>> the poll says 71% of americans do not support the war tax. >> he has got to figure out where the money will come from. if we have your troops in iraq, it is less costly there, so there is some savings to be found there, but probably not enough to account for what they will be sending to afghanistan. >> does president karzai get it, and is the message clear to him? >> this would seem to be the last chance, but time will tell. c3ha>> he will have to find somy to demonstrate a certain level of getting it. particularly, members of the hill are looking for some kind of token signal. >> what role the greater

thanreed play in this is -- what role does senator reed play in this whole debate? >> he has a very tempered, moderate voice. people trust his experience. >> john stanton, thanks for being with us on this sunday." >> thanks for having us. >> we run an ever increasing risk of over confidence. >> for of malcolm glad well's books or on the best-seller list. >> up next, an update of the status of the senate health care bill from congressional quarterly.

kate hunter is a staff writer staffcq. >> president obama and vice president biden came up this afternoon to meet with the democratic caucus. it is a critical moment in the debate over health care. the president was looking to essentially rally the troops over the issue. >> can you tell us who was there with president? >> it was the president, vice- president, and secretary salazar, the interior secretary who used to be a senator and the secretary of health and human services, among other administration folks. >> and the democratic leaders? >> every single member of the caucus. the senate stayed in session, and republicans actually presided over that senate so that every member of the caucus could attend the meeting. >> did any news come from the

meeting? >> not really. members came out talking about how the president focused on the big picture. he did not get into details. some of the more liberal members who were looking for him to get behind the idea of a public option came out saying that he did not do that. he did not talk about policy issues are way in on approaches going forward. he talked about this being the biggest piece of legislation in generations, since the passage of so security, and that people 30 or 40 years from now would look back on this congress and judge its members by how they handled this debate. he made the case to senators that the 2010 elections are coming up and that house democrats there in those elections could hinge on how the health care debate is handled. >> how much impact is it likely

to have? >> senator baucus said that some of the center is to have been more problematic in opposing certain assets -- certain aspects of the bill, but they work more amenable to the proposal. i think that remains to be seen. when you have a president who can come in and talk to members, that is potentially helpful. how far it moves the ball forward remains to be seen. >> abortion funding is a key issue in this debate. how soon might we see an abortion amendment come to the fore? >> there is a series of proposals that have been threatening to come to the floor for several days now. we will potentially see a vote tomorrow on some kind of abortion amendment. >> what else can we expect to see on the floor? >> there is a proposal from

senator gregg that deals with medicare. republicans have really been trying to hammer home the idea that the bill is using cuts in medicare. democrats have been offering amendments that came to take some of that political staying against voting for the republican proposals. >> there seems to be an apparent target date of christmas. what is senator reid going to have to do to get the bill finish by christmas? >> the days are taking away. the time to do this is dwindling. one of the spokesman this morning said that potentially sometime this week, before the end of the week, senator riegle begin filing cloture on various aspects of the bill. -- senator reid will begin filing cloture on various

aspects of the bill. if the republicans -- without republican cooperation it could take even longer. it seems like it is quite the task to try to get something passed out of the senate by christmas, but the majority leader is getting to the point where he might start wielding the procedural hammer a little more. >> you can read some of cake hunters articles at c-span.org. >> speaking with mitch mcconnell and his colleague john mccain, this is about 10 minutes. >> good afternoon, everyone. the fact that the president of the united states is over meeting with democrats only tells you where this debate has gone.

earlier in the year, there was talk about producing a bill that 80 of 100 senators could support, doing it on a truly bipartisan basis, but instead, as you know as you have all this over the weeks and months, it has drifted off into a completely partisan effort. to take half a trillion dollars in cuts out of medicare, 400 billion dollars in new taxes, produce higher insurance premiums for 85% of the country, not surprisingly that is not a bill that generates much enthusiasm on our side of the aisle. here we are a few weeks before christmas with the democrats trying to squeeze every single one of their members to swallow a pretty bitter pill for the american people. with that, let me call on senator mccain. >> i do not like to refer back to last campaign, for obvious reasons, all the time.

the fact is, last october the president of the united states and i -- i have repeated the quote so often. i think he should go right on over to the meeting, because that was the commitment made, that the c-span cameras would be in there so that the american people a goat would know who is on the side of the insurer's -- so the american people " would know who is on the side of the insurers, and who is on the side of the people." of like to have a discussion with him about why we feel so strongly, there needs to be a medical malpractice reform in this legislation. what we feel that people should be able to go across state lines and get health insurance.

what we think wellness and fitness should be emphasized in this legislation. why is that the trial lawyers seem to have dictated the language of this legislation that in 2000 pages there is no significant reference whatsoever to medical malpractice reform. i noted on the front page the "washington post" this morning, and maybe that is the reason why the president is here, it deals cut with help groups may be at peril. yesterday we had a very spirited discussion about particular deals that had been made, and i made reference to that deal that pharma and others have made, and there was some blow back that maybe that was an unfair characterization. here you see it, and has been reported in other media outlets.

it is time to stop this behind closed doors routine they have been going through and deal cutting. that's do with the president said last october. let's all sit down together with c-span in the room and negotiate so that the american people can see what is going on here. it is not an accident that as longe as this process goes on, the americans are against this massive intrusion and takeover of the healthcare system in america by the federal government. we are always glad to see the president back where he once worked, and we stand ready to sit down and meet with the president if he has time as well. we would like to have the c-span cameras in when we do so. >> the fact that the

administration has accepted a number of the republican ideas -- >> you would have to tell me one idea of significant policy implications that would change the bill that went through the health committee of the finance committee that was accepted by the democrats. you cannot find one, because i have been in all of this debate and discussion. >> you talk about opening up the meetings and having c-span cameras in there. you know as well as i do that to get things done, not that there is anything awful going on behind closed doors, but that is how things are done in the senate. you have been here long enough to have been part of that. >> i am sure you have been around long enough to see the approval ratings of congress and washington. they are down 18%, and i have not met anyone in the 17% or 18%

category. the fact is, maybe we ought to do things differently. the president committed to do things differently, my friend. whether you are of the opinion that that is the way business as usual is done, that is not what the president committed to when he grinned. maybe we should all be so cynical that when politicians run for office, that they are not really committed to do what they pledged to do. i do not think that is helpful to our system of government. >> the only reason this bill is behind closed doors is because at -- is because they are trying to pass it with 60 democrats only. if this were a truly bipartisan measure, all of that would not be necessary. they have crafted a bill that has virtually no appeal to any republican, so they are left with trying to get everyone of their ducks in a row.

they are completely vulnerable to any senator who says you need to do this for my state, and another one who says you need to do this for my state. as senator mccain has pointed out repeatedly on the floor, all 100 senators would like to have the same opportunities, if there are special fix is being put in for one state or another. -- special fixes. >> who is it that is left out of the deals? the american people are the ones who are left out. the deal that pharma cut, that return for their support of the legislation, the administration would oppose the drug importation from canada, where prices could be as much as 2% lower, and would oppose competition for medicare recipients by the pharmaceutical

companies. so who got damaged by that deal? certainly not the pharmaceutical people, but the american people did. when the details of all these deals comes out, and they will over time, those special interests did very well, but the american people did very poorly. >> there are a lot of republicans who are co-sponsors of the bill. d think that will be with you on the floor? >> i don't know. i have no idea, but i know this. the administration and pharma are pulling out all the stops to try to stop legislation which is clearly in the best interest of people who have to buy prescription drugs, because they are much less expensive when they come from another country such as canada. there is no way you can this proved that statement.

there is evidence of it. so they are pulling out all the stops. obviously the pharmaceutical companies -- their lobbyist is very well reimbursed. i think $1.7 million, and their campaign contributions and the ads they are running, i have no idea how many millions of dollars in support. they have done very well in this deal. >> [unintelligible] is that hold any appeal to you? >> the public option does not hold any appeal to me. >> there was no interest in drafting a proposal that was in the political middle.

a year ago, the president looked at the situation and said i am sitting on a 70% approval rating, i am on the way to getting 60 votes in the senate. we really don't need these republicans, so they decided to write a bill that republicans could not in good faith and good conscience support. so they are left with what senator mccain has just described. the only way they can get 60 is with all this deal making. had they chosen to go down the middle, a lot of the special interests would have been disarmed by a truly bipartisan bill. we could have done something we have been recommending from the very beginning, go step by step and fix the problems and deal with costs. all that has been lost in this desire to restructure, through this 2007 and four page bill, one sixth of our economy. thanks, everyone. -- through this 2074 page bill.

>> shortly after ms. mcconnell and john mccain spoke, senate democratic leader harry reid came to the microphone to give his version of where things stand with health care bill. he spoke for about 10 minutes. >> we just completed a caucus. as you all know, the president was with us. obama has been a senator, and he understands the process we are going through now. in short, he pledged to work with us in any meaningful way he can. upon introducing him, i told him how much i appreciated the work of his staff. they have done excellent work.

they have been such a tremendous help to us, and i expressed that to him. there's still a few things we have to work out in the bill, but the issues are being narrowed as we speak. we are working toward a consensus. we are not there, but we understand how important it is we arrive at a consensus and are working to do that as quickly as we can. the question we are ask, what is your disappointment? we have not had a single public statement from the republicans that they will do anything to help us with the bill. quite to the contrary. that is too bad for the american people. the american people last year call for change, and changes taking place. the president's been some time going through the things we have accomplished this year, and

they have been significant. even before he became president, in december, 670,000 jobs were lost. november, more than 700,000. february, more than 700,000. so we have made great progress, and we are going to continue to do so. >> what is the status of the talks now? >> i called and personally asked five moderates and by progressives to work things out on the issues they care a lot about. the public option, small- 't know how many meetings, and they

are having another one this meeting -- this afternoon. progress is being made. the message from the presentation of the president is that not since social security have we had such an issue in this country, and in words that only barack obama could utter, 10, 20, 30, 40 years ago people are going to look back at what this congress did, and every time they see a child and able to go to the doctor when they are heard, and someone who has

diabetes not being able to get insurance, that is what this legislation is all about. we are working to find out when we will start the procedure a process to finish this legislation. of course, we have the abortion issue that has not been overlooked. >> senator lieberman said that [unintelligible] is that true? >> the president -- senator lieberman said that to me after the meeting also. that does not mean is not an issue, just because the president did not talk about it. >> some of the members said that the president is coming in

to take a side on this issue. >> the president is available anytime, day or night. rahm emanuel is just a cell phone away. we have had tremendous support with secretary salazar. we have had secretaries the bilious. they have always been tremendous. -- secretary sibelius. one more question. [unintelligible] >> you are going to have to talk louder. >> [unintelligible]

>> we are still where we were yesterday. republicans love to telalk about this legislation being a surprise to them. some statistics here speak volumes. remember, we had a vote on a saturday evening, because we wanted to make sure that bill on the floor had ample opportunity for people to look at it, even though it had already been available to all of you and anyone else who wanted to look at on the internet for almost 10 days. on this legislation, just the finance committee process there, we have not had legislation that has been so transparent in recent history.

the senate finance committee had public meetings on health care reform, 53 of them. the finance committee had just the markup itself, which was very public, eight days. it has been 22 years since we have had a marked up ever that has taken eight days. the finance committee considered 135 different amendments. the health committee -- the help committee posted their legislation for six days before the markup.

the number of round tables, hearings, what bruce, 47 -- walk-throughs, 47. the number of amendments the help committee considered, 300. so for them to talk about non transparency is to talk about the rest of the bill as they have about not being transparent, they are in a different universe. talking about this bill being r immigrants, the bill running up the deficit, which is absolutely false. this bill running up premiums -- absolutely false. the republicans are being destructive. they want this to be president obama's waterloo, and is not

going to be. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> the senate was in session again today debating health care legislation. now a portion of today's for debate, beginning with minority leader mitch mcconnell of kentucky. >> first, i want to extend a welcome to the president who is coming up to the capitol today to meet with some democrats on the subject of the health care bill. so for they have voted to cut medicare three times, cuts that previously described as immoral and irresponsible. cuts that made it impossible for the president to keep his pledge that people who like their plan can keep it.

health care, cuts that will reduce benefits for nearly 11 million american seniors on medicare advantage, cuts that raid medicare instead of fixing it, cuts the american people vehemently, vehemently oppose. democrats are in a tough situation on this bill, mr. president. they want to expand the government's reach into health care, but they don't have the money. and they don't have the support more importantly of the american people. so what did they do? they decided to take the money they need out of medicare, and that's only made their health care plan even less popular with the american people. now, the gregg amendment which we'll vote on later this afternoon would help reverse the damage of last week's votes. the gregg amendment says that democrats can't raid medicare, which is already in serious trouble, in order to pay for their $2.5 trillion bill.

the money going out of medicare is hospital insurance trust fund already exceeds its annual income. it's already drying up. by 2017, the hospital insurance trust fund won't be able to pay full benefits, and that's before our colleagues get their hands on it. this program needs to be fixed, not pillaged, to create another one. so the gregg amendment prohibits using money from medicare to pay for any new government programs, for expanding existing programs, or for subsidies. instead, it directs that any money from medicare be put back into medicare to strengthen and preserve it for future generations so that we can keep our promises. frankly, this is just common sense. americans don't want this bill to pass, and they certainly don't want it to pass at the expense of the roughly 40 million american seniors who depend on medicare. the gregg amendment would keep that from happening. a vote for the gregg amendment is a vote to keep our promise to

seniors. we're also going to have another vote today on the ensign amendment. the amendment is simple. it is designed to ensure that injured patients, not their lawyers, receive the vast majority of any settlement in a medical malpractice suit. it says that since lawsuits should benefit patients, not lawyers, lawyers can't take more than one-third of the recovery their clients receive. in other words, the lawyers can't take more than one-third of what the client gets. these are responsible limits. moreover, they were written by a democrat and supported in the past by 21 of our current democratic colleagues as well as the vice presi they would drive down costs, the original purpose of reform. the in the congressional budget office has said the comprehensive liability reforms would save the taxpayers more than $50 billion. the incident amendment is a step in that direction.

it will offer a better step-by- step reforms to end it junk lawsuits against hospitals and doctors later in the consideration of this bill. i am hopeful my democratic colleagues will support it again, since so many of them have supported it in the past. >> mr. president, senator reid contacted me earlier today and was unable to be here for the opening of this ithe session. . mcconnell, continue to raise question about the future of medicare. i hope that senator mcconnell is sensitive to the fact that this last week on december 3, we voted 100-0 for the amendment offered by senator bennet of colorado, which said that nothing in the amendments to this act shall result in a

reduction of guaranteed benefits under the social security act provisions related to medicare. and he went on to say that any savings would be used to extend and he went on to say that any savings would be used to extend the solvency of the premiums, and other cost sharing for beneficiaries, and approve or expand guaranteed medicare benefits and protect access to medicare providers. we voted 100-0 on a bipartisan fashion to make sure that we protect the medicare p c c c cog the next 60 minutes. mr. nelson: mr. president? the presiding officer: the senator from florida. mr. nelson: mr. president, i want to speak on the bill and in part respond to the minority leader. at the end of the day, why are we staying around the clock discussing this bill with the intent that we are going to pass the bill? it is simply that we cannot continue as we are. we are in a system whereby

insurance is not solving the nation's health needs. all you have to do is talk to a doctor, and if they haven't already pulled their hair out, they are about to, in that when they want to give a certain treatment to a patient, they feel like they have to negotiate with the insurance company and, in fact, the insurance company often is dictating to them what treatment and what drugs they can or cannot do. or, look at the simple little cases that we hear about that are just absolutely simple cases but catastrophic because someone is in the middle of treatment of something and they get a notice

that their insurance company is going to cancel them, or they have lost their job and they are desperately trying to get health insurance again and an insurance company uses as an excuse that they had a pre-existing condition, and it may be a flimsy excuse. i gave the example yesterday of it may be something like a skin rash. that's a pre-existing condition that they can't get health insurance now on their own. so we have a system that's out of control. now, when it comes to -- you hear a lot about costs out here. we hear a lot about costs, and indeed if we don't do something about the costs of health care, none of our people are going to be able to afford it. talk to corporate america and

the c.e.o.'s and listen to them what the insurance companies are saying to them, how they are jacking up their rates on their employer-sponsored group policies, and oh, please pray that you are not an individual who can't get a group policy and you're having to go out there and try to find an individual policy because the likelihood is that you're not going to be able to afford it. so cost is critically a factor here, and it's a factor also to the united states government, because we cannot -- the u.s. government cannot afford the cost of medicare as it keeps exploding into the future. we have to bring these costs under control. and when you mix that in with the horror stories that you hear

of 46 million people don't have health insurance, but when they get sick, where do they end up? the emergency room. they get that care at the most expensive place, and the rest of us pay, and that is a hidden tax on average in this nation. that hidden tax is $1,000 per family health insurance policy, and i can tell you in my state of florida, it's even higher. it's $1,400. so in florida, a family that has a group insurance policy, they're paying $1,400 more per year to take care of those folks that do not have insurance but end up getting sick, and the bill is paid by everybody else.

now, what i have just described is a system that is in tilt. it's not working. and the whole purpose of this bill is to try to make it work so that, number one, it's affordable, and number two, that health insurance is available. so at the end of the day, we're going to pass it, and at the end of the day, poor old harry reid, our majority leader, is going to figure out a way to get 60 of us to come down here to shut off the filibuster so that we can go to final passage and get it down into a conference committee in the house. and at the end of the day, after that conference committee comes back, we're going to get those 60 votes again because this is so desperately needed, despite

all of the supposed arguments that you hear on the other side. now, can this product be improved? of course it can. and i certainly want to share -- as i did in the finance committee -- an amendment that would cause the pharmaceutical industry to come up with some more money. they have pledged -- and to their credit -- and let me just say that billy tauzin, the head of the pharmaceutical association, he is smart, he knows what he's doing, and he's trying to play ball with the leadership and the white house, and i want the pharmaceutical industry to know that this senator appreciates that

because, with everybody else, like the insurance industry, trying to kill it deader than a doornail, at least they're helping. but, the pharmaceutical industry said that they were coming forth with $80 billion over ten years they were going to contribute. the hospital industry said they were going to contribute about $150 billion over ten years. and so forth. but, in fact, mr. president, the pharmaceutical industry is not contributing $80 billion. here is a morgan stanley analysis for investors of pharmaceutical stocks, their analysis of what's going to happen to the pharmaceutical industry in the future. and morgan stanley has said these guys are so smart, they're not contributing $80 billion. they're contributing only $22 billion.

why? because when they say this -- we're going to contribute discounts to allow half of this so-called doughnut hole to be filled, that means there's going to be a lot more drugs sold. and, oh, by the way, the bill takes medicaid from 100% to 133%. that's going to be a lot more drugs sold as a result of this bill. so the real loss -- or contribution, if you will -- of the pharmaceutical industry is $22 billion over ten years, not $80 billion. and that doesn't even include -- remember, they just raised their prices 9%, three times the rate of inflation. so they're going to make up a lot of that, anyway. well, what i want to plead with the leadership in the white house and the leadership of the

pharmaceutical industry, come back to your $80 billion real figure over ten years. and one way to get there is the amendment that i offered in the finance committee that was rejected on a nature revote of 13--- on a narrow vote of 13-10. out here on the floor, it is my intention to offer that amendment. i filed it. it would produce, according to c.b.o., $106 billion of taxpayer fund savings over ten years because the discounts would have to be there for the medicaid recipients that are entitled to discounts but now since they buy their drugs through medicare, they can't get those discounts because we changed the law six years ago in the prescription drug benefit. and that's just simply not

right. now, i'm not out here to try to punish anybody. i am out here to try to make this work and to get 60 votes, so we can go to final passage. but everybody has got to do their part, and everybody has got to contribute their part. and i look forward to the future discussions, as we close in on what probably is going to end up being -- the presiding officer: senator's time has expired. mr. nelson: -- the final passage of this, probably a week or eight days down the road. and i thank you, mr. president. mr. specter: mr. president? the presiding officer: the senator from pennsylvania. mr. specter: mr. president, the schedulers have allocated 15 minutes to me, so i would ask unanimous consent at this time that i may speak for up to 15 minutes. the presiding officer: without objection. mr. specter: i thank the chair. i have sought recognition to speak in opposition to the

ensign amendment. the authoritative statement on attorneys' fees has come from the national association of insurance commissioners in a document -- a 2008 document entitled "countrywide summary of medical malpractice insurance." and these are authoritative figures on how much the defense lawyers have taken and how much the plaintiffs' lawyers have taken, and it shows that the plaintiffs' lawyers on the state of the record are underpaid, paid less than defense lawyers; hardly the cause for an amendment to lower attorneys' fees even more for plaintiffs' lawyers. these are the statistics by the national association of insurance commissioners, as to the attorneys' fees.

the attorneys' fees for defendants were $2,110,000,000. the total recovery by plaintiffs was $4,090,000,000. calculated attorneys' fees at one-third would mean that the attorneys' fees were for the plaintiffs' attorneys $1,340,000,000, substantially under the $2,110,000,000 for defense attorneys. the attorneys who take on cases on a contingent fee do so because, unlike insurance companies which have the funds to retain lawyers on an hourly basis, most plaintiffs are

unable to pay attorneys' fees, do not have the capital to do so, and the arrangement is worked out that the fee will be paid by a share of the recovery. now, if there is no recovery, there is no fee. and beyond the absence of a fee, the plaintiffs characteristically cannot afford the costs of litigation. when depositions are taken or filings are made or various other costs arise, it is up to the plaintiff's lawyer to pay those fees and those are not reimbursed. an effort is being made now to have those deductions on an annual basis. the plaintiff's attorney can't even take them in thier when they are paid. so that if you see a situation where in absolute dollars plaintiffs' lawyers on

contingent fees are paid less than defense lawyers, and you have added to that the risk factor that the plaintiff's lawyer may get nothing, there should even be a greater compensation for plaintiffs' lawyers and defense lawyers, and as these statistics show, it is lesser. i have had experience -- most of my experience in the courtroom has been as a prosecuting attorney. but some experience working for a big law firm, represented the pennsylvania railroads, defendants; represented insurance companies. and in the firm practice on that kind of representation, there is frequently a senior lawyer or junior lawyer, an associate and a paralegal at multiple tiers running up the costs. most plaintiffs' lawyers do not have large firms. many single practitionering pra.

and postulate a situation where the fees would be cut even further is just not reasonable or not realistic. when the contention has been made -- just made by the republican leader, repeated earlier contentions -- that there are senators who voted in favor of the kennedy bill on liability reform, it is not so as represented. first of all, senator kennedy's bill in 1995 was a much different, much different bill. secondly, it was a tabling motion. and those who voted against tabling were willing to consider the issue, not that they agreed with what was in the bill. procedurally when there is a motion to table, if it's passed, the bill is off the floor.

if a motion to table is defeated, then the bill remains on the floor for consideration. but it does not mean to people who want to consider the -- that people who want to consider the bill are in agreement that the bill ought to be enacted. the issue of attorneys' fees and the issue of malpractice litigation have really -- really ought to be left to the states in our federal system. and pennsylvania, my state, is illustrative of the way state governments can handle the issue and deal with it to avoid excesses. in pennsylvania, there was a rule change made to require that before a malpractice suit could be brought, there had to be a certification from a doctor that the case fell below applicable standards of care.

a second major change was made which required that the medical malpractice action be brought only in the county where the cause of action took place. and that was a move aimed at eliminatineliminating so-callede shopping, to go a have e venue e there is likely to be a better result. and as a consequence of these two rule changes, the number of filings in pennsylvania dropped dramatically. with a comparison of the years 2000 to 2002, it was noted that the rates dropped by more than 37% in 2003, continued to decline in every succeeding year, and in 2008 had dropped 41.4%.

the improvement in the picture was further illustrated by the fact that the reforms resulted in the reduction of premiums on malpractice insurance. these reductions are in sharp contrast to 2002, when one leading carrier increased its rates an average of 40% and a second leading carrier increased its rates by 45%, and then the rates had been decreased consistently in ensuing years. other indications of the success of pennsylvania was the renewed interest by companies that want to sell medical malpractice insurance in pennsylvania. 57 newly licensed entities are

now writing medical malpractice coverage since april of 2002. now, this is illustrative of the way the states can deal with this issue. and it ought to be left to the states. interestingly, the senator from nevada, who has proposed this amendment, has filed legislation this year -- senate bill 45. and in senate bill 45, he has a different approach. he allocates for some recoveries up to 40%. and why there is a difference now -- kind of gets back to 33% and then down to 25% is unexplained. so, mr. president, when an amendment of this sort is

offered on a bill for comprehensive health care reform, it is not germane to the issues before the senate. the standard of being germane means whether there's any provision in the bill now which relates to this matter. had this really been a serious effort to get legislation, the process and the course to be followed would have bin considerably different. -- would have been considerably different. the way to get legislation enact enacted is not merely to come before some bill and offer it without hearings before the committee of jurisdiction, without the consideration of witnesses. there have been no hearings on the amendment offered by the senator from nevada. had there been hearings, we would have been in the position to make a determination as to what are the real facts.

are the fees collected by plaintiffs' attorneys on a contingent basis excessive? what is the reality for the justification in terms of the time it takes? and the expenses involved? but no request was made, to my knowledge, for a hearing before the judiciary committee which has jurisdiction. i do know that no hearing was held so that we do not have a factual basis for really making an evaluation of this amendment at this time. it is my hope, mr. president, that we will move from this amendment and take up the issues which are in dispute. we need to eliminate and reject the false rumors which have been

advanced. the contention has been made that there would be death panels as a result of this bill. i think that has been thoroughly debunked. there has been a contention that there would be cuts in medicare. we argued an amendment a few days ago on the contention that there would be very substantial cuts in medicare. aarp opposed that amendment because it was fallacious, it was untrue. aarp is an outstanding guardian of the interest and rights of senior citizens and aarp opposed that amendment. the contention has been made that there will be a government takeover of medical care, which has also been disputed and pretty well disapproved. when the government option is offered, it is just that, and i

believe america would be well served by having a robust public option. but the option is nothing more or less than what it says. it is one alternative. and private insurers would still be in the picture. there have been repeated contentions that there will be an increase in the deficit. president obama has pledged not to sign a bill which will add to the deficit, and i am pledged not to -- and i have pledged not to vote for a bill which will add to the deficit. when you take a look at what this bill will accomplish, there are very, very substantial savings in the -- in the current costs of medical care which is is $2,400,000,000,000. and i'll be specific in what they are. with annual examinations available and incentives for people to take annual examinations, there will be

catching what could turn out to be chronic ailments. very disabling, very, very expensive. catching a problem with a cardiac issue, with a heart problem, or catching breast cancer at an early stage or catching a hodgkin's at an early stage. and i speak with some experience about this issue. it will cut down medical expenses tremendously. when there are advance directives, there will also be additional savings. this bill provides for counseling for people who want to know about advance directives. no one should tell anyone else what they ought to do about end of life medical care, but i think it is fair to say consider it, make a decision, have a living will, do not leave it to the last minute when someone is rushed to the hospital and the burden then falls on family

members. estimates range as high as 27% of medicare costs in the last few days, few weeks of a person's life. there are also very substantial savings available for changes in lifestyle. safeway has demonstrated lower insurance premiums for people who stop smoking, lower insurance premiums for people who have lower cholesterol, so that is another major area of savings. an additional area of savings would be to change the current approach of having fines imposed for medicare -- i ask for 30 additional seconds, mr. president. the presiding officer: without objection. mr. specter: currently the criminal justice system results most of the time in fines, and that is totally ineffective, but if there were jail sentences imposed, that would be a

deterrent to others, something that i learned years ago as a prosecuting attorney. and i think we can also come to terms on the abortion issue, allowing women to pay for abortion coverage in their medical care. no reason they should decide in maintaining the principles of the hyde amendment with no government payment for abortion services. i thank the chair and yield the floor. the presiding officer: the senator from illinois is recognized. mr. durbin: mr. president, i want to thank the gentleman from the commonwealth of pennsylvania for his opening remarks because he has addressed an issue relative to a spending amendment offered by the senator from nevada, and he makes no -- note of a very critical flaw in this amendment. the senator from nevada is restricting the ability of the victims of medical malpractice to go to court to recover by

restricting the attorneys' fees that can be paid, contingency fees, because people usually don't have enough money to buy an attorney, an attorney takes the case and says if i win -- if you win, rather, then i get paid. if you lose, i don't get paid. contingent fee basis. so the senator from nevada is restricting the ability of these attorneys to represent plaintiffs, victims, on a contingency fee basis but doesn't restrict the defense attorneys and the amount that they're paid. as the senator from pennsylvania just noted, the record is clear. the amount of money being paid to defense attorneys in medical malpractice cases is 50% higher on an annualized basis than that that is paid to those representing victims. the motive -- i won't question the motive of the senator from nevada, but the effect of his amendment is to reduce the likelihood that an injured victim will be able to go to court and be represented by an

attorney to make their claim. now, i think our system of justice has a courtroom and jury and judge there to make that final decision, and what the senator from nevada does is preclude and reduce the possibility that victims can recover. how many people die each year in america from medical malpractice? the institute of medicine told us ten years ago the number was 98,000 people a year die from medical malpractice. many more are injured because of medical malpractice. how many lawsuits claims are successfully filed each year in america for medical malpractice? for injuries and deaths? about 11,000. a very small percentage of the actual victims of malpractice go to court. it just doesn't happen. those who try to go to court are usually not rich people, and so they do it on a contingency fee.

so what the senator from nevada is trying to do, unfortunately, is close the courthouse door to favor the defense of a malpractice case over the victim, and that, to me, is unfortunate, and i hope that we are successful in defeating it. for those who were following the proceedings of the senate today, either in person or through c-span, it is unusual -- not unprecedented, but unusual meeting on sunday that we would come together, but it is appropriate that we would do something extraordinary when you consider the matter at hand. this twowp -- this 2,000-page bill is the health bill that has been in the works now for a year. it has been considered by three committees in the house, two in the senate. the presiding officer from new mexico has the dubious distinction of having been privy to all of the senate committee proceedings and some extraneous proceedings, so he has probably been subjected to more debate on

this issue than any other member of the senate. i will tell you that a lot of hard work has gone into this bill. some of the critics of the bill say well, it's just too long. there are too many pages in the bill. when you consider that we are tackling our health care system in america, which comprises 1/6 of our gross domestic product, one out of every six dollars spent in america, it's understandable that we would need to work carefully and try in a comprehensive way to address all the issues. so what does this bill do? first, it's historic in that it moves us toward 94% of american people having health insurance. today about 50 million people don't have health insurance in america. that's not counting the people with bad health insurance. these are people who have no health insurance. some have lost their jobs. some work for businesses that can't afford insurance. and some just can't afford to buy it themselves, 50 million of

them. 30 million of those are going to move toward coverage in this bill. it will be the largest percentage of americans with the security of health insurance protection in our nation's history. that's what this bill does. secondly, this bill makes health insurance premiums more affordable. for over 80% -- some say over 90% of the people in america, they will see either a reduction in premium or a slowdown in the rate of growth in health insurance premiums. that's something that is absolutely essential, because health insurance premiums are breaking the bank. ten years ago, the average health insurance plan for a family of four costs $6,000 a year. $6,000 is a lot of money. $500 a month. that was ten years ago. now it has doubled. the average is $12,000 a year. $1,000 a month for a family of four for health insurance coverage. that's the average. to work and earn a thousand

dollars a month strictly for health insurance. what's the projection in eight years? that it will double again to to $24,000. that you will be working and earning $2,000 a month just to pay for health insurance. that's unaffordable for so many people. that's why that's one of the highest priorities in this bill. the third thing this bill does is to give people across america a fighting chance against the health insurance companies. these private insurance companies are some of the wealthiest companies in america and pay the highest amounts to their c.e.o.'s each and every year. what we are trying to do is to make sure that they don't turn down people when they need help the most. too many of these insurance companies, as has been noted on the floor many times, raise the issue of pre-existing conditions and say well, we're not going to cover that particular surgery or that particular drug because you had a pre-existing condition you didn't disclose. they gaimed the system against the person who is sick. that's going to change.

this bill will provide for coverage despite pre-existing conditions, and we won't allow the insurance companies to assert a limit, a lifetime limit on what they can pay. you know what happens? you get seriously ill and they cut you off. what's happening today is that two out of three people who file for bankruptcy in america today do so because of medical bills, bills that he can't pay. that tells you that the number of people facing this threat is huge, but even worse is the fact that some 70% or 74% of those filing bankruptcy already have health insurance. it turns out the health insurance wasn't worth much when they really needed it. the last thing this bill does, and one of the most important things, is it doesn't add to the deficit. president obama told us to do this job but don't make the deficit worse. so the congressional budget office, which is the referee and umpire when it comes to the cost

of bills, came back and said our bill will actually reduce the federal deficit by $130 billion over the first ten years and and $650 billion over the next ten, bringing down the costs of health care brings down the cost of government health programs, and so it saves us money. saving families and businesses money, saving the government money. it is the largest deficit reduction bill ever considered by congress, and it's before us now. now, it's no surprise we heard this morning from the republican senate leader and we have heard before that there are those who are arguing that this is a dangerous bill, and this bill should not be passed. i asked my staff to do a little bit of work on previous debates right here on the floor of the united states senate and what was said. in 1934, when congress was considering the social security program which gave everybody a basic retirement plan, an

insurance plan for retirement, even after the social security bill came to the senate floor, not including health insurance, a republican senator from delaware, daniel hastings, said on this floor about social security i fear it may end the progress of a great country. a congressman from the state of new york, james wadsworth, in the same debate over social security said that the package of social security opens the door and invites the entrants into the political field of a power so vast, so powerful as to threaten the integrity of our institutions and to pull the pillars of the temple down upon the heads of our descendants, end of quote. we know that when former senator from ohio robert taft was addressing the effort by president harry truman to have universal health care in america, he said, and i quiet -- "i consider it socialism." it was used against lyndon

johnson, that same charge was used against bill clinton. it's virtually being used today. when we hear the republicans who are opposing this bill come to the floor, i have a basic question to ask them -- we have been at this debate for a year. where's your bill? what do you want to do? oh, they tell us we have some bills and you're going to see them any day now. well, i'd like to. i'd like to see the comprehensive health care reform bill from the republican side of the aisle. this is ours and it has been on the internet for two weeks for everybody in this nation to read word by word, line by line. sadly, there is no republican bill. i know there are two possible reasons for that. this was hard work. this wasn't easy, politically or otherwise, and they have not engaged in that hard work. what we've seen are press releases and speeches, graphs and pictures, but no bill. no comprehensive health care reform bill from the republican

side. secondly, there are many on that side of the aisle who like this system of health care. they agree with the health insurance companies. let's keep it the way it is. but americans know better. we're going to go to work today in the senate on this bill, as we should. while we're working today, 14,000 americans are going to lose their health insurance. 14,000 lost their health insurance yesterday and 14,000 will lose it again tomorrow and every single day of the year. that's how many people, despite their best efforts, lose the coverage. we've got to stop that. it's time for us to provide the kind of peace of mind that every single family deserves in america when it comes to quality and affordable health care. and i yield the floor. mr. casey: mr. president? the presiding officer: the senator from pennsylvania is recognized. mr. casey: thank you, mr. president. mr. president, i rise this afternoon now to speak about the amendment that we're going to be voting on later today -- or one

of the amendments we're going to be voting on later today. as we stand here today, we're debating the bill before the floor -- on the floor, the health care bill that -- where we're trying to do a couple of things at one time, and i think we can and i think this bill does it, even though we'll make some changes to it. we're trying to improve the quality of care for americans, whether they get their care heah care through a public program or a private insurance company or private plan. we're trying to finally use preventive measures to make people healthier and have better health outcomes. we're also working to reduce costs. and if you wanted to talk about it in terms of a doctor and a patient or a health care system and an america who should benefit from a health care system, we basically want to have the people get the care they need from the doctor they choose. and what what we are engaged in now is a debate about an amendment which the other side says is about the fees going to

trial lawyers. that's the way they like to talk about it, and i know that's popular. it's always good to have a -- when the other side makes an amendment like this, they like to have a target so their target is a trial lawyer or trial lawyers. but unfortunately for this debate, i think it's misleading because this amendment that i would urge people to vote against is not about lawyers, it's about victims and whether or not we're going to ensure that victims have a shot, a fair chance when they have a claim for medical negligence when they've been injured as a result of negligent conduct. i said before we're debating the health care bill and we're talking about costs. this amendment will do nothing to lower costs. what it will do is not really lower anyone's costs. what it will do is increase th

the -- the cost or the -- the burden that a claimant has to -- has to bear when they have a claim against any kind of health insurer -- hospital or doctor in the case of a medical negligence case. so the question is: are we going to enable people who don't have the means to bring cases versus very powerful interests or not? that's one of the basic questions we'll answer with regard to this amendment. now, i would hope that if a member of my family or any family -- and i think this is true of everyone in this chamber -- if a member of your family was the result of medical negligence and had to bring a claim, you would hope that that individual could walk into a

courtroom or -- or file a claim with someone who has the skill and the ability to be their advocate. because i'll tell you one thing, they are going to be up against a very powerful interest, insurance companies, who write medical liability policies. an incredibly powerful interest. and a lot of us come at this question through our own personal experience, through the only -- the experience of our families. i had a -- a grandfather that i never met, my father's father, alphonses casey. he was like a lot of people in northeastern pennsylvania, as young kids, went into the coal mines at a very young age, worked as a mule boy. and one of the days he was tending to the mules in that mine, just as a kid -- 11, 12 years old at the time -- he was kicked by the mule and he got a scar that started above his head -- above his eye browrks et

across his face, split his lip and went down one side of his chin. so he understood injury as a child, injury in the course of working. and so i think he also understood that when he became a lawyer many, many years later, well into his adulthood, he understood what it's like to suffer an injury and to -- to make a claim for an injury but but what he did was represent injured workers. that was his law practice. i wonder what he would say if he were here talking about what happens to victims when they're the -- when they have a -- an injury that they want redress for. now, on -- just like on so many other things here in this deba debate, i think the other side of the aisle's carrying water for the insurance companies. just my opinion but i think that's the case. and yet in the case of medical negligence and what happens in the real world, we know that 98,000 deaths a year are from

preventable medical errors. let me say that again. 98,000 deaths in america, according to the institute of medicine, 98,000 deaths a year are from preventable medical errors. so what this amendment does is deny patients the attorney of their choice. it further restricts access to the courts. it drives up costs for victims. and we talk about bringing a case and the barriers to doing that, that isn't some future result of this amendment only. i think that will -- this amendment will make that problem a lot worse. but right now, no matter what happens in this debate, no matter what happens in this -- on the vote on this amendment, there are barriers right now for people to bring a lawsuit. it costs in many cases thousands, if not tens of thousands, to bring a case and

then to see a case all the way through costs a whole lot more than that. what are we talking about here? we're talking about allowing someone who has a claim for a serious injury to go to see a lawyer and to sit down with that lawyer and enter into an agreement for the fee, whatever that fee will be, whatever that will be. and if -- if that lawyer and that person, that patient or victim, goes forward with the case, they bear a risk. they -- the victim bears a risk that they won't be successful and that at the end of that, they will have no recovery at all. but because of the way the contingent fee works, the lawyer bears the risk as well. he or she will not be paid and has -- stands a risk also of having to -- to pay for costs that the victim can't pay and the lawyer will bear the costs -- bear those costs throughout the pursuit of that case. so here's what we're talking about. it is basically about -- a

debate about victims and whether or not they're going to have the kind of representation they ne need. now, if you were going in to have surgery in a hospital, i would hope that the surgeon would be someone of the best -- of the highest skill possible. i would want the best surgeon as i take on that battle. anyone would. and i would hope that we would not do something in this debate to injure or to reduce the chances that a -- a victim of medical negligence can't go into a courtroom or can't file a claim without the best, most highly-skilled person, lawyer that they can find. i would hope we would not want to do anything that would injure that basic right. and it's -- it's interesting. this amendment applies only to patients. it doesn't apply to anyone else. patients who become victims of medical negligence.

and i would say in conclusion, just in terms of what happens in our states, states regulate the conduct of lawyers. they do it all the time. but they also -- we also have evidence to the state -- from the states about what happens in these kinds of cases. in pennsylvania, for example, in most counties in our state, cases going to trial in medical malpractice claims, those kinds of lawsuits in most counties in pennsylvania, 90% -- 90% of those cases are won by the defense, won by the insurance company. that's their -- that's the evidence in pennsylvania. so i know we have others who are ready to speak on this amendment and others, but i think we should make it very clear, this is a debate on this amendment about two parties: victims of medical negligence versus insurance companies. and it's time to choose up which side you stand on. unfortunately, this amendment is

very clearly drafted and intended to help insurance companies, not victims of medical negligence. amendment. mr. president, i yield the floor. the presiding officer: the senator from texas. mr. cornyn: mr. president, the president of the united states is reportedly traveling to capitol hill to meet with senate democrats here in just a few moments. unfortunately, republicans are not invited, which is really a -- follows an established pattern here, where notwithstanding the -- the public statements that republican ideas are welcome, they've been rejected at every stage of the development of this 2,074-page bill. party-line votes in the health, education, labor, and pensions committee, in the finance committee, every -- virtually every republican idea rejected. so the president's coming to rally our democratic friends to basically do it a may way or the

highway sort of thing. they're going to, of course, tone 1,000%. and i think it's perhaps very timely to recall some of the president's promises, because, frankly, if the president follows the promises he's made to the american people, he won't be able to sign this bill or anything like it. first of all, talking about transparency, he said, "we're going to have negotiations around a big table." we're going to have it on c-span so people can see who's making arguments on behalf of their constituents and who's making arguments on behalf of the drug companies or the insurance companies. but the reality is that this bill was merged between the -- the finance committee bill and the "help" committee bill merged behind closed doors with only three senators present, and they're -- presumably there's staff. another promise the president made, he said, "the plan i'm announcing tonight" -- this is i believe during the joint session of congress that we all

attended. he said, "the plan i'm announcing tonight will slow the growth of health care costs for our families, our businesses, and our government." this is a pledge the president of the united states made to the american people. because that was his stated goal for these -- for this bill. we see something very different in this 2,074-page bill, a different reality. we see that premiums for those in the individual market, families, will be increased by 10% by 2016, according to the congressional budget office. you don't have to take my word for it. it's not some insurance company talking. this is the congressional budget office. businesses who fail to comply with this job-killing -- with the job-killing mandates in this bill will face additional taxes of $28 billion, yes, during a recession, when unemployment is at 10%. that's according to the congressional budget office.

taxpayers will see federal outlays for health care coverage increase by about $160 billion over ten years. and here's from the dean of the harvard medical school, he said, "in discussions with dozens of health care leaders and economists, i find near unanimity of opinion that whatever its shape, the final legislation that will emerge from congress will markedly accelerate health care spending." "markedly accelerate health care spending." so much for bending the proverbial cost curve. and then there is this promise. another solemn promise. the president said, "i have made a solemn pledge that i will sign a universal health care bill into law by the end of my first term as president that will cover every american" -- this bill obviously does not -- and it will cut the cost of a typical family's premium by up to $2,500 a year." as i mentioned, under the

congressional budget office score, the average premium for families in the individual market will go up by $2,100, not go down by $2,500. another promise made that will not be kept if this bill is passed into law. and then the president talked about deficits, and there's been a lot made over this bill being so-called deficit-neutral, which, of course, means if you cut enough benefits for seniors and you raise taxes enough on everybody else, you can produce a deficit-neutral bill. but this bill will spend $2.5 trillion over the next ten years after full implementation. well, president obama's own chief actuary at the center for medicare and medicaid services called the ability to sign a bill like this without raising the deficit unrealistic and doubtful. david broder, the dean of the washington press corps, said while the c.b.o. has said that

both the house-passed bill and the one reid has drafted meet obama's tests for being budget-neutral, every expert i've talked to says that the public has it right. these bills as they stand now are budget busters. and then there's the promise of choice. the president said, the american people ought to have choice when it comes to health care, choice of their doctors and health plans. but the fact of the matter is, this bill would consign 60 million americans to a health care gulag called medicaid. i say that because although medicaid provides what some people would say is coverage, it certainly doesn't provide access. in the met spro plex of texas, the dallas-fort worth area, only 15% of doctors will see new medicaid patients because of medicaid's low rates. and then there's this claim that it won't raise taxes. well, the joint committee on

taxation caidz tha indicates thf the people earning less than $200,000 a year will see a tax increase under this bill. in other words, this is another promise the president made that will be sphrieltd this bill is passed into law -- that will be violated if this bill is passed into law because taxes will go up for 38% of the people. and it -- as a matter of fact, out of that 38%, 24% of them will experience a tax increase even after taking into account the premium tax credit that is being paid under this bill. another promise made. another promise that cannot be kept if this bill becomes law. and then there's this one. the president said, "so don't pay attention to the scare stories about how your benefits might be cut that. will never happen on my watch." he said, i'll protect medicare. well, we've seen time and time again, dr. elmendorf, the head of the congressional budget

office, who said that medicare's managed care plans would see reduced benefits. i'm sorry, that's -- that's th the -- according to cbs news. but here's the chief actuary who said, "providers might end their participation in the program possibly jeopardizing access to care for beneficiaries." dr. elmendorf was the one who said you would see the additional benefits that seniors get under medicare advantage cut by about half. another promise made. another promise broken. if this bill becomes law. and then there's this one. this pe pertains to the ensign amendment that's pending on the floor. the president said, "i want to work with the american medical association so we can scale back the excessive defensive medicine that reinforces our current system and shift to a system where we are providing better care simply rather than simply more treatment. so this is going to be a priority for me." well, if this is a priority for the president of the united

states, it's apparently not a priority of those who've authored this bill, because all that's contained in this bill is a nonbinding sense of the sena senate. we've heard that medical liability reform laws like those that have been passed and implemented in texas, if passed nationwide in this health care reform bill could bend the cost durvcostcurve by $54 billion ovn years. and yet all we get is a watered-down sense of the senate that has no binding effect at all. mr. president, if the president was sincere about making those promises to the american people, then this congress ought to be sincere about helping him keep that promise. and the fact of the matter is, time after time after time after time again, this bill breaks the promises that president obama made to the american people. it's not too late to change that and i hope today when he meets

with senate democrats behind closed doors, to the exclusion of republicans, that there will be some discussion of, mr. president, how can we help you keep those promises to the american people you can watch a video on demand, see town hall meetings, and president obama's speeches. also, see the latest ads, links , and twitter. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> on december 7, 1941, a surprise attack on pearl harbor left americans dead. the national park service has been collecting stories about

the day. here is one. >> i was a crew member of utility squadron t2. i had the duty and was actually at the hangar at the time, so i was ready to muster the section. we thought a plane had crashed, so we ran out of our hangar. we see this smoke coming up from the hangar, and we still did not know what was happening. about that time, here comes the plane. they dropped two bombs, and it pulled out. we knew we were being attacked for the japanese. i started looking for a place to hide. we did not have any bomb shelters, but here comes the

japanese plane flying from south to norrith on the west side of e island. i could see the goggles on his helmet as he swings his machine gun around. i looked around, and the splattered concrete with dust. i jumped behind this tractor. that gave me the protection i needed. >> if you would like to see extended interviews with survivors of the attack on pearl harbor, go to c-span.org. tonight, malcolm live well, best-selling author and writer for "-- now come