money. so here we are with a bill passed by the senate, two months and 10 days ago and passed by the house a month -- months before that, and so, clearly, one can only assume while -- let me put it this way. one would question why the senate passed its version on october 6, the house passed its version on july 30, why would we wait until december 16 to bring it to the floor of the senate? now, one might conjecture that they didn't bring it to the floor of the senate because they knew that it was going to have to be passed by the congress of the united states. of course we are going to pass it. and yet, this is -- so this is the best opportunity to add these programs and projects that

would never otherwise be passed. so, here we are with a legislation to take care of the men and women in the military and our national security needs, and we have loaded it up with $7.3 billion in pork, $18 billion in new offset funding, which is not paid for, and so then my friend and colleague from illinois comes to the floor and says republicans are holding up the passage of this bill, even though -- even though the senate passed this bill on october 6. mr. durbin: would the senator yield for a question? mr. mccain: i'll be more than happy to engage in a colloquy with my friend from illinois if he would request to do so, or a

question. either way. mr. durbin: i have a brief question. when we were here at 1:00 a.m. blearry eyed voting and there were two unanimous consent requests made to pass the department of defense bill immediately, does the senator from arizona remember that the objections to passing the bill immediately so we could get the money to the troops came from his side of the aisle when we tried to pass this bill? mr. mccain: i do recall that, i say to my friend. and i also recall that i was only allowed ten minutes -- ten minutes -- to talk about this bill and the 1,720 earmarks, the telescope in hawaii -- i've got some list over here. i was allowed ten minutes. i need a long time to talk about this. if the democratic majority, which is their right, wants to wait until december 17 and then

jam it through in the middle of the night, that's their right to try it. but we need to talk more about why the american people are angry. $18.9 million to defend the nation, to defend the nation, $18.9 million for a center at the university of massachusetts -- quote -- "dedicated to educating the general public, students, teachers, new senators and senate staff about the role and importance of the senate." now, i really hope that this, this organization at the center for the university of massachusetts would somehow come into being, perhaps not with taking it out of money for defense. but if there's ever a time that the american people need to understand the role and importance of the senate given our approval rating is about 4% -- and i haven't met of them -- i understand why someone would want to have a center to teach new senators and senate

staff about the role and importance of the senate. but $18.9 million when people are not being able to stay in their homes, when they're unemployed, when they can't feed their families, when unemployment is 17%, sure, add it on to the defense appropriations bill. that's the way to do it. $500,000 for my old favorite -- the old brown tree snake program. i totaled up the millions spent on the old brown tree snake program and the historical fort hamilton community club, that needs $1,800,000. i'm sure it's a nice place to visit. i'm sure it's great to have $1.6 million to study human genetics at the maine institute in brewer, maine. $3.5 million for a micro algae fuels project in hawaii. $5 million for the presidio

heritage center in san francisco. $1.6 million for a space tpher -- i think that would match up with the $2.9 million we appropriated for the previous bill to study in outer space. $1.6 million for virtual business accelerator for the silicon prairie. $7.8 million to develop key technologies needed for the long-term operations in near-space conditions. so we've got surgery in outer space and key technologies needed for near-space conditions for the oryan high-altitude long endurance risk reduction effort. the aurora in mississippi. $800,000 for advanced tactical laser flashlight in wyendot,

michigan. $10 million for the hawaii technology development venture. my friends, this is kind of a classic example -- i see my friend and colleague on the floor, senator coburn, a man of courage and integrity and one who i think has led in many ways this fight. but here's an earmark in this bill, never authorized, never had a hearing, $10 million for the hawaii technology development venture. what could that be? what could that be? did we ever have a hearing? did we ever have a depiction of this? did we ever have it? no. it was stuck in, stuck in by the appropriators. $3.9 million for intelligent decision exploration. if there's ever a place that needed that, it must be, in my view, the united states

congress. $3.9 million for intelligent decision exploration. i think that, frankly the results of that exploration would be rather pwhraoefpblgt $2.3 million for marine species. $2.4 million for naverre high fidelity oceanographic library. the list goes on and on. here's hawaii again. $2 million for an advanced laboratory for information integration, naturally in hawaii. $1.2 million for the model for green laboratories and clean rooms project. again i want to point out, as my colleague from oklahoma has, that these may be very worthwhile projects. they may be projects that may be help america. maybe spending our defense dollars, $5.8 million of it, for the rock island arsenal roof replacement in rock island,

illinois, is something badly needed. maybe the $800,000 for the natural gas fire tube boiler demonstration at the rock island arsenal is also very necessary. but how are we to know? how are we to know? so, it's -- the senator from i will tphoeup and the democratic leader have come to the floor -- the senator from illinois and the democratic leader have come to the floor and saying the republicans have blocked passage of vitally needed funding for the men and women in the military who are defending our nation as we speak. my response is: where were you for the last two months after the senate passed this bill, the senate and the house could have had a conference and we could have had this bill long ago. and the fact is that it's been loaded up with food stamps, satellite home viewer act extension, patriot act extension, flood insurance extension, small business extension, payment for a construction project, highways

extension, unemployment insurance, cobra extension, the old doc fix, the old doc fix that we do year to year and other chapter and profiles in courage on the part of the congress. poverty adjustment freeze, rescission of dtv funds. it goes on and on. what does that have to do with defense? what does that have to do with defending this nation? what does that have to do with giving the men and women who are serving in our armed services today in harm's way the best equipment, best training and the best support we can provide with. i see my colleague from oklahoma on the floor. i yield the floor at this time. a senator: mr. president? the presiding officer: the senator from oklahoma. mr. coburn: i think as america looks at us and says here it is a week before christmas and

we're debating the defense appropriations bill, but it's interesting to note that the first bill -- appropriation bill that passed out of the congress was the bill -- we put ourselves first, not our troops first. we've had no inflation this year. what did we do? we gave ourselves a 5.8% increase. the first bill to be passed. the first appropriation bill to be signed by the president. we put us first. and so here we find ourselves a week before christmas debating the defense bill that -- and we're in the midst of two wars that has an increase of only 4%. and we have all of these people who say they're for the defense. and, yet, we pass a bill that increases our expenses by 5.8%

and we tell the defense department you can't do that. you can't have what we have. and the fact is it's easy to return 15% of everything that you take in up here and what you're allotted. i've done it on every year that i've been year. and my employees are well paid. they work hard, but they're well paid. but we gave ourselves a 5.8% increase and this defense department bill in the middle of two wars have a 4% increase. the average of all of the increase right now is 11% on all the rest of the bills. and here they are. and that doesn't include any of the spending for each of these agencies which averaged around 30% of their budget that they got in the stimulus bill. so here we go.

we give ourselves a 5.8% increase. homeland security 72% increase. and t-thud23%, interior, 20 -- and state and foreign ops, 33%. but we did us first to make sure that we got us covered. now, all of this is very ironic to me in the fact that out of every dollar we spend this year, 43 cents of it is borrowed. of every dollar the federal government spends, 43 cents out of that dollar is borrowed. we are borrowing $4.2 billion a day. that's not a business day. that's every day of the week.

there's $350 billion t to $800 billion of waste in the federal government. not one place in any of these bills did we eliminate duplicative services. not one place in any of these bills did we eliminate fraud. not one place in any of these bills did we cut the value of earmarks. the number is down only slightly. but the total dollar is up. we made -- we made no attempt to do what every family in america is doing today and that is to prioritize. so we -- now we find ourselves. and next year, it's going to be 45 cents of every dollar that the federal government spends, we're going to borrow. why is that important? it's important because the people making the decisions to borrow the money are not the ones that are going to have to pay it back. we're going to transfer that --

we're going to violate the tradition and heritage of our country because we're going to transfer a marketedly lower standard of living to our children. i met this little girl. she's from maryland. her name is madeliene. and if you divide the total debt by the total population -- just the debt we owe now. and that's truly enron accounting. because it doesn't account internal debt that we owe. money we borrowed from medicare. money we borrowed from social security. money we borrowed from other transfer funds. $38,385. that's when it picture was taken, it's now well ove over $39,000 per man, woman, and child. that's just on external debt. and the only thing she owns is a doll house. the real tragedy is that when

madeliene's 45, everybody her age and younger will be responsible for $1.19000 worth of -- $1.119 worth of debt before they pay any other taxes, before they buy themselves a home or automobile. before they snd their kids to school -- send their kids to school, they'll be a at $1.19 million, debt plus defined unfunded liabilities. this is the u.s. debt clock. it sits in the doorway of my office in the russell building. i had it out in the floor. the rules committee would not allow people to look at that. i don't know whether they didn't want people to see it or it truly doesn't fit with the pot kal. so now i have a -- protocol.

so now i have a door opened to my office and i have a live computer screen that changes every day. this is as of november 21st. november 21st to december 18th, that's 27 days, we're borrowed anothe another $100 billion since we took this picture off the internet. so we're at $12,118,000,000,000. calendar year to date, the federal government had spen spent $3.285 trillion. the debt per citizen on the 2st was $39,000. per taxpayer it was $110,000. and our deficit as of novembe november 1st, for the calendar year was $1,409,000,000,000. all of it bore wroted. -- all of it borrowed. the private debt in the country

is $16 trillion. that's our private debt. that's what all of us owe on our own stuff. and the mortgage debt is $14 trillion. and if you look at the second screen that's outside my office, what you see is -- is the total cost of the bailout so far far, $11 trillion. we only have personal savings of $643 billion. and our savings per adult is less than $3,000. so how do you take that $3,000 against the $39,000 and make any sense out of it? and then the final screen shows the personal, individual debt, the credit card debt and payment. it shows our g.d.p. we're good as a nation. our woarks are good. we -- workers are good.

we pro -- that's going to decline because of what the federal government is doing. there was a guy once named cisaro, and he warned about one of the things that would happen to one of the bes best known republics in the world. he said, the budget should be balanced. i think 90% of america would agree with that. the treasury should be refilled. the public debt should be reduced. the arrogance of officialdom, should be tempered and controlled. the assistance to foreign lands should be curtailed less roam become bankrupt. people must again learn to work instead of living on public assistance. well, they didn't listen to cicero. much like the u.s. senate is not

listening to the citizens of this country. and we're growing a federal government that we can't afford outsides the bounds of what this document, the u.s. constitution, says is our legitimate role. if you look at our article 1, section 8, you see the enumerated powers, and you go look at the 10th amendment, you ask, how in the world is the federal government involved in all of these things. we have before us a bill to fund our troops and fighting two wars and other than one other appropriation bill, we gave it the smallest increase. and, oh, by the way, in this bill is $18 billion of what we call emergency. so we don't have to pay inside the budget. so we just automatically transferred another $18 billion to madeliene. and her generation.

how do we get out of this? what do we do? well, we actually -- congress should be following the lead of the families in this country. what are families doing? families are sitting down and making priorities. they're saying, what are the things we must do? what are the things we want to do? and what are the things we'd like to do. and most of the things we'd like to do are going out the window for american families today. a large portion of the things families want to do are going out the window so that they can maintain the things that they must do. it's called making hard choices. and when you see the fact that the congress took care of itself before it took care of anybody else, it describes the problem

in washington. because we're absolutely clueless to what the average american is going through. and we can have all the words on the senate floor said that we want to say, but our actions speak far louder than any words we could ever say. and what are our actions? our actions are to steal the future and prosperity of our children. not a very noble cause. we're here this week, not because of the defense department bill. we're not here the week before christmas because of this bill. we're here the week before christmas because somebody has set an artificial deadline that we must pass a health care bill, any health care bill, so we can say we passed a health care bill. that's why we're here.

and when we look at health care in our country, we recognize that we have significant problems in making sure everybody has access to care. and we know what the problem is on access to care because we know per capita we spend almost twice as much as anybody else does in the world on health care. so the problem plaguing access to care, and as a practicing physician for over 25 years, is cost. and so we have some bill coming some time that won't be available for 72 hours for everybody in the country to read, that by the time you add the 2,074 pages to the couple of pages that we're going to add on it, nobody's going to understand exactly what they're voting on. but we're going to vote on it because we said we would. and we're going to impact

one-sixth of our economy and we're going to destroy the best of our health care system in the name of fixing some of the problems in our system. we are totally disconnected with america. the america i know. you know, there was a guy who made -- and i will paraphrase the statement, freedom is a precious thing. it is not ours by inheritance alone. it must be fought for and defended by each and every successive generation. what's that freedom he's talking about? and who is he talking to? he was talking to the american people. he wasn't talking to our troops. and the freedom he was talking about was the liberty that comes when free people come together

under a democratic republic with a limited federal government to make the best choices that they can make for them and their families. and the freedom to do just that. that person was ronald reagan. i got an e-mail from a constituent of mine. i can't use the exact words because they're not appropriate for the senate floor. but he kind of paraphrased that statement and then he said, every now and then somebody comes along and pe rces it all away. he said, son, don't let it be you. well, our freedom's being taken away in this country. not intentionally, but unintentionally. because as the federal government grows an expands --

and expands, your opportunity to help you and you family becomes limited. we have a health care bill that will spend $2.5 trillion over the next 10 years. it's going to cause premiums to rise. it's going to cause quality of care to go down. it's going to cause us to lose 1.6 monthly jobs, and it's going to cause the government between the patient and the caregiver. that bill will create 70 new government programs, 15 thousand to 20,000 new federal employees, will create three panels that will ration care in this country directly and will in fact take americans -- not just americans

on medicare and medicaid, americans' freedom to make the best decision for them and their family as regards to their health care and stuff it in a box. because we're going to tell you what you can have, what you can buy, and we're going to totally disregard the art of medicine. and we're going to practice cookbook medicine in this country. you know, a week ago we reversed the u.s. preventive task force recommendation on breast cancer screening. we're going to have to do that hundreds of times every year under the bill being proposed right now because all of that is based on cost estimates. it's based on one out of every 1,970 women they find with

breast cancer between 40 and 50. on -- the majority whip earlier today said that the republicans didn't have any ideas on health care. well, the fact is we do have ideas on health care. what we know from thompson reuters that came out in april of this year is that there's $700 billion in our system today that isn't helping anybody get well and isn't preventing anybody from getting sick. and if we want to truly cut the cost of health care, what ought to be required reading for every senator in this body is the thompson reuters report. because they can go through the fraud and abuse, 19% of

everything we spend. unwarranted use, that includes me as a doctor, doing tests i shouldn't be doing. that includes defensive medicine. administrative system inefficiencies. provider inefficiency and error. avoidable care and lack of care. duplication. we've not attacked the disease of runaway health care costs in this country. what we've attacked is the symptoms. you don't cure people by treating their symptoms. you cure people by finding out what their disease is and curing the disease and treating the disease. we're accused of being the "party of no." i want to tell my colleagues and the american public "no" is a wonderful word when your child's misbehaving, you say "no." when your adolescent child is making bad judgments, "you say

"no." when somebody's stealing something from somebody else i.e., liberty, you say "no." when you're stealing the future in terms of opportunity, we should say "no." when you're creating a government-centric health care system rather than a patient-centered health care system, "no" is a great word. we've heard all about why we don't have any ideas. we had two markups. the ideas we offered were rejected. i see senator wyden on the floor. he has a wonderful health care bill. it's somewhat different than the one i introduced, but it's a great bill. and it doesn't fall into any of the traps that the bill that's on the floor today falls into. and it also addresses many of the problems that are outlined

in the thompson reuters study on health care in america. so, saying "no" at the right time saves lives. saying "no" at the right time saves money. saying "no" at the proper time preserves our future. saying "no" when "no" is the best answer is the correct right thing to do. we have a government we can't afford -- the presiding officer: the senator's time has expired. mr. coburn: i will finish up. i ask unanimous consent for 30 seconds. the presiding officer: without objection. mr. coburn: we have a government we can't afford. we're borrowing money to buy things that we don't need. we earmarked $18 billion worth prof skwrebgts this year. -- worth of projects this year. some are good, some are terrible. we eliminated no duplication in

any of the agencies. we did nothing about efficiency, and we did nothing about creating priorities in this country. i agree with my democrat colleagues that health care should be a priority. and when we had the leadership, we didn't do anything with it, and we should have. mark my words, this is a turning point in america if we pass the health care bill. it's a turning point that we will not recover from. with that, i yield the floor. mr. durbin: mr. president? the presiding officer: the majority whip. mr. durbin: mr. president, it's my understanding the democratic side has 30 minutes now. the presiding officer: the senator is correct. mr. durbin: i see the senator from oregon is here. if i could have a few minutes to respond and then turn the floor over to him for as much time as he would need. first, the history lesson, and sometimes facts are tenuous, difficult, sticky things you can't get rid of. so let's look at the facts. when william jefferson clinton left the presidency, america's

budget was in surplus. for the first time in 30 years, we were generating more revenue than we were spending. we were adding life and longevity to the social security system, to medicare and many others. we did this with a prosperous, booming economy, one of the most prosperous we have seen in modern history, creating new jobs, new businesses, new home opportunities across america. and when william jefferson clinton left office, we had a national debt of $5 trillion. in came the republicans. billing themselves as fiscal conservatives. they were going to do it better. get government off our backs, reduce spending and show us how they could manage. they took a $5 trillion national debt and over the next eight years more than doubled it. in other words, when george w. bush left office, america had more debt, twice as much as was

the case when he took office. how did we reach a point where our debt mushroomed and more than doubled in eight years? because these fiscally conservative, flinty-eyed republicans engaged in a war that they wouldn't pay for. some of the senators who have just spoken on the floor of the senate this morning voted for us to go to war and not pay for it and just added to the debt. secondly, presideñ -- president bush did something that was counterintuitive. what was it? he cut taxes in the midst of a war. it's never been done, because you can't explain it. you have the ordinary expenses of government that still continue and now you have the new expense of war and instead of doing what franklin roosevelt did in world war ii and say we're going to sell bonds, we're going to do our best to pay for the war, they did the opposite. we're going to go into debt even

deeper to pay for the war, to not pay for the war. and that's what they did. they went in debt by cutting taxes on the wealthiest americans. unpaid for wars, tax cuts in the midst of wars for the wealthiest people, and then to add insult to injury theyed the -- passed the medicare prescription part-d program and didn't pay for it adding hundreds of billions of dollars to the debt too. at the end of eight years, george w. bush, who inherited a surplus in the treasury, from bill clinton, gave us twice the national debt, gave us the largest annual deficit we had ever seen and left the economy in shambles. witness the recession we're currently in, just starting to inch away from. that was the record of the fiscally conservative, let's get tough on debt republicans for eight years and many of those years they controlled congress. all of those years the president

had a veto pen. so when i come to the floor and hear from my republican colleagues how they have a better vision of america -- their vision in many respects is a good one, to reduce our debt for future generations, but the record speaks for itself. they failed. so now comes president obama and basically says to congress, we've got to get this economy moving again. and some republicans are criticizing. saying it's a mistake for us to put money into our economy. the president said we've got to put people back to work. give working families a tax cut, key the ate jobs building -- create jobs building infrastructure, help to expand people's payrolls. it costs money for sure, i know we're in debt, but if we don't get the engine of the economy churning and moving forward, we're never going to get out of the whole and more suffering that will be the lot of the american people. not a single republican would -- we didn't get one republican vote for that in the house of representatives over here we had

three. two senators from maine and the senator from pennsylvania who has since crossed the aisle and joined the democratic party. that was the reality. as a party, the republicans opposed stimulating the economy in the midst of the deepest recession. and now comes health care. and president obama says to us, before you pass this health care bill, there's one basic rule, do not add to the deficit. find a way to reduce health care costs for individuals, families, and businesses. do not add to the deficit. and the congressional budget office took a look at this bill, took a year to prepare it and said it is the biggest deficit cutter in the history of the united states. because over 10 years, this bill alone will save the federal government $130 billion and over the next 10 years, $650 billion. if we continue without change current health care system, it will be more debt for everyone, higher premiums, higher costs and more deficit. that's the fiscal choice that we face.

when i hear senator mccain, who is my friend. i respect him. we serve the same -- served the same period of time together in the house and senate. we disagreed on a whole lot of things and i like him. i think he likes me a little bit, some days. and he comes to the floor and says, you know what's wrong with the department of defense appropriations bill? in his words, the democrats have larded it up. they have larded on things. what is the lard in this bill? the extension of unemployment benefits for the millions of americans out of work. the last time that came to the floor of the senate, it passed 97-0. not exactly a controversial issue. but, sadly, it took us one whole month to get to a vote and it passed. lard it had up with food stamps. the state of michigan, one out of six people are on food stamps. food stamps are a lifeline for people who are out of work and don't know where their next meal

will come from is that the squandering of taxpayers' dollars? i don't think so. he's not a hard-hearted man. he wants to feed children. how about koab. a it is an acronym for people to pay for health insurance. one of the first casualties when you lose your job is health insurance. we help to pay the premiums when you're out of work. i don't think we're larding it up when we include that. the extension of the patriot act for a few months? of course, if we're going to be vijt rant against our enemies, we should extend it. an extension of nate act is going to mean that america will be safer. the alternative is unacceptable. money for the small business dmimtion? that's where jobs are created. -- administration. that's where the jobs are created. if we don't give money to small businesses, people will cut back on employment. there is no respectable main line economist who argues that the way to get out of spending is to cut spending at the

federal level. you have to help people at the safety net. you have to try to create a catalyst for more job creation and that means spending money. i don't think this is lard, earmarks, and pork barrel. we're talking about the basic necessities of life and the department of defense appropriation should not be filibusters as the republicans are currently doing. i will say before i hand it over know friend from oregon, i want to salute him, because you've given more hard thought as an individual senator than enemy anyone in chamber about what to do with the system and your premise in health care is the right premise, more competition, more choice. we may disagree on some concepts, that's what we're here for. but i want to salute the senator from oregon and just tell him that this underlying health care bill is going to do things for america that need to be done. it's going to start, not as much as we like, but start to bring down the increase in cost. affordability for families an businesses. it's going -- and businesses.

it's going to extend the reach of health insurance to 94% of the american people. it's an maig amazing thing. it will extend the bill of rights to give families the ability to fight back when the insurance companies say no to your family or what are you family needs. one last thing i'll mention before i sit down, i want to salute you, senator wyden, as well as senator bernie sanders of vermont, for one particular provision in here. we don't have the details yet, but we believe that this will result in the most dramatic expansion of health care clinics across america. those of us who represent communities like chicago and even down state illinois, know that these clinics are the first line for medicine. that men and women can walk through the front door and find primary care and have their

needs taken care of even if they're poor. some of the most dedicated hard-working professionals in medicine are in those clinics. i have said to people there, the director at one, said, carmen, if i were sick or my wife were sick, i would feel confident walk through your door. i ask consent that the record include an article from this morning's "chicago sun-times" that talks about the terrible health care disparities in the united states, particularly between african-americans and white americans. the presiding officer: without objection. mr. durbin: in heart disease deaths in 1990, there was an 8% difference between african-american and white americans, 8%, breast cancer deaths, today there's a 99% difference. prenatal care during the first trimidwester, 19% difference in

1990, today 199%, tuberculosis 310% in 1990, 490% today. these gross health care disparities are a result of the lack of primary care in the neighborhoods and towns in america. thank you for leading the fight to expand that. i yield the floor. a senator: mr. president? the presiding officer: the senator from oregon. mr. wyden: before he leaves the floor, i want to commend the distinguished senator from illinois for his statement and also that the body recognizes that it has been senator sand hoarse has championed this -- sanders who has championed this cause making the case that dollar for dollar there is no better investment in health care than these community health centers. i was going to spend my time this morning talking about the opportunities for democrats and republicans to continue to team up on this health reform issue. i think it's worth noting, that senator sanders, who has

championed this effort in this bill, is actually picking up on work that a number of the most influential republicans in this country have been interested in for years. george bush -- president george bush was a great champion of community health centers an bernie sand -- and bernie sanders in this bill is making sure that we get a very significant increase. thousands of new clinics. so are opportunities for democrats and republicans to work together. i'm going to talk about a way we can create a new marketplace in american health care through these exchanges and get more value for the health care dollar, again, focusing on the opportunity that we see with community health centers for democrats and republicans to team up. and i thank my colleague for his statement. mr. president, and i know because of our work together on health legislation, you share my view that we can continue this effort to bring the senate

together, both sides, around key principles of health reform. and i want to do that again this morning by focusing on one of the most transformational and least understood parts of the health care debate. and that is the question of the health insurance exchanges. now, my guess is across the country people are trying to figure out what in the world these are and is this, yet, some other kind of health care lingo? but i think it's fair to say and just base -- in just basic english, this will be like farmers markets. this will be an opportunity for people to go to one place and to do what you can't do in the dysfunctional american health care system today. and that is actually shop and be in a position to compare various kinds of products and services and when you invest wisely, you

can put the savings in your pocket. and the reality is that has not been possible in our country since the middle of the 1940's. during the 1940's when there were wage and price controls, judgments were made about the delivery of american health care. made sense back then when people went to work somewhere and stayed put for 30 years until you gave them a gold watch, but today's economy's very different. people change their jobs 11 times by the time they're 40, and we need to make sure that no longer is the consumer insulated from the health care system. no -- no longer are most consumers incapable of being rewarded when they shop wisely, and we make sure that people even understand that they lose out in terms of

their wages if health care costs continue to rise as a result of inefficiency. so these health insurance exchanges are the key to making health care markets work in effect for the first time since the middle of the last century. now, in the merged bill, senator reid, in my view, has laid an important foundation, and there are three fundamental principles in senator reid's merged bill -- and of course, we're going to continue to work on this. the managers' package. this bill gets out of the united states senate. we're going to be working on this for quite some time, mr. president. we're going to be working on this long after 24/7 cable tv has moved on to other topics. but in senator reid's merged bill, there are three important features of the exchange. the first is it's going to be possible for consumers to make

apples to apples comparisons of various health care plans. consumers will be able to see that one plan will cost them $20 in co-pays for a physician visit, but perhaps another plan will cost them $30. it will be much like you can do in a store, a costco, a grocery store where consumers look at products on a shelf, look at the price, look at the various offerings and choose the best product for themselves. the second feature in the merged bill that democrats and republicans alike should appreciate is it will be possible to keep low quality plans out of the marketplace. this is especially important at the outset, prpt, and i learned this back in the days when i was codirector of the oregon gray panthers, the senior citizens

group. one of the things the country learned in the early days of medicare is a lot of the policies that were sold to supplement medical were just junk. they weren't worth the paper they were written on, and people would buy 10, 12, 15 policies, literally wasting money that the seniors could have used for food and fuel and paying the rent. and it took us until the mid 1990's to drain the swamp, and finally we were able to do it, standardize those packages, stop the rip-off of older people with products that literally weren't worth the paper they were written on, and the consumer protection provisions that senator reid has put in the merged bill as it relates to exchanges are going to keep low-quality plans out. this is going to offer consumers the peace of mind, knowing that

when they look at the plans, they can be certain that they will have to meet minimum consumer protection standards. this is an important message to send in a new marketplace, and, boy, it will be an opportunity to have a very different start than we saw with medicare during those early days when seniors were sold these policies to supplement their medicare private insurance policies that were a lot of junk. finally, under the merged bill, you're going to be able to see the value that you're getting for your health care dollar in an important respect through what are called loss ratios that insurance companies would have to make public. what this means, of course, mr. president, is that consumers want to know that when they put out a dollar for premiums, that they get a significant portion of that dollar back in actual

benefits, services and benefits, and with the exchange it's going to be possible to finally get this kind of lost information in one place and make it public. now what i'd like to do is talk about the steps from here, and particularly build on principles that the president talked to us about earlier this year in terms of ideas that bring democrats and republicans together, and that is more choice and more competition in the health care marketplace. and what we're pointing to, mr. president, is the day when every tourism in america can say to their insurance company i'm giving you an ultimatum. you treat me right or i am taking my business elsewhere. that is what we are pointing to, and here are some of the steps that it is going to take in the

days ahead to build to that future. first, you've got to have a big enough pool of people as soon as you can so as to maximize their clout in the marketplace. you've got to make sure that the exchanges are open to more than just folks who have been uninsured. if you open it just to folks who are uninsured, who haven't seen a doctor, have chronic illnesses, haven't been able to get the preventative care, you have coming to the exchanges folks that are sicker, and, of course, they are more expensive in terms of getting them good health care and it is harder to hold costs down. now, once you have a big enough pool where the risk is spread across a large group of people who have a wide range of health

seasons, you will be in a better position to force the insurance companies to compete and drive down costs for everybody. so in effect in the days ahead, we'll be in a position to put in place a cycle in the health care marketplace that will get more value for the american consumer. more and more people will come to the exchanges because the premiums are lower. more insurers will come into the exchange because they see that's the place you have to go in order to get business, and you have what amounts to the beginnings of a revolution in the health care marketplace. get as many healthy people into the exchange, make it impossible for the insurance companies to find loopholes and use slick marketing campaigns to cherry pick just the youngest and

healthiest, force them to compete on the basis of price, benefit, and quality, and then you are on your way, mr. president, to taking a dysfunctional american health care system and getting the choice and competition that will finally pay off for the american consumer. now, there are some additional interim steps that i just want to mention briefly, mr. president. the majority leader, senator reid, and chairman baucus and i have come to an agreement that will also provide the opportunity to get more choice and more competition into the health care marketplace. what we have agreed is that folks who spend more than 8% of their income on health care but aren't eligible for subsidies --

in effect, folks with what are called the hardship waiver -- they would be able to get a voucher and go into the marketplace and with that kind of approach, which would be tax free to them, our estimate is that that will be only about a third as expensive, in terms of getting health care for those folks as the alternative, the traditional system of subsidies. so, again, we get more people covered in a more affordable way, building on these time-honored principles of choice and competition. finally, senator collins, senator bayh and i have a proposal, a proposal that has been endorsed by the national federation of independent businesses that would say that employers who are in the exchange, if the employer

voluntarily says that they want to give their workers more choices, they could do so. in effect, it would say to the small employers in the exchange you and your workers will have a choice to have a choice. no employer is required to do anything but should they want to concentrate on making their widgets rather than being in the health insurance business, they would have the opportunity to do it. what they would give their worker would be tax free to the employer, tax free to the worker, and once again you bring the principles of choice and competition into the health care marketplace, move us closer to that day when the consumer can give the insurance company the ultimatum i have envisioned, which is treat me right or i go elsewhere. mr. president, i close by saying that in my view, the majority

leader has laid the foundation for a new health care marketplace. i'd certainly like to do more. as the distinguished president of the senate knows, the cosponsor of our bipartisan healthy americans act, i'd like to do more and i'd like to do it faster, but make no mistake about it, this is laying a foundation to create a new marketplace in american health care where that concept has been foreign, to let people make apples to apples comparisons, keep crummy products out of the exchange, to make sure people can get information about loss ratios. that's a real foundation. then we seek to go further, and we have had the counsel of some of the country's leading thinkers about american health care. let's get more healthy people into the exchanges. let's make sure that we have these big pools. let's make sure that the insurers can't try to steer the

marketplace because we know that they are going to try an ingenious ways through advertising and market promotion strategies to still find the best risks. let's build on what senator reid has laid out with respect to the exchanges in the days ahead. we're going to be at this a long time, mr. president. you aren't going to fix a dysfunctional american health care marketplace in a matter of weeks. we are going to be at this the rest of this week, next week, well into 2010. i have been part of this debate since i was codirector of the oregon gray panthers going back 30 years now. i continue to believe there is an opportunity for democrats and republicans to work together. our party has been right on the issue of coverage. you cannot fix this unless all americans have good quality,

affordable coverage because otherwise there will be too much cost shifting. but as i have said to my colleagues on the other side of the aisle -- i see senator bunning here. he and i have worked together on the finance committee. our colleagues on the other side of the -- on the other side of the aisle make important points with respect to choice, with respect to markets, with respect to competition. this is an area we can work together. there is nothing partisan in my view, mr. president, about creating a new health care marketplace through these exchanges. this bill lays a foundation, and there will be opportunities for democrats and republicans to build on that foundation in the days ahead. mr. president, i yield the floor. mr. bunning: mr. president? the presiding officer: the senator from kentucky. mr. bunning: mr. president, since we are -- what is the current order of business?

the presiding officer: the republicans control 29 minutes at this point. the republicans control 29 minutes at this point. mr. bunning: 29 minutes? the presiding officer: yes. mr. bunning: and the order of the day would be the defense appropriation bill? the presiding officer: the senator is correct. mr. bunning: thank you very much. i rise today to talk about the 2010 department of defense appropriation bill. there are several parts of this legislation that i like -- that i would like to discuss, but first of all i would like to talk about the process that the majority has used for this bill. this past weekend, we passed an omnibus bill that jammed together six different appropriation bills. i had high hopes that this year we would not have to resort to an omnibus appropriation bill. we have done it in the past. i was hoping this year we

wouldn't. i hope that we could go through regular order and give each bill the time and attention that it deserves. in fact, i think we could have done that if we were not spending so much time on the floor with this monstrous health care bill. we have had a lot of floor time, but not much action on health care. however, earlier this week we passed a bill containing all of the remaining appropriations bill except one for funding the department of defense. now, why was this done? why was in bill left for last? it was done because this bill was used as a political football the majority felt that because this bill contains important funding for our troops, they could attach unrelated

provisions to it and then insulate that -- insinuate that anyone who has concerns about these provisions and tries to slow the bill down to look at them is jeopardizing our fighting men and women. in fact, some members of the majority have made those claims this week. my question to them is: why didn't the majority include the appropriations for the department of defense in the omnibus that we just passed? the funding for our troops could have been signed by the president and made into law by now. however, the majority wanted to use this funding as a political hammer. this is not right, and the american people should know what is really going on here.

our troops deserve better. i would like to talk about some of the provisions contained in this bill, beginning with the detention facility at guantanamo bay. now, the bill before us does provide that no detainees from guantanamo may be released into the the united states. it also does not provide funding for the closure of guantanamo detainee facility. these are good provisions, but they are not good enough. this bill does not prevent sending these prisoners to the united states for trial and housing them in our own backyards. it would be much improved if it contained a complete ban on moving them to the united states on january 22, 2009, president

barack obama signed an executive order to close the detention center at guantanamo bay. i am against the shutting down of this facility. it is absolutely irto order this closure and not have a plan in place to address what the united states will do with all the detainees held there. under no circumstances should they be brought to the united states. the terrorists that are housed at guantanamo bay are the worst of the worst. i have personally visited these facilities and met with the brave men and women that guard these detainees. as long as the terrorists remain housed at guantanamo, they cannot harm us or any of our allies.

however, the administration has seen fit to push ahead on sending guantanamo detainees to the united states. in fact, we learn that they now plan to send some of the most dangerous terrorists in the world to illinois. president obama could not bring the olympics to illinois, but it looks like he will bring terrorists there instead. the plan appears to be to use a current empty supermax facility in northeastern illinois to hold guantanamo detainees. i think bringing these terrorists to the united states is a terrible idea. first of all, there are serious legal problems associated with bringing these terrorists to our soil. the supreme court has noted that it is -- and i quote -- "well

established that certain constitutional protections available to persons inside the united states are unavailable to aliens outside of our geographic borders." unquote. the nonpartisan congressional research service said -- and i quote again -- "that noncitizens held in the united states may be entitled to more protection under the constitution than those detained abroad." unquote. this means that they could be afforded extra rights which are available to american citizens. they could include protection under the fifth amendment due process clause which would cover how they are confined, or they also may raise claims regarding religious practices.

furthermore, while the obama administration may not have the intention of releasing any detainees, their wishes to be overruled by a civilian judge. guantanamo detainees who are cleared for release have in fact petitioned the court to be released into the united states. last year a federal judge even approved such a request before being overruled by an appellate judge. the reason the higher court sided for overturning the ruling was that the government could not be forced to accept someone into the united states from outside the country. if we start bringing detainees to the united states, this legal safeguard will be removed. throughout the debate on whether

closing guantanamo is good policy or not, supporters of the idea have consistently maintained that the facilities serve as a lightning rod for anti-u.s. sentiment, and it is a -- used as a recruiting tool for terrorists. i don't buy that argument. i would argue that the greatest recruiting tool for these terrorists is the united states itself and our way of life with democracy and freedom of religion. what if it was found that the statue of liberty was being used as a symbol to incite attacks on our country. would we tear it down? of course not. the united states has suffered many terrorist attacks prior to the opening of the guantanamo bay facility, including the horrific event of september, 11, 2001. if we close this facility, then

those that hate us will simply find another tool of motivation for their followers. the bottom line is that the guantanamo bay detention facility works, and we are putting ourselves at a disadvantage by not using it. i wish that this bill had taken a stronger position on making sure this facility is not abandoned. as everyone here knows, this bill also provides further funding for the wars in iraq and afghanistan. i was glad to see the president finally announced a plan for afghanistan earlier this month. we waited far too long for this decision. i was very concerned that this wait was unnecessary and putting our lives of our service members at risk. i am glad he finally heeded the

call of our commanders on the ground for more troops. in fact, i agree with the bulk of his strategy for waging the war in afghanistan. however, i strongly disagree with him on one particular issue. i have serious concerns about the administration's decision to set a timetable for troop withdrawal. i could not disagree more with the announcement that u.s. troops will begin leaving afghanistan in july of 2011. what makes this situation even more confusing is that the announcement also claimed that any withdrawal will take conditions on the ground into account. this is puzzling and it's a contradiction. what will the administration do if conditions on the ground dictate that no troops be

removed from afghanistan? will it proceed with the withdrawal anyway? i don't want to keep any of our brave men and women in afghanistan any longer than absolutely necessary, but we have to work to do -- leaving before it is done it is unaccept afpblt by announcing an arbitrary deadline for our troops to come home possibly before the job is done, the president is telling our enemies how long they will have to hold out and wait until we hraoefplt they will bunker down and emerge after we are gone. it is unimaginable what this horrible consequence of this would be. i was glad to see this strategy rejected in iraq, and it is no

less foolish to apply it to the war in afghanistan. i fear we could be setting our efforts up for defeat and putting our fighting men and women in further danger, and i am deeply troubled by this. while i strongly oppose president obama's notion for a timetable for withdrawal from afghanistan, do i support his call for a surge of traols to staeublgz -- troops to stabilize the country. we learned a great deal from the counterinsurgency strategy implemented by general petraeus and ambassador crocker in iraq. he knew that if the u.s. forces spent most of their time only in a small protected area such as the green zone in baghdad, then little would be accomplished. the surge in iraq was not successful only because we were

simply having more troops in iraq. it was what they did that mattered. by simply going out into insurgent areas and being more visible, this gave reassurance to the local populations that americans were still around, but it did not stop there. previously coalition forces would clear an area but then retreat. this time they were there to stay. our soldiers became involved with the local communities, assisting with infrastructure and even doing things like helping to set up farm cooperatives. the strategy evolved from only clear to clear, hold and build. soon our forces had the trust of the locals. the citizens of iraq began to help with the stabilization of rebuilding of their country.

they began to cooperate with our military efforts and help us fight insurgents. before they were scared and powerless. now they were safe and had the ability to make their lives better. these conditions have made it very difficult for our enemies to operate. it is now time to apply these lessons to afghanistan. it's time to clear, hold and build there. it is unfortunate but true that the afghan government suffers from a deplorable level of corruption. however, it will not do us any good to refuse to help until things get better. this is because they won't get better without our help. the citizens in afghanistan by and large do not trust their government, and this creates an atmosphere that is very helpful to our enemies. when our forces move into

communities, they create stability and undermine insurgent forces and corruption. use of the proper strategy can help improve the government as we have seen in iraq. however, if it is not improved, then the people will never trust it and it will not protect them. they will have no choice but to comply with the wishes of the insurgents. eventually the government will slide into chaos and the taliban and al qaeda will return to power. we cannot let this happen. a return to afghanistan's previous status as an unhinged launching pad for global terrorist plots is totally unacceptable. we know all too well what the consequences of this are.

however, it could be possible, given even worse than that, we have seen the difficulties that pakistan has had in fighting the taliban on its own soil. currently u.s. and nato forces are fighting, and hopefully soon beating the taliban and al qaeda in afghanistan. if we were to leave before finishing the job, the result could be disastrous for pakistan. a taliban-controlled afghanistan would be a sanctuary and staging point for the radical islamist terrorists to attack from. pakistan is a nuclear power and its fall to these groups would be utter catastrophic victory in in -- victory in afghanistan is essential. we learned a lot from the bush administration revised strategy

for iraq that puts the war on a path to success. it would be a shame if we did not apply those hard-learned lessons to the current conflicts in afghanistan. as i mentioned at the beginning of my remarks, this is a large bill, larger than it had to be. it -- the use of this defense appropriation measure as a political football is why it is so big. i think it's a shame that the majority chose to legislate in this manner. we did not need to do it this way. it's probably too late in the process for us to fix this mashed up of different bills and give all of these issues the individual attention they deserve. however, hopefully next year will be different. hopefully the majority will not try once again to politicize this bill that is supposed to be about funding our military.

hopefully they will not hold this bill back and wait until the last minute like they did this year. it is in the -- it is the responsible and responsibility of the majority to set the schedule of the senate. we will see this next year if they still devote to playing politics with the funding of our troops. i sincerely hope they do not. thank you, mr. president. and i ms. murkowski: mr. president? the presiding officer: the senator from alaska. ms. murkowski: how much time is remaining on our side? the presiding officer: ten minutes. mrs. ms. murkowski: i rise to speak on the defense appropriations bill.

i appreciate all the hard work that goes into the formulation of this bill and i commend the appropriations committee, senator inouye and senator cochran on a very fine product. it's a product that does justice to the men and women who wear the uniform of our country in defense of peace and liberty, and it's a product that does right by our military families who we must never forget also serve. i just want to recognize this morning, share some comments about what this bill means for the fighting men and women in my state of alaska. alaska's home to about 21,000 men and women who serve on active duty. add to that number approximately 4,700 members of the national guard and the reserves. the bill that is before us supports the soldiers of fort richardson, fort wayne write, -- waynewright, clear air force station, and 18 radar sites in remote rural areas of our state. we also have the marine detach many that's hosted by elmendorf

air force base and naval special warfare center detachment in kodiak. it supports units big and small, units like the fourth airborne brigade combat team of the 25th infantry division based at fort richardson which numbers in the thousands of troops. the fourth airborne brigade combat team is also known as the spartans. this spartan brigade will be spending christmas in afghanistan. also in afghanistan this christmas are 11 members of the alaska air national guard 176th wing who left anchorage on november 5 after serving an early christmas. we wish them all well during this holiday season. we are thinking about their families and we collectively pray for your safe return. mr. president, i mentioned christmas. we know that we are upon the holiday season here, although here in this chamber, it certainly doesn't feel that way. there is no sense of giving and

sharing and the general cooperation and cheeriness that comes at least in my family with the holiday season. i think we have -- we have also -- as we approach the holidays, we think about what is going on throughout the country as we face an economic recession. families are -- are choosing to do differently this year. they are squeezing back on their family budgets. they are -- they're making some different choices, some hard choices. and i think it's fair to say, mr. president, that folks are probably looking at us here in congress and saying well, we wish that they would be doing more of the same, making some of these hard choices when it comes to -- to spending. and just to kind of put it into context in terms of what we have seen here in congress in the past week or so, it was last sunday, just less than a week, that we passed a

a $1 trillion-plus spending bill. these were six different appropriations bills. three of those six bills were not subject to senate amendment and debate. we went above and beyond the regular order and produced an omnibus package. again, it was a package in excess of a trillion dollars worth of spending. about a 12% increase over the year previous. shortly before that, about a week prior to the action on the omnibus, the e.p.a., the environmental protection agency, issued an endangerment finding. this endangerment finding, for those that have been following this issue, i think many recognize that the potential cost to this country, the burden, the financial burden that could be placed on this country if we advance through the regulatory process as opposed to the legislative

process, these -- these regulatory burdens, i think it is clear that the cost and the impact to this country and our nation's economy is truly in danger. so when we talk about an endangerment finding coming out of the e.p.a., it really is just that. it endangers our economy. iten banks jobs, it endangers the competitiveness of those of us here in this country. so again, people are looking at this and saying well, what is going on in washington, d.c.? don't you realize that we need to be working to -- to save and create jobs. we need to be doing those positive things that are helping us as a nation and an economy, not those things regulatory or legislatively that would hurt us. and now, mr. president, we are in the midst of trying to move through a health care bill in the final days before -- before

christmas a $2.5 trillion reform package that at this point in time we're not quite sure what's in it, but when it is revealed, it's possible that we will have about 36 hours to review this, to understand it, to appreciate the implications for us and our respective states, the impact to our economy. but again, one of the things we do know about this is that the framework that we're operating off of is one that will increase taxes on the -- the small businesses and the individuals in this country. it will cause cuts to medicare at a level that is just incomprehensible. almost half a trillion dollars. and it -- for all that we can tell, it's going to increase premiums. so alaskans are looking at this package and saying this isn't the reform that we thought the congress was going to be giving

us. following on the track of this spending, we are going to be discussing increasing the debt limit. again, people in the rest of the country are wondering what -- what's going on here in washington, d.c., what's in the water that is allowing, that is causing you to spend at -- at levels that are almost uncontrollable? and our reality is that it's not you and i that are going to be facing the -- the financial consequences in the out years so much as our children. mr. president, during the holiday season, i still have kids that i try to keep the presents secret, so i have a tendency to kind of rat hole them away, hide them. but i will tell you, the one thing that we cannot hide from our children this christmas is the fact that what they will be receiving is an incredible debt, an incredible debt, and that's not a gift that we can afford to give our children.

mr. president, when it comes to discussion about the health care bill and the consequences of it, there have been a great number of -- of journalists that have been opining and comments that are made and we have certainly kept the presses busy with this, but there was an article in the the -- in "the washington post," in the opinion page a couple of days ago. this is from michael gersen, and he makes a statement that i would like to read. he states -- "the entire democratic health reform effort is foundering as its deep bow enters the shallow channels of fiscallity. that splash you hear is the sound of various groups being thrown from the ship to lighten the load instead of beginning with affordable, realistic objectives, president obama and the democratic congress set the goal of guaranteed comprehensive coverage for everyone. this requires a lot more money in the system, which must come from somewhere, actually, from

someone." then you go to an article that was in this morning's "hill" magazine, and this one, the headline is "senate plans to tax -- senate plan to tax health plans is bad policy." and the article starts off by saying this. "millions of working americans will pay thousands of dollars more in taxes under the senate proposal that taxes health care benefits to finance reform. according to the c.b.o., this excise tax will affect one in five americans. millions more will have their health benefits cut and see their costs go up. this is the opposite of health care reform." well, mr. president, you might think that that was an article that i might have written or some of my republican colleagues wrote. actually, this article is penned by jim hoffa who is the teamsters general president and mr. laroccoen who is the

communication workers of americas -- the president of communication workers of america. so, mr. president, my -- my point in saying this is that as -- as people understand more and more about what is contained within this health care legislation, they're coming to understand the impact to them and to their families, and they are quite anxious because they know that as -- as the years go out, the costs don't go down. the costs only go up. we are concerned in alaska about access to care. i've stood on this floor many times and talked about how in -- in alaska we simply do not have the medicare providers that we need to see the people in my state, particularly in our largest community. we just learned that one of the

medical clinics in anchorage has has -- has made an announcement, issued a letter to their patients. northwest medical has four practicing physicians that were seeing medicare patients earlier this month. three of the four physicians opted out of medicare, resulting in 550 medicare beneficiaries being without a physician. so what's happening? they're calling us. they're calling us for a doctor's appointment. and the problem is that we can't get them in anywhere either. we have got one facility in -- in anchorage where they are taking new medicare-eligible individuals. when we did a count, the institute of economic research did a count as to how many providers in anchorage, alaska, were taking new medicare

individuals, it was 13. well, we heard from a provider just last week that she is opting out. these three make a total of four. mr. president, this is simply not sustainable. so for us, for us as a senate, for us as a congress to be moving forward in the name of health care reform, any provisions that will further jeopardize access to the people of alaska or the people of rural america or all over this country, that we would do anything that would jeopardize their access is foolish, it makes no sense. we must, we must stop this reform effort. we must do our job here in congress to provide the people of my state, the people of all of our states real health care reform that reduces the costs, provides for access, and does

right by the american people. with that, mr. president, i believe my time has expired, and i yield the floor. the presiding officer: the senator from ohio. mr. brown: mr. president, as we near christmas, our troops are overseas, away from their families during this holiday season, facing dangers most of us cannot even contemplate. many in this chamber long supported the wars in iraq and afganistan, but many of the loudest supporters of war are today leading the charge in trying to block the defense appropriations bill. it's irresponsible, plain and simple, to play politics with the funding of our troops. it's a disservice to them. it's a disservice to their families. it's a disservice to our great country. we don't agree on health care reform. i understand that. i get that. but to hold up the funding for our troops, i don't get that. this bill funds our overseas

military operations an provides our troops the hard-earned pay raise. it includes funds for joint i.e.d. defeat fund, mine resistance ambush protected vehicles, it provides equipment for our national guard and reserves. the tired politics of delay and distraction offered by my republican friends does a it's service to the troops, families and nations. does a disservice to the millions of families who would benefit from the defense appropriations bill that would extend the cobra premium assistance program. thousands in ohio, in dayton where they were hit so hard, from d.h.l. to general motors to -- to -- to n.c.r. to the supplier force those companies. hundreds and hundreds in the mahoney valley. where people in "the washington post" read from warren, ohio,

and read about the terrible, terrible recession there. it is a disservice to those all over the state who saw a 60% spike in their health insurance premiums. that's because the cobra subsidy -- one of the things that we did right early in this year. the government has never done that, to help people in tough times with their health insurance -- the nine-month cobra subsidy we established started phasing out in december. cobra provides a much-needed health insurance option to americans out of work. it allows workers to stay on their previous employer's health plan for 18 months. but it can be expensive. that's why i introduce add bill 11 months ago, the coverage community act to provide a health insurance subsidy to laid off workers. they can't afford cobra without it. remember, mr. president, cobra is the insurance -- health insurance program, if you lose your job, can you keep your same health insurance, you continue to pay your own premium, but

also have to pay what you've been used to paying, but you also have to pay the employer contribution. and if you've lost your work, if you've lost your job, it's pretty hard to do that, putting it mildly. so this, for the first time, gives a very generous subsidy so people can keep their insurance. a version of that proposal that i introduced in january was included in the stimulus. provided a 65% subsidy toward the price of the cobra premium for recently laidoff workers. now that subsidy's expired. for some it's about to expire for many more. nearly 16 million americans are out of work still. and 14,000 lose their health insurance every day. and that's when i hear my friends on the other side of the aisle say, you've got to slow down on health reform. we don't want to do this too fast. they need to go back to their states. i hope they get some time off at christmas. i hope after they spend time with their family, they talk to people who are getting hurt by this recession. they're not hard to find in every neighborhood, in every

community in this state. in my state and in this country. people who have lost jobs. people who are losing their health insurance in ohio alone from toledo to willard to gallipolis 390 ohioans every day lose their insurance. across this country 1,000 people a week die because they don't have health insurance. 1,000 people a week die because they don't have health insurance. yet, too many people in this institution, too many people think we just have to wait. they need to know when you think about 1,000 people dying every week without health insurance, they need to understand a woman with breast cancer is 40% more likely to die if she doesn't have insurance than a woman with breast with insurance. if -- bras cance breast cancer h insurance. if that's not enough to say to quit tactics and say, let's slow down. it hasn't worked. that's why the cobra extension

is so important. it's similar to the one did -- the extension is similar to the one included in s. 27 30:00, the cobra -- 2730, which i introduced with senator bob casey in november. the bill before us today will ensure that americans receive the cobra subsidy for 15 months, not nine. it means most workers who first started receiving a subsidy last march when it started, will continue to receive it until may of next yeemple it extends date in -- year. it extends the date in which you can be laid off and eligible for the subsidy. in current law only those who lose their job in the next two weeks would be eligible. we need to extend the window to february of next year. it will help americans like don hall from castilla, in the northwest part of the state. don was laid off from an auto supplier. as severance there was six months of paid koab. a then he became eligible for --

cobra. then he became eligible for the assistance program. he's still out of work. on december 1, he and his wife were charged $763 for their coverage. up $500 from the month before. he was paying$2 50, now he's paying $763. he is trying to save his house from foreclosure. he has cut back as much as he can. he said six job interviews in the last 13 months, none have panned out because there is not enough jobs in sandilla, and like so many men and american he experienced hard time. needs some help. and they, on the other side of the aisle say, let's slow down. we've got to slow down. for don slowing down, it means loss of house and more likely of getting sick and not being ruined financially because they

want to slow down. don's story is not unique. take tim wolfe. he's cobra subsidy is scheduled to expire at the end of december, he will owe $1,400 a month. when tim started shopping around in the individual market, knowing he would be forced out of cobra, everything he found had either exorbitant premiums or bare bones coverage. two years ago tim suffered a heart attack. these preexisting conditions made him a liability for private insurance companies. tim's confident he can find a job once the economy picks up. but in the mean time he can't and needs the cobra subsidy. carole williams from dayton, ohio. she's 63, employed at r.j. reynolds for 16 years before being laid off. he started to receive a cobra

subsidy in march, but is responsible for the entire premium this month. cobra is what you pay when you're employed. you lose your job, you pay cobra to keep your insurance, and you have to pay your employer contribution. almost nobody can do that after they lost their job for very long. that's why the subsidy that we nut the stimulus package back in february, that's why the subsidy that we want to put in this against authorization bill is so darn important to so many americans. because carole remains unemployed, and she suffers from minor thyroid problems an high blood pressure, her insurance options are limited. she decide to pay the full cobra premium in december. while they delay -- while they say, let's slow down on the other side of the aisle, carole thinks, let's see, my premium went up several hundred dollars, if i cancel, i won't ever have insurance. if i dig deep and don't heat my

house as warm, don't eat as well for the next few days, next few weeks, i'll pay more. i hope congress passes this so she can get the better rate again. that's what delay says. delay for their little -- for their little political reasons and the little political games and tricks the other side of the aisle's playing, like they did at 1:00 in the morning last night, it puts carole williams in a position where she has to make the hard, hard, hard decisions. i wish my friends on the other side of the aisle would meet the carole williams of the world. i wish for one day we could walk in the shoes of the carole williamss of the world and see the kind of horrible decisions they have to make because they want to play their political games. let's not let carole down. let's not let don down, let's not let tim down. i hope that we hear their cries. i hope they hear the cries of thousands of people in helena, and wilmington and dover and all over this country. it's too important for us to

fail. mr. president, i yield the floor. the presiding officer: the senator from montana. mr. baucus: mr. president, i thank my friend from ohio for his statement and for, one, he's very much on track and, second, mentioned a couple of towns in my state of montana that have some of the same problems that his towns in the state of ohio have. we're all of us together there are so many people in so many towns across the country who need health care coverage and are denied coverage because an insurance company -- has had some preexisting condition, et cetera, and i thank my friend very much for his statement. mr. president, the defense appropriations bill before us today provides essential support for american troops fighting for our freedom abroad. the bill before us today also continues crucial safety net programs for american families. those families struggling with tough economic times here at home. when our colleague and former

majority leader, robert c. byrd said in 1988, remains true today, without economic security, we cannot have national security. millions of jobless americans struggle for economic security every day. and even people with jobs are seeing their paychecks stretched. for every six unemployed workers, there's only one job opening. only one for every six unemployed. we need to continue to work to help create jobs. we also need to address the challenges that unemployed americans are facing right now. this bill takes action to help americans who are seeking jobs. without this bill, the three unemployment insurance provisions established or continued by the recovery act passed at the beginning of the year will expire in two weeks. if we don't pass this legislation, unemployed americans will not be able to apply for new, unemployment

insurance benefits after december 31st. and those who aren't currently receiving benefits will lose their vital help. the loss of these benefits will be devastating to many americans. including a young father in my home state of montana, from whom i heard recently. he was working hard to support his family at a car wash in northwestern montana. then he was laid off. since then, he has been unable to fine work much his work situation only adds to his concerns because he recently lost a child to sudden infant death syndrome. and his wife is now pregnant with another child. they're living in a house 20 miles out of town. to heat the house -- they heat the house entirely by burning wood bus that's all they can afford on -- because that's all they can afford on his unemployment benefits. without this bill, his benefits will run out in two weeks and

his family will be left in the cold while he tries to find work. but this bill would extend emergency compensation for two weeks, that would provide benefits for out of work americans. the bill would provide two additional months of extended unemployment benefits. those benefits provide targeted assistance to areas of our country that have been affected by particularly high unemployment rates. and the bill includes a two-month extension of federal additional compensation program. that program increases all unemployment benefits by $25 a week. together these provisions will protect unemployment benefits for roughly two million americans. those are people who would lose unemployment benefits if we don't pass this bill. these extensions will provide much-needed economic security for americans who are struggling to find work in these uncertain

times. i don't think, mr. president, enough of us realize the depth of angst people suffer when they're out of work and trying to find work and when potentially when their unemployment benefits, which help a little bit, might not be extended. in addition to the unemployment extensions in this bill, this package also includes an extension of what people call cobra. what's that? that's assistance that helps unemployed americans and their families to maintain their health care coverage. when workers lose their jobs, they lose more than just their paychecks. unfortunately, h they lose their ability to pay their health insurance as well. the recovery act passed this year provided assistance to help unemployed workers and their families to pay for health insurance while looking for a new job. fortunately, in most cases, workers who lose their jobs, have a right to keep their employer health insurance for up to 18 months under the cobra

program. it's called that after the name of the consolidated, omnibus, reconciliation act. to be eligible, workers typically had to pay all of the costs plus an additional 2% administrative cost. that's a spenty, that's not a -- that's not a gift. that's not assistance. that's a penalty. paying the full premium plus administrative costs is more than most families can afford. it is wrong to have that in the first place. fortunately, this provision, the cobra provision provides for struggling workers. what did they do? they made a change. that provision covered up to 65% of health care costs for nine months for unemployed americans. previously it was zero percent.

this premium subsidy has made a real difference in helping unemployed workers and their families maintain health coverage. roughly 7 million americans have benefited from this assistance. the bill before us today would extend this assistance for another six months for those remaining unemployed. in addition, the legislation would offer similar assistance to people who lose their jobs between now and the end of february. this assistance is the right prescription for families in these tough economic times. for many americans who have lost their health coverage because they have lost their jobs, this benefit provides critical help to ensure they can get the health care in their day of need. this bill also protects access to health care for seniors and military families. the legislation would ensure that doctors will not suffer a reduction in payments for their services. the bill would reverse plans to cut physician payments under what is called the sustainable

growth rate, otherwise known as the s.g.r. blocking cuts to doctors' payments would keep health care available to seniors and medicare and would help keep health care available to military families insured by the tricare program. without this provision, medicare and tricare providers would see a 21% cut in their payments. that could make it difficult obviously to continue to participate in the program. doctors say they can't do it. not going to participate. i'm committed to finding a permanent solution to the flawed payment formula that has caused this cut. in the meantime this bill makes sure our physicians in medicare and tricare will not face deep cuts, unfair cuts as they are in this bill. rather, this bill would ensure they could continue to care for our seniors and military families. another reason why this legislation is so important. not only to help our troops, but all these other benefits, those

i have been outlining which make a big, big difference, mean so much to so many people, people out of work in these tough economic times. it will include provisions to protect access to critical safety net programs for low-income families who would otherwise lose those benefits in already tough economic times. this legislation would hold the poverty level constant at the 2009 level. why is that important? because that would prevent a decrease in the year 2010 because prices went down this last year. this legislation would keep struggling families who are right at the poverty line from dropping off of critical safety net programs. to keep up with the rising cost of living, the federal poverty level is adjusted for inflation each year. because of the great recession this year, prices actually went down. there was what economists call deflation snuff inflation. as a result of this de --

instead of inflation. as a result of this, the american families right at the poverty line, who rely on programs like medicaid, home heating assistance and food stamps could actually lose their access to these vital services even though they did not have any additional income. this legislation would allow families who qualify for safety net provisions today to stay on those critical programs if their circumstances don't change. these families cannot afford to bear any additional hardship in this recession. and this provision would ensure they do not lose the vital services they need to keep them afloat. and this bill also extends vital funding for the maintenance and repair of our roads and our bridges. this would save hundreds of thousands of american highway jobs. these are jobs that pay well and these are jobs that cannot be be shipped overseas. this provision provides a

two-month extension of federal highway funding. not very much, but two months is better than no extension. that will allow important repairs to american roads and bridges to continue so we can next year also pass a meaningful highway program, a multiyear program, hopefully four or five or six years. without this provision, this two-month extension the federal highway construction projects across the nation would be forced to shut down, taking thousands of jobs along with them. the safety of our nation's roads and bridges is vital. at a time when unemployment is already more than americans can bear, we cannot atoward to lose hundreds of thousands of good highway jobs. these provisions make sure that we don't. economists have seen some signs of the economy is starting to recover, but many american families, unfortunately, continue to struggle. this legislation will provide vital support and services the american families and our economy need to get through

these tough times. working together, we're going to get this economy back on track. passing in bill is part of the answer. passing this bill is important for both national safety and our economic security. i urge my colleagues to support this vital legislation. mr. president, i yield the floor. and suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

mr. bond: mr. president, i ask unanimous consent that the equal of the quorum be dispensed with. the presiding officer: without objection. mr. bond: i thank the chair. mr. president, earlier this month, president obama renewed his commitment to the counterinsurgency or clear hold and bill strategy for afghanistan. as i've said several times before on this floor, i believe this strategy will allow our troops to return on success and put afghanistan on the road to

stability, but as i've also said, when you go into a war, i will launch a major effort like this involving tens of thousands of americans who will be putting their lives on the line, we must go in with an attitude of success. we are going in to succeed. let us be clear about that. we must succeed in afghanistan unless we are to face the kind of risk we faced on 9/11. hearken back to the early 2000's when the taliban-ruled afghanistan, their friends from al qaeda came into afghanistan and used it as a grounds for recruiting, training, issuing command and control and preparing for attacks from that part of afghanistan came the

directions and the leadership for the tragic attacks on 9/11. as president obama has said many times over, fighting in afghanistan is the war of necessity. it's one we cannot fail to win because we have seen what happens when afghanistan falls in taliban hands. now, i happen to disagree with him because iraq was the next featured spot for al qaeda, osama bin laden and zawahiri zawahiri to go. we had that from the clinton administration. their intelligence chief, security chief clark said that when we drive osama bin laden out of afghanistan, he will boogey to baghdad. that's what all of the information we saw in the intelligence committee indicated, that they wanted to

make iraq, baghdad at the confluence of the euphrates and tigress rivers the headquarters for their operations. well, we went in and cleaned out saddam hussein, who was a vicious, murderous tyrant. we didn't find any weapons of mass destruction. people said oh, well, we didn't need to go in. however, in the intelligence community, we found out, number one, the intelligence was off base. they made assumptions they shouldn't have. but we also sent in the iraqis survey group headed by david kay who went in to look at the conditions in iraq and find out what those conditions were prior to making our going in to iraq to clean out saddam hussein. and the conclusion that mr. kay and his various skilled team came to was iraq was a far more dangerous place even than we

knew. there were terrorist groups running around in there. abu massad who became famous for beheading westerners. the edification of his twisted viewers. he had a group called ansal al-islamic. that group later morphed into al qaeda and became al qaeda in iraq. fortunately, very good intelligence work, and the administration of a shot from a lightning pod on a -- on an air national guard f-16 -- and i'm proud to have been a sponsor of putting -- of earmarks to put lightning pods on national guard -- air national guard aircraft wiped out abu massad

disark. there is no question that osama bin laden had used weapons of mass destruction before. he had used them against the kurds, his own people. he had the facilities to produce them. he had the scientists to produce them. he had the recipes to produce them. it's what we call just in time inventory system. he could have started up chemical or biological weapons of mass destruction had he not been taken out and turned them over to terrorist groups. well, iraq, we successfully took out saddam hussein. then we tried to prevail with a counterterrorism strategy. that's where you send in some of our elite forces and you take out the leaders of al qaeda, and then you go back to your base. well, the problem we found was that once we left al qaeda, we

come back. insurgency is different than a regular war. they would come back in, and if anybody had cooperated with the american forces, they would kill them or torture them first and kill them or even torture their families in front of them and then kill them. so we knew things weren't going right, and president bush chose with secretary gates, and he and secretary gates chose general david petraeus who was a real scholar. happened to go to the same college i went to, but he was a real scholar who had developed a counterinsurgency strategy that he felt was the only way to deal with insurgents. so they instituted the clear, hold and bill approach in iraq. they would send in the troops clear out of al qaeda, and then they would embed or lock down

with the iraqi forces there. and that way they could maintain the security of the area. people wouldn't dare come back in with american and iraqi troops there. my son happened to see both sides of that. he was there in 2005 in the ground intel operation in fallujah, and he found that the locals weren't interested in working with the americans. we now know why. they were very fearful for their lives if they did. the second time he went, and he went in here with the marines who drove al qaeda out of anbar province, and he -- his scout snipers were assigned to capture his old stomping ground of fallujah. they did it and the difference was dramatic. by that time, general petraeus

had set up the sunni citizens' watch, working with the iraqi government. they had the sunni police. when they went in, they immediately started recruiting young sunni men to serve in the police force of fallujah. they offered -- they offered the people who had injuries medical help. they offered assistance for those who had reparations, had had damage, they got that done, and by within a month, my son said the marines weren't at all needed, they weren't active. because when somebody brought in an i.e.d., impro viced explosive device or al qaeda, an iraq person came in, the sunni citizens watch would turn it over to -- to the sunni police, and they would take care of

them. so that's why we have made the progress. despite what some on this floor said the war is lost, we can't win it, we ought to withdraw, the counterinsurgency strategy worked. well, when we moved into afghanistan, we found that in the years since we had driven the taliban out, we turned the task of keeping afghanistan stable and secure have been turned over to nato. nato forces regrettably were not adequate. they employed a counterterrorism fire and fall drak strategy or even less. some rode around in armored vehicles and during the daytime and went back and had tea in the late evening, and the taliban owned the evening. so when general stan mcchrystal went there, he was assigned by president obama to carry out his strategy, and the

president outlined a very clear strategy which was we need a counterinsurgency strategy. clear hold and bill, what i reafer to as smart power. you need military force, economic development, assistance, whether it be medical or governance assistance. you need to help people develop a better life. and he tasked general petraeus to do that. well, when general petraeus outlined the strategy, he outlined it in august. we first saw it then. and he outlined a good strategy. he said we need 40,000 troops. since the president said he would send 30,000, he has cut back on the objectives, and he believes that that will work. so we are now getting the troops there, and it's going to take time to get the troops there.

i wish we had started three months earlier because we have been losing ground until we got the additional troops in, but he started getting the troops there, and i believe that we can provide stability and security in afghanistan. are we buildiñ -- building a nation? no. before you can have a nation or a working economy, you have to have security. you have to make sure the insurgents, the taliban or occasionally their friends from al qaeda don't come back in and take over the area and destroy your crops. previously the taliban cut down all of the pomegranite trees, afganistan was the breadbasket for that part of the world. they destroyed the agriculture so that only their colleagues in the drug trade could control the land. that's where the significant amount of the money for funding

the taliban was coming from poppy production and the drugs it produces. well, that process is ongoing, but we have found, mr. president, as i've said on this floor several times before, some test markets where that's worked. i was told by then-general eikenberry in january of 2006 and echoed by president carter, that they needed agents to come in and help them rebuild their agriculture. i tried for two years with the help of my colleagues on appropriations committee. we appropriated -- twice appropriated $5 million to the department of state to send -- get the usaid to send in extension agents. with $10 million, absolutely zero people went, as far as we know. so in 2007, i worked with the missouri national guard, good

friends of mine. they sent a survey team over. they said, we can help. so in early 200, they sent a 50-member agriculture development team to nangahar province, gentleman al bad. gentlemajalabad.why did they ch? it was the number two producing nation and they had an excellent governor and they wanted to work. so the guard team went in. these were trained soldiers and armed airmen and women who knew how to fight in a battle. but they also had agricultural backgrounds in their day jobs, in their civilian employment. they were farmers, they were agronomysts, soil specialists, foresters, food processors, veterinarians. and they went in and helped the farmers of nangahar province rebuild their agriculture.

by the end of the growing season in 2009 -- in 2008, president karzai said they'd made a tremendous defense. when he was over here, he said it was one of the great successes. so ten more national guard teams are going. and in december last year, a year ago when i was there, before i went out to nangahar, president karzai served us a wonderful dinner, including broccoli from nangahar province. you know, the interesting thing i found was that not only did they have security but poppy production in nangahar went from being the second highest in the nation to almost zero. almost zero. we now have our third missouri national guard team over there. they're planning on going seven more years because they want to continue that partnership. and guard units across the nation are lining up to partner with other -- with other

provinces. and this is a great model, but unfortunately it's not enough to have guard forces there. we have got to have a national security budget that includes the civilian side, the economic development side, the agricultural side, the educational side along with the military force. and that's one of the things that i'm worried about. we've got to make sure that we get the build side of clear, hold and build, of smart power working in afghanistan. because we can't expect them to maintain their security and flourish if they don't have a way of earning a good liveliho livelihood. and they're earning -- make no mistake about it, they're earning a better livelihood with legitimate crops than they were with poppies. and they're not bowing down to the -- to the drug lords or to the taliban. and most of all, producing flowers for drugs was against

their religion. so they're happier, but we need to do a lot more of that. and i think that the first and most significant part in doing that, of course, was sending the 30,000 more of our trained military volunteers deploying to afghanistan. and the bill before the senate today is critical to ensuring these troops have the equipment, training and resources needed to execute their mission. you can't send that many more troops there without getting them the resources. this bill is absolutely essential for giving the resources. but i -- at this point, i want to especially thank the majority in the house and the senate for not loading this critical troop bill up with poison pills. i know it had been -- there was some discussion and it must have been tempting to use legislation to pass unrelated and controversial proposals.

i've always voted for and continue to support funds that our troops need. but if we had seen on this bill things to add -- for example, another expensive doomed-to-fail spendulous bill -- i would have had to vote "no" on it. we have seen that the majority's trillion-dollar stimulus bill past last -- late last winter has failed to produce the jobs promised and the budget, which doubles the debt in five years and triples it in 10, puts our children and our grandchildren's financial future at hock. i didn't want to see that on legislation to appropriate our troops funds. and i'm glad they did. and i offer a very special thank you to my good friend, chairman dan inouye, who heads our

appropriations committee. he's a true american hero and i have the utmost admiration for him and i greatly commend him for the manner in which he has led and is leading the appropriations committee. he tirelessly worked to ensure that american priorities in defense are put in the right place, and i issue my strongest thanks to him and our distinguished republican leader, thad cochran. one of the things i did -- i think they did which was absolutely necessary was to add the most reliable, heavily used workhorses in the air force inventory. the c-17 cargo aircraft to the bill. this is the modern transport bill that we need when we move our war fighters into battle. it gives them the equipment, supplies to execute their mission. the president's recent announcement of the additional 30,000 troops is going to be more -- there's going to be more need for them and it is only growing. secretary gates has said we must

prepare or fights we're in today. it's no secret that country-17 is in the -- that the c-17 is in the middle of the fights in getting the equipment and troops from iraq and to afghanistan today. it's a combat-tested aircraft, essential to the fight we're in. congressional research service said it was designed to fly a thousand hours per year over 30 years but overseas we've seen it flying 2,400 hours a year. and the logistics are particularly responsive to the kind of delivery that the c-17 can make. some people say, well, we have enough c-17's and c-5's, but i agree with general schwartz who stated too much iron is worse than not enough. and the c-5a's, which must be retired and now can be retired,

are only have a 50% readiness level, a per-hour operating cost of $29,000 and 40 maintenance man-hours per flight. and it's time to replace them with the c-17. dr. ashton carter hit the nail on the head and i commend him for his vision in saying that the industrial base issues are completely legitimate, because having the best defense industrial and technology base is not a birthright, it's something we have to earn again and again. and as america's only large airlift production line, if we were to end the c-17 production, it would risk our nation's long-term opportunity to produce the aircraft we need. it will also keep the scientists, engineers, designers, and dedicated workers who can turn out the future aircrafts we need.

madam president -- mr. president, rather, excuse me, i'm going to -- i see my colleague from texas has joined me but i do wish to add very quickly, the commendations and congratulations to the northwest missouri state university football team on their most recent victory in the ncaa division ii championship this past weekend. their journey to the game and their performance in it testifies to their dedication and perseverance. the bearcat football team has been -- has had much success and disappointment over four seasons. it's reached the championship contest the previous four years only to come -- fall short in the title game. but this year, the bearcats, led by coach mel chirzma, would not be denied victory in this fifth straight national championship contest. i ask unanimous consent that the

full statement of my support and congratulations for northwest missouri state university be included in the record at this point. the presiding officer: without objection. mr. bond: and i yield the floor. mrs. hutchison: mr. president? the presiding officer: the senator from texas. mrs. hutchison: mr. president, i just was hear listening to the remarks of the senator from missouri about his football te team, and i would just say that that -- i couldn't possibly follow that without mentioning my beloved texas long horns, who arlonghorns whoare going to plae national bcs championship. mr. bond: i am on your side. mrs. hutchison: i appreciate the senator from missouri saying that he supports fully the longhorns as the big 12 champions. it's always good for the conference, of which the university of missouri is a great member, that we win the national championship, which i have all confidence that my beloved longhorns will do. moving right along to the other important issues of today, and i

certainly am serious when i start talking about the issue that is before us today -- i see the distinguished chairman of the appropriations committee sitting on the floor -- the winner of the congressional medal of honor, the only member of our body who has that great distinction and well deserved. and senator dan inouye is one of the great leaders who fought in world war ii, was a hero, was given the congressional medal of honor, our nation's highest military honor that can be bestowed. and he has led our committee in such a commendable way. senator inouye has always assured that we have the support for our troops. i've served with senator inouye and senator cochran, our ranking member, and senator ted stevens before him, and i can tell you

that all of these gentlemen have led our defense appropriations committee and they have led it by assuring that our troops always have what they need, whether they are in the field of battle, which has been the case for part of our terms here, or whether they are not in the field of battle, which has also been the case for much of our term here. but it just so happens that our troops are on the field of battle today, and that's why i have supported this appropriations bill, supported it as a member of the defense appropriations subcommittee and certainly have assured that we have the appropriations that give our troops who are in harm's way today the support they need. i was in iraq this year, was in

afghanistan and iraq last year visiting with those who are doing the work that keep us free, that allow us to speak on this floor, that allow us to have christmas holidays with our families. and there is not a better experience in my entire time in public life than to get visit with our troops on the field when they are in harm's way. and i've been to bosnia when we were in bosnia, kosovo, then iraq, afghanistan, kuwait, where we have so many troops who are supporsupporting our troops in , and also now supporting our troops with equipment transfers into afghanistan. and those troops are not going to be with their families this christmas, and so we will pass this bill. we will support our troops. we will follow in the great tradition of the united states senate and this will be a very

bipartisan vote. i also want to mention in the time that we have left that the major issue that we must face before we -- we finish here in the christmas holidays and then hopefully go on into next year is the health care reform bill that is before us, and this is of great concern to me because i don't think we ought to rush the health care reform bill. the health care that affects every family, every person in our country is a quality-of-life issue. and america has had the great tradition and now expectation that we will have the best health care in the world, that we will have a doctor and a patient relationship that determines what treatment is best and what is needed, and the patient then makes the final

decision. i very much fear this government takeover of health care that is going to put government in between the doctor and the patient. this is a bill that for the next ten years is going to transform our health care system with half a trillion dollars in new taxes, new mandates which can only run up the cost of health care for those who have coverage, it will be more expensive. and for those who don't have coverage, i fear that the alternatives are not going to be much better. i think we have alternatives that can work. i just don't think this one is it. what would work? what will republicans support? republicans have a plan with three basic principles. number one, we want to bring the cost of health care down so that there could be more affordable access for more people in our country. that means we have medical malpractice reform to curb the frivolous lawsuits.

it means we have the ability to have risk pools that are bigger so that premiums are lower. that means small business health plans. it means that we allow small businesses without a bunch of bureaucratic nonsense to come together, form bigger risk pools and give lower-cost options to employers to give to their employees. that's what every employer in this country wants. they don't want mandates. they don't want taxes. they don't want sticks. they want carrots. and that is alternatives that are affordable for them. last but not least, why not give every individual that buys their own health care, why not give them a tax credit that helps them buy their own health care at an affordable cost? i'm supporting a bill, it's the demint-hutchison bill that would just have a $5,000 tax credit available for people who have to buy their own health care coverage because they don't

have employer options. that would take away the burden that is so heavy on families today. so we have alternatives. we can do this right, mr. president. we can do it right if we will take the time to do it right. now the bill that is going to be voted on surely within the next three or four days is actually a bill we haven't seen. we have a bill before us. we've been debating it for three weeks. but there's another bill that supposedly is the consensus bill that is being written behind closed doors that we have not even seen, and we're going to be asked to vote on it in a two- or three-day period. we tkphoepbt how long it is, so we don't -- we don't know how long it is so we don't know how long we're going to have to read it, but we know that we can't mess around with health care in this country and pass something that may not be right, that may not cover all the bases, that may have hidden things in it

that we can't prepare for. we need the time to do it right. the republicans are offering a hand to the other side and saying let's do this in a bipartisan way. i say to the republican principals, we can do health care reform with those principals. maybe the democrats have certain principles that they could lay out, that we could come together and have something that would not be a government health care takeover, that would not be half a trillion dollars in medicare cuts, that would not add $2.5 trillion to the debt of our country, which is about to sink in debt, and that will not have taxes and mandates and burdens on small business at a time when we want small business to hire people. we want small business to grow and help our economy thrive. but it can't with more taxes and burdens. and we know we can do better.

and we're asking the majority -- the presiding officer: the time of the republicans has expired. mrs. hutchison: thank you, mr. president. and i hope that we will go back to the drawing boards and create a bill that america will be proud of and that we will see the american people support. thank you, mr. president, and i yield the floor. mr. inouye: mr. president? the presiding officer: the senator from hawaii is recognized. mr. inouye: mr. president, first i'd like to thank the gentlelady from texas for her very generous remarks. mr. president, the measure before us represents the culmination of the work of the appropriations committee for the year. but in many respects, it is our committee's most important responsibility. mr. president, what could be more important today, one week before christmas, than demonstrating support for our men and women in uniform who

sacrifices and dedication to the people of this country are unmatched? and if i may be a bit personal at this point, i have spent several christmases away from home in my youth when i was serving in italy and france during world war ii i. seen the anguish of wives without their husbands on christmas eve. i've seen the tears of mothers when they received the news of the death of their son. i've seen the blood. i've seen the misery. it has been noted by others this measure here before us provides the essentials for the department of defense. that's the least we can do for

our men. yes, the amount involved is tremendous: $3636 billion. the -- $636 billion. the amounts in this measure will go to pay the troops, it will support their families, provide care for the wounded and equip our forces. a funding of $128 billion is included in this total to give our men and women in harm's way the resources they need for guns, the bullets, the bullet-proof vest, helmets and such. i know there are some who oppose the wars in afghanistan and iraq. i should like to remind my colleagues that i too voted against sending forces to iraq. yes, i did.

one of 23 of us here nonetheless, when the majority of both houses voted to engage in that contest and in that conflict, regardless of my personal view on the wars in which our nations are involved, i have always supported the funding required to ensure that those who have responded to our nation's call are provided all equipment and resources they require to carry out their missions. that's the least we can do. while others may disagree, i would flatly state that it is unconscionable not to support them. mr. president, this is a good bill. it's a good measure. some will criticize the relatively small amounts which are allocated to items requested by members of congress.

some will question the overall level of resources for defense. and as noted earlier, there are some who oppose funding the war. but, mr. president, despite the few loud voices who raise objections to this bill, i am certain that the majority of my colleagues support this measure because, mr. president, this is a good bill which provides essential funding to provide for the common defense. i think we should remind ourselves, mr. president, that at midnight tonight the continuing resolution providing stopgap funding will expire. tomorrow morning, if it is not clear that the congress will pass this measure, the department of defense will begin

to take steps to shut down some of their functions worldwide. and i can assure you, mr. president, it will be costly. it will be inefficient and totally unnecessary. mr. president, the senate has already voted overwhelmingly to cut off further debate on this measure. it is clear that there is broad-based support. there is no reason to wait any longer. mr. president, as we sit here one week from christmas, we are engaged in an extremely partisan debate in a highly charged atmosphere over our nation's health care system. both sides of the aisle feel passionately about this issue.

i do not fault my colleagues who oppose that measure. but, mr. president, this defense bill is too important to be caught up in a partisan politics. this bill was tkraftd in a bipartisan agreement, and i think we should recall that it was reported out of the appropriations committee by a vote of 30-0, unanimously. and both bodies of this congress, the respective versions of this bill were supported overwhelmingly. the compromise measure that we are working on at this moment passed the house of representatives by 398-24 vote. that's almost unanimous.

unheard of. and so i plead with my colleagues, mr. president, let's not force a wasteful shutdown of the defense department. let's not continue the delay which will stall action on this bill. and above all, let's not raise doubts in the minds of military men and women worldwide who would follow our actions and make them question us, do we support them. instead, mr. president, let's come together in a bipartisan spirit in which this bill was created and crafted and vote to pass it today. as in ancient times, it was said, "peace on earth. goodwill to all men." i yield the floor, mr. president. the presiding officer: the senator from delaware is recognized. mr. kaufman: mr. president, i want to thank you for your help

in this. as always, you are a great colleague, and i appreciate it. i ask to speak as if in morning business. the presiding officer: without objection, so ordered. mr. kaufman: i want to speak about television and to alert my colleagues to a troubling situation. recently the only vhf television stationed licensed in delaware canceled the one nightly public affairs program which covered delaware issues, closed its local studio and moved almost all of its employees out of delaware. that station, whyy tv, did this even though the community that is supposed to serve first, that should be its primary focus is wilmington, delaware. this is offensive and it's wrong. these and other actions led the

city of wilmington last week to challenge the license renewal of yy. i understand the city --'s complaint. frankly, i think whyy was emboldened to make these changes by the weak end oversight of the regulatory agencies charged with making sure that broadcasts serve the public interests, the federal communication commission. if this sort of snub proceeds with no repercussions, we could be seeing less and less local service from stations all across the country. if the requirement to serve the public interest has no meaning, if the broadcast station provides its community license with nothing more than what we can get from a national cable, satellite or internet channel, the public is getting a bad deal for giving away spectrum at no charge. at the core of the f.c.c.'s

licensing policies, right the from the beginning is the principle that every community of appreciable size needs and deserves its own station. as a nation, we have licensed broadcast stations to cities all across america. in america we do not have nationwide broadcast channels. you get that on cable channels like hbo or discovery either through cable or dish. tv channels are local. these stations are granted free use of public airwaves are required to be responsive to local needs. each has a duty to determine the programming appropriate for its viewing community and then make its programming decisions based on those needs. that's the deal. you get the spectrum, you take care of the local needs. broadcasters are, in all enter tents and purposes, -- in you'll

intents and purposes, public trustees of the airwaves. for that reason they must serve their own communities. it is for that reason that the f.c.c. required cable companies to carry local broadcast channels. for the same reason, satellite carriers have been restricted in their ability to bring distant network sig signals into homes t should be receiving their signals. unless the f.c.c. steps up and makes it clear to broadcasters that their duty to serve broadcasters is real, and make it responsive to the community license, i fear that the community is going to lose out and local needs will go unmet. as long as stations think they can get awhich with doing less, they will be tempted to do less. if there are no consequences to ignoring their obligations, they will take shortcuts and our

communities will be the worse off for it. if that happens, our historic allocation of channels all across the country designed to ensure community-oriented services will become a sham. this is happening in my home hometown of wilmington, delaware. we have one v.h.s. station in delaware, it's channel 12. its city of license is wilmington, delaware, and it's a public television station. whyy tv was not always on channel 12. it started out on a uhf channel. in the 1960's when channel 12 ran into problems, whyy won the license. it is not secret that whyy made the move because it wanted to

relocate from philadelphia to wilmington, because it wanted to move to a stronger v.h.s. channel with greater viewership. however, this move, nonetheless was tied to a promise that the station's primary duty was to serve the interest and needs of the people of wilmington, delaware, its new city of license. unfortunately, it has been a near constant struggle for our community to get the attention that it was promised. when its license was first granted, whyy agreed to present 16 1/2 hours per week of delaware-oriented viewing. they promised to have 16 1/2 hours per week of delaware-oriented programming. by 1978, it was providing less than 3 1/2 hours per week. as renewable of the license was

challenged, whyy added additional wilmington oriented programming. the issue of the license was demonstrated on commitment of programming from wilmington. whyy was chastised for serving wilmington during the 1983 1983 renewal. it -- the station studio, staff, the production of nonnetwork programming and the amount of locally produced programming on delaware. the f.c.c. ordered whyy to base personnel in wilmington capable of addressing the many failures. with the diminishing of f.c.c. oversight and broadcasters responsiveness of local needs, whyy service to wilmington diminished as well. the main studio has been long in

wilmington, the public broadcasting and the public broadcasting service was listed as a philadelphia station, even though the license was based in wilmington, delaware. in june of this year, whyy announced that it was closing and putting up for sale in wilmington and relimb naight most of the 16 employment positions in delaware. in short, it is virtually leaving our state and its city of license. whyy's programming decisions also mock its community of license. gone is the daily afternoon report that focused on issues of interest to those living in and around wilmington. today delaware's only v.h.s. station has committed to producing a single 30-minute weekly -- weekly program focused on our state. the program that is scheduled to air at 10:00 a.m. on fridays an to be rebroadcast over the

weekend. if you look at the locally produced programs touted on whs pages, you would have a hard time finding those focused on wilmington. they say this that -- they will provide more delaware-focused stories on the philadelphia license f.m. radio station and on. they have a broadcast and license and the programming is going to be on the radio station in philadelphia and online. you don't have to be a genius to see this is not an acceptable subs true this plan leaves entirely unserved those who looked to television information about their local community. reporting through the media is not the same as television. to do so whyy does not need a tv license. the people in my state feel shortchanged and they should and are. whyy operates a noneducational

commercial tv station that receives support from tax revenues and corporate donations. the public expects that the licensing will be responsible and attentive to the obligations it holds to the community of license. there is no doubt whyy has failed in this regard. those of us who live in delaware understand that we're situated in one of those areas in the country where airwaves are crowded. also television assignments to adjacent states have left little room for allocations in our state. i know other states face the same problem. the television stations to which delaware tunes their sets are primarily out of pennsylvania and salisbury, maryland. these station owe a secondary obligation to address the needs of the delaware viewers. mr. president, broadcasting in this country is coming to a significant transition.

but the programs that comes with digital transmission should mean states like delaware and communities like wilmington will receive more attention to their local needs and interests, not less. that was the promise of digitalization. that was the promise of high-definition tv. that was the promise of broadband. thele indication of a channel to a -- allocation of a channel to a community must -- the f.c.c. needs to reassert its role for the companies that get free use of the public's airwaves, take their responsibilities to serve the public interest seriously. if they do not, we will see more stations like whyy take advantage of lax policies. we will have more citizens in more communities left with little or no local programming. the complaint filed by the city of wilmington last week against

whyy's license provides the f.c.c. with a perfect opportunity to give real meaning to a broadcaster's obligation to its community of license. i strongly, strongly encourage the f.c.c. to use this chance and act decisively to protect the public interest. mr. president, i yield the floor and suggest the absence of a quorum. quorum call:

quorum call: a senator: mr. president? the presiding officer: the senator from georgia. a senator: i rise for a moment to address the -- the presiding officer: the senate is in a quorum call. mr. isaacson: i ask -- mr. isakson: i ask the quorum call be vitiated. mr. isakson: i rise to take a few minutes to talk about a couple provisions of the bill that are very important to my state of georgia, but in

particular also point out something important for us to recognize as members of the united states senate. in this appropriation is an appropriation to the office of economic assistance for for $40 million. that money is appropriated to be competitively granted back to communities for various economic difficulties they have suffered. one of those communities is heinzville, georgia, in liberty county which is the home of fort stewart. fort stewart is the base through which most of our troops who serve today in afghanistan and iraq pass through, and many are trained. it's an outstanding facility and a community with a town the population of about 29,000. it's a rural county near the coast and the great port of savannah where almost all the materiel and equipment is shipped from the united states of america to the theater in the middle east. a few years ago, it was announced by the department of defense that we would add three

new brigade combat teams in the united states of america, and that fort stewart would be the host to one of those new brigade combat teams. immediately, the community did what it has always done. it invested tens of millions of dollars in infrastructure, in road improvements, community improvements, and it incentivized the private sector through the banks and the development community to build the housing necessary to house the dependents and the families of those new troops that would come and be a part of that brigade combat team. and so the construction work began over two years ago. moneys were borrowed, developments were begun. and then a little earlier this year, it was announced quickly and summarily that the department of defense was dropping back those three brigade combat teams and that none of the three would be created or deployed.

unfortunately for the community of liberty county, for the private developers in liberty county and the banking system in liberty county, they can't get a do-over. they have already borrowed the money. they have already deployed the capital. they have already made the investment. and worst of all, the announcement came at a time when we're in great economic turmoil anyway, where our banking senators are under great stress, and as i'm sure the president knows and the rest of the body is aware of all the states in the united states, the state of georgia has had the most banks closed by the fdic during the last 18 months. to have these assets become not accruing assets because the military changed its mind in its decision puts all of the banks who participated in that in a very difficult position. so in that setting, i rise to thank the committee, chairman inouye, ranking member cochran, and all the members of the house committee, especially congressman jack kingston from savannah for adding this $40 million to the office of economic assistance.

it will be a help, but it also should be a warning. whenever we announce to communities in our states an expansion of our military in that state and we call upon them to provide the money, the infrastructure, and the manpower at their cost to support those troops, that if we pull the plug, if we change our mind, unfortunately they don't get a do-over, and it is important for us to live up to the responsibilities we have to see to it that to the maximum extent possible, those communities are made whole. so in the months ahead, i will continue to work on behalf of liberty county and the people of heinzville, florida, who have made this investment, to see to it that we do everything we can to have the deployments necessary to make up the difference and where that's not possible to see to it funds are available to hopefully mitigate some of the damage. the beginning of that starts with the passage of this bill today or tomorrow morning.

it will pass this $40 million program for the office of economic assistance. heinzville and liberty county and other communities who have been damaged by the decisions made to withdraw the brigade combat teams will have a chance to in part be made whole. and, mr. president, for just a minute, i would like to ask unanimous consent to do as if in morning business for about 60 seconds. the presiding officer: without objection. mr. isakson: and i would ask that it appear separately from my previous remarks in the record. the presiding officer: without objection. mr. isakson: mr. president, it's christmas and we're all here in washington working, and our troops are working for us around the world in afghanistan and iraq, but there are a lot of other soldiers that have been working very hard this past year. those are the soldiers that support the feed the hungry programs and the community food banks all over the united states of america. in atlanta, georgia, and in our state, there has been an award sponsored by atlanta gaslight

for many, many years. it's an award called the shining light award. it's an award the tribute to which is a gaslight is installed somewhere in atlanta to pay a tribute to an individual who has made a historic contribution to the community and the betterment of mankind. people like president -- former president jimmy carter, people like ambassador andrew young, people like the founder and the gem of our state, the founder of chick fil-a. this year the award has been named and will be given in honor of bill bowland. bill bowland runs the atlanta community food bank. bill bowland this year will oversee the distribution of 20 million pounds of food through 800 nonprofit agencies to feed citizens of our state. it's his 29th year in building the atlanta community food bank into one of the finest facilities in our country.

bill bowland is an unselfish, untiring, honorable man of our community who unselfishly gives of his time to see to it others in pain and in hunger have food, have support, and have nourishment. at this christmas season, 2009, on the floor of the united states senate, i pay tribute to bill bowland for his unselfish contribution to our state and to those less fortunate, but equally i do the same for those around the country who in this difficult time of recession and this wonderful time of holiday see to it that those that have little have food, see to it those who have hunger have nourishment and see to it that america is what it always has been, a giving and compassionate country on behalf of its people. mr. president i yield back the balance of my time.

mr. roberts: mr. president? the presiding officer: the senator from kansas. mr. roberts: i thank the president or the acting presiding officer. mr. president, the bill pending is, of course, appropriations for our national security or defense, but within this bill is legislation, mr. president, containing a doctor fix, a doctor fix meaning to prevent any further cuts in briewrmt to our nation's doctors, our nation's doctors now only get reimbursed 80%. i think it's very important to do that, to do something for doctors, but it's equally important to prevent something that would be very -- very disastrous to doctors in the entire health care delivery system of our country. in that vain, -- in that vein,

there are a lot of things in this bill that i object to. the $2.5 trillion cost, the 24 million people still left uninsured, the unconscionable half trillion dollar cuts to medicare with another half trillion dollars in job-killing tax increases, the stunning assaults on liberty and the orwellian policies making health insurance even more expensive. any one of these things would make me vote no on this dangerous legislation which i think has been very ill-conceived, and we don't even know what the last bill or the last iteration of this effort will look like, and we don't even know what the cost will be. but there is another issue that has troubled me the most, and that is the issue of rationing, and i really don't think, mr. president, that this issue has really sunk in with the american people and especially within the media, so i want

everyone to understand this bill aims to control the government spending by rationing your access to health care. now, that's not scaremongering, that's not a scare tactic. facts are stubborn things. in this bill, there are at least four government entities, and we're going to call them the rationers over here to my right who will stand between you and your doctor. these four entities are represented by the four walls on this chart behind me, standing between you and perhaps your wife and the doctor. these folks are obviously somewhat elderly, and that's the big issue in regards to rationing which i will talk about in just a minute. let's talk about the first one, the patient-centered outcomes research institute. the acronym for that is pcori. that's one you haven't heard of

before. but it's the patient-centered outcomes research institute. that's this one here. that's the first wall between this couple, or you, and your doctor. the obama-reid bill establishes the patients-centered outcomes research institute to conduct something called comparative effectiveness research or c.e.r. now, rest assured every health care provider in the country knows what c.e.r. is, but i'm not sure the public understands it and i'm not sure those in the media yet fully understand it. it is research that compares two or more options for the same condition to see which one works best. now, that sounds like a great idea, and it is a pretty good idea, but unfortunately when c.e.r. is conducted by a government under pressure to meet a budget, it can be manipulated in some very sinister ways, and that has been demonstrated by the united kingdom's c.e.r. institute.

take a good look at that as an example. the national institute for health and clinical excellence. now, the acronym for that is "nice" but it hasn't been very nice." nice "is notorious for delaying or outright denying access to health care treatments based on comparative effectiveness research. that takes into account the cost of the treatment and the government's appraisal of the worth of the patient's life or comfort. some of the more shocking c.e.r. decisions handed down by "nice" over the years include restricting drugs to save seniors' vision from mac already degeneration until the patient is blind in one eye, denying access to breakthrough treatments for aggressive brain tumors and refuse to go allow alzheimer's therapy until the patient deteriorates. that's unbelievable that that happens. the patient-centered outcomes research institute, right here, will be the american version of "nice" using c.e.r. to save the government money by rationing

your health care. we try very hard in the "help" committee to simply insert one word called prohibit. the c.e.r. cannot be used in any way for cost containment, it should be used for patient care, and the word we tried to put in was prohibit. and so consequently, it was talked about about two or three days and then in a very partisan decision why prohibit became a thing of the past. now, i have offered several amendments along with my good friend and colleague and a real leader on trying to alert the senate all about c.e.r. and the dangerous path we might be taking, senator kyl. senator coburn has talked about this. he has an excellent article in "the wall street journal" two days ago. senator enzi, who is the ranking member and also serves on the finance committee to protect american patients from "nice" style rationing. unfortunately, they have all been voted down on party-line votes. it's not that we haven't tried. let's get to rationer number

two, the independent medicare advisory board, right here, the second wall between you and your doctor. the obama-reid bill establishes a new, independent medicare advisory board, an unelected, unelected body of 15 so-called experts who will decide medicare payment policy behind closed doors, no congressional input. so when they make this decision on briewrmt -- on reimbursement to all of the health care providers and then all of the health care providers, some of which in their national organizations have chosen to go along with this bill and wake up to the fact that they are not protected, they're going to come to the congress and some in the congress will say well, we can't do anything about it because, obviously, the medicare advisory board will make that kind of a decision. that is a complete abrogation of our responsibility. one way or the other in terms of cutting reimbursements in the appropriate way to save money or to make sure that reimbursements don't close down a particular

vital part of our health care delivery system. and although this bill says this anonymous board shall not include any recommendation to ration health care, what else would you call denying coverage for medicare patients based on costs? that's why this board will do -- or what it will do, deny payment for knee replacements or heart surgery or breakthrough drugs all to achieve an arbitrary spending target. i don't know what you call that, but i call that rationing. if this nice lady would like to have a knee replacement and through c.e.r. and through the medical advisory board, that is just something that means discomfort, sorry, she can't have that kind of an operation. also notice that this board will necessarily ration to health care based on age and disability, of all things, since its payment policies will only affect the elderly and disabled who receive medicare.

what will be a patient's recourse if medicare fails to fay for an innovative new therapy that could save or prolong their life? these are the reasons the "wall street journal" dubbed the board "the rationing commission." let's go to number three, this is another rationer, right here, the c.m.s. innovation center. the centers for medicare and medicaid services, or c.m.s. -- and rest assured again, every health care provider recognizes that acronym because they're the folks that implement and then enforce what happens with the department of health and human services. they currently administer the medicare program on which 43 million americans rely. that's almost 15% of the population. now, listen up, c.m.s. already rations care. it's not authorized to do so but it does. it does so indirectly through payment policies that curtail the use of virtual

colonoscopies, certain wound healing devices and asthma drugs. medicare already has a higher claims denial rate than most private insurance companies. let me repeat that. medicare already has a higher claim denial rate than most private insurance companies, something you're not going to hear my friends on the other side admitting, not when it's so convenient to simply demonize the big, bad insurance companies. in fact, the courts recently had to intervene to prevent c.m.s. from rationing a relatively expensive asthma drug in medicare because rationing is now against the law. however, the reid bill establishes a new c.m.s. innovation center which will be for the first time granting c.m.s. broad authority to decide which treatments to ration. last one -- last rationer, it's like the four horsemen. the u.s. preventive services task force -- right here, the u.s. preventive services task

force. they got a lot of headlines here recently and i'll go into that here in just a moment. it's yet another panel of appointed experts. we've got four panels here, none of them elected, so-called experts. this will make -- this particular task force will make recommendations on what preventive services patients should receive. currently the task force recommendations are optional but the reid bill bestows this unelected, unaccountable body with substantial new powers to determine insurance benefit requirements in medicare, medicaid and even the private market. and the task force has already revealed the types of recommendations that it will be making. just recently, it decided to reverse its long-standing recommendation that women get regular routine mammograms to detect breast cancer starting at age 40. one really has to wonder if the task force's abrupt aboutface -- and it was abrupt -- has

anything to do with the fact that the federal government's financial responsibility for these screenings ask for the health care needs they would potentially reveal would be greatly expanded if this health care reform bill passes. in the words of one prominent harvard professor, "tens of thousands of lives are being saved by this screening." and these -- quote -- "idiots want to do away with it. it's crazy, it's unethical, really. the outcry from oncologists, the american cancer society, the american college of radiology and breast cancer survivors and families all across the country forced health and human services secretary kathleen sebelius to backpedal away, do a backstroke real quick from the task force's recommendations, saying that they do not affect government payment policy. but this bill relies on the task force's recommendation some 14 times throughout the legislation to set benefits, to determine copayments, to make grant

awards, et cetera, et cetera, all policy decisions. so contrary to secretary satisfy we'll yus' assertion -- secretary sebelius' assertion, if this bill passes, the recommendations of the task force will become government policy. not only that, it will be force odd to private insurers as well. now, i know some may ask: senator, why so cynical, why not trust that these tools will be used only for good, to advance medical science and patient care? and to those folks, i'd like to answer you by showing you this chart over here. it's my favorite chart. dr. azekialy emanuel's complete life system. it's dr. emanuel's complete life system. now, why is that important? as many of you know, dr. emanuel

is the brother of white house chief of staff rahm emanuel. he's a bioethist. he's very talented and very smart. maybe he should be the rationing czar. he's published some very disturbing ideas on how to ration care which can be summed up by this brave, new world, humpback whale graph behind me. dr. emanuel's complete lives system basically works off the premise that the older you are -- listen to this -- the older you are, the more you've lived and, therefore, the less you deserve health care. let me repeat that. the older you are, the more you've lived, and, therefore, the less you deserve health care. well, you know something? the average age of my colleagues in this body is 62 years old. just something for you to think about in terms of what you're contributing to the country and

maybe you're eligible for health care, you should get a health care or maybe not. because if you look here where this chart goes, you've got a lot of -- a lot of input here. you've got a lot of investment in health care in our entire health care system. and like the humpback whale, wee, off we go here to about 60. and when you get to 70, boy, it's like they left you on the last hill on some tribal situation and then just left you to die. president obama has clearly been listening to dr. emanuel's counsel. remember his observation in an interview this summer that as patients get closer to the end of their life -- quote from the president, no less -- "maybe you're better off not having the surgery but taking the shots and pain killer instead. telling someone because they cannot have a knee replacement because they're too old? how old is too old? who should be making that decision? the doctor and the patient or any one of these four task

forces, more especially this complete lives system as a blueprint? that's why the "wall street journal" reported on the age rationing that occurs in canada's government-run health care system and that in that country, apparently 57 is too old for hip surgery. luckily, many of these so-called old geezers can drive south and find care right here in the united states. i'm not sure where they will go after this bill passes, however. the white house may complain i'm taking doctor emanuel's musings out of context. my response to that is this, mr. president -- this is the context. this is how the government will contain costs. this is the blueprint right here, the complete lives system. this is what we're going to be basing decisions on in terms of reimbursement, not between your doctor and your patients. all of the rationing policies in this bill must be viewed through the prism of dr. emanuel's ideas of this chart and consequently

this is the goal to save the government money by rationing care. that's what the president means all time when he says we're going to squeeze money out of the health care delivery system. now, by basing that rationing on something like a pseudoscientific graph like this, at least in the united kingdom, they're honest about it. and here it's a very generic approach. and these are the tools of rationing. these tools will restrict your ability and your family members' ability to get a knee replacement or a breakthrough cancer drug or a treatment for alzheimer's or a mammogram. the four rationers, they're writing hard out on the prairie in regards to the rural health care delivery system. in fact, my colleagues, if allowed to continue without legislation, legislation that was introduced by my good friend from arizona -- we've already considered that legislation. i don't think too many senators were aware of the consequences of that, but senator kyl did

offer legislation on this floor, did offer legislation within the finance committee -- if we are not able to stop this, you're going to see the destruction of the american health care system. the best health care system in the world and they are among the main reasons why i will vote no on this bill. we have no -- no, no -- no reason to put these task forces in with the kind of power that they have to follow this kind of a chart which is just not acceptable. mr. president, i yield back the balance of my time. a senator: mr. president? the presiding officer: the senator from arizona. mr. kyl: thank you, mr. president. first of all, i want to compliment my colleague from kansas. he and i have been working on this problem of delay and denial of care, the problem of rationing of care specifically as it comes about through the comparative effectiveness research that's in this legislation for a long, long

time. and i appreciate what he has said here today. given the amount of time, if i'm not able to get a little bit more time over there, i'm just going to speak off the cuff here commenting on a couple of the things that he said. i am concerned about the cost of this legislation. i'm concerned about the cuts in medicare. i'm concerned about the taxes. i'm concerned about the fact that premiums go up, not down under the legislation. i'm concerned about all sorts of things that are in this government takeover of health care in our country. but nothing concerns me more than the problem raised by my colleague from kansas. because in my view, nothing is more important to all of us all over the country than the health of our families and ourselves except, perhaps, our freedom. and in many respects, this legislation takes away that by denying us the ability to work with a physician, a family physician who can help decide what's best for us and then

provide that kind of treatment to us. when that's taken away from us in the name of cost cutting for the federal government, yeah, we're bending the cost curve down all right and we're also hurting quality of health care for all americans from now on. that's what bothers me most about this legislation. i wonder why if my colleagues on the other side of the aisle are so certain that rationing is not going to occur, they have defeated over and over and over again the amendments that my colleague from kansas and i have proposed that very simply say, you won't use cost-effectiveness research to deny coverage. it's very simple. they say, well, the language already covers it. i don't think so. but if it's your view that we shouldn't ration care, then let's just say it. no, they don't want to do it.

and i think the reason they don't want to do it is very clear. because throughout this legislation, there are numerous ways in which rationing will occur and it has to occur under their scheme of things because it's the only way to accommodate the promises that have been made relative to the amount of money that they have to pay for it n. some countries, they -- pay for it. in some countries, they basically set a budget and say we have -- i'll just pick a number out of the air -- $50 billion this year to spend on health care. it's kind of like we deal wit with -- how we deal with indian health care in our country. and it is said on our indian reservations, you better get sick early in the year, because when they run out of money, that's it, your appointment will be next january. get in line. we don't want the kind of care that great britain and canada and some other countries have, where the quality of your care

depends upon how much money they have available to treat you. at first it's done subtly. they simply don't inform you of things that might otherwise be available so you don't even know that the treatments are available. then they begin delay, it takes longer and longer and longer to get an appointment with the doctor. and then finally, it's actual denial of care. they simply don't make various treatments available, various pharmaceutical products available to you and so on. i was going to mention one of the experiences in great britain where they've finally figured out how to get the delay down to 4.5 months. anand are really proud of that. this is the national health service in great britain launched what they called an end

waiting changed lives campaign. campaign's goal is to reduce patients' waiting time from 18 weeks -- to 18 weeks from referral to treatment. 18 weeks? and that's supposed to be a good thing? that is not what americans want, and they know that what starts with delay in getting an appointment eventually results in denial of care. but probably the most pernicious thing is what my quality was talking about with comparative effectiveness research where panels of experts decide what kind of treatments work best and which are most cost effective for most people most of the time. the difference between that and a physician treating a patient is the physician knows each one of his or her patients. he knows their needs, and they're not all average. they're not all the general rule. some require special circumstances. mr. president, let me just conclude by reading from what

one of our colleagues said, dr. tom coburn. he wrote this in the "wall street journal." as everyone knows, he is a physician. he said "the most fundamental flaw of the reid bill is best captured by the story of one of my patients i'll call she l.a. when sheila came to me at the age of 33 with a lump in her breast, tests like a mammogram indicated she had a cyst and nothing more. because i knew her medical history i wasn't convinced. i discovered she had a highly malignant form of breast cancer. sheila fought a heroic battle and enjoyed 12 years with her family before succombing to the disease. if i had been practicing under the reid bill, the government would have likely told me i couldn't have done the test that discovered sheila's cancer because it wasn't approved under c.e.r., comparative effectiveness research.

under the reid bill, sheila may have lived another year instead of 12 and her daughters would have missed a decade with their mom. the bottom line is that under the reid bill, the majority of america's patients might be fine, but some will be like sheila. patients whose lives hang in the balance and require the care of a doctor who understands the science and the art of medicine and can make decisions without government interference. mr. president, i rue the day that government stands in between a patient and a physician, when the physician says i don't care what the research says, the average patient needs or generally what's indicated or what costs too much i. know what this patient needs. and unless she gets it, she's going to die. at that point if our government has inserted itself between a patient and physician and says it can't be done, our freedom

will have been taken away, the quality of our health care will have been taken away and we will have succombed to a government so powerful that it literally has life and death control over ourselves and our families. that is fundamentally wrong and we cannot allow that to happen by adopting the legislation that's before us. mr. roberts: would my friend and colleague yield for just a moment? mr. kyl: i'll be happy to yield. i think i have 30 seconds left. mr. roberts: i promise to be brief. i thought about saying this, but i think the example that dr. coburn wrote about in the "wall street journal" about sheila made me think about this. avis very close friend -- i was a very close friend with a member of the british parliament who thought he had broken his wrist. had a lot of pain. took quite awhile to get in to see a doctor for a broken wrist. final did, it was put -- finally did, it was put in a cast. he kept feeling bad and thought

it was set wrong. finally got back in and never left the hospital. he died within two or three days. he had cancer. that to me was incredible that in great britain -- and i'm not saying a member of parliament deserves any better treatment than anybody else, but that was inconceivable to me. you have to sort of equate it to what this bill would do and what other people would experience very similar to that and the situation that sheila found herself in as well. so, i thank the senator for yielding. mr. kyl: thank you. i believe my time has expired. mr. durbin: mr. president? the presiding officer: the senator from illinois. mr. durbin: mr. president, for those who are keeping score and following the senate and may wonder what we are doing here, we are in the middle of a filibuster, which is an attempt to stop legislation from moving forward. it is a filibuster inspired by the republican side of the aisle, and the bill that they are filibustering and trying to delay is the department of

defense appropriations bill. this is the bill that funds our military. it is the bill that funds our soldiers and sailors, airmen and marines who are at war in iraq and afghanistan. it is a bill that almost without fail passes overwhelmingly with a bipartisan majority in the senate and the house each year. and it has passed the house of representatives with a substantial vote of about 394- 394-35, 164 republicans voted for it over there. there was no controversy associated with it. and yet when it came to the senate, the senate republicans announced they were going to filibuster the defense appropriations bill. why? do they disagree with any of the contents? i've yet to hear, aside from senator mccain and senator coburn whorbgs went to two or -- who went to two or three provisions of the bill they disagree with, i've yet to hear anyone say we shouldn't fund our military. we certainly should. some have come to the floor and

argued the reason we're in this predicament is because the democrats, in control, have waited too long to bring this bill to the floor. but that statement fails to acknowledge the reality of what this calendar year has meant because day after day and week after week, month after month with very few exceptions the role and strategy of the minority -- the republicans in the senate -- has been to slow down and stop consideration of important legislation. mr. roberts: would my friend and colleague yield? mr. durbin: pardon me? mr. roberts: would my friend and colleague yield? mr. durbin: only for a question. mr. roberts: only for a question? mr. durbin: i yield for a question. mr. roberts: i want to assure him, in the form of a question, if he were asking me am i filibustering, that is not the case. the problem was, as i see it -- and i'm asking the distinguished senator that i've known for a long time and respect -- what

would he think about the response -- this is the question -- where we have only had seven amendments that have been allowed on this bill? i have one on the medicare advisory board, we have one on c.e.r. here, rationing, i had another one in regards to a tax matter -- about four amendments, all of which have been considered in the finance committee. all were defeated by a party-line vote, so i know where it was headed. but i thought it certainly deserved some debate and some consideration on the floor, to all of a sudden limit a bill of this side -- health care bill, not defense bill -- to seven amendments seemed to be very untoward and showing a lack of comity in regards to a bill of this size. the defense bill has the doc fix in it. as such, i think you could pivot into the problems that doctors face and at least have an opportunity to talk about, this

is the first time i have had 10 or 15 minutes to talk about anything about health care. it's not that i would choose to do it when we are considering the defense appropriations bill. i served on the armed services committee, the intel committee, as the senator knows. there's no person stronger for our warriors than our men and women in uniform, and they will get their money. this bill is going to pass. that's not the issue. the issue is we haven't had enough time -- and i would ask the senator to comment on my comments and tell me if i'm wrong. mr. durbin: i would say in response to the senator from kansas, he has a grievance in consideration of this bill, the health care reform bill, 2,000-page bill which i will address in a moment. we are considering this bill, the department of defense bill. because of the grievance over the consideration of this bill, the republicans are filibustering the department of

defense appropriations bill. they are trying to slow down as much as possible the passage of the department of defense appropriations bill. many of us think that that is unfair, particularly when we have our best and bravest young men and women at war, that we would somehow make the bill funding their effort and funding the things they need to protect themselves the center of a political debate over another bill. and it is a filibuster. twice last night on this floor -- early this morning, i should say, in the early hours of the morning i made a unanimous consent request that on a bipartisan basis we fund our troops. i offered it on the floor, and twice it was objected to, the last time by the republican leader and the republican whip in the well of the senate. had a chance to pass this bill. the funding for our troops runs out at midnight tomorrow. we are going to come in at 7:30 tomorrow morning because the republicans insist on this delay, and we are actually going

to fund the troops. i really believe when push comes to shove we will. i hope we do. i'll be voting for it. i hope the republicans will join me. so i don't understand why the republicans are holding the department of defense bill for our troops hostage to their anger or frustration over health care reform. and then let me address health care reform. i'd say to the senator from kansas, we've been on this bill for 19 days. you know how many substantive amendments have been offered by the republican side to this bill in 19 days? four. not even one a day. and six amendments -- i should say motions were made to this bill to send it back to committee and start over. so if the senator has substantive amendments, and others do, the obvious question is: where have they been? 19 days, 4 amendments. it appears to me when the decision was made several days ago on the republican side to order the reading of an 800-page

amendment, it was very clear this had nothing to do with debate and voting on amendments. it was all about slowing things down and stopping them. and they tried and couldn't on the reading of this bill. and now they are trying as best they can when it comes to an unrelated bill. there comes a point, i would say to the senator from kansas, where there has to be a vote. and we are here to vote. let's get on with it. we either win or lose. you either win or lose. and we have to go forward. you don't support this, i know, from what you've said. i do. i may prevail. you may prevail. but at some point don't we owe it to the american people to take a vote? unfortunately, this delaying tactic that's been going on here is just postponing what i think we're here to do. and it's doing it at a time of year when i have to tell you that, you know, i always say, at least they told me when i ran for the house, if you don't like this job, don't run for it. and if you get this job, don't

complain about it. well, i'm not going to complain, but i do have to tell you that most of the members of the senate would like to be home with their families for christmas, and we may not be. mr. roberts: allow me to respond to your question? mr. durbin: i can yield for a question. otherwise i'd be yielding the floor. so i would certainly yield to the senator from kansas for a question. mr. roberts: you could go for it and yield the floor and see what happens. i think the question the senator asked of me -- and i will traoefr back to him in the -- refer it back to him in the form of a question was that we, i, was taking part in a filibuster. the only reason i'm here to talk about rationing -- and i had that rationing amendment ready along with the medicare advisory board and along with several others and all of a sudden were told that they were not in order. why are they not in order. they're just not in order. we're going to move on this bill. so consequently i have four amendments sitting on my desk waiting to at least talk about them as opposed to bringing them up. i don't think that's filibustering. i think i'm taking advantage of

whatever time we have to at least talk about these amendments certainly on the health care bill, on the defense appropriations bill, i can assure you, i don't think there will be one republican that will vote "no." and it wasn't too long ago, i would ask the gentleman if he can remember, on your side of the aisle with a previous president, i think people over there said the war is lost, we oppose the surge. we're going to hold up some of the bills, et cetera, et cetera. i didn't like it then, i don't like it now. it's very unfortunate this situation has developed. but i want to assure the gentleman and my good friend that i am not here trying to hold anything up. and one other thing, isn't it true that there is a bill out there but nobody has really seen it, more especially the manager's amendment combined with what came over from the house and we do not have a score? whatever you have there, if that's the bill, i'd sure like to get it up on the web or

something so we can take a look at it and also have a score. we keep talking about the bill. i would just ask the gentleman: is that the bill? is that the final bill with a score? mr. durbin: i would say to the senator from kansas, it's not the final bill. there will be a manager's amendment offered tomorrow. it will be considerably smaller than this. and it will have specifics in it that have been reviewed by the congressional budget office, and that is underway. it will be introduced, i hope, tomorrow morning. and it will be up for consideration for a procedural vote early monday morning, and then the remainder of the week as long as the republicans want us to stay. it's your decision whether we'll be here for christmas. we are prepared to stay if necessary to get it done if that's what it takes. but it is true that there is a manager's amendment coming. it is also true that the congressional budget office may be one of the most powerful agencies of the federal government because it literally can stop the congress in its tracks while the people who work

there pore through these bills and try to make some estimate as to whether they're going to add to the deficit or not, whether they will in fact reduce health care costs. the good news for all of us is they took a look at our bill, the democratic health care reform bill and concluded that it would in fact reduce the deficit $130 billion over the next ten years and $650 billion beyond that. it's also true this is the only bill brought before us that would expand the coverage of health insurance to 94% of americans. there have been talk about rationing in other countries. senator kyl of arizona talked about racking and there is a fundamental unfairness to waiting in line when the doctor said that you need treatment. keep in mind that there is rationing in america. 57% of people don't have insurance and many don't have -- have health insurance policies

that aren't worth anything. that's rationing. more and more people in america are filing for bankruptcy because they don't have the out-of-pocket money for medical care they need in america and that's rationing. and in the developed world, which america certainly leads, we're the only nation on earth where a person can die for lack of health insurance. and that's rationing. and that's our current system. some say, well, these reforms are too complex, 2,000 pages. i defy to find anyone to find 2,000 pages an write down the current health care system in america. they can't. it is much more arcane, complex and bewhich wouldering than this bill. this bill is going to give people an opportunity to fight the health insurance companies who consistently turn down the requests of doctors an patients for care saying they're not covered by the policy or the person failed to disclose everything they should in their application for health insurance. we take them on here.

and it's about time we did. these health insurance companies make a fortune. their c.e.o.'s are paid a fortune and they have created a situation which rations care to american today. i've seen it firsthand. i know friends who are going through it. people right in my office and anyone who is listening to their constituents back home know this is true. there is also one other element i'll mention before yielding the floor to the senator from minnesota. we will dramatically expand the community health care clinics in america with this bill. if you're aware of these clinics, and you should be, you'll know these are the clinics with the doctors, nurses, dentists, raidologists who provide basic primary care to people who are not wealthy. they provide care at a fraction of the cost to people going into a hospital or emergency room for people with a fever or a child with an earache. they do it well, they do it all

over my state and we will expand it. you will see a dramatic change in primary care. more and more primary care physicians, costs brought down with quality care at a local level. there is nothing coming from the other side that even matches it. i'm prepared at this point to yield the floor to the senator from minnesota for the balance of the time until 4:00. the presiding officer: the senator from minnesota has the floor. mr. franken: i will yield to the senator from kansas. for a question. for a question. mr. roberts: you again. mr. franken: you again. mr. roberts: just a personal aside. well, when we get through with the defense appropriation bill, which will be soon, and that issue will be settled and i'm not going to talk about it anymore with the exception that this is the only time that i

have had to speak to several amendments that i feel very strongly about. but, as i say, i don't know whether four is the accurate number of being a subsidy or not. i think the four amendments that i have on the desk, i think it i will skinny is down to three, that i will offer to the finance committee, i say to the senator -- are you going to -- the senator is surely not shifting his position. i would say to the senator when we take up health care again would the senator give me some assurance i can offer the medicare advisory board, one to cut out the cuts in regards to the hospitals, that's $1.5 billion to kansas alone, and then what we're talking about here is the four rationing task forces we had when i was making my speech. if i could have some assurance

that i could offer them -- the presiding officer: the senator from minnesota has the floor. if you've -- if he's yielded for a question, the senator -- should propound the question. the senator from minnesota has the floor. not senator from illinois. mr. roberts: that's a question. if he could ghief some assurance -- give me some assurance that that could be considered, but that hasn't happened with the situation we are. i'm done. mr. franken: thank you, mr. president. mr. durbin: if the senator from minnesota would yield for a kind of -- kind of a question. mr. franken: certainly. mr. durbin: i wonder if you're aware that we've been debating health care reform for 19 days and in that time there were four republican amendments to change the bill, six motions to commit the bill back to commit, stop the -- committee, stop the debate on the floor and that is the sum total of all of the

effort on the republican side to date. we don't choose the amendments, the leadership chooses it on the republican side of the aisle. i ask the senator from minnesota, are you aware of it? mr. franken: i am now. i was aware of the general shape of things which is the sort of dearth of substantive amendments offered and sort of the delay, yes, then i'm aware. thank you. mr. president, i -- i ask unanimous consent to speak for 10 minutes as if in morning business. mr. roberts: mr. president? the presiding officer: is there objection? mr. roberts: reserving the right to object, and i will not object to my good friend. but i can't -- i can't let this stand when the distinguished senator from illinois indicates there's only been four substitute amendments and i have three on my desk -- the presiding officer: does the senator from kansas have an objection? mr. roberts: i'm reserving the right to object, mr. president. under my reservation, i would point out to my distinguished friend i'd like to invite him to

my office to see the amendments that were ruled out by the leadership. the presiding officer: the senator from minnesota. mr. franken: thank you, mr. president. the american dream and its promise of prosperity has long been predicated on the simple idea that opportunity is a right and not a privilege and that every individual should be afforded a level playing field on which to set out into the world. to fulfill this promise to our children, we must close the school achievement gap that is leaving so many of our low-income and minority children behind. closing the school achievement gap is one of the defining civil rights issues of our time. it is a cause that challenges our society to uphold its

time-honored commitment to equal access and opportunity for all. yet, reversing tech kaidz of educational -- decades of educational inequality is no easy task. we cannot expect our schools to do it alone. we also need to improve social services and low-income communities and address the challenges that are faced outside the classroom that make it difficult for them to learn. at the same time we cannot absolve schools of their responsibility to improve considerably. there are exemplary schools scattered across the country that are proving -- paving the way, improving every day while they cannot solve all of their students' problems, they can can push them to increasingly higher levels of achievement under the most trying of circumstances. our task now is to learn from these schools.

while "no child left behind" shined a light on the i inequaly of the educational system, it has done little to address the problem. as we approach the reauthorization of "no child left behind", it is critical to look to the schools that are beating the odds and determine how to replicate their success. one of the moss common features of successful schools in low-income and high minority communities is the presence of an effective school principal. this should come as no surprise. it's a matter of common sense to expect the successful school or any successful organization to have a strong leader. moreover, research underscores the importance of school leadership. in fact, research shows that school leadership is second only to teacher quality in its impact

on student learning. yet, despite the importance of school leadership, the federal government has not devoted adequate attention and resources to improving the quality of principals in high-need schools which serve high proportions of low-income a and minority students. senator hatch and i intend to change this. having seen the extraordinary impact of effective school principals in minnesota and in utah, we believe that improving principal quality is essential to turning around high-need schools. that's why we have introduced the school principal recruitment an training act. the bill -- and training act. the bill will train a pipeline of effective principals for high-need schools by providing high-quality programs with funding to recruit and train principals to take on the

challenge of leading those schools. one principal who has made a particular impression on me is principal andrew collins at dayton bluff elementary school in st. paul, minnesota. it is diverse and poor, most students are eligible for free an reduced priced lunch, one-third are english language learners. dayton bluff used to be one of the worst learning schools in minnesota, only 1% of its fourth graders and 4% of the fifth graders were efficient in reading and math. today the school is restructured. today principal collins is in his fifth year of leading the school. under his leadership the student achievement is at an

unprecedented paisms it has increased from 49% three years ago, 10 points below the state average to 71% or eight points above the state average. african-american students at the school have performed more than 20 percentage points above african-american students statewide in both math and reading scores. it's the same school, the same neighborhood and the same kids. yet, the school is achieving vastly different results. the success of the school is a testament to the hard work of principal collins and -- and -- and his staff. principal collins has led the school's transformation by working closely with teachers to help them improve their instruction and their use of formative assessments in student data. he has also supported the growth of his teachers by giving them

time to collaborate with each other on improving their instructional practices. principal collins is, unfortunately, the exception to the rule. many districts report shortages of qualified principals willing to lead schools that are particularly in need of a strong, guiding hand. we need to recruit and prepare more principals, like principal collins, in order to improve student achievement and close the achievement gap. we can't afford not to make this a priority. when schools are not performing adequately, we -- we hold principals accountable. but it doesn't make sense to place underprepared principals in schools facing great challenges, and then be surprised when these schools experience high principal

turnover rates and continue to struggle with -- with student achievement. we need to provide principals with more intensive and hands-on training than most of them currently receive so they'll be ready to tackle the challenges of leading high-needs schools. they need to inspire staff, create a positive atmosphere for students and engage families and use data to have a continuous progress of improvement. the training act would provide principals with the high quality and intensive training that they need to address these challenges. we are fortunate to have principals in some schools who have put in long hours with school leaders trying strive their schools for the sake of their students. we need to recruit, train, and support more principals of the caliber of those princ principao

that every school, and particularly those in greatest need, can benefit from effective leadership. senator hatch and i will continue to work in the coming months to ensure that we invest in principal recruitment, training and retention so that our schools have the leadership they need to do right by our students. we view this investment as key to closing the achievement gap, and in the process, delivering on america's promise of opportunity for all. thank you, mr. president. i yield my time. the presiding officer: the senator from utah. mr. bennett: mr. president, may i inquire as to what the status of the time allotment is? the presiding officer: the minority now has 30 minutes.

mr. bennett: thank you, mr. president. i appreciate that. i rise to discuss the bill before us, which is the defense appropriations bill, and we think of that in terms of funding the troops and taking care of our challenges overseas, but there is an aspect to this bill that i would like to focus on because in this bill, in addition to appropriations for the defense department, there is what has come to be known around here as the doc fix. that is every year we face a situation with respect to physician reimbursements for medicare. every year, the bill -- the law that is before us cuts the level of reimbursements from medicare to doctors, and every year the doctors come back to the congress and say we can't survive this, we can't live with this. we have to have some more

reimbursement. the cuts that are in the law can't be allowed to continue. every year we come along and say all right, we will fix that but just for this year. every year, we say all right, we will give you the full amount of reimbursement that you feel you're entitled to and thereby postpone the amount of cuts in your reimbursement that are in the law. as i say, this has happened so often that it now has a name, a generic name, and every time it happens, it's called the doc fix, and in this year, the doc fix is included in the appropriations bill for the defense department. well, mr. president, the reason that it's appropriate for us to be talking about the impact of the doc fix at this particular time is because of the impact of the doc fix on the health care

bill which is what we will return to when we are through with the defense appropriations bill. so given the fact that the doc fix is in the defense appropriations bill, i think it appropriate that i talk about the underrifying problem for just a moment. when you get to the health care bill and try to figure out how it's going to be paid for, this multitrillion dollar bill, you find that one of the main reasons, one of the main ways it's going to be paid for is by cutting the reimbursement to doctors and hospitals under medicare. indeed, i believe the amount that will be cut is up to half a trillion dollars. the reason i say i believe that's the amount that will be cut is because we have not seen the actual language of the bill we will be asked to vote on probably on christmas eve. the bill has been drafted, the manager's package has been drafted, it has been referred to

c.b.o. for a score, but it has not been shared with any of the members of the senate. so we are guessing as to what it will be, but there has been enough said and enough written about it that i think the guess of half a trillion dollars cut in appropriations to physicians and hospitals is a legitimate number. all right. we have never seen a cut of this magnitude before. we have had much smaller cuts that have come along, and every time, as i said at the opening, we have dealt with those cuts by passing a doc fix. now what we're seeing here is the passage in the defense appropriations bill of yet another doc fix, and what that means is we know based on precedent that the congress of the united states will never allow the $500 billion cut that's in the underlying health

care bill to actually take place. well, if it's not going to take place, why is it in the bill? and the answer to that is something i have a hard time explaining to my constituents because they don't understand the ins and outs of the scoring situation in the c.b.o., but i'll do my best to help make it clear. the congressional budget office is called upon to score each bill separately, so if you have a bill with respect to defense, they score that bill and they do not talk about the impact of that on the overall budget. they just say these are the numbers. if you have a bill that deals with interior, they score that bill. if you have a bill that deals with transportation, they score that bill and so on. each bill is scored separately as a single entity. all right. let's talk about the health care bill. the health care bill is going to increase costs dramatically, and

when it increased costs dramatically, in order to keep president obama's pledge that it will not add one dime to the federal deficit, there has to be something in that bill that cuts the cost. so we assume, based on previous investigators of the bill -- previous versions of the bill what will be put in the manager's amendment is a a $500 billion cut in medicaid -- or medicare reimbursements. all right, now you begin to balance the dollars within that bill, because if we have got got $500 billion more spending but we're going to take take $500 billion out of medicare, then the two balance each other and you can say well, as the computers at c.b.o. do say, this bill is in balance and will not increase the deficit. all right. but if you take the $500 billion

that has been cut from medicare reimbursement and pass a fix, if you will, for that $500 billion in another bill, it doesn't get scored against this bill, and that's what we're doing with respect to the defense appropriations bill. we're taking the defense appropriations bill and passing a bill that would pay doctors under medicare, would take care of the shortfall under medicare, but would not be scored against the health care bill. now, i don't know of any business that dares keep the books -- its books that way. i don't know of any business that could possibly survive that would say all right, we're going to calculate only in this one area the costs of the product against the sales of the product and say okay, the two balance each other in such a fashion

that this is a logical thing to do, but at the same time in a separate situation we're going to say we're going to borrow x amount of money to pay for the shortfall in this product and we're going to pretend that the borrowing of the money separately somehow doesn't affect the accounting with respect to the product. nobody keeps books that way. indeed, i think if a private entity were to try to keep its books that way, it would not only go out of business but possibly its owners or managers would end up going to jail. you cannot do that kind of sleight of hand in a private enterprise, but we do it all the time with respect to the government. now, the attempt was made here on the floor of the senate, mr. president, if you will recall, for us to do the doc fix

prior to the time when we got to the health care bill. and the senate turned it down. the senate said no, we're not going to engage in those kinds of smoke and mirrors with respect to the budget, and we turned that down. as i was driving home that night, and i had the radio on on on -- in my car and listened to people talk about today in congress, this is what i heard. they said two items with respect to today's activity. number one, they talked about the progress of the health care bill in the senate, and then number two, it said the house just passed a $200 billion doc fix to take care of the shortfall in reimbursements to doctors with respect to medicare.

again, the computers at the congressional budget office can't link these two events, but they were clearly linked in the comments and the report that was made on the radio, and they are clearly linked in the deficit. so the house is saying we understand that we're not going to keep the pledges we are making in the health care bill, and we are going to appropriate appropriate $200 billion for the sole purpose of breaking the pledge that will be made in the health care bill, but because they're done in two separate pieces of legislation, we hope no one will notice. we hope the american people won't find out that this is the kind of bait and switch that we're going through with respect to this bill. as i say, we are finding an example of this in the bill that's before us, the defense appropriations bill. it has a doc fix in it to take care of the situation as far as the computers are concerned, but

it will not take care of the situation as far as the deficit is concerned. now, this is not the only piece of smoke and mirrors that we have in the underlying legislation. going along with it is another item that i find absolutely incredible. i have run a business. i have kept books. i have paid taxes. i have dealt with the government as they have come in to audit, and i know that no one in a business could ever get by with the thing that is proposed in the manager's amendment we think -- as i say, we haven't seen the manager's amendment the thing that's proposed in the manager's amendment along with the doc fix that i have just been describing. let me try and put it in this form. let's assume, mr. president, that you or the manager of a company and the salesman engineer comes to you and says

we have got a new product and it's going to be a really hot new product. it's going to be fabulous in terms of its return for the company. you say well, it's great. i love that. good news. how does it work? well, we're going to manufacture this new widget and it's going to cost us x, but the revenue from it is going to be y that's that much more than x, and so we're going to make all that money. and you say all right, how much does each widget cost? well, each widget costs more than we're going to sell it for. okay. how in the world are you going to make so much money when you have a widget that costs more to make than you can sell it for? and he says easy. this is the way we're going to do it. we're going to lay out a

ten-year program of sales and we're going to sell this widget for that entire ten years, but we're only going to deliver the widgets for six years. so we have got four years of revenue and only six years -- pardon me, we have ten years of revenue and only sick years of costs. so we have four years of pure revenue and no costs whatsoever. at that point, mr. president, i'm sure you would say let's get ourselves a new salesman engineer. let's get ourselves somebody who understands that the world doesn't work that way. you cannot balance your books by charging for ten years and then only delivering for six, but that's what the underlying health care bill does. it says the taxes to pay for this health care plan will start in 2010. indeed, it will start within a week or two after the passage of the bill, if we pass the bill on

christmas eve. but the expenditures under this plan to make things available for all of these people that have been telling us we need health care reform now, that we cannot wait, we have to have it today -- i have seen the placards that have been raised, i have seen the protests, everybody has. we have got to have it now. we say all right, the one thing that you will get now are the taxes, and the increases in premiums on people who already have health care, but you won't get any of the other benefits out of the bill for four years. and we have to do it that way in order to make the books balance. all right. you have got the doc fix, which the underlying bill that we're debating, the defense appropriations bill makes clear is not going to happen as part of the way you pay for the health care, and then you have the ten-year revenue, six-year

expense kind of scheme to pay for a good portion of the rest of it. so what's going to happen between now and 2014 when the bill finally kicks in? you're going to have three open seasons for those who understand the language of the insurance -- health insurance business. three open seasons in which people will look at their level of premiums and say wait a minute, how come my premiums are going up when nothing additional is being done with respect to health care reform? and the answer will be your premiums are going up so that the money can be charged by the computers as compensation for the new benefits that will kick in in 2014.

now, if you're so -- so impudent as to ask well, is the money that's going to come from the increased taxes and the increased premiums being put in a trust fund somewhere, to be held solely for the purpose of paying for the increased health insurance benefits, the answer, of course, will be no. the money that's coming from that increased taxes and from the increased premiums will all go against the current deficit. it will all go to deal with the money that we're talking about with the stimulus package. it will all go for other governmental purposes. there won't be a dime of it saved to deal with health care. that's not the way the government keeps its books. the money comes in, it goes into the general fund, it gets spent and it gets spent immediately. so that means to 2014, when the expenses of this bill kick in, there will not be a dime that

will have been accumulated to help pay for that. that's true as far as cash flow is concerned but it's not true as far as the c.b.o. score is concerned. and that's all we care about. all we care about is what the c.b.o. computers tell us about scoring this bill. one of the frustrations that i've had coming to the senator from a business background, having run a business, having understood the challenges of running a business, is the way the government keeps its books. and i cannot think of a more devastating demonstration of how misleading the government accounting system is than the bill that we will get to when we're through with the bill that we're debating here today. and the -- as i said at the beginning, one of the primary examples of that dishonesty is contained in the defense appropriations bill as it has this year's version of the doc fix. now, mr. president, let me move

to a related subject because, as i say, this bill talks about the doc fix. the doc fix is connected to the way we try to deal with entitlements. let me step a step beyond the specifics of this bill for just a moment and describe what we are dealing with, with the entitlements. first, i need to explain what an entitlement is. i've had constituents come to me and say, "i hear all of this conversation about federal entitlements and i don't understand. what is an entitlement?" simply put, an entitlement is a payment to which the individual is entitled, whether the government has the money or not. it's not the same thing as the government appropriating money and saying, now we're going to

give it to you or now we're going to buy this or now we're going to pay that bill. an entitlement means you are entitled to this money ahead of everything else. you are entitled to this money whether we have it or not. if we did not have the tax revenue that would give us the cash to pay you this entitlement, we have the legal obligation to go out and borrow the money and pay you the entitlement. and entitlements, or, as they are known in the appropriations world, mandatory spending now comprise more than two-thirds of all federal expenditures. let me repeat that because i get gasps of disbelief when i say this to my constituents back home. entitlement spending, money that the government is required by law to pay whether it has it or not, now comprises more than

two-thirds of the entire federal expenditures. and the largest portion of the entitlement spending that we deal with is in, you guessed it, health care. and if we allow the health care costs to continue to go up as they have been going up, this is what we're looking at. we will be unable, by virtue of our tax base, to pay this entitlement spending. it will all be borrowed and the consequences to the national debt will be as follows. this is from the congressional budget office. this is not an outside analysis. this is from within the own group that we turn to her in hen the congress to tell us what's going to happen financially. at the end of 2008, the publicly

held debt of the united states was $5.8 trillion, and there were many who were very, very critical of the congress and president bush for allowing the debt to get to $5.8 trillion. if there is no diminution of the rate of increase of entitlement spending, if it goes as it has been going, if we take no steps to turn the cost curve down, what will it be in ten years? not a long period of time in the nation's history. it's $5.8 trillion at the end of 2008. what will it be in 2019? and the congressional budget office says it will have grown from $5.8 trillion to

$17.1 trillion. it will triple in a ten-year period if we don't do something about entitlements. so what are we talking about with respect to the health care proposal? we're talking about creating a new entitlement. we're talking about not turning the cost curve down on the entitlements we've already got. we're talking about creating a new one and adding it on top. the best way to dramatize this i think is to look at the 2010 budget where we are right now. the 2010 budget on which we're drawing up appropriations bills. we passed that budget here. i didn't vote for it but it was passed here, and here are the details of the budget that was passed for 2010. it projected federal revenues in 2010 at $2.2 trillion.

seems like a lot of money. should be enough to cover all of our bills. and then you go to the next line and it says, "mandatory spending" -- those are the entitlements -- $2.2 trillion. that meant that in 2010, every single dime that came into the federal treasury was already committed to go out to an entitlement and not subject to the appropriations process in the congress. that means everything we appropriated money for in the congress, the embassies overseas, the military, the war in afghanistan, a.i.d. activities, transportation, the national parks, education -- everything else you can think of that the government does -- was paid for by borrowed money. $2.2 trillion in and $2.2 trillion out for

entitlements meant that the additional $1.4 trillion that actually grew to $1.7 trillion that with -- that we spent had to be borrowed and added to the national debt. and that's why the congressional budget office says we're currently on track to go from the national debt when president bush stepped down at 5.8 trillion 10 years from now to a national debt of $17.1 trillion. now, mr. president, i see my colleague from texas has come and i would be happy to allow him to take the rest of the time. i -- it's up to him as to whether or not he wishes to enter into this. mr. cornyn: mr. president? the presiding officer: the senator from texas. mr. cornyn: mr. president, i'd

like to pose through the chair a question to my colleague from utah, the -- is the senator aware that on october the 6th, eight of our colleagues on the other side of the aisle wrote a letter to the majority leader asking that when a bill is introduced, the so-called substitute that presumably is going to be revealed tomorrow morning, that eight of our democratic colleagues asked that that legislation be posted for a full 72 hours along with a score or cost estimate of the congressional budget office before they would be required to vote on it? mr. bennett: i say to the senator from texas, i was aware of the letter. i wasn't aware that there were that many democratic signers to it. mr. cornyn: i would say to my colleague from utah, senator lincoln, senator landrieu, senator mccaskill, senator pryor, senator bayh, senator

lieberman, senator nelson, senator webb were all signatories on that letter. and i -- i know at different points of the debate, we've had some discussion --ic senator --k senator dorgan from north dakota that sponsored the amendment that would deal with drug prices had expressed some concerns. i know certainly the senator from arizona, senator mccain, has expressed some concerns about drug price issues and what kind of deals had been basically cut on the side that members of the senate are not necessarily privy to. and i would just ask my colleague, is he aware that the obama administration has now been sued for the visitor list at the white house which they have claimed privilege to, has been sued because they have withheld the -- the names of the stlaidindividuals that have como the white house, some of whom

may have been involved in negotiating these side deals that we are not privy to. was the senator aware of that? mr. bennett: i say to the senator from texas, i was not aware of the lawsuit and i appreciate his calling it to my attention. mr. cornyn cornyn: well, i woult finally ask the senator from utah, you have heard, along with me and others, senators say they're for the bill but it's amazing how few people have actually seen it. and presumably it will be revealed to us and the rest of the the world tomorrow morning and presumably amendments will not be allowed on that bill. the majority leader can take procedures to block any amendments to the bill but that we will then be put on a fast-track presumably for passage, at least that's the intention of the majority leader, by christmas eve. is that the senator's understanding of the process

that we are looking forward to starting tomorrow morning? mr. bennett: it is my understanding that that is the process, but i am not looking forward to it. i had hoped to spend christmas eve with my family. in my family, the tradition is that we have the extended family get together on christmas eve, and my house in utah is being decorated on the assumption that there will be anywhere from 60 to 70 people there to celebrate christmas eve. regrettably, i will not be one of them. but i say to the senator from texas that i will be here doing whatever i can to see to it that the bill does, in fact, not pass on christmas eve, for all of the reasons that we've been talking about. and i think the best christmas present we could give to the people of america and particularly to their children and grandchildren would be to defeat this bill and see to it that there is not another new

entitlement created that will cause the national debt to go up even more extravagantly than it is currently projected to do. mr. cornyn: mr. president, i'd ask unanimous consent that the two documents i referred to earlier be made part of the record at the end of this colloquy. the presiding officer: without objection. mr. cornyn: and i would finally ask the distinguished senator from utah, you were alluding to this earlier, but are you aware of any reason why this bill, much of the benefits of which will not kick in until 2014, why there is such an emergency to pass this bill before -- before christmas? mr. bennett: that has been the greatest logical disconnect of this entire debate. because, as i've said, i've seen the protest signs that are raised "we want health care reform now," i've seen the people come to the offices and pound on the doors and say we've got to he go reform now. i've heard our friends on the other side of the aisle give examples of people who do not

have health care coverage and say they must get this coverage now. you and by the way we've crafted a bill that will not do anything for them for four years. if the thing is four years away, we can certainly wait until january to allow people to read the bill and offer some amendments. mr. cornyn: i would thank the senator. i said that was my last question. this one really will be. is the senator aware of late-breaking news to the effect that not only howard dean, the former chairman of the democratic national committee, but several liberal pundits -- keith oberman, that now even the moveon.org and the afl-cio have all come on opposed to the bill. is the senator aware of not only

the opposition not only on the right, but also the left. was the senator aware of that? mr. bennett: i have been aware of that opposition. my own sense is that in the end that opposition will melt in the face of those who are trying to rush this bill through in the hope that by next november the american people will have forgotten the details. i do not believe the american people will have forgotten the details of the bill by next november because even though the bill will not be enforced in terms of benefits, it will be in force in terms of increased premiums and increased taxes. mr. president, i believe the time for the minority has expired. the presiding officer: the senator from utah is correct. a senator: mr. president? the presiding officer: the senator from pennsylvania. mr. casey: mr. president, i ask unanimous consent that we continue with alternating blocks

of time until 6:00 p.m. the presiding officer: is there objection? without objection. mr. casey: mr. president, i rise at this late afternoon hour to talk about what has transpired over the last 24 hours. we had a, as you know, a vote at 1:00 a.m. this morning. to say that's unusual is an understatement to have the united states senate voting at that hour is most unusual. and what that vote symbolized and what happened here pursuant to that vote was, i think, an exercise in washington game playing. we have now a health care bill that the american people have been debating for months. the bill itself, the one in

front of the senate right now is the bill we've been debating intensively in the last couple of weeks and we want to get to a vote on that. in order to get to a vote on health care, the republican side of the aisle decided that they would use any tactic necessary to stop the bill. so they came out in full force at that 1:00 a.m. vote and voted against the department of defense appropriations act for 2010. it's hard to understand why -- i can understand opposition to a health care bill. we can debate that. but it's hard to understand why any political party, even one that was intent on killing the health care bill, why they would use the department of defense appropriations act to do that. but that's what they did.

and it's another example of what makes people angry about what happens or doesn't happen in washington. we've seen over the last couple of months a real debate about what our policy will be in afghanistan. we've had a debate for years about what's been happening in iraq in those two conflicts and what our fighting men and women are doing around the world serving their country. we know now that there are some more than 34,000, almost 35,000 americans deployed in afghanistan. when i consider my home state of pennsylvania, we have -- when you just look at the number of pennsylvanians overseas -- afghanistan, iraq, as well as other places around the world where they're serving, where they're deployed -- 10,430

pennsylvanians serving around the world. 6,431 are active duty and 3,999 are guard and reserve pennsylvanians. and many other states could point to similar numbers. you have tens of thousands of americans serving around the world, especially those who are serving in afghanistan and iraq right now, and yet we have the united states senate and the republican side of the aisle of the united states senate using a defense appropriations bill to slow down the health care debate and to stop the bill. it's beyond insulting to the american people that they would use this tactic. and what's the bill all about? well, i won't go through all of it, but here's what the department of defense appropriations -- the appropriations act entails.

first of all, military personnel personnel -- funding for more than 2.2 million americans who aring serving our country. more than 1.4 million are active duty and over 844,000 for the reserve component. military pay. military pay -- the the bill provides for a 3.4% military pay increase above the requested amount. operations and maintenance, readiness and training -- the bill includes $154 billion for defense operations and maintenance. procurement, research, development, testing and evaluation, and a whole series of expenditures that our fighting men and women need to have in place to help them around the world, and a whole list of vehicles and other

equipment that are paid for by this bill. and it goes on from there, a long important list of what our fighting men and women need. what they don't need -- what they don't need is a group of washington, d.c. politicians using the defense appropriations bill to play a game on health care. if the republicans want to slow down health care, they have every right to do that and they have every right to use lots and lots of tactics and procedures. what they should never do -- there may not be a rule against this per se, but you would think as americans who are supposed to be supporting fighting men and women in afghanistan and iraq and other places around the world. you would think that they would draw the line and not cross the line of using the defense appropriations act to enforce their will as it relates to health care.

what our fighting men and women expect of us is they expect us to give them the resources they need to fight those battles and not to play petty, insulting political games in the midst of that. but that's what we have. we had republican senators come down to this floor at 1:00 in the morning last night and vote one after another after another against moving the department of defense appropriations act forward. we know that in the midst of all that, secretary of defense, secretary gates, who we know served several republican presidents, served now former president bush and president reagan and served under the first president bush as well. he recently wrote that delay of this bill -- delay of the department of defense

appropriations act would result in a -- quote -- "serious disruption, serious disruption" in the military's ability to pay troops. the secretary of defense continued "it is inconceivable to me that such a situation would be permitted to occur with u.s. forces actively deployed in combat." unquote. now, i couldn't say it better myself. it is inconceivable. we know that political parties fight. both parties have battles where they carry too far once in a while. but i don't know of an example where a political party, in order to stop a domestic bill that deals with domestic issues in, this case health care, to stop that from moving forward would use the department of defense appropriations bill as its vehicle. as it stands now, we know that

the vehicle that keeps our government moving and paying for government programs, the so-called c.r., which is an acronym for continuing resolution, which to get out of the washington-speak for a moment means the way we're paying to operate over a limited period of time. we know that that resolution, the funding in that resolution as it relates to pentagon operations runs out at midnight. and i recognize that there's some flexibility that will allow operations to move forward. but it's really outrageous and insulting when a political party feels the need to unreasonably delay funding for the troops because they want to put something in the way of having health care move forward. there are lots of ways to obstruct. there are lots of ways to slow things down. and under the senate rules, the

minority party, in this case the republicans in the senate, have rights to do that. but you would think when we have people on the battlefield they would draw the line at this. but they haven't. and they've crossed this line. i think the american people know what's going on here. it's a game. it's a big washington game. the only problem here, the fundamental problem here is that it's in direct conflict with our obligation to make sure that we move legislation as it relates to our military to move that as fast as we can. this isn't something that people have been working on for a couple of days. there have been hearings that undergird the foundation of this appropriations act. there have been debates about what the spending increases should be. all of that took place over many, many months. and now we have to move the defense appropriations act forward, and what are the republicans doing?

they're using that vehicle to stop the health care bill. so to say, even as i said before, to say it's insulting or outrageous doesn't begin to capture it. i think the american people know what we're talking about. they can see a game -- or they understand a game when they see it. and they're seeing it with this shell game that's been played for the last couple of hours. so, we're going to continue to make sure that we do everything possible to move this legislation forward. and then after we get this legislation moved forward, then we're going to get back to health care and pass a health care bill before christmas. and with that, mr. president, i would yield the floor and note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

a senator: mr. president? the presiding officer: the senator from utah. a senator: mr. president, i ask unanimous consent that further proceedings under the quorum call be dispensed with. the presiding officer: without objection. a senator: i understand that there is a member of the democratic caucus that is headed to the floor. i will cease speaking as soon as he arrives. mr. bennett: i wish to make a few comments with respect to statements made with -- with respect to the schedule.

and question was asked by my colleague from texas: why would people want to rush the bill through when the effective date is not until 2014? and the other question was saying: well, why would someone want to delay the vote? and i think the answer to both questions is the same. the american people are looking at this bill. admittedly they're loo looking t the specific bill. because no one knows what the specific bill is. it is still being rewritten. they're looking at the general outlines of the bill. and the more they look at it, the more they don't like it. every poll that comes out shows increasingly decreasing support for the bill and increasingly opposition for the bill. the gap between these two positions is growing wider and wider.

and this is quite remarkable because when we began the debate back in the spring, support from the polls among the american people for the idea of health care reform and particularly for some of the specifics was very high and disapproval was very low. and we have seen over time those two lines cross. and now opposition to the bill is, according to some polls, as high as 60% or more, and support for the bill has dropped. so i can understand that those who want the bill passed, want to rush the process as fast as possible because they don't want anymore erosion in popular support. and, those who want the bill stopped want to stretch the process out so that the polls can have their impact on members of this body. it should not, therefore, come as a surprise to anybody that the procedures will be handled

in the way they are. with the one group saying, let's get it done quickly before people find out more about it and the other group saying, let's slow it up as much as we can while people find out more about it. and i think that's the answer to the questions that have been raised here with respect to the procedure. i see there are other senators that may well be coming, but until they arrive, i will note the absence of a foam. -- of a quorum. quorum call: the presiding officer: the senator from maine.

a senator: thank you, mr. president. mr. president, i ask unanimous consent that the proceedings under the call be dispensed with. the presiding officer: without objection. ms. collins: thank you, mr. president. the presiding officer: will the senator suspend? the time is currently allocated to the democratic side. if you seek to speak, you must ask unanimous consent to do so at this time. ms. collins: mr. president, i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. ms. collins: mr. president? the presiding officer: the senator is in a quorum call. ms. collins: mr. president, i ask unanimous consent that the

proceedings under the quorum call be dispensed with. the presiding officer: without objection. ms. collins: mr. president, i ask that notwithstanding the fact that there are a few remaining moments on the other side of the aisle, that i be permitted to proceed. the presiding officer: without objection. ms. collins: thank you, mr. president. let me emphasize that was cleared by my colleague on the -- colleagues on the other side of the aisle. mr. president, i rise on behalf of the fiscal year 2010 national appropriations act. let me begin by thanking the committee's distinguished chairman, senator inouye, and the ranking member, senator cochran, for their leadership in crafting this bill and for their strong commitment to our nation's armed forces. mr. president, i'm very proud of the work that the state of maine does that contributes to our

national defense. the appropriations bill provides vital resources that our troops need and recognizes the enormous contributions made by the state of maine to our national security. from the portsmouth naval shipyard in kittery, to the pratt & whitney engineer plant, to beth iron works ship builders to the university of maine's engineers, to the maine military authority in arusta county. mainers all over our great state are leading the way to a stronger national defense. mr. president, i would ask that the remainder of my statement on this issue be inserted into the record as if read. the presiding officer: without objection. ms. collins: mr. president, i'd like to comment further on the

health care bill that is currently before the senate. i've talked about my concerns previously about the impact on premiums. my belief that the bill will actually cause many middle-income americans to pay more for health insurance and i've also talked about my concerns about the impact on our small businesses. i'd like today to talk about a couple of other issues that are particularly important to the state of maine. the first is the impact of the nearly $500 billion in medicare cuts on maine's home health, hospital, and other health care providers, including, our nursing homes. i'm concerned that the bill before us is