Congressional Record EPLURIBUS UNUM United States 111th of America PROCEEDINGS AND DEBATES OF THE CONGRESS, FIRST SESSION Vol. 155 WASHINGTON, THURSDAY, DECEMBER 17, 2009 No. 192 House of Representatives The House was not in session today. Its next meeting will be held on Saturday, December 19, 2009, at 6 p.m. Senate The Senate met at 10 a.m. and was O God, from whom all noble desires ings, enabling them to see and experi- called to order by the Honorable and all good counsels do proceed, crown ence evidences of Your love. May their KIRSTENE. GILLIBRAND, a Senator from the deliberations of our lawmakers consistent communication with You the State of New York. with spacious thinking and with sym- radiate in their faces, be expressed in pathy for all humanity. As they face their character, and be exuded in posi- PRAYER perplexing questions, quicken in them tive joy. Sanctify this day of labor The Chaplain, Dr. Barry C. Black, of- every noble impulse, transforming with the benediction of Your approval. fered the following prayer: their work into a throne of service. Let us pray. Lord, shower them with Your bless- We pray in Your great Name. Amen. NOTICE If the 111th Congress, 1st Session, adjourns sine die on or before December 23, 2009, a final issue of the Congres- sional Record for the 111th Congress, 1st Session, will be published on Thursday, December 31, 2009, to permit Members to insert statements. All material for insertion must be signed by the Member and delivered to the respective offices of the Official Reporters of Debates (Room HT–59 or S–123 of the Capitol), Monday through Friday, between the hours of 10:00 a.m. and 3:00 p.m. through Wednesday, December 30. The final issue will be dated Thursday, December 31, 2009, and will be delivered on Monday, January 4, 2010. 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Members of Congress desiring to purchase reprints of material submitted for inclusion in the Congressional Record may do so by contacting the Office of Congressional Publishing Services, at the Government Printing Office, on 512–0224, between the hours of 8:00 a.m. and 4:00 p.m. daily. By order of the Joint Committee on Printing. CHARLES E. SCHUMER, Chairman. E N NLI O C- E R G- N O with C ∑ This ‘‘bullet’’ symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor. D O R P S13343 B1 Y O S K69 . S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00001 Fmt 0637 Sfmt 8633 E:\RECORD09\S17DE9.REC S17DE9 S13344 CONGRESSIONAL RECORD—SENATE December 17, 2009 PLEDGE OF ALLEGIANCE an amendment they did not like, and RECOGNITION OF THE MINORITY then complaining when that amend- LEADER The Honorable KIRSTEN E. GILLIBRAND led the Pledge of Alle- ment they did not like was withdrawn, The ACTING PRESIDENT pro tem- giance, as follows: they have made their point to the pore. The Republican leader is recog- I pledge allegiance to the Flag of the American people. They have made it nized. perfectly clear they have no interest in United States of America, and to the Repub- f lic for which it stands, one nation under God, cooperating or legislating. indivisible, with liberty and justice for all. But the families and businesses who HEALTH CARE REFORM are suffering, hurting, and dying every Mr. MCCONNELL. Madam President, f single day have no time for these kinds Senators on both sides acknowledge APPOINTMENT OF ACTING of games. That is why we are going to that the health care bill we are consid- PRESIDENT PRO TEMPORE finish health care whether the other ering is among the most significant The PRESIDING OFFICER. The side cooperates or not. pieces of legislation any of us will ever clerk will please read a communication But health care is not the only crit- consider—I think, I would argue, the to the Senate from the President pro ical issue this body faces. It is not the most significant piece of legislation tempore (Mr. BYRD). only critical issue to this country or certainly in my time here. So it stands The legislative clerk read the fol- before this body. Right now we have to to reason we would devote significant lowing letter: complete a bill that supports the fight- time and attention to it. ing men and women of this country, Indeed, some would argue we should U.S. SENATE, whether they are in Iraq, Afghanistan, spend more time and attention on this PRESIDENTPROTEMPORE, Washington, DC, December 17, 2009. Korea, Japan—all those many bases bill than most—if not every—previous To the Senate: where tens of thousands of people are bills we have considered. Under the provisions of rule I, paragraph 3, stationed. It is as simple as that. The majority, obviously, disagrees. of the Standing Rules of the Senate, I hereby Here are some of the good things in Why? Because this bill has become a appoint the Honorable KIRSTEN E. the bill that is now before the Senate, political nightmare—a literal political GILLIBRAND, a Senator from the State of New the message from the House. It funds nightmare to them—as evidenced by York, to perform the duties of the Chair. more than $100 billion for operations, more and more public opinion polls, in- ROBERTC. BYRD, maintenance, and military personnel cluding the Wall Street Journal/NBC President pro tempore. requirements for the wars in Iraq and poll out this morning. They know Mrs. GILLIBRAND thereupon as- Afghanistan. Part of that money will Americans are overwhelmingly opposed sumed the chair as Acting President also support preparations to continue to it, so they want to get it over with pro tempore. withdrawal from Iraq. There is more as quickly as possible. f than $23 billion for the equipment used Americans are already outraged at RECOGNITION OF THE MAJORITY by our servicemembers in Iraq and Af- the fact that Democratic leaders took LEADER ghanistan to do their jobs and stay their eyes off the ball, rushing the safe. There is more than $150 billion to process on a partisan line that makes The ACTING PRESIDENT pro tem- train our troops and prepare them for the situation even worse. pore. The majority leader is recog- Americans were told the purpose of battle. There is more than $30 billion nized. reform was to reduce the cost of health for the health care of our servicemem- care. Instead, Democratic leaders pro- f bers, their families, and their children. duced a $2.5 trillion, 2,074-page mon- It also gives our brave and valiant SCHEDULE strosity that vastly expands govern- troops a pay raise of 3.4 percent this Mr. REID. Madam President, fol- year. ment, raises taxes, raises premiums, lowing leader remarks, the Senate will This is not a partisan issue. Yester- and wrecks Medicare. And they want to resume consideration of the motion to day, this bill passed the House 395 to 34. rush this bill through by Christmas? concur with respect to H.R. 3326, the More than 90 percent of Democrats They want to rush this bill through by Defense Appropriations Act. The first voted for this bill. More than 90 per- Christmas that does all of these de- hour will be equally divided and con- cent of Republicans in the House of structive things. One of the most sig- trolled between the two leaders or Representatives voted for this bill. nificant, far-reaching pieces of legisla- their designees. The Republicans will That is because they know to our fight- tion in U.S. history, and they want to control the first 30 minutes and the ing men and women—these brave rush it. majority will control the next 30 min- Americans half a world away, a lot of Here is the most outrageous part. At utes. I filed cloture on the motion to them—who wage two wars on our be- the end of this rush, they want us to vote on a bill that no one outside the concur. That vote will occur sometime half, it is immaterial whether the lead- majority leader’s conference room has in the next 10 or 12 hours. ers who will give them all the re- seen yet. No one has seen it. That is f sources they need to succeed are pro- right. The final bill we vote on is not gressives or conservatives. Surely, our PASSAGE OF CRITICAL even the one we have had on the floor troops who are on deployment after de- LEGISLATION of the Senate. It is the deal Democratic ployment after deployment spend more leaders have been trying to work out in Mr. REID. Madam President, we are time counting the days until they can private. That is what they intend to going to finish this health care bill be- see their loved ones again than they do bring to the Senate floor and force a fore we leave for the holidays. counting the political points scored by vote on before Christmas. For nearly an entire year, we have either side. They do not care most of So this entire process is essentially a reached out to the other side, offered the time, Madam President. They just charade. But let’s just compare the Republicans a seat at the table, tried do their jobs. process so far with previous legislation to negotiate in good faith—nearly a The House proved as much yesterday. for a little perspective. whole year. Now we are closer than The Senate should do the same today. Here is a snapshot of what we have E ever to fixing a badly broken system We received this bill yesterday at 2 done and where we stand on this bill. ONLIN aAnmde rdiocianng camno areff otrod tmo alkivee sau hree aletvheireyr pro.mw .t Ao rpea swse i tg?o iTnhgi st os iwmapilty uins tniol tt ormigohrt-. thTish ed embaatjoe rtitoy al ecaldoesre ianst eenadrsly t oa sb rtihnigs REC- life than this country has done in dec- Let’s give our troops what they need to weekend—4 days from now—on this $2.5 G- ades. succeed, and do it now. Then let’s get trillion mistake. No American who has N CO The Republicans have made their back to giving all Americans what they not been invited into the majority with point. Through obstruction manuals, need to stay healthy. leader’s conference room knows what OD admissions that they believe stalling is These two bills—these two pieces of will be in the bill. PR good for electoral politics, and gambits legislation—are about life and death. The bill has been the pending busi- YB1 like the one we saw yesterday; that is, Our responsibility is too great to waste ness of the Senate since last Novem- SO forcing the full, hours-long reading of time playing political games. ber—less than 4 weeks ago—but we K69 S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00002 Fmt 0637 Sfmt 0634 E:\RECORD09\S17DE9.REC S17DE9 December 17, 2009 CONGRESSIONAL RECORD—SENATE S13345 have actually only started the amend- Madam President, I yield the floor. So here is Governor Schwarze- ment process 2 weeks ago—just 2 weeks negger’s advice, following up on the f ago on the amendment process. comments of the leader: ‘‘So I would We have had 21 amendments and mo- RESERVATION OF LEADER TIME say be very careful to the Federal Gov- tions—less than 2 a day. The ACTING PRESIDENT pro tem- ernment.’’ So let’s look at how the Senate has pore. Under the previous order, the This is from the Governor of Cali- dealt with previous legislation, argu- leadership time is reserved. fornia: ably of lesser consequence than this Before you go to bed with all this, let’s one. f rethink it. There is no rush from one second No Child Left Behind in 2001: 21 ses- DEPARTMENT OF DEFENSE to the next. Let’s take another week or two. sion days over 7 weeks, 44 rollcall APPROPRIATIONS ACT, 2010 Let’s come up with the right package. votes, 157 amendments offered. I wonder if the Senator saw it. ritTyh eA c9t/1 1i nC o20m02m: i1s9s isoens/sHioonm edlaaynsd oSveecru 7- poTreh.e UAnCdTeIrN Gth eP RpErSevIDioEuNs To rpdreor , tetmhe- froMmr. TMenCnCeAsIsNee. wI htoh aanlkso tuhned eSresntaantodrs weeks, 20 rollcall votes, 30 amendments Senate will resume consideration of this issue as well as or better than any- offered. the House message with respect to H.R. one, having been a Governor and recog- The Energy bill in 2002: 21 session 3326, which the clerk will report. nizing the problems the Governors days over 8 weeks, 36 rollcall votes, 158 The legislative clerk read as follows: face. amendments offered. House message to accompany H.R. 3326, a If I could step back a second, Gov- Now, Madam President, this is not an bill making appropriations for the Depart- ernor Schwarzenegger is a very astute energy bill. This is an attempt by the ment of Defense for the fiscal year ending observer of the political scene in Cali- majority to take over one-sixth of the September 30, 2010, and for other purposes. fornia. May I point out to my col- U.S. economy—to vastly expand the Pending: leagues, in this morning’s Wall Street reach and role of government into the Reid motion to concur in the amendment Journal: ‘‘Democrats’ Blues Grow health care decisions of every single of the House to the amendment of the Senate Deeper in New Poll,’’ and then: ‘‘Sup- American—and they want it to be done to the bill. port for Health Overhaul Wanes.’’ after one substantive amendment—one Reid motion to concur in the amendment large, substantive amendment. This is of the House to the amendment of the Senate There is some remarkable informa- with amendment No. 3248 (to the House tion concerning the mood and views of absolutely inexcusable. amendment to the Senate amendment), to the American people, following on a I think Senator SNOWE put it best on change the enactment date. Washington Post ABC News poll out Tuesday. This is what she had to say Reid motion to refer the amendment of the yesterday that says 51 percent of Tuesday of this week. ‘‘Given the enor- House to the Committee on Appropriations, Americans say they oppose the pro- mity and complexity,’’ Senator SNOWE with instructions, Reid amendment No. 3249, posed changes to the system; 44 percent said, ‘‘I don’t see anything magical to provide for a study. approve. about the Christmas deadline if this Reid amendment No. 3252 (to Reid amend- Thanks to the efforts of so many peo- bill is going to become law in 2014.’’ ment No. 3248), to change the enactment And I think Senator SNOWE’s com- date. ple, including our leadership, we have ments on a lack of bipartisanship at Reid amendment No. 3250 (to amendment turned American public opinion be- the outset of this debate are also right No. 3249), of a perfecting nature. cause we have been informing them of on point. Here is what Senator SNOWE Reid amendment No. 3251 (to amendment the consequences of passage of this leg- said in November of this year—late No- No. 3250), of a perfecting nature. islation. vember: The ACTING PRESIDENT pro tem- Let me quote from the Wall Street pore. Under the previous order, Sen- Journal article: I am truly disappointed we are com- mencing our historic debate on one of the ators are permitted to speak for up to More Americans now believe it is better to most significant and pressing domestic 10 minutes each, with the first hour keep the current health system than to pass issues of our time with a process that has equally divided and controlled between President Barack Obama’s plan, according to forestalled our ability to arrive at broader the two leaders or their designees, with a new Wall Street Journal-NBC News poll. agreement on some of the most crucial ele- the Republicans controlling the first Findings mark a shift from the fall when the ments of health care reform. The bottom line half and the majority controlling the overhaul enjoyed the edge over the status is, the most consequential health care legis- second half. quo. According to the poll, 44 percent of lation in the history of our country and the Americans said it is better to pass no plan at reordering of $33 trillion in health care The Senator from Arizona is recog- all compared with 41 percent who said it is spending over the coming decade shouldn’t nized. better to pass the plan. be determined by one vote-margin strate- Mr. MCCAIN. Madam President, I ask What they are saying is: Don’t do gies—surely— unanimous consent that the Senator this government takeover; don’t in- Surely— from Tennessee lead a colloquy includ- crease taxes; don’t increase spending; we can and must do better. ing the Senator from Oklahoma, the don’t increase the costs. It is a remark- Well, Senator SNOWE is entirely cor- Senator from Wyoming, myself, and able shift, thanks to informing the rect. the Senator from Kentucky. American people. The only conceivable justification for The ACTING PRESIDENT pro tem- Could I mention a couple of other rushing this bill is the overwhelming— pore. Without objection, it is so or- points made in this poll in the Wall overwhelming—opposition of the dered. Street Journal. In September, 45 per- American people. Democrats know the Mr. ALEXANDER. Madam President, cent of Americans said they wanted the longer Americans see this bill, the less I thank the Senator from Arizona. plan passed; 39 percent wanted to they like it. I was thinking as I listened to the ‘‘keep the current system.’’ In Decem- Here is the latest from Pew; it came Republican leader, I wonder if the Sen- ber, in polling out today, only 41 per- out just yesterday. A majority—58 per- ator noticed the comments of the Gov- cent of the American people want it cent—of those who have heard a lot ernor of California on Monday. Gov- passed, and 44 percent say keep the about the bill oppose it, while only 32 ernor Schwarzenegger said on ‘‘Good current system. E percent favor it. Morning America’’ that he supports Then, of course, we have another in- REC-ONLIN bthlTianhtd e irsre u nsohist, genxooco edp jetu nsaot iupfgiochlai ttfoiiocran tl hofeon rAe ,m tahenrids- tbGhuoetv :e ird‘n‘etoahr e oSflc ahsowtv aertrzhheiannueglg ingweger , hn‘e‘eiasel dtah,’n ’ octsahareiedr, triegTrhretus:st t2i n1t ghp aestrt catehtneits gtsoiacvy:e ranlmwaeynst wori llm doos tw ohfa tt hies G- ican people, and that is not justifica- $3 billion in spending when we already time; 46 percent say only some of the time; N CO tion for forcing the Senate to vote on a have a $20 million deficit.’’ and 32 percent of the American people say al- with bill that none of us have seen. He was referring to one of the unin- most never. D Americans already oppose the bill. tended consequences of this bill, which Of course, the anger and disapproval O PR The process is just as bad. It is com- is big State costs for Medicaid being of this health care plan right now is YB1 pletely reckless and completely irre- shifted to the States—unfunded man- the centerpiece of Americans’ dis- SO sponsible. dates. satisfaction of the way we do business. K69 S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00003 Fmt 0637 Sfmt 0634 E:\RECORD09\S17DE9.REC S17DE9 S13346 CONGRESSIONAL RECORD—SENATE December 17, 2009 Let me say finally, because my col- American, but most historians agree it what my colleague from Wyoming leagues wish to speak, we don’t have a was a mistake and it contributed to thinks. bill. We don’t have a bill. Here we have the Depression. Mr. BARRASSO. Madam President, I been debating all this time and we do There was the Alien and Sedition Act agree completely. As a practicing phy- not have legislation. This was one of of 1798. It sounded good at the time. We sician taking care of people in Wyo- the bills we were presented with, but were going to keep the foreigners in ming for 25 years, I have great con- we know that significant changes are our midst—they were mostly French cerns about this bill, what we know for being made behind closed doors. We then—from saying bad things about the sure is in it, which is $500 billion of don’t have a CBO estimate of the cost, government, but it offended all of our cuts in Medicare to our patients who do we? We understand they keep send- traditions about free speech. depend on Medicare, and that is a sys- ing estimates over to CBO and it comes In 1969 Congress enacted the ‘‘mil- tem that we know is going broke. That back and so they send them back, lionaires’ tax,’’ they called it, to try to is why there is a front-page story in which probably is why last week the catch 155 Americans who weren’t pay- one of the Wyoming papers: ‘‘Doctors Senator from Illinois, the No. 2 rank- ing any tax. That turned out to be a Shortage Will Worsen.’’ It is going to ing Democrat, said to me, I don’t know historic mistake, because last year it be harder on rural communities and what is in the bill either. I have the caught 28 million American taxpayers others around the country if this goes exact quote: until we had to rush to change it. through, and we know that because the Just a couple more. There was the folks who have looked at the parts of I would say to the Senator from Arizona that I am in the dark almost as much as he Catastrophic Coverage Act of 1988. the bill we have seen have said that is, and I am in the leadership. That was well named, but it turned out one-fifth of the hospitals in this coun- That is an interesting commentary. to be a catastrophe, a congressional ca- try will be—if they are able to keep Of course, the issue of the protection tastrophe. The idea was to help seniors their doors open—operating at a sig- of the rights of the unborn is still un- deal with illness-related financial nificant loss 10 years from now. That is clear. That is a big issue for a lot of losses, but seniors didn’t like paying not the best future for health care in Americans. It is a big issue with me, for it. They surrounded the chairman our country. of the Ways and Means Committee in I had a telephone townhall meeting. and I know it is a big issue with my Chicago and now the leader of that People from all around the State of colleagues. So here we are back, off of the bill group is a Member of Congress. Wyoming were calling in and asking itself, and apparently we are going to Then there was a luxury tax on boats me questions, and they asked: What is have some kind of vote on Christmas over $100,000, another historic mistake, in the bill? What is coming to the Sen- Eve or something such as that. because it raised about half the taxes it ate? was supposed to and it nearly sank the We don’t know yet. We haven’t seen What the American people are saying boating industry and it put 7,600 people it. now is, when they say keep the status out of jobs. They said: Well, when you find out, quo, they are saying: Stop. Go back to I ask my friends from Oklahoma and come home and let’s have some more the beginning. Sit down on a bipartisan Wyoming—it is going to be a lot harder townhall meetings so we can have some basis and let’s get this done, but let’s for Congress, if they try to fix the input. get it done right. health care system all at once, to come That is what we ought to do as a Sen- Americans know that Medicare is back and repeal it than it was to repeal ate. We ought to know what is in the going broke. Americans know that a boat tax. Do my colleagues think we bill and then let us go home and share costs are rising too quickly, but Ameri- ought to take the time to avoid an- it with our friends so they know. Be- cans want us to do this right and not in other historic mistake? cause right now what the American a partisan fashion and not with a bill Mr. COBURN. Well, I would answer people have seen of this bill, the 2,000- that costs too much, taxes too much, my colleague from Tennessee. As a page bill, they rightly believe this will and deprives people of their benefits. practicing physician, what I see as the increase the cost of their own personal Mr. ALEXANDER. Madam President, historic mistake is we are going to care. I thank the Senator from Arizona for allow the Federal Government to de- Mr. COBURN. Madam President, if his comments. We have two physicians cide what care you are going to get. We my colleague would yield, yesterday I in the Senate, Dr. COBURN from Okla- are going to compromise the loyalty of asked the chairman of the Finance homa and Dr. BARRASSO from Wyo- your physician so that no longer is he Committee to agree to a unanimous ming. I wonder if they would bear with or she going to be a 100-percent advo- consent request that, in fact, for at me for a minute or two to reflect on cate for you, he or she is going to be an least 72 hours the American people something the majority leader said— advocate for the government and what would get to see this bill; the Members minority leader said—I hope he is the the government says. Because in this of the Senate would get to see this bill; majority leader before too long—and bill—even the one that is going to that there be a complete CBO score so the Senator from Arizona. come—there are three different pro- we can have an understanding. He de- The minority leader, the Republican grams that put government bureauc- nied that request. leader, talked about a historic mis- racy in charge of what you can and That comes back to transparency. take. There has been a lot of talk cannot have. It doesn’t consider your The American people expect us to around here about making history on personal health, your past history, or know exactly what we are voting on. health care. The problem is there are your family history; they are going to They expect us to have read what we many different kinds of history, as the say here is what you can and cannot are voting on. His explanation was: I Republican leader has pointed out. It do. That is called rationing. That is in can’t guarantee that. It presumes a seems our friends on the other side are the bill. That is coming. That is a his- certain level of perception on my part, absolutely determined to pursue a po- toric mistake because it ruins the best an understanding of delving into the litical kamikaze mission toward a his- health care system in the world in the minds of the Senators that they could toric mistake which will be disastrous name of trying to fix a smaller problem actually understand. What does under- for them in the elections of 2010, but in terms of access, and it ignores the stand mean? That is the kind of gib- E much more important, for the country. real problem. berish the American people absolutely REC-ONLIN ttahIke deUisd.n iaWt eleid t thSlaetv arete essme.a aMrdceah y otbhnee hwmies tbwoerofioucrl med ibisne- tkhnTioshw ec torhueinas tlb riypl lr ocdboolseetsmsn ’ ttio sdo r hivmeeau ldctohhw. ncWa creoe s atislnl, dwreohanad’tty twwoea vnoattr.e e Tovnho ettyhin isgw baoinlnlt . wuhse nt ow ek ngoewt NG- wise to take Governor Schwarze- it increases costs. So your premiums Mr. MCCAIN. Madam President, isn’t CO negger’s advice and slow down and stop go up, your costs go up, your care is that a violation of the commitment with and learn from our history rather than going to go down because the govern- that was made that for 72 hours any OD try to top our previous historic mis- ment is going to tell you what you legislation would be online, not just for PR takes, such as the Smoot-Hawley tar- have to have. us to see but for all Americans to see? YB1 iff. That sounded pretty good at the I think that is a historic mistake and Could I ask the Senator from Ken- SO time in 1930 when the idea was to buy we have not addressed that. I wonder tucky, the Republican leader: Is it not K69 S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00004 Fmt 0637 Sfmt 0634 E:\RECORD09\S17DE9.REC S17DE9 December 17, 2009 CONGRESSIONAL RECORD—SENATE S13347 the perception now that this bill is Republican candidates in next year’s elec- cratic Party. And just 38% of Hispanics feel probably going to be pushed through? tions. Support from independents for the positive, down sharply from 60% in Feb- Through various parliamentary proce- president and his party continues to dwindle. ruary. In addition, voters intending to back Repub- The survey, which was conducted Dec. 11– dures, the majority will try to force a licans expressed far more interest in the 2010 14, has a margin of error of 3.1 percentage final vote on this legislation, no mat- races than those planning to vote for Demo- points. ter what, before we leave? Isn’t that in crats, illustrating how disappointment on contradiction to what the majority of the left over attempts by party leaders to [From the Wall Street Journal, Dec. 17, 2009] the American people are saying, that compromise on health care and other issues SUPPORTFORHEALTHOVERHAULWANES they want us to do nothing? Is this a is damping enthusiasm among core party (By Janet Adamy) responsible way to govern, to have the voters. Senate in round the clock, 24 hours, But public displeasure with Democrats The public is turning against an overhaul wasn’t translating directly into warmth for of the health-care system, complicating people on the floor, quorum calls and Republicans. Twenty-eight percent of voters Democrats’ effort to pass a sweeping bill in all this kind of stuff; and there would expressed positive feelings about the GOP—a the Senate. also be no amendments allowed at that number that has remained constant through More Americans now believe it is better to time for us to at least address some of the Democrats’ decline over the summer and keep the current health system than to pass the issues of this bill that begins cut- fall. Only 5% said their feelings toward the President Barack Obama’s plan, according to ting Medicare by $500 billion, increases Republicans were ‘‘very positive.’’ a new Wall Street Journal/NBC News poll. taxes by $500 billion on January 1, and And in one arena, Afghanistan, Mr. Obama The findings mark a shift from the fall, when appeared to have some success in winning the overhaul enjoyed a slight edge over the in 4 years begins spending $2.5 trillion? support for his planned troop surge. Liberals status quo. They could make it more dif- Is this a process the American people remain largely opposed to the strategy, but ficult to get wavering lawmakers on board as are reacting to in a negative fashion, in fewer numbers compared with before Mr. the Senate prepares to vote on the measure obviously, by polling data? Obama made his case in a speech at West as soon as next week. Some Democrats ex- By the way, I ask unanimous consent Point. Overall, by 44% to 41%, a plurality be- pect support will rebound if they can pass a that the Wall Street Journal article lieve his strategy is the right approach. bill quickly and start selling it. entitled ‘‘Democrats’ Blues Grow Deep- Still, the survey paints a decidedly gloomy According to the poll, 44% of Americans er in New Poll’’ and ‘‘Support for picture for Democrats, who appear to be said it is better to pass no plan at all, com- bearing the brunt of public unease as unem- pared with 41% of Americans who said it’s Health Overhaul Wanes’’ be printed in ployment has risen from 7.6% to 10% since better to pass the plan. In early October, 45% the RECORD. Mr. Obama took office. Just 35% of voters of respondents preferred passing a bill, while There being no objection, the mate- said they felt positively about the Demo- 39% preferred passing no bill. Uninsured peo- rial was ordered to be printed in the cratic Party, a 14-point slide since February. ple were among those who have grown less RECORD, as follows: Ten percent felt ‘‘very positive.’’ supportive of the plan. [From the Wall Street Journal, Dec. 17, 2009] ‘‘Overall, it’s just a depressing time right In seeking support for his top domestic pri- now,’’ said Mike Ashmore, 23 years old, of ority, Mr. Obama has said the status quo DEMOCRATS’ BLUESGROWDEEPERINNEW Lansdale, Pa., an independent who supported wasn’t acceptable because insurance pre- POLL Mr. Obama last year but now complained miums were rising sharply and government (By Peter Wallsten) about the president’s lack of action on jobs. insurance programs were headed toward in- WASHINGTON.—Less than a year after Inau- Julie Edwards, 52, an aircraft technician solvency. Republicans have argued that guration Day, support for the Democratic for Boeing Co. in Mesa, Ariz., said she voted many Americans could be worse off, particu- Party continues to slump, amid a difficult Democratic in the past two elections but larly the elderly, because the legislation economy and a wave of public discontent, ac- wasn’t sure how she would vote next time. contained hundreds of billions of dollars in cording to a new Wall Street Journal/NBC She wondered why Wall Street firms were cuts to health-care providers through Medi- News poll. bailed out when average Americans needed care. The legislation would extend health-in- The findings underscored how dramatically help. ‘‘We can bail out Wall Street, but ev- surance coverage to at least 30 million more the political landscape has changed during erybody else has to suffer in spades for it,’’ Americans by widening the Medicaid federal- the Obama administration’s first year. In she said. state insurance program for the poor and January, despite the recession and financial Democratic leaders, while bracing for providing subsidies to lower earners to help crisis, voters expressed optimism about the losses next year, have argued that unlike the them buy coverage. future, the new president enjoyed soaring ap- 1994 elections, in which Republicans gained The idea of creating a government-run proval ratings, and congressional leaders 54 seats and took the House majority, Demo- health-insurance option still enjoys consid- promised to swiftly pass his ambitious agen- crats would survive 2010 in part because they erable support. Democrats dropped the idea da. are taking steps to avoid that possibility. from the Senate version of the health bill. In December’s survey, for the first time, Republicans must gain 41 seats to take con- When asked what they thought of removing less than half of Americans approved of the trol. the public option, 45% of respondents said job President Barack Obama was doing, House Speaker Nancy Pelosi said Wednes- that wasn’t acceptable, while 42% called it marking a steeper first-year fall for this day that Democrats ‘‘fully intend to be in acceptable. president than his recent predecessors. the majority’’ after November 2010, and she Respondents also favored letting people Also for the first time this year, the elec- was now shifting to ‘‘campaign mode’’ to buy into Medicare starting at age 55, another torate was split when asked which party it help candidates. Party officials are leaning idea Democrats abandoned to win the sup- wanted to see in charge after the 2010 elec- on a number of longtime colleagues to fight port of centrists needed to pass the bill in tions. For months, a clear plurality favored for their seats rather than retire. the Senate. Democratic control. The Journal/NBC survey found Ms. Pelosi’s Democrats ‘‘clearly have irritated their The survey suggests that public discontent presence on the campaign trail could do own base in a way that has dropped their en- with Mr. Obama and his party is being driven more harm than good. Fifty-two percent said thusiasm for their own plan,’’ said Bill by an unusually grim view of the country’s they would be less likely to vote for a can- Mclnturff, a Republican pollster who con- status and future prospects. didate who agreed with the speaker almost ducted the Wall Street Journal/NBC News A majority of Americans believe the U.S. all the time, compared with 42% who felt poll with Democratic pollster Peter Hart. is in decline. And a plurality now say the that way about candidates siding with Re- In September, 81% of liberal Democrats U.S. will be surpassed by China in 20 years as publican leaders. thought the health plan was a good idea, and the top power. For Mr. Obama, who has relied on his per- 6% thought it was a bad idea. In the most re- Democrats’ problems seem in part linked sonal popularity to retain the clout he needs cent survey, 66% of liberal Democrats called to their ambitious health-care plan, billed as to enact his legislative agenda, the survey it a good idea, while 13% called it a bad idea. the signature achievement of Mr. Obama’s pointed to troubling signs. House Speaker Nancy Pelosi suggested the NE first year. Now, for the first time, more peo- A majority for the first time disapproved decline in support for the health legislation NLI ple said they would prefer Congress did noth- of his handling of the economy. And the was due to ‘‘mischaracterization’’ by oppo- C-O ing on health care than who wanted to see public’s personal affection for the president, nents. She predicted views would turn RE the overhaul enacted. a consistent strong suit, has begun to fray. around when the House and Senate coalesced CONG- fu‘l‘lF omra Dste,m’’ oscariadt sD, tehmeo rcerda tfilca gpso alrlset eflry iPnegt aetr Fsiixf tpyo ipnetrsc elnotw enro wth afnee li np Ooscittoivbee r aabnodu ta nh i1m8-, aserloluinngd ait stinog tleh eb ipllu balnidc . th‘‘eIt ’psr evseirdye nht abredg atno D with Hlicaartn, pwohllos tceorn Bduilclt Medc ltnhteu sruffr. v‘e‘Wy hwaitt hw Re edpounb’t- poDinetm dorcorpa tssin’ cter ohuisb leeasr lcya wn ebeek sa itnt roifbfuictee.d in mbiellr,c’’h sahned sisaei d.h ealth care until you have a O know for certain is: Have we reached a bot- part to changing feelings among some core YB1PR toTmhien gb-oigugte psot inwto?r’’r y for Democrats is that sguropupopr tthearst. tAu rtnheidr do uotf hvoeatevrisly 3 4fo arn Dde umnodcerra, tas I sMary. tMoC mCOyN fNriEenLdL .f rMomad aAmri zPorneas,i dweintth, SO the findings could set the stage for gains by last year, feel negative toward the Demo- reference to the issue of the process, it K69 S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00005 Fmt 0637 Sfmt 0634 E:\RECORD09\S17DE9.REC S17DE9 S13348 CONGRESSIONAL RECORD—SENATE December 17, 2009 has been a bit of a charade—in fact, a 1979: Raises an almost $150 billion tax phone town meetings. That is what we whole charade. We have been out here on many middle-class workers using are hearing in all of our States. This is for 2 weeks on the amendment process. so-called Cadillac health insurance what the American people continue to We have had 21 votes, many of them plans. Page 1997: Will cost families and say: Do not pass this bill. have been side-by-sides, in order to individuals an additional $5 billion by As our leader said, we do need health cover the majority against the poten- prohibiting the use of savings set aside care reform, and Dr. COBURN certainly tial downside of voting to cut Medicare for health care expenses through knows that. But it is not this reform and voting to raise taxes. health savings accounts. Page 2010: that we need. But there is no serious effort to en- Will make the cost of lifesaving medi- Mr. ALEXANDER. We come to the gage in any kind of genuine amend- cine more expensive by taxing pharma- floor every day and point out the prob- ment process, such as the Senator from ceutical research firms an additional lems with the bill. We don’t have a bill Arizona and I have been involved in $22 billion. The list goes on and on, in- now, we can’t read it, and we don’t here for quite a while. Then the bill, cluding on page 2040: Increasing Medi- know how much it costs or how much which we are actually only allowed to care payroll taxes by $53.8 billion. it affects the American people. It have about two votes a day on, is not That may be a reason why it is going raises taxes and premiums. It will in- the real bill. The real bill—we know to be difficult for them to win passage crease the debt, because it doesn’t in- the core of it, but there are a lot of of this after 72 hours of examining this clude things such as the physicians things around the edges being slipped bill. Medicare reimbursement. It cuts Medi- in and slipped out, and they want to Mr. MCCONNELL. It makes this bill, care by $1 trillion over 10 years once it in addition to all of the other prob- jam the public before Christmas, as the is fully implemented. Senator from Arizona indicated. lems, a job killer. With unemployment We point out what we think should How arrogant is that? They think: at 10 percent, there is a big tax in- be done. My colleagues have talked crease on a variety of different Ameri- We know better than you, we know about it many times. Instead of wheel- better than the Republicans, and we cans, as Senator MCCAIN pointed out, ing in another 2,000-page bill, we should in addition to all of its other prob- know better than the public. Why don’t focus on the goal of reducing costs, and lems—substantive problems, process all of you—the Republicans and the we should take several steps toward problems. It is a job killer in the mid- public—sit down and shut up and leave doing that. The Senator from Arizona dle of a very difficult recession. it to us and we will take care of it be- talks about one of those things, which Mr. COBURN. I say to my colleagues fore Christmas. is reducing the number of junk law- that one of the things President Obama Mr. ALEXANDER. I say to the Re- suits against doctors. I don’t think said he wanted to have was trans- publican leader and the Senator from that is in the bill, unless it is secretly parency. There has been no trans- Kentucky, I believe there is another bit being added in the back room today. parency in the process. That is why at of history being made. This process is Mr. MCCAIN. Well, I don’t think that least if there is not going to be trans- historic in its arrogance. This isn’t is being added today. Again, I also parency in the process, we ought to at very hard to understand. The proposal point out that Americans are now least have it transparent to the Amer- is to take 17 percent of our economy, against passage of this legislation. But ican people for 72 hours. This is a quote affecting 300 million Americans, and in that polling data, it is very inter- from the chairman of the Finance nothing could be more personal, as the esting, also, the majority of seniors, by Committee: Republican leader has said, than our much larger numbers—the actual bene- I think it is impossible to certify that any health care. ficiaries of Medicare—are turning Senator will fully understand. But now we don’t have the bill. We do against it, and the intensity of Ameri- We are going to have a 2,000-plus page not have the bill. It is being written in cans against it—which is harder to bill, and the chairman of the Finance secret in another room. If there is any gauge in a poll—is incredible. Committee says he thinks it is going to part of this debate that went through If the responses that our efforts are be impossible to certify that any Sen- to every single household in America, I getting are anything close to indic- ator will fully understand this bill. believe it was when the Finance Com- ative of the mood of the American peo- That is the best reason I know not to mittee voted down a motion—the ple, and the intensity of it, it is prob- pass this bill, because if we don’t un- Democrats voted down a motion that ably as great as I have ever seen in the derstand it, you can bet the American the bill should be on the Web for 72 years that I have had the privilege of people aren’t going to understand it. hours so that the American people serving in the Congress of the United Mr. MCCAIN. When more Americans could see the text, know what it costs, States. begin to understand it, they don’t want and know how it affects them. This polling data says more Ameri- it. That is thanks to the efforts made Eight Democratic Senators wrote the cans now believe it is better to keep all over this country to educate the Democratic leader and said they want the current health system than to pass American people about what the im- to insist that they know what the text President Obama’s plan. That is a mes- pact of the bill will be. is, and that they have the official score Mr. BARRASSO. Following along sage being sent, and the intensity is from the Congressional Budget Office, what the Senators are saying, that is higher than any I have ever observed in and that they have it for 72 hours be- why the support of the American peo- my years of service. I thank them for fore we move to vote. ple for the bill is at an all-time low. It that. We don’t have the bill. We don’t have is at the lowest level of support ever. There is a chance that we can stop the official score from the CBO. Sev- According to this NBC poll, fewer than this, and we start in January. We enty-two hours is three more days, and one out of three Americans support would be willing to come back and sit even though eight Democratic Sen- this bill. They don’t know all that is in down and negotiate, with the C–SPAN ators and all the Republican Senators it, but they don’t like what they see so cameras on—as the President said or said we want to know what it costs, far, because they believe, in over- committed he would do as a candidate. know what it is, and how it affects us, whelming numbers, that the cost of We would sit down together here, at they want to run it through before their own care will go up, that this will the White House, or anywhere, and we E Christmas. add to the deficit, it will hurt the econ- can fix this system that we all know REC-ONLIN cthoMellyer .a dgMounCe’ Ctt AhwIaNatn. tmM iatay ybt oeI btmhe eeo nnrteiloiannseo ntfo o wrm h7yy2 oamlSlyyo , b wae nhbdye t ttwheeori urilf d hw eeta hlpteah s Asc amnroeetr hwicioanungl .d p eaocptule- nite Aeisds stt hfhieex icSnogesn.t a tthoar tf rhoams tOok blae haodmdrae sssaeidd,, G- hours is because when they examined support a bill that is going to cost not the quality. N CO what we have—on page 324 in this bill them more personally and when their Mr. COBURN. I want to bring up an with is an $8 billion tax on individuals who health care will get worse? That is not example. We are going to see this time OD have nongovernment approved plans. the value the American people have and time again if the bill goes through. PR On page 348 is a $28 billion tax on busi- ever wanted. We had the U.S. Preventive Health YB1 nesses that cannot afford to offer in- That is what I hear from patients at Task Force put out a recommendation SO surance to their employees. On page home, and it is what I hear on tele- on breast cancer screening through K69 S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00006 Fmt 0637 Sfmt 0634 E:\RECORD09\S17DE9.REC S17DE9 December 17, 2009 CONGRESSIONAL RECORD—SENATE S13349 mammography on the basis of cost. clearly points out that this legislation the Patient Protection and Affordable They said it is not cost effective to would increase taxes dramatically, in- Care Act. It has been an extraordinary screen women under 50 with mammo- crease costs dramatically, decrease legislative process with a good bit of grams, because you have to screen 1,900 care, and it would have the effect of the calendar year 2009 taken up with before you find 1 breast cancer. On forcing people not only out of the sys- very intensive work to try to pass cost, they are right; but over 50, you tem, but even if they are in the Medi- health care reform. At the moment, have to screen 1,470. care system, they would not have phy- there is still some doubt as to what So what we had was a decision made sicians to provide the care, because will happen with the bill. The Congres- on cost, not on quality, not on pa- more and more physicians would fail to sional Budget Office has not yet sub- tients, but based on cost. We fixed that treat Medicare patients. mitted a report on the so-called man- as part of an amendment to this bill. Mr. COBURN. So we go back to the 72 agers’ package. We actually fixed that. There are three hours. We are going to get a new bill, There are still some concerns being different agencies within this bill that but we will not have the opportunity to expressed by some Senators. I can un- are going to do the same thing. Every amend it. We are not going to be able derstand the frustration that some time they make a ruling based on cost, to read it and study it, nor are the have had as we have moved away from not on clinical outcomes and what is American people. What do you think a public option. I have been an advo- best for patients, are we going to fix it? the outcome of that will be? cate of a robust public option and No. We are transferring the care of the Mr. MCCAIN. I think we know what think it ought to be part of the legisla- American patient to three bureauc- the outcome will be. We will either be tion. racies within the Federal Government, able to reflect the feelings and intense The public option is what it says. It and they are going to decide what you feelings of the majority of the Amer- is an option. There have been efforts have to do. If you think about it, this ican people about this legislation and made to demagog the issue by saying it week the wife of a Member of this body say let’s go back to square one and all is a takeover by the Federal Govern- was diagnosed with breast cancer. She commit to a bipartisan approach to ment. It is not. The private insurance was diagnosed through a mammogram. this issue or we will see jammed industry remains in the field, and this Under that task force’s recommenda- through on Christmas Eve legislation is one option. tion, she would not have gotten that that will have the most far-reaching ef- As President Obama has put it, it is mammogram. fects and devastating effects, I think, an option to try to keep the private in- Mr. MCCAIN. I ask the Senator from not only on our ability to provide surance companies honest. We have Oklahoma, would that aspect of this much-needed medical care to all of our seen, in the past several months, very bill come to light if it hadn’t been for citizens, but also an impact that would large increases in premiums for small the recommendation that was made by be devastating on the debt and deficit, business. The reports have been that another similarly acting policymaking upon which we have laid an uncon- those increases in premiums have come body? In other words, that is what trig- scionable burden already. from Wall Street pressure on the insur- We have two choices—to go back to gered the investigation of what was in ance companies to try to increase their the beginning and enact many reforms this bill, which would have had exactly profits before there is legislation. The we can agree on—and there are many the same effect. So if we hadn’t had public option would be a forceful factor we could agree on immediately on a bi- that information of a recommendation dealing there. partisan basis; as the Senator from by another government policymaking When the objections were raised to Tennessee pointed out, there has never bureaucracy, we would not have known the public option and in an effort to been a fundamental reform made in about this until the bill would have find 60 votes—it is difficult when you modern history that was not bipar- taken effect. have no help at all from the Republican tisan—or we are going to see jammed Mr. COBURN. So there is no trans- side of the aisle, illustrated by the per- through, over the objections of a ma- parency. What we do know is that we formance just put on with their pre- jority of Americans, legislation that are going to have three organizations, pared colloquy—it is not easy to find they have never seen, read, or under- the Medicare Advisory Commission, everyone in agreement. Then there was stand. the Cost Comparative Effectiveness an effort to move to expand Medicare. That is the choice we have. That is Panel, and the U.S. Preventive Health I think that is a fallback position that what it is boiling down to. I think that, Task Force that will tell everybody in would have been very helpful. frankly, the American people should be America what they are going to re- There are some who are contending heard, not a majority over on the other ceive. that people who are disappointed with side. Mr. MCCAIN. This example wouldn’t Mr. BARRASSO. The American peo- the lack of a public option and dis- have been known if it hadn’t been for appointed from the retreat of expand- ple are saying: Don’t cut my Medicare, the actions of the bureaucracy. Doesn’t ing Medicare say we ought to start don’t raise my taxes, don’t make that bring into question what else is over and begin again. I can understand things worse than they are right now, buried in this 2,000-page piece of legis- that frustration. and this bill cuts Medicare, raises lation? My own view, after thinking it taxes, and for people depending on a Mr. COBURN. What are the unin- through very carefully, is we ought to health care system in this country this tended consequences of this that they proceed and do as much as we can this makes things worse. don’t know? What we do know is there year, realizing that some of the tough Mr. MCCAIN. By the way, could I are 70 new Government programs that legislative achievements take a period mention, if you live long enough, all will require over 20,000 new Federal em- of time to accomplish. But the Civil things can happen. I now find myself in ployees, and there are 1,690 different Rights Act of 1957 was necessary, al- complete agreement with Dr. Howard times when the Secretary of HHS will though it did not go as far as people Dean, who says we should stop this bill write rules and regulations about your would have liked then, to get the Civil in its tracks; we should go back to the health care in America—the Secretary, Rights Act of 1964. Again, it did not go beginning and have an overall bipar- not your doctor; your doctor isn’t as far as people would have liked, but tisan agreement. Dr. Dean, I am with going to write the regulations. The we did find the Voting Rights Act of E you. NLIN Secretary of HHS is going to write the The PRESIDING OFFICER (Mr. BEN- 1965. We have to find times when we REC-O ruMlers.. MCCAIN. Let me point out again NETTh).e T Sheen aSteonra ftroorm’s tPiemnen shyalsv aexnpiair. ed. hmaavtet etros. build incrementally on these NG- that we don’t know what the CBO esti- Mr. SPECTER. Mr. President, I ask I have been in the Senate following CO mate is, because we know the majority unanimous consent that I may speak the elections of 1980, and I have seen with leader keeps bouncing proposals back up to 20 minutes. matters take a very substantial period OD and forth to CBO. That is why we The PRESIDING OFFICER. Without of time. While it is not on the subject, PR haven’t had CBO information now for objection, it is so ordered. we were trying to provide more than YB1 many days. But there is the Commis- Mr. SPECTER. Mr. President, I have 100,000 jobs in Pennsylvania by deep- SO sion for Medicare and Medicaid, which sought recognition to comment about ening the channel. The authorization K69 S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00007 Fmt 0637 Sfmt 0634 E:\RECORD09\S17DE9.REC S17DE9 S13350 CONGRESSIONAL RECORD—SENATE December 17, 2009 came in 1983. It took until 1992 to get were in recess, I found instead of the There being no objection, the mate- the Corps of Engineers to agree on customary 85 or 100 people, more than rial was ordered to be printed in the funding. Now it has $77 million. We are 1,000 people and 3 national television RECORD, as follows: still in court, but it is going to move sound trucks—CNN, MSNBC, and FOX. PROVISIONSINTHEPATIENTPROTECTIONAND forward. I do not expect health care There were a lot of vituperative state- AFFORDABLECAREACT legislation to take that kind of a long ments. One man approached me apo- GENERALINSURANCEREFORMS term, but it is a matter which does plectic and said the Lord was going to Insurance companies will be barred from take some time. stand before me. I think he got mixed discriminating based on pre-existing condi- It is my hope we will yet improve up. I think he meant to say I was going tions, health status, and gender. this bill. It is my hope that when the to stand before the Lord. Senators are New health insurance Exchanges will make bill goes to conference, we will find a reputed to have power but not quite coverage affordable and accessible for indi- way, perhaps, even to bring back the that much power. I think the public viduals and small businesses. public option in a refined sense. The tenor is considerably more favorable to UNINSURED public option is in the House bill. health care insurance today than it With a reported 47 million people without One Republican Senator has stated was then. After the 2010 election, it health insurance the status quo is not ac- opposition on the ground that there may be substantially more favorable. ceptable. Additionally, there are millions more Americans who are underinsured, with has not been time enough to review the We have to move ahead with building health insurance that is inadequate to cover bill. It is complicated. I think there blocks, and we do have a chance to im- their needs. has been time enough to review the prove the bill in conference. In 2007, 1,206,115 Pennsylvanians under age bill. But I respect the view of the Sen- I point to the provisions of the bill as 65 were uninsured for the entire year, which ator on the other side of the aisle. to what we have. We have very signifi- is 11.3 percent of the under 65 population. When the bill goes to conference, that cant insurance reforms. We have elimi- The analysis found that the legislation Senator will have an opportunity to re- nating discrimination based on pre- would extend coverage to 33 million more view the bill further. That Senator has existing conditions. We have new Aicmanesr iwcaitnhs ,h berailntghi nings uthraen pceer cteon 9t3a%ge. of Amer- shown some inclination to support the health insurance exchanges. We have The bill covers 10% more Americans with bill, having voted it out of the Finance an elimination of a cap. We cover many only a 0.7 percent increase in spending—a Committee. of the uninsured, expanding to some 33 change of only 0.1% of GDP in 2019. Another Republican Senator has million additional people. We have sub- SMALLBUSINESSASSISTANCE commented that the bill has been very stantial more small business assist- In the current health insurance market greatly improved, not sufficiently for ance, preventive care, increased health small business are at a distinct disadvantage the taste of that Senator, but perhaps workforce. We have improvements in in providing health insurance to their em- we will find a way to improve the bill. the health delivery system. We have ployees. In a recent study it was found that We still do have a bicameral legisla- fiscal responsibility that this bill will 58 percent of small employers do not offer ture. We do have the House of Rep- not add to the deficit but will, in fact, health insurance, with nearly 50 percent resentatives which has the public op- reduce the deficit in the first decade by stating that they can’t afford it. tion. some $120 billion and in the second dec- CaTrhe eA cPta atidednrte ssP hroetaelcthti oinns uarnadn ceA pffroorbdlaebmles Comments were made about the fall ade by some $650 billion. facing small businesses by providing more of the expansion of Medicare on the We have a provision I have pressed in health plan choices, fairness in the market- ground it was considered in too brief a earlier legislation, S. 914, to provide for place and improving affordability with tax period of time, not enough time to di- transformational medicine. credits. gest it, not enough time to think During my tenure as chairman of the PREVENTATIVECARE through. We will have, in the month of Appropriations Subcommittee on The Patient Protection and Affordable January, some time to consider that Health and Human Services, I took the Care Act will eliminate co-pays and further, and in conference we may well deductibles for recommended preventive lead, with the concurrence of Senator find we are able to improve the bill. We care, provide individuals with the informa- cannot get to conference unless we pass HARKIN, who was then in the minority, tion they need to make healthy decisions, the bill out of the Senate. to increase NIH funding from $12 bil- improve education on disease prevention and I was asked yesterday how will I re- lion to $30 billion and then in the stim- public health, and invest in a national pre- ulus package to add $10 billion more. vention and public health strategy. spond to my constituents if we have the bill which has had so much taken There has been a gap on what we call INCREASEHEALTHWORKFORCE from it. I said: A more relevant ques- transformational medicine, going from Currently, 65 million Americans live in tion or an equally relevant question is the so-called bench in the laboratory to communities where they cannot easily ac- the bedside. While I have not seen the cess a primary care provider, and an addi- how will I respond to my 12 million final version of the managers’ packet, I tional 16,500 practitioners are required to constituents in Pennsylvania if we go am informed that provision will be a meet their needs. The Patient Protection home with nothing. If we have 80 per- part of the bill. and Affordable Care Act will address short- cent accomplished, then that is a start- ages in primary care and other areas of prac- ing achievement. We have very important measures for tice by making necessary investments in our It may well be it will take the cam- preventive care, for annual exams, nation’s health care workforce. paign in 2010. If this Congress will not which will cut off many chronic ill- IMPROVEMENTSINTHEHEALTHDELIVERY pass a bill with a robust public option, nesses which are so debilitating and so SYSTEM it could well be a campaign issue. expensive. The legislation we are considering will es- I believe my colleagues on the other I have pressed an amendment, which tablish an Independent Medicare Advisory side of the aisle may well be is pending, to have mandatory jail sen- Board to present Congress with proposals to misreading the American people. I be- tences for at least 6 months for some- reduce cost growth and improve quality for lieve the American people do want one convicted of $100,000 or more of Medicare beneficiaries. In years when Medi- health reform. It does take time for the Medicare or Medicaid fraud. Jail sen- care costs are projected to be unsustainable, Board proposals will take effect unless an al- American people to understand the tences are a real deterrent. The experi- ternative is adopted by Congress. This type E ramifications of it. But this may well ence I had as Philadelphia’s DA showed of reform is necessary to ensure the financial ONLIN bCeo nag rceasms pmaaigyn hiasvsue ea i nd if2f0e1r0e. nTt hvei e1w12 tahs maded etdh aotn wtoh etnh ey ocuo sht aovfe dao ifninge ,b uthsiante siss fuPturreev eonf tMabeldei chaores.p ital readmissions dimin- EC- to how we ought to proceed. and is passed on to the consumers. ish quality and efficiency in the health care R G- During the month of August, when I I ask unanimous consent to have system. Nearly 20 percent of Medicare pa- D with CON wiwnaigtssh mminay k iPnhegan bntihts yet lvoroa unconiavd,es r i onaf ltmaocowcsnot r mdeaveneerctye- trphirzieen dtp erwdo hviiinsc ihot nhaser ewR vhEeiCcrOhyR DIf abavr oisretafablytlee m suienmn ttm haois-f taPiraeeyn mtrsee awndthm oiA tatdrevedi sdowirsiycth ha C3ro0gm eddma fyirssos.m ioT nht he e(MM heeoddsPipcAiatCrae)l O estimates that Medicare spent $12 billion on YB1PR ctoo utnhtey fairlmsto tsot wenv emrye eyteinarg,, wthhee ns eIc ognodt bCirlilm ainnda la sJtuastteimcee ntS oufb tceosmtimmiotnteye att ao psiootnesn tiina l2l0y0 5,p wrehviecnht awboleu ldh boesp mitaolr e rtehaadnm $i1s5- SO Tuesday in August, the first week we show the value of deterrence. billion today. K69 S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00008 Fmt 0637 Sfmt 0634 E:\RECORD09\S17DE9.REC S17DE9 December 17, 2009 CONGRESSIONAL RECORD—SENATE S13351 The bill also begins the payment system and I can tell you, Senator: In a white-collar the other side of the aisle today, I reform of bundling Medicare provider pay- case—I’ve been in the conference room with could bring somebody with me. I don’t ments as a lump sum fee—instead of paying my clients—there is nothing—there is noth- know. That is entirely speculative. a fee for each service—encourages care co- ing like an individual—who feels as if he or Without revealing any more of the ordination and streamlining. It removes the she has been sort of the center of their com- confidence which went on inside of the incentive to generate additional services for munity, is well-respected and has had a com- Republican caucus, when I talk about a added reimbursement. fortable life—realizing that they’re facing FISCALRESPONSIBILITY jail time. The terror in their eyes is like Republican Senator’s statement that The legislation is fully paid for and reduces nothing else, and there’s simply no deterrent this should be the Waterloo of Presi- the deficit in the next ten years and beyond. like it. dent Obama and this should break him, The revenue provisions in the bill focus on KAUFMAN: You know, I think I know the those are matters in the public record. paying for reform within the health care sys- answer to this, but I think it’d be good to be But the pressure over there in the Re- tem. on the record, and starting with you, Mr. publican caucus is absolutely intense, Breuer. Why don’t—why haven’t we seen THECOSTOFINACTION more, you know, board room prosecutions? and we were sent here to govern. In 2000, family health insurance purchased In the Democratic caucus—and the through an employer cost $6,438 and con- Mr. SPECTER. Mr. President, how Presiding Officer, the distinguished sumed 13 percent of median family income. much time do I have remaining? Senator from Colorado, was there on In 2008, the same family health insurance The PRESIDING OFFICER. The Sen- Monday evening—when my turn came cost $12,680, a 97 percent increase over the ator has 7 minutes remaining. to speak, I said: I have two sentences. 2000 cost, consuming approximately 21 per- Mr. SPECTER. I thank the Chair. And may the record show a smile on cent of median family income. In 2016, the Mr. President, there is another very the face of the Presiding Officer. I said: snaemarel yi ndsouurbalnec eth ies 2p0r0o8 jeccotsetd, wtoh iccho swt i$l2l 4c,2o9n1-, important aspect, in my opinion, of the I have two sentences. One sentence is, sume 45 percent of projected median family Senate enacting legislation on this the bill is a great deal better than the income. bill; that is, we were sent to Wash- current system, and the second sen- ington to govern. What we have seen in tence is, we should not let obstruc- Let’s kind of go back to (inaudible). Can the recent past has been staggering tionism prevent us from governing. you—each one of you, starting with Mr. Per- partisan politics. Partisan politics be- And that is why I crossed the aisle to kins, talk about kind of what’s the—the im- came a blood sport in Washington, DC. make the 60th vote. I was very sur- pact of criminal prosecutions and prison It is a blood sport on the floor of the prised to see in the public record—been time versus civil actions and fines. KEVIN PERKINS, Assistant Director, FBI: Senate. It pervades the entire town. in the newspapers—that everybody Yes, Senator. The—it’s really a combination The point from the Republican side stood up and applauded, and I read in of both. We, obviously, are very successful in of the aisle has been very clear; that is, one of the Hill newspapers today that the health care fraud side, where we have to make this President Obama’s Water- you could hear the applause down the civil remedies that we utilize each day in our loo, to make this ‘‘break President corridor. So they knew what was going investigations there. But again, I’m a—I’m a Obama.’’ on. Well, that is the role, it seems to very strong proponent of criminal prosecu- I saw the ramifications when we took me, of a Senator. We are facing a situa- twihointse -tchoallta rin cvroilmvein saelsr.i oTuhs ajta iils sae hnutegnec dese tfeorr- up the stimulus package earlier this tion where, if defeated, it will have a rent. year. There were only three Repub- significant impact on the tenure of I’ve seen it over the years, and I—I know— licans—Senator SNOWE, Senator COL- President Obama. I know that, from my own personal experi- LINS, and myself—who would even talk We had a meeting on Tuesday—2 days ence, going and interviewing individuals who to the Democrats. There was a deter- ago—in the Executive Office Building, are—who—white-collar criminals who have mination to look ahead to the 2012 and it was a rather remarkable setting. been—or are doing jail time, going and talk- elections on the Presidency even before There was a large rectangular table, ing to them on various occasions—it’s—it’s a the ink was dry on the oath of office and in the center on each side—one huge deterrent. It’s—it’s something that we taken by President Obama on January side was President Obama, the other have to have, going forward, to make this work. 20. This was the second week of Feb- side was Vice President BIDEN, and al- KAUFMAN: Mr. Khuzami. ruary, the week of February 6, as I re- most all of the 60 Senators were ROBERT KHUZAMI, Director, Securities call, just a couple weeks, and already present. I think Senator BYRD couldn’t and Exchange Commissions Division of En- the plans were for the next election. be there because of his ailment, but I forcement: (Inaudible), yes, but there’s— As I reviewed the matter, it seemed believe everybody else was present. there’s no deterrent that’s a substitute for to me we were on the brink of going During the course of that session, the jail time. I miss the cooperation tools, and into a 1929 Depression. The 1929 Depres- President expressed himself—and this I—I miss the sentencing guidelines even more. But there is a very significant role for sion was very hard on the Specter fam- has also been publicized—that if action the civil regulators as well, simply because: ily, living in Wichita, KS, at the time. was not taken now, it would discourage Because of the standard of proof of beyond a Both of my parents were immigrants. anyone from the foreseeable future— reasonable doubt and the necessity of con- In the mid-1930s, the family moved any President—from undertaking vincing 12 jurors of the—of the guilt of some- from Wichita to Philadelphia to live health care reform if now, with both one, the criminal authorities, by definition, with my father’s sister. That is what Houses and 60 Members of the Demo- cannot and should not capture the whole happened in the Depression—you cratic Party, you can’t get it through field of wrongdoing. moved in with relatives because there the Senate and get it conferenced and And so what you’ll often see is criminal authorities focused on the core wrongdoers, were no jobs. get it enacted. and we may cast a wider net—because we I sided with supporting the stimulus Some of those who were most vocal have a lower standard of proof—cast a wider package and played a key role in hav- in favor of the public option urged net amongst those involved in the wrong- ing that enacted. And the political con- those in the caucus who disagreed to doing as well. And in particular, there’s lots sequences on a personal level are not reconsider their position, and I would of wrongdoing that goes on that doesn’t rise something to be discussed on this floor renew that request that they recon- to the level of criminal intent, all sorts of at this time, but the conduct of par- sider their position. The people who activity across regulated broker-dealers and tisanship on the stimulus package is would classify themselves as most pro- investment advisors and others where, if you E can at least make it unprofitable—so that directly relevant to what we are doing gressive in the Democratic caucus have EC-ONLIN twthirmeoyen gohfuuatlv loye r g tlooots ,e gp itavhyee iarb paleiccnkea nlstteyh—,e ptehmrahotan, petsyo os,ut hfhfeaeysr hbeeIir netg h tisnotdkoan yiet,w iaasl nlhedad r.t dheart foirs at hRaetp uwbel icaarne spbwuilbal llielcovlweyne d tt hhahotau rtgdhh e ayitn dwd oohueasldnv ’ets uhapnapvnoeor tua nt chreoids- R G- a significant impact. to stand up on health care reform and bust public option, doesn’t have the D with CON erKLalAA: NUSNFenMYa AtBoNRr:,E MoUbrEv. RiBo,ru Aesulsyesi,r s.a tas nRto Abt (tpohrn) esya yGse: nA- jioonfi nuJ sa tndhuieda rDsyoe .am nAodnc dirna i tfFs Ie tbwordeuaraeyr y ot nwh ahtnhe nei tot htwhreaeers MshIeitfd ti icysa erftea. ire xapnadn saicocnu. raAten dt o tshaayt tmhearye O comprehensive approach is essential. Civil YB1PR ryeemaresd iiens tahree persisveanttei apl.r aBcutitc eI,’ vaen dh aId’v em ahnayd spiodret ionfg thheea altihsl ec atroed aryef, oIr mwo. uI ldw obuel dsu bpe- afrroen timngo rteh e pUrneistseidn gS taptreosb lteomdasy tchoann- SO many years when I represented individuals, supporting, and perhaps, if I were on at any time in our history, and we have K69 S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00009 Fmt 0637 Sfmt 0634 E:\RECORD09\S17DE9.REC S17DE9 S13352 CONGRESSIONAL RECORD—SENATE December 17, 2009 to finish health care next year to move It would be my hope that Iran, for you to file a cloture motion which ahead to jobs. We have the issues of humanitarian reasons, would release would put an end to a filibuster. We global warming and climate control, these people and that we would exer- want you to fill the tree with amend- and we have the problems with the cise our best efforts—the U.S. Govern- ments so that this bill isn’t assaulted. Mideast peace process and the difficul- ment working through Syria or what- Believe me, the terminology would ties in Iran and North Korea and Af- ever other channel we can find—to se- lose most people, including many Sen- ghanistan. We need a strong President, cure their release. ators, but the bottom line is this: In- and we need a Congress which has the Mr. President, I yield the floor, and I stead of just doing what we know needs courage to act and the tenacity and suggest the absence of a quorum. to be done and what should be done, willingness to confront tough prob- The PRESIDING OFFICER. The Republicans have insisted we delay this lems. We need to show the American clerk will call the roll. process for at least 2 days. people that it is not all gridlock here, The assistant legislative clerk pro- Why? Why would we want to delay that it is not all desperate, desolate ceeded to call the roll. funding our troops in the middle of a partisan politics. Mr. DURBIN. I ask unanimous con- war? Why would we want to say to our So my vote will be in favor of the sent that the order for the quorum call troops that the military pay raise they bill. Although I am, frankly, dis- be rescinded. were counting on so their families can appointed and I share the frustration The PRESIDING OFFICER (Mr. get by back home, and for those sta- expressed by many people who say go KIRK). Without objection, it is so or- tioned in the United States, make sure back and start again, this is a signifi- dered. that they have what they need, why cant step forward. We have a great Mr. DURBIN. Mr. President, before would we say to them that we are chance to improve it in conference, and the Senate now is an issue of funding going to raise a question as to whether beyond that there will be another Con- our military, the Department of De- we are going to put $29.2 billion into gress. And with the analogy of civil fense appropriations bill. This is a bill the defense health program, the health rights legislation, we can get the pub- that is critically important because it program for our military members and lic option and get greater public in- provides the funding our men and their families? volvement for the benefit of the Amer- women in uniform now risking their Why would the Republicans insist on ican people. lives while we meet in the safety of our delaying a vote for $472 million for I thank the Chair, and I yield the businesses and offices and homes in family advocacy programs for military floor. America, it funds their needs to make families who are separated, many of Mr. President, in the absence of any sure they will be safe to perform their whom are going through extraordinary other Senator seeking recognition, I missions effectively and come home. stress because of the separation? Why ask unanimous consent to speak up to Without fail, every year this bill comes would they want to delay a pay raise 3 minutes on another subject. before the Senate and is a consensus bi- for the military? Why would they want The PRESIDING OFFICER. Without partisan bill. to delay $154 billion for equipment and objection, it is so ordered. Regardless of our debates over for- training for our military? AMERICANSHELDBYIRAN eign policy, we all want the men and I don’t understand it. It would seem Mr. SPECTER. Mr. President, there women in uniform to know we stand to me that we ought to come together has been wide publicity given to three behind them. As a consequence, this by noon today and say: Let’s do this. young Americans who were taken into bill usually passes with an over- Let’s not waste another minute in custody by Iran and the recent reports whelming number. I asked how this bill terms of helping our troops and show- that they are going to be tried in an fared in the House of Representatives ing them we stand behind them. But, Iranian court. Senator CASEY and I, in when it was considered yesterday. The no, the decision has been made on the the Senate, introduced a resolution vote was 395 to 34. There were 164 Re- other side of the aisle that we are urging the Iranians to release those publicans who voted yes on this bill. It going to delay this matter until tomor- three young Americans—Congress- was clearly an overwhelmingly positive row. woman ALLYSON SCHWARTZ, on the bipartisan vote. There is no reason it They say in politics, for every deci- House side, did so in the past—and it is would not be the same in the Senate. sion there is a real reason and a good my hope Iran will change its view. But there is a problem. The problem reason. There may be some good reason I was talking to the Syrian Ambas- is this: Tomorrow the funding for our they are giving on the other side of the sador yesterday, who advised me that troops runs out. It is the end of our aisle for delaying funding our troops, when the five British citizens were continuing resolution in funding. We but the real reason is their hope that taken into custody by Iran, the Gov- ernment of Great Britain made a re- are not going to leave them high and they can stop health care reform in the quest of the Syrian Government to use dry, but we are going to leave them un- Senate. That is what is behind this. their good offices to secure the release certain if we don’t act decisively and The lengths to which those on the of the five British citizens. That re- quickly. Why would we do this to other side of the aisle will go was dem- quest was made via Syria, and they them? onstrated yesterday. were released. Military families across America, as We had a defining moment when the I have written to and contacted the we go into the holiday season, I am leadership on the Senate Republican State Department since that meeting sure, are saddened by the absence of side insisted, through Senator COBURN yesterday afternoon to find out what is their loved ones who may be in Iraq or of Oklahoma, that an 800-page amend- the status of U.S. activity because if Afghanistan, saddened by a separation ment be read by the clerk. It is the we have not asked the Syrians for help, from children and other loved ones right of a Senator to ask for that. It is my view is that we should. It would be they would like to avoid in their life- an archaic right because people don’t my hope that with the very difficult time but they have offered it up for sit here hanging on every word to un- problems facing the United States in this great country. With this kind of derstand an amendment. That never Iran, that Iran would relinquish the uncertainty and sadness and emotion, happens. It didn’t happen yesterday. custody of those three young Ameri- why would we be uncertain when it But the clerk started reading. E cans and release them to their family comes to funding our troops? Almost 2 hours into it, it was pretty ONLIN athned yferaiern. ds, especially at this time of yeHsteerred iasy w. hWeer e swaied :a rLe:e tW’se vooffteer efdo rt hiits. cislhea rt htihsa t8 0it0 -wpaoguel d atmakeen d1m0 henout,r sd teos pfiitne- EC- I have been an advocate of dialog Let’s vote for our troops and get this the best efforts of the clerk’s office. R G- with Iran for years. I have tried to go behind us so the Department of Defense Why did the Senate Republican leader- N CO to Iran since 1989, when the Iran-Iraq appropriations bill was clear. ship want to take 10 hours out of a day with war ended. Senator SHELBYand I got to The other side of the aisle said: No. for something that was meaningless— D Iraq and met Saddam Hussein, but as We want you to go through all of the the reading, word by word, line by line, O PR yet we have not had an interparliamen- hurdles that you have to go through page by page, of an 800-page amend- YB1 tary exchange, which I have sought for under the procedures of the Senate for ment? To stop debate on health care SO a long time with the Iranians. the most controversial bills. We want reform. K69 S D mmaher on VerDate Nov 24 2008 02:38 Mar 11, 2010 Jkt 089060 PO 00000 Frm 00010 Fmt 0637 Sfmt 0634 E:\RECORD09\S17DE9.REC S17DE9
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