like that product or not rather than have them go to at&t, comcast or verizon and say, can we have your permission to introduce this product to your users? >> host: final question, ann veigle. >> host: scott, final question to you. a lot of people distrust large companies and look at their phone bills and think why am i being charged all these things? how do you effectively combat the arguments you've been making with just a general distrust of companies? we've seen, you know, meltdowns in the financial markets. right now it's just not something that people feel very strongly about. when you say open internet, they're going to, they're going to relate to that, and the information or the letters coming in to congress are saying those things. so that's not something that just comes out of thin air. >> guest: it doesn't. it comes because there is this political demonization campaign.

they know that if they use pejorative words like discrimination or blocking or degrading, you know, big companies want to do bad things that they can generate, you know, people to be concerned. but let's go back to the fact thes -- >> host: well, just one question there. even if it's not true in your mind, what about the momentum of those letters coming in and, you know, e-mails and those types of things? how does that factor into what's going to happen? >> guest: well, i think what's interesting, what'll happen on the hill, you know, you did have 72 democrats in the house basically write to the fcc and say, whoa, this is changing, this isn't what we wanted to do. but to go back to -- well, i'll conclude at that. >> host: final word. >> guest: well, we're going to have an interesting process, and i think we're at a key moment here in washington on whether policymakers will preserve the kind of internet that has been, that has enabled it to be the most successful tool for

innovation and dem on craty cyst ever invented or whether we're going to turn the internet into something that looks more like cable television. >> host: markham erickson, scott cleland, ann veigle. >> you've been watching "the communicators," c-span's weekly look at the people and issues impacting telecommunications in the digital age. if you missed any of today's program over net neutrality rules, you can see "the communicators" again tonight in its regular prime time slot, 8 eastern, here on c-span2.

>> over the weekend a rally was held in manhattan to protest the obama administration's decision to hold civilian trials there for 9/11 defendants. brian den hi and relatives of victims of the 2001 terrorist attacks. this was organized by the group calls the 9/11 never forget coalition. this portion is about 90 minutes. >> many other religious festivities.

pray together for the gift of life and love and families. the lord god, this is not the time and the place to have a trial here. [cheers and applause] this is -- [inaudible] why? on september 11, 2001, an act of war was committed against america, and we're here to ask all of us in a respectful, loving way to make this a military trial. that is the time and place for that and not here. but god love us -- [inaudible] on the road to salvation. we thank you, critter, amen. god bless you and god bless america. >> ladies and gentlemen, i've interviewed lots of people over the course of lots of years, but

yank of anyone -- i can't think of anyone who i admire and respect more than our first speaker today. deborah burling game is the sister of chick burlinggame the third, pilot of american airlines flight 77 which crashed into the pentagon on 9/11. she has been working since that day to bring justice in every possible way, and she is the co-founder of 9/11 families for a safe and strong america, a directer of the national september 11th memorial and museum foundation at the world trade center, and a founding directer of keep america safe. you'll read her articles in "the wall street journal" and everywhere else, you see her on television on the talk shows. i've been graced with her presence on my talk show, and, of course, she's been very, very

instrumental in her testimony before congress. she's been a strong advocate of enforcing the patriot act, the market security agency terrorist surveillance program, she's been instrumental in every single issue that we care about. and, of course, some of you don't know, she's a former producer at court tv where she covered dozens of civil and criminal legal proceedings ranging from the o.j. trial and the clinton impeachment hearings to the microsoft antitrust case. and, of course, you know how she feels about what's about to take place in that courthouse right there, but we can stop it, and here's our leader, deborah burlingame! [cheers and applause] >> are we mad or not? [cheers and applause] let me tell you something, steve is right. that tall building there, the

one nestled behind the new york state courthouse, that's the federal courthouse that our attorney general wants to bring an admitted unrepentant war criminal protected by our own military, surrounded by our own police officers and federal marshalls, to protect him from you. he wants to give him a stage in that federal courthouse. we're here to say that is not going to happen. [cheers and applause] as we stand here today, american women in uniform are fighting al-qaeda and their sympathizers on fronts all over the world. soon 30,000 more of our fellow citizens will be deployed into that fight. in the midst of war, the obama administration wants to put on a

show trial, a show trial on the site of al-qaeda's bloodiest battle against this country. the citizens of this country need to understand this trial will not happen soon. not this year, not next year or the year after that. and it's not just because we don't want it to happen at this courthouse, it's because this trial has to start from day one in a federal civil system. it will take three years to prepare this case for trial, and family members, 9/11 family members and first responders who think that mohammed and his cohorts will be seated in front of a jury panel soon, you need to know that won't happen because there will be hundreds of thousands of pieces of

evidence that federal prosecutors will have to comb through. and one of the things they will be doing is combing through it to hand our intelligence secrets to the defense. you need to know that the military prosecutors who have spent three years getting this case ready for trial, and we're ant to end -- about to end it when these men decided they wanted to plead guilty. they are worried, ladies and gentlemen, that the parents of some of these victims will not be alive when justice finally occur cans. it will take that long in the civil federal courts. on the morning of 9/11, it took hijackers 12 minutes to take control of the cockpit of my brother's plane.

it took six minutes for them to kill my brother and his co-pilot. six minutes in a closed cockpit is a very long time. i am not the sister of a victim. i am the sister of a fighter! [cheers and applause] we are not here today surrounded by our cherished courthouses to complain and lament what happened eight years ago. we are here to prevent it from happening again. [cheers and applause] and this perverted policy must be reversed because we know that they are going to use that courthouse to put our country on trial, to mark the victims, to exult in the pain of the families, to disgrace the judge,

to disgrace our country. this is not an ennobling plan. this is not going to help our countries in the eyes of the rest of the world, they will laugh at us. if if you take one thing away today, folks, take this message: don't get mad, get busy. this is the beginning of a national campaign. we are going to go out into the districts of every member of congress who is hiding behind their desk, and we are going to out them, we are going to come after you, and we are going to make sure -- [cheers and applause] we are going to make sure that you are put on notice! thank you very much. [cheers and applause] >> all right, ladies and gentlemen, our next speaker, he's a retired, decorated

20-year fdny firefighter and a survivor of the 9/11 attacks on the world trade center. he was a first responder to the 1993 terrorist attack on the world trade center and a veteran of the new york urban search and rescue task force team that responded to the 1995 terrorist attack on the alfred murrah federal building in oklahoma city. he's worked at all levels of government in the emergency management homeland security field including the u.s. department of health & human services and the governor's office in the state of rhode island. and along with his firefighter brother, chris, he owns the popular fdny web site, the bravest.com which you should all go to and check out. ladies and gentlemen, tim brown. [cheers and applause]

>> thank you. thank you. we are the backbone of america right here. this ises the backbone. [cheers and applause] we are the firefighters, police officers, construction workers and united states military veterans from new york city. right here, these guys. [cheers and applause] it is our belief that the attack on the world trade center was an act of war. [cheers and applause] and that those who participated in that attack the are war criminals. [cheers and applause] we don't agree that these murderous terrorists are entitled to the same rights afforded our nation's citizens under our constitution. [cheers and applause]

these terrorists declared war on our city and our nation. the september 11th attack killed 343 new york city firefighters, 37 port authority police officers, 23 new york city police officers, hundreds of construction workers and thousands of other innocents. these murders showed no mercy -- murderers showed no mercy, and they didn't think twice about the rights of our family and friends when they planned this attack. attorney general holder has suggested that we who oppose prosecuting these men in that courthouse are afraid of khalid shaich mohammed. let me ask you something, do these guys look like they're

afraid? i don't think so. that somehow we don't have the courage to face cleed shaich mohammed. you don't think these guys will face him? these are men here. these are americans. how dare eric holder imply that we lack courage. courage is carrying on after watching your loved ones die. knowing that they burned to death, they were crushed to death, or they jumped from 100 floors up. courage is carrying on even as we waited in some cases for something of our friends to bury more than 1100 families still wait for something to bury. how dare the attorney general suggest that we firefighters, police officers, construction workers and military vets who

oppose this trial need to man up. how dare he suggest that we allow this enemy of america to mock our brothers in this country's most magisterial setting, that court howt right there -- courthouse right there. let me refresh the attorney general on the meaning of courage. courage was going into those buildings that day knowing we might not come out alive. [cheers and applause] courage was my best friend, terry hatton, captain the terry hat torrance hugging me in the lobby of tower one saying to me, i love you, brother, i may never see you again as he went into the stairwell to save lives. i never saw him again. courage was digging for nine months on hands and knees breathing in toxic smoke to find the ravaged remains of brother firefighters, police officers, citizen responders and office

workers. this courage was not summoned from false bravado, it sprang from an abiding love of our fellow human beings and a sense of obligation to them. their families and their beloved country. eight years ago all americans stood with us as we dug for our friends and loved ones, and when we were lucky, you stood with us to bury them. we need all good americans to stand with us again as we fight this travesty. join us now at 911neverforget.us. thank you. god bless our troops and god bless america. [cheers and applause] >> usa! usa! usa! usa!

>> all right, folks, we're going to bring you another man with a firefighter background, peter eagan is an active fdny fire fighter and a u.s. marine who's served two tours in iraq and is a 9/11 family member. he lost his father, firefighter donald regan, fdny rescue company number 3, and he is here to make a very special introduction. peter regan. [cheers and applause] >> like to thank everyone for coming out here.

start off, the united states constitution, in my opinion, is arguably the most sought-after piece of literature in its time behind the bible. by new ambitions seeking freedom, liberty and endless possibility or by rogue, spiteful nations that feel threatened by it and want it destroyed by any means. the united states constitution was written by americans and for americans. it was intended for the protection of the nation and it people. it is a set of guidelines that we are expected to uphold. i say we because i am speaking as we, the people. the fact that ksm and his cohorts are about to get what they asked for by the graces of attorney general eric holder is an outrage. attorney general holder is granting enemy combatants that

are now called unprivileged enemy belligerents as per the military commissions of 2009, granting enemy combatants a hearing in a civilian courtroom in the united states of america. in the history of this great country, this has never been done before. why are we starting now? what is the benefit of this? this administration has still not explained in any manner the reason for any of this. what i got out of attorney general holder's testimony at the senate judiciary committee hearing last month was that for some reason the killing of nearly 3,000 americans, mostly civilians, raised an article 3 hearing whereas the uss cole bombing killed far less americans, a military commission. not devaluing the latter. both were acts of acompression

from terrorists. -- aggression from terrorists. it should not make a difference who the enemy kills. the terrorists should be tried in a military commission court. [cheers and applause] they planned, aided and oversaw the the attacks, attacks of september 11th, 2001. this was a preemptive strike on the united states. they were at war with us. they went to flight schools, devised aggressive hijackings, steered planes into preplanned targets and slammed them into a nation, this nation. this is an act of war. with the act of war, there are rules that go back beyond any memory, and with the military commissions this nation has tried and convicted unprivileged enemy belligerents that do not follow the rules. the military commissions act defines these men in chapter 47

47a. the term unprivileged enemy belligerent means an individual other than the privileged belligerent who has engaged in hostility against the united states or its coalition partners as purposefully and materially supported hostilities against the united states or its coalition partners or was a part of al-qaeda at the time of the alleged offense under this chapter. attorney general holder has told us not to be afraid of khalid shake mohammed. well, sir, i'm not afraid. i'm not afraid of this terrorist or any other terrorist. as a marine, i have seen their kind on the battlefield, and i will verify that they are afraid of us. [cheers and applause] they fear us on the battlefield because they know they're no match for our military. they fear the idea that we will

eventually bring the fight to their doorstep and hit them before they can hit us. america is not afraid. we are a strong nation only getting stronger. the only fear that i may have is the fact that if this case goes in the direction ksm wants it to go, he will win. he will not win the case, however, he will be able to use our rights and privileges to defend himself against the united states, and to me that is our loss. the idea terrorists from a foreign nation that killed so many people, caused deteriorating health effects for countless others to get to sit in a federal courtroom in the united states and have the rights of an american is appalling. my father, donald regan, a firefighter working in rescue three was killed on september 11th, 2001. he taught me respect, pride and honor. my dad said to always do the right thing and to never give up. well, i'm here today doing that.

[cheers and applause] i was also recently told that attorney general holder doesn't have to listen to my opinion. well, we have elected officials in congress that are elected by our opinion. so for someone to say that my opinion doesn't have an effect on attorney general holder, that's like saying none of your opinions have an effect on attorney general holder. stand up. [cheers and applause] our next speaker, famed actor also was a marine back in

1959-'63. the only thing i can say is once a marine, always a marine, semper fi. brian dennehy. [cheers and applause] >> are you all wearing your sun block? [laughter] i have been honored to give the opportunity to read a letter, a statement written by judea and ruth pearl, the parents of daniel pearl, "the wall street journal" reporter who was brutally murdered by the terrorists in 2002. in fact, the terrorist who actually wielded the sword is one of the men who will be tried right over here whenever it happens.

this is from judea and ruth pearl written december 5, 2009. friends, on behalf of the daniel pearl foundation, we wish to join you today in a call to reverse attorney general eric holder's decision -- [cheers and applause] to try america's new-type enemies in a new york federal court. we wish to add to your rally the perspective of our own personal tragedy which, in many ways, has come to symbolize the depth of inhumanity that has swept our planet in the 21st century and the sense of urgency with which this planet is watching your rally in new york city.

a rally that may very well hold the key to the future of open society. we who witnessed the darkest side of hell and have since spent every moment of our lives studying the anatomy of terror, we refuse to accept the strategy of normalization that attorney general holder's decision represents. i'm going to repeat that sentence. we refuse to accept the strategy of normalization that attorney general holder's decision represents. [cheers and applause] terror is a crime against society. and should not be tried in the same court as crimes against individuals or against a

particular country can. let us make it perfectly clear, we are not concern canned about the safety issues that this trial poses to new york city. we trust our law enforcement officers. nor are we concerned about the anguish of our children who will be seeing the memories and values of their loved ones mocked and ridiculed in that courtroom. they have known greater pains before. we are concern canned about the millions of angry youngsters, among them potential terrorists, who will be watching this trial unfold on al-jazeera tv and come to the realization that america has, in fact, caved in to al-qaeda's demands for publicity. the atrocity of 9/11 and the brutal murder of daniel pearl are vivid reminders of jihadist

terrorists craving to dramatize their perceived grievances against the west. today america has given these people an even louder megaphone in the best theater in the world, and thus signaled to thousands of would-be terrorists that joining al-qaeda or other terror organizations is one way to obtain that megaphone. we who have studied the anatomy of terrorism cannot accept the logic that terror has no country. that it cannot be defined, named and fought with the same determination and creativity that civilized society has fought other existential threat since the invention of gun powder.

these include piracy, the introduction of poison gas and the threat of nuclear weapons. all were contained by creative changes in international law and the establishment of new legal categories. the invention of the suicide belt is of no lesser threat. terror is an ideology that elevates one's grievances above the norms of civilized society, and like any epidemic of global dimension, it must be fought by attending to the distinct mechanisms that transmit and propagate the disease. in 2002 the international community gave america a moral mandate to fight the new epidemic with all the necessary

instruments including a new court system, new legal regimes, the decision to try the arch symbols of terror in ordinary criminal court using traditional legal instruments constitutes a betrayal of that mandate. ..

[applause] >> okay. ladies and gentlemen, a very amazing couple of folks who are going to talk to you next. laura nanning is a managing partner at cantor fitzgerald. on 9/11 she was catastrophically injured in the attacks on the world trade center. and her story has been chronicled around the press around the world including all major publications, and it's the subject of a "new york times" bestseller, "love, greg and lauren" by her husband, greg manning. she was chosen as women of the year for 2002 and selected as one of 15 extraordinary women of

2003 by biography magazine. her husband, greg, has been an editor and executive in the financial information industry and a partner at market data corp. he was director of information sales and marketing at eurobrothers and most recently a partner at cantor fitzgerald. and as i mentioned he wrote the best bestseller "love, greg and lauren" and they have one heck of a story to tell. so let's welcome lauren and greg manning. [applause] >> good afternoon, everyone. and a beautiful one it is. i'm honored to be here to join all of you to oppose the decision to bring khalid sheik mohammed to new york to face civilian trial. i'm here before you because i witnessed my wife's remarkable

battle to survive after she was injured in the 9/11 attacks. between us, we lost hundreds of colleagues but we did not lose each other. for that reason, i've never felt comfortable being referred to as a member of a 9/11 family. i did not lose a loved one. my loved ones are still here. but the decision by attorney general eric holder to bring khalid sheikh mohammed here. it doesn't mean a cliche of bereavement or an inability to get over 9/11 or to move on. or a group of people shouting by a hole nath ground for 364 days or resight thousands of names amid a stony quiet every morning in september. it means knowledge.

it means we know the impact that terrorism can have on a family and the cost of a casual attitude toward our enemies. we know we may forget the terrorists but that they never forget us. we have a visceral and immediate grasp of what it really means to bring a mass murderer to his place of triumph, to grant him the rights of due process that he removed from thousands of his victims. we have a deep sense of his disdain for our legal system and society indeed for human life. we know he will not care whether he is perceived as a cowered as has been predicted or whether he is found guilty. now that he has gained such a spectacular forum. we know the joy he will feel with every hateful word he preaches. governor thomas keane the leader of the 9/11 commission doesn't know how much leeway it will curb mr. mohammed's speech when we say it's rambling but he

calls it part of his defense. we know that governor kaine is right that the governor's decision will gives mr. mohammed what happens and a single piece of information may be spun into a web of violence and slaughter to strike us at any time when we are most vulnerable. we know that this is not an issue of right versus left. republican versus democrat. we know that our anger at mr. holder's decision is not drawn from our mourning the lost but out of concern for the living. we know the time has come for the 9/11 families to deliver a message of commonsense. i worked in the world trade center. once or twice a year there would be a sound so loud and i'm sure it was an explosion and i look out the window to see if the few was changing and the towers were falling to the ground. when the view didn't change, i went back to work.

on the day the view finally disappeared, i was not in my office. i was lucky. the memory of 9/11 is mixed with firemen, policemen, and first responders who rushed into the burning towers to rescue the afflicted who died in action. but to khalid sheikh mohammed it was merely a bonus. his real targets in new york, the people he spent years planning to kill worked on wall street. we didn't wear uniforms unless you call this a uniform. we were office workers like hundreds of millions of americans. khalid sheikh mohammed was aiming at me. he was aiming at my wife. he was aiming at us. we honor all the loss but if we look past the uniforms in the foreground of our collective memory, we see ourselves.

we know that we can never truly move on from 9/11 because we can never afford to be complacent about the real threat of terrorism. we know that deep down despite our heartbreak, 9/11 could have been unimaginably worse. we know that khalid sheikh mohammed's objective was to knock the towers over fully loaded to send tens of thousands to their deaths in an instant and break the will of our nation. we know that if the highjackers had been better pilots, they might have succeeded. we know attempts to kill hundreds or thousands of millions of innocent civilians are not criminal acts but acts of war. [applause] >> they are the definition of crimes against humanity. we know that if the targets are civilians and that can bring you constitutional rights, should

one send an nuclear weapon into a city and kill millions of civilians you shall be ending up with a civilian trial in a criminal court according to mr. holder. but in that event the city will be gone. that is why we know that the attorney general's decision is to be -- is fundamentally wrong. not because it tweaks our group of families. but because it enhances the threat to all families. we know that it is foolish and irresponsible to grant an unrepentant mass murderer the constitutional rights of due process when it will be disrupted against our fight for terror and to probe for intelligence among classified and unclassified information. we know that thousands are already dead because of khalid sheikh mohammed's choices. we do not want to see thousands dead or hundreds of thousands because of the attorney general's choices.

we know that the national security risk is not worth taking when the outcome will have no meaning to the defendant. we know that there is nothing more certain than the guilty plea that khalid sheikh mohammed desired to make before a military tribunal. we know that we should not now be asked to spend millions of dollars to waste millions of dollars to gamble on a guilty verdict just so we can say we did it our way. thank you. [applause] >> usa, usa, usa, usa, usa. >> my name is lauren manning and on september 11, 2001, i entered the lobby of the north tower of the world trade center.

an instant later i was engulfed into a wall of fire and burned over most of my body. from west street i watched the second plane hit the south tower. at that moment it was obvious it was another terrorist attack. i couldn't know then that a single unclassified list of names had been provided to the defense during the trials of the 1993 world trade center bombers. and delivered promptly to obama bin laden that provide a feast of intelligence that did ease the way on the attacks on 11. now, attorney general u.s. -- attorney general eric holder decisions to try khalid shaq mohammed in courts will launch a second round of terrorist trials posing the same security risk as it did eight years ago. i will let others debate the detailed and serious rep cush -p

mr. holder's choice. mr. holder told congress that if mr. mohammed failed to be convicted at trial, that the united states would retain authority to detain him. senator kyl's questions at the hearings made it clear that such an event, mr. mohammed would revert to the status he has today. and we would all be back to square one with our resident enemy combatant. by any definition, other than mr. holder's, this makes the civilian trial a multimillion dollar charade. we should go back to square one today and spare ourselves this experience. [applause] >> it has been just three weeks

since his announcement but we already know what to expect. the men who sent the planes to kill my colleagues and to light the flames that burn me will plead not guilty. and make this trial their public relations exercise in global jihadist recruitment. our attorney general would force us to listen. my message is simple. we refuse to listen. i refuse to listen. [applause] >> we refuse. we refuse to let new york become the leading platform for this terrorist mockery. we refuse to present another intelligence jackpot for our enemies that may cripple the effects of the service men and women on our battlefields around the world.

we refuse because we know that if we falter on the battlefield we will face our enemies again in the streets. experience tell us security risks posed by mr. mohammed's trial are real. we have the case studies to prove it. we are being led back down the path that carried us to 9/11. and the attorney general says, he will take the heat if he is wrong. if the coming trials provoke or facilitate another large scale attack, he will take responsibility. pardon me, i am not willing to risk so much for such small comfort, mr. holder. i did not return from the fires of 9/11 to remain silent as this scenario unfolds.

i am compelled to speak out because of a promise i made. while in a coma for more than a month, when i finally opened my eyes it was not until november 16th, 2001, that i finally learned how many of my colleagues, friends, and friends were killed alongside thousands of others. i said i will avenge them. and because of that vow, i oppose a decision even if it replicates the circumstances that preceded the most terrible attack on our soil in the history of this country. if there is a compelling reason to do so, we should endorse it. but there is no history. there are no case studies again to justify this rationale. we hear only, trust me. the attorney general is creating a historical precedent out of

whole cloth at the clear risk to our city, to our nation. he tell us we should not cower before the enemy. we cower only when we grant our enemy constitutional rights to demonstrate in mr. holder's words. that we will enable every forum possible to hold the terrorists accountable for their actions. mr. holder tell us not to be scared. indeed, it takes a brave person to make a difficult decision. it takes a braver person to recognize and to change a wrong decision before the eyes of the world. mr. holder, you have a choice. we must find the courage. you must find the courage to make the right one before it's too late. thank you. [cheers and applause]

>> can you hear me? >> yes! >> are you angry? >> yes! >> is this a bad decision? >> yes! >> are we going to fight this? >> yes! >> are you going to go to your congressmen and are you going to go to your local offices and are you going to do what you need to do to change this? >> yes! >> my name is edy lutnick i'm part of the kantner relief fund. and the euro broker relief fund. we are the largest group of victims of 9/11. my brother, gary, lost his life that day. the word "lost" is wrong.

658 of our loved ones, that means mothers and fathers and husbands and wives and sisters and brothers and colleagues and friends were murdered. they were murdered by the terrorists, khalid sheikh mohammed, and we do not want him and his fellow terrorists tried in that building. [applause] >> and we are not the only victims. the people who live and work in new york city are victims, too.

the people who live and work in the united states of america are victims, too. and we are tired of being victims. we need to tell eric holder that we will be victims no more. [applause] >> no more! i thank you on behalf of the cantor fitzgerald families and

the euro broker families. we are united with the firefighters and the police officers and the military. [applause] >> anyone who tells you that the civilians are not part of this are not telling you the truth. the 9/11 families stand united against the decision to try these terrorists in new york federal court. [applause] >> you can find a handful of families who disagree but those are not the majority. and last time i looked, this was still a democracy. [applause] >> help us tell our government that the majority rules, and

what the majority wants, is these trials out of new york federal court. go tell your congressmen. go to your local offices. get your friends to do it also and let's change this decision now! [cheers and applause] >> usa. >> all right. ladies and gentlemen, i direct your attention to the jumbo tron. we have a video montage of eric holder. [booing] >> can you give me he a case in the united states history where an enemy combatant caught on a battlefield was tried in civilian court?

>> i don't know. i'd have to look at that. i think that, you know, the determination -- >> we're making history here, mr. attorney general. i'll answer it for you. the answer's no. why would you take him someplace different than ksm? >> well, that might be the case. i don't know. >> does it matter if you use the law enforcement theory or the enemy combatant theory in terms of how the case would be handled? >> well, i mean -- >> if we captured bin laden tomorrow, would he be entitled to miranda warnings at the moment of capture? >> again, i'm not -- that -- all depends. >> well, it does not depend. if you're going to prosecute anybody in civilian court, our law is clear that the moment custodial interrogation occurs, the defendant, the criminal

defendant, is entitled to a lawyer and to be informed of their right to remain silent. the big problem i have is that you're criminalizing the war. that if caught bin laden tomorrow we have mixed theories and we couldn't turn him over to the cia, the fbi or military intelligence for an interrogation on the battlefield because now we're saying that he is subject to criminal court in the united states. and you're confusing the people fighting this war. what would you tell the military commander who captured him? would you tell him you must read him his rights and give him a lawyer? and if you didn't tell him that, would you jeopardize the prosecution in a federal court? >> you have repeatedly said that your decision to try khalid sheikh mohammed in article 3 courts is because that's where you have the best chance to prosecute. that the chances of success are enhanced in article 3 courts and that you have access to all the evidence so you're in a better position to judge than those who

are ignorant of that evidence are. how could you be more likely to get a conviction in federal court when khalid sheikh mohammed has already asked to plead guilty before a military commission and be executed? how could you be more likely to get a conviction in an article 3 court than that? >> senator, you're dealing with -- >> are you concerned that a judge may say you made an election, an election to try these terrorists as a criminal and you're bound by that election and you cannot go back and revert to the laws of war? >> no, i'm not. you perhaps detain somebody but you can detain somebody for lawful reasons. >> so military commissions are a

legitimate way historically that other nations have used as well as the united states to try people who violate the rules of war; is that right? >> that's correct. and when appropriate i will make use of those commissions. >> well, i just want to tell you, i think this is causing quite a bit of concern. i see today that governor thomas kaine of new jersey who chaired the 9/11 commission says he thinks this is a mistake. that it will provide khalid sheikh mohammed the position to be a martyr and a hero among al-qaeda sympathizers around the world. i would note that mary jo white, the new york united states attorney under president clinton say it may take three years to try these cases. the decisions has been strongly criticized by rudy giuliani who was mayor of new york when the

attack occurred as associate attorney general was a federal prosecutor himself and united states attorney in manhattan. i take his views seriously. i served under him when he was a associate attorney general. and he complained former attorney general mukasey has also criticized this decision. i don't think the american people are overreacting. i don't think they're acting fearfully. i think they think that this is war. and the decision you made to try these cases in federal court represents a policy or a political decision. wouldn't you agree? >> no. >> it's a policy decision at least, is it not? >> it was a policy decision -- it was a decision that was case-driven. it was a decision based on the evidence. >> with regard to the specific decision that you made, i noted

that you referred to the cole and another case in which a military person was killed but isn't it true that on 9/11, the united states' pentagon, the center of our defense establishment was directly attacked by the people who had declared war upon us? >> yeah, there's no question that is true. one of the factors -- one of the factors that i considered in making this determination. the number of people who had killed on 9/11 were largely civilians. it was obviously a very grievous and heinous act that occurred at the pentagon. but because of the fact that this was an act that occurred on our shores with the victim population that was largely civilian, among other things including the admissibility, my desire to make sure, to ensure that certain evidence would be admitted, it was my determination that bringing that

case in an article 3 court made the most sense. >> well, sir, the military personnel were killed on 9/11. they attacked our pentagon. and i don't think we should give a preference to military commission trials simply because the enemy attacked civilian people rather than military people. >> all right, folks, i think you get the idea. can you believe that this man is attorney general of the united states of america? god help us! he's still going? oh, i'm sorry. i thought they cut it already. [laughter] >> all right. well, they are cutting it. listen, my next -- our next speaker is a man who is just amazing. he's a former federal prosecutor. he helped prosecute the blind sheik. you read him as a contributing editor with national review online.

he cochairs the senate for law and counterterrorism. a joint project of fdd and the national review institute where he's also a senior fellow. his book "willful blindness: memoir of the jihad" is must-reading. he's my friend. he's brilliant. andy mccarthy. [applause] >> well, we heard the attorney general. does that make sense to everyone now? >> we're back here because he nd we know it's a war. and we're back here in the spot where they declared war against us 16 years ago. and when they declared war with

us, they were using bombs. and we answered with subpoenas. they attacked and we indicted. and we brought them to that building where they could have a jury -- a trial before a jury of their peers. and now they want to give khalid sheikh mohammed a trial before a jury of his peers. when i look out at my fellow new yorkers, i don't see khalid sheikh mohammed's peers. i see khalid sheikh mohammed's enemies. [applause] >> we're here 'cause we don't want to go back to september 10th. and no one should dare tell new yorkers that we're here because we're afraid of khalid sheikh

mohammed. there are people up here who before 9/11 were facing down terrorists when the people who were running this government now were porting terrorists. there were people here after 9/11 were fighting terrorists. while the people who were running this government were at guantanamo bay representing terrorists. we're not here out of fear. we're here because we want justice. we want the rule of law. the attorney general talks about the rule of law, but he doesn't seem to understand what the rule of law has always been in wartime. in wartime, the rule of law for terrorists and for enemies is

war crimes trials before military commissions. it is not to wrapñ@ our enemien our bill of rights. it's not to bring them to the majesty of the federal courthouse and clothe them in all the rights of the americans that they're sworn to kill. the rule of law for wartime enemies has been military commissions since the beginning of this country. it was the right thing for george washington. it was the right thing for andrew jackson. it was the right thing for abraham lincoln. it was the right thing for franklin delano he roosevelt. -- franklin delano roosevelt. it's the right thing. it's always been the right thing. a war is a war. a war is not a crime. and you don't bring your enemies to a courthouse. [applause] >> come away from this with one thing today.

the people who made this decision are not your rulers. the people who made this decision are your representatives. the justice department isn't eric holder's. the american government isn't barack obama's. the government and that courthouse belong to you. [cheers and applause] >> this decision doesn't have to stand. but we'll have to be strong to change it. and that means we have to light a fire under congress 'cause guess what? they work for you, too. congress is the master of the jurisdiction of the federal courts. if they don't want this trial to happen, if they vote against this trial happening, it can happen. but they won't change unless they hear you. are they going to hear you? thank you so much for coming out under these conditions. it's an honor to be here with

you. and let's get this changed. [applause] >> thank you, andy. ladies and gentlemen, curtis slewah. [applause] >> first off, let me just extend my brother in solidarity steve malzberg who has been with us in many campaigns before. let's give a great round of applause. [applause] >> to beth, my sister in solidarity who has been pounding the pavement for years seeking justice against our enemies. those who have tried to destroy our freedoms and our democracy. and to many of you who have joined us side-by-side and rubbed shoulders before, but can there be any more of an outrage?

than what we saw the son of new york city, eric holder, born in southeast queens, too, a double disgrace by bringing these terrorists to new york city to add insult to injury. to those who have suffered before. the losses of loved ones. to give them a bully pulpit. to give them a forum. but let us first honor those brave men and women in far off afghanistan and iraq. who are pouring hot lead into the valleys of death because these jihadists, they don't worship a religion. they worship the cult of death. and if it's death they want, then death we should give them. let them go straight to hell without an asbestos suit. [cheers and applause] >> usa!

usa! >> to those men and women, those cia operatives in pakistan and other countries, oftentimes anonymous, killed if action, never to be recognized, we universally salute them as they follow the enemies until the end of time. until every last one is killed and extinguished. and, ladies and gentlemen, as we see onwzu al-jazeera, if they w to jump on the paradise express and go right on up to allah's side, let's speed up the process. [cheers and applause]

>> and to the brave men and women of the e)nypd, the fdny,e court officers, the federal marshals, the fbi agents, all those who will be charged with our public safety when these monsters of mayhem are brought here, they are going to have to continue to risk their lives. the national guardsmen. we honor their service to america and to our great city of new york because they are the ones who will have to keep us safe and sound. [applause] >> let me tell you about this criminal justice system. as many of you know, i've had to sit through four trials against john gott tgotti, jr. who tried

take my life on two separate occasions. two times on hungized. -- hung juries. how are opportunity to report each and every day what goes on in that courtroom.

u.s. attorneys saying what a great career opportunity to prosecute khalid the shamuck mohammed. this is not about career opportunities. this is about freedom, justice, the american way. khalid sheikh mohammed wanted to come off that plane and have a press conference after reigning death and destruction. remember, his nephew was the bad seed. ramsey josef who started it in 1993 with the first attack. the dna is poisoned down to the marrow of their bone. i ask all of you in honor of all

those brave men and women who perished, the 9/11 victims, their families, our sons and daughters who will have to continue to battle al-qaeda and osama bin laden. let's say to eric holder, and to barack obama, our president, we want justice. we want penalties. we want them to know the wrath of america. [cheers and applause] >> and in every madras around the world that produced the ramzi ousefs and the khalid

sheikh mohammed and let them know that until the day we die, we will trail them until the ends of time. [cheers and applause] >> and finally, when khalid the schmuck mohammed and his jihadists who have vowed to kill every american, every jew, and every one of our freedom-fighters -- when they go before the judge and let us hope the wheel of fortune directs towards a judge who is law and order, not a friend of terrorists -- that when they go for their sentencing and they ask for death, that we put them all on the paradise express and

send them right up to allah's side. god bless all of you. >> all right. ladies and gentlemen, i want to introduce four of eight dads that make up what has become known as the band of dads. each one lost a firefighter, son on 9/11. each one a firefighter themselves or a former firefighter came to 9/11 and stayed there and helped and served for weeks and months after the terrorists attack. i want to welcome lee and terry mullen also here. dennis o'berg, george reilly and jack lynch. >> thank you.

listen, i was asked to come up here and just say a few words about what this group of dads did at the site. i guess it's a powerful story. when i got there, i met a lot of fathers and sons looking for their dads or for their sons and i met a lot of police officers that were looking for their sons. i met a lot of port authority police officers that were looking for their sons and relatives. so a small group of us stayed together and we worked together. some of us are on the stage. some of us are out in the audience. our mission, of course, was what? our mission was to look for the folks that were lost here at this site on 9/11. and the process went on for many months. we stayed together as a group of dads. we became, you know, an

inspiration, i'm going to say, because it was a very difficult place to work. you can imagine what it was like. but the men and women that we can never say thank you to in enough ways would look at this and say, they have a mission here so we should stay with them, band together and we're going to work as hard as we can. so that's how we work together. that's how we stayed together for nine months in recovery work. i've said it before, that i was blessed to be able to bring home my son. some of the dads that are here today, to this day, have not been that fortunate. but we have to keep a clear message here. the easiest thing for me, some of the other folks that worked

at the site, the dads here on this stage, you out there that lost loved ones, the easiest thing to say is hate. we can't say hate. we have to stay positive. if we say hate, then we lower ourselves to the standards of the people that did this to us. and i'm not about to do that. so why am i up here now? i'm up here because on september 11 war was declared on united states of america. war was declared on all free world countries. in that process of war, we sent our troops off to fight it. and we lost a lot of beautiful young men and women in fighting this war. and many, many more have been wounded. but in this process of fighting this war, our military and some of our agencies captured who? they captured terrorists. they captured combatants that are at war against us.

my feeling, they deserve a fair trial in a military tribunal. [applause] >> not on our soil. guantanamo is where it should be. that simple. nothing more. nothing less. thank you. [cheers and applause] ♪ >> all right. ladies and gentlemen, when i say let's roll, you know what i'm referring to. the heroic efforts of flight 93,

which was, of course, crashed in pennsylvania thanks to the brave heroic efforts of the passengers led by one todd beamer. let me introduce to you right now todd's dad, david beamer. [applause] >> good afternoon, everyone. i am very, very thankful to be an american and to have the freedoms of assembly and speech here today. the brief remarks i have are primarily directed to our president. mr. president, it is one thing to break a campaign promise. but quite another to break the solemn vow that you made in your oath of office. you pledged to preserve, protect, and defend the constitution of these united states.

this trial decision is wrong. and if you allow it to proceed, you will be breaking your sacred oath. it will be -- it will be a second attack on new york city in america. it will be september 11 the sequel. mr. president, do not be a party to september 11 the sequel. right this wrong. stop this attack. mr. president, do not convey constitutional rights to the enemy. right this wrong. stop this attack. mr. president, do not erect barriers to victory on the battlefield still raging. right this wrong. stop this attack.

mr. president, do not risk our security, our intelligence, our safety. right this wrong. stop this attack. mr. president, do not make show the world a priority. right this wrong. stop this attack. mr. president, do not put americans in harm's way. right this wrong. stop this attack. mr. president, do not provide ammunition for our enemies' propaganda machine. right this wrong. stop this attack. mr. president, do not revisit pain, suffering, economic harm on new york and on america. right this wrong. stop this attack.

>> mr. president, do not allow the enemy to step foot in america. right this wrong. stop this attack. >> mr. president, do not violate your sacred oath. right this wrong. stop this attack. >> mr. president, i would have given my life to prevent september 11, 2001. i merely ask you to exercise leadership. right this wrong. stop this attack. commander in chief, sir, once upon a time, a young man issued a call to action to do the right thing. to fight back when he said let's roll. the people on flight 93 did just that, successfully.

commander in chief, sir, on this day, his old man is calling you to action. stand up, commander. issue a command. do the right thing. reverse this attack. right this wrong. stop this attack. one other thing, mr. president, our attorney general -- our attorney general has demonstrated that any confidence placed in him is misplaced. he needs to be removed. [applause] >> mr. president, mr. president,

holder must go. [applause] >> commander in chief -- >> go, go, go. >> holder must go, holder must go, holder must go. holder must go he. >> commander in chief, commander in chief, two commands, stop this attack, fire eric holder. [applause] >> ladies and gentlemen, all decent americans agree with us and all decent muslims agree with us. we have many, many many muslim supporters.

i want to introduce to you dr. mjasser. he is chairman of the board, founding member and president of the american islamic forum for democracy. and you may have seen him featured in a film that first pbs wouldn't broadcast, islam versus islamists. [applause] >> thank you. i stand before you today a father, a husband, a doctor, a soldier. i served 11 years in the navy, proudly, on navy scholarship. and i stand before you also as a devout muslim. but most importantly i stand before you as an american. [applause] >> while i do not have a name of a personal family member that lost their lives and gave the ultimate sacrifice on 9/11, or

on 11/5 at the massacre by mr. hasan at fort hood i share keep kinship especially the last 13. they attack our nation and they attack the very ideals of who we are as a country of liberty. these barbarians seek to destroy our country that my family came from syria to seek the freedom that their country of so-called muslim lands would not give them. like all americans on 9/11, my heart sank for the loss of our countrymen. the men and women that gave my family the god-given rights to practice their faith freely here like no so-called muslim nation would let them do. each time i've learned that it was at the hands of muslims that this was done, i felt a greater responsibility to act. because only muslims can defeat this threat.

and i promise you -- i promise you most american muslims despite our relative silence do feel deeply the burden to claim back our faith from these extremists political and theological ideology, radical islamism. the followers of radical islamism are at war with this country's ideals and they're at war with the very concept that defined me as an american and as a muslim. this war has its kinetic elements and mr. khalid sheikh mohammed is the tip of the iceberg of what we're fighting. the enemy, though, is not terror. that is a tack particular. -- tactic. the enemy, the core of this conflict is a struggle between liberty and theocracy. between freedom and supremacy

and between democracy and fascism. i'm here to tell you as a devotional muslim, that while my family escaped much of this conflict in the '60s and they left the oppress syrian government, it's clear that they followed us to the united states. and we have dedicated our lives to fight this conflict. our leaders in washington need to stop being naive. these are not run-of-the-mill criminals or just terrorists. they are enemy combatants and they are hatched by an enemy ideology. my enemy, our enemy as an american is skm. -- ksm, my enemy is al-qaeda, hamas, hezbollah. my enemy is the taliban and the monarchs and the wahhabis of saudi arabia and the brotherhood.

and the islamist kin. i had the honor to serve in the u.s. navy for 11 years after a blessed military scholarship. and in that whole time i never once felt hyphenated or labeled. i served pure and simply as an american. let us not give this platform here to al-qaeda and khalid sheikh mohammed. let us not give them this platform. we formed our american islamic forum for democracy to build a future of our faith that's not in conflict with liberty, democracy, and the separation of mosque and state. political islam is a clear and present danger not only to americans but to muslims and the free practice of islam. after the fort hood massacre, despite what was presented as the overwhelming concern of harassment and other things, most american muslims actually asked not what was about going to happen to us but how we could

help prevent the next attack and that's what we're dedicated to. it's time for congress to formally declare war on radical islamism. and it's time to declare a war on al-qaeda and all of its breathren. we ask for justice, military justice and let me be the first to say that i hope that ksm and mr. hasan and other radical islamists reach the ultimate punishment, which is the jip. -- death penalty. i ask you after this rally to call, to write, to protest to engage your communities, engage your muslim and interfaith communities to speak out against political islam as the source of this radicalism and speak out against shari'a law and other types of legalities that are actually at the core of what divides liberty from theocracy. it's time for muslims to shed denial.

lastly, let me assure you, just as you see my fathers as a father, a husband, and a citizen, as an american muslim know that there are thousands upon thousands of other american muslims who come out of the same fold that i came out of. we need your help. kiconnect us together. -- connect us together. there are also many muslims who are ready to take on the challenge for a civil war of ideas within the faith. thank you for including our voices. god bless you. god bless america. we will never forget 9/11. [applause] >> what new >> the u.s. senate begins its second week of debate today on

healthcare legislation. this would be the eighth day. lawmakers will begin by considering two amendments. one by new hampshire republican and budget committee ranking member jed gregg that bars rate increases for anything other than medicare and another amendment by arkansas democrat mark pryor requiring health and human services to see how they like it. votes on those amendments will take place after 3:15 eastern today and so far all amendments have required 60 votes to pass. later today, an amendment dealing with abortion coverage in the bill. and now live coverage of the u.s. senate. the time of storm, thank you for the opportunity to serve you and our country. remind us that you are more interested in our faithfulness than our success.

today, empower our lawmakers to be faithful in the small things, thereby qualifying themselves for greater opportunities to serve. make them worthy stewards of the rich resources you have given our nation, as they remember the rich legacy of labor that punctuates our history. guide their thinking so that they will see your plan and follow your leading. and, lord rs on this anniversary of the attack on pearl harbor, we think of all the veterans of past wars, those currently in

harm's way, and all who have served in our nation's military. thank you for their sacrifices and for the faithfulness of their loved ones. we pray in your powerful 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 7, 2009. to the senate: under the provisions of rule 1,

paragraph 3, of the standing rules of the senate, i hereby appoint the honorable kay hagan, a senator from the state of north carolina, to perform the duties of the chair. signed: robert c. byrd, president pro tempore. mr. reid: madam president? the presiding officer: the majority leader. mr. reid: following leader remarks, the senate will resume consideration of the health care legislation. following those remarks, the first two hours will be for debate only, with senators permitted to speak for up to 10 minutes each. the republicans will control the first 30 minutes, and the majority will control the next 30 minutes. the remaining hour will be equally divided and controlled between the two leaders or their designees. the pryor amendment regarding enrollee satisfaction in the gregg amendment regarding medicare are pending, in addition i've been informed by senator ben nelson that he will offer sometime today the abortion amendment, either as the leader sponsor or as a

cosponsor. these amendments we hope to complete this afternoon sometime and move on to other mea matter. f i should inform members we won't be in late tonight. there is an event at the white house that representatives will be attending. so we won't -- we aren't going to be late tonight but the rest of the week we probably will be. and as i indicated, mr. president, it appears that we certainly will have to be in this weekend again. i think everyone would acknowledge the historic time legislatively that we're now involved. we've tried to get to this point with health care legislation for almost 70 years and we're there. we can see the light at the end of the tunnel. so that people in the future, madam president, will not have to file bankruptcy because they get sick. and that's what's happened today.

750,000 people filed bankruptcy last year, as i've said here on a number of occasions, almost 70% of them who file bankruptcy did so because of medical expenses. and 62% of those that filed because of medical expenses had insurance. that pretty well says it all. there is not one of us that's gone home in recent months who hasn't had someone come to us at a grocery store or some other public event and public told, you know, my daughter has diabetes. she is you a now 23 years old. she goes off our insurance. what are we going to do? she can't get any insurance. that's going to stop. there's nothing the people of america want more than for us to do something about this. they want us to stop greedy insurance companies from denying health care to the sick and taking away your coverage at the exact time you need it the most. they want us to make it illegal

for these multibillion-dollar companies to say, i'm sorry, your high cholesterol is ghg to prevent us from giving you -- is going to prevent us from giving you an insurance policy. or, you were in an accident and badly injured your leg a few years ago. we can't give you insurance now. or, you're too old or you have hay favor, or you have asthma. we've all heard the stories. so these insurance companies say you're on your own. why? because they're concerned more about their bottom line than they are taking care of the american people. i was here a couple days ago talking about a company that made more than -- an insurance company more than $1 billion in profits last year, their executive executivchiefexecutiv0

million take-home pay. but they're still out denying coverage to anybody. these companies are not good for the american people. so what we want to do, madam president, is to make sure that people who get sick can get the tests they need to make sure these diseases don't stamplet there was an interesting piece, sad though it was, on public radio this morning. african-american women get breast cancer at a much earlier age and it is a much - more difficult type of breast cancer. that's why what senator mikulski does was owe importan so import. women can get a test to find out -- a mammogram, to find out if you have breast. so they need these tests. and we need to make sure that women want to be able to get pap

smears when they need them and the other things that are so important. men need to be able to be checked for prostate cancer, which is certainly something that has now become something that's fixed on men's minds. seniors want to be able to afford their prescription drugs, want to know their medicare benefits will be protected. those who do have it will keep pay extra for those who don't. they want us to cut the waste and fraughted out of the health care system so that everyone can save some money. they want us to make sure that they can choose their own doctors, hospitals, and the health plan that's right for them. they want us to guarantee them that they will be able to afford health care, even if they lose or change jobs. that's why we've i think weren a good billings one that will make it possible for every single american to stay in the condition known as health. it is a bill that will make health care more affordable and

health insurance companies. our colleagues in the senate want nothing more than failure. they want us to do nothing. that's why the republicans have found add familiar cry. slow down. stop everything. start over. we've seen it again and again. they like to pretend america's health care crisis isn't the problem. it can have some minor tweaks here and there and everything will be fine. they choose to ignore the fact that unchecked insurance companies, unchecked company policies that these insurance companies give out are forcing people to lose their homes, file for bankruptcy and even die. it amazes me that the republican leader rejects the suggestion that what we're doing is truly historic. in fact, the day before yesterday he said it's an act of total arrogance. that's a direct quote.

i'm confident, madam president, history, ironically enough, will prove the republican leader wrong. this indeed historic, as i started my conversation with you today. i am a not afraid to say this. instead of joining us on the right side of history, all republicans have come up with is this: slow down, stop everything, let's start over. you think you've heard these same excuses before, you're right. in this country, there were those who dug in their heels and said, slow down, it's too early. let's wait. things aren't bad enough about slavery. when women wants to vote, slow down, there will be a better day to do that. the day isn't quite right whvment this body was on the verge of guaranteeing equal civil rights to everyone, regardless of the color of their skin, some senators resorted to

the same filibuster threats that we hear today. more recently, when chairman chris dodd of connecticut, one of the people who will go down as a chief champion of the bill today, said that americans should be able to take care of their families without losing their jobs, you heard the same old excuses. seven years of fighting and more than one presidential veto, it was slow down, stop everything, start over. history is repeating itself before our eyes. there are now those who don't think it is the right time to reform health care. if not now, when, madam president? a reality for many that feel that way, it will never, never be a good time to reform health care. i know this country has never had a place for those who vote for failure, so here's who i would rather listen to: the men and women in nevada who write me every day, hard-working people, lots of different letters, really sad letters,

people who play by the rules and don't understand why their health insurance system doesn't do the same. they write from the heart and here are a couple stories they talk about. a woman named lisa lives in gardnerville, nevada, a great place near the se sierra nevada mountain tainls. she lives with her two daughters, both in elementary school. the youngest suffers see diseurs. the teachers think she has a learning disability. because of her family history, lisa's mom is at a high risk for serving cal cancer. though she is supposed to get an exam every three months, now she is not able to get one at all. when lisa lost their job, she lost her health coverage. now both lisa and her daughter miss out on the tests for preventive medicine that should keep them healthy. her letter ended with a simple plea. it wasn't slow down, stop everything, start over. it was, we want to go to the doctor. that's a quote.

"we want to go to the doctor." another person named brayden lives in sparks, nevada. sparks and reno are side by side. brayden works a 5-hou 5-hour weo support his family. just barely pays the bills. he had to go to the emergency room. $12,000. it's the only place he could go. he is a brave man, though, in his letter he doesn't dread the debt he carries. he is going to pay it. he has one fear. it is not that the senate is doing its job. his fear is -- quote -- ," "if i was seriously sick or jrksd i'd lose it all." end of quote. that's the way many americans feel. one more, michelle, a 60-year-old woman from fallon, nevada, about 60 miles southeast

of reno. "like so many in my state," she's moved to nevada in the last ten yearsment, like so many, she's self-employed. she has two choices, one is a company that won't give her a policy because she takes three prescription medications. the insurance company only allows to you have two. so, michelle is stuck buying insurance from the other company. the only one who will sherl a plan. when michelle moved to nevada a few years ago, she picked the cheapest plan. now -- now -- within these three years, her plan now costs three times as much. three times as much. that doesn't include dental, vision insurance. it's very minimal, bare-bones policy. she is waiting. not waiting for us to scrap everything and start over. no, she wrote that -- quote -- "she's waiting to be old enough for medicare before the surgery

my doctor says i need. i know with my current policy it costs more than i could i can afford. these are real stories about real people. brayden, michelle, and lisa. they aren't written with a political objective in mind. i don't know whether they're democrats or republicans or independents. far as any partisan view. they're written by people who know that insurance companies discriminate against their policyholders, and it's not based, i repeat, on party affiliation. it is written by critics who know this crisis is too big to ignore. it is written by americans who want to be able to live a healthy life without going broke. my colleagues on the other side want us to slow down, stop everything, and stop over. as the course of our country goes in different directions, there is only one direction: we move forward. we make progress, and when

history calls on its leaders to make life better for its citizens, we answer. we act, and we're going to act. the presiding officer: under the previous order, leadership time is reserved. under the previous order, the senate will r-plgs of h.r. -- resume consideration of h.r. 3590. the clerk will report. the clerk: 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. the presiding officer: under the previous order there will be two hours of controlled debate equally divided and controlled with the republicans controlling the first 30 minutes and the majority controlling the second 30 minutes. mr. alexander: under the republican time, senator wyoming, senator barrasso, will lead a colloquy and ask for

permission to do that concerning senator gregg's amendment which we'll be talking about this afternoon making clear to the american people that this democratic health care bill is being paid for by waiting -- by treating medicare as a piggy bank. but before we do that, i wanted to say briefly something in response to the majority leader's comments. he -- the majority leader said that the republican leader had said that the democratic health care bill is arrogant. it is historic in its arrogance. it is arrogant to think that we are wise enough -- we 100 senators are wise enough in a 2,000-page bill to completely turn upside down and change a comprehensive health care system that affects nearly 300 million americans, 16% or 17% of our economy, all at once. it is arrogant for us to imagine that the american people aren't

wise enough to see through the proposals in this bill, which are to transfer millions more americans into a medicaid program for low-income people that none of us would want our families or members a part of. it is arrogant to send a significant bill, for much that have to state governments. we make the decision, we send them the bill and do that in a way that in my state at least will cause devastating cuts in higher education or huge tax increases. it is arrogant to say to the american people that it is an $800 billion bill, when as the senator from new hampshire has pointed out, when it's fully implemented, it's a $2.5 trillion bill, half paid for by medicare cuts. it is arrogant to say that we have balanced our budget when in fact, when in fact we leave outside the budget what it costs

to pay doctors to work in the government-run programs that we have today. so, madam president, this legislation is historic. it's historic in its arrogance. and the american people will see through it and will expect us to instead identify a clear goal. that's the republican proposal, which is to reduce costs and go step by step in direction toward those goals, whether we're allowing small businesses to put together their plans so that they can serve more people at a lower cost, whether it's allowing competition to across state lines, whether it's reducing junk lawsuits against doctors. we've made all of these proposals. we're ready not to roll a wheelbarrow of our own in here with a comprehensive proposal, but day after day we said instead of increasing costs, raising taxes, allowing premiums to go up and shifting costs to

states and dumping low-income americans into medicaid, let's reduce costs, and we have a plan to do that. now, madam president, i'd like to recognize the senator from wyoming so that we can have a discussion about senator gregg's amendment. mr. barrasso: madam president, i ask unanimous consent to engage in a colloquy with my colleagues and discuss the issue at hand. the presiding officer: without objection. mr. barrasso: thank you very much, madam president. and i've been looking at this bill which to me is going to hurt the health care system of our country. i'm a physician, took care of families in wyoming for 25 years. i think if we really want to get costs under control, really want to help families across america who are struggling with their health care needs that we focus on an amendment before us today brought forward by the senator from new hampshire. i would ask my friend and colleague from new hampshire, is it not true that the numbers that we're looking at are just underreported, that it's going to be much more expensive and the cuts are going to come from

our seniors, those who are vulnerable, those who depend on medicare for their health care, and that we need to make sure and promise the american people that we will be protecting those folks who depend on medicare for their health care? mr. gregg: the senator from wyoming is always first as a doctor and second as a senator, raises a very important point. and that is that this is the largest expansion in government in the history of the government. let's begin right there. $2.5 trillion the size of the government, massive growth in the size of government. most that have growth comes from the expansion of government in two areas: the expansion and creation of a brand-new entitlement and the expansion and creation -- and the expansion of medicaid as was alluded to by the senator from tennessee. how's that paid for? how's this huge explosion in the size of government paid for? well, a large part of that is paid for by reducing the a.

money in medicare -- by rue duesing the amount of money in medicare, that's paid to medicare, paid to medicare providers and is available to medicare recipients. $460 billion in the first ten years, $1 trillion in the second -- in the ten years when the program is fully implemented. that would start in about five years. and then $3 trillion by our estimates, which are linear -- and i suspect it will be more -- over the first 20 years of this bill. $3 trillion reduction in medicare benefits. now, we've heard arguments from the other side of the aisle, that's not going to affect benefits. well, you know, that's not believable. we know that. you can't reduce medicare provider payments and you can't

cut medicare advantage, total cuts of both combined by $460 billion in the first five years, $1 trillion in the first year -- first ten years of full implementation and $3 trillion over 20 years and not affect benefits. this is money that is going to have the most significant impact we have ever had occur on our seniors and their medicare system. i mean, this is a fundamental change in the way medicare services are paid for and in the insurance that is available to seniors under medicare, specifically medicare advantage. we know for a fact that of the 11 million people on medicare advantage, approximately a fourth of them will lose it, simply lose their medicare advantage. we also know that hospital groups, provider groups, doctors are all going to see significant reductions in their reimbursement rates which means,

of course, that they're going to change the way in which they treat seniors. seniors are going to find it harder to find a doctor. they're going to find it harder to get a procedure they need, because the reimbursement rate for those procedures is going to have been cut so significantly under this bill. home health care will be dramatically impacted. in fact, the senator from wyoming had a very interesting letter from his home health care groups in wyoming which related what percentage of home health care agencies would actually close. it was a very high percentage under this proposal. now, there's no question but that medicare is in dire straits. it is headed towards insolvency. it goes into a negative cash flow in two years, and it has $35 trillion of obligations which we have no idea how w*er going to pay for them -- how we're going to pay for them.

and so medicare reform is important and i've supported it, proposed it here. in fact, i've proposed it a number of times and it's always been voted against by those on the other side of the aisle. but any reform to medicare of this size -- $464 billion in the first ten years, $1 trillion in the first ten years of full implementation, $3 trillion over 20 years -- anything that is going to cut medicare by those numbers, those savings, if they're going to occur, those reductions should go to benefit making medicare more solvent. what happens under this bill? that's not what they're used for. those dollars which come right out of the pocket of seniors and the people who provide seniors care and the ability of seniors to purchase insurance under medicare advantage, those dollars go from the senior over to creating this new, these new

major programs, these new entitlements. in fact, i was looking at the bill. it appears to me that some of those dollars go to get votes around here. isn't that incredible? they're going to take money away from seniors and use it for the purpose of getting votes to pass this bill by sending money back to states of members who may be a little waivery or whether they want to vote for this bill. that's where some of the money goes to. but most of the money goes to creating these new entitlements for people who may be deserving -- probably r deserving -- but who are not seniors and who probably have not paid into the insurance fund that seniors have paid into for all their lives. and that is just totally inappropriate to do that. and so i have an amendment that's very simple. it is an amendment that has real teeth. it is an amendment that follows up on a number of statements from the other side of the aisle, which says simply no

medicare money can be used to fund other parts of this bill. to the extent medicare savings occur under this bill as a result of cuts to home health care, cuts to medicare advantage, cuts to provider groups, those dollars will not be taken and used to fund new entitlements for people who are not on kphaeurbgs not seniors -- not on medicare, not seniors. they will not be taken to fund the purchase of votes around here to pass this bill. this is a real amendment. a lot of stuff has been happened around here that have been sense of the senates, where people stand up and say, "oh, i'm for that," exactly what i just said. let's do a sense of the senate to that effect. sense of the senates have no impact at all. they're just political cover. this is not political cover. this amendment as structured will actually accomplish the goal of not allowing medicare

dollars, cuts in medicare that's more than $60 billion over the first ten years, $1 trillion over the fully implemented period and $3 trillion over the 20-year period, will not allow any of those dollars to be used to fund new programs in this bill which do not benefit seniors. and so that's all it says. it seems to me that if you're going to stand up for responsible action in the area of medicare, if you're going to live by the sense of the senates that have been voted here, you're going to stand behind your word as the sense of the senates have called for that medicare money be used for medicare and that medicare money not be used to fund extraneous, things that are extraneous to medicare, medicare cuts, savings, then you've got to vote for this amendment. a senator: would the senator yield for a question? mr. gregg: i'd be happy to

yield. mr. thune: it strikes me that the senator's amendment is very straightforward, very simple and very clear. and that is that any savings that come out of the medicare program cannot be used to fund a new entitlement program. in other words, -- mr. gregg: that's not prelateed to seniors. mr. thune: correct. and to me it seems at least that your amendment gets at what some on the other side have argued through their amendments they are trying to accomplish. could the senator from new hampshire describe how the effect, the legal effect of his amendment differs from, say, for example, the votes that we've had where it was a 100-0 vote the other day on a bennett amendment, what the impact of the senator from new hampshire's amendment would be relative to the previous votes we've had which appear to me at least were completely meaningless, sort of cover votes to try to give people on the other side the opportunity to say we voted to protect medicare when in fact they didn't.

how does the senator from new hampshire's amendment, how would you distinguish your amendment from those that have been voted on previously? mr. gregg: my amendments have force of law behind it. those amendments had no force of law behind them. they had no effect at all. they were, as you said, a political statement, an editorial comment, a piece of paper written. this amendment, if passed, will have the force of law behind it and will, very simply, instruct you in a way that the money cannot be taken out of medicare if it's going to be used for the purposes of funding the new programs in this bill, whether they be entitlements for people who are not seniors, this expansion of entitlements, or whether they're for the purpose of getting votes to pass the bill. mr. thune: so if a senator on either side of the aisle, a republican on this side, or a democrat, was serious about protecting medicare and ensuring that medicare's solvency is protected in this debate and that these funds are not going to be reallocated to create some new entitlement program or spend money on some new, clearly, $2.5

trillion expansion of government, which we know is going to require enormous amounts of revenue, which seems to me h's t has to come from somewhere, what the senator's amendment would systemly say -- and sphors the other side to really -- and force the other side to really put up or shut up with regard to this argument that they have that they are in fact supporting medicare, the senator's amendment would essentially say very clearly, very -- in a very straightforward way -- that funds that come in out of savings in medicare have to be retained in the medicare account? mr. gregg: that's correct. this is the first and only vote that members on this floor are going to have to make it clear that medicare dollars will not be used for something other than medicare. mr. chambliss: would the senator yield for an additional question? the language in the bennet amendment that passed 100-0 the other day said that medicare

savings should benefit the medicare program and medicare beneficiaries. that sounds pretty straightforward and pretty simple. mr. gregg: anybody who voted for that amendment would want to vote for my amendment. mr. chambliss: is there anything in the bennet amendment that removes the expenditure of almost $500 billion from medicare in the base reid bill that would require the restoration of those cuts to benefit medicare versus using it as a fund to pay for the underlying reid bill? mr. gregg: well, the senator has made an excellent point, that -- is essentially mak makig the point that the bennet amendment has no teeth, has no substantive effect. it is just a statement of purpose. and if the statement of purpose is, as just recited by the senator from georgia, then you'd need to vote for this bill, for my amendment, if you voted for the bennet amendment, because my

amendment has the teeth that bong-- thatbacks up the bennet . mr. chambliss: you're requiring the office of management and budget as well as c.m.s. to certify to congress basically that the savings that are referred to in the bennet bill as well as in your bill are in fact be used to fund medicare benefits versus being used to fund other benefits outside of medicare until such time as medicare is fully funded? mr. gregg: that's essentially what it says. it says that c.m.s. and o.m.b. must certify that no funds are being used to fund the additional activity in this bill that does not relate to medicare with medicare funds. it does not say that medicare savings -- it agrees to the medicare savings. those medicare savings would be used for the purpose of reducing the out year fiscal imbalance of medicare.

so it doesn't contest the medicare savings as proposed in this bill, although those amendments -- we've already voted on a number of those. we voted on home health care, swreeted on medicare advantage. but to the extent those savings go in, these cuts in medicare benefits go in, they cannot -- the revenues from those cuts cannot be used instead to expand the size of government someplace else that has nothing to do with senior citizens. mr. barrasso: well, if i could ask my colleague, as i read "the new york times," it said the bennet amendment was completely meaningless. the bennet amendment was meaningless and it also goes on to say that senator mccain is trying to keep that $500 billion in medicare, but the democrats are trying to take that money out of medicare and, as the article says here, to -- the editorial says, "to finance coverage for uninsured americans" but not people on medicare. so it does seem that "the new york times" at least in this segment got it right, that the

bennet amendment that our colleague referred to is meaningless that the cuts are going to come out of people who depend upon medicare for their health care to pay for a whole new government program, and not to focus on medicare. well, shouldn't -- we don't we owe it to these seniors who have paid into the program, who have been promised the program to save that program first? mr. gregg: the senator from wyoming is absolutely right. i think "the new york times" got it right. it is a convergence of two unique forces of nature that the republican minority here in the senate and "the new york times" should be on the exact same page on this issue and both be right. mr. alexander: i wonder if the senator from new hampshire would characterize this discussion this way: in order to -- as i'm hearing it, in order to protect medica medicare, the senator wouldn't want to say, i voted for the bennet amendment and then i voted against the gregg amendment when it really

counted? mr. gregg: it would be virtually impossible to make that argument with a straight face -- i think. mr. barrasso: i had a question for my senate colleague from south dakota who is here. we heard the majority leader, senator reid, come to the floor just a few minutes ago, and talk about how this bill was going to get premiums under control, keep the cost of people who have insurance -- keep their premiums under control. now, i saw a chart from the senator from south dakota yesterday that said, for 90% of americans, those who have insurance now, that if we did nothing and did not pass this bill, that the premiums would be lower than if we do pass this bill. that passing this bill is actually going to raise premiums in spite of the fact that the president of the united states promised while campaigning that he would lower the cost of premiums for american families by $2,500. so i would ask my colleague from south dakota, isn't it true that if this bill passes, americans

wanting shall feeling they've been promised that premiums would be reduced, aren't they deemed to disappointment in. mr. thune: well, the senator from wyoming is correct. and i -- this is where the real rub in this bill comes into play, because what we were told and the promises that were made -- of course many promises were made throughout the course of the campaign, most of which will never be realized with this legislation. there was also a promise made that taxes wouldn't go up for people making less than $250,000 a year. not payroll taxes, not income taxes, not any kind of taxes. and in fact we now know that 38% of the people who make under $200,000 a year are going to see their taxes go up under this legislation. so promises are, you know, made during a campaign season, tend not to necessarily be adhered to when it comes time to legislate and to actually make -- to follow through. i think that's clearly the case heemplet but with regard to the senator from wyoming's question, the whole purpose of health care

reform, at least as i understand it -- and i think for the most part the people of south dakota tndz -- is to lower cost. people complain -- if you go back to georgia, wyoming, new hampshire, people say, do something about the cost of health care. we have these year year double-digit increases. we're dealing with this. small businesses are dealing with t more and more people, families are struggling with the high cost of health care. nobody argues that. not -- obviously we all i think basically accept the premise that health care costs have been going up and that health care reform ought to be focused directly on trying to get those costs under control. the irony in all of this is that after cutting half a trillion dollars in medicare in the first ten years -- and if you go under the fully implemented time period it is about $1 trillion, and half a trillion in tax increases -- what happens with premiums? well, according to the congressional budget office, 90%

of americans would be the same or worse off. in other words, 90% of americans would see no improvement in their health insurance premiums. if you buy in the small group market, if you buy in the large group market, your premiums go up by about 6% a year, year after year. a family of four -- let put it in per sphisk than an american family can understand f you are a family of four, according to the c.b.o., if you are a family of four paying $13,900 for insurance this year and you're getting your insurance in the larger market because you wok for a large employer, in 2016 your insurance costs are going to be over $20,000 a year. in other words, your insurance is going to go frup -- just about -- a little under $14,000 to over $20,000 in that time period. so what american in their right mind is going to say, that's reform? i think most americans are going to say, what are you doing? you're spending $2.5 trillion. you are raising my taxes and

cutting my parents or my grand parents' medicare benefits for what? so that my premiums can stay the same or go up? if you buy your insurance in the individual marketplace, your insurance premiums, according again to the congressional budget office, are going to go up anywhere from 10% to 13% a year. so you get medicare cuts. you get tax increases. and for 90% of americans, you stay the same or are worse off. in other words, you're -- the insurance premiums are not going to be impacted. you will have achieved the status quo, or worse yet, your insurance premiums are going to go up 10% to 13% if you are buying in the individual market. that is according to the c.b.o. and so that -- i had sea say to my friend from wyoming, you're right. the exercise ought to be about reducing cost. clearly that's not the case with this legislation. mr. chambliss: let me decrease a question to our colleague from wyoming, who is a medical doctor in addition to being a senator. what we are being asked to

believe from the folks on the other side and what the american people are struggling with and having a hard time believing is that they are saying that even though they are cutting medicare by a total of $450-plus billion over a ten-year period, that medicare is actually -- the sofltz of medicare is going to be -- the solvency of medicare is going to be extended. they expect the american people to believe that somehow. when the fact of the matter is that we know from the information that we received this spring from the bipartisan medicare commission that, unless something is done, medicare is going to become insolvent in the year 2017. peer and simple. and -- pure and sivment and what we're dewing here is not take being the savings that they are proposing and while we don't agree with them, but irrespective of that, i irrespective of the savings that they are saying are going to be achieved, instead of applying that back, we're going to use

that to grow the size of government, tie some payments -- reimbursement payments to physicians to the medicare program, and now we're looking at about 23% reduction in payments to physicians as reimbursement under medicare if we don't take some action next year. when you put all of this together, the american people are saying, you got to be kidding me? how in the world are you going to extend the life of medicare by cutting it by almost $500 billion? mr. barrasso: and as my colleague from georgia knows, there's no way you can save medicare when you cut that kind of money out of it. and how when they cut physician payments by 23% are we going to have physicians going to -- a number of our small communities in south dakota, in georgia, in wyoming, where we have many people who depend on medicare for their health care? i worry about access to care. i mean, your colleague, senator isakson, yesterday talked about home health care and how for

pennies on the dollar you can help people. it provides a lifeline for people who are homebound, keeps them out of the hospitals, out of the nursing homes. but instead, this senate, the democrat-led senate yesterday voted to cut $42 billion out of home health care, which people in the small communities depend upon. so there is no way this program can stay solvent and it is -- it is hard for me to fathom, and clearly fathom for the people of wyoming to fathom -- how with all of this budget trickery it is going to work for people to go see a doctor, to have a home health care provider in many of our rural communities. we all have town hal meetings. people say, don't cut my medicare. no raise my taxes. don't make things worse for me than they are now. mr. thune: if the senator would yield, he is one of only two physicians in the united

states senate. has great depth on this issue and knows what it is like to serve people with services in i would places like wyoming and south dakota and some places of georgia. three, four years ago, 2005 now, we had a debate about medicare. the senator from new hampshire proposed cutting $10 billion in medicare, taking $10 billion over a five-year period or about $2 billion a year, and paid for it by income-testing the part-d benefit that people got. in other words, the premiums that are paid, those who are in the higher income categories would have paid a higher premium for their part-d drug benefit than would those in lower-income categories. you would have thought -- i mean shall the apocalyptic pronouncements and predictions around here about what that was going to do to medicare, $2 billion a year over -- $10

billion over five, $2 billion a year. and you heard the other side describe it as immoral, cruel, it was a disaster of monumental proportions. those are some -- that was some of the terminology that was used around here at the time. that was for $10 billion over five years, and that basically was to say people who have higher incomes, the warren buffets of the world, ought to pay a little bit more for their prescription drug benefit under medicare than those in lower-income categories. and people just went nuts. on the other side went nuts about that. and here we are talking about cutting $465 billion over a ten-year period, $1 trillion over ten years when it is fully implemented, and it seems to me, mr. president -- and i would say to my colleagues -- that the other side is going to have a lot of complaining today to the -- explaining to do to explain why cutting $10 million was immoral and cruel but cut half a trillion somehow to pay for an

entirely new entitlement program, $2.5 trillion expansion, is somehow making sense. mr. barrasso: i appreciate the comments from my colleagues. i think we are hearing all around the country we do need kind of a health care reform, we need to get the costs under control, we need to have patient-centered reform, not government-centered reform, not insurance-centered reform. we need to not cut medicare. we need to not raise taxes. we need to not make things worse for the american people. and, mr. president, i would just say that from what i have seen of this bill and worked my way all the way through it, this bill makes things worse for the american people, not better. this is not the right prescription for health care in america. and with that, mr. president, i yield the floor. the presiding officer: the senator from montana is recognized. mr. baucus: i would first like to take a moment to lay out today's program. it has been two and a half weeks

since the majority leader moved to proceed to the health care reform debate. this is the eighth day of debate op the bill. the senate has considered 16 amendments and motions. we have conducted 12 roll call votes. today the senate will debate the amendment by the senator from arkansas, senator pryor, on consumer satisfaction. at the same time we will debate the amendment by senator gregg to ban new spending taking effect. at least the first two hours of debate today are equally divided. republicans control the first 30 minutes. the majority will control the next 30. there may or may not be a side-by-side amendment to the gregg amendment. the senate will conduct votes on relation to the pryor and greg amendments this afternoon. we expect at least those votes to begin sometime between 3:15 and 4:00 this afternoon. mr. president, i'd like to take a few moments to discuss the amendment the senator from new hampshire, senator gregg, offered yesterday. the gregg amendment has been billed as protecting medicare.

that seems to be the new fashion on the other side of the aisle, just to say that the bill cuts medicare. frankly, that's a misleading statement at best and it's inaccurate, basically. in reality, the gregg amendment is a killer amendment. it is designed to prevent health care reform from taking effect. that's the purpose of the gregg amendment. it's a killer amendment. to stop health care reform from taking effect. the amendment has more details to it, but you can get the flavor of it from a few excerpts from it. let me quote from the amendment: the first sub section of the amendment is entitled: "ban on new spending taking effect." you really don't have to go much further to get an idea of what the amendment is about. just focus on that statement in the amendment, a ban on new spending taking effect.

let me quote further from the first sub section: the amendment says: "the secretary of the treasury and the secretary of health and human services are prohibited from implementing the provisions of and amendments made by sections 1401, 1402, 2001, and 2101. as as -- 2101." what are those sections? what are those sections that the gregg amendment would stop from taking effect. section 1401 is the refundable tax credit providing premium assistance for coverage. those are the tax credits, the tax reductions that help people to buy health insurance. the gregg amendment says you can't people -- can't help people buy health insurance. you can't have those tax credits. the second amendment would stop section 1402. what's that? 1402 is the reduced cost sharing for individuals. that's the part that would make co-pays and out of pocket

expenses affordable. the gregg amendment says you can't reduce cost sharing for individuals. you have to keep those co-pays in effect. you have to keep the out-of-pocket expenses too high. the gregg amendment prevents any expenditures that would help people with those co-pays and out-of-pocket expenses. the third section that the gregg amendment would stop is section 2001. 2001 is a section that provides medicaid coverage for the lowest income populations. that's the one that provides expanded medicaid coverage up to 133% of poverty. the gregg amendment says huh-uh, you can't help poor people. prohibited, the secretary is prohibited from making those payments to medicaid if that amendment is adopted. the fourth section that the gregg amendment would stop is section 2101. what's that? section 2101 is a section that provides additional funding for the children's health insurance program. can you believe that? a senator here gets up on the floor of the united states senate and wants to stop funding

to the children's health insurance program. that's what that section would provide, one of the four sections in the gregg amendment. so if you don't like tax credits , that is, tax reductions to help people buy health insurance, if you don't like making health insurance affordable, if you don't like health care for the lowest income americans, if you don't like health care for kids, then the gregg amendment is for you. now, folks, the other side of the aisle have spent a whole lot of time this year -- in fact, it's about all i hear from them -- talking about medicare. they make it sound like they want to help medicare. in effect, they're hurting medicare. a lot of folks on this side of the aisle say that they want to help medicare and the big crocodile tears they shed, so let me take a few moments to set the record straight about how the medicare trust fund works. that might help them understand, frankly, why the bill before us, the reid bill, helps medicare.

contrary to protestations of those on the other side. the medicare trust fund provides hospital insurance for seniors and americans who are disabled. working americans pay into the trust fund when they pay their payroll taxes. and when a senior has to go to the hospital or let's say even the nursing home -- there are lots of areas where seniors get help -- the spending to help pay for that hospitalization comes out of the trust fund. the actual sum for the nursing home comes out of medicaid, but some of the payments to nursing homes also comes out of the trust fund. it's medicare. like home health care, et cetera. when payroll tax revenues are greater than payments for hospitalizations, the assets in the medicare trust fund grow. that's good. on the other hand, when spending for hospital care is greater than payroll tax revenues and interest payments on the trust fund assets, then assets in the medicare trust fund diminish. that's not good. the actuary for medicare.

this is the person charged with determining the health of the medicare trust fund. the actuary for medicare over at h.h.s. tells us that if we don't do anything, that is, if this legislation is not passed, then by about 2017, the medicare trust fund assets will be exhausted. that's clear. that's definite. that's a fact. and i emphasize the word fact. because i'm just being honest, mr. president. i've got to be objective and be honest about this stuff. when i hear senators on the other side of the aisle talk about medicare, they're not looking at the facts. it's one thing to say something and engage in all this rhetoric, but if it's not backed by facts, it's a bit irresponsible. i ask them to look at the facts. the fact is that the medicare trust fund will be -- the life of it will be extended under this legislation for five years according to the actuary. i walked to one senator on the other side privately. i asked him -- after on the

floor they said the medicare -- the solvency will not be extended for five years. i asked him privately how could that be true? didn't you read the actuary report? he said what actuary report? i told him about the actuary report. it's not this senator sitting right here. it's another senator. the senator said i don't believe it. that's the result of the legislation before us, namely that the solvency of the trust fund will last five more years. that's a fact. that's what the actuary report says. that's what it says. so we could either raise more payroll taxes to continue the solvency of the trust fund so that seniors get benefits or we can reduce spending out of the trust fund. either you increase money in or you decrease the money coming out. i'll say again the medicare actuary tells us that health care reform will extend the life of the medicare trust fund by five years, or put it another way if we do not act on health care reform, we would hurt medicare's long-term solvency,

payments used for seniors. now, let me cite a few concrete examples on how that works. health care reform would discourage hospital readmissions, for example. that's waste. see, here's what the other side doesn't quite understand, i think, because you don't hear them talking about it. the goal here is to extend the life of the trust fund basically by cutting out waste. not hurting seniors, but cutting out waste and cutting back on overpayments in some areas where some providers are overpaid, and where seniors are helped, not hurt. an example again is hospital readmissions. if you discourage hospital readmissions, that's fewer dollars that are wasted out of the trust fund for seniors, and it's better health care for seniors. we know -- the incentive is for hospital to have more

readmissions because that's how they make some money. get readmitted back to the hospital. that's how they make money. and some hospitals, frankly, don't go out of their way to prevent readmissions because they know they can make more money that way, although it's not good care for seniors. that is, when a senior is discharged from the hospital, you want to make sure that there's a flow, even seamless effort of keeping health care for that patient, whether extended care or home health care or nursing home or whatnot, there is a physician involved and nurses involved and so on and so forth so the patient is taking his or her medication and it's just a mixture that patients keep getting better all the time. we all know -- at least i know. i have experienced it. i have watched it firsthand and i have heard many people talk about this. too often when a patient is discharged, that patient has got to -- care for that patient isn't as great in the sense that the physician at the hospital or

the hospital is no longer involved and sometimes the physician -- the regular doctor is not involved because the regular doctor is not involved very much with the patient in the hospital because the hospital is there. it's just -- in my view, it needs improvement. it's not working too well. anyway, we're saving on health -- saving dollars in the medicare trust fund by preventing excessive readmissions. they are excessive, that's wasteful, and it doesn't help the patient, so that's one way we're saving and it helps extend the solvency of the medicare trust fund. that's one way. and there are others. let me cite a second. health care reform discourages hospital-acquired infections. i think in america, unfortunately -- i don't know if it's a fact, but i read somewhere this, and i haven't confirmed it -- that the rate of infections in american hospitals is greater than it is for other industrialized countries.

that is clearly a problem. people die from infections in hospitals. it just seems to me that the more we can encourage fewer infections in one way as in health care reform to get maybe lower payments to the hospitals that have too many infections -- i know it's hard to do. it's a judgment call but you have to do the best you can -- that, too, will help the solvency of the trust fund and it will help care for patients. so that's one other way we're extending the solvency of the trust fund. i have heard people talk about it. i see my good friend from wyoming on the floor, senator barrasso, talk about home health care. i am sure that he wants to eliminate fraud in home health care. i'm sure he does. we all want to. so we cut back on areas where there's fraud. where is there fraud?

there is fraud in outliers. too many hospitals build too much for outlier patients. additional payments because they say they have got -- especially a sick patient, it's an outlier. one county in florida billed for 60% of outlier patients in america even though that county had 1% of seniors in america. there are other examples like that. the general accounting office came to us with this and said we've got to do something about this. there's fraud in the home health care program. i don't want to single out home health care. i'm a big fan of home health care. big, big fan of home health care. they do really good work. but we want to take out the fraud. the excessive payments are fraudulent. isn't that a good thing to do? doesn't that also help extend the solvency of the trust fund? isn't that helping patients, not hurting them? that's what we're doing here. and there are other examples like that. in fact, home health folks came to us and said make some of these changes because it's much more efficient, we could get

better care and the result is there are fewer dollars going to the home health care. we also added a provision for rural home health care. rural america needs extra help, rural health care. we had an extra bonus in for rural health care. so my point very simply is when senators stand up on the floor and said we're cutting medicare, sometimes they use the word cutting benefits, sometimes they say we're hurting beneficiaries, it is patently false. it is not true. it is true that in some cases we're taking some of the fraud out. it is also true in some cases we're taking some of the excessive pavement payments -- e not by our understanding, but by medicaid they are. one senator stood up and said he thinks the payments to medicaid are excessive. doesn't it make sense to take out the waste and fraud in order

to extend the life of the trust fund? that's what this bill does. it doesn't -- quote -- "hurt seniors" by hutting seniors. if we say something loud enough, maybe people will start to engage. if you look at the facts, the actual facts, the actuary stays does extend the life of the solvency of the trust fund. the actual farkts the industry has come to us and said, help us with this and that so we can be more efficient much that's what's going on here. you might find -- i got countless of examples. let me give a third one. this legislation would encourage hospitals and doctors to work together by bundling up payments. if doctors and hospitals work together, guess what happens, mr. president? then they are less likely to order duplicate tests. it is not all siloed. they are working together. payments based on

fee-for-service. payments based today on volume, on quantity is in some cases wasteful. it is wasteful. all of us that go to the hospital, go to the doctor's office, we kind of wonder, my gosh, something seems wasteful here. we got to do new tests, new this, new that. doctor doesn't know what happened when i was here previously. got to start all over again. new x-rays, new imaging. we're trying to cut out a lot of this waste and bundling payments is definitely going to help. we have other techniques, accountable care organizations, medical home concepts, so forth. these could take a year, two, three, or four. it is really the model of integrated care systems we all talked about which cut out waste, improve quality at the same time, and that's going to help medicare. these integrated systems are going to also extend the solvency. trust fund and it is improved

quality of care. not reduced but improved. the main point i am packing is these reforms will extend the life of the trust fund and, guess what, mr. president? they improve the quality of care. not decrease the quality of care by improve t we also add in some additional benefits for seniors they would not receive if this legislation does not go into effect. i note, mr. president, we're -- we only have a half-hour on our side. i also note the chairman of the "help" committee is on the floor. and i would first ask how much time is remaining on the majority side. the presiding officer: 13 minutes remaining. mr. baucus: mr. president, i yield 10 minutes to the senator from iowa. mr. harkin: mr. president, i thank my colleague from montana, the chairman of the finance committee, for his great leadership on this issue and on

this i will, along with senator dodd who took the leadership on our committee, on the help committee, putting our bill together. the two of them have just done an admirable job getting our bill this far along and hopefully we'll see the light at the end of the tunnel here pretty soon, mr. president. i think one of the best christmas presents that we could give the american people would bring this to a close, let's have our votes up or down and let's get it passed so that the american people can look ahead to a brighter future in terms of their health care and its quality and affordability and accessibility. but, mr. president, i wanted to take a little bit of time this morning to speak in strong support of senator pryor's amendment, which is before us right now. which would provide information on the consumer satisfaction of health plans offered through the exchanges. the pryor amendment develops an enrollee satisfaction survey for

these plans and requires exchanges to include information from this survey on an internet web site. now, this tool will allow consumers, both individuals and small businesses, to easily compare survey results and make well-informed choices. currently, o.p.m. manages an enrollee satisfaction program for the federal employees' health benefit plan, the ones that we're all in. and the ones our staffs are in, the one that postal workers are in and civil servants all over this country are in. right now o.p.m. in managing that has an enrollee satisfaction survey. so the pryor amendment would provide a tool to all americans that we as members of congress have when we select a plan. the survey results b results cod

by the g.a.o., the government accountability office, and the committee i chair and to fulfill our oversight responsibilities over the exchanges. as a little aside here, i keep reminding people, mr. president, that we'll pass this bill. we'll get this health reform bill passed. it will be signed into law. but that doesn't mean that, like the 10 commandments, it is written in stone never to be changed. laws are laws, and laws change, they get amendments and we change and we adapt as times and conditions demand. and so, as we move ahead, and as we look at how the exchanges work and what's happening out there, i have no doubt in my mind, there will being some bumps in the road and we'll have to come back and revisit it and make those changes. well, by having this pryor amendment and what we have in the bill to provide for this kind of survey, to see how

satisfied people are with the plans, it gives us that kind of oversight ability, that oversight responsibility, that oversight responsibility to look ahead and plan on changes that we most surely will probably be making in the future. but, most importantly, the my i don't remember amendment will give consumers an important voice. it'll keep the insurance companies honest because they will know that to maintain and grow their enrollment, they must satisfy their customers. this amendment truly complements and reinforces the functions of the exchanges, the patient protection and affordable care act, our reform bill, creates exchanges a place for one-stop shopping where consumers, the self-employed, small businesses can easily compare plans. so this amendment will increase competition and lower premiums, as the exchanges will. the exchanges by themselves will increase competition and lower

premiums. just this past week, the congressional budget office validated this approach. the c.b.o. said this about the exchanges. here's what they said. "the exchanges would enhance competition among insurers in the nongroup market" -- that's our small businesses, individuals, self-employed -- "by providing a centralized marketplace in which consumers could compare the premiums of relatively standardized insurance products. the additional competition" -- the additional competition -- "would slightly reduce average premiums in the exchanges by encouraging consumers to enroll in lower-cost plans and by encouraging plans to keep their premiums low in order to attract enrollees." so what we've been hearing from the other side of the aisle all along is oh, my gosh, premiums are going to go up, everything is going to skyrocket. well, c.b.o. debunked that just

this last week. c.b.o. also said that this would benefit small business. they said, and i quote, "those small employers that purchase coverage through the exchanges would see similar reductions in premiums because of the increased competition among plans." so, mr. president, the senate bill that we have before us ensures that consumers and small businesses have the information they need to make informed choices. one, our bill requires exchange plans to provide information on quality measures for health plan performance. this was a provision offered in our committee by senator jack reid, and -- jack reed, and i want to commend him for that. our bill develops a rating system that will rate exchange plans based on quality and price. ratings again that will be available on the internet web site. third, our bill requires exchanges to operate a toll-free hotline to respond to requests for consumer assistance. fourth, our bill develops an

online calculator so the consumers can figure out how much they will have to pay, factoring in their tax credits and cost-sharing reductions. and, fifth, and perhaps most importantly, i want to acknowledge the contribution made by nor dodd in this-- --senator dodd in this area. he offered a key provision in our bill to require all plans -- all plans, not just exchange plans, all plans to provide a uniform, easily understandable summary of coverage to enrollees and applicants. in other words, no longer will americans have to read and try to comprehend the fine print. all of these provisions are currently in our bill to enhance consumer choice, which is really what this bill is about; enhancing and expanding affordable choices. now, some of them have kind of been overlooked in a lot of the verbiage going on here about cutting medicare and all that

kind of stuff. but, these provisions will do a great deal to change the way americans shop for and buy health insurance. this amendment by senator pryor will add one more important tool to help our consumers. it is a consumer amendment, to make sure consumers get the information they need and the input -- a satisfaction survey so that consumers can have an input. that way we know here if we need to make changes down the road. so i commend senator pryor for offering the amendment of i urge my colleagues to support it. with that, mr. president, i yield the floor. a senator: mr. president? the presiding officer: the senator frosenator from minneso. ms. klobuchar: i ask unanimous consent to speak as if in morning business for up to seven minutes. the presiding officer: is there objection? no objection is heard. the senator can smeek for up to

seven minutes. ms. klobuchar: i rise today in support of the amendment offered by senator pry that calls for an enrollee satisfaction survey for health care plans offered through the exchange. as you know, mr. president, the exchange will be a series of different policies that people can choose from. what i love about this side for my small businesses and self-employed that are paying 20% more than people that work for big businesses right now because they simply can't leverage their numbers. it is hard for hem to get good rates because they're out there on their own. this exchange where they can choose a lot of the different kinds of policies like members of congress can choose from, whether it's blue cross or whether it's a number of other choices, they can pick a policy on the exchange. i serve with senator pryor on the consumer public protection subcommittee. this improves resources for individual whose buy insurance.

a satisfaction survey will be a tool to help consumers navigate through the complicated process of purchasing health insurance. the survey results will allow individuals and small businesses to make well-informed health care decisions by comparing current enrollee satisfaction levels between the plans offered through the exchange. this survey also provides, as senator harkin has pointed out, an oversight tool for congress so we can monitor the progress of the exchange and present information to patients in an open, transparent manner. mr. president, as i have said many time, i come from minnesota, often known as a medical mecca. we're home to the mayo clinic, home to the universality of minnesota. and countless innovative businesses that contribute to groundbreaking medical research that is bettering the lives of patients. now the key to this minnesota model where we have some of the highest-quality care in the country at some of the lowest cost has been putting the

patient in the driver's seat. i have been at the mayo clinic. i have seen what happens there. it's integrated care with one primary doctor with a group of doctors at work with them, like a quarterback on a football team. they also focus on the patient with satisfaction surveys and knowing -- and keeping the team accountable for how they're doing. i always say to my colleagues, it is counterintuitive. if you go it a hotel, you pay more money, you often get the best room with a view. that's not true in health care. you can pay more money and get some of the worst-quality care in this country because there's no accountability. that is why these patient surveys andsllowing consumers to really look at these different plans and figure out which one is better for them is the way to go. in my state we have 92% of our state covered by some form of health insurance, and we have done that by learning the importance of transparency and providing quality information to

consumers. in 2004, a minneapolis-based nonprofit called minnesota community measurement, developed a consumer resources called "developed health scores." health scores is based on information submitted by more than 300 clinics statewide and is available to consumers on an easy accessible web site. health scores is used by medical groups and clinics to improve patient care and by employers and patients to provide access to critical information about the quality of health care services. researchers at the university of oregon studied public reporting efforts and found that public reporting motivates health care providers and insurers to work harder on improving care largely because of the concern about their reputation. this is how the private market should work, mr. president. you can't just have insurance policies that have a name and not understand what they mean for the consumer. by having these surveys, we are going to be able to understand so a survey -- a consumer can

navigate through and figure out which policy's good, what it offers, what is best for their family. as we continue our debate on health care, we must remain focused on solutions with outcomes. public reporting works. senator pryor's amendment ensures that customers are able to voice their approval or disapproval of plans offered by insurance companies, and that information will be available to small businesses and individuals to make well-informed decisions about their health care. how can they make a well-informed decision without knowing what plans are good, what plans are bad, what plans offer? that's why we need this if we want to make this private market solution work for consumers. as the experience in minnesota has shown, public reporting also has the ability to improve quality as well. health scores in minnesota has forced health plans, medical groups and employers to focus on a common set of goals. through this pro serbgs patient outcomes -- process, patient

outcomes produced dramatic improves for conditions like diabetes. we know already that small businesses are paying too much, up to 18% more than large businesses, often forcing small businesss to lay off employees or cut back on their coverage. and we all know from the letters we've gotten in our offices what the average american families are facing with skyrocketing premiums. we must provide these patients and these consumers with tools to make informed health care decisions, not only will we make the consumers and put them in the driver's seat so they can make the decision, we also have an effect on the entire market. because if insurance companies think that no one's watching them and consumers really can't figure out, maybe something has a great name so they go buy it, they're never going to be able to get that kind of accountability and cost reductions we want. the lessons from minnesota have shown that providing consumers with information about their health care has the ability to improve patient satisfaction and drive our system to focus on

quality results. thank you, mr. president. i yield the floor. a senator: mr. president? the presiding officer: the senator from utah. mr. bennett: mr. president, i ask unanimous consent that i be allowed to proceed as if in morning business for not to exceed ten minutes. the presiding officer: without objection. mr. bennett: mr. president in, this morning's "washington post," we have once again an outstanding article by robert samuelson. this one entitled "health care nation: medical spending threatens everything else." mr. samuelson has been critical of republicans, and he is in this article. he's been critical of democrats, and he is in this article. but he makes some points that i think are worth bringing to our attention. the primary one being that we are not focusing on the right thing, which is making some kind of attempt to turn the cost curve down using the budgetary doublespeak, with respect to

health care. let me quote a few comments from mr. samuelson's presentation. he says first, "the most obvious characteristic of health spending is that government can't control it." a very true statement which i will show in just a moment is demonstrated by our past history. he goes on to say, "the consequences of slow, steady and largely invisible degradation of other public and private goals. historian ni le ferguson writing recently in "newsweek" argued the huge federal debt threatened america's global power by inexorable reduction of resources in the military. ferguson got it half right. the real threat is not the debt but burgeoning health spending. even if the budget were balanced, would press on everything else. everything else includes universities, roads, research, parks, courts, border protection, and because similar pressures operate on states through medicaid, schools,

police, trash collection and libraries. higher health spending, similarly weakens families' ability to raise children because it reduces households' discretionary income either through steeper taxes or lower take-home pay as higher employ paid premiums squeeze salaries." he concludes, "obama talks hypocritically about restraining deficits and controlling health costs while his program would increase spending and worsen the budget outlook. democrats congratulate themselves on caring for the uninsured who already receive much care, while avoiding any major overhaul of the delivery system. the resulting society discriminates against the young and increasingly assigns economic resources and political choice to an unrestrained medical industrial complex." i ask unanimous consent that the entire piece be printed in the record at the conclusion of my remarks. the presiding officer: without objection, it will be included.

mr. bennett: to demonstrate the accuracy of what mr. samuelson has to say, i have some charts. this one shows the breakdown of federal spending in 1966. why do i pick 1966? because that was the beginning of the year -- that was the year for the beginning of medicare. at that time 26% of the federal budget went more mandatory spending, overwhelmingly social security. 7% went to pay interest on the national debt. and 44% went for defense, with 23% for non-defense. where are we now? in 2008, mandatory spending had more than doubled and had gone to 54%. interest costs remained about the same, 8%. defense had shrunk to 21%, cut in half in non-defense

discretionary 17%. the difference? medicare and medicaid. taking over the mandatory side. now, what do we see as we look out in 2019? we can't break down the difference between defense and non-defense because that would require an analysis that's not available to us in that future year. the mandatory by that time will have grown to 61%. the size of the debt increasing costs now, interest costs have grown to 10%. and defense and nondiscretion -- defense discretionary have shrunk to 29%. a complete reversal. that's roughly what mandatory was when medicare was started. now i'm not saying we should not have medicare and i'm not saying we should not have medicaid. but i am saying we should be focusing on how we make people healthier, how we reward people for not using the system, how we do something to control the

costs instead of increasing the status quo with respect to health care spending. and this chart was drawn up before we had the bill before us. i think it's very likely that if the bill before us passes, this mandatory will grow even further. and we find ourselves in this situation with respect to 2010. i watched the budget as it came down and it said in 2010, federal revenues were going to be $2.2 trillion and mandatory spending was going to be $2.2 trillion, which means that every dime of everything else had to be borrowed. i worked with senator wyden and a number of others on both sides of the aisle to craft a health care plan that would turn the cost of health care -- turn the cost curve down. we didn't even get a vote in the

finance committee. we didn't even get anybody to consider what we had to say because everyone was focused entirely on the issue of let's cover the uninsured. and the position is let's cover the uninsured by taking what we're doing now and spreading it even wider. and as mr. samuelson says very clearly in his column today, that squeezes out the money for everything else. that is an uncontrolled expenditure. we're not focusing on changing the system in a way that can cause cost curves to come down. we're just focusing on taking the present system and spreading it wider. the cost curve can come down. i've quoted this before. the darthmouth study talks about where the best health care is available in america. it is in three cities: seattle, washington; rochester, minnesota and salt lake city, utah.

it goes on to say if everyone got health care in salt lake city, utah, it would be the best in the country and one-third cheaper than the national average. one-third cheaper than the national average because the focus in that plan, as it is in rochester, minnesota, mayo clinic and other places, is trying to make health care better and, therefore, cheaper instead of focusing on taking the present system and perpetuating it. if we don't get into that mentality, if we just take the present system, which this bill does, and spread it over a wider number of people which this bill does, we will see the spending go up, and we will see everything else suffer as a result of it, and the health care will not get any better for the people who are involved. now, mr. president, i see the senator from iowa wishes to ask me a question, and i'm happy to respond. tell me how much time i have left and maybe some of it will have to come off of him. the presiding officer: the senator has 2 minutes remaining.

mr. bennett: in my 2 minutes, unless it is a long question, i will be happy to respond to a question the senator from iowa may have. mr. harkin: i thank the senator from utah. i will just say a lot of what he says i agree with. that's why in this bill -- and i keep reminding people it's not talked about much, but there are more provisions in this bill to promote wellness and prevention than any health bill we've ever passed ever in the united states congress. there are huge investments in this bill on prevention and wellness. i happen to think that perhaps one of the preens salt lake city is so -- one of the reasons salt lake city is so good is because people don't smoke and they don't drink. that goes a long way toward healthful living. people talk about bending the cost curve only in terms of the spending. i think, and i sincerely believe this, the only way we're going to bend that cost curve is pushing more of this upstream, keeping people healthy in the

first place, starting with kids, adults, community-based, workplace-based wellness programs. i ask my friend from utah to look at that part of the bill. mr. bennett: mr. president, if i can reclaim my 2 minutes and respond to the senator from iowa, i can give you data that indicates that it's not just the fact that there are a lot of people who don't smoke and don't drink in utah that as a result they're healthier. i agree there are many things in this bill that promote wellness, and i approve of that. but the fact is that this bill does not go anywhere near far enough in this direction to change the paradigm that has created the situation in which we find ourselves. and every expert that i have talked to in the three and a half years i've immersed myself in this issue has repeated that, has said that. they said the only way you're going to deal with this is to do something dramatically different, which is what senator wyden and i tried to do, and we got cold shouldered.

all right, i understand. if you don't have the votes, you can't get anywhere. but the fact remains we are not going to be able to afford all of the things we want to do in this country militarily and otherwise in the cost projection that we are on with respect to health care right now. my time is gone. the presiding officer: the senator has used ten minutes. mr. bennett: that's right. my time is gone. i'll be happy to respond to the senator from montana if he wants to take the time -- mr. baucus: just maybe three minutes. the presiding officer: the senator from montana is recognized for three minutes. mr. baucus: i understand the senator is saying, like everything around here, there is a kernel in truth in everything, and it is true that health care expenditures are going to go -- i read that samuelson article and what i take from that is the guy is pessimistic. people love health care -- but the main point is this, you

mentioned how quality of care is so good intermountain. mr. bennett: there are other agencies that have done a good job. mr. baucus: basic integrated systems. there is one in montana called the billings clinic. generally in these areas, this integrated systems which i think quite well, a lot of doctors are salaried. a lot of them -- the incentives are there to focus on health care on a patient, is coordinated care in contrast with other parts of the country. in this bill, in addition to wellness and prevention -- i ask the senator if he agrees -- the delivery system reforms will help move the way we provide health care in intermountain and other health care industries. namely, they encourage coordinated care. they encourage bundling, and so

forth. i was wondering if the senator thinks that will help systems, clinics, doctors, hospitals, nursing homes and health care providers generally to work better together, where there may be more salaried physicians than currently, but the salaried physicians i talked to at mayo clinic, for example, and kaiser and other places, similar places, they kind of like that because they get decent salaries and they're able to spend the time not on paperwork, not a lot of stuff, but can focus on the patients. i'm asking the senator do you think that will help? mr. bennett: responding to the question from the senator from montana, i'm delighted that there is as much of that in the bill as there is, but i still believe that the basic structure of the bill is fatally flawed because it perpetuates the present system in ways that will

guarantee that the cost curve will continue to go up. i disagree with him about samuelson's article. i don't think he's being overly pessimistic. i think he is being very realist. mr. baucus: if i could have one more minute, mr. president? i understand that the bill that you and senator wyden cosponsored. it's basically to move us away from employer-based system where currently our tax law encourages employers provide tax-free health insurance and so forth, and i understand the theoretical , actual problems that occur in the system. in fact, i earlier advocated moving that direction all the way with your legislation, but as you know this town, this city, this country, this white house just wasn't moving and major business just would not move in that direction, so therefore i would find something else. my main point is if we can't go in that direction, you might as

well keep trying, but i think if you read the tea leaves, we can't do that. isn't it better to at least start moving toward these integrated systems with delivery system reforms in this bill? mr. bennett: mr. president, i certainly hope that this legislation will surprise me by producing the result that the the senator from montana is hoping for. mr. baucus: i like your answer. thank you. mr. bennett: i'm not going to hold my breath, however. mr. baucus: mr. president, i yield -- this is jump ball, so why don't you go ahead. ten minutes to the senator from vermont. the presiding officer: the senator from vermont is recognized for ten minutes. mr. sanders: mr. president, there are two major goals that we have to achieve in health care reform, and that is we have got to expand access to everyone in america, and we've got to control costs. we focus a lot on expanding insurance but expanding insurance is not expanding access. there are people today in america who have insurance but

they don't have access, and the fact is that we have 60 million people who do not have access to a physician on a regular basis, and many of those people, according to recent studies, 45,000 may die, may die because they don't get to a doctor in a timely manner, and by the time they walk in to the doctor's office, their situation is terminal, terminable. so we need to substantially improve access to health care, and when we improve access, we save money because people do not go to the emergency room, they do not end up in the hospital sicker than they otherwise would have been. mr. president, we need a revolution in primary health care in america. unless we do something and do it now, our primary health care system infrastructure is close

to collapse. we have an aging primary care work force which is not being replaced. at a senate hearing i chaired earlier this year, it was noted that only 2%, 2% of internal medicine residents were choosing primary care as their specialty. happily, mr. president, there are two federal programs that can both assure access and control costs, and i refer to the community health center program and the national health service corps. both are well-established programs that have guarded -- that have garnered broad bipartisan support because of their proven cost-effectiveness. what a federally qualified community health center is about -- and i believe they exist in all states in this country. they have widespread support from members of the senate and the house, both political parties. what they are about is saying that anyone in an underserved area can walk into that

facility, get health care either through medicaid, medicare, private insurance, or a sliding scale. if you don't have enough money, you pay on a sliding scale basis. low-cost prescription drugs. this is a very, very successful program that now provides health care to over 20 million americans, and it is a 40-year-old program, again supported widely in the house and the senate. mr. president, i am pleased that in the senate bill, health -- the senate bill recognizes the importance of both federally qualified community health centers and the national health service corps. the national health service corps is a long-established federal program which says to people in medical school we are proposed to provide debt

forgiveness to you, and on average i know in vermont people are coming out $150,000 in debt if you are prepared to work in primary health care in an underserved area. in the senate bill, we recognize the importance of the federally qualified community health center and in the national health service corps, and in fact our bill calls for authorization levels that, if appropriated, would enable the health center program to expand to every underserved area within five years and would result in supporting at least 40,000 more primary care professionals in the next ten years -- doctors, nurses, dentists. but we can and must improve the senate bill. i favor very strongly the language in the house bill which calls for a dedicated trust fund

with mandatory annual spending for health centers in the national health service corps. in other words, in the senate, we have authorized funding, the house has established a trust fund to actually pay for it. the senate bill contains authorization levels that would be sufficient to fund a community health center in every underserved area in america, and thus provide primary health care to 60 million more people by the year 2015. these are people who do not have to go to the emergency room, they don't have to go into the hospital because they are sicker than they should have been. they can get timely, cost-effective health care at a community health center. therefore, let me be very, very clear, i favor the language in the house bill which includes community health centers in its public health investment fund and guarantees mandatory funding for health centers totaling

totaling $12 billion over the incomes five years. this is in addition to the the $2.2 billion current annual appropriation for community health centers, which it is anticipated would also continue to be appropriated each of the next five years. while this house funding level will not achieve a health center in every underserved area, it will take us very far toward that goal, bringing primary health care services to some 40 million citizens living in underserved area. and also in the house bill areas, appropriated money to greatly expand the national health service corps. so in the middle of all of this discussion on health care and health insurance, let us not forget a few basic points. 60 million americans do not have access to a doctor. we need a revolution in primary health care. we need to make sure that we have the physicians, the nurses, and the dentists who are going to get out in underserved areas. senate bill provides

authorization. the house bill provides a trust fund for community health centers and disease prevention in general, and my strong, strong hope -- and i'm going to do everything i can to make sure that it happens -- is that the senate adopts the house provisions. so, mr. president, if we are serious about providing health care to all americans, we have got to expand community health centers, we have got to make sure they are primary health care doctors, dentists, nurses out there. in addition, we need to focus on disease prevention, and i know my colleague from iowa has worked very, very hard on that, so we have got to support the trust fund in that area. i would yield to my friend from iowa. mr. harkin: i want to thank the senator from vermont. there is no one who has been leading the charge more strongly and fervently than the senator from vermont, senator sanders. i want to thank him for that. obviously, we all have community health centers in our states. in iowa, they have been a god

send for so many people in rural areas that did not have access to these kind of facilities. i remember one time i was in fort dodge several years ago and they had a small free clinic there that was in a church basement one night a week for -- so people could come in that didn't have insurance, couldn't get access to a doctor. they had one old dental chair there. i think every couple of weeks a dentist would come in for people. a woman had come in and had tried -- she had an abscessed tooth that was hurting her so much she took a hammer and a screwdriver and tried to knock her tooth out. of course, then she damaged her gums. that's how desperate people get. well, it was because of that i got the fort dodge community looking at a community health center. they now have a wonderful community health center, they have doctors there, they have nurses there, and people have access to that kind of dental care and health care. mr. sanders: let me just mention to my friend, in the state of vermont, the poorest region of

our state borders on canada. it's called the northeast kingdom, the northeastern part of the state. for 30 years, we have had a number of community health centers in that region, and you know what? amidst all of the poverty, all of the unemployment, all of the economic problems, we do not have a problem in terms of primary health care in the poorest area of the state of vermont precisely because of these community health centers, which you indicate addresses dental care, which we often forget about, mental health counseling which we forget about, low-cost prescription drugs. so i look forward to working with the chairman of the "help" committee and others to make sure that we fund the kind of revolution we need in disease prevention, in primary health care, which at the end of the day improves people's health, keeps them out of the emergency room, keeps them out of the hospital, saves us money. study after study, saves us money. mr. harkin: i can't -- i thank

the senator again. i can't help but every time we talk about community health centers, i always have to add one thing. a lot of people think community health centers are just for poor people who don't have anything. nothing can be further from the truth. they will take anyone who walks in the door. you can have health insurance. you can be on medicare. you can be on medicaid. you can have no insurance. you can have a great insurance plan. whoever walks in the door -- and they have a sliding scale based on income, based on resources of who they will take. it's been my experience -- i would ask the senator from vermont what has been his area, but it has been my experience in our growing number of community health centers in my state of iowa that more and more people -- mr. sanders: i ask unanimous consent for two minutes more. mr. harkin: with insurance are coming to the community health centers. why? because they get the kind of hands-on care, they get the kind of supportive services. a lot of times language barriers that are a problem.

they get preventative care. they get all the things that make people feel better about their own quality of health care. so more and more, we're finding people that actually have health insurance going to community health centers. i ask if that has been the experience? mr. sanders: let me concur with my friend from iowa. in the state of vermont, we have gone from two to eight, with 40 satellites. over 100,000 people in vermont are now accessing community health centers for their primary health care. and the other point that we don't often make about community health centers, they are democratically run. they are run by the communities themselves. my experience exactly is what the senator from iowa's experience is. they are community health centers. in rural areas, it's not rich or poor. by and large, most of the people, regardless of their income, go in there, the doctors are there for a long time, the dentists are there. it is, in fact, in the best sense of the word a community health center, open and accessed

by all people. people take responsibility for it because it's democratly -- democratically run. it is a program, it is one of the bright, shining stars of public health in america, and i would hope to work with the chairman of the health committee to make sure that these programs are funded adequately in this bill, that we adopt the language in the house which goes a long way. i would yield to my friend. mr. harkin: i can assure my friend from vermont that this senator will be in the forefront of fighting for the maximum possible support, money, and input for our community health centers that we can possibly get out of this bill, i can assure him of that. mr. sanders: i thank the senator very much and yield the floor. the presiding officer: the senator from wyoming. mr. enzi: mr. president, i would yield myself as much time as i might need out of the remaining time that we have. i, too, would like to thank the senator from vermont for his passionate comments on community health centers. in wyoming, we have community health centers and they serve a great role. for underserved areas across the

nation, they are absolutely critical. i wish this there were more that we were doing in the area of community health centers, and i think it provides somber solutions than some of the other things that we're -- that we're doing in this bill. wyoming is considered to be underserved. the whole state is underserved. even their bigger cities are considered underserved. and we are missing every kind -- every single kind of medical provider, including veterinarians. and usually when i make that comment, somebody says people don't use veterinarians, do they? i say as far as our distances are, some people are happy to get to a veterinarian to get health care in an emergency situation. one of my concerns is that we're doing this huge medicaid expansion, and when we do the medicaid expansion, we already have it priced for doctors so that 60% of the doctors won't take medicaid patients.

if you can't see a doctor, you don't have insurance. period. i don't think we're doing enough to take care of that difficulty prior to expanding this population, so we're going to shove more and more people out of getting any health care. the main thing i want to talk to today, is to rise in support of judd gregg's amendment which would prevent medicare cuts in the reid bill from being used to pay to create new entitlement programs to cover the uninsured. yes, i want to have the uninsured covered. i don't oppose covering the uninsured, nor do i oppose reforming the medicare program. we need to do those things. we absolutely need to do those. but, we shouldn't do it on a system that's going broke. we shouldn't take the money from a system that's going broke to do new entitlement programs. and i know the senator from montana this morning admitted

that if we don't -- if the gregg amendment were to pass that it would limit some of these entitlements, that they wouldn't be able to do them. again, we're not opposed to do those new entitlements. we're just opposed to paying for them with medicare money because medicare is going broke. everybody agrees with that. they do say that if we put these extra burdens on medicare, that we will extend the life of it. you can believe that or not, but we could extend it even more and we could solve some problems that are in medicare if we took the medicare money and we used it for medicare. medicare needs changes. medicare needs to have money that we're now going to move away and put into other programs. but don't worry about it, because we're going to form a medicare commission, and that medicare commission every year is going to come and tell us what we need to do to make more cuts. before we start doing more cuts, maybe we ought to make sure that the cuts we're doing go to what

we anticipated needed the most help. so i'm not opposed to covering the uninsured. i don't oppose reforming the medicare program. we should do those things. what i oppose is this reid bill. this is the wrong approach to solve the problems. the gregg amendment would go quite a ways to solving some of my discontent with the bill. the amendment offered by my friend from new hampshire highlights the main problems with the reid bill and suggests a better approach. his amendment would protect the savings from the medicare program and prevent them from being used to create a new entitlement. this would mean that this new program would not have to rely on cuts to medicare to fund its operation. it would also reserve all the money taken from medicare so that it could be used to fix the problems in the medicare system. earlier we had an amendment, and it said that the money for medicare would go to medicare. let's see, every single program that we allocate money to, we

have inspectors general that are supposed to make sure that the money for that program goes to that program. but this is a different situation. what we're saying here is that we want the money from medicare to go to medicare, not the money for medicare to go to medicare. the money for medicare has to go to medicare. but we're going to take money from medicare. and i say if we've got that money that we can take from medicare, we ought to put it to medicare, and only to medicare until we have the medicare problem solved. our seniors are relying on that. so don't be caught up by the little words in do-nothing amendments that say the money for medicare is going to go to medicare. what we want to see is that the money from medicare goes only to medicare. it's a very important part. mr. baucus: will the senator yield on that point? mr. enzi: i'm on my time limit here. mr. baucus: how much time remains on our side, mr. president? the presiding officer: there are 12 minutes remaining on the majority side and 14 minutes

remaining on the republican side. mr. baucus: i'll take two minutes, our side, to ask a question. the presiding officer: does the senator from wyoming wish to yield time for a question? mr. enzi: it's my understanding that the senator from montana is willing to take his time for the question. mr. baucus: correct. the presiding officer: the senator from montana is recognized to ask a question. mr. baucus: to, from, for, isn't the result the same? if we take a program, let's take home health care. we all love home health care, we're all for home health care. but if there's fraud, if the ability office says there's -- if the accountability office says there's fraud in home health care, don't we think we might take money from the medicare program? mr. enzi: absolutely. mr. baucus: if that program, say home health, just for kpepl

pell, is -- for example, is spending few dollars not on home care but neuro dollars because it is not -- but fewer dollars because it is not making fraudulent payments, would the senator agree that program would be spending fewer dollars, doesn't it have the effect of extending the quality of health care and doesn't that reductions for medicare, for seniors not take it away, but giving it to seniors because it extends the life of the trust fund? mr. enzi: that's where the senator runs into a dead end. if you take the money that would be from home health care and you put it into an entitlement that has nothing to do with health care, nothing to do with medicare -- mr. baucus: no, no, no. there's less spending. therefore, by definition, the solvency of the trust fund is extended so there's more dollars for seniors in future years. you see, that's the basic point

here. that's not a dead end. that's a big, wide avenue to help extend the solvency of the medicare trust fund. mr. enzi: reclaiming my time. i'm the accountant? it. if you take money from a program and give it to something else, you have less money in that program. and if it's having problems -- and we admit that medicare does have problems in the long term, seven or eight years out there it's going broke. maybe we can extend it a year or two. tpwu we took that money, that -- if we took that money, that fraud and abuse -- and i'll say more things about fraud and abuse here in a minute -- if we took money from fraud and abuse and put it into the medicare program, we should give assurance to seniors that we're doing something for seniors. that's where a lot of the concern comes from in this country. on fraud and abuse, if there's all this fraud and abuse out there, how come we haven't been getting that fraud and abuse in the past and putting it to some kind of good use? all of a sudden we're saying there's all this fraud and abuse, and we're going to take

this extra fraud and abuse and we're going to put it in there. i took a look at some of the fraud and abuse, and i noticed we're increased the number of fraud and abuse we're capturing, but we did that by changing the definition. we didn't capture more money, we just claimed more fraud and abuse. that's one of the problems with having a government bureaucracy do things that really have no value in doing. if a government agencies finds money, it doesn't come back to their program, so they're not very excited about doing it. we keep passing fraud and abuse things around here and the fraud and abuse never gets found to any extent and the money can't be used if it can't be found. as an accountant, what i've always suggested is we have a separate fund set up and when we find that fraud and abuse we put it in that fund and we only use the money where we say we're going to have fraud and abuse money because we have no incentive from government to go out and collect the money. it's a huge problem we have around here.

i've got to move on to my statement or i'll run out of time. some democrats have argued we're not creating a new entitlement program. they're wrong with that. just like social security, medicare and medicaid, this bill will commit the federal treasury to paying for these new subsidies for the uninsured forever. when we start a program around here, we don't put an end date on it. and as soon as we've passed it, the people say, wow, thanks, that's really great. now what are you going to do for us? we look around and say maybe we can do like medicare part-d. then we pass that. and they say you gave us medicare part-d, but you've still got that doughnut hole, what are you going to do about that? we take about that? we keep adding to the entitlement regardless of how the money is coming in. that's how medicare has gotten in trouble. once these subsidies are given, they're never taken back. they're only expanded. there is no appreciation for what's being done.

as i mentioned, medicare part-d. now they want the doughnut hole closed. and we're going to do kind of a phony thing to close the doughnut hole. pharmasaid they would give $50 billion that can be used as a subsidy as people go through the dough in a hole. pay attention to this. they said you can only use this subsidy if we can pay it directly to the customer -- that way they keep in contact with the customer -- and you can only use it if they stay with our brand name. okay, so they get through the doughnut hole. then the taxpayer picks up the money for it, and they're stuck with the brand name out here. that's why pharmaceuticals can make -- why the pharmaceutical companies can make so much money. if they can get them to not switch to that generic and make good economic decisions as they go through the doughnut hole action they can make a lot more money once it's on the taxpayer outside of the doughnut hole. i'm really upset with the pharmaceutical industry for doing that. this is the reason they're putting all the money in this,

promoting this. okay, so that means that as federal spending continues to grow, the new programs continue to grow. and it will crowd out other federal spending priorities like education or national defense. the states will tell that you it's already crowding out education. when we put these new medicaid requirements in there and they have to pay for them, they have a limited budget too. and what they've done is take money away from colleges, so colleges have had to increase tuition dramatically in order to cover the money that they had to give to medicaid. so pwhe we do some of -- when we do some of these things, we're affecting a lot of things. other spending priorities like education and national defense. any future attempts to modify or restrain this growth will be met by cries of indignation, arguing that cuts would devastate access to health care. if anyone has any doubts, they should look at the transcripts from our debate on the deficit reduction act. in 2005 congress tried to reduce

medicare spending by about $20 billion and enact modest reforms to the medicaid program. these programs would have strengthened the long-term solvency of these programs, which we're talking about now, and helped reduce the federal deficit which we're talking about now. in response, senator reid called that bill an immoral document. the junior senator from california said she strongly opposed the cuts in the bill because they would -- quote -- "cut medicare and medicaid by $27 billion." end quote. there are thousands of media quotes on that. the media quotes the majority more often, and here in d.c. the volume of quotes is equated with being right. well, that doesn't actually work that way. yet today, these same members and the rest of my democratic colleagues want to create a new entitlement program -- make that programs -- that will spend hundreds of billions of dollars, and they would pay for it by cutting $464 billion from the medicare program. that's enough money to run the state of wyoming for 320 years.

we don't understand how much money we're talking about here. you can't take that kind of money from a program, give it to other programs and expect the program -- and we recognize that. that's why we put this medicare commission in there that annually is supposed to suggest extra cuts. well, let's see, we made a deal with the hospitals that we weren't going to cut them any more. we made a deal with the pharmaceuticals that we weren't going to cut them any more. we made a deal with the doctors that we weren't going to cut them any more. although we never follow through on any of the doctor stuff because their deal, as i understand, and these are hidden deals, their deal was supposed they would either get a one-year fix on the doc fix and medical malpractice or they would get a ten-year fix on the dock. that isn't in either of the bills, so i don't know if they're going to stick with the hidden deal that they made. and i don't know what other hidden deals there were in this thing. but i do believe the facts

highlight why we need to adopt the gregg afpltd we should be very -- amendment. we should be very careful creating an entitlement program. in fact, the way we maxed out our credit cards, we're talking about the seniors having to pay for these other new entitlements, so grandma and tkpwra pa are going -- and grandpa are going to be paying for that too. if my colleagues insist on doing it, we need to guarantee any new program has a stable and reliable source of funding. medicare cuts in this bill are neither stable nor reliable. my democratic colleagues have spoken at length about how the medicare provisions in this bill will bend the growth of health care spending. that, unfortunately, is far from accurate. if you don't believe me, list ton what the other nationally recognized experts have to say. according to "the new york times," the c.e.o. of world renowned mayo clinic, which we use around here