat-out not approved. so if there is a market for that, if there is a need for that, then let's build and give consumers the choice at the moment of time they need it most. >> it doesn't seem that long ago that that was the response. you hit your limit and your transaction will not go through. is that just a few years ago, wasn't? >> according to the testimony today, again, at citibank we don't do is if you don't have the dough in the account or if it is not linked to another account, there said they are not funds available for you to drop at the transaction is not authorized. and i suspect that was a much more typical practice earlier on and has migrated over time. but i'm sure mr. calhoun's point of view. >> i would have go his comments that it is not going to immediately be available to have a point have point-of-sale real-time warning. and it is critical that reform not be dependent upon that, because particularly if you set

the standard as universal two-way communication, there will be a gas station out in some small county that it may be 10 years before it would have two-way communication. and i think as this bill properly does, it ought to set the goal and the incentive to move in that direction. but in the absence of that warning, the practice should be, and the law should be, that no fee should be charged on those debit transactions. if the bank for convenience or for a particular customer wants to cover it, this build 1799, does not prohibit it. it prohibits though these abusive fees which also i think points that has not been covered. these fees actually beget more defaults. the majority of these views are from accounts where people have fallen into a hole where they cannot make up the money. and most of the seas, programs, overdraft fees have for example

$500 of its. once you hit that limit, you are getting checks turned out even or overdrafts turned out that you have just been turned into all these defaults because, as we heard about, the default put you behind that a lot of people's paychecks can't catch up that hole and cover the deficiency. the next month they are facing more these overdrafts. >> i would think that regards to the technology for the two-week indication in the future, right now we have the old style that would work, which is a bank could say, well, jeff merkley, you have a choice, you can either sign up for a line of credit and have your overdraft covered by a line of credit. or you can choose for us to turn on your transaction if you hit your limit. or you can choose to do some third option. but there are a range of options that addresses that we do have the technology for right now and. >> yes, that is correct that we

do. >> thank you, mr. chairman. it is a great line of questioning an important point. and maybe some of you know the answer to this, because i heard of something like 17 or 20 percent of consumers are paying about 90 percent of the fees. at my close to accurate on that? is a relative small number of people and people are busy -- not obvious he. but primera aren't difficult, they lost their jobs or are in difficult straits going through a medical crisis of one kind or another. they are in a correct spot is that correct is that the numbers? >> yes, the senator -- bft id again -- at the ac did a report that nine customers did an overdraft and a year, and so it's a -- 25 percent of banking account customers overdraw in a

given year. so it is a very small fraction of customers who are keeping the banks afloat. >> that constituency that's paid a 24 billion last year, and the estimated 38.5 billion this year. >> i think the 38.5 billion includes both bounced check and overdraft fees, but that's the cost to consumers of not having sufficient money in the bank account, and the banks going head and loaning money, charging that the? >> i will give it to you exactly. the fdic reported that 93 percent of all overdraft fees are paid by 14 percent of account holders. >> yes, that's about right. >> 14 percent of account holders page 93 percent of that number. at the worst outcome of people who are struggling the most are paying the lion's share of these billions of dollars. it's ridiculous. >> mr. chairman, if i could add, there are two subgroups again,

and there are two separate. there are over 27 million families will pay five or more overdrafts in this year based on last stated that that is a pretty good hit. and then there is this group that just gets hammered, because that same study found that the average household in that high youth group paid $1600 a year in overdraft fees. $1600. that the abuses not just at very high youth. it does bread across a much larger swath of account holders. 27 million to be exact. >> senator, if i may. >> yes. >> a couple points points worth making. i asked because i anticipated this question, is that i want to see whether there was a disproportionate impact of the people who received an overdraft fee or an insufficient funds he. and again, since we don't do the debit and we don't do the

atms, so this is limited to a group that would otherwise be bouncing checks. and it actually doesn't spread out, it doesn't load up on the lmi. it spreads out across the entire spectrum. as again i want to make sure that we are focusing on the problem. and the problem to me is around the velocity of electronic debit and atm transactions, where people are just simply caught unaware. >> we appreciate what city has done it. have i said that in a? >> you can never say it enough. >> i appreciate the step in the right direction. that is an interesting statistic as well. tell me again how that works. >> in essence, because it is primarily made up of people who are writing checks, or overdrawn and a question that i ask is, is a disproportionate impact in lmi. and it is not. it is brought out across that

spectrum. and i think the reason why is because we don't charge that he, people aren't caught with -- they aren't using debit cards the way -- >> i suspect another factor is an awful lot of low income people don't have checking accounts that are about 10 million people in this country who never access a traditional financial institution, other than through credit cards and democrats. so there is that element. >> senator, a few years ago congress enacted to require that federal benefit recipients get direct deposit of their income. so security, veterans benefits. so we have pushed a lot of banks on consumers and to mainstream banking without making it safe for them to have bank accounts. and all the social security that is supposed to be exempt from attachment, banks take that money to pay overdraft fees for

overdrafts they permitted to take place. so that is a drain on older consumers and low income consumers. the fdic study looked at a cross-section of large and small banks that they supervised. they don't have the big money center in the big national banks into their field of supervision. but if you look at banking across the board, it is low to moderate income consumers who have a bank account. they don't have enough money to make ends meet. and the banks are not helping them avoid fees. >> we have problems but i think that one of the things i want to point out, one of the ideas of letting someone know they can opt into an overdraft coverage, but they need to make sure that when these fees are not going to be excessive which is a point we made earlier. and also that there are alternatives such as lines of credit or link accounts that i can citi does but not everyone does. but they are important as well.

consumer awareness about what is available to them rather than just do you want to have a few charge or not, but what else is available to me ought to be critically important that senator merkley? >> thank you. mr. carey, i want to ask you about the type of conversation your financial institution went through. because i pictured a board meeting in which someone comes forward and says, now, our competitors are charging beasties for overdrafts, and it is x. number of billion dollars a year. and to be competitive, we want to make sure we don't give up this source of revenue. and somehow citibank came to the conclusion not to do that, and could you walk us through the thinking that transpired? >> well, i'm not sure if you were here earlier, but what i said was -- >> i apologize for that but we have just never done it. and it's not been -- you know, it's not been a part of the sort of fabric of the company.

you know, people are very unhappy about these in general, and i think you have to basically try and drive better transmit. you know, i'm responsible for business practices within the consumer businesses, and a lot of it is centered around all sorts of revenue opportunities. and we spend a great deal of time in those discussions trying to weigh all of the risks and rewards that come from that. such as the damage to reputation risk, potential revenue opportunity, where we are in a competitive space. and a vigorous debate and discussion. and it is a very good and i think useful process that we do to try and come up with really what the right answer is. but it is through those kinds of things that we come up with the decisions that we do come up with. about what makes the most sense. i think we would like to believe is, you know, at the end, we

have got to be entirely transparent to our customers. we have got to make sure they understand exactly what is going on and they have informed choices, that they can make those choices over a reasonable period, you know, in reasonable time so that they are not trapped. that's basically a bedrock and have a look at these things. >> thank you. >> if i may add, i think citi's testimony addresses and aboard point that was raised earlier today. there was concern that perhaps this reform effort would disadvantage other consumers. and particular one argument that has been thrown out is somehow that if you regulate overdraft fees, you may be ending to a free checking which lots of consumers like. i think two points are, first of all, citi find a way to both turned down and not charge overdraft fees on debit cards, bus to offer free checking. and free checking predated these aggressive abuses, overdraft

programs. they are not interdependent and that if you take away the abusive overdraft, you're no longer going to have free checking. >> that is a good one, you provoke me to say that someone obviously negotiated and tried for many, many years to get some reform in the credit card industry, and this year thanks to senator merkley and other members of this committee we were able to get out of committee by a one's will market margins accredit cargo. it passed the senate overwhelmingly but one of the things we negotiated was the delay for anthem and the provisions of the bill. in order to provide at the request of industry time for them to be able to adjust to the changes. what they've done in the integrate is not just a adjust to changes but charge outrageous fees and interest has just been skyrocketing in this window. to get as much out of this window as you could get. completely defined in the that very request they made. and that was to basically allow for an adjustment in which i thought was a reasonable request. i am angry now in the sense that

they took advantage of that request in your. and we should put a freeze on if we can, i don't know if we cannot. they been arguing, because you change the rules now we're going to end up doing all of these things. we're only doing it because you passed the credit card bill. and frankly, that is baloney, that argument. and frankly, the argument that it will do away with free checking and other things. citi is a living example of what you can do. you can decide what they have done with the debit and credit cards. also provide free checking and heavy for reasonable response in these areas. so i hope that those in the lending institutions will not try these tricks again. further evidence in why can need a consumer financial products safety. you don't have to have a bill in every time. you don't have to produce a bill and to put a freeze on these rates. instead of having an agency that could put it in immediately without having to through all of this. tranny, we thank you particular. it is not easy for anyone to stand up and talk about something. and again i think all of us

agree. we all their responsible at the outset to conduct our affairs and the knowledgeable about where we are in these matters. so to stand up and to talk about a situation about $2.17, for a guy who's been in business for many, many years obvious he is an uncomfortable moment ago we appreciate you doing it because you have become the face of an awful lot of people. besides just numbers and tickets. again, ms. fox, mr. pollack, mr. calhoun, we thank you as the. we will do the record open for additional questions. i am pleased with all of you here. the committee stands adjourned. [inaudible conversations] [inaudible conversations] >> president obama will address the nation on his new military and diplomatic strategy for afghanistan tonight.

the president will make his remarks at the west point military academy. watch live coverage at 8 p.m. eastern on the c-span networks. in a moment live to the u.s. senate where members return to work on health care legislation today. they will debate the bill and possible amendments before turning to consider a judge nomination at 11:30 a.m. the vote on not nomination is scheduled for noon eastern time. the chamber plans to reset at 12:30 p.m. for weekly party lunches but they will return this afternoon to continue the health care debate. live in just a moment or two to the floor of the u.s. senate on c-span2.

senate will come to order. the chaplain, dr. barry black, will lead the senate in prayer.

the chaplain: let us pray. our father god, author of liberty, as our governmental leaders face grave questions and perplexing problems so vitally affecting national welfare and world concord, we bow in reverence in your presence. we acknowledge that it is because of you that we live and move and have our being. strengthen the leaders of our executive, judicial and legislative branches to make their utmost contribution to the healing of the tangled tragedy of our troubled world.

through the lips that speak in this forum of freedom, lord, speak to our nation and world, so that your will may be accomplished on earth. lord, heal the divisions which shorten the arm of our national might in this decisive season. help our lawmakers to be patient and considerate one with another, as you give them reverence for truth and a passion for justice. we pray in your holy name. amen.

the presiding officer: please join me in reciting the pledge of allegiance to the flag. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the presiding officer: the clerk will read a communication to the senate. the clerk: washington d.c., december 1, 2009. to the senate: under the provisions of rule 1, paragraph 3, of the standing rules of the senate, i hereby appoint the honorable roland burris , a senator from the state of illinois to perform the duties of the chair. signed: robert c. byrd, presidet pro tempore. mr. reid: mr. president, following remarks of the leaders the senate will resume consideration of h.r. 3590, the health care reform legislation. that will be until 11:30 and for debate only. republicans will control the first 30 minutes.

the majority will control the next 30 minutes. any remaining time will be equally divided and controlled between the two leaders or their designees with senators permitted to speak up to ten minutes each. at 11:30 the senate will turn to executive session to debate the nomination of jacqueline nguyen to be united states district judge for the central district of california. the vote will occur at 12:00 noon today. that will be the first vote today. the senate will recess from 12:30 to 2:15 to allow for our weekly caucus luncheons. following the recess the senate will resume consideration of the health care reform legislation. votes are expected this afternoon in relation to the health care legislation. mr. president, there are two truths about the historic health reform bill that is now before this body. the first is it will save money, it will save lives and it will save medicare. again, mr. president, the legislation before this body

will save lives, money, and medicare. while there's a pretty good start toward that, the second fact is there's always room for improvement in this bill. of course that's what the legislative process is all about. senator barbara mikulski of maryland has offered an amendment that does them both. they are amendment would improve this bill by making sure that women get at no cost preventive screenings they need to stay healthy. these are important screenings that can catch potential problems as early as possible, that will save lives and save money. as health care premiums rise higher and higher every year, the insurance industry, mr. president, this year has already raised insurance rates an average of 10%. an average. of course, this is far faster than incomes in this country, and that is an understatement. more women are skimping the preventive care they need. why? they're skipping screenings for

cervical cancer, breast cancer checkups. they're skipping screenings for pregnancy, annual checkups, doctor visits that can catch problems like postpartum depression and domestic violence. why is this happening? do women care less about their well-being? of course not. are diseases on the decline? quite to the contrary. the only reason women are putting off going to the doctors is that our broken health care system is broken. it costs too much to stay healthy. senator mikulski's amendment also makes clear that the decision of whether and when to get a mammogram should be made by patient and a doctor. it shouldn't be made by an insurance company, by members of congress or by someone you've never met. no matter what an independent task force repdz and no matter what some republican members falsely claim, this legislation, the one before this body, offers

prepreventive service to millions of women's who are being discriminated against by insurance companies. this amendment before this body makes that absolutely clear. senator mikulski has long been a leader who has looked out for women's health. years ago she worked with me to -- on a problem that women have. 90% of the women that have a disease called interstitial cystitis are women. i discovered that when three women came to visit me in las vegas. it is a disease that was ignored. people thought it was psycho somatic. working with senator mikulski, we have the -- we have set up a protocol. now 40% of those people previously thought to be psycho somatic suffer, described by shoving slivers glass down their bladder are symptom-free. not 100%, but 40%. it is easier diagnosed now. senator mikulski has also worked

hard to help set up a division for women's health problems. so she is a leader in this, has been for a long time. and with this amendment, she does it once again. i'm sorry to see republicans deliberately confuse the facts about women's health, particularly as they relate to mammograms. it shows how desperate some of them are to distract the american people from the real debate, from the fact that they have no vision for fixing our health care system which is so broken. i'm even more sorry to say it's part of a larger trend. in recent days they have been distorting the data from the congressional budget office. an independent agency, republicans if the past have praised. what they're complaining about now -- the republicans -- about two of this nation's top priorities: reforming our health care insurance system and helping our economy recover. first on health care, the congressional budget office said yesterday that the majority of american families who buy

insurance in the new marketplace will create what we call health insurance exchange. what they will see is their premiums go down. they'll go down by as much as 60%. out of 100% of the american people, 93% will have a drop in their insurance premiums with this legislation. 93%. c.b.o.'s experts aren't the first to recognize these benefits. the massachusetts institute of technologies, jonathan gruber, is one of the most respected economists in the world, said in today's "washington post" -- here's a quote -- "here's a bill that reduces the deficit, covers 30 million people -- 30 million more people and has a promise of lowering premiums." a pretty good statement. that means that millions of americans who today cannot afford coverage or whose medical bills drive them to financial ruin -- and remember, i repeat,

mr. president, what i said yesterday as this debate began, last year 750,000 people in america filed for bankruptcy. almost 70% of the bankruptcy filings were because of health care costs. but those people who filed for bankruptcy because of health care costs, 62% of them had insurance, health insurance. does that speak about our system that is so in trouble? of course it does. so, i repeat, that means millions of americans who today cannot afford coverage or whose medical bills drive them to financial ruin will be able to afford to stay healthy. it means if we don't reform health care, millions more will find themselves in bankruptcy. second, on economic recovery, the congressional budget office said yesterday that the extraordinary steps we took to bring our economy back from the brink has created and saved

hundreds of thousands of jobs. mr. president, and i direct my comments to the american people but also to the brave republicans who joined with us to make this possible. senators snowe and collins. i want them to know what they did to help us get that legislation passed, according to the congressional budget office, saved hundreds of thousands of jobs. quoting directly, the c.b.o. said yesterday the extraordinary steps we took to bring our economy back from the brink has created or saved hundreds of thousands of jobs. its estimate reaches as high as 1.6 million jobs, each one a direct result of the economic recovery plan. pretty good. the same report said our country's gross domestic product has gone up as much as 3.2 percentage points. now, mr. president, let's not do

as my friends on the other side of the aisle are doing, betting on failure. let's talk about this country coming out of the hole that was did you dug by the last administration for some eight years. the factors that we wha* we did on a bipartisan -- that what we did on a bipartisan basis january and february has brought this country out of an economic hole. we still have a ways to go; there's no question about it. but created 1.6 million jobs, increased the gross domestic product by as much as 3.2 percentage points. pretty good. these facts tell us the same thing, mr. president not acting is not an option. some of my republican colleagues prefer to close their eyes and ears to this reality. they prefer to play politics and do what is right and what is necessary. they're content to just say "no" without offering any constructive alternatives and response. that is no way to lead our

country and constituents back to health. mr. president, at the beginning of this day, at the second day of this debate, i say come on, work with us to improve this legislation. try to improve it the way senator mikulski looked at it and said this legislation can be improved. we want to work with the minority. we want to have a legislation that is bipartisan. we don't want to do this alone. we need the republicans' help. and i hope that they will join with us. it would certainly look better. and let's stop berating the legislation that's before this body. if they don't like it, try to do something to make it better. but as we know, it saves lives, it saves money, saves medicare, brings down insurance premiums. pretty good deal. and, mr. president, brings down the debt. it saves $130 billion over the next ten years, and after that

$650 billion. not bad. and so the numbers they keep talking about, they're out of -- i don't know where they come from, mr. president. we, as a body, have used for 50 years the congressional budget office. that's bipartisan. that's the way it should be. and we should start talking real numbers, not fake numbers. mr. mcconnell: mr. president? the presiding officer: the republican leader. is recognized. mr. mcconnell: it certainly is the case in a country of 300 million people there are differences of opinion, and you'll see them on full display here in the united states senate on this monumental 2,0 # 4-page -- 2,074 page scheme that would expand the reach of government deeper into our lives, raise taxes, increase

health care premiums and cut medicare for seniors. on the other side are the american people. we know, mr. president, from all the surveys that we've seen, the american people are opposed to this bill. they're astonished that we are trying to pass a bill that is clearly opposed by the american people in every survey that's been published. americans do support reform, but this isn't the reform that they were asking forks and it's not the reform they were told they could expect. in fact, it's pretty clear by now that the american people were sold a bill of goods when the administration and its allies here in congress said their health care bill would lower costs and help the econo economy, because the plan that has been produced -- that is before the senate -- won't do either. so the debate is no longer about

improving care by reducing cost. we're past that. this bill will raise costs on american families, and it will make an already struggling economy even worse. the only question now is how we got to a point where we're actually considering spending trillions of dollars on a brand-new government entitlement at a time when more than one in ten americans is looking for a job and when our debt and deficit are well past -- well past -- the tipping point. now, for many, the answer to that question is quite clear. we know that some here in washington have wanted government-run health care for many years, and it's hard to escape the conclusion that the same people saw the current economic crisis as their moment. earlier this year some in the administration said that a

crisis is a terrible thing to waste. americans are hoping this bill isn't what they meant. but they're concerned that it is. americans will know -- already know this bill will make our economic problems worse, not better, without even addressing the serious health care problems that we already face, and they'd be right. that's why they want us to start over and accomplish the real mission of lowering costs. and that's precisely what the mccain amendment would allow us to do. the mccain amendment would send this bill back for a rewrite. it would send it back to the finance committee with instructions -- with instructions -- to give us a new bill that does not include a half a trillion-dollar cut to medicare. send the bill back to committee.

send us a new bill without a halfhalf a trillion dollars in s to medicare. that doesn't pay for the bill on the backs of seniors, if you pass the mccain amendment. here's a program -- the medicare program -- that's already struggling, a program that needs help. yet, in order to finance their vision of reform, our friends on the other side want to use medicare as a biggi piggy bank o create an all-new government program that's bound to have the same problems as medicare. as written, their bill would cut nearly half a trillion dollars from medicare -- not make the program stronger but to fund more government spending. and in the process, millions of seniors would lose biforts.

-- millions of seniors would lose benefits. literally millions of seniors would lose benefits. the mccain amendment wouldn't let that happen. the mccain amendment tells the committee, don't cut hospitals. the mccain amendment tells the committees, don't cut hospice. the mccain amendment tells the committee, don't cut home health. the mccain amendment tells the committee, don't cut medicare advantage. it would allow us to focus our efforts instead on the prevention of waste, fraud, and abuse, which we know to be rampant in this program. it would ensure that we're not cutting one government program just to create a new one. that's what a vote in favor of the mccain amendment would be. it would be a vote to preserve

medicare, not weaken it, and that's a message america's seniors want to hear in this health care debate, that improving health care in america doesn't have to come at their expense. now, some might argue that the need to cut medicare to create a new government program. that's their call. but it's not the call americans are asking us to make. i haven't gotten a call yet, mr. president, from anybody in kentucky or around the country saying, please cut medicare so you can start a new program for somebody else. not my first call. the american people want us to start over from the beginning and craft a bill that they can actually support. and we know they don't support this bill. all the surveys indicate that. then we could start over and end junk lawsuits against doctors

and hospitals that drive up costs, something the majority didn't find any room for in their 2,074-page bill. not a word about controlling junk lawsuits against doctors and hospitals. then we could encourage healthy choices like prevention and wellness programs, something that the majority somehow couldn't squeeze into their 2,074-page bill. then we could lower costs by letting consumers buy coverage across state lines, something the majority must have overlooked in their 2,074-page bill. then we could address the rampant waste, fraud, and abuse, something our friends didn't think was important enough to seriously address in their 2,074-page bill. the mccain amendment would allow us to vote for seniors.

that's what the mccain amendment is about. it way how the senate to say, we're -- it would allow the senate to say, we're not going to finance a new government program on the backs of seniors. we're not going to use medicare as a piggy bank to fund a new government program. it would allow us to vote with the american people. most importantly, mr. president, it would allow us to start over and get this right. i yield the floor. the presiding officer: under the previous order, the leadership time is reserved. under the previous order, the senate will resume consideration of h.r. 3590, which the clerk will report. the clerk: calendar number 175, h.r. 3590, an act to amend the internal revenue code of 1986 to modify the first-time home buyers credit in the case

of members of the armed forces and certain other federal employees, and for other purposes. the presiding officer: under the previous order, the time until 11:30 will be for debate only with the republicans controlling the first 30 minutes and the majority controlling the next 30 minutes, and with the remaining time equally divided and controlled between the two leaders or their designees, and with the senators permitted to speak therein for up to 10 minutes each. mr. kyl: mr. president? the presiding officer: the senator from arizona. mr. kyl: mr. president, i ask unanimous consent that during the 30 minutes controlled by the republicans that we be allowed to engage in a colloquy. the presiding officer: without objection, so ordered. mr. kyl: thank you. mr. president, i'll begin by making some comments about the amendment that senator mccain, my colleague from arizona, has filed. this is an amendment that, as the minority leader just said, will protect americans -- america's seniors. it will disallow the medicare

cuts that this bill includes. the economist milton friedman famously said there's no such thing as a free lunch. thathat applies to health care s well. someone has to pay. since this bill is a $2.5 trillion bill, the first question is, who pays? the first answer is it it's america's seniors because about half the bill is allegedly paid for by cuts to medicare. now, let me break down a little bit more specifically than the republican leader did exactly what that means. this is about $500 billion in medicare cuts, as follows: $137.5 billion from hospitals, who treat seniors. $120 billion from medicare advantage. that's the insurance program that provides benefits to seniors which will be cut more than in half as a result of this $120 billion reduction.

$14.6 billion from nursing homes who treat seniors. $42.1 billion from home health care for seniors. and $7.7 billion from hospice care, one of the most cruel cuts of all. obviously with quuts this dramatic -- obviously, with cuts this dramatic, there's no way to not jeopardize the care that seniors now enjoy. seniors know this. that's why they've been writing our office, sending e-mails and attending town hall meetings to let us know. i quoted from two letters that constituents from arizona had sent asking us to please not cut their medicare advantage programs. this has been called the crown jewel of the medicare system, and many of them rely on medicare advantage to provide the kind of dental care or vision care or hearing assistance that they have come to rely on. and they're not buying the claims that somehow or other we can make a half a trillion dollars in cuts to medicare without somehow hurting their care. they know better than that, and

they're right. the care they've been promised will be compromised to pay nor this new government -- to pay for this new government entitlement under the bill. and finally, many are wondering what happened to the promise that they get to keep the dhair they have. -- keep the care that they have. we heard the president say that. if you like the care you have, you get to keep it. well, that's simply not true. there are thousands of arizonans who are medicare advantage patients and they like what they have and yet we know, according to the congressional budget office, that the benefits that they achieve -- that they have, rather, under medicare advantage are going to be cut by more than in half, and so they're saying, well, what happened to the policy that i like, i am neat going to be able to keep -- i'm nolt going to be able to keep it -- i'm not going to be able to keep it if this bill passes. this is why the mccain amendment must pass. if our democratic colleagues are not willing to not cut medicare.

mr. alexander: mr. president? the presiding officer: the senator from tennessee. mr. alexander: i want to cliewt the senator from arizona -- i want to congratulate th the senator from arizona. i heard the senator talk about figures. we have some figures and the democrats have other figures. i agree with him. i think someone watching this must think we're on two different planets sometimes. but -- so let me focus in on the figures. i believe i heard you say that to pay for this health care bill over ten years there would be $465 billion in medicare cuts. now, where does that figure come from? mr. kyl: mr. president, i had say to my friend from tennessee, first of all, it comes from a reading of the bill. it's very clear in the bill as to how much money is taken from medicare and the number that the senator from tennessee just articulated is the correct number. in addition to that, the congressional budget office and

the joint tax committee analyzed the specific numbers and obviously they were given the numbers in the bill, but the numbers that they are using are -- and i just broke it down into four or five general categories; there are other divisions within that -- but as i said for purposes here, $137.5 billion from hospitals, $120 billion from medicare advantage. that number might be $118 billion. i'm not precisely certain of it. but it is very close. $14.6 billion from nursing homes. $42.1 billion from home health. and $7.7 billion from hospice care. and if any of our colleagues would like to contest these numbers, i'd be happy to be corrected. but i believe those are the correct nulls. -- but i believe those are the correct numbers. mr. alexander: the president of the united states in his address to us about health care and "the new york times," "the wall street journal," everyone who has reported on the congressional budget office

figures said the same thing. we're going to pay for this bill, which is $2.5 trillion over ten years when fully implemented, by $465 billion cuts in medicare. and what senator mccain in his amendment that we're in support of is saying -- it's saying, don't cut grandma's medicare to pay for someone else's insurance. and he goes on to say, if you're going to find some savings in waste, fraud, and abuse in grandma's medicare, spend it on grandma. and the reason for that is that the medicare trustees have said to us that they're $38 trillion in unfunded liabilities for the medicare program, and that the program will start going bankrupt between 2015 and 2017, and according to the medicare

trustees, they say -- quote -- "we have timely and -- we need timely and effective action to address medicare's challenges." and the proposal, if i may say to the senator from arizona on the finance committee and deeply involved in what we need to do about our nation's finances, i don't think the medicare trustees were thinking that the timely and effective action we could take to keep medicare from going broke was to take $465 billion out of it and spend it on some new program. mr. kyl: mr. president, that's exactly correct. what the medicare trustees were saying if we can effect cost savings in medicare -- and surely there are some to be had there -- that it should go to strengthen the medicare program itself and not allow it to go bankrupt rather than being used to create a new government

program. i might also say that perhaps one of the reasons why there are different numbers from one side of the aisle to the other is that sometimes we're not talking apples to apples. we're talking apples to oranges. perhaps both numbers are correct in their context. the senator from tennessee used the number $2.5 trillion when the program is fully implemented. that is a very important statement because the other side will argue it is only $1.5 trillion for the first ten years of the program. that is a correct statement. but it's $2.5 trillion for the first ten years of total implementation of the program. and what is the reason for the difference? well, for the first four years, money is being collected but very few benefits are going out. the benefits really start in after year number four. if you just take the first ten years of the program, you're collecting money to pay for it over the entire ten years, but

almost all of the benefits only occur during the last six years. and so naturally you have collected more money than you've paid out. but when you take the first full -- first ten years of full implementation, it is exactly as my colleague from tennessee noted, a cost of $2.5 trillion. that's how sometimes you get somewhat different numbers here. but as long as we're clear about what we're talking about, one thing is crystal clear, whether it's $1.5 trillion or $2.5 trillion, we're talking real money here. somebody has to pay for it. and if america's seniors are being asked in effect to pay for half of it, that's not fair to america's seniors, given the commitment we've made to them. and that's the point of the mccain amendment. protect medicare, protect america's seniors. and we can do that with the simple amendment that senator mccain has which is send the bill back to committee. we'd only take one day, not delaying anything and send it

back without those medicare cuts in the bill. mr. alexander: i see the senator from idaho here, and i'd like to hear his observations on this. if there is any issue in this entire health care debate that symbolizes why we on the republican side want to change the debate to a step-by-step approach to reducing the cost of premiums, it would be the medicare issue. because as the senator from arizona said, what we need to do about medicare is make it solvent as quickly as we can, as effectively as we can. the senator from kansas said the other day that the proposal to take $465 billion from grandma's medicare and spend it on some new program is like writing a check on an overdrawn account in a bank to buy a big new car. there's a lot of truth to that. the president of the united states said earlier this year, something i agree with, he said this health care debate is not just about health care.

it's about the role of the federal government in the everyday life of americans. and he's exactly right about that. this health care debate which we're beginning this week is not just about health care. it's about the stimulus package. it's about the takeover of general motors. it's about the $1 trillion debt, it's about washington takeovers. it's about too much spending, too much taxes, toot debt. and the medicare in this bill is a symbol of that. that's what senator mccain is right. what he's saying is don't cut grandma's health care and spend it on some new program. if you can find saeufgdz in the waste, fraud and abuse of grandma's medicare, spend it on grandma. make sure those of us who are older and those of us who are younger and looking forward to medicare can count on its solvency. later this week we'll talk more about premiums going up. there was a lot of celebration

yesterday because, according to "the wall street journal," some health premiums would rise. basically it said that for employers, for people who get their insurance from large employers, this bill won't make much difference, and that for small employers, if you get your insurance from a small employer, it won't make much difference. and if you go into the private market to buy insurance yourself, your premiums will go up except we're going to get some money from somewhere to help pay part of your premiums, at least for about half of americans who are in the private market. where are we going to get that money? going to get it from grandma. we're going to get it from medicare. so that's what's wrong about this bill and what's right about the mccain amendment, i would say to the senator from idaho, is it says very simply, don't cut medicare. if we find savings -- which we hope we can -- in medicare, we should spend it on making medicare solvent.

i wonder if the senator from idaho is hearing from seniors in your state about the proposed $465 billion in cuts to medicare and how they feel about taking that money and spending it to create a new program. mr. crapo: i thank the senator from tennessee for that question. thank you, mr. president. and very definitely we're hearing from our seniors in idaho who see through this. it is very clear to the folks in idaho that what we're seeing is a proposed massive growth of the federal government by over $2.5 trillion when fully implemented that is to be funded on the backs of the american taxpayers and our senior citizens through cuts in medicare. and in fact, in addition to those who have contacted me who are seeing their cut -- their health benefits lost, i've also been contacted by a number of the providers. we're talking about those who are in home health care or

hospice health care, skilled nursing facilities or hospitals and the like, and they make a very interesting point. their point is that not only will senior citizens in medicare advantage, in particular, literally be losing their benefits dramatically, but that other senior citizens who are in traditional medicare will also be losing access and quality of care. and how is that the case? well, we know from the details of this bill that we are going to see major cuts in hospice care, home health care, skilled nursing facilities and hospitals. and the points that are made to me by those providers are that they have already gone through a series of very deep cuts, cuts to the point that in idaho, i believe the number was for home health care we lost something like 30% of our facilities already. and the way one of them explained it to me was that if you reduce the compensation that we are receiving, then we have to reduce something in our budget. and he said, we can't just start

take bricks off of our buildings. what we will end up having to do is to reduce our personnel. that would be the nurses and the doctors and the other care providers who are there to provide support for these individuals. we'll have to reduce the number of rooms that we operate or the facilities that we provide. and in the end there will be a reduction of services and access available to senior citizens, including a reduction in the quality of the care that they are able to be provided. mr. alexander: i wonder -- in discussing the medicare cuts, another provision of the bill which we'll be talking about this month and next month as we go through the health care debate is what about the problem of paying doctors and hospitals who see medicare patients? today doctors who see medicare patients get paid at about 83%,

i believe, of the rate they would be paid in they were seeing a private-care patient. and so every year congress comes along and has to make an adjustment -- it's something we did a few years ago -- which automatically cut the amount of money that we pay doctors for seeing medicare patients. that's a big problem for medicare patients because if the doctorsan so the medicare patients may find themselves increasingly in a condition that medicaid patients do -- low-income americans who operate through the state program, that is our largest government-run program -- where they're paid about 63% of what doctors who see private patients are paid. and about half of medicaid doctors won't see new patients. so i would ask the senator from idaho, does he see anywhere in this bill a provision for the $500 billion that will be needed

just to pay doctors about the same ten years from now that they're making today? and if it's not in the bill, where is that $250 billion going to come from? is it going to come from medicare cuts or will it come from adding to the deficits? mr. crapo: obviously it's going to come from cuts in medicare or increased taxes or simply more debt on the federal level. i think the senator raises a very interesting point. this question of fixing the compensation rates for physicians in medicare is a huge question, one which we have been fighting for a number of years to try to find a solution to as each year we delay the expected cuts that are going to happen. i've talked about this factor in the context of being a budget gimmick in this bill. what do i mean by that? those who say that this bill reduces the deficit are able to say so only because it has about $500 billion of new taxes, about

$500 billion of medicare cuts, and a number of budget gimmicks that delay the implementation of the spending sides of the bill or, in this case, don't even include at all one of the major expenses that needs to be accommodated. and that is the fix for physician compensation. if any of those things were not in this bill, this bill would drive up the deficit tremendously. and what we're going to see in addition to these fiscal impacts on the federal treasury in terms of huge increase in debt or huge increases in more taxes, even more than we are talking about in this bill, we are going to see the very real potential that access to medical care for our seniors will be again reduced because of this factor. let me just give a couple statistics. in their june 2008 report, the medicare payment advisory commission, or medpac, said that 29% of medicare beneficiaries

who were surveyed were looking for a primary care physician and had trouble finding one to treat them. in other words, about 30% of our medicare beneficiaries today are having trouble finding a physician who will take a medicare patient. that's before the $465 billion of cuts and before simply not including the physicians at all in this legislation. a 2008 survey by the texas medical association found that only 58% of the state's doctors took new medicare patients. and only 38% of the primary care doctors accepted new patients. again, an example from medpac and an example from one state indicating what we know is happening around the country, namely, that doctors are no longer taking -- in increasing numbers are no longer taking new medicare patients, just as they have been doing with medicaid patients for years. and yet we see these massive cuts to medicare being proposed

that will have the same impact on hospice care, on home health service, on skilled nursing facilities at hospitals, and we see the doctors not even included at all, meaning that they are projected now to receive major reductions. i think it's over 20% reductions in their compensation for taking medicare patients. the solution here to establishing a massive new federal entitlement program is not to cut medicare. i want to repeat something that both the senator from arizona and the senator from tennessee have already said that is very critical here. reducing the medicare budget by $464 billion is something, by any number, is something that has been encouraged in terms of trimming the growth path for medicare. and that's something that this congress has looked at in the past but never was it intended by those who have made these projections about needing to control the spiraling costs of

medicare, never was it intended that we address the fiscal circumstances in medicare with the intended purpose of creating another new massive federal entitlement program that will grow the federal government by over $2 trillion. we talked about the numbers. the full ten-year period is $2.5 trillion. and leave medicare with these dramatic cuts, this loss of service and loss of benefits to the recipients while they see this new government growth with a new government program. that was not in the minds of anybody who was asking us to deal with the solvency issues on medicare. and it was, i don't think, in the mind of anybody who asked that we have some kind of health care reform to deal with the rising cost of premiums. mr. alexander: mr. president, how much time is remaining on the republican side? the presiding officer: 8 1/2 minutes. mr. alexander: will you let me know when 4 minutes is remaining, and the senator from idaho and i will conclude our

remarks at that time. mr. president, the senator from idaho has made a very important point in anticipating that our democratic friends will have the next 30 minutes and some other things they may be saying the rest of the day. there was a lot of talk yesterday about the congressional budget office report about the effect of this $2.5 trillion bill on premiums. rather than take my word for it let's go to the news section today of the "wall street journal" which has a headline, "some health premiums to rise." that means going up, mr. president. that means the cost of your insurance is going up. -- for some americans. so my question is, why would we spend $2.5 trillion over ten years, cut medicare, raise taxes, and run up the debt to raise some health premiums? i thought the whole exercise was to lower the cost of health care premiums. the article says, "the analysis released monday by the nonpartisan congressional budget office and the joint committee on taxation" -- now, we're

supposed to pay some attention to these as nonpartisan outfits -- "painted a complicated, uncertain picture. people who pay for their own insurance would see a higher bill, albeit for more generous benefits, unless they're lower earners who equal foy for the new government subsidy." where is the money going to come from? it is going come to from grandma. it is going to come from taxes and increasing the debt. those are facts, mr. president. "employees of small firms," says "the wall street journal," "would effectively see their insurance premiums unchanged." for small firms we'll spend $2.5 trillion over ten years, cut medicare, cut taxes, run up premiums for millions of americans so your insurance will continue to be up at about the rate it already was. why should we be doing that? whil"while workers at large firs

would see slightly lower premiums or unchanged premiums under the bill according to the analysis." mr. president, we need to change the debate. we need to start over. instead of this comprehensive 2,000-page bill that's full of taxes, mandates and has as its general effect raising premiums and taxes and cutting medicare, we should set a clear goal of reducing costs and begin to go step by step to that goal. reducing junk lawsuits against doctors, allowing health care to be purchased across state lines to increase competition, allow small businesses to combine in health plans so that they can offer more insurance to employees at a lower cost. these three bills i just mentioned have been offered and rejected so far by the democratic majority. and more flexibility in health savings accounts, efforts at waste, fraud, and abuse, which

infect medicaid, the largest government-run program, and medicare, the second-largest. and more aggressive steps to encourage wellness and prevention. now, one approach -- the comprehensive 2,000-page washington takeover apreach hernamericans are very leery of. this bill is historical for thinking we could take a system that affects almost all americans and change it all at once. why don't we instead go step by step to reearn the trust of the american people. republicans will be making those proposals on the floor this month and next month and as long as it takes to try to see that we get real health care reform. cutting medicare by $465 billion, cutting grandma's medicare and spending it on a new program at a time when med compare is going broke -- at a time when medicare is going broke, is not real health care

reform. mr. crapo: mr. president? how much time remains? the presiding officer: four and a half minutes remain. mr. crapo: i'd like to focus on the largest picture a little bit as my colleague from tennessee has just done in his concluding remarks. when you ask americans do they want health care reform? the vast majority say yes. when you asked them what they mean by that the vast majority and the polls in my personal experience are saying, we want to see the spiraling costs of health care and our health insurance brought under control and reduced and we want to see increased access to quality health care for those who don't have access today and for those who have limited access today. this bill fails on those two central points. what this legislation does instead is increase the size of government by $2.5 trillion of new federal spending, establish

massive, new federal controls over the economy and even creates a federal government insurance company. it increases taxes by about $500 billion and not just on the so-called wealthy; the vast majority of these taxes are going to squarely hit those who president obama said would not be hit, those who make less than $200,000 a year and frankly all the way down the income chain. it cuts medicare by $464 billion. it puts a major new unfunded mandate on our states who are already struggling in their fiscal budgets. and as my colleague indicated, it causes the price of insurance premiums to go up for the individual market, to go up in the small group insurance market, and to be basically unchanged in the large insurance market, according to the c.b.o. study. and by the way, one of the things that is not pointed out in that c.b.o. study very much

is in that large market which it says will be the only part of the market that doesn't see insurance rates go up, one of the reasons is because their health care will go down. in other words, there is a tax on these larger high-cost insurance premiums that is going to be either passed through and cause their insurance to go up or will be avoided by reducing the cost of their insurance and reducing the coverage of the benefit in these policies. so one way or the other, all americans are going to see their health care premiums go up or see a major -- a portion of them in the large groups see their health care premiums be held the same by reducing the quality of the insurance that they have. now, if you go back to those two reasons that americans wanted health care reform, did we see premiums go down? no. did we see increased quality or increased access to care?

well, there are some who are going to get a subsidy in this program from this new massive federal program, but at what price? $2.5 trillion and $464 billion of cuts in medicare. the establishment of a major new government program that would essentially be funded on the backs of massive new tax cuts, massive federal -- massive medicare -- massive new tax increases, massive federal tax -- excuse me -- medicare cuts and in the end, we will still be in a system in which we are seeing spiraling increases in health care costs. to me, that's not the kind of reform we need. my colleague from tennessee indicated, there are a number of reforms on which we can find common ground that will reduce health care costs. there are a number of reforms on

which we can find common ground that will help us to increase access to quality care. and that's where our focus should be. that's why i stand here today in support of my colleague, john mccain's amendment, which is a motion to recommit this legislation to the finance committee. as it was indicated, it would be done in one say, to simply remove the medicare cuts that are contained in it. let's just fix that part of this bill and then let's work forward. i see, mr. president, that my time has expired. i encourage this senate to focus closely on this legislation and to let us work together in a bipartisan fashion rather than speeding ahead and trying to pass legislation that has not had the opportunity for this kind of bipartisan effort to develop a good work product for the american people. mr. dodd: mr. president? the presiding officer: the senator from connecticut. mr. dodd: mr. president, our colleague from maryland, senator mikulski, i believe, is on the way to the floor of the senate. she and several other members in

the time we have allocated to us between now and 11:30 will be to address her amendment that she proposed yesterday. but pending her arrival, i just wanted to respond, if i could, very, very briefly to some of the conversation here this morning. first of all, i'm -- i know people -- some people have short memories, but i am somewhat intrigued to hear my good friends talk about preserving medicare. i recall the debates in 199 1995-1997 on the issue of medicare where my friends on the minority -- one of the ways they did so was by cutting the medicare benefits. we don't do that in this bill. despite the language about big cuts in medicaid here. in fact, we strengthen the medicaid program substantially. that's the reasoning the aarp and other major organizations involved with the elderly have

endorsed our proposal. they would hardly be doing so if they thought this was some massive cut into the medicare program that has been so critical too many of our fellow citizens. in 1995, just for a little bit of history here, our republicans proposed cutting benefits to medicare beneficiaries. newt gingrich, our friend from the other body, the former speaker -- i remember the quote. "let's let med care" -- quote -- "wither on the vine." that's just a few years ago in all of this debate. and so nes there's again some v, very strong provisions in this bill that reduce co-pays for seniors, ensures that seniors see their own doctors, prevents medicare from going bankrupt for an additional five years. we're being told today by c.b.o. and others that medicare becomes

iinsolvent in eight years if we vote for the mccain amendment. we provide new preventive and wellness benefits for seniors, lower prescription drug homes, not end up in nursing hoaxes this is a long bill, a big bill. but instead of complaining about its size, i'd encourage my colleagues to read it and understand what's being done for medicare. this is a complicated area but nonetheless critically important. i see my colleague from california, senator boxer, who is here and others who want to address the issue on the mikulski amendment. and i'll yield the floor so they can be heard. i yield -- mrs. boxer: senator, if i might respond -- the presiding officer: the senator california is recognized. mrs. boxer: the plan is that women completion will be coming to the floor and as they come, i will yield to them.

mr. dodd: that's all right. mrs. boxer: i want to say too-to-my colleague from connecticut how much i appreciate his work, senator baucus, senator reid. and what a remarkable moment we have here. when i go home -- and i was home for the holidays -- people are urging us to get this done. they know that their biggest chance of going into bankruptcy is a health care crisis -- 66%. they know, as my friend, senator dodd has said almost every day this debate, that every morning 14,000 people lose their health care, and they know that if we don't intervene here with a good bill, their premiums -- in my home state, senator - -- will be 41% of their average income by 2016. can you imagine? that's unsustainable. so, this bill for people who say, why don't we do the economy

instead of health care, let me just say what happens to my constituents if they have to pay 41% of their income for premiums. even if they have a good job, i say to my friend from connecticut, they can't make it. so the status quo is cruel. and it's particularly cruel to women, and i will get into the reason why i am so proud to support the mikulsk mikulski-harkin-boxer amendment to improve preventive health care coverage for women. and here's why: it is a fact that women are increasingly delaying or skipping altogether preventive health care, and they're doing it because of costs. i read a statistic done by a nonpartisan group that about 36% of men are delaying going to a physician, checking on a probl

problem, that over 50% of rim ar--50% of women are doing that either because they're fearful of the co-pay or they don't have enough money. that's the easy thing to do, to do nothing. or we could step up to the plate and save medicare, which is very important to save, and that's what this bill does. because we sai say, we're not gg to spend money on waste, fraud, and a. we're going to spend money on health care for our people. to believe that my friends on the other side are the ones who are going to save medicare, you just have to read history. you know, senator dodd explained it. newt gingrich saying, "let medicare wither on the vine." bob dole, our friend, who said at the time of his campaign -- his presidential campaign, "i fought against medicare." it was a failure. well, if you ask our seniors, i think they're the group most

pleased with their coverage. it's not perfect, but it's critical. and we save it here. we extend the life of medicare. so here we are in a situation where many women are delaying going to the doctor, getting their preventive services. and the mikulski amendment addresses this critical issue. it requires that all health plans covers comprehensive women's preventive care and screenings and cover these at little or no cost. now, the reason this is so important that, first of all, in the "help" committee, under senator dodd's and senator kennedy's leadership, we knew that this piece of the package was in the bill because senator mikulski and others pushed so hard to get it placed into the bill. and i'd ask my friend in maryland, i would ask senator mikulski if i could complete my remarks and then give the floor

over to her. thank you. i'm so proud to work with senator mikulski. i wanted to say, senator, that we worked on this over the years. i just asked my staff to go back and look at the first time we teamed up to ensure that women get mammograms at age 40, and that was in 1994. and then again over the years, every three, four years this whole notion would rear its ugly head that, well, women can do without mammography. the question i have is what's going to replace it? they would keep trying to take away our tools, our tools. self-examination, mammography. and we know that if you look through the years -- and senator mikulski, you and i are proud of the lot of the work we do, but this goes right at the top of

the list. we know that mortality for breast cancer is way down since the early 1990's. 20% down since the early 1990's. we have had to stand our guard to protect women, to make sure they get those services that they need, those lifesaving services at little or no cost. now, i'm going to ask unanimous consent to place the rest of my statement into the record, but also say that the american cancer society continues to recommend annual screening using mammography and clinical breast exams for all women beginning at age 40. mr. president, there are a lot of other very important tests that are included in senator mikulski's amendment. very, very important tests to deal with cervical cancer and

ovarian cancer, finding the markers so that we know how to deal with these deadly diseases. but to give up the tools we have to turn it over to some organization that really has no link to secretary of h.h.s. makes no sense. and what my friend has done in her amendment, in our amendment is to make sure that the group that decides this is under the jurisdiction of the h.h.s. secretary. and we know that the h.h.s. secretary has already said she wants to make sure women, starting at age 40 get those mammograms. i'm going to close by reading from an article in the march 10, 1994 "san francisco chronicle." it said joining what became a phalanx of six female senators staring down the federal health officials, boxer and feinstein are in this story, said they'll

insist that routine mammograms and a host of other women's health needs be part of any new health benefit package." and the article goes on. it's very, very clear. what i said at the time is after all these years of women being told it's crucial by age 40 to get a baseline mammogram, now to have this tremendous confusion hit us is very disturbing. well, mr. president, it was disturbing on march 10, 1994, when i first got involved in this issue. it was disturbing when senator snowe three years later had us pass s. res. 47 which said this is our only tool, let's do it. and thank goodness, we have now in this body women and men who get the fact that we refuse as women to be stripped of the only tools that we have and making all of these important tests part of this package, it's going

to save lives. it's going to save money. it's going to mean that our families can breathe a deep sigh of relief out there. so i want to thank senator mikulski for her leadership on this and always to stand right at her side on this issue of mammography. we also worked on standards for mammography. remember that one? you know, it was the deregulation fever that hit the republican side. they wanted to take away the regulations for mammography, roll them back. we fought the fight, and we will continue to fight the fight. so thank you very much. i strongly support this amendment. and i yield the floor to my friend, senator mikulski. the presiding officer: without objection, so ordered, for the record, senator. the senator from maryland. ms. mikulski: mr. president, as we debate health care reform, we need to recognize in the united states of america that health care is a woman's issue. health care reform is a must-do

women's issue. and health insurance reform must be a must-change women's issue. too often when we look at when health care is even available to us, we face discrimination. we face continuing the punitive practices of insurance companies that charge women more and give us less in a benefit. a 25-year-old woman pays more in health insurance than her male counterpart of the same health status. a 40-year-old woman pays almost 35% more of her insurance than a male of same age, same health status. we want to change that in health reform. we want to end the punitive practices of the private insurance companies in their gender discrimination. we are concerned -- we, the

women of the senate, are concerned that even being a woman is being viewed by the insurance companies as a preexisting condition. now, we have the opportunity here to change the law and change the direction of health care. and what we want to be able to do is -- i have offered an amendment to expand the screening and preventive services available to women in order to save our lives, make sure our lives are not impaired as we get older, and at the same time be able to save money. because we do know that early detection does save lives, curtails the expansion of disease, and in the long run save money. now, there are certain killers of women. the dreaded "c" word -- cancer. breast cancer, ovarian cancer,

cervical cancer, that are unique to we women. and then there's the dreaded disease of lung cancer that affects men and women but is emerging as a main killer of women. then there's the other issue of heart disease and vascular disease. we know that often for years women were left out of the research when heart disease, for years women's heart disease went undetected and unrecognized because our symptoms are different. but we can change this law. in my amendment, we expand the key preventive services for women, and we do it in a way that is based on recommendations from the center for disease control and from hrsa. it will be based on the benefit package available to federal employees. it means that if our amendment passes, the women of the america

will have the same access to preventive and screening services as the women of congress. and what's good enough for a united states senator should be good enough for any woman in the united states of america. that's why we ask not only the women to join us, but the good men of quality who support us. we know that people like senator dodd, senator reid, senator baucus, men of quality never fear we women who seek equality. they have raise reyesed for the cure as long and as hard as we have and fought for mammogram standards. this is why we're working pink today. pink is the universal color that says while we race for the cure, we want to have access to it when we find it. to have access to the cure, you'll need access to mammograms to be able to get that diagnosis. then you're going to have to have health insurance to be able to pay for the treatment we have here. this is the titanic advantage we

have here today. are we going to have access to health insurance and are we going to have access to these preventive services? we do know that in the area of heart disease and cancer and silent, undetected killers like diabetes, it's often undetected. what happens is for many women, they do not get that early detection and screening, one, because they can't afford it. they can't afford it because they either don't have health insurance and there are other demands on their family. or when they go, if they do have insurance, they find their benefit might not be covered. so many of these benefits are based on state mandates. but worse than that, it's the co-payments and high deductibles. many a woman says, well, my insurance company provides work, but this co-payment and deductible, i've got to choose between my children's shoes or my deductible. well, we want to either

eliminate or shrink those deductibles and eliminate that high barrier, that overwhelming hurdle that prevents women from having access to these early detection and screening programs. much is being debated about mammograms. you know, we believe access to mammograms should be universal. universal access. but the decision on whether you get one should be made with your doctor. well, that's great to say, but you need to have access to your doctor. you need not to have to overcome the high hurdle of deduction -- deductions or co-payments to be able to do it. but if we do know that mammograms screening decreases breast cancer by over 40%. regular pap smears reduce cervical cancer by 40%. you know, this year 4,000 women will die of cervical cancer.

then let's take the dreaded but often underlooked things like diabetic screening. diabetes is the underlying cause of two-thirds of chronic illness in both younger and older women. if we find it early and get everybody in the right program, they're going to be able to get the treatment they need so they don't lose an eye, they don't lose a kidney, they don't lose a leg. and we can't lose any more time. we need to provide universal access to health care to the american people, and we need to make sure that you have access to the screening and early preventive actions that will save your lives. mr. president, i urge the adoption of the mikulski amendment, and i thank you for your leadership on this issue. i yield the floor to -- i ask

unanimous consent that the remaining time be equally divided between governor shaheen, hagan and murray -- hagan, murray and gillibrand. the presiding officer: without objection, so ordered. who seeks recognition? the senator from new hampshire. mrs. shaheen: mr. president i ask that a fellow in my office be granted floor privileges for the duration of the consideration of h.r. 3590. the presiding officer: without objection, so ordered. mrs. shaheen: thank you. mr. president, i rise today in support of senator mikulski's amendment to ensure that women have access to preventive health care screenings and care at no cost. and i want to thank senator mikulski for her leadership not just in this effort, but over the years to make sure that women are treated fairly when it

comes to our health care. as a woman, mother of three daughters and a grandmother of three granddaughters, this is an issue that is critically important to me personally. but as a former governor, now a u.s. senator, and a policy-maker, i understand that these preventive services that we're talking about today are not just good for women, but they're good for families, for the children and husbands and brothers and fathers of the women that we're talking about today. these -- this amendment that we're talking about is good for our society as a whole. women must have access to vitally important preventive services such as screenings for breast and cervical cancers, pregnancy and postpartum depression screenings, annual well-woman visits and preconception counseling that

promotes healthier pregnancies and optimal birth counts. it's the right thing to do, but it is also the fiscally responsible thing to do. not only does diagnosing disease early significantly increase a woman's chances for survival, but it also significantly decreases the projected costs of treatment. in fact, one recent study estimated that almost 80% of all health care spending in the united states can be attributed to potentially preventible chronic illness. this amendment takes a great step forward to early diagnosis of these costly and potentially preventible diseases. and, mr. president, we must ensure that these important services are provided at no cost. too often women forego their health care needs because they're not affordable. we know that that cost plays a greater role in preventing women from accessing health care than

it does men. in 2007, more than half of all women reported problems accessing needed health care because of costs. so, mr. president, it is clear we need to support senator mikulski's amendment that will give women access to important health care screenings. thank you very much. mr. dodd: i thank the senator from new hampshire. the presiding officer: who seeks recognition? the senator new york. mrs. gillibrand: i rise today in support of senator mikulski's amendment which improves the health care measures that are already in this act. women, as we've been discussing, shoulder the worst of the health care crisis, including outrageous discriminatory practices in care and coverage. not only do we pay more for the coverage that we seek for the same age and the same coverage as men do, but in general women of child-bearing age spend 68% more of out-of-pocket health care costs than men. some of the most essential services required by women are currently not covered by many insurance plans, like

child-bearing, pap smears, and mammograms. a standard in-hospital delivery can cost between $5,000 and $10,000. so you can't make what it's like for a pregnant woman to realize she may not have coverage for the essential services she needs for her and her child. the health care bill before us ensures that this will no longer happen. however, there is much room for improvement. in america today too many women are delaying or skipping preventive care because of the costs of co-pays and limited access. in fact, more than half of the women delay or avoid preventive care because of costs. this fundamental inequity in the current system is dangerous and discriminatory and we must act. the prevention section of the bill before us must be amended so that the coverage of preventive services take into account the unique health needs of women throughout their life span. the hope is that with senator mikulski's amendment, even more of women's preventty screening will be covered, including

postpartum depression, domestic violence and family planning. covering more preventive screenings at no cost to women will encourage that more women will go to the doctors improving their health, saving lives, and as senator mikulski pointed out, saving money. the whole point is to lower costs across the board and when you shift america's health care system to preventive services over current emergency room services, you're going to do exactly that. so this amendment will ensure that the coverage of women's preventive services is based on a set of gi guidelines developey women's health experts. this amendment also will preserve the doctor-patient relationship to allow the patient to consult with their doctors on what services are best for them. this will cost $490 million over ten years and it is fully paid for. the health care crisis in america must be addressed and i am very supportive of senator mikulski's amendment. mr the presiding officer: i thank the senator. who seeks recognition? the senator from north carolina.

mrs. hagan: i rise in support of the amendment offered by the senator from maryland. this amendment tackles a serious problem: women are increasingly scripg health care screenings because of cost, even when they have health insurance this. summer i received an e-mail from a woman named julie in raleigh, north carolina, about her sister who had no insurance and waited years to get a mammogram because she couldn't afford to pay the $125 fee for a mammogram. then she found a lump in her breast. the mass grew so large that julie's sister finally got her mammogram and paid for it with cash much the mammogram confirmed what she had suspected -- that she had breast cancer. but now that she had a diagnosis, she had no way to pay for the treatment. she lost her battle with breast cancer in march of this year. julie's sister perhaps could have beaten this cancer if she

had access to affordable preventive care and after her diagnosis access to insurance or medical care to cover her cancer treatment. in this heartbreaking situation, julie's sister was sick and stuck. the health care reform bill will provide people like julie's sister with access to affordable, quality health insurance. mr. president, the president of randolph hospital in ashburn, north carolina, wrote to me recently that a few years ago he was in a meeting with 20 to 30 of his nursing assistants who were covered by the hospital's insurance plan. of those who were old enough to require a mammogram, only 20% of actually gotten one. the reason: they said it was the high cost of the out-of-pocket cash in order that they would have to pay. when these women had to choose between feeding their children, paying the rent, and meeting other financial obligations,

they skipped important preventive screenings and took a chance with their personal health. the hospital then decided to remove the financial barrier to preventive care and pay for 100% of preventive screenings. with the passage of senator mikulski's amendment, we will do the same for all women. a comprehensive list of women's preventive services will be covered with no added out-of-pocket expenses. with this amendment -- the presiding officer: the senator has used her time. hague -- we will ensure as the old saying goes, "an ounce of prevention is worth a pound of cure" for women across america. thank you, madam president. mrs. murray: madam president? the presiding officer: the senator from washington. mrs. murray: thank you, madam president. madam president, i want to add my thanks to the senator from maryland for bringing forward this important issue as we address health care reform in this country to ensure that all of our families have access to health care.

one of the most important things we can do is to make sure that the care givers in their families, the women, get access to preventive care so that they can take care of their families. this amendment will require all of the health plans to cover comprehensive women's preventive care and screenings and at no cost to women. that's extremely important. we all understand that. but especially in these tough economic times when families across the country are struggling, one of the results has been that a lot of women are skipping or delaying their health care. we all know this personally. as moms, you take care of your kids first. when you do that you often leave your families at risk because you haven't taken care of preventive care. we know in 2007 a quarter of women reported delaying or skipping health care because of costs. in may of 2009, a report by the commonwealth foundation found that more than half of women delayed or avoided preventive care because of its cost. madam president, this amendment will ensure that those women

don't delay their preventive care because they can't afford it. it's extremely important for this bill, it's important for women in this country, it's important for men and children in this country as well. i want to add my thanks to the senior senator fro senator fromd that one of the first things we do is make sure that women's preventive care is covered. thank you, madam president. i yield the floor. the presiding officer: the senator from maryland. ms. mikulski: madam president, that concludes our discussion on this. we didn't know if the lead sponsors of the health reform bill wished to speak. but i must say, alert, alert, alert. we've just been informed that a shrill acting group is spreading lies about this amendment. they're saying that because it is prevention, it includes abortion services. there is no abortion service included in the mikulski

amendment. it is screening for diseases that are the biggest killers for women, the silent killers of women and it also provides family planning, but family planning as recognized by other acts. let's get off of it and save lives. the presiding officer: the senator's time has expired. mr. baucus: madam president? the presiding officer: the senator from montana. mr. baucus: madam president, i yield myself one minute. very much straight to the point here. there's been some discussion about the c.b.o. assessment of health care premiums. the letter was out just yesterday. that letter shows that for all americans -- all americans -- premiums will be lower. they will be modestly lower for those larger employers. we have a range between those -- for small businesses between 1%

reduction, maybe 2% increase, and for the individual market there's more variation. that's obviously because there's much more variation today currently in the individual market. but those who purchase the individual market are going to be getting a lot better quality insurance than they are getting today, much better. and for about 60% of those in the individual market, they're going to find their premiums are actually lower after the tax credits/subsidies are taken into consideration. so netted all out together, all americans are going to see their premiums lower for what they get today -- from what they get today. about 7% will see an increase but tear gating better coverage -- but they're getting better coverage than they're getting today. quite a bit better. so on a net basis, bottom line, everyone is going to see his or her premium lower, and for those 7% that's not lower, they're going to gret a lot better -- to

get a lot better quality of insurance. and it'll offset their increase in premium. that's what the c.b.o. letter says. one minor point here: that's on the so-called cadillac plans. c.b.o. said those who receive cadillac plans will find their premiums reduced. not increased but reduced. i think the figure is 6%, 7%. and that, too, is very important because there's been a lot of discussion about what's the effect of the cadillac plans on premiums. c.b.o. says those premiums will be reduced. my one minute is probably up, madam president. i want to use the last second of that one minute just to say that net all the way across the board the c.b.o. letter says that premiums will be reduced. when you take subsidies into consideration and when you compare the plans people get today with what they'd otherwise

get in the future -- because they get higher quality coverage in the future. mr. coburn: madam president? the presiding officer: the senator from oklahoma. mr. coburn: how much time remains on the republican side? the presiding officer: three minutes. mr. coburn: i would ask unanimous consent that i consume that three minutes and that 15 minutes allotted for our side on the executive nomination and that when this 18 minutes is up, the remainder be following the time on the democratic side -- the nomination be reported. the presiding officer: without objection. mr. coburn: thank you. i wanted to spend a few minutes'minutes-- as a physiciad for medicare patients for years, i can't tell you how worried i am about what this bill will do to my senior patients. you know, when medicare was first written, two things were put into the law. very straightforward, very direct. and let me read them to you for

a minute. and i hope america listens to this, because here's what the law is. and c.m.s. is breaking the law today, and with the new medicare commission, they're going to break it even further under this bill. section 1801, nothing in this title shall be construed to authorize any federal officer or employee to exercise any supervision or control over the practice of medicine or in the manner in which medical services are provided or over the selection, tenure, or compensation of any officer, employee of any agency or person providing health services. or to exercise any supervision or control over the administration or operation of any such institution, agency, or person. that says the federal government can't practice medicine. that's what it says. section 1802 -- and this is why it's really important for my medicare patients and every medicare patient out there.

"any individual entitled to insurance benefits under this title may obtain health services from any institution, agency, or person qualified to participate under this title, if such institution, agency, or person undertakes to provide him such services." well, what we have in this bill is the gutting of those two foundational principles of medicare. the first is the medicare advisory commission is going to tell you what you can and cannot have. and here's what we're going to see. "you will choose what i tell you" you will choose if you are a medicare patient. not only do we have almost $5 billion in cuts -- $500 billion in cuts to medicare, under the auspices that we have to control entitlement spending, not only

are we taking away plans from people who are very satisfied with what they have today, but we have been asked and will enhance the ability of the federal government to practice medicine. my colleagues on the other side of the aisle who have never practiced medicine, who know the legalese but don't know the consequences of right now, the rationing of medicare on drugs like epigen and the nupigen. medicare has decided when oncologists can use those drugs. they have taken a blanketed position, although they have released it somewhat. let me give you a patient. patient has breast cancer. she's 67 years old. she's being treated for breast cancer. she becomes anemic and nutrapenic. her ability to fight infection goes down. we have these wonderful drugs that raise the white blood cell

count back up and raises the red blood cell count back up. but medicare in its obvious wisdom in practicing medicine has told the oncologists when they can and can't use it. that's fine for 75% of the patients but totally ignores the other 25% of the patients who happen to have complicating factors like congestive heart failure. for if you become anemic under your breast cancer-chemotherapy and you have congestive heart failure as well, the government says you can't have arithropodin regardless of whether you have congestive heart failure or not. what happens is the practice of medicine out of washington or maryland, more specifically, determines who can and cannot have a drug. and in this case, arithropoitin.

what are the consequences of that? the consequences are if the patient didn't die of their breast cancer. they died of their congestive heart failure that could have easily been treated had we not had medicine practiced by c.m.s. denying the ability of a physician to give a patient exactly what they needed when they needed it. we are starting down that road with this bill. aggressively starting down that road, because the medicare advisory commission combined with the cost comparative effectiveness panel won't look at complications, won't look at secondary diseases. they will look at the average. and i want to tell you, when you're sitting in an office with your doctor, you're not average. you're you. and you are specific individual with a set of factors that

nobody else has anything in comparison to. and the judgment in the practice of medicine cannot be done by an insurance company or c.m.s. at a distance without them having the hand on a patient. and they never have their hand on a patient. so the whole art of medicine, which is 40% of getting people well, the knowledge and training and experience and gray hair that comes with looking at a total patient being one on one, not having the government in between their doctor and their treatment of them. and what this bill does, this bill is a lie one of two ways. one is it says we're going to take this money out of medicare, and you're not going to notice any difference. that cannot be true.

if we take $500 billion or $400 billion-plus out of medicare, millions of seniors are going to notice a difference in their health care and what they get under medicare. and if we say that isn't true, then the only way that isn't true is the game that's being played on the financing of this program. and that's to say we're going to cut this money out of medicare and then with a wink and a nod know that we're never going to do it. now, the majority leader said yesterday there is nothing more important in this nation right now than us passing health care. i want to differ with that. i think 10.2% unemployment is a whole lot more important in finding those people jobs than us passing health care. i think a $12 trillion debt is

more important to address than us fixing health care right now. i think the fact that we have $350 billion worth of waste, fraud, and duplication in the federal government every year and we're not addressing it is more important than fixing health care right now. i think the fact that our economy is still on its back and people are continuing to lose jobs is more important than us fixing health care right now. i understand the political dynamics, but i also understand very well, with my quarter of a century practice in medicine, that what this bill is going to do is going to destroy the best health care system in the world, and it's going to undermine the security of every senior in this country because what starts as a small couple of things like

nupogin and epogin or like when you can have bone dysmotry, it's the start of the government practicing medicine it is the beginning of our seniors to have the government step in between them and their physicians in terms of the physician wanting to do what is best for that senior and the government saying "no, i'll tell you what you're going to have. i will tell you what you will have." you know, thomas jefferson taught us a lot. and he predicted that we would have future happiness for us if we can prevent the government from wasting the labors of the people under the pretense of

taking care of them. i want to see a lot of things changed in health care. i want to see true competition in the insurance industry. i want to make sure nobody loses their insurance because they get sick. i want to make sure everybody can get insurance if they are sick. i don't disagree with the basic premises. what i disagree is moving $2.5 trillion more under government control which will raise costs ultimately in the health care sector. and if it doesn't raise costs and we're truly going to take this money from medicare, what it's going to do to our seniors, i have a message for you: you're going to die sooner. and they're going to go that isn't true. that isn't true. when you restrict the ability of

the primary caregivers in this country to do what is best for their senior patients, what you are doing is limiting their life expectancy. we're saying that c.m.s., the medicare advisory commission and the cost effectiveness comparativeness panel will tell the doctors what they can and cannot do, ignoring the 20% of the people that that is exactly the wrong prescription for. so for 20% of our seniors, this bill is going to be a disaster, but it's going to save money because you're not going to be around for us to spend any money on you, because the government will have already told us what the treatment plan will be for you. we will decide in washington, through the services, what you will receive. now, they'll dispute that. but the people that's going to be disputing that are lawyers. they're not doctors. they never laid a hand on a

patient. they never put their hand forward on a medicare patient knowing the consequences of the whole, total patient, the background, the medical history, the sociologic factors that fit, the family dynamics, the past medical history and the family history, and the present state of mind of that patient. and even more important, what this bill's going to do is divide your doctor away from you. when you go to the doctor today, most of the time that doctor's number-one interest is in you and your well-being. and when you have this medicare advisory commission and you have a cost effectiveness-comparative effectiveness panel, what that does, that causes the physician, he or she, to take their eyes

off of you. now they've got to put their eyes on what the government says because the consequences of not doing what the government says will ultimately result in some type of sanction. so, do we want physicians to be patient-centered and focused on their patients? or do we want physicians to have their eye on the government and half of an eye on the patient? which do you think is going to give us the best care? which do you think is going to give us the greatest quality of life? what's going to give us the greatest longevity with the greatest quality of life? is it the government practicing medicine or is it the trust that has been developed through years between a patient and a doctor to do what is in the best long-term interest of that patient? i can't tell you the number of people that died from the medicare c.m.s. regulations on

epigen for oncologists. but there were hundreds, hundreds, because medicare never looked at a patient. they looked at dollars. so as we go forward in this debate, what i want seniors in america to know -- and i'm fast approaching medicare age. i'm three years from it. i want them to know that the key thing they're going to lose in this bill is they're going to lose the loyalty and primacy of their physician thinking about them. and we're going to divide that loyalty to where the physician is going to be looking at the government. and if you think that isn't true, just look what's happened so far when c.m.s. has decided to start practicing medicine. in the "help" committee, i offered an amendment to change

the language so that there would be absolutely a prohibition on rationing care and directing the care from washington. it was rejected out of hand. rejected out of hand. not one of my colleagues on the other side of the aisle voted to prohibit rationing of health care. now, why would they do that? because the ultimate intention through the cost comparativeness effectiveness panel is to ration care. it's to ration the care. it's to limit the amount of dollars that we spend and never look at the individual patient. if we think about the medicare cuts in this bill, we're going to take $135 billion out of the hospitals. do you think seniors will ever notice that? i do.

i think when you ring your button and you're hurting and you need pain medicines or you need to go to the bathroom, the time it takes for somebody to get there won't be sufficient. what will happen is you wait. you'll have a complication. if you become acutely shortness of breath and you punch your button, the available nurses won't be there. there will be a consequence to cutting $135 billion from payments to hospitals in this country. we're going to take $120 billion out of the seniors, the one in five seniors who now have medicare advantage. i agree it's more expensive than medicare. it has cost containment through competitive bidding, but we shouldn't be decreasing the services, which is exactly what's going to happen. so if you're a senior on medicare advantage, you're going to lose benefits that you now

have. you're going to lose them. one of the ideas of medicare advantage was preventive services. one of the things that improved the care in rural america was medicare advantage. and yet, we're going to take that away, the vast majority of the benefits. we're going to cut them in half. we're going to take $15 billion from nursing homes. that may or may not be appropriate. but the way to do that is through a competitive experience based on quality and outcome rather than some green eye shade staffer saying we can take $15 billion out of medicare from payments to nursing homes. you know, one little secret that's not in this bill, that has not been addressed in this bill is the estimate by a harvard researcher that there's $120 billion to $150 billion a

year in fraud in medicare alone. h.h.s. admits to $90 billion. we know it's well over $100 billion. $100 billion a year in cleaning up the fraud in medicare would pay for a lot of health care for a lot of folks in this country. there's $2 billion in this whole bill to clean up the fraud. why would we not fix that first? why would we take money from medicare to create a new program when in fact we're wasting 10% to 15%? the presiding officer: the senator's time has expired. mr. coburn: i will close with this remark. if you are a senior and you're on medicare, you better to be afraid of this bill. i don't come to the floor and say that very often, but your health care is totally dependent in terms of being decreased tbhi bill. i yield the floor. mr. dodd: madam president? the presiding officer: the senator from connecticut. mr. dodd: madam president, i would ask unanimous consent that i be allowed to speak for one minute and seven seconds and the

time be taken from my good friend and colleague from vermont, the chairman of the judiciary committee. the presiding officer: without objection. mr. dodd:, thank you, madam -- mr. dodd: well, thank you madam president. senator coburn an i have become great friends. we spent a lot of time this summer on our "help" committee. someone who has practiced medicine for a long time, he speaks from a strong personal experience and i admire and respect that immensely. let me say to my colleagues, without this bill that we're talking about here, this comes down a simple choice: under existing law, one institution stands between a doctor and a patient. that's your insurance company. they ration care all the time. in fact, i'm a living example of rationed care, having been through surgery, getting preapproval twice before surgery and then being rejected by the very insurance company that i

paid premiums to for a very long time -- as a member of this body. we're working it out because they thought i am 65. they were rationing my care. the insurance company -- it wasn't some government entity. they're the ones. so without our bill, the only one getting to decide what health services anyone receives is -- the presiding officer: the senators's time has expired. mr. dodd: -- is the insurance company. so i would hope that we would have a chance to debate this further, as i'm confident we will. let me also say quickly how much i support the effort by senator mikulski on efforts to ensure that women are treated equally. i strongly support her amendment and ask to be added as a cosponsor of her amendment. the presiding officer: without objection. the senate will proceed to executive session to consider the following nomination, which the clerk will report. the clerk: nomination, the judiciary. jacqueline nguyen to be united states district judge for the

central district of california. mr. leahy: snp? the presiding officer: the senator from vermont. mr. leahy: madam president, i understand the senator from california needs some time. i will yield her five minutes beginning now. mrs. feinstein: thank you very much, mr. chairman and madam president. the presiding officer: the senator from california. mrs. feinstein: i rise to speak in support of jacqueline nguyen to be a federal district court of california and i'd like to urge her confirmation. judge nguyen is a successful judge with a proven track record. she will be the first vietnamese american on the federal bench. her nomination comes about this way: i have had for a long time a bipartisan judicial selection

committee in california to advise me in recommending judicial nominees to the president. the committee gave judge nguyen its unanimous recommendation and then i recommended her to the president for his nomination to the federal district court. i believe she's going to be an excellent federal district court judge in the central district. judge nguyen was born in south vietnam. she immigrated to this country with her family at the age of ten during the final days of the vietnam war. the nguyens spent several months living in a refuge camp in camp pendelton, san diego, before moving to a neighborhood in los angeles. she was naturalized in 1984. judge nguyen's parents worked two and three jobs at a time in los angeles and judge nguyen and her siblings worked side by side with them, cleaning a dental office, peeling and cutting

apples for a pie company, and finally managing the doughnut shop that their parents bought and owned. in her application to my selection committee, she explained that looking back on these experiences, she realizes now that they were difficult. she wrote, "but i never loo letl incredibly important because they have shaped mo who i am today." she went on to graduate from occidental college in 1987 and from ucla law school in 1991. she was in the moot court honors program. for the first four years of her career, she practiced commercial law as a litigation associate at the private law firm of music, peeler and garrett. her caseload included contract disputes and intellectual property cases. she left the firm to become an

assistant u.s. attorney in the u.s. attorney's office in los angeles and a very good one. at an assistant u.s. attorney in the criminal division, she prosecuted a wide variety of crimes, including violent crimes, narcotics trafficking, organized crime, gun cases, and all kinds of fraud. she spent six months in the organized crime strike force section, handling a title 3 wiretap investigation of a russian organized crime group responsible for smuggling sex slaves into the united states from the ukraine. and in 2000 she received a special commendation from f.b.i. director louis freeh for obtaining the first conviction ever in the united states against a defendant for providing material support to a designated terrorist organization. the justice department recognized her with three

additional awards for superior performance as an assistant u.s. attorney and in 2000 she was promoted to deputy chief of the general crime section. in 2002, judge nguyen left the u.s. attorney's office when governor gray davis appointed her to the superior court in los angeles. and she's been on that bench for more than seven years and has presided over more than 65 jury trials. as she has said in her own worded, "i am deeply passionate about the privileges we enjoy as americans and am committed to spending my life in public service. if i'm given the honor to serve as a united states district court judge, i believe my experiences, work ethic, maturity, and judgment will serve me well." end quote. i could not agree more. i think judge nguyen will be a truly outstanding judge of the

federal district court, and i urge my colleagues to support her nomination. thank you, madam president. i yield the floor. mr. leahy: madam president? the presiding officer: the senator from vermont. mr. leahy: i have six unanimous consent requests for committees to meet during today's session of the senate. they have the approval of the majority and minority leaders. i ask unanimous consent these requests be agreed to and these requests be printed in the record. the presiding officer: without objection. mr. leahy: madam president, i absolutely concur with the distinguished senator from california in my support of judge nguyen. i supported her in the committee. i supported her when it passed in the committee. she should have confirmed. she has the highest possible rating for a judge. i'm glad that we are able to act on her today, even though she was reported more than six weeks ago. when she is -- but i am -- i'd urge senate -- the senate to

also confirm several others we've acted on. for example, the nomination of ms. gee, the first chinese district court judge in the nation. and the nomination of judge chen, also -- both of these -- all three of these were confirmed from the committee -- or voted out of the committee, the judiciary committee, six weeks ago. judge chen would be the first asian pacific american in the federal descrirkt court in the history -- in the federal descrirkt court in the history. i would hope that we could move these very quickly and i'd ask unanimous consent that my whole statement be placed in the record. the presiding officer: without objection. mr. leahy: madam president, i'd ask consent that my full

statement regarding my amendment to the patient protection and affordable care act, and amendment that would bring about real competition in the costs of medical insurance, be placed in the record as though read. the presiding officer: without objection. mr. leahy: and, madam president, i would just note that my amendment removes the outdated, antiquated, unnecessary antitrust protection given to our insurance companies, a protection which instead of allowing them to thrive and give us lower premiums, as perversely act -- has perversely acted in such a way that our premiums continue to rise 15% last year alone, and this will help change that. now, madam president, in the time i have remaining, i also want to speak briefly on a

subject that many members of congress, both democratic and republican alike, have an abiding interest in. throughout this week, delegates from countries around the world will gather in columbia to participate in the second review conference of the convention on the prohibition, use, and stockpiling of antiperso antipel land mines. this would give the obama administration the opportunity to announce its intention to join the other nations that are parties to the treaties, including our coalition of allies in iraq and afghanistan. in fact, every member of nato and every country in our member is sphere except cuba is a part of the treaty. the united states is only one of 37 countries that has not joined, along with priewsh and china. -- along with russia and china.

we are the most powerful nation in the earth. we ask our countries to join these treaties. we've been unwilling to ourselves. we do not use these land mines. we should be doing -- can anyone imagine the united states using such land mines in afghanistan, where usually it's civilians that die from it? a country where more civilians have been killed or horribly injured from mines than any other country in history. why shouldn't we? and yet we see the united states going down and doing what would be the right thing. we have a state department spokesman who announced last tuesday that the obama administration decided to continue supporting the bush administration's policy on land mines, which was a retreat from

the policy of president clinton. i think the obama administration has made a dramatic mistake in this area of land mines. this is not what we expected from this administration. it is not what i expected in my conversations with the president. i'd remind everybody the united states does not export antipersonnel mines since 1992 when we passed the leahy law prohibiting the export of such land mines. we have not produced antipersonnel mines for over a decade, not since 1997. and the united states has not used antipersonnel land mines in almost 20 years, not since 1991 when mammogra many of them malf. we've been in compliance with

the treaty for 18 years. indiscriminate land mines, whether persistent mines or those designed to self-destruct or the be activated over a period time are nothing more than boob by traps. these land mines cannot distinguish between an enemy combatant, a u.s. soldier, a young child, or a woman out collecting firewood for her family. they do not belong in the arsenal of any modern military. i have supported president obama. i look forward to supporting hill on many issues in the future -- i look forward to supporting him on many issues in the future. i hope that the administration will change the course they're presently on. i am confident that if they do a real review, they will get rid of these. i want to commend the government of columbia,