a cat paid of any sort aco, you're going to be interested in having a partner especially because we can offer the convenience of a reasonable number of sort of locations, and with the highly trained nurse practitioners providing the care. we have a relationship with capitals west and over the course of the 16 weeks will announce another eight, 10, 12 of those kinds of affiliations. . .

i was sort of an observer, but chris kohler, who is the insurance commissioner up there, good thing about rhode island, you can get somebody involved in health care in one way or another around the table. >> and a small table at that. >> a small table, exactly, although they all talk very loudly, nonetheless. but it's interesting to sort of see what happens, because there's a lot talk about sort of medical homes and participation in health care organizations and things like that, but the actual cash that's flowing right now is probably not very substantial. what chris said was, we're going to look at sort of some good systems, what percentage of the totals dollars actually go for primary care and they came back with the 11% to 13% and then they looked in rhode island,

what percentage of our dollars are going to primary care and they said 6% and they said over a period of time, we'll increase it from 6% to 13%, so each year, there's an increase in the amount that has to be spent on primary care. there's only two big insurers, united and blue cross blue shield of rhode island, basically dominate the market, so what they had to do was sort of begin to identify ways if which they were going to pay for new kinds of services by primary care doctors and the primary care doctors had the new money coming in and had to figure out what to do with it. it shows if you actually put cash on the barrel, it starts to sort of lubricate creativity, so there's a lot of really -- >> amazing how it works. >> a lot of interesting things going on there, so we wrote that up in the volume. >> great. great. well, let's reflect again on what we've heard from this panel. first of all, we heard from paul, that he and others involved with the patient center, primary care

collaborative have truly launched a social and political movement. i don't know if they have fetish dolls that they carry, but it is a movement to essentially move from the world's best partialists only to the world's best comprehensivists, and as he mentioned, our partialist system is extraordinary, even such that japanese gangsters come here to get their delivers transplanted. i didn't know that paul. we might have to work that up as a health affairs story article. but what he's describing is essentially not unlike what went on with the auto industry, where they figured out how to do quality lean production and nobody in the united states listened to him but the japanese did and it became the toyota production system and we can clearly hear how some consultants and others basically informed, the examples of spain,

den park and others, to put in place the kind of comprehensive primary care systems that we should have been instituting all along. so now, as paul said, we have to clear evidence, we saw those lower hospital admission rates, lower readmission rates across the board, essentially, and boeing announcing a 20% carrie ducks patient from the patient's medical home, 1% lower cost for employees in ibm who have a relationship with a comprehensivist, so this should be a slam-dunk at this point. we heard from katie, that there's going to be lots of different ways to pay these models, and there's not going to be any single right answer, but we can let a thousand flowers bloom and i think for the community that came out the 1990 scare to death of capitation, this is somewhat reassuring, that there could be other ways of being paid that don't necessarily result in hall of the negative incentives of the

managed care era and then we heard of course from troy about how cvs mayor character is attempting to be the first floor of that membered home but also more broadly attempting to build the kind of connectivity and coordination capability that we all desire throughout the health care system and with 49% volume growth in patients, troy, in 2009, i guess something must be working. you must be concluding that at cvs caremark, so i guess the question then is back to you, paul. let's start you out and then we do want to open this up to questions from the audience. you've got a lot of people engaged in this social movement. we've got now the capacity for the government to step in, and institute these pilot projects in accountable care organizationers and patients centered medical homes 789 but it doesn't look like we're dwight quite at the tipping point yet. or maybe we are. what do you think? are we -- if what you described

is really out there, and happening, we could be in for just phenomenal reorganization of the delivery system and change in the next two years. and probably we have to get there, if we're going to bend the curve. are we? >> i think we are. i think we've really passed that tipping point a year or so ago. when the dod and d.a. stepped up and said this is our future, this is the work force we need and the social engine that they have both had. you saw what the dod and the d.a. did after world war ii. i think they have the same social phenomenon and i think that the large employers really stepping up and saying we value comprehensive primary care, we value you, the primary care providers, the comprehensivist and that's what we want to buy, i think we've passed the tipping point. i think the train has left the station. i think those systems that are embracing this and are the early adapters of this are going to be

the future mayo clinics. they're going to be the ones that really succeed, geisenger is already showing that and those that don't will fail. a phenomenon that i don't think americans understand is that i spent quite a bit of time in denmark, and the danes have gone from 155 hospitals in 10 years to 25. profound change. where chronic diseases are no longer things that happen in the hospital. it's prevented or care is provided at home. some row motor monitoring with technology that delivers information that's actionable, right into the medical home. the technology that the $60 billion that's coming down the pike, right from the era, is going to do to the doctors' minds what x-ray has done for their vision. i mean, it's just going to open up. the kind of communication that troy envisions, you know, from a brand, for the first time, we have a national brand of health

care, with many clinics. a concept of a brand, you know, integrating into a more integrated model system, that's what we're going to demand to buy. that's what we're going to keep the pressure on troy to produce, because we don't want to buy fragmented, we want to buy integrated and thankfully, the system, like troy, and the primary care providers will want that as well, so i think we've passed the tipping point. >> we would like to hope this up to questions from the audience. we have some roving microphones, so please introduce yourself by name and affiliation and we'll start right there. >> michael cook, a health care attorney, for about the last 36 years in and out of government and private practice. how do you deal with getting the primary care into the inner cities? i don't think there are any models, for example of geisenger or mayo that get to the inner cities. on the other hand, we've got an

increase -- a machine date for 2013 and 2014 that medicaid pay primary care doctors at med compare rates. obviously, that's a starter, but how do you get the integrated system? >> and also the capacity for medicaid to offer the medical home model, an for states to join in on that authority. >> yep. >> anybody want to touch that? paul? >> i think that that's a very important and fundamental question, and i do think that it takes relooking at how we attract folks going into delivering comprehensive care and it also takes restructuring the model as we talked about. i think for the first time in history also, we're no longer going to be geographically trapped by where the doctor is. my employees in denmark have 78% of their encounters using

technology. >> meaning they're sitting at home or in their offices and they're having e-mail or teleconference contact with their primary care providers? >> that's correct. i visited a young physician in florida, who has gone from having an average of one patient hospitalized a week for asthma to zero in 19 months. and i watch what happened in that phenomenon. and in this case, the folks were using their text messaging phones, they were empowered by their primary care provider to really do a better job of med compassion management of integrate. i sat in that office and watched a care coordination nurse talk to an asthmatic or a mom of an asthmatic inner city person, about medication empowerment, medication management. i mean, those kinds of tools, i mean, we're not even thinking about them, but they're there already and already being used in part of the world, so i think

we're going to see a fundamental shift of really how delivery is done. >> katie? >> i think at least in the context of chicago and i don't know how much this generalizes, part of that is going to depend a little bit on how the community health center rampup works and we've heard a lot about it, doubling the support for them and improving their footprint, and how they get integrated or not into bigger systems of care, at least in chicago, it's going to be a really big piece of the answer to your question. >> troy? >> yeah. for us, you know, narrowly, we've already made the investment in terms of inner city retail pharmacies, so you know, the invested capital is already there, and it's a good model for us. medicaid payment is fine for us, critical thing for us is working with the community health centers and we're working on a set experiments right now with the mass leg community health centers, how we sort of coordinate care with them. that's what we need to integrate, especially for medicaid population in the inner

city. >> ok. another question, let's take a question right here in the front and we'll get a microphone over to you. >> jim, aasa fp newstown. want to know what dr. grundy and dr. merrill think of the medic clinic concept and how it fits into everything and the membered home aspect. >> i think we just let another elephant into the room. go ahead, paul. >> i personally think that, if it's used as troy broached it, as an integrator, rather than has a disintegrator, that it will add tremendous value. i think it will address some of the issues about projecting into inner cities and other places like that. i think it could be potentially powerful.

i think if we don't integrate it as a beyer of care, i don't necessarily want to pay for that care unless it's integrated. i don't want one more fragmenter as oppose today an integrator. we're working hard, i know that troy is as well. >> let's introduce the word convenience in to that equation, because as troy mentioned, their analysis suggests that convenience is a huge motivator for people to access the mini clinics and you talked about it. denmark having 24/7 access. it's not possible to have 24/7 access here, unless you access either the choice is the emergency department or a medic clinic or an urgent care center. >> absolutely. when i survey my patients, they want access, they want

convenience, they want a real relationship. those are the things they tell me they want in the care that they get and they can't get access or convenience, it's very difficult, given the way the current payment structure is. so access certainly can be satellite facilities, they can be systems that have after-hours clinics, convenience clinics. they can also be a portal with an e-mail and in the danish model, it's telephone and access 24/7 to a physician. so every comprehensivist can cover for every other comprehensivist and the response time is two minutes. so you can call your primary care provider and if your primary care provider doesn't want to take that calm, he'll turn off his click, but he'll answer and say my name is hans and i'm answering on behalf of lars, what can i do for you. >> just to select a couple of

names at random. >> so there's ways of doing this, much more convenient ways doing this with technology as well as with points of convenient access that a minute clinic can provide. >> so me, they represent of on demand for the health care system. it's location, it's convenience, it's whatever it is, and i think like an economist that is going to persist whether it fits in to whatever the new paradigm is that gets created, so if we move forward with the definition of a medical home and you're supposed to go see this particular guy or this particular practice, but it doesn't have the kind of access or convenience or whatever, you're still going to go to troy -- like if there's still demand for that, then there's still a disconnect between what people want and what's been created and to me, from just as a payment thing t will -- it would affect the nature of the contract. and one the things we haven't talked at all about that i still can't get anybody to talk about, but maybe it's a bad topic is

the notion of what's the commitment on the patient's side. if i'm getting a capitated monthly payment, whether it's a small marginal one or a bigger primary care one, how did you get me, katie merrell to silenuses as your guy and promise to never go see somebody else and you're getting a few bucks a month as my medical home, i need to honor that too, and i need to not go see him, no offense. but if if we don't figure out what the accountability is on the patient's side and if the mechanisms that get created don't suit the patient, then there's still going to be a demand for troy if they aren't integrated into part of the answer and you're going to get a bunch of money for no reason and i'm still going to go see troy. so to me, there's a canary in the coal mine, about what they're getting, whether they'r getting it or not and whether they become part of the new integrated system or not, there's going to be demand or not depending on how the new mechanism suits the needs that they are currently getting. >> i might add to that, that

the -- you know, 50% of the kids and 60% of the adults don't have a primary care doctor, so there's a huge medical homelessness out there, and we can act as a sort of integrators on that end by trying to get people plugged in with primary care. >> and in fact, do. correct? >> yes. >> from personal experience, i know, that this is the case. ok. let's take a question back here and then we'll come over here. >> alice chen, from san francisco general hospital and this is actually a followup to both the previous questions, i guess the practicing comprehension ivist, in the innr city, i find this high need of the minute clinic both fascinating and promising. i usually think of minute clinics as the typical urgent care, acute care issue and i want to ask troy, what's driving

this shift of chronic care, is that people are really coming into cvs saying i want my mammogram, my vaccination, my asymptomatic diabetes and limb foe deem i can't checked, or is it that they are trying to capture the people coming in for their sore throat and sprained ankle? >> from the population, we see a lot of people don't have primary care doctors and there's a lot of untreated illness out there, as well as there's literature on how people are doing with regard to the simple things they should be taking their medications and being on the right medication. we've never hit, sort of at six months, people are chronically ill are about 50% adherence, so they're just not taking their medications, and from the evidence-based guideline literature, about 50% of the time, you're on an effective regimen. you've got gaps in care, so especially when we're dealing on our pbm side, we're the pharmacy benefit manager for large corporations or insurers, what we're saying is we can get

people on basically very inexpensive generic medication that will treat the chronic disease and as a result of that, bring down your costs on the health care side. so to some extent, that's what we're interested in, high quality care, lower health care costs but it's also a business model for us, because there's so much unmet need out there. now that push in the chronic disease is what really forces us into integration, because what happens is we begin to do that, we find a lot more underlying disease and then we need partners out there, so you can't operate in sort of an isolated acute care type of model at that point. you need good sets of hospital and physician partners to be able to work with. >> you've got your essentially going to have to make referrals to higher levels of care. >> not only that, but you need organic relationships and that's what we're building with our care partners. >> ok. let's take a questioner here. let's get you a mic.

>> i want to follow up some where katie was before, but with paul. what is going on in terms of how reimbursement is in denmark, also with, let's say, what's going on with boeing, in terms of what's going on with medical home there and patient responsibilities there, in those places. >> sure. under the danish model first, because i think that's a pretty interesting model, the danes really looked at how do you fundamentally enhance the doctor-patient relationship, and how do you reverse against that, so they really put their money there. so in the danish model, the primary care providers, the comprehensivists are all competing against each other in a commercial marketplace, they build their own business, and all the parcellists work out of hospitals as consultants and they're all salaried, so that's the beginning. and they're considered -- you know, they're considered a cost

center, right? so the comprehensivists build their own practices and they're reimbursed on three mechanisms. about a third each. about a third is about service delivery. so how efficiently, how quickly, how effectively i deliver service is about a third. so they're paid more if they see a patient in two hours, they're paid significantly more if they answer an e-mail in 20 minutes, they're paid quite a bit por if they have 24/7 coverage, they're part of this whole integrated coverage system, which markedly decreases the amount. and one-third is capitation, so they're paid in order to make sure that the population, there's a sense of who belongs to a medical home, right. so i travel to denmark and i ask every dane, who is your doctor. only once did somebody say, i don't know the name of my doctor. i should, but i just call them by their first name, right. >> lars, as we heard.

>> right. so the third component is a fee-for-service, which is about a third and that's to incent certain services to be delivered at the primary care level, so the colon is being scoped that are considered primary care services, and the parcellists, right, the specialties of are a part of the body are salaried and their salary is dependent on the feedback that the h.r. system gets from how well they serviced the comprehensivist and the patients. so it's a system, a transformation. i mean, here in the medical home models that have occurred, that are employer based,, you know, some of them -- some of them i would call corporate c sousa nsier's medicine where we've hired our own. the boeing, for example, was a contract relationship with group health in seattle and they

basically made for that. some of us, many of us have been part of all of these pilots. ibm is part of a number of them and so are many other large employers and we work with our health care plans, ibm for example is working with one, united health care in arizona and we just pay differently. we pay more -- we add that component of a fee-for-service or a capitation per month, so $12 per member per month or something equivalent to that to sort of prime the pump. we think it's been very important over these last three ar four years to do something we call pay for process, to begin to change, help the doctors have the money to change the system, and so we've been doing that in various pilots. we now have, i think, about 44% of our employees, we're the largest corporate employer in vermont, we have about 44% of our lives now enrolled in medical home in vermont, and the patients of love it.

i mean, they just love it. it's just phenomenal. and the doctors, because i've been up and visited many of the practices, the doctors feel much more satisfied about the care. in rochester, we worked with the two largest employers there are the may haveo clinic and ibm and we worked with them, and actually, have built out or the mayo clinic has built out nurse practitioner-based convenient care facilities in the community, and we've migrated care, you know, to the medical home model for both our employee population, an over the past three and a half years, we've seen a zero trend line in costs. that was on abc news. it's phenomenal, because you see some of the cost escalations that are talked about, 36% increase, etc., that are being passed on by some of the health care plans now. zero trend line in throe years is pretty phenomenal. >> or as geisenger has seen, 5%

to 7% of their curve through payment of medicaid model and medical home. let's take this last question and then move to a break. >> hi, melissa clark, i'm a medical director at active health management and one things that i haven't heard touched on a lot, just a little bit here and there, is that chronic care and health care, a lot of it really is self-care, those behaviors that are really going to prevent diabetes and heart disease from happening down the line. to what extent are you looking at models that -- of primary care provision that really emphasize the self-care aspect and how that care can be provided and extended beyond the office visit? either through say, health

coaches or other kinds of models that provide more real-time support? >> i think you'll probably get more of that later on today, as we talk further about the model, but you're absolutely right. and active healthy think has been one of those agencies that's really been at the forefront of trying to figure out how to project those kinds of models right at the point of care. it's pretty interesting, what you're doing, bus i've been watching, and paying attention. and i think you're absolutely right on. i mean, the example of the asthma and the asthma control, was all about self-management and empowering patients to do self-management. so in some of the work we're doing with for example geisenger, we're actually going on providing information and providing predictive information about what's going to happen to you if you don't do this, and that's really going to be useful.

but i think it's really about empowering the patient to do better bed medic clinic indication management. -- better medication management. i visit a clinic in iowa and i think there's a mccain-palin in here, very powerful. it was an 84-year-old nun who came in that day, a diabetic, and chris, you know, starts asking this lady about her diggery do lessons and then, you no, after two minutes of relationship building with this patient, the patient and the nurse care coordinator go next door and they sit down and they design a plan for the whole year and there's this whole discussion about empowerment and exercise and discipline to follow up with you, how you're going to follow up and how we're going to beat you up in you don't, right? and so there was a plan and there was a discipline around

that plan, and we see phenomenal results. we move 2,500 jobs to iowa. we're putting our money where our mouth is. >> troy, are you training the nurse practitioners to be disciplindisciplinarians at thes caremark? >> no. we're trying to figure out how we integrate that into the retail pharmacists. there's a paper on how the pharmacist becomes part of the medical home. we think that's an important intervention at well. the other thing we're doing is trying to get integrated with the disease management firm, so a number of the disease management firms we're working with directly, so we can do face-to-face counseling that complements that here tying on the phone. all of this stuff has to be tested. there's a number of great ideas out there that have not panned out in this particular area of trying to reduce costs through health service, so we have relatively comprehensive studies going on in most of these areas, so hopefully we'll have evidence about how they work relatively

shortly. >> speaking of healthy behaviors, we're going to take a break now so you can engage in some of them that are most urgent. we'll see you back here in 15 minutes to reconvene our discussion on teams. [applause] [inaudible conversations] [inaudible conversations] >> live coverage of the u.s. senate now. where lawmakers are gaveling into resume work on a financial regulations bill.

legislators are trying to work out an agreement on amendments. yesterday, both parties agreed to remove a 5 to billion dollars fund to remove costs arising from the collapse of large financial firms. other measures currently in the bill include the creation of a consume are protection agency and a system to liquidate failed financial institutions, also a provision to regulate the derivatives market. the house coming in in a half-hour, 10:00 a.m. eastern, 14 bills on the agenda there. live coverage on c-span. now to the senate here on c-span2. the presiding officer: the senate will come to order. the chaplain, dr. barry black, will lead the senate in prayer. the chaplain: let us pray. lord of all the worlds, great and wonderful are your works, and your ways are just and true.

be near to our lawmakers today. help them to see that their attitudes, words, and actions have consequences that leave this chamber to influence our nation and world. remind them, therefore, to be masters of themselves that they may be servants to others. keep them calm in temper, clear in mind, and pure in heart. in these challenging days, strengthen them to perform what

you require, even to do justly, to love mehr circumstance and to walk humbly with you. we pray in your strong name. amen. the presiding officer: please join me in reciting the pledge of allegiance to the flag. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the presiding officer: the clerk will read a communication to the senate. the clerk: washington, d.c, may 5, 2010. to the senate: under the provisions of rule 1, paragraph 3, of the standing rules of the senate, i hereby

appoint the honorable tom udall, a senator from the state of new mexico, to perform the duties of the chair. signed: robert c. byrd, president pro tempore. the presiding officer: the majority leader is recognized. mr. reid: following leader remarks, the senate will resume consideration of the wall street reform bill. mr. president, the manager of this bill -- at least most of the bill -- is the chairman of the banking committee, senator dodd. as i reflect on what we've been through with him in this congress, it's really incredib incredible. we withstood seven filibusters on housing legislation that he was responsible for managing -- seven. the height of the housing crisis we were trying to deal with the seven filibusters. we worked our way through many different issues that he has been front and center on, including health care, and he's

done this with such remarkable strength. we have had situations that he's been thrown into as a result of the death of senator kennedy that will be written about in the history books for sometime. then with no breathing room in store for him, immediately he had to go in this very important piece of legislation dealing with the wall street crisis. mr. president, we started on this two weeks ago tomorrow -- two weeks ago. and we have been stalled ever since. now maybe today there will be a breakthrough, and we'll be able to legislate. we don't have a lot of time to spingdspend on this bill. we have so many important things to do that have been held up as a result of these scores of filibusters conducted by the republicans, an indication of how they treat themselves. we had amendments that their senators offered yesterday that we were willing to accept, but

they refused to let us do that. but that's nothing unusual. we've had nominations they've held up for months, yet virtually unanimous support after we go through t all the time wasted in the cloture process to move forward. so yesterday i announced we had a really big day yesterday legislatively. i love classic cars, love to watch them. we accomplished yesterday -- that's what we accomplished. we voted here on a unanimous basis to establish classic car day. that was our accomplishment in this body. we're waiting around on issues relating to the financial crisis. states -- new mexico, nevada, connecticut, states all over the country, desperate for us to do something with this legislation. so that people on wall street can't continue to take advantage of the people of america.

we'd like to move forward and start legislating on that. it would seem after two weeks, it would be a pretty good thing to do because basically during that two-week time we've accomplished nothing, virtually nothing. so, mr. president, i am a little frustrated, but i understand that the republicans have made a decision that they're going to be the party of "no," and you would think after they established that, that would be good enough for them. but i guess they want to underscore and underline it and have a big exclamation mark so no one will ever miss the fact that the republican party in this congress has been the party of "no." mr. dodd: mr. pre consicticut is recognized. mr. dodd: well, mr. president, let me first of all thank the distinguished majority leader. he has shown remarkable endurance as well as patience over the last two years. the health care debate went on for almost a year -- more than a year actually, when you consider the beginning of it until we

finally ended up passing the legislation -- a lot of other matters to deal with, obviously the economic crisis, and we're a he now on the financial reform bill. and my hope is here -- and again this is not -- i'm not making any procedural requests here, but based on conversations we've had late last evening and again early this morning, my hope is -- and i think senator shelby shares this hope with me, and i say "hope" -- we're working os w-- we're working as we speak here -- we might be able to have a vote on senator boxer's amendment at 11:00, 11:30. and a vote son senator shelby's amendment maybe around 12:30. and not to have to vote on them. i think they'd be agreed to to unanimously. senator snowe had a couple of amendments she spoke about yesterday. there's a hutchison-tester proposal that i've endorsed and

i think all of us have. so in the next couple of hours, my hope is that we'll move forward and start the process. and then there are more controversial amendments that members want to raise. they should have an adequate time to debate those ideas. i think people are exhausted. it has been a long congress, one that's been -- we've taken on some major, major issues. and so people are understandably tired, and that tired situation can lead to frustrations that people feel. but i noticed this morning's headlines in the papers, the market declined by 2% yesterday, not because of something that happened here but it happening thousands of miles away in the small country in the mediterranean. again, an indication of how global our economic situation is, how precarious it is, where events in one part of the world can affect all of us. so it is all the more important that we try to establish some sound rules for the 21st century. the last time that we established in a broad sense any

rules for the structure of our financial institutions was almost 100 years ago, coming off the 19th century, the early part of the 20th century. here we're at the end of the first decade of the 21st century, and i think, as we've painfully learned, we're in desperate need to reform the financial structures of our country, having seen what occurred over the last two years in our nation with the job loss, the home foreclosure numbers, the decline in home values as well as retirement incomes, the loss of household wealth. you don't need to hear the numbers. you've lived it. the majority of americans are still struggling today as we speefnlgt they're anxious for us to respond to this situation with as much thought and care as we can to see to it that we don't leave our nation vulnerable to the kinds of economic decisions and failures that caused our nation to come to the brink of a meltdown financially in our country. so these are challenging times. it is difficult and there are

strong feelings about how to proceed, but that shouldn't serve as a barrier to us doing our job. and to making the decisions that each of us was elected to perform in this chamber. so again i appreciate immensely the patience of the majority leader and his staff and others, with my colleagues, many of whom have amendments that they want to offer to this bill, and i want to give them a chance to do that, so they can be heard -- both democrats and republicans. i'm particularly grateful to members who have come up and sought ways to offer amendments we can agree to and capes part of this legislation. that's a -- and accept as part of this legislation. that's a very constructive way to engage in this debate. there are other amendments that people feel equally strong about that will not be resolvable in the sense of accommodating them, that we'll have to vote on to decide whether or not to include them in this financial reform peafnlgpackage. tbhaw process ought to be able to go -- but that process ought to be able to go forward with civility, with the ability to

respect each other and the needs of this institution. this is not the only matter had thatthis congress needs to deal with. i know the majority leader has talked about unemployment benefits that will be needed in the coming weeks. we have the tax extenders that are important. we may have a supreme court nomination coming along. the president has set up the names of three people to serve on the federal reserve board, which are going to be very, very important as well, considering the economic implications. we have appropriations bills we haved to to do. so this is an -- we have appropriations bills we have to do. so this is an important issue. i hope as people come, engage in the garret debate, and then deco move forward "yes" or "no." i hope in the next hour, hour and a half or so we'll be able to get this process moving, where we can actually start casting votes on ideas and particularly the one that senator shell bands i will be -- that senator shelby and i will be offering to resolve in the

minds of most, if not all, that the too-big-to-fail proposition is no longer an issue in this bill. there are those that think it is an issue and to the extent we can satisfy them with additions to this bill it s. is a great p forward. in the meantime, mr. president, i'd urge members who do have amendments to come on over, maybe start talking about their amendments, trying to educate the offices about what they want to do with their proposals, and i havmembers of our staff here e able to -- and i have members of our staff here to be able to look at the amendments. if we can accept it or modify it to make it acceptable, certainly reach out to my republican colleagues to see how they feel about it that might move the process further along. so this time between nods and the votes -- so this time between now and the votes ought not to be dead time but time spent advancing this piece of legislation.

with that, i see my good friend from virginia on the floor and others, and if not -- any desire to be heard? if not, mr. president, i'd note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: mr. mcconnell: mr. president? the presiding officer: the republican leader is mechanicked. mr. mcconnell: are we in a quorum call? the presiding officer: yes. mr. mcconnell: i ask that the quorum call be dispensed with. the presiding officer: without objection, so ordered. mr. mcconnell: all americans

are leaved that federal and local law enforcement officials were able to apprehend faisal shahzad, the man they believe to have been behind the attempted times square bombing. we were especially relive reliee bomb never went off. those who tracked him down and get a confession from him deserve our respect and gratitude. republicans are waiting to hear to what extent shahzad had ties to terrorists, terrorists in pakistan in fact. whether his efforts were part of a wider plot to strike the homeland, whether he was on the no-fly list, why he was permitted to board an international flight, and whether intelligence community interrogators have had access to shahzad. it's been my consistent view that when a terrorist is captured, members of our intelligence community must be able to interrogate the prisoner

in order to extract intelligence. this is true whether the suspect is an american citizen, like shahzad, or not an american, like the christmas day bomber. in this case, it is my hope that the administration did all it could to gear all the relevant information -- to gather all the relevant information that it could. attorney general holder indicatd yesterday that the attempted times square bombing doesn't change the administration's thinking on the trial of 9/11 mastermind khalid sheikh mohammed and still considering new york city as a trial for k.s.m. the administration only shows that on this issue it really doesn't get it. that much was clear to anyone who watched yesterday's press conference. here was the new york police commissioner reminding reporters that no fewer than 11 terrorist plots have been directed at new york city since 9/11 and that,

as he put it, nothing has changed with respect to terrorists coming to new york to hurt and kill americans. to me, it was jarring in the face of that kind of cold reality that the repeated pleas of elected officials in new york from both parties to see the attorney general still stuck -- still stuck -- on the notion that holding these trials in downtown manhattan is anything but a bad idea. trying k.s.m. in new york city was a bad idea last year. it's a bad idea today. the only thing that's changed is the american people have just been reminded of how determined terrorists are to carry out their deadly plans. as i've said repeatedly, guantanamo is the right place to detain, interrogate and try terrorists like k.s.m. guantanamo is a safe and secure, a state-of-the-art facility where we can detain enemy combatants far from our

communities and without fear of on-site retaliation. some we hold indefinitely. others we hold until we deem them safe for transfer to another country. still others we can hold until we try them in military commissions, and we can do that right there at guantanamo. guantanamo is a wise investment. it was built for good reason. let's use it for the purpose for which it was built rather than further endangering communities like new york or burdening them with the disorder and the massive expense that would accompany a terror trial. it is precisely because of potential dangers and difficulties like these that we established military commissions in the first place. and if we can't expect the very people who mastermind the 9/11 attacks to fall within the jurisdiction of these military commissions, then who can we? americans don't want guantanamo terrorists brought to the u.s., and they don't want the men who planned the 9/11 attacks on america to be tried in civilian

courts, risking national security and civic disruption in the process. mr. president, on another subject, today i rise to introduce a bill that would renew sanctions against the burmese junta. as in years past, i'm joined in this effort b'nai phao*eu good friend senator feinstein, senators mccain, gregg and lieberman are original cosponsors of this bipartisan legislation and tiffin to be leaders on the issue. renewing sanctions against the military regime in burma is as timely and as important as ever. over the past year the regime not only made clear that it has no intention of reforming; it is also trying to stand up a new sham constitution and to legitimize itself in the eyes of the world through a sham election. in my view, the u.s. must deny

that regime that legitimacy. by way of background, a little history is in order. for nearly half a century, burma has been under some kind of military rule, and every popular effort to reverse that situation has failed. in 1988, military authorities violently put down a popular uprising. two years later the burmese people went to the polls and handed an overwhelming victory to the pro-democracy opposition and the junta ignored the results. it never ceded these popularly elected candidates t. jailed pro-democracy -- it jailed pro-democracy leaders like aung san and maintained brutal rule ever since n. response the united states established ton a bipartisan basis sanctions against their regime. these include in 1997 executive order, the annual import ban renewed yearly since 2003 and

restrictions on burmese jade and timber, enacted in 2008. on a number of occasions since 1990, the u.s. and the u.n. attempted to engage burma diplomatically. these include during the clinton administration a delegation led by deputy assistant secretary of state thomas hubbard, madeleine albright and two trips to burma by then congressman bill richardson in the mid-1990's. other efforts included secretary of state christopher hill's road map in 2006 and overtures made by the u.s. in 2007. in 2008 admiral timothy keating met with burmese officials as part of an effort to provide hugh mainer assistance -- humanitarian assistance in the wake of a cyclone. the u.s. dispatched an envoy to burma 16 times and special

envoys 26 times over the past two decades. and u.n. secretary ban ki-moon visited burma on two occasions. none of these efforts has yielded anything in the way of reform. indeed, when burmese citizens led by buddhist monks it took to the streets in peaceful protest against the government in 2007, these pro-democracy protesters, much like their predecessors were brutally suppressed. nonetheless, the regime sought at various times to save face internationally. in response to this last major challenge to its authority in the fall of 2007, for example, the regime unveiled a proposed constitution. but a quick look at the document shows that it could scarcely have been less democratic. it precluded suu kyi from participating in the electoral process and ensured the charter may not be amended without the military's blessing. the noted constitutional law professor david williams of

indiana university told the senate foreign relations committee last year it was one of the worst constitutions he'd seen. what's more, the vote to adopt this constitution took place two years ago in the immediate aftermath of cyclone nargis, the worst natural disaster in modern burmese history and international election observers were not permitsed access to the country during the vote. if the regime was really interested in legitimacy, holding a vote like this in the middle of a natural disaster without election observers is not exactly the way to do it. so the results of this vote were widely condemned and for good reason. still despite widespread condemnation of this constitution and the circumstances surrounding its adoption, some held out hope that a subsequent election might lead to democratic reform. but those hopes were dashed earlier this year when the regime actually issued the long awaited election law. among other things, the law would force the democratic

opposition, the national league for democracy, to expel suu kyi if the party chose to enter any of its candidates in the upcoming national election and it forbids bill prisoners and buddhist monks from participation. the deadline for registering candidates under the new law is later this week. and parties that failed to register before then will be deemed illegal. in other words, the law's practical effect would be to sideline burma's most prominent democratic reformer and force its leading party out of business. we also get periodic press reports of ties between burma and north korea, including a particularly alarming report in recent days about an alleged weapons transfer. now, last year the obama administration initiated a review of u.s. policy with respect to burma. as a result of that review, the administration decided it was time for the u.s. to take

another run at engaging the regime. that's why last summer secretary clinton purportedly proposed to her burmese counterpart that the u.s. remove its investment ban on burma in exchange for the unconditional release of suu kyi. whatever the merits of this overture, this was a serious offer from a high u.s. official aimed at improving bilateral relations. not only was the offer ignored and suu kyi not freed, the regime extended suu kyi's extension for a year and a half. it was short shreu after the that that the -- shortly after that that the regime released the antidemocratic law referred to. the policy engage has unfortunately met with the same fate as earlier engagement efforts not withstanding the fig leafs the regime holds out as proof of its willingness to reform.

clearly the regime craves legitimizeation of its rule. why else would it suddenly move to finalize the constitution it's been working on intermittently for 14 years after its rule was challenged by a revolution in the fall of 2007? they did it for the same reason they trotted out a transparently flawed election law earlier this year. they wanted to provide the appearance of reform where there was none. but they can't have it both ways. if the regime wants legitimizeation, it must show real progress. secretary clinton's policy review toward burma concluded engagement along sanctions might produce results where sanctions alone failed. although we have yet to see positive results from engagement, the administration concedes that sanctions should remain in place. but the administration, to its credit, has been candid about the lack of tangible progress by the regime. assistant secretary of state campbell acknowledged as much

after the release of the burmese election law. the u.s. approach, he said, was to try to encourage dough phefpbg die -- domestic dialogue between key stakeholders, doesn't leave much room for such a dialogue. it should be noted the absence of any tangible result from engagement has nothing to do with the work of american diplomats. it has everything to do with the type of regime we're dealing with here in burma. again, the fact remains that no progress -- none -- has been made. legitimacy is the one thing that the regime cannot impose by force. but if legitimacy is what it wants, a first step would be credible elections. and at this point there is no reason to believe that's even possible under the current constitution, under the current election law and in the current political climate in burma. renewing sanctions is important because it denies the junta the legitimacy it craves. a sanction to the regime says to the junta and the world in no

uncertain terms that the united states does not view this government as having the support of its citizens. it says that the united states will not be a party to recognizing the junta's attempt to overturn the democratic elections of 1990, the last true expression of the burmese voters. sanctions should remain in place against the junta for the same reason the term burma is used by friends of democracy instead of the junta's chosen name of myanmar because that is the name of a government not chosen by its people. sanctions should remain in place because lifting sanctions would give the regime precisely what it wants. namely, legitimacy. i strongly urge my colleagues to support sanctions renewal against the burmese regime, and i ask unanimous consent that the text of the joint resolution be printed in the record. the presiding officer: without objection, so ordered. mr. mcconnell: mr. president, i suggest -- mr. president, i withhold. mr. dodd: let me commend the minority leader for his comments on burr massachusetts it was a

good -- on burma. it was a good education for me to listen to it. i ask unanimous consent that i be added as a cosponsor of the legislation. the presiding officer: without objection, so ordered. mr. mcconnell: i thank my friend from connecticut. the presiding officer: under the previous order, leadership time is reserved. under the previous order, the senate will resume consideration ofhichhe clerk will report. the clerk: calendar number 349, s. 3217 arcs bill to promote the financial stability of the united states by improving accountability and transparency in the financial system, and so forth and for other purposes.

a senator: mr. president? the presiding officer: the senator from connecticut is recognized. mr. dodd: i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: quorum call:

mr. chblis mr. president? the presiding officer: the senator from georgia is recognized. mr. chambliss: i would first ask that the quorum call be suspended. the presiding officer: without objection, so ordered. mr. chambliss: what's the current status of the senate, mr. president? the presiding officer: the peengeing business is senate -- the pending business is senate 3217. mr. chambliss: i'd be asked to be recognized for up to 10 minutes. the presiding officer: without objection, so ordered. mr. chambliss: mr. president, coil to the floor this morning to talk about -- i come to the floor this morning to talk about the current pending business before this body. this is an issue which obviously raised its ugly head a couple of years ago with the financial meltdown that occurred in this country, and i think all of us in this body agree that it's imperative that the senate take action to try to make sure that what happened to the financial industry in th in america nevers the opportunity to happen again. and i would commend senator dodd, senator shelby for their work on this bill. we've had our disagreements, but

yet we have ehad significant agreement on some -- but yet we've had significant agreement on some areas. we're now trying to take the base bill and make that bill a bill that all of us in this body hopefully will wind up being able to support because we've improved the bill to the point where it really addresses the root cause of the problem that arose during 2007, 2008 and on into 2009 and 2010. there are se provisions in the bill that i have particular objection to, and there are some things that are not in the bill that i think should be in the bill. for example, one of the major causes of the problem -- and i think it goes without saying -- is the fact that the g.s.e.'s -- fannie mae and freddie mac -- have been authorized over the years to purchase mortgages from individuals who simply couldn't make their payments, and those

mortgages have been bundled up together and have been sold on the market and have been one of the root causes, in my opinion, of the problem. and i'm not by myself in thinking about that. other individuals, but more importantly, people who know a lot more about the root cause of the problem than anybody in this body agrees that that is a major issue that has to be addressed in any overall financial reform. and to leave any reference to the g.s.e.'s -- freddie mac and fannie mae -- out of any additional regulation i think is a mistake. there are going to be amendments with respect to that, and i look forward to the debate on that. another issue is that there are no mortgage standards that are specifically set forth in the underlying bill. i can remember very well going in and buying my first house, making application for a mortgage. i was nervous as i could be. even though my payment was going

to be fairly minimal to the amount of money i was making, i had to pay 20% down. it took me a couple of weeks to be approved by individuals in my hometown that i knew very well. and at the end of the day, they just wanted to make sure i was going to be able to pay that loan back. not that we need to go all the way in that direction, but certainly we need standards in place that are going to ensure that people who are buying houses can afford to make the mortgage payments that they are making application for. and with respect to the consumer financial protection act, it appears that in the underlying bill there is an umbrella that is cast out there that is going to require the inclusion of more nonproblem areas of the consumer finance industry than are really in any way potentially a part of

any future financial meltdown. so i hope that as we debate these amendments -- and i know we'll have a very spirited debate on them -- that we can come to some agreement as to what's reasonable. let's do what we need to do to provide our regulatory agencies with the additional oversight they need to make sure that we put them in a position and give them the tools not to allow the situation that occurred in 2007, 2008, and 2009 to reoccur, but that we don't go too far to where we overreach and exercise more control on the part of the regulators than what is absolutely necessary. i want to speak for just a minute about the derivatives section and some amendments that we're going to have on that particular title. the agriculture committee has jurisdiction over swaps and tkweufrbts by virtue -- and

derivatives by virtue of the fact that we have jurisdiction overt commodities future and trading commission. there are some swaps and derivatives that are secured by securities themselves. those securities being regulated by the s.e.c. gives the s.e.c. some jurisdiction here. that's been part of the discussion here and will continue to be as we go through the debate. but there are a couple of things that i particularly want to address that i think are a faulty in the base bill that need to be corrected as we go through it. and we're going to have a substitute amendment for the derivatives title that will do several things that are of primary importance to the industry that today is very unregulated that will bring all of the derivatives trades out of the shadows and in a total

transparent manner now make those trades available to the regulators so they can look not only at the trades themselves to make sure that entities that are entering into those trades are the right kind of entities that ought to be trading and that they are not creating systemically risky industries that will have the potential to create situations similar to what we saw in 2007-2008, but also that the agencies, the regulators will have the ability to call into play additional margin requirements or other tools that they will have to ensure that those entities that are engaging in these practices don't ever reach that point of being systemically risky. there are some specific provisions that we need to look

at. one of those is an expansion of what we call the end user provision. an end user is an individual, whether it -- or an entity, whether it's a manufacturing company could be an individual, but for the most part it's a financial entity, usually a manufacturer of some sort that doesn't engage in the finance end of the economy of our country but does seek to hedge its own particular financial issues in the more productive, more conventional financial industry itself. for example, a manufacturer like john deere or caterpillar or ford motor company or any, for that matter, manufacturer across the country seeks to have stability in the marketplace with respect to interest rates, because they don't look at 90

days, 120 days. they look at years into the marketplace to ensure that there's stability from an interest rate standpoint so that they know how to purchase items, they know how to price their vehicles that they make or the widgets they make or whatever it may be. and those manufacturers engage in the purchase of derivatives by hedging the interest rate that they're going to pay. they also hedge the purchase of metals. ford motor company, for example, may hedge the purchase of steel in the steel market so that they can ensure themselves of some stability in that market. these are the type of derivatives that we're going to be talking about and that we need to make sure because they were not part of the problem that caused the financial meltdown, but if we're not careful they're going to be overregulated to the point to

where the cost of an automobile is going to be increased. and that's an unintended consequence, i know, of this bill. the cost of a john deere tractor to one of my farmers is going to be increased. again, an unintended consequence. i want to take just a minute to read a portion of a letter, an unsolicited letter i got from a fairly new, it's a bank in atlanta that is a community bank that began in 2007. and according to the chairman of the board, has built an exceptionally strong balance sheet with superior asset quality, solid and stable deposit funding. at the end of the quarter their equity to asset ratio was 14.39%. very significant, very substantial, very stable. the regulatory approval to offering has been offering interest rate derivatives to

middle market clients who are concerned about the effects of riding interest rates on their -- rising interest rates on their businesses. this affords our clients an opportunity to fix interest rates in what would otherwise be a floating rate environment which could work against them. the bank will not take interest rate risk on these derivative contracts but instead will hedge all trades with one of our correspondent bank counterparties. in other words, the bank will operate a match loan level hedging program. the bank does not otherwise engage in any derivatives activities. there are three key problems from our perspective with the regulation drafted by the senate agriculture committee, which is a part of the base bill that we are debating now. one, the bank would likely be considered a swap dealer under section 50-a and will have to spin off or terminate its swap activity. two, there are no practical end user exemptions for our clients who would be subject to posting

margin against their trades with a clearinghouse. three, all swap parties have to be an eligible participant so a real estate private partnership would not qualify. it makes no sense that community and regional banks that run matched loan level hedging programs should be subject to the swap dealer provisions as such programs are fully hedged and are not taking undue risk. and the letter goes on just to simply say that they hope as we go through the debate on this that we can fix these unintended practical issues -- unintended consequences that really provide practical issues in the day to day operation of commercial and community banks that are not on wall street, but are in atlanta, in mole try and other communities around my state and every other community in america. just because a bank is big does

not mean that bank is risky. and we need to remember as we think about this that our regulators need to have the right kinds of tools to look at every single trade that comes up. that's why it's important and why we agree on both sides of the aisle that there needs to be 100% transparency in these markets. and we're going to provide for that in our substitute. the -- there needs to be a fixing of the definition in the underlying bill of what is a major swap participant. and there again, that goes to the issue of whether you're a big bank, you're automatically systemically risky -- which is not the case, but you're automatically covered by this provision. should wall street be covered? yes. will they be covered in the base bill? yes. will they be covered in our

amendment? yes. every swab dealer on wall street needs -- every swap dealer on wall street needs to have not just 100% transparency but needs to have all of their transactions with other financial institutions go through a clearinghouse. that's done in the base bill. that is also provided in our amendment. but what we want to make sure of is that these end users who don't deal in these swaps on a daily basis and the kind of volume that the banks do are not thrown had into a category of af a sudden having to pay huge fees and huge costs added to the cost of doing business that they don't have today. because at the end of the day we know who's going to pay for that. it's us consumers who buy the widgets and buy the automobiles or whatever it may be. the last issue i want to talk about is the provision in the bill that requires, it's called

section 106 or the 716 provision. what this provision does is to require all swaps dealers and financial institutions to be physically moved out of the financial institution and kind of operate on its own. here's the practical effect of what that's going to do. any wall street bank that's a swap -- a dealer in swaps and derivatives today -- and every one of them are -- is simply going to take their swaps desk, and they're going to move it across the street. under the base bill, they're going to be required to earn huge amounts of capital for that swaps dealer desk. there really is no reason for that to happen. if they're going to be required to raise capital, it ought to be in the bank where they can use that money to be able to loan that money out to their customers. in the other, i think, truly

unintended consequence of moving the swaps desk out is the fact that the financial institution itself, again, major banks are going to be included in this, those individual banks are not going to be able to access the discount window at the fed because they're all of a sudden not going to be able to borrow money from any federal entity under the language that's in the bill, in the underlying bill. that doesn't make sense. and the reason it doesn't make sense is that all of these swaps and derivatives transactions, whether interest rates, whether metals or whatever the transaction may be, have to be cleared every day. and the bank needs -- or the swap dealer needs a huge amount of cash in order to clear those trades. if they don't have access to the fed discount window, they're simply not going to be able to access the amount of cash they need to clear these

transactions. and the reason they need that cash is to ensure that the parties to that transaction are going to in fact be able to have the assurance that the other party to the transaction is going to be able to live up to its rights and obligations. so if they don't have access to the fed discount window, then they're not going to be able to access that cash that they're going to need to make sure that these transactions are in fact cashed out at the end of every single day. so, mr. president, we're going have one amendment that will be a substitute, and then we'll have a series of additional amendments that will be more in the way of rifleshots to address the specific issues that i've talked about here, and i talked with the chairman of the banking committee about these over a period of time. obviously i've talked with my friend, senator lincoln, about this. and as we go through this debate, i want to make sure that

at the end of the day, we do exactly what all of us want to do and what certainly the chairman and senator shelby set out to do from the start, which is to protect consumers. to protect people who lost a lot of money in the market because of transactions of greed that took place on wall street. and we can do that in a bipartisan way because we all agree that that's got to be done. but the thing we want to make sure of is that that umbrella or that reaching out to accomplish that particular part of the problem that exists does not look for other problems that don't exist on main street and that we have the ability of our community banks, our main street banks, as well as our manufacturing sector, to have access to the swaps and derivatives markets that they have done in a commercially responsible way for decades, and

they are not part of the problem, but yet it's going to be of a significant consequence to every manufacturer and not every community bank engages in swaps and derivatives transactions but a lot of them do. and we need to make sure that we take into consideration the continued ability of those banks to operate in a normal commercial banking way. and under the base bill, they're simple plea not going to be able -- they're simply not going to be able to do that. so i commend the chairman for his hard work on this. i know he and senator shelby are still trying to work out some agreements on the too-big-to-fail issue. and it is my understanding that some of the provisions in the hopeful agreement that they are talking about is going to have a direct impact on some of the things that i've talked about here today, and it'll make our job a little bit easier of trying to fix the derivatives title this bill. with that, mr. president, i

would yield back. mr. dodd: mr. president? the presiding officer:he senator from connecticut is recognized. mr. dodd: mr. president, before my friend leaves the floorks let me first of all tank -- leaves the floor, let me first of all thank him for his hard work. as the ranking member of the agriculture committee with senator lincoln of arkansas, andious to address a few points my friend has raised, one you think all of us acknowledges, the g.s.e. issue is one that needs to be addressed. we've kind of reached the conclusion thiets a such a huge issue. there's only so many issues we can take on in a bill of this magnitude obviously. and -- but clearly there's some language here that would allow for some studies to be done or other matters that would help address the issue. i'm open to some issues like that. for us to try to take on the whole issue of how we reform government-sponsored enterprises, we need to do. it is clearly one of those issues that must be addressed. but i was concerned about on how

much you could actually take on in one bill dealing with the entire financial reform structure. so i just want to assure my colleague that i'm prepared to at least support some ideas and get us moving in the right direction on g.s.e. reform. on the home mortgage area, underwriting standards -- again, we're open to ideas. as you may recall, a year or so ago we fought hard to include some underwriting standards. the federal reserve has actually now written some. we're trying to get some responsibility on both sides of that equation. we have a lot of lenders out there that were pushing things out the door. the shadow economy as it's called was luring people in to take no-documentation loans and the like and then secure tieing them and moving -- and then securitizinsecuritizing them ang things along. i know people are are working on how to come up with some good language that doesn't so restrain the ability of a lender to have some flexibility this

those standards. but obviously we want standards in place that everybody has to meet as we move forward to avoid the kind of pitfalls that have occurred. on the consumer protection, the last thing we want to have is asking the dentist, the butcher -- i know some people have talked about them being subjected to what we're talking about in financial products and financial services. again, not imposing any new laws at all but how do we make sure that the seven agencies today that are responsible for those laws can be consolidated in a thoughtful manner? and lastly, on the derivatives -- and again this is an area that is predominantly, although not exclusively, in the pursue of the ag committee but clearly as the senator points out, when you're talking about future contracts involving securities, and there is clearly an s.e.c. voft, and thus our committee has had some interest in the subject matter. senator gregg and jack reed have worked on that issue.

my hope would be that -- on this subject matter, which the senator has explained and talked about, and u.a.e.ppreciate his comments this morning -- and appreciate his comments this morning -- that thans area where there would be an effort to develop a bipartisan approach. it is a complicated area of law, and it would be, i think, in everyone's advantage if there was a lost communication back and forth to try and come up with some ideas that we might be able to change some strong bipartisan support on. i know he's tried to do that. i'd just encourage him to keep that up so we can end up with some good answers to this. i am very grateful to him for his interest in the subject matterment and my determination this morning is to move along on this amendment process. i thank him very much. mr. chambliss: i thank the chairman. mr. dodd: mr. president, i see our colleague from wyoming. and if he's ready toarks i'll yield the floor. -- and if he's ready toarks i'll yield the floor. and if he's ready to go, i'll

yield the floor. the presiding officer: the senator from wyoming. mr. barrasso: i thank you for the opportunity to take the floor. mr. president, i come here because of new information that has come to light about the health care bill that has been signed into law. and as a physician who's practiced medicine in wyoming for 25 years, as an orthopedic surgeon, i come to offer a second opinion on this bill and now this law, because i went into this focused on the sorts of things that the president had talked about: lowering the cost of care, improving the quality of care, increasing the access to care. but i come to the senate floor today, mr. president, with my second opinion because i think that these things have not been accomplished by the bill that has been signed into law enforcement -- that has signed into law. for many years i have been the medical director in wyoming of the wyoming health fairs, to give low-cost screenings, give

them opportunities to learn about themselves and their health and getting down the cost of care. so today when i come with my second opinion, it is that this bill, this bill now signed into law, is going to be bad for patients, bad for providers, the nurses and the dlas take care of these patients, and bad for payers, the people who are going to be paying the bill nor this new larks th law, the taxpayerse country. and, mr. president, i believe fundamentally in passing this law, this is going to result in higher costs for patients, not lower costs; it will result in less access for patients, not more access; and this is going to result in unsustainable spending at a time when we're looking at record unemployment and record debt. and so, mr. president, i come to you today to talk about what i've seen in the new information

coming forth as the bill has been signed into law, and i have an editorial written in "the columbus dispatch" which just this week comes out and says, "almost daily, the ill effects of the health care bill passed by congress are becoming apparent." the editorial in "the columbus dispatch," -- "as employers and bureaucrats analyze the effect of the law, the alarm bells are ringing." "the tragedy is that these ill effects could have been and should have been calculated before the law was passed, not after." it goes on. "in fact, many of them were prophesied before passage of the bill but the prophets were ignored by president obama and the democratic majority in congress. that's because they are you were-most goal was not to pass the best health care bill possible but merely to pass anything that could be called health care reform and could be

claimed as a political victory by a president," it says, "desperate for one." i come today with my second opinion or the high-risk pool which has been in the headlines the last couple of days. when the president and democrat members of congress were pushing the health care bill, they promised that people with preexisting conditions would receive immediate relief. well, now the bill has been signed into law and americans with preexisting conditions remain as confused as ever as to how this new law will impact them, will impact their lives, and will impact their pocketbooks. now, unfortunately, mr. president, hundreds of thousands -- that's right, hundreds of thousands of americans with preexisting conditions are going to end up getting the short end of the stick. in fact, even "usa today" recently reported that the new law is going to trap 200,000

americans in a pricey, state-operated, high-risk plan. here it is, mr. president. front page "usa today" last thursday. "health law traps some in pricey state plans." "200,000 hard-to-insure can't get the federal option." 200,000 americans trapped, mr. president. these are the folks who have been paying for coverage through the state high insurance programs that exist today. you say, how can that be? what's the catch? well, these 200,000 people aren't eligible for the brand-new, low-cost, high-risk program that is created by the law. so aren't thee the peopl these e were trying to help? well, the law requires that for people to get threw this new plan, they have to have been without insurance for the last six months.

so we have 200,000 americans, mr. president -- 200,000 americans -- with preexisting conditions who have been playing by the rules, who have been doing what is right, and what happens? they are not going to have any access to the benefit that the president and the democrats in this congress promised would be available to them. now, don't just take my word for it. here's what the kansas insurance commissioner had to saivment she says, "we've got people who've strugged, who have struggled to stay in our existing pool and take care of their existing health needs." and then here this new pool comes along and it's more generous and they are not going to be eligible for it." what's the difference? well, with the new pool, the maximum amount that someone is going to have to pay for an individual, $5,950, for a family, $11,000 900. tha100% of the rate.

but many of these high-risk pools across the country are at a point where they're charge twice the standard market rate because these people are an increased risk for because of their preexisting conditions. so the people who have been playing by the rules and doing it right and as the insurance commissioner said, people that have struggled to keep in the existing pool, they are going to be left out, ignored, and rejected by this new law that the president has signed into law. so this week all 50 states were given the opportunity to tell the administration whether they wanted to run their brand-new, high-risk pool for individuals with preexisting conditions. the answer, mr. president, has not been positive. just yesterday, tuesday, may 4, "the washington post," "18 states decline to run high-risk insurance pools." 18 states said to washington, "no, thank you." 18 states have refused to

participate. why? well, mainly because they don't know if and when the federal money runs out they're going -- how it's going to be paid for. so what do you mean the federal money runs out? they've just passed this health care bill that's going to cost almost $1 trillion. well, nor high-risk pool, the amount of money that was put in dshedz 5 billion -- in the actuarial report, the chief actuary of medicare and medicaid, they said the money is likely to run out before 2012, even though it's supposed to last until 2014. so what's going to happen to these states? no one knows, and the administration is not saying. now, the gone of wyomin governog said, what do i want to do? do i want to participate or not? he is one of those governors who looked at it look theed at it vy carefully.

is one of the governors representing the 18 states that said "no, thank you." tthis is when he said in miss letter to secretary of health and human services kathleen sebelius. goings the state of wyoming has operate add very successful high-risk health insurance pool for years." we have. i have a been involved in this. "a very successful high-risk health insurance pool for nearly 20 years which has served the citizens of wyoming very well.", "based the -- the necessary requirements have not been set out with the new program, and key terms have not been defined. with such guidance," he said, "i find it unwise" -- unwise, mr. president -- "to further consume my staff and the department of insurance with guesswork currently necessary to

implement this program." these governors are just guessing. guessing if it will work, guessing if it won't work. nobody knows. that's why in an interview with the associated press yesterday, the governor of wyoming said with the $8 million the federal government offered the state to run the high-risk insurance program until 2014, he said wouldn't be enough. he also said he's concerned the state wouldn't have been allowed to administer the federal pool together with the existing successful state program. sorry, states. this is what the secretary is saying. we in washington know better than you. very successfully in your home state of wyoming. we don't want to know about it. we want you to either set up a new program and do it our way or forget about it. and that's what the people of wyoming have decided, mr. president. because as the governor says, when i looked at it, it just

didn't seem to make financial sense. once again, mr. president, once again the administration is saying trust us. they want to act now and ask questions later. well, americans and governors across our country have serious questions about this new high-risk insurance program, how much will it cost the states, how much will it cost the taxpayers, and why won't all american patients with preexisting conditions have access to the immediate benefits that they were promised? unfortunately, washington's lack of answers clearly demonstrates that this administration doesn't have its act together. the administration has not delivered on the president's promise to help all americans who have preexisting conditions have access to the same affordable health insurance coverage. and that's why, mr. president, all across this country people

are saying, you know, this bill crammed through the congress, all the sweetheart deals signed into law. it wasn't passed for somebody like me. it was passed for somebody else. so i come to the floor, mr. president, to say it is time to repeal this legislation and replace it with legislation that delivers personal responsibility and opportunities for individual patients that will get down the cost of care, that will improve the quality and will improve the access to care. we need patient-centered health care, something that's going to provide individual incentives such as premium breaks for people by encouraging healthy behavior, that allows people to take their health insurance with them when they move from state to state or when they change jobs, that gives the uninsured and the self-insured the same relief when they buy insurance that the big companies get. it allows people to buy insurance across state lines,

that deals with lawsuit abuse, that allows small businesses to join together to get down the costs of their care. these are the things, mr. president, that will work to get down the cost of care, to deliver high-quality care and improve access to care. those things, mr. president, are not in the health care bill that was signed into law. they are not in the health care bill that passed this body and passed the house. and that is why today, mr. president, i come to the floor to once again offer my second opinion that it is time to repeal this bill and replace it -- replace it -- with something that will work well for the american people. thank you, mr. president. i yield the floor and -- i see the senator from pennsylvania. mr. casey: mr. president? the presiding officer: the senator from pennsylvania is recognized. mr. casey: thank you, mr. president. i rise this morning to speak about the issue that's before not only the united states

senate -- and thankfully we are in the debating process finally, after many days of discussion about debate be; we're finally debating. but i think this is also an issue that's on the front burner, so to speakers at kitchen tables and places around our country wherever families are gathered or small business owners or others. and it's about reforming our financial system and making it more accountable. i wanted to back up for a second and just put this in perspective of where our economy is. we have an economy which has resulted in a job loss that is a record of one kind or another. we've heard it over and over again, the recession we're living through right now, even though i think we're recovering, but we're still in the throes of this recession. it's the worst economic climate we've had since the 1930's. lots of ways to measure that,

but of course the most important data point or numbers is the unemployment rate and the number of americans out of work. some 15 million in pennsylvania, over 582,000 people out of work. our rate is 9%. a lot of states would rather a 9% rate than 11% or 12% or 13% or 14%. in our state, 9% means 582,000 people out of work through no fault of their own. and that's the reality that we're living with. one of the ways to dig out of that hole, so to speak, or get the car out of the ditch -- pick your image, your analogy -- is not only to put in place the job creation strategies which we've put in place over the last year, and even more recent, the last couple of months, but also is to reform our financial system to prevent the abuses that took place that led to the problems

that so many americans are experiencing right now. one of the problems we've had is the fact that we have not just big banks -- that was always the case in america. we always had large institutions and small institutions. but we've gone beyond big to what you might call a mega category. mega banks that have too much power concentrated in them, too much impact on our system. so we have what -- what developed was this too-big-to-fail problem, and it's a big problem that we have to make sure that we prevent from happening again. where a bank is such a big institution, it has tentacles reaching so far into the economy that the failure of one institution wrecks the economy. or the failure of two or three wrecks the economy for so many others. one thing we're going to do in this legislation is to make sure that doesn't happen. so how do we hold wall street

accountable and how do we put consumers in control, at long last? first of all, we've got to have strict regulations to stop wall street from engaging in reckless activity. we've got to stop the reckless gambling that wall street was engaged in for far too long. we've got to end taxpayer bailouts forever. that's one thing we've got to achieve with this. i mentioned the too-big-to-fail problem. we've got to end too big to fail as a problem for our system. we've got to have a new cop on the beat. this isn't just a question of having a couple of tweaks of regulations. we need tough regulations and tough format. of course the -- tough enforcement. the analogy we use is one from law enforcement, having a new cop or a number of cops on the street, on wall street in particular. and we've got to put consumers in control with information about transactions that are in

plain english. the problem that -- one of the problems that we're experiencing now is we got away from the system we had in place, not just strong regulation and mechanisms to control powerful institutions so they can't wreck our economy because of their reckless behavior and the scheme artistry and the fraud that took place over far too many years. what we also got away from is that basic concept that people in their community knew the bankers and the pwafrpger knew the customers so to speak. if you went to get a mortgage for your home, you knew who you were dealing with. one side was invested in the other and it worked very well for a long period of time. we've gotten away from that. i'm not saying we can replicate the system we had 30 or 40 or 50 years ago, but we have to borrow some of those concepts where you had more accountability and more

sense of investment. we know that 15 years ago -- not that long ago -- the six largest banks in the united states had assets that totaled 17% of gross domestic product. what are those six mega banks today? well, they control not 17% -- or the equivalent of 17% of g.d.p. they control 63%. that changed from 17% to 63% in 15 years. virtually unchecked. so instead of supporting a small business in a community or a little league team or a family who is trying to borrow money or a small business, these mega banks gather deposits from wall street. they slice and dice them. they leverage them to the hilt and then use the hard-earned wages and savings of americans to make a handful, a very small,

tiny number of americans incredibly wealthy. it's the kind of wealth that's afghanistan tkpwerg, almost -- that's staggering, almost incomprehensible and incalculable. these mega banks profited tremendously from this new model. that's an understatement. over the last 30 years, profits in compensation in the banking industry have skyrocketed. i don't think wages have skyrocketed. we know at best they have been flat for very long, and when they increase, it's been in very small numbers. so you have mega banks in a flawed system leading to mega profits for a small, tiny percentage of the american people; or even a small percentage of the business community so to speak. so american families have been living with this problem. so the big guys got us into the ditch.

and as we're trying to push out of -- push the economy out of the ditch, the american taxpayers have had to pay the freight. well, it's time that we made some basic changes. this legislation gives us this chance. and now is not the time to slow down and delay and wait and scratch our heads. we know what's wrong. we know what the problem is. and we know how to fix it. we have, i know this morning the continuation of a debate on the bill. we had an example last week where goldman sachs came before the united states senate, not in a situation where the united states senate was a prosecutor or a law enforcement agency. but the united states senate played an important role as it relates to goldman sachs. chairman carl levin, the chairman of the relevant committee -- the investigations committee -- said we were

focused on policy and theubgs. and -- and ethics. i think that's an important role for the united states senate. what happened in that goldman situation? there's a lot of way to describe it, but one way to look at it is this way. that goldman sold investors a product, in this case a derivatives product and its value was tied to the peformance of a big portfolio of subprime mortgages. so that's where it starts. but it appears that goldman worked both sides of the deal. they'd sell these products to investors, on the one hand, while also plotting with a hedge fund manager who is betting against the pr-frpbs of the very -- peformance of the very same mortgages. it gives conflict of interest new meaning, and it's a disturbing, a large image, i think, for a lot of americans. selling on one side and then going over to the other side and

plotting and scheming to make money and not worrying about what's down when, what's downstream, the horrific consequences, like a wrecking ball to a building, and just kind of hrafrg all the way to the -- kind of laughing all the way to the bank. i know it's over time. i'll wrap up. i'll be coming back with an amendment i'll be offering. i want to say how much i appreciate the work that's been done today -- even though we're at the beginning of the debate -- on the restoring financial stability act of 2010 to establish an early warning system, to enhance protections for consumers and investors, to strengthen the supervision of large, complex financial organizations, and finally, to regulate at long last in a much more aggressive way the so-called over-the- counter derivatives market. i see the chairman of the banking committee, senator dodd here, has done great work in this area not only more

recently, but for many years. we're grateful for his leadership, and i know the debate is in the early stages. but i think we're going to have a good product by the end of this. mr. president, i would yield the floor. mr. dodd: yield for 30 seconds? mr. president? the presiding officer: the senator from connecticut. mr. dodd: i want to ask the colleague to yield. i see my friend from louisiana here and want to give him time. i want to say to senator casey how much i appreciate his work. we worked together on this committee before he moved on to i won't say greener pastures here but was a member of the banking committee. and i'm grateful to him for his involvement when we dealt with the housing issues, credit card issues and the like as well. and his comments this morning are ones i appreciate very, very much and look forward to working with him, along with my colleague from louisiana, senator vitter as well, who is a member of the banking committee as well. mr. vitter: mr. president? the presiding officer: the senator from louisiana is recognized. mr. vitter: thank you, mr. president. representing louisiana in the

senate along with senator landrieu, you can imagine i've been focused exclusively on the ongoing oil spill/leak, ongoing flow that we in the country have been battling. because it's been almost a week since i've been here in washington and on the senate floor, i wanted to use the opportunity to briefly give an update from my perspective. along with many other officials, industry folks, interested citizens, i've been all through and up and down the coast, as well as offshore. i had the pleasure of traveling with several cabinet secretaries and other members of our congressional delegation last friday, going offshore to look at the site of the former rig, the site of the ongoing spill or leak very, very closely. i also took another helicopter tour later that day. i've been in all the affected

coastal communities -- st. bernard parish, plaquemines parish, lower jefferson, reach out to folks daily, local elected officials and leaders, the industry, federal agencies, the coast guard and others working on this ongoing crisis, the governor and the state who are extremely proactively engaged. and having done that, again, i wanted to give a brief report to my colleagues and my fellow citizens. obviously, i think we need to start in remembering that this is a great human tragedy and that started with the apparent loss of 11 lives. and i think it's very important to start all of our discussions and recollections about this

incident with that human tragedy and with those families. you know, as the media and others cover the environmental danger, which is great, the economic impact, which is enormous, i think sometimes those families, that enormous human loss, is a little glossed over. so i certainly want to stop and reflect on that again and continue to offer my heartfelt thoughts and prayers to those 11 families who were the most impacted, who've suffered the most. i say a prayer for them every day, as so many folks in louisiana, and will continue to lift those families up. secondly, mr. president, this is an ongoing challenge and crisis because, as i said a minute ago rng this leak, this flow continues.

it hasn't stopped yet. and of course priority one of everyone involved is to stop the leak, to stop the flow. iterit's a little difficult to estimate exactly what that flow is, but the best guest matter, and it's really an art, not a science, is about 5,000 barrels a day. just to naught in perspective -- just to put that in perspective, already as of four or five days ago, that meant the product leak surpassed all of the spill, all of the events combined from health insurance keen and rita. -- from hurricane katrina and rita. if that rate is constant and continues 5,000 barrels a day, then in about another 35 days we'll equal the volume leaked from the exxon valdez. that is a very real threat to

equal or success pas surpass thf oil. lots of activity going on at the well head in that area to try to control and stop the leak. there are multiple plans -- i guess plan "a," full, is to close off the valve that should have been shut down automatically through the blowout preventer. needless to say, there was a massive failure in terms of that automatic closedown, which is supposed to happen at multiple levels. but there's ongoing effort to send underwater robots down to the floor of the gulf and shut down those valves. unfortunately, that has not worked yet. plan "b" is to put out a large constructed box or dome to cover the part of the gulf floor where the leak is coming from and then to pipe up the material, to vacuum up the material in a

controlled way, from there to the surface and store it. that box or dome has been constructed. it will be sent out to the site in the next 48 hours. and so that attempt will start. this technology has been used before in other spills, but never in anything like this depth of water 5,000 feet. it's been used in 400 feet, 500 feet, not 5,000. so that is a big difference which brings up all sorts of engineering challenges because of the enormous pressures at that depth of water. and plan "c," if you will, mr. president, is to drill a relief well -- in fact, two relief wells -- that work has already begun to relieve the pressure on this well and to bottle it yo up, to put mud and cement down there to stop the flow from the existing well.

and that can work and that will work. the problem is, that will take 60-plus days, 630 to eve 60 to . to stop the leak in the immediate area of the leak, the coast guard and b.p. and others in industry are using dispersants and other methods of trying to mitigate the ongoing flow. so, mr. president, that's one category of very important work. there's a second category of extremely important work, and that's all the work that is under way to protect the louisiana coastline and marshes, as well as similar work in neighboring states -- mississippi, alabama, and florida. i have to say, mr. president, last friday when i took that plan ride with the cabinet secretaries, i was extremely concerned that all of that coastal protection planning and

execution had to go through b.p., and it was very evident to me that that challenge and that end of the endeavor was bigger than b.p. and bigger than any single company. and i was concerned that that was a bottleneck. i wasn't arguing in any way that b.p. is the responsible party under federal law, that b.p. had enormous monetary responsibility that flowed from that. nobody is arguing with that. but, operationally, i didn't want all of that crucial coastal protection -- marsh protection activity to be stalled or delayed because it had to fit through that bottleneck. mr. president, i think the good news from over the weekend is that old system was blown up and that bottleneck was relieved. and i particularly want to compliment and commend admiral thad allen, who the president

appointed on saturday, to be the federal coordinator of this effort. i think he recognized, at my urging and many others, that having all of that planning and execution flow through b.p. was a problem and a mistake, so that has been corrected. again, mr. president, as of friday, detailed planning in terms of coastal and marsh protection efforts was not getting done by b.p. and, quite frankly, it was not getting done by the federal authorities, the coast guard or anyone else. but local and state leaders stepped in the folks who know that coastline and that marsh area the best stepped in, and they have provided those detailed plans over the last several days. and so over that time period, in particular from friday on, individual parishes in coordination with the state, in

coordination with many experts have developed pair issu pirishe arab -- parish-by-parish plans. that pulse together many -- that pulls together many levels of leadership. the people know the mash like the back of their hands. that void has been filled thanks to the leadership and vision by local leaders in strong coordination with governor jindal and the state. now those individual parish-by-parish plans are ready. they're being tweaked. they're being improved. but they're ready. the next ste step is for the cot guard to formally approve those plans. that has been donthat has been . the coast guard needs to quickly and timely approve those supplemental plans. i talked to the coast guard

leadership yesterday afternoon and urged them to do that in a very time-sensitive way, and they assured me that that was happening. once that happens, b.p. automatically is on the hook to pay for implementation of those plans. that takes no additional approval or signature from b.p. that's automatic under federal law. and then the plans need to be executed, either through b.p. or independently by using fishermen in the area, by using other contractors, or otherwise. that's a decision of the locals and the state. so i think that process is moving in a very good direction and is well under way. mr. president, let me close by focusing on another big category of concern that i share with so many others, and that is the concern about economic impact starting with the folks who have

been hit and affected the most -- the fishermen of louisiana, oystermen, fishermen and the industry. already, as of at least sunday and monday, this is having devastating economic impact on those folks and our hearts go out to them and our prayers go out to them as well. i've been working with many others to try to get them the hope and relief they need, in particular focusing on four categories of activity. first of all, when i talk to local fishermen in st. bernard and lower jefferson, plaqueminess, all through south louisiana, they all say the same thing. they don't want aout, a big federal program. they -- they don't want a handout, a big federal program. that's their lives, their tradition, their spirkts and -- that's they are laiive lives,

their tradition, their spirit. all efforts are being called to be the backbone of this response. i have taked to both local and state leaders and b.p. and we're all in agreement that a hyper aggressive effort needs to happen to hire up as many of those fishermen as possible to man that coastal marsh protection effort. secondly, that's not going to take care of all of the immediate need. so i am pushing strongly to make sure that b.p. holds to its promises of setting up a hotline and a program of getting quick dpengs compensatiocompensation f families who are suffering economic loss. i talked directly with the c.e.o. of b.p. yesterday about this. he assured me that that was being done, that would mean

quick checks to people and families that needed it. without any signing away of future claims. so i'm going to work very hard to enforce that personal promise. in fact, today i'm setting up a hotline in my office. it'll be advertised on my web site www.vitter.gov to ensure that that program is developing as promised. and if anybody out there -- fisher mn, others -- who are applying to that program are treated differently, i urge policemen to call this hotline and -- i urge them to call this hotline and we'll get all over thew immediately and try to correct that situation with b.b. third in terms of helping that local industry, of course we're looking medium and long term in terms of full economic damages. b.p. is a responsible party.

they're responsible for those economic damages. in addition, we have an open trust fund under federal law which at present has ads 1.6 billion balance -- has a $1.6 billion balance funded since the exxon valu valdez incident to cr these impacts. fourths, additionally, there is an outpouring of citizen private support to help these families. and i'm not directly involved but i know several organizations under the umbrella of the united way is leading fund-raising efforts to directly help these families. but as this ongoing challenge and really crisis continues, that will continue to be a prime focus of mine: the families directly impacted, fishermen,

oystermen, the shrimpers, their families, who after suffering so much through katrina and rita are sort of hit below the belt yet again. mr. president, i'll continue obviously with senator landrieu and others to stay very focused on this ongoing crisis to do all sort of work i've described. and i ask my colleagues to be sensitive to that and to be aware of that. in particular, there is going to be, and there has to be, enormous discussion about policy, federal and other policy coming out of this disaster. we need to look at mandated technology. we need to look at procedures. we need to look at the current liability cap and the open trust fund. all of that is important. but as we begin to do that, mr. president, my first request would be that we all realize that down in louisiana off our

coast, in the gulf coast, in the real world, there is an ongoing crisis that still continues. the leak is unabated. the flow is unabated. and i'd ask all of us to be sensitive to that so we're not diverting attention or resources away from that ongoing crisis. the work needs to be there right now to shut down the flow of oil and to protect our coastline. many, many members, democrats and republicans, have offered their support to me and senator landrieu. we both deeply appreciate that, and we look forward to working with everyone in this body on this ongoing situation. thank you, mr. president. i yield th floor. a senator: mr. president? the presiding officer: the senator from delaware is recognized. mr. kaufman: mr. president, i ask for subsequent to speak -- i

ask for consent to speak as if in morning business. the presiding officer: without objection. mr. kaufman: this week once again we celebrate as we do every year public service recognition week. public service recognition week provides us all a chance to reflect upon the contribution by those who serve in government. all throughout the week the partnership for public service, a leading nonprofit, nonpartisan organization dedicated to honor those who work in government, will be hosting formative programs across washington, d.c. one of the most exciting moments during that week is the announcement of this year's finalist for the distinguished service to america medal. this year once again the crop of finalists is outstanding. the winners will be announced at the partnership's annual service to america gala in september. during last year's public service recognition week, i

delivered the first in a series of weekly speeches from this desk honoring great federal employees. now, one year later, i'm proud to continue this effort today by recognizing my 60th great federal employee along with a few others who won the service to america medals in the past. aung dong worked at the naval service in maryland for 27 years. she came to this country after escaping from vietnam as a teenager having fled by helicopter to a navy vessel offshore. after coming to the united states, aung obtained a degree in chemical engineering and computer science at the university of maryland. after graduation, aung began working at the naval service warfare center as a chemical engineer. and from 1991 to 1999 she oversaw the centers advanced

development program in high skpwhroe seives. -- ex-phroe seufrs. 1999 to 2002 she worked at the head of the program to develop undersea weapons. after september 11 attacks when armed forces were given the mission to defeat the taliban, it was aung who was asked to develop a thermo baric bomb that could be used to reach into afghanistan's mountain caves where taliban fighters were hiding. she and her team were only given 100 days to prepare such a weapon for use. they did it in 67 days. since 2006, she's worked with the navy criminal investigative service to create mobile battlefield forensic labs to help quickly identify those behind any terrorist attack. aung dong was awarded the service to america medal for national security in 2007. another dedicated federal employee who won the service to america national security medal

in 2005 is alan estevez. alan is the principal deputy assistant scare of defense for the -- secretary of defense for military readiness. the old adage says the army runs on its stomach. a modern army runs on much more than that. there are thousands of pieces of equipment and supplies that need to be transported in and out of an area of operations. alan has been working since 1981 to make our military logistics system more efficient. over the past several years alan has overseen efforts to implement radio frequency identification, or rfid, technology into our military supply chain. he saw the companies like wal-mart were using data to track products with a high degree of accuracy and reduce waste. alan's work over the past three decades saved the military and taxpayers countless dollars and helped ensure our troops have

the supplies they need to fulfill their missions. mr. president, another service to america medalist i want to highlight today is riaz alawan. he served as attache to the ukraine when he won a samee to secure the site of the chernobyl meltdown. he won the 2003 service to america medal for international affairs which recognizes several years he spent living near the site of the chernobyl disaster and working with the local communities to mitigate its social and economic impact. as part of his work, riaz oversaw the construction of a new concrete shelter over the former chernobyl reactor, one of the largest and most complex engineering products in the world at that time. his work on no one proliferation in the ukraine helped prevent terrorists from getting their hands on nuclear materials left over from the fall of the soviet

union. in the same year that he won the award, the service for america medal for call to service which recognizes new federal employees was won by allison mcfar land at the state department. allison only worked at the state department for three years when she found herself in the middle of a tense diplomatic situation. she was working as a program development officer at a consolate in a city near the north korean border. one summer day in 2002, three north korean refugees jumped over the koupbs hrat wall -- consolate wall seeking asylum. allison quickly became instrumental in communicating with the refugees, authorities and the chinese and the south korean government. by playing a key role in supporting negotiations with the refugees and government officials, she helped enable the asylum seekers to reach freedom in south korea. at the time of the incident she

was only 28 years old. the fifth and final story i want to share today is about the winner of the 2002 service to america medal for justice and law enforcement. special agent robert rutherford won it for his work at the u.s. customs service, which has since been renamed the u.s. customs and border protection. robert served as the group supervisor for the customs service air and marine investigations group in miami. his primary job is to keep illegal drugs from reaching american shores. starting in 1999, robert began noticing a sharp rise in the amount of cocaine and other narcotics being smuggled in the country from haiti which was contributing to the rise in local crime. on his own initiative, robert worked with colleagues to form operation river sweep to block the my my river as a trafficking -- the miami river as a trafficking route for

drugs. between 1999 and 2001, operation river sweep made over 120 arrests and prevented over 13,000 pounds of cocaine from reaching florida communities. as robert's efforts met with success, the local crime rate dropped. in order to stay afloat drug traffickers adapted their methods hoping to outstart the customs service. however, in 2001, robert launched a second task force -- operation river walk -- involving over 300 law enforcement personnel from local, state, and federal agencies. this second task force arrested over 230 trafficking suspects and seized over 15,000 pounds of cocaine and can nab business. mr. president -- and cannabis. although the details are different in each case, all five of these stories about service to american winners send the very same message. it's a message of service above self, of motivation to carry out

the people's work. when i first spoke about federal employees a year ago, i noted the importance of the oath taken by all those who serve in the federal government. the spirit of the oath to -- quote -- "support and defend the constitution" and -- quote -- "faithfully discharge duties of the office" undergirds the service of every man and woman who served as a federal employee since 1789. our work in congress today is tkrafrgt of a -- drafting of a blueprint for roeufrp and prosperity -- for recovery and prosperity, dedicated to civil servants. they are regulators who restore stability to our financial system. they are lawyers who will prosecute terrorists detained overseas. they are the doctors and nurses who will care for our returning veterans. they are the aid workers who spread hope and healing around the world. they are the instruments by which we, the people, secure the

blessings of liberty. as we mark public service recognition week, let us all make an effort to thank those who have chosen the path of public service. they are all truly great federal employees. i yield the floor. a senator: mr. president? the presiding officer: the senator from nevada is recognized. mr. ensign: mr. president, the american people are tired. they are tired of the government spending money that it doesn't have while they are forced to make tough decisions about their own family's budgets. but more importantly, the american people are tired of the government stepping in, blank check in hand, to bail out giant wall street firms that were

irresponsible with their money. the american people are sick and tired of seeing their hard-earned taxpayer dollars squandered away in the name of too big to fail. one of the most important lessons that we learned from this financial crisis -- hopefulfully we learned -- is that the bailouts were unfair. they allowed the government to manipulate the market by picking winners and losers, and they used taxpayer dollars to do so. republicans have made this point repeatedly during this debate. those on the other side of the aisle have accused us of trying to hold up reform. but what we have been trying to do is to listen to the american people when they demand no more bailouts. this bill does not address the concerns of the american people. despite the enormous size of this bill and its complexity -- and believe me, it is truly

complex -- i don't believe anybody in this chamber, and as a matter of fact, i don't believe anybody on capitol hill fully understands this bill. but this bill makes more explicit the ability of the government to continue to pick winners and losers when bailing out irresponsible wall street firms. mr. president, i come from a state where gambling is a big part of our economy, and yet a las vegas casino could not get away with half of the gambling that wall street does. when people walk into a casino to gamble, they do so knowing that the odds are against them. but wall street takes gambling to a whole new level. they do it because they actually manipulate the odds while somebody's playing the game. what's more, wall street then asks the government to cover their bets when they can no longer afford to do so on their own. can you imagine a casino booking

a bad bet, losing money and then asking the government to bail them out? that's basically what wall street did. and this bill continues that ability. the proof of this is self-evident because we are now debating an amendment that tries to fix that. it's the boxer amendment. if this bill did what it claimed to do, we wouldn't be here debating this amendment. which, although this amendment sounds very nice, it actually does very little to address the problem of preventing futur bilw government bureaucracy for the purpose of managing bail out banks and their creditors. the management of this does nothing to prevent taxpayer money from being used to pay off debts of failed financial institutions. for example, billions of dollars in taxpayer money were used to pay a.i.g.'s obligations to

goldman sachs after the insurance giant's collapse. this amendment does nothing to stop the federal reserve from risk -- risking even more taxpayer money on these firms again in the future. the language of this amendment does not even prevent the government from imposing fees on companies that can be spent to bailout firms. i regret that this flawed bill is on the floor now instead of a bipartisan piece of legislation that the american people have been asking for and, quite frankly, deserve. i hope in the process of debating this bill that we can offer amendments that will fix this bill, that will finally end this too big to fail concept. but instead the american people are left dealing with the reality that another partisan bill has come to the floor and will probably become law. and another government bureaucracy will be created as a

result of this legislation with little regard to the will of the american people. mr. president, here we go again. unfortunately, too much partisanship has gone on in this body. there are several of us working on bipartisan amendments -- and i hope that we can actually dramatically improve this bill. i think both sides have the same objectives, and that is that we want to cleanup wall street. we don't want to do that, though, while hurting main street. we want to hold wall street accountable, but we don't want do it in a way that holds -- that harms people who had nothing to do with the financial crisis that occurred. so, mr. president, i hope we actually can end up with a system that ends too big to fail. we already have several financial institutions in this country that are already too big to fail. what to do about those firms is

very difficult, very complex, and we have to do it in a way that doesn't messup our entire financial system and system of credit that we have in the united states. so i believe we need to take our time. because the expertise that -- to get this right is -- is very difficult to get, and i don't believe that necessarily the senate, the house, has that kind of expert cease. so -- expertise. so we need to take our time on this bill to get it right to make sure we are doing when we are intending too. mr. president, i yield the floor. mr. durbin: mr. president? the presiding officer: the senator from illinois is recognized. mr. durbin: mr. president, i don't know if there's ever been a perfect law. maybe that law that was written on the stone tablet and brought down the mountain by senator moses was a perfect law. ever since then human beings have tried to write laws, and maybe the laws will have to be

revisited and revised. i think that humility comes with this job because this is an imperfect process. we try to make compromises, we make consensus. virtually every time, you would say, that isn't what i would have written but that is what the senate as a body decided to move forward with. so now we're debating this law, 1,400 pages lodge, called the financial stability act. why are we doing a bill that looks like a telephone directory? we're doing it because of the recession. the recession that hit america harder than anything since the great depression. $17 trillion taken out of the american economy. that is more than the value of all of the goods and services produced in the united states in one year, $17 trillion yanked out of the economy and most of us felt it. you felt in your savings account, your 401(k), you saw it when the shop down the street laid somebody off or closed.

you know this was a real recession that hit america hard, eight million people unemployed, six million people sitting out there discouraged that aren't even looking for jobs. that's a real recession. how did we reach that? we are reached that because of very bad decisions on wall street and in washington. the situation in washington was due to housing in america, are we going to expand the opportunity to people to own homes who traditionally did not own them. when my wife and i owned a home, our lives changed. we were no longer renters. we were interested in that house and our neighborhood and our parish and community. it's a different look at light. so homeownership, i think, is a real american value we thought it was a good investment. stretch to make a house payment. do you think we can make that monthly payment? and if you can, watch the value of that house go up and say, pretty good decision. nice little house for our family

and a good investment so we thought in washington, let's expand that model. there's nothing wrong with where we started. nothing selfish about it or really outlandish that we would move in that direction. then came wall street and wall street said, if this is a good thing, we can make money on it. and they took the mortgages that people used to enter into with the bank down the street or downtown, and they sold the mortgages dow downtown to some r bank and pretty soon that mortgage went into the business atmosphere and chopped up into pieces, sliced and diced into derivatives and sold at the highest levels of wall street. and, unfortunately, it got out of hand. it got so far out of hand, that at the end of the day it collapsed. home values started coming down, defaults an foreclosures started increasing, and the people who were making all the money on wall street were sitting in financial institutions that were

crumbling around them. so where did they turn for help? they turned to taxpayers and they asked taxpayers across america, bail us out. come to our rescue. keep our company in business even though we made some fundamental mistakes here. we did. there was some good arguments. having sat in the room with the secretary of the treasury and the chairman of the fed said, senators and congressmen, if you don't move and move fast, the american economy's going to collapse. what do you do? you know, i have an education. it's an experience, but i'm not sure i'm ready to save the american economy single-handedly. i took their advice and others did too in bipartisan votes that led to the bailout that saved the institutions. they showed their gratitude to american taxpayers for saving them from their own malfeasance by declaring bonuses for one another. million dollar checks that they gave to one another in congratulation for their economic failure. and, naturally, members of

congress and members of the american public said, this is disgusting. that these people would make these mistakes, ask the average mom and pop in america to bail them out with tax dollars and give one another boneus checks to reward their misconduct. and that's what brought us here today. that's what this bill is about. this bill is about changing financial institutions in america to guarantee there will never be another taxpayer bailout, period. senator wit barbara boxer has te first amendment. and it should have every vote in the chamber and it says no, more taxpayer bailouts, period. i think that's a good starting point. let's proceed from there. what are we going to do with these institutions to make sure they're held accountable that they don't get so big that their failure jeopardizes the american economy. that is part of this as well. amount of money they have to keephood and, the leverage, the lickeliquidity, the rules of thd

to make sure we never get in this recession mess again. there's another provision in here too, one that i think is equally important. it says we're going to create one agency in the government that's going to look out for families and businesses across america who can be duped into legal agreements that can explode on them at the expense of their life savings or their home. it's a consumer financial protection law, the strongest one ever passed in the history of our country. i heard the other side, the senator from nevada call it a massive bureaucracy. it's not that. in fact, it is a self-enforcing agency that has the power to make decisions independently of existing agencies of government with one goal in mind, empower consumers across america to make the right choices. we can't make the final decision about whether you sign that mortgage paper or not. we shouldn't. but you ought to know when you sign it what you're getting into. what's the interest rate? what's the term of this

mortgage? can i prepay this mortgage without penalty? those are basic questions people need asked and answered. and that's what this bill is going to guarantee through the consumer financial protection agency. it took a while to get to this point where we'll have our first vote on this bill. it took much longer than it should have. senator chris dodd of connecticut who is a member of the senate banking committee, sat down with republicans, senator shelby of alabama, over three months ago and said, let's work together. let's make this a bipartisan bill. and after two months of effort, they concluded they couldn't reach an agreement. at that point senator dodd said, well, i'll reecht out to senator -- reach out to senator corker of tennessee, a republican, and see if i can reach agreement with him on a bipartisan bill. he's on my committee. they are worked for a month and could not reach an agreement. senator dodd said, you know, there comes a point where we have to move this legislation. he called this bill before his senate banking committee an invited the republicans and

democrats on a committee to come in, give us your best ideas. how would you change this? improve it? what would you do to this bill? the republicans filed over 400 amendments to this bill. it's a lot of work. then came the day of the actual hearing on the bill and the decision was made on the other side of the aisle not to offer one single amendment. not one. 20 minutes after it convened, it voted to pass the bill out an adjourned. so when senators from the republican side of the aisle come in and say, you know, there's just not enough bipartisanship in this bill, i have to tell you it isn't because of lack of effort by senator dodd and members of the banking committee. we have tried to engage our friends on the other side of the aisle to help us make this a better bill and we'll still offer that invitation. there will be bipartisan amendments. there should be bipartisan amendments. but at the end of the day, if we don't make a fundamental change in the economy and the way that we manage financial institutions, we will invite

another breakdown and we can't let that happen. there have been too many victims of this recession to let that happen. president obama has challenged us to get this done. we do so little around here, it is just frustrating. we spent a whole week here, a few weeks ago, one whole week debating whether we would extend unemployment benefits for four weeks. one week of debate, four weeks of extension. the following week we spent an entire week on the senate floor debating five nominees that the president has sent to us out of the 100 that are sitting on the calendar, all of these nominees were noncontroversial, passed with strong votes. we ate up an entire week on these nominees. then we wasted last week when the republicans mounted a filibuster to try to stop a debate and taking up the bill, three straight weeks in favor of a filibuster and finally, thank

goodness, several republican leaders went to their leadership and said, this is a bad idea, we awd awt to be on the side of history, the right side of history with wall street reform and we're not going along with the filibuster at which point it ended and we started moving to the bill. today we may take up the first amendment. and i hope we do. there are a lot of things that need to be included in this. let kneel you one thing that i'm going to offer an amendment on that most americans are not aware of. if you have a credit card and you go to a local business whether it is a restaurant or flower shop or get your oil changed and you present your credit card to pay for the goods or service that you're buying, you are not only going to pay the shopkeeper, the shopkeeper is going to owe the bank a percentage of what you paid. it's called an interchange fee. it turns out to be a substantial amount of money for retailers. they end up paying these credit card companies a percentage of

the bill for the use of the credit card. there's nothing wrong with that. there should be a fee associated with the use of credit cards by businesses. but it has reached a point now of unreasonableness. it has reached a point much unfairness. let me give you an example. if i go to a restaurant in chicago, illinois, and pay for my dinner with a check, the restaurant turns the check into their bank, the bank contacts my bank, the money transfers, no fee, no cost. however, if i go to the same restaurant and use a debit card -- a debit card, which takes the money directly out of my bank account, just like a check, the company that issued the debit card and credit card will charge a percentage of that restaurant check to the owner of the restaurant. well, that money's coming directly out of your checking account just like a check is, why is the credit card company taking as much in a fee from the

restaurant as they do with credit cards where there is at least some question as to whether ultimate payment will be made? so we're going to have a bill which addresses the interchange fee. and tries to bring some fairness to it. i think it's long overdue. i hope that all of the members of the senate who really believe in small businesses will call them and ask them about the durbin amendment on interchange fees. you will find, as i have, that this is one of the major concerns of retailers and businesses across the united states. i talked to the c.e.o. of a major drugstore chain yesterday, and he told me his top four expenses for his nationwide chain of drugstores, number one, salaries. number two, what he called mortgages and rent. number three, health care. number four, interchange fees. the amount of money his chain pays to credit card companies, it is a huge expense of small

business. now, we're not saying there shouldn't be an interchange fee. we're saying it should be reasonable, and if it does not involve effort, service or liability on the part of the credit card company such as the debt card, it ought to be reflected in the fee that is charged. the last amendment i offered is one that i think taxpayers across the country ought to pay attention to. more and more each year, the federal government is accepting payment by credit card. you can pay for your income tax with a credit card. what does that mean? it means uncle sam, the taxpayers, pay an interchange fee to the credit card company, even though ultimately those credit card companies are all being paid. so in my estimation, it calls for a bill which says the lowest interchange fee rate should be charged to the federal government so that taxpayers are not subsidizing credit card companies which they are currently doing with interchange fees that don't reflect the liability involved in the transaction. this is just one of the aspects

of the bill. some will say what's that have to do with the recession? i can tell you consumer debt and personal debt had a lot to do with the recession and a lot of people in desperation turned to their credit cards and a lot of people found the interest rates on their credit cards going through the roof and a lot of people didn't understand why they were so expensive. we're going to bring this out for debate here. once again, i hope my colleagues who support small businesses as i do and believe that they are the lifeline to bring us out of this recession will join me in supporting small businesses to make sure that we bring some sense to the interchange fees charged on credit cards and debt cards across america. mr. president, i yield the floor -- excuse me. let me withdraw that and make the following unanimous consent requests. i have six unanimous consent requests for committees to meet during today's session of the senate, with the approval of the majority and minority leaders. i ask unanimous consent these requests be agreed to and the requests be printed in the record. the presiding officer: without objection, it is so ordered. mr. durbin: i suggest the absence of a cle will call the roll.

quorum call: