people who might have coverage but it's hard for them to afford it or to continue to afford it. and sometimes people have coverage and it's not of the kind of quality that would ensure the best health care for them and for their -- for their families. so, really, we're at a point now where we're beginning to see a basic choice that the congress has to make and the american people have to make. it's the status quo or change. it's the status quo, where we are now, which, in my judgment, is unacceptable. that status quo or reform. it really is coming down to basic fundamental choice. the status quo right now is the enemy of change. the status quo is the -- is the impediment in front of us. the tree across the road or whatever image you want to -- whatever image you want to illustrate it. so we have to get to work making sure that the status quo doesn't stay in place. and there are so many ways to tell this story. every member of the united states senate and every member of the house and, frankly, virtually every american could tell a story about someone they know or someone they've

substantial investment in the national health service corps that will make medical training more affordable for primary-care doctors and nurse practitioners so they are not drowning in debt when they enter the workforce. [applause] somebody back there is drowning in debt. [laughter] the second structural reform need to make is to improve the quality of medical information making its way to doctors and patients. we have the best medical schools, the most sophisticated laboratories, the most advanced training of any nation in the globe. yet we're not doing a very good job harnessing our collective knowledge and experience on behalf of better medicine. less than 1% of our health care spending goes to examining what treatments are most effective. less than 1%. even when that information find its way into journals, it can take up to 17 years to find its way to an exam room or operating table. as a result, too many doctors and patients are making decisions without the benefit of the latest research. a recent study found only half of all card the guidelines are based on scientific evidence. half.

so, how is it that we are going to afford the uninsured access to affordable coverage?he tenet that we are operating on and our plan is based around is we want to provide access to a basic plan for all americans and to coverage in terms of a basic plan. we do so by making sure we keep down costs and incorporate the ability for folks to pull together, to ago ses lower costs -- to access lower costs and bring private sector that the game and keep government out. i applaud the thaefrts have resulted and work forward to working with president obama, speaker pelosi, to make sure we do arrive at a consensus so we can have some healthcare reform in this country. >> thank you, eric. we have had a hard-working group and it continues to work to be part of this debate and part of the solution, the healthcare solutions group hopes to be exactly that. and republicans in the house are for a health care plan that is more affordable, that everyone has access to regardless of any preexisting condition they had with a renewed focus on quality and the doctor-patient relationship. democrat

the one affordability. one of the reasons why am excited about this plan is that i have a large number of people who are 65 -- 55 - 64. they start to have some health problems. this offers them availability and affordability. they will not have to wait until they are 65 to get medicare. there are additional fixes in the bill that would increase funding and availability of qualified health centers which are of great resources in the majority of districts that are very low-cost health care insurance, part of the solution. doctors are warning their patients about what is going to happen, because they see the obama plan is not going to work for the patient. in this bill, we protect the doctor-patient relationship which is so important. >> as a heart surgeon with over 20 years of experience dealing with some of the most critically ill patients with lung and heart surgery's, i have seen the sickest of the sick in america. i have dealt at the heart of the problem where we deal with the doctor-patient relationship.

more affordable options.y want to make it possible for people who cannot get any health care to get affordable health care. we have the same goals, adjusted for ways of achieving them. host: will health care benefits be a taxable benefit for americans? guest: that is certainly under discussion in one of the committees. the president has said all along that he is skeptical of any plan that would tax the health care benefits that you get from your work because he wants to build a health reform upon the existing, employer-based system. they call it the tax exclusion, that is, not taxing health care benefits. that is an important part of that -- that employer-based system. he prefers a proposal that would repeat -- that would give a return of itemized deductions for the wealthiest americans. he thinks this is a very id -- a good idea and has spoken to members of congress about it many times. this is the idea that the president prefers. host: steve is on the phone from robert p., and mexico -- albuquerque, new mex

access is affordability. we understand that we have a responsibility to treat all of our policyholders fairly and i assure you we take this responsibility very seriously. unfortunately for a variety of reasons some people choose not to purchase individual health insurance until they have a significant health the event. this decision not only has the financial impact on these families but raises the cost of healthcare for everyone. as you know the practice of precision has long been recognized by the laws of virtually every state. precisionism common but unfortunate and a necessary recourse in the event of material in times of fraudulent misstatement or omission on an application. under our current reeves system failure to act on these cases is fundamentally unfair to those working families that play by the rules. because it severely, it would severely limit our ability to provide quality and affordable health insurance. inner riff and we determined it is necessary to rescind coverage and after a thorough inve

the nation's -- afford. the nation's health care costs are $7,400 for every man, woman and child in this country for a total of $2.4 trillion. we spend 15% of our gross domestic product on health care in 2006, the highest country by far. switzerland which is number two, spends 11%. the average of the eced nations is 8.5%. we spend approximately twice as much. as the industrial nations of the world spend on health care. we don't have the results to warrant this type of expenditure. of the 191 countries ranked by the world health organization we are ranked 37th on overall health systems' performance behind france, canada, and chile, just to mention a few. we rank 24th on health life expectancy. and we ranked number one, by far, on health care expenditures. between 2000 and 2007 the median earnings of maryland workers increased 21% yet health insurance premiums for maryland families rose three times faster than the median earnings of that same time per. so we can't afford the cost of health care in america. it

so long as we provide -- so long as we provide a hardship waiver for those who still can't afford its we move toward this system. the same is true for employers. while i believe every business has a responsibility to provide health insurance for its workers, small businesses that can't afford it should receive an exception. and small-business workers and their families will not be able to see coverage in the exchange if their employer is not able to provide it. now here's some good news. insurance companies have expressed support for the idea of covering the uninsured. and they certainly are in favor of a mandate. i welcome their willingness to gauge constructively in the reform debate. i'm glad they are at the table. but what i refuse to do is simply create a system where insurance companies suddenly have a whole bunch of more customers on uncle sam's dime, but still fail to meet their responsibilities. [applause] >> we're not going to do that. let me give you an example of what i'm talking about. we need to end the practice of denying coverage on the basis of pre-existing condition

making health care affordable for all americans will cost somewhere on the order of $1 trillion over the next 10 years. that's real money, even in washington. but remember, that's less than we're projected to have spent on the war in iraq, and also remember, failing to reform our health care system in a way that genuinely reduces cost growth will cost us trillions of dollars more in lost economic growth and lower wages. that said, let me explain how we will cover the price tag. first, as part of the budget that was passed a few months ago, we put aside $635 billion over 10 years in what we're calling a health reserve fund. over half of that amount, more than $300 billion, will come from raising revenue by doing things like modestly limiting the tax deductions the wealthiest americans can take to the same level it was at the end of the reagan years. same level it was under ronald reagan. some are concerned this will dramatically reduce charitable giving, for example, but statistics show that's not true. and the best thing for our charities is the stronger economy that we will build wi

but affordable health coverage for all americans is an essential. we owe it to our citizens to bring about the change that we need so desperately. if chairman kennedy were sitting in this chair, i wish he were, i know he would be saying let's roll up our sleeves and get to work. so we have to do that. the bill we're marking up today is a product of a year's worth of work by committee members on both sides of the proverbial political divide and decades worth of study, of advocacy, of experience on the part of health care providers, patients and experts, who input -- whose input we are all very grateful for. what began this process, we started on a blank page, so to speak. we heard each other's ideas and put them on paper. and throughout this process we have incorporated many different viewpoints and strove to find consensus wherever we could. with this bill, the affordable health care choices act, i believe we will. we want to protect people's choice, and not to mandate choice and doctors and hospitals and insurance plans. we want to reduce costs obv

real reform will be affordable for our nation and for our taxpayers. it will reduce current costs and bring the rate of health care, inflation in line with economic growth. failure to meet this test would result in massive new government obligations without means to pay for them. mr. president, real reform must end the health care caste system in which low-income americans are treated as second-class citizens. no longer should low-income americans have less access to doctors than their member of congress or other americans. today 37 million adults and 10 million children effectively lack access to primary care physicians. those are americans who have health insurance but who cannot find a doctor to care for them. real reform means ending the caste system in america that, in my view, discriminates against the most vulnerable and most impoverished among us, and it means with reform they will be able to get a doctor when they need to see one. real reform rewards americans for making smart choices. americans ought to be rewarded for choosing the right insu

[applause] every plan should include an affordable, basic benefits package. if you cannot afford one of these plans, we should provide some assistance to make sure that you can. [applause] i also strongly believe that one of the options in the exchange should be a public insurance option. [applause] the reason is not because we want a government takeover of health care. if you have of private plan that works for you, great. but we want some competition. if the private insurance companies have to compete with the public auction, it will keep them honest and it will help keep their prices down. [applause] now, covering more americans is obviously going to require some money of front. we will save money when they stopped going to the emergency room for regular checkups, but it will cost some money up front. helping families lower-cost -- there will be across to this. it comes a time when we do not have a lot of extra money to spend. let's be honest. when i came in, we had a 1.3 trillion dollars deficit. with the economic recession we are born free, tax revenues

they know that were it not for medicare, they couldn't afford health insurance. people live a whole lifetime without health insurance protection, finally when they hit age 65, they have medicare. and they thank the lord for that day. and medicare does a great job. medicare is a proven success for over 40 years medicare has provided quality care to america's seniors and disabled and we have seen the longevity, the life expectancy of seniors increase every year and their independence increase because they don't end up with a mountain of health debt to pass on to their children or to exhaust their savings. if the senator from ken kennedy the senator from arizona want to come to the floor and argue against medicare, i welcome the debate. want to be here on -- i want to be here on the floor when they say that that govert

because it is a guaranteed, affordable option that can travel with an individual from job to job. a public health insurance option would make a tremendous different to our small business owners who face crippling health care costs while trying to keep their business open. madam president, health care reform cannot wait. the president has said that he wants a health reform bill on his desk by this fall and i will work hard with my colleagues to make sure we send him a good bill that good bill that guarantees every american high quality affordable health insurance and includes a strong public health insurance option much after so many years of delay and inaction, now is the time to act. madam president, i yield the floor and suggest the absence of a quorum. the presiding officer: will the senator withhold? golmr. feingold: i withhold the request on the quorum call. mr. gregg: madam president? the presiding officer: the senator from new hampshire. mr. gregg: did the chairman wish to speak? mr. inouye: i'll speak after you. mr. gregg: i'm happy to yield to the chairman if he wishes to

we can't afford this. we can't afford to be distracted from the cap and trade they are trying to do tomorrow. i'm very, very, very worried. that's it. guest: thank you from richmond. i share the concern that we are seeing an administration that lacks the focus on the number one priority we need to be about right now. and that is getting this economy back on track. host: is a health-care part of the comet? guest: sure, it is part of the economy. but if you don't have jobs, the way this health care system works, you are not going to have health care coverage because most people, as we know, get their health care from their jobs. in fact, 77% of americans. we ought to be focusing on, number one, the jobs. and, number two, if health care will be the cost factor in terms of businesses out there, we need to address and we need to implement reform because if we don't, you will have businesses exiting the business of providing health-care coverage and then we will end up exactly where we don't want to end up, whic

thirdly, the affordable health choice act ensures quality, affordable care. we know the numbers.y one estimate by 2025 at our system will cost us $7 trillion from where and is now at about two and half are close to two and have. next we're going to build on the system have, no reason to dismantle the system we have but we do have to build it. senator brown's and we have to fix what is broken in keeping works. we will protect the doctor patient relationship. and we will at long last for tricia urban and other people cover pre-existing conditions. unfortunately for her it is far too late because of her loss of her husband andrew. i wanted to talk about two other major issues went into a about another constituent. one is that we should have in my judgment a public auction like medicare. and when i think a public auction i think of two words, a lot to talk about and not enough time in opening statements but i think of choice and competition. but we really want competition we should have that in the bill and have that in the final bill that we work on. and we ought to give people a ch

small businesses who cannot afford it should receive a small exemption. small-business workers and their families will be able to seek coverage in the exchange if their employer is not able to provide for it. here is some good news. insurance companies have expressed support for covering the uninsured. they are in favor of a mandate. i welcome their willingness to engage constructively in reform debate. but what i refuse to do is create a system where insurance companies suddenly have a whole bunch of more customers on uncle sam's dime but failed to meet their responsibilities. [applause] we are not going to do that. [applause] let me give you an example of

we want a health care plan that you can afford. we want a health care plan your government can afford so your children don't get a big debt piled on top of them. and we want to make sure that the uninsured are covered as well. we want to make sure on this side that washington doesn't come in between you and your doctor. in other words, you and your doctor make the health care choices, not some washington bureaucrat who might cause to you wait in line or deny treatment that you and your doctor think is needed. so how does the senate bill that we're working on stack up with the president's ideas that we should cover everybody, be able to pay for it, and allow people to keep their insurance? well, i'm very disappointed to report, madam president, that according to the congressional budget office, which is a nonpartisan agency in the congress, and the congress of course is majority democrat by a large margin, has given us some very disturbing information about the bill we're working on in the health committee, a place i'm about to go i

and that care will be affordable to them. and it provides an important safety net through the medicaid program by establishing a floor on eligibility of 133% of the federal poverty level. mr. andrews and mr. scott were talking earlier about the kind of cost shifts that take place when people don't have coverage. and we released a study that the president cited last week that showed that in 2008, the cost shift, the hidden health tax if you will, for those who have coverage to pay for the uncompensated healthcare costs of theéí uninsured in 2008 was $1,017h0ñ and i would suggest t this year it's considerably higher because more people lost their jobs and in the process Ñ÷ñ their healthcare. it's probably closer to $1100. this plan also ends insurance company discrimination. you no longer can be denied coverage due to a preexisting condition. when you get coverage you're not going to have a loophole so that everything is covered other than your preexisting condition. it means that insurance companies are not going to drop you

those -- afford to make those payments to the doctor or to the hospital. this is the moment when families and small businesses and large businesses are coming together to paint a new vision to improve the quality of life. to strengthen the foundation for our families. let us seize this moment. thank you, mr. president. i yield the floor. a senator: mr. president? mr. president? the presiding officer: the senator from nebraska. a senator: mr. president, i rise today to introduce a piece of legislation that i believe that the senate should consider immediately. mr. johanns: i believe this legislation is so important that it just can't wait. the legislation is called the free enterprise act of 2009, and its purpose an effect is very straightforward and very simple. a senator: with the senator from idaho allow me a brief interruption? the presiding officer: the senator from nebraska. mr. johanns: yes. mr. merkley: i ask unanimous consent that the period for morning business be extended until 11:30 a.m. with senators permitted to speak up to 10 minutes each. th

every plan will offer an affordable, a basic package. this is for people who are not happy with their current plan. if you like which you are getting, keep it. nobody is forcing you to shift. if you are not, this gives you some new options. and i believe one of these options needs to be a public auction that will give people a broader range of choices and inject competition into the health-care market, so that we can force waste out of the system and keep the insurance companies honest. [applause] i know there is some concern about a public auction. i understand you are concerned that today's medical rates, which many of you are ready feel are too low, will be applied broadly that means our cost savings are coming off of your back. these are legitimate concerns. i believe they can be overcome. the reforms we propose to reimbursement are to be worked best practices focused on patient care not on the current peace work reimbursements. we seek more stability in the health-care system that is on a sounder financial footing. these reforms nee

i can't afford that one. all know that the odds of him having another heart attack go up significantly if he has to sit there at the drug counter and decide which prescriptions he can and can't afford. and the article went on to describe a conversation with people at pharmacies saying, this is being seen more an more an more and more in our broken health care system. so let's ask ourselves, what is the family value? is it a family value to say to 50 million working americans, you you may not have access to health care in our society? is it a family value to have three generations in a cafe who are doing just fine if only they could afford health care? health care an a good job are essential to success of our families. and if you care about strengthening families, then you've got to care about seeing what we can do to make the system work better. now, our status quo system, it's broken in so many ways. year before last, one of our major health care providers in oregon, their rights went up 26% for small busine

-- promotes affordability.thank you very much. [applause] >> thank you andrew, and thank you, cleve. that's a very interesting experiment. it's not an experiment. i mean, it's really happening in the marketplace and it's unique because of the size and the number of participants in it, and it's really happening and it's really worth paying attention to. now i'd like to introduce paul ginsburg. i'm sure almost everyone knows him. he is a well known expert on health policy and has a very detailed knowledge of markets and costs and he will also be talking about the misaligned incentives and the need for payment reform. and he is frequently quoted in of the paper and asked to testify before congress, because he has that unique ability to take something that's very complex, really understand it, and analyze it, but make it accessible and understandable to a wide audience. so paul. thank you. >> thanks, nancy, and sometimes it's hard for me to understand it. it motivates me to keep it simple. but i'm going to talk abo

people who are not covered will be able to choose affordable plans. at this will be portable and guaranteed. finally, the insurers that everyone will have affordable health care. this will include essential benefits. there'll be caps on expenses. insurers that the care will be as it should be. it will be driven by patients' needs. it will simply not invest in utilization, but more so when outcomes. it will avestan wellness and it is the insurance company is discriminatory practices. it requires shared responsibilities. it ensures that all americans have access to these benefits. in the coming weeks, we will continue to seek input from staplers of lawmakers. many are also clamoring for inaction. let me be clear on this one point. on behalf of every parent of six care for their sick child and for every american that -- i assure you that it is in fact off the table and that is saying no to health care reform. to succeed, we will need the cooperation of all colleagues and our president. we must think about the future of our country and every american that

it helps to achieve cost containment, helps to achieve affordable health care. the private states for much in place. host: chief economic adviser for vice president biden. the first caller is from new orleans. caller: good morning. there is a not unwanted perception out here that' washington does not listen to the american people and you are so far divorced from what we want, come up with plans that do nothing but destroy us. i could come up with numerous examples of this, but i would just use a few and will ask you one per in question. when the bailout first came out, the calls were 1000 to one against the bailout. yet, this government went ahead against the wishes of the american people and passed it. the health care reform, when you had your committee asking about it, the majority of people want single payer health care deployed in all of the other industrialized nations, and this government would not even allow a representative on the panel to talk about it. recently i witnessed mr. biden, vice-president biden, handed information that nine scientists from ar

richardson: america cannot afford to wait for health care reform. right now more than three out of four americans are dissatisfied with the total cost of health care. that is why congress is working hard to craft legislation to fix the health care system for american families, american businesses, future generations, and of course our own fiscal survival. since 2000 wages have only increased 3% while health insurance has increased more than 50%. this has caused many families to delay visits to the doctor, skip treatments, and to allow their health coverage to lapse. despite having the most expensive health care system in the world, americans are no healthier than many of our global partners. president obama and this congress are working together to provide adequate, accessible, and affordable health care now. i yield back the balance of my time. the speaker pro tempore: the gentlewoman yields back the balance of her time. for what purpose does the gentleman from michigan rise? >> to address the house for one minute. the speaker pro tempore: without

we can't afford that. we can't afford to spend money on all these new breakthroughs. we're basically stuck with what we can afford back in 1980, for example. and good luck, we know that's not going to help you all that much with your illness, but that's all we can afford to pay. that's what we're trying to avoid, mr. president. we're trying to take a very small step first and say that at a minimum, nothing in this legislation would allow the government to use comparative-effectiveness research to ration our care. i don't think that's too much to ask. and i would ask all of my colleagues to join senator mcconnell and me in sponsoring that legislation and seeing to it that we can get it passed for the benefit of our families and our constituents. mr. president, i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: #

we cannot afford these wars financially. they add trillions to our national debt and destroy our domestic agenda. we cannot afford the human costs of these wars, the loss of lives of our beloved troops and the loss of innocent civilians in afghanistan and pakistan. so why do we do this? why do we keep funding wars since they're so obviously against truth and justice and when they undermine our military? these are matters of heart and conscience which must be explored. our ability to bring an end to these wars will be the real test of our power. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from south carolina rise? mr. wilson: mr. speaker, i ask permission to address the house for one minute and to revise and extend my remarks. the speaker pro tempore: without objection, the gentleman is recognized for one minute. mr. wilson: mr. speaker, the commissioner of the bureau of labor statistics has admitted there is no way to actually substantiate the number of jobs saved in this ec

the market is dysfunctional and they face on affordable rate increases. that kind of discrimination will end. third, people who don't have employment-based insurance or a change in their jobs will always have access to affordable coverage, and they can take it with them wherever they may go. from one job to another, even if they are out of court. that insurance will be there for them. with that covers they will have the protection from the catastrophic costs that are faced by many who need care and don't need coverage. choice is the key. choice is the key for consumers to pick which plan they want, whether it is a private insurance plans or a public insurance plan. choice is important for patients to be able to pick their own doctors. fourthly, we are taking comprehensive action to make sure that everyone gets more value for their healthcare spending. we are moving to get costs under control through pain and improvements and delivery reforms. and we are taking a number of steps to improve quality and reduce ethnic and racial disparities. under this propos

it is about small businesses who eliminate insurance because they can't afford it. it is about the three and five families who put off necessary medical care because it costs too much. american families and every one of our states are counting on us to work together in our common interests. they are not counting political points scored by either party. senate democrats want nothing more than to work with republicans to create a bipartisan health reform bill that assures quality, affordable health for all americans. that's why the "help" committee has held 14 bipartisan round tables, 13 committee hearings and 20 meetings of committee members to discuss various proposals. each one with the goal of reaching a bipartisan agreement. hard-working americans are too often the casualities of our broken health care system. they deserve better than to be also the casualities of this kind of politics. it's not too late for republicans to join us for a serious discussion and dialogue about how to move this country forward. as i did at the beginning of this year, this congress, t

but in the long run, in the long run, if people can then afford because of that program, they can afford to take medications for some of the diseases i mentioned earlier, high blood pressure, cholesterol, diabetes beat east, keep these things under control, clearly what happens is you shift cost from part a, the hospital part of medicare and from part b, the doctor part, the surgeon part, the amputation part, the renal transplant part. and then also in part d, keeping folks from having a massive stroke hopefully by controlling their blood pressure and you spend less on the skilled nursing home part. so i think that's a pretty good bargain and a pretty compassionate way of a -- approaching things. but our democratic colleagues stood up here and said, well -- some of them tore up their aarp cards because that senior organization had the audacity to support a republican bill. and then of course they said, well why can't we have a government default plan and why can't the government come in and set the price and say, ok, you know, this is the price, this is the monthly premium for part b, th

we hear stories every day from small-business owners who can't get affordable coverage. an entrepreneur in nashville, tenn. had to abandon her business after a few months because she couldn't get decent coverage. one company quoted her as $13,000 monthly premium. others, such as larry peterson, co-owner of a mail-order bank rate, struggled to do the right thing and provide health care coverage. larry notes that, quote, the tremendous downside to being uninsured can be instant poverty and bankruptcy. that is not something by employees deserve. our polling confirms the health cost to small business owners's number one concern, on average, more than 18% more for health-care coverage than big businesses. the economic study we released earlier this month based on research by jonathan gruber found that without reform, health care will cost small-businesses $2.4 trillion over the next 10 years. we are pleased to see the house bill addresses key cost containment measures such as expanded use of transparency, prevention and chronic disease management. our polling shows that the k

access is affordability. we understand that we have a

we want this to be as affordable as possible. we will not have coverage paid for by taxpayers for people at 500%. we will not have coverage where the taxpayers pay for families that make over $50,000. that is not part of our plan. we might start by looking at the numbers and personages we allow for medicare and figure out how you dial those up or down to get at a number that the american people will benefit from by having more people in the health-care system. fewer people at the emergency room. fewer people who do not have a doctor patient relationship that keeps them well. the relationship that charles was talking about. many of our doctors on the solutions group, we think access to care is important. >> i wanted to mention, as you know, the majority party is first in line for scoring their legislation. we are at the end of that line. those at the front of the line, we have not actually heard all other numbers. i think it is important to read a bill that has a common-sense approach. >> are you going to raise taxes to pay for it

and people can afford it and the insurance company will say, no we will not cover your ailments. the biggest problem now is you have five million insurance plans and you almost need a rocket scientists to determine whether they'll cover everything you need or don't need. @ 8 on one of the most vecksing issues of the overhaul debate, whether to have a new government sponsored health plan. and kent conradt would create health care cooperate tiffs owned by groups of residents and small businesses similar to how electric or other cooperate tiffs operate. they would be nonprofit and without the government involvement that troubles republicans and business groups about the public plan options. senate finance committee chair baucus said yesterday that the idea could be key to a bipartisan health bill. that's in the "philadelphia inquirer." more from senator baucus. baucus aides warn k street. called a last minute preemptive strike wednesday with a group of prominent democratic lobbyists warning them to advise their clients not to attend a meeting with senate republicans set for today. r

for affordable biologics, and frankly, madam president, we should not make them. i yield the floor. a senator: madam president? the presiding officer: the senator from delaware. mr. kaufman: i ask consent to speak in morning business for up to ten minutes. the presiding officer: without objection. mr. kaufman: madam president, i've spoken here a few times already about federal employees and the great work they perform. i'm honored to be in a position to come here and do it again. i enjoy sharing stories about excellent public servants. the stories are not only a -- are only but a few pieces in the vivid mosaic of our federal workforce. the stories are exemplary, not exceptional. these are regular people doing a great job. the real story of our federal employees and that of their dedication, their talents and important contribution needs to be told. service in government is characterized by sacrifice. many of our federal employees wear a uniform and sacrifice in the battlefield. others work in civilian jobs but still make great sacrifices by working long hours and

far too many cannot afford this. if we are going to fix our broken system we have to return control to the people who need that care. i yield the floor. mr. mcconnell: madam president? the presiding officer: the republican leader. mr. mcconnell: madam president, the american people are frustrated with the u.s. health care system but they're also increasingly concerned about some of the proposals coming from washington. now the alarms are sounding. as reported in today's "the new york times," the nation's doctors have strongly opposed to the so-called government plan that appears to be gaining steam here in washington. the american medical association says the government plan threatens to restrict patient choice by putting out of business existing health plans that cover nearly 70% of americans. one estimate suggests 119 million americans could lose the private coverage they have as a consequence of the government plan. moreover, the a.m.a. in a statement yesterday notes that "the corresponding surge in public planned

we also have to provide americans who can't afford medical insurance more affordable option ts. that's an economic imperative but also a moral imperative. we know when people don't have insurance they end up getting treatment at the e.r. the average family pays an extra thousand dollars to pay for people who are going to the emergency room. you're subdiesing, but you're subsidizing the most expensive care. you would be better off to subsidize making sure they're getting regular chkups. we're already paying for it, it's just hidden in your premiums. so we're working on the health insurance exchange which would allow you to one stop shop for a health care plan. compare benefits and prices, choose the plan that's best for you. if you're happy with your plan, you keep it. none of these plans, though, would be able to deny coverage on the basis of pre-existing conditions. [cheers and applause] every plan should include an faudable basics package. and if you can't afford one of these plans, we should provide you some assistance to make sure that you can. [applause] so i also strongly

the cranston-gonzalez national affordable housing be act as amended. why are we amending the cranston-gonzalez national affordable housing act? i thought we were doing an energy bill here. page 142, use of building materials and methods that are healthier for residents of the housing, including the use of building materials that are free of added known carcinogen that is are classified as group one known carcinogens by the international agency for research on cancer. outlined building materials as well, it appears. then we have a grant program to increase the sustainability of low-income community development capacity. we are going to provide loans, grants, or predevelopment assistance to eligible

like can i afford an apartment? can i find a job where i can be able to support a family? these were questions that were urgent at the time because the iranian economy was bad before the global collapse acquainted everybody, especially in the west about what a bad economy could really mean. iranians were dealing with this all the way along. and so young people also were attracted to his message. he promised to battle corruption. he promised to bring the country's oil wealth to people's dinner's table and this was certainly appealing to a young generation who was starting to think very seriously about whether or not they could afford and sustain decent married adult life back in iran. my move back to iran was occurred with a change in my life. given the title of my book, i met someone who would later become my husband, and when i moved back so that we could start our life together and go forward, i began to experience and sort of firsthand witness all of the things that iranian young people were dealing with when it came to marriage and moving on in life beyond simply being

the world cannot afford for iran to have a nuclear weapon. cannot afford it. no option should be taken off of the table the president has said that i agree with those statements he has made by countries like ivory and come with a really only understand strength. remember libya? when ronald reagan was president i may veterinarians why can use this analogy he neutered khaddafi. [laughter] [applause] i did not mean to offend anybody. [laughter] but the better dairy and come stock and that really is they understand the strength. you can not pass it by ahmadinejad. they understand strength we have to get the roll committee behind us it cannot be idle talk they have to be prepared to act if necessary. >> the next question can you define conservatism and how would you promote it? >> conservatism is one word goes to the heart and that is freedom whether free enterprise system, whether it is freedom from government intervention come and means less regulation and, if you were laws that encourage litigation, lower taxes because that is freedom from government oppression

madeline in pawtucket cannot afford health insurance coverage despite working two jobs. her family has a history of colorectal cancer but she cannot afford to get a colonoscopy. without insurance, madeline waits and hopes that she doesn't get sick. because that's the only option she has. for these rhode islanders and millions more americans silently suffering all over the country, we must now be a voice. we must improve the quality of our health care. develop our health information infrastructure. and invest in preventing disease. we must protect existing coverage when it is good. and improve it when it is not. and the president has said, if you like your health care plan, you can keep it. we must dial down the paperwork wars. and dial up the information to consumers. and we must speak for the 46 million americans, 9 million of whom are children, who have no health insurance at all. for the rhode islanders lining up today at the rhode island free clinic to draw straws, in this great country of ours, to draw straws to see which ones will be able to see a doctor. some have

the market is dysfunctional and they face an affordable rate increases. of that kind of discrimination will end in. a third, people who don't have employment based insurance or who change their jobs will always have access to affordable coverage and they can take it wherever they may go from one job to another even if they are out of work without insurance -- that insurance will be there for them. with that coverage to they will have protection from the catastrophic cost that is raised by many who need care and don't have coverage. choice is the key. choice is the