this bill come to light if it hadn't have been for the recommendation that was made by another but singularly acting policy? in other words, that's what triggered the investigation of what was in this bill, which would've had exactly the same effect. so if we hadn't had that information of a recommendation by another government policy making bureaucracy, we would not have known about this until the bill would've actually taken effect. >> so there is no transparency and what we do know that it's transparent is that we are going to have three organizations, the medicare advisory commission, the cost effectiveness panel, and the u.s. preventative health task force that's going to tell everybody in america but you're going to with these. >> this would've never been known if it wasn't for the actions of the bureaucracy in being. so then doesn't that bring into question what else is buried in

his 2000 page piece of legislation -- >> what are the unintended consequences of this and they don't know. what we do know is there are 70 new government programs going to require of her 20 new federal employees with 1690 different times when the secretary of hhs is what to write rules and regulations about your health care in america. the secretary, not your or, not your doctor is going to read the rules or regulations the secretary of hhs is going to write the rules. >> mme display not again that we don't know what the cbo estimate is because we know that the majority leader keeps bouncing proposals back to the cbo, back and forth. that's why we don't have any cbo information now for many days. but there is the committee -- commission for medicare and medicine -- medicaid that clearly points out that this legislation would increase taxes

dramatically, increase cost dramatically and decreased care and would have the effect of forcing people not only out of the system, but even if they're in the medicare system, they would not have physicians to provide that care because more and more physicians would prevail to treat medicare patients. >> so we go back to the 72 hours. we're going to get a new bill. we're not going to have the opportunity to amend it. we're not going to get the time to read and study it. the american people won't get the time. what do you think the outcome of that is going to be? >> well, i think we know that what the outcome will either be able to reflect the feelings and the intense feelings of the american people about the majority of the american people about this legislation and say, let's go back to square one. let's all commit to a bipartisan approach to this issue. or we will see gm through on christmas eve legislation that

will have the most far-reaching effects and devastating effects i think not only on our ability to provide much-needed medical care to all of our citizens, but also impact would be devastating on the debt and the deficit which we have already laid and unconscionable burden. so we really have two choices here it seems to me. go back to the beginning and enactment of the reforms he could agree on and there's many of them that we could agree on immediately. on a bipartisan fashion. and as a senator from tennessee pointed out, there has never been a fundamental reform made in the history, modern history that was not bipartisan. or we are going to see gm through over the objections of the majority of americans legislation that they've never seen nor read or understand. so that's really the choice

between us. that's really what this choice is boiling down to and i think that frankly the american people should be heard, not the majority of the other side. >> people are saying don't cut my medicare, don't raise my taxes, don't make things worse than they are right now. and this bill cuts medicare, raises taxes, and for people depending on the health health e system in this country this makes things worse. >> by the way, can i mention that, you know, if you live long enough all things can happen. i now find myself in complete agreement with dr. howard dean who says that we should stop this bill in its tracks, which go back to the beginning and have an overall bipartisan agreement. dr. dean, i am with you. >> the senator from pennsylvania. >> mr. president, i ask consent that i may speak up to 20 minutes. >> without objection.

>> i have recognition to comment about the patient protection and affordable care act and it has been an extraordinary legislative process with a good bit of the calendar year 2009 taken up with very intensive work to try to pass health care reform. and at the moment, there is still some doubt as to what will happen with the bill. the congressional budget office has not yet submitted a report on the so-called managers package and there is still some concerns being expressed by the senators. and i can understand the frustration that some of them not as we have moved away from a public option.

i have been an advocate of a robust public option and think that it ought to be part of the legislation. the public option is just what it says. it's an option. there have been efforts made to demagogue the issue by saying it is a takeover by the federal government. well, it is not. the private insurance industry remains in the field and this is one option as president obama has put it, it is an option to try to keep the private insurance companies honest. we have seen in the past several months very large increases in premiums for small business. and the reports have been that those increases in premiums have come from wall street pressure, for the insurance companies to

increase their profits before there is a legislation. well, the public option would be a forceful fact dirt and dealing manner. when the objections were raised to the public option in an effort to find 60 votes, it is difficult. when you have no help at all from the republican side of the aisle, illustrated by the performance just put on on bare prepared quality, it is not easy to find everyone in agreement. and then there was an effort to move to expanding medicare. and i think that is a fallback position that would have been very, very helpful. and there are some who are contending that people who are disappointed with the lack of a

public option, disappointed from the retreat of expanding medicare to say that we ought to start over and begin again. and i can -- and i can understand that frustration. my own view after thinking it through very carefully is that we ought to proceed and do as much as we can do this either, realizing that some of this health legislative achievements take a period of time to accomplish. at the civil rights act of 1957 was necessary, although it didn't go as far as people would've liked to get the civil rights act of 1964. again, didn't go as far as people would've liked. but we did find the civil rights act of 1965 and we have to find time when we have to build incrementally on these matters.

and i have been in the senate following the elections of 1980 and i have seen matters take a very, very substantial period of time. while it's not on the subject, trying to provide more than 100,000 jobs in pennsylvania by deepening the channel. the authorization came in 1983, took until 1992 to get the corps of engineers to agree in funding now has $77 million. we are still in court but is going to move forward weird i don't expect health care legislation to take that kind of a long-term, but it is a matter which does take some time. it is my hope that we will get improved this bill. it is my hope that when the bill goes to conference, we will find

the ways perhaps even to bring back the public option in a refined sense. the public option is in the house bill. one republican senator who has stated opposition on the grounds that there hasn't been time enough to review the bill. well, it is complicated. i think there has been time enough to review the bill, but i respect the view of the senator on the other side of the aisle and when the bill goes to conference, that senator will have an opportunity to reveal the the bill further. having voted out of the finance committee. another republican senator has commented that the bill has been very greatly improved, not sufficiently from the taste of that senator, but perhaps we will find a way to improve the bill. and we still do have a right

camera legislature. we do have the house of representatives which has the public option. the comments were made about the fall of the expansion of medicare on the grounds that it was considered in to brief a period of time. not enough time to digest it. not enough time to think through. well, we'll have a month of january some time to consider that further. and in conference we'd may well find dead were able to clear the bill. now we can get to conference unless we pass a bill out of the united states senate. i was asked yesterday, how will i respond to my constituents if we have the bill which has had so much taken from it? and i said more relevant question or an equally relevant

question is how will i respond to my 12 million constituents in pennsylvania if we go home with nothing? and that if we have 80% accomplished, then that's a great achievement. or it is a starting achievement. and it may well be that it will take the campaign in 2010 if this united states congress will not pass a bill web a robust public option, could well be a campaign issue. i believe that my colleagues on the other side of the aisle may well be misreading the american people. i believe the american people do want health reform. and it does take time for the american people to understand the ramifications of it, that

this may well be a campaign issue in 2010 to 111th congress may have a different view as to how we ought to proceed. during the month of august, when i was making the rounds of town meetings in pennsylvania in accordance to my habit to cover almost every county, almost every year, when i got to the first town meeting, the second tuesday in august, first week we were in recess i found instead of the customary 85 or 100 people, more than 1000 people, three national television sound, cnn, msnbc, and fox. and there were a lot of it to produce statements. one man approached me and said the lord was going to stand before me. i think he meant to say that i was going to stand before the lord. senators are reputed to have

power, but not quite that much power. well, i think the public tenor is considerably more favor to health care insurance than it was then. and after the 2010 election, it may be substantially more favorable. but i think we have to move ahead with building blocks. and we do have the chance to improve the building conference. i would point to the provisions of the bill, as to what we have. we have eerie significant insurance reforms, eliminating discrimination based on preexisting conditions. we have new health insurance exchanges. we have an elimination of account. we cover many of the uninsured, expanding to some 33 million additional people, substantial more small-business assistance.

preventative care, increased health workforce. we have improvements in the health delivery system. we have fiscal responsibility that this bill will not add to the deficits but in fact reduce the deficit in the first decade by some $120 billion in the second decade by some $650 billion. we have a provision that i have pressed in the earlier legislation that senate bill 914 be provided for transformational medicine. during my tenure as chairman of the appropriations committee on health and human services, i took the lead with the concurrence of senator harkin which was then in the minority to increase nih funding from 12 to $30 million. and then in the stimulus package to that $10 billion more.

and there has been a gap of what we call transformational medicine going from the vents in the laboratory to the bedside. and while i haven't seen the final version of the managers packets, i'm informed that such provision will be a part of the bill. we have a very important measures for preventative care for annual exams which will cut off many chronic illnesses which are so debilitating and so expensive. i have pressed an amendment which is pending to have mandatory jail sentences for at least six months for someone to invade date of $100,000 or more of medicare or medicaid fraud. and jail sentences are a real

deterrent. the experience i had as philadelphia's d.a. is when you have a fine and send along the cost of business passed on to the consumers i would ask consent that the statement of the provisions which i briefly summarized, which are very favorable in this bill in the statement of testimony of a criminal justice subcommittee hearing be included, showing the value of deterrence. >> without objection. >> mr. president, how much time do i've remaining? >> the senator has seven minutes remaining. back i think the chair. mr. president, there is another very important aspect in mind of the senate and acting a legislation on this bill. and that is, we were sent to

washington to govern. and what we have seen in the recent past has been a staggering partisan politics. partisan politics has become a blood sport in washington d.c. it's a blood sport on the floor of the united states senate. and the point from the republican side of the aisle has been very clear. that is to make this president obama's waterloo. to quote, break president obama, close quote. and i saw the ramifications when we took up the stimulus package or earlier this year. and there were only three

republicans, senator snowe, senator collins, and myself who would even talk to the democrats. and there was a determination to look ahead to the 2012 elections of the presidency, even before the ink was dry on the oath of office taken by a president obama on january 20. this was the second week of february, the week of february 6th as i recall, just a couple of weeks. and already the plans were for the next election. and as i reviewed the matter, it seemed to me that we were on the brink of going into a 1929 depression. the 1929 depression was very hard on the specter family. living in wichita kansas at the time, both of my parents were immigrants in the mid-30's the

family moved from wichita to philadelphia to live with my father's sister. that's what happened in a depression. you moved in with relatives because there were no jobs. and i cited with the supporting the stimulus package and played a key role in having not enacted. and the political consequences on the personal level are not something to be discussed in this forum at this time. but the conduct partisanship on the stimulus package is directly relevant to what we're doing here today. and that is where been stonewalled. and i think it is harder for the republicans to stand up on health care reform and join the democrats today than it was in january and in february when three of us did so. and if i were on the other side

of the aisle today i would be supporting health care reform. i would be supporting it and perhaps if i were on the other side of the aisle today i could ring somebody with me. i don't know. that's entirely speculative. and without revealing any more of the confidence which went inside the republican caucus, when i talk about a republican senator's statement, this should be the waterloo of president obama and this should break and. those are matters in the public record. but the pressure over there of the republican caucus is perhaps intense. and we were sent here to govern. and the democratic caucus the presiding officer, distinguished senator from colorado, was there on monday when my turn came to speak i said i have to sentences.

may the record show a smile on the face of the presiding officer. i said i have to sentences. one sentence is that the bill is a great deal better than the current system. in the second sentence was we should not let obstructionism prevent us from governing. and that's why i crossed the aisle to make the 60th vote. and very surprised it's been in the public record i'm a bit in the newspapers, they stood up and applauded and i read in one of the newspapers today you could hear the applause down the quarters so that they knew what was going on. well, that's the role that seems to me of the united states senator. and we are facing a situation where is defeated, we'll have a significant impact on the tenure

of president obama. we had a meeting on tuesday, two days ago in the executive office building and it was rather a remarkable setting. it was a large rectangular table and in the center on each side, one side was president obama, the other side was vice president biden. and almost all of the 60 senators were president. i believe everybody else was present. and during the course of that session the president expressed himself and this has also been publicized that if action was not taken now that it would discourage anyone from the foreseeable future, from undertaking health care reform. if now with both houses and 60 members of the democratic party you can't get it through the senate and get a conference and get it enacted.

and some of those who were most vocal urged most vocal in the favor of the public option urged those in the caucus who disagreed to reconsider their positions. and i would renew that request, that they reconsider their position. and the people who would classify themselves as most progressive in the democratic caucus have swallowed hard and announced publicly that they would support this bill, even though it doesn't have the robust public option, doesn't have the medicare expansion. and that may -- that may shift a shift yet. but we have an enormous number of problems facing this country. i think it is fair to say, accurate to say 30 seconds more mr. president. >> without objection.

>> fair and accurate to say that there are more problems facing us today than anytime in our history and we have to finish health care next year to move ahead to jobs. we of the issues of global warming and climate control. we have the problems of the mideast east process and the difficulties in iraq and north korea and afghanistan. and we need a strong president and we need a congress which has the courage to act, the tenacity and willingness to face tough problems. and we need to show the american people that it's not all gridlock here. that it's not all desperate desolate partisan politics. so my vote will be in favor of the bill, although i am frankly disappointed that i share the frustration expressed by many people who say go back and start again. and this is a significant step forward.

we have a great chance to improve it and conference and beyond that there'll be another caucus with an analogy of civil rights legislation we can get the public option and get to a greater public governmental involvement but for the betterment of the american people. i think the chairman and yield the floor. >> pennsylvania senator bob casey said he will continue to negotiate with nebraska democrat ben nelson on abortion language for the senate health care

bills. those remarks came during a news conference on the 2010 defense spending bill which the house passed on wednesday. this is about 35 minutes. >> good afternoon i'm delighted to be joined by senator stabenow and senator casey. we are in very difficult and challenging times for our economy after the failed policies of the bush administration. yesterday the house passed a 2010 defense appropriations bill. we are here to call for quick passage of this without delay. we could've passed a bill yesterday. we could've passed it today. we should pass it as quickly as possible. first and foremost, this bill provides the funding for our military forces across the globe and ensure they have the proper equipment, proper quality of life, to ensure that they continue to do their job as they face the threats better posed against the united states. but it also assists countless

americans who are hit hardest by these difficult times. people love love their jobs through no fault of their own. it would help them to literally put food on the table, pay the rent, keep the heat on in the wintertime, provide help with health insurance and do other things that are necessary while also contributing to the economy of the united states. our bill includes a short-term extension until the end of february of several critical safety programs. it extends unemployment benefits, including increased payout and longer duration of benefits through february 2010. if this deadline does not extend beyond december 31, 1 million jobless americans will lose their benefits in january. we also extend to february february 28th the benefits associated with cobra. 65% of cobra health insurance for individuals have lost their jobs in this will help american

danley's deal with the pressures that they are facing. and it also provides funding for the supplemental nutrition assistance program or snap program including $400 million to other states effectively administer the program and speed up processing applications. using reports in the press where the individual families who never in their life.they would be needing nutrition assistants, who now have to depend upon not to keep their families fed. and that's something we have to respond to. this is a problem and it has reached out across the country and up into middle income families that never in their life thought they'd be needing and actually relying upon food assistance like this. ..