mr. whitehouse: are we in a quorum call? the presiding officer: we are. mr. whitehouse: may i ask that the pending quorum call be vitiated. the presiding officer: yes. mr. whitehouse: we are embarked on one of the most important challenges that our country faces. we will begin to reform our tragically flawed and broken health care system. to bring down its skyrocketing costs, to cover its tens of millions of americans left uninsured, and to improve its way below average results. so the high-quality health care comes within reach for every american family. the stakes are high. this week in a speech before the american medical association president obama said this: the cost of our health care is a threat to our economy. it is an escalating burden on our families an businesses. it is a ticking time bomb for the federal budget. and it is unsustainable for the united states of america. the president said health care reform is the single most important thing we can do for america's long-term fiscal health. savings in waste, confusion, unnecessary or defective care a

mr. whitehouse talk to me last week about working on something like what we are trying to do here, so what we leave it on the table. let's talk over the next few days and see if there is a way-- >> some language? >> that will make it work that will satisfy the concern. i don't want to comment on this letter until i can really digested. >> i agree with you. what we do that together and you have my public pledge that i want to work with you on this, once we move forward, but to go ahead. >> i appreciate it. >> good work. >> mr. chairman? >> yes. >> i think we have got to talk about it. advanced directives are important. , do you know what i see? to waffen they are ignored. were they ignored? it is the one issue we won't address in this bill. the liability question in this country. you brought it up. two episodes have been told to me in the last week the people who had advanced directives that were placed in i see you, in debated, and lived 14 days even though they did not want that. because the judgment of the time was were free to follow this because something had been said by a family memb

mr. chairman? >> yes. senator whitehouse? >> even if it were efficacious, i still think that it is completely wrong because it puts 100% of the cost of this social problem on the woman who's coming home from the hospital with a disabled baby who she's going to have to take care of for the rest of her life, with the woman who is coming home from the hospital with a disfiguring injury that she will carry for the rest of her life, the woman coming home from the hospital, coming home from the doctor's office, being told that she's dying of cancer because of a missed diagnosis. those are the people who are going to suffer when their damages for physical and emotional pain, suffering, inconvenience, physical impairment, mental anguish, i'm reading the amendment now, disfigurement, loss of enjoyment of life, loss of society and companionship, loss of consortium, et cetera, et cetera, et cetera can't be adequated ely compensated. why we have to put 100% of the cost on that woman, i don't understand and even if we did save millions in

mr. reid: in accordance to the resolution, i recommend to the chair the appointment of senators mccaskill as chair, klobuchar, whitehouse, udall of new mexico, shaheen and kaufman. the presiding officer: the republican leader is recognized. mr. mcconnell: mr. president, in accordance with the resolution on the appointment of an impeachment trial committee, i recommend to the chair the appointment of senators martinez, demint, barrasso, wicker, johanns, and risch. the presiding officer: pursuant to the resolution on the appointment of an impeachment trial committee and impeachment rule 11, the chair appoints upon the recommends of the two leaders the following senators to be members of the committee to receive and report evidence in the impeachment of judge samuel b. kent: senators mccaskill, klobuchar, whitehouse, udall, shaheen, kaufman, martinez, demint, barrasso, wicker, johanns and risch. the majority leader is recognized. mr. reid: the resolution on will meet at a time to be determined. the presiding officer: the senate will take proper order and notify the house of representatives and counsel for judge kent. mr. r

whitehouse? >> thank you, mr. chairman. i appreciate the ranking member withdrawing his amendment. i would offer a comment and an answer to his question. the comment is that i think the case that this allows the injured individual a meaningful choice to stay within the american jury system would be better advanced if it didn't require the patient to opt out of the alternative to the jury system way early on, way before he or she is injured and in a way that, frankly, would allow the opt out to be buried in the fine print of medical and jury information. that would be suggestion of going forward with this idea. i don't think it's a legitimate opt out in the way that it's framed. just my view. in terms of how you get after this, well, the easy way to stop killing 100,000 americans every year with avoidable medical errors and underneath the tip of the iceberg of the 100,000 lethal medical errors is a larger portion of the iceberg of the sub lethal medical errors where somebody lost both legs instead of one or an extra month in the hospital or two because of acquired infection or -- th

mr. chairman i want to comment and then i know senator whitehouse also wants to. first of all, i just want to assure the gentleman from oklahoma, who comes to this table with a great deal of clinical experience, and has always had his patience first. so, i appreciate him and i appreciate all physicians. when i looked at the issue of comparative effectiveness, there were going to be two things that i, as we looked at it from experience of other countries and even from learned groups and foundations here. one was the shelp not shackled a physician, and interject government into the practicing room. that a physician brings experience, brings scientific training, brings dedication, and assumes risk and liability in that room. so, we made sure that what we had in our legislation would in no way interfere with who is in charge in that room when that doctors talking to the patient. the second argument that this raised was stifling innovation, and what we were also told there is, if you follow the obama language in the stimulus package about we must not be construed, you

mr. chairman. madam secretary one area i've been working extensively with chairman wax man and senators rockefeller and whitehouse on is legislation that would strengthen the federal health care quality infrastructure in order to identify and track key health indicators as well as to develop and implement new science across the states. what this bill does that we introduced would tab national priorities for health care quality and specifies that pediatric health quality is one of the first. and a lot of this legislation has now been incorporated into discussion draft that we're talking about today. but the draft bill also contains a provision that requires the director of the agency for health care research and quality to work with you, as secretary, to develop quality measures for the delivery of health care services in the united states. i think this is an important requirement but i'm worried about the implications for pediatric health care quality measures because even though discussion draft requires the measures to be designed to assess the delivery of health care services to individuals, regardless of age,

follows: reid, pryor, whitehouse, inouye, feingold, dodd, burris, durbin, murray, tester, udall of colorado, klobuchar, reed of rhode island, baucus, merkley, lincoln, cantwell, dorgan. mr. reid: i ask that the mandatory quorum be waived. the presiding officer: is there objection? without objection. mr. reid: i ask the senate resume legislative session. the presiding officer: without objection. mr. reid: i ask now that we proceed to a period of monk business, senators allowed to speak -- of morning business, senators allowed to speak therein for up to ten minutes each. the presiding officer: without objection. mr. reid: madam president, let me just say a brief word on the cloture that was not invoked on the travel bill. i hope that everyone understands what obstructionism is. this is obstructionism at its best, and it goes along with what the republicans said they wanted to do and that is stop everything. as indicated in "roll call" newspaper last week. this is a bill that saves the government money, almost a half a billion dollars over ten years. it would create in the first year of the -- after passage of the bill 40,000 jobs. the republicans just killed th this. over

mr. casey: thank you. this is cosponsored by senators dodd, rockefeller, brown, whitehouse and sanders. i'll highlight some of the features of it. first of all, it starts with a recognition that the medicaid program is a cornerstone of the nation's health insurance infrastructure. it notes in the resolution that medicaid covers a quarter of all children in the country -- one quarter -- and half of all poor children. it notes as well that medicaid has been shown to reduce racial and ethnic disparities in health care and provides coverage for two out of every five african-american american and children. it provides benefits for infants and young children. it has care coordination benefits to support at-risk children and its administrative spending -- medicaid's administrative spending is lower than that through heist insurance. here's the end -- through private insurance. here's the end of the resolution. i'm summarizing here. it is the intent of this resolution to say that the nation's health care system shall benefit all children -- all children -- and that no child shall be worse off a