To clarify the authority of the Nuclear Regulatory Commission regarding the acquisition and lease of certain additional office space.

ENERGY AND WATER DEVELOPMENT AND RELATED AGENCIES APPROPRIATIONS ACT,
2010

The PRESIDING OFFICER. Under the previous order, the Senate will
resume consideration of H.R. 3183, which the clerk will report.
The assistant legislative clerk read as follows:

A bill (H.R. 3183) making appropriations for energy and
water development and related agencies for the fiscal year
ending September 30, 2010, and for other purposes.

Pending:

Dorgan amendment No. 1813, in the nature of a substitute.

The PRESIDING OFFICER. The Senator from North Dakota.
Mr. DORGAN. Madam President, this legislation comes from the
Appropriations Energy and Water Subcommittee. It has passed through the
full Appropriations Committee and reported to the floor of the Senate.
This is another one of our appropriations bills that we very much hope
we can get done, have a conference with the House, and send to the
President for signature. Regular order for this bill has not happened
for a couple of years, which is a failure of the Congress and the White
House because of the way things developed in the last few years. We
need to change that.
I thank Senators Inouye and Cochran, the chairman and vice chairman
of the full committee. They have made a decision that they want to
drive these individual appropriations bills through the process, get
them conferenced, then send them to the White House to sign them into
law. That is the way they should be done.
We have put together legislation that we think is a good bill. It
funds all of the energy functions across the country, including
programs attached to the Energy Department. It funds all of the water
policy issues across the country, all the projects that are ongoing. It
is a very important bill. If we think of the subject of energy and
water, there is not much more controversial or important at this point
than those two subjects.

[[Page S8158]]

This bill is 1.8 percent under the President's budget request and 1.4
percent over the amount spent in the previous fiscal year. This is a
fairly conservative, austere bill we have put together. We have tried
to make the best case we can for the best investments for the future.
The other thing that is important to understand is that, at a time
when our country is in a deep recession, funding water projects and
energy projects provides a way of putting people to work and creating
jobs. At the end, rather than only spending and having the money
disappear, we have invested and we have returns on those investments in
the form of water and energy projects that will benefit the country for
many years.
Yesterday, I talked for a moment about the Department of Energy's
national laboratories. We fund a lot of issues in this appropriations
subcommittee, including all of our science, energy, and weapons
laboratories. I am so proud of those laboratories. They remind us of
the old Bell Laboratories, where so much good research and scientific
inquiry occurred. The Bell Labs are now largely gone. The laboratories
that we have--the science, energy and weapons labs--are the repository
of the most important research that goes on in this country.
I believe it was in the last fiscal year that Los Alamos in New
Mexico announced it had completed work on what is called the
Roadrunner, which is the most powerful computer in the world. That most
powerful computer does not exist somewhere else, it exists here at Los
Alamos Laboratory.
It is a computer that has met the speed of what is called a petaflop.
That sounds like a foreign language.
Let me start first by talking about a teraflop. A teraflop is
something where a computer can do 1 trillion discrete functions per
second. In 1997, we reached that standard of a teraflop, 1 trillion
functions per second. Ten years later, the amount of space for the
hardware to do what was called a teraflop was a very large home
essentially. That is the amount of space it took for the hardware. The
amount of energy it took to run all that computer power was the amount
of energy it took to supply hundreds and hundreds of homes. Then, 10
years later, a teraflop, the same 1 trillion functions per second,
could be provided with the energy equivalent of a 60-watt lightbulb on
equipment the size of a very small token.
Now we are not talking about 1 trillion functions per second or a
teraflop. We are talking about a computing standard called a petaflop.
The Roadrunner achieved it. A petaflop is 1,000 trillion functions per
second. It is so powerful and unbelievable, it is almost hard to
describe. I asked a scientist: What does it mean that you can do 1,000
trillion functions per second? He said: As an example, they are using
them on stockpile stewardship and weapons issues. There are something
like 1 or 2 billion synapses in the brain that communicate with each
other. This is the first computer that has the capability and the power
to analyze what these billion synapses of the brain are doing in
communicating in order to produce something from one's eye called
vision. We understand we can see. We just don't understand how it is
all possible. Yet the development of very powerful computers like the
Roadrunner, the world's most powerful computer in this country, allows
us to do almost unbelievable things in science and research and
inquiry. Is that an investment in the country, in the future? Yes, it
is a big investment, an investment that will pay dividends for decades
to come.
I point that out to say that we have brought a bill to the floor that
deals with so many important energy and water issues. It attempts to
accelerate research into renewable energy for programs like wind and
solar and biomass. It attempts to evaluate how, through science and
research, we can understand our ability to continue to use our most
abundant resource: coal. We understand we will have to have a lower
carbon future and capture carbon and sequester it or use it for
beneficial use. The way we will do that is by investing in the kind of
research and inquiry that will unlock the mystery of doing that. I am
convinced we will. This is the legislation in which we make those
investments.
Senator Bennett has no doubt had the experience I have had because we
lead the committee that funds all of this. I have had people from all
around the country come to my office breathless about the silver bullet
they have now patented that will solve all of our problems in energy,
either the newest form of energy or the newest approach to capture
carbon. They come in breathless. By the time they are finished talking,
we are out of breath because they are so excited about what they are
doing.
We have a guy who was a witness at a hearing on the beneficial use of
carbon so that we can continue to use coal and not severely impact our
environment. He has developed and patented an approach by which he
takes the effluent coming out of the stack of a coal-fired generating
plant and doesn't separate the CO<inf>2</inf>. Through chemicals, he
mineralizes it and creates a product that is equivalent and harder than
and better than concrete. Is that the silver bullet? I don't know. But
he made a strong and interesting case before the committee that this
will dramatically advance our ability to use coal in the future while
at the same time protecting our environment.
Senator Bennett and I, in this legislation, provide the investment
funds necessary to begin to scale up and demonstrate new approaches and
new patents and new technologies in so many of these areas. Why is all
this important? We are unbelievably dependent on foreign oil. Almost 70
percent of the oil we use comes from outside of our country. That makes
us vulnerable from a national security and an energy security
standpoint. The country knows we have to move off that dramatic
dependency and find ways to produce more here. That means more of all
kinds of energy. That is what we support in this legislation. We
produce, we conserve. We provide greater efficiency for virtually
everything we use every day, as we use energy in our daily lives.
Then, in addition to that large area of energy, which we will
describe in greater detail as we have amendments to the bill, all of
the water projects in this country, through the Army Corps of Engineers
and the Bureau of Reclamation, are projects that are making life better
for people, providing access to clean water and the storage of water.
We understand how controversial water is, but we also understand that
water is essential to economic growth and human health. To monitor and
conserve water resources and make the best use of all of those
resources is exactly what we are trying to do with this legislation.
I won't describe more except to say this legislation includes the
President's recommendations, his wide range of earmarks, and what the
White House would like to be funded in water projects. We respect that
and have accepted most of what the President has recommended for
specific project requests. We have added some, while eliminating some
of the President's, that we believe have higher value for various
States based on information we have gleaned.
We will have amendments. I think there are already a couple dozen
amendments filed. Some say the Congress should not have any imprint on
what should be funded here, let's just let the White House tell us what
they want funded.
Well, that does not make a whole lot of sense because the folks in
this Chamber are elected by their constituents and perhaps have the
best sense of what kinds of water projects will best meet the needs of
their region or their State. But, as I said, we respect the President's
views, and we have funded most of the specific projects he has asked us
to fund and made some modifications where we think appropriate and
where we think it will improve the legislation.
I say on behalf of myself and Senator Bennett, we were here
yesterday, and we did not have amendments offered. We had some filed
but not offered. It is a quarter to 12 today, and we will be here all
day. We very much hope, if people have amendments, they will come to
the floor of the Senate, offer them, and debate them so we can proceed.
So we are here. We very much would like to finish this bill by tomorrow
evening--perhaps this evening, if people would be as optimistic as we

[[Page S8159]]

are. But we would like people to come and offer amendments as soon as
possible.
Madam President, I do not know whether Senator Bennett wishes to
speak. Well, I believe we have someone who wishes to offer an
amendment. We appreciate Senator Voinovich coming to the Chamber.
The PRESIDING OFFICER. The Senator from Ohio.

Amendment No. 1841 to Amendment No. 1813

Mr. VOINOVICH. Madam President, I ask that the Voinovich-Carper
amendment No. 1841 be called up.
The PRESIDING OFFICER. The clerk will report.
The assistant legislative clerk read as follows:

The Senator from Ohio [Mr. Voinovich], for himself and Mr.
Carper, proposes an amendment numbered 1841 to amendment No.
1813.

Mr. VOINOVICH. Madam President, I ask unanimous consent that reading
of the amendment be dispensed with.
The PRESIDING OFFICER. Without objection, it is so ordered.
The amendment is as follows:

(Purpose: To clarify the authority of the Nuclear Regulatory Commission
regarding the acquisition and lease of certain additional office space)

On page 63, after line 23, add the following:

SEC. 3__. AUTHORITY OF NUCLEAR REGULATORY COMMISSION.

The Nuclear Regulatory Commission may use funds made
available for the necessary expenses of the Nuclear
Regulatory Commission for the acquisition and lease of
additional office space provided by the General Services
Administration in accordance with the fourth and fifth
provisos in the matter under the heading ``salaries and
expenses'' under the heading ``Nuclear Regulatory
Commission'' under the heading ``INDEPENDENT AGENCIES'' of
title IV of division C of the Omnibus Appropriations Act,
2009 (Public Law 111-8; 123 Stat. 629).

Mr. VOINOVICH. Madam President, I thank Chairman Dorgan and Ranking
Member Bennett for allowing me to bring this amendment to the floor.
This bipartisan amendment renews authorization granted to the Nuclear
Regulatory Commission and the General Services Administration in the
fiscal year 2009 Omnibus appropriations bill that allows GSA to acquire
additional permanent office space near the Nuclear Regulatory
Commission headquarters location in Rockville, MD. We need to renew
this authorization in the fiscal year 2010 appropriations because the
current lease negotiations will likely extend beyond September 30, the
end of fiscal year 2009.
This is a fairly straightforward and simple amendment, but I want to
take this opportunity to underscore the importance of the original
intent of the authorizing language.
Having served as either the chair or ranking on the Clean Air and
Nuclear Safety Subcommittee for the past 8 years side by side with my
good friend, the senior Senator from Delaware, I take great pride in
the fact that the NRC has become one of the best regulatory agencies in
the world.
Senator Carper and I, together with other members on the Environment
and Public Works Committee, have worked hard to provide the NRC with
the necessary resources to do its job; that is, ensuring safe operation
of the 104 operating nuclear powerplants while conducting licensing
reviews of the 17 applications for construction and operation of 26 new
reactors. That may sound like some new information, and it is. We have
17 applications filed with the Nuclear Regulatory Commission for
construction and operation of 26 new reactors.
With three pieces of legislation included in the Energy Policy Act of
2005, we were able to help NRC hire more than 1,000 new workers and
rehire retirees in the last 4 years to meet the increasing demand. The
rehiring was to train new people who are being brought on board.
Now we need to follow through and provide NRC with adequate,
colocated headquarters office space to ensure maximum efficiency and
effectiveness. I must say that the subcommittee has looked at this over
and over again, and we have concluded that it is very necessary to have
them have space in the same vicinity so they can more adequately and
more efficiently run the operation.
Lately, we have been hearing a lot about how we need to increase the
use of nuclear energy if we are to achieve our energy independence,
reduce greenhouse gases, and create jobs. I would point out that the
NRC is at the center of all of this in the midst of reviewing those 17
applications for 26 new reactors.
Providing NRC with the tools necessary to achieve regulatory
stability, efficiency, and effectiveness not only makes sense, it is
the job of Congress. I urge my colleagues to vote for this amendment.
Madam President, I yield the floor.
The PRESIDING OFFICER. The Senator from Utah.
Mr. BENNETT. Madam President, I am in favor of the Voinovich
amendment. To use the language of the cloakroom, it has not yet been
hotlined. I do not know of any objection to it, and at least on this
side, we will do what we can to get it hotlined, get it cleared, so it
can be adopted, I would hope by voice vote, as quickly as possible. But
because it has not been hotlined on our side, I would suspect the vote
will probably take place this afternoon, if that is acceptable to the
chairman.
There has been, as Senator Voinovich has pointed out, a significant
increase in the NRC workload, and GSA has been in negotiations with NRC
to construct additional building space next to the existing NRC
headquarters. The negotiations may extend beyond the end of this fiscal
year, with the lease award occurring in 2010. So in order to anticipate
that, the NRC and GSA agreed that the language should be continued in
the fiscal year 2010 appropriations for the NRC. That will facilitate
the procurement process and protect the government from any protests
after a contract is awarded. This would mean the NRC could continue the
current procurement without interruption. For those reasons, I think we
should facilitate this.
With that, Madam President, I yield the floor.
I suggest the absence of a quorum.
Mr. DORGAN. Madam President, if the Senator would withhold?
Mr. BENNETT. Madam President, I will withhold the suggestion of an
absence of a quorum.
Mr. DORGAN. Madam President, I, too, rise in support of the amendment
offered by Senator Voinovich. It is a good amendment. In fact, it would
extend authority we have previously carried in this legislation in
fiscal years 2008 and 2009. So I believe we would be able to clear this
amendment by voice vote, but it has to be hotlined, I think. So my
expectation is we will be able to clear this amendment at some point
after lunch today.
Madam President, I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. UDALL of New Mexico. Madam President, I ask unanimous consent
that the order for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. UDALL of New Mexico. Madam President, I ask unanimous consent to
speak as in morning business for 10 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. UDALL of New Mexico. Madam President, as to the bill that is
before the Congress, I heard Chairman Dorgan mention Los Alamos
National Laboratory and the Roadrunner computer. I thank him for his
attention to the two national laboratories in my State, Los Alamos and
Sandia. This computer, the Roadrunner computer, is a very important
computer in dealing with issues such as climate change, national
security, and other scientific research. I applaud his efforts in
moving us forward, and also Ranking Member Bennett. I applaud them both
for their leadership.

Health Care

Madam President, if you follow the debate in Washington about health
reform, it is easy to get the wrong idea. The press likes to cover what
we are doing out here as if it is a game of chess--one side wins by
passing health care reform; the other side wins by blocking it.
I understand that somebody will disagree with whatever plan we
produce to reform health care. That is democracy. Some Members of this
body might decide they have to vote no on health reform. But let's be
clear on one thing: If we fail to pass a health reform

[[Page S8160]]

plan, nobody wins. If we keep the status quo, all of our constituents
will be worse off.
The health care debate can get complicated. Both sides have a list of
numbers a mile long that are supposed to explain the problem and the
possible solutions. But these numbers do not tell the whole story. For
example, we know that 22,000 Americans die each year because they do
not have health insurance. But that is only part of the story because
every one of those 22,000 is a unique and irreplaceable individual--
somebody's mother, somebody's son. Numbers cannot convey the injustice
of it all, the needless pain for families and friends. Every year, this
country produces 22,000 unnecessary stories of loss and suffering--
22,000 stories that could go unwritten if we act now. These stories are
everywhere we look, if we look.
Last week, I got a short note from a man in Pena Blanca, NM. The man
wrote:

My wife and I have been self employed craftsmen for 25
years. We never made enough money for health insurance. My
wife now has terminal colon cancer. If she could have had a
colonoscopy at 50 [years old] she would not be dying at 54.
My heart is broken.

All this woman needed was the simple preventive care that should be
available to every American--care that costs little and saves lives.
But our system did not provide that, and now she is dying. If we do not
get health care legislation passed, thousands of women like my
constituent in Pena Blanca will not get their colonoscopies and
thousands more hearts will be broken like her husband's. I do not care
where you stand in this body, that is not a victory for anybody.
Another thing we talk about in Washington is ``preexisting
conditions'' reform. It sounds as if it should be something
complicated, something most Americans do not quite understand. But my
constituents know exactly what a preexisting condition is. It is the
heart attack from 10 years ago that prevents dad from getting insurance
through his job. It is mom's age. It is the fact that Sarah from down
the street might get pregnant--a fact that forces her to pay more for
insurance than her male coworkers.
I have held a number of townhalls on health care reform in New
Mexico, and everywhere I go I hear stories.
A couple of weeks ago, I heard a story about a constituent who had
come to my office for some casework a few years ago. This is one of
those people whom you would expect to do great things. He works an
incredibly technical job at Los Alamos National Laboratory. Until
recently, he thought his knowledge and hard work would get him through
any crisis. Then John began suffering from a host of unexplained
neurological problems. The problems got so bad that he was actually
relieved when a doctor told him about a tumor in his brain. He chuckles
when he remembers that day. He was so relieved to know what was wrong
with him, and his doctor said something could be done.
But John's insurance company had other ideas. Months went by, and
John was not approved for the operation his doctor recommended. Only
just recently was he approved for the procedure he needs. But now he
has other problems. His medical leave is about to run out, and he does
not know what to do. If he loses his job, he loses his insurance. And
if he loses that, he could lose everything. He will become just another
American whose preexisting condition prevents him from getting health
care.
John was supposed to be one of the lucky ones. Before he began having
problems, he assumed he was one of the 55 percent of New Mexicans who
have adequate health insurance. But John was just one illness away from
the edge. And he is not alone. If we do not act, millions of Americans
will fall off the edge in the coming years. I do not care how you feel
about the President's health care plan, that is not a victory.
Because John cannot work, he could lose his health insurance. But you
do not have to lose your insurance to lose everything.
When I was back in New Mexico over the Fourth of July recess, I
stopped at a local TV station for an interview. I went to the front
desk to check in and introduced myself to the woman sitting there. It
was like I had touched a nerve.
``Senator Udall,'' she said, ``I need your help.''
This woman works full time and she has health insurance through her
work. Not too long ago, her doctor told her she needs cataract surgery
or she will lose her sight. On Monday, before I met her, she was
scheduled to get that surgery. Then, days before her appointment, she
was informed that the deductible would be more than $2,200, not
including the cost of any followup care. Like many Americans, she has
been struggling to make ends meet in this economy. She cannot spare
$2,200 from her paycheck, so she canceled her operation. Now she is
afraid she will lose her sight and she doesn't know what to do. So when
a Senator walked through the door, she asked me for help.

We can help this woman. She shouldn't have to choose between paying
her rent and keeping her sight. Nobody should. And we can make it so.
We can create a system where people can find and afford to pay for
quality health insurance that provides the care they need. We can
create a system where people do not have to worry that they are one
layoff away from losing their insurance or one medical emergency away
from losing everything. We can guarantee quality affordable health
insurance to every American. If we don't--if we miss this opportunity--
this is not a victory of one political party over another; it is a
massive loss for all of us and for everybody we represent. It would be
a national disgrace.
We are better than this. We can pass something that helps every
American. We can declare victory not over the other political party but
over the status quo. I hope we do so.
Thank you, Madam President.
I note the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. KOHL. Madam President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. KOHL. Madam President, I ask unanimous consent to speak as in
morning business for 10 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. KOHL. Madam President, I rise today to talk about our effort to
achieve comprehensive health care reform. Most people agree that
reforming our health care system is a necessity and that we cannot
afford to wait another 10 or 20 years until health care costs consume
the American economy as well as the budgets of most American families.
However, as urgent as this issue is, we must approach every aspect of
health care reform thoughtfully and not rush to complete what might be
one of the most important legislative initiatives any of us will ever
work on during our time here.
As the HELP Committee and the Finance Committee release their
proposals for health reform, we know we cannot consider a bill that
does not control costs. Controlling costs is an enormous priority. I
believe it is as important as ensuring universal coverage, because if
we provide universal coverage without controlling costs, the result
would be financial catastrophe for our Nation.
I want to be clear that lowering costs does not mean limiting access
to care, although opponents of health care reform will try to convince
the American people that it does. These political talking points are a
distraction at a time when we are trying to expand access to health
care. No one will be forced to change their health plan, their doctor,
or their hospital if they like what they have now. Health care reform
will provide coverage to those who do not have it today, and it must
lower costs for both families and businesses.
One key component to cutting costs is to eliminate unnecessary
testing and overtreatment. If we can do that, then our health care
system and America's patients will be in better shape. We can move in
this direction if the Federal Government starts paying for value of
care, not volume. As it stands, the Medicare reimbursement system
provides perverse incentives. Currently, geographic areas that provide
the most inefficient care oftentimes get the highest reimbursements. We
need to ensure that all health care systems provide better care in a
more efficient

[[Page S8161]]

way and reward those systems that already do so; otherwise, we will
never get costs under control.
As chairman of the Aging Committee, I am familiar with many of the
health care issues that affect seniors as well as all Americans. In
this capacity, I have been pushing for health reform to include
improvements to our long-term care system. Our Nation's population is
aging at a record rate, and with every passing year more elderly
Americans find themselves in need of long-term care. Most of us will at
some point struggle with the high and rising costs of caring for a
loved one. These too are costs we must get under control as part of
health care reform, and I applaud Chairman Kennedy for including the
CLASS Act in the HELP Committee bill. This bill will provide new
funding for long-term care through a voluntary social insurance
program.
We can also get long-term care costs under control by promoting a
move toward home and community-based long-term care services in
Medicaid. These programs break away from a ``one size fits all''
approach, offering flexibility and choices tailored to an individual's
needs. Even better, they save a lot of money that would otherwise be
spent on nursing home care. Senators Kerry, Grassley, and Cantwell all
have good ideas in this area that I hope will be considered.
We must also protect those consumers who are making an effort to plan
for the costs of their own long-term care in advance. In recent years,
long-term care insurance has gained popularity. Over 40 States have
initiated programs to encourage residents to buy long-term care
insurance in an attempt to ease the burden of Medicaid costs on State
budgets. I believe we have a duty to make sure these policies, which
may span several decades, are financially viable.
Many long-term care insurance companies have been raising their
policyholders' monthly premiums, which can be devastating for older
persons who are living on a fixed income. Until we can guarantee that
consumers have strong protections, that carriers will not deny
legitimate claims, and that premiums will not skyrocket down the road,
long-term care insurance is not ready to be a major part of the health
care reform solution.
The funding of care is not our only concern. It has been 22 years
since we raised the standard of care in nursing homes, and quality
improvements are long overdue. Every year, as part of our Medicare and
Medicaid reimbursement system, our government collects information
about all 16,000 nursing homes across the country. We should make this
information available to consumers so they can judge a home's track
record of care for themselves before deciding where to place a loved
one. We should make nursing homes safer by instituting a comprehensive
background check system for long-term care workers. Pilot programs have
shown that this would keep thousands of predators out of our nursing
homes where they can cause, and do cause, terrible physical, financial,
and emotional harm to residents and their families.
The truth is that while there are some hot button issues that divide
us and while there is seemingly endless ground to cover, there is a lot
about improving health care we do agree on. We all recognize the need
to bolster the ranks of those who provide care. As America ages, we
will face a severe shortage of workers who are equipped to manage
seniors' unique health needs. It is important to expand the training
and education for licensed health professionals, direct care workers,
and family caregivers, and I applaud the HELP Committee for recognizing
this need in their bill.
We agree that America's health systems should expand the use of
health information technology, which has been shown to save lives by
reducing medical errors and save money by promoting efficiency in
testing and communication. We agree that those who have suffered from a
health problem in their past should not be denied insurance that will
protect them for the future by ensuring that these individuals with
preexisting conditions can purchase coverage.
We also agree that we should do everything we can to remove fraud,
waste, and abuse from the system. We must employ a vigorous health care
fraud enforcement program that will protect policyholders, businesses,
and taxpayers.
We agree that we should work to provide appropriate care at the end
of life. We need to break down the barriers to advance planning and
encourage Americans to talk with their doctors about end-of-life care
long before such choices must be made.
Finally, we agree that we have a lot to gain if we get this done in a
thoughtful, deliberate way. We can do this right and we must do this
soon because so many Americans are depending upon us.
I yield the floor and suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. THUNE. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. THUNE. Madam President, I ask unanimous consent to speak as in
morning business.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. THUNE. Madam President, I think the American people are beginning
to react in a negative way to what they perceive to be happening in
Washington, DC, today with regard to the debate about health care, the
debate about new energy taxes in the form of a cap-and-trade program.
Of course, we know there are a lot of questions about whether there was
any value in the trillion dollar stimulus bill that passed earlier this
year, which was supposed to keep unemployment below 8 percent, and now
in many States it is well into the double digits and continues to go
north from there.
They have seen a lot of government spending with the stimulus, a
takeover of many industries, whether it is auto manufacturing,
financial services, or insurance companies in this country. They have
seen the cap-and-trade bill, which passed the House of Representatives,
which they know--there are debates about how much, but they know it
will increase what they pay for energy in this country. And now we are
having this discussion about the government taking over one-sixth of
the American economy in the form of health care.
I think what we are starting to see is that the American people, as
they engage in these issues, are becoming increasingly concerned about
the level of government expansion and intervention in the marketplace,
and the amount of new taxation and new borrowing and spending that is
going on in Washington, DC, at a time when the American people are
being, by virtue of the fact that they have to live within a balanced
budget, required to make hard choices in their daily lives. They see a
disconnect between what they are experiencing in their family lives and
what is happening in Washington, DC, where there continues to be this
pattern of new taxes, spending and borrowing.
Logic would dictate, I think, when you are in a recession, you should
not raise taxes. The worst thing to do in a recession is raise taxes
and actually crush any economic recovery that might occur because, as
we all know, what helps create jobs is small business. If small
businesses are faced with higher taxes, they have less to invest in new
equipment and in hiring new employees.
The other thing I think logic dictates is that when you are running
trillion dollar deficits as far as the eye can see, you should not be
piling more debt upon future generations. It seems as if everything we
are talking about these days is an expansion of government in
Washington, at greater additional costs to the American people, either
in the form of higher taxes or increased borrowing from future
generations, neither of which is something I think most Americans would
acknowledge we ought to be doing when you have an economy in a
recession and trillion dollar deficits as far as the eye can see.
The current health care debate is a good example of something about
which people have reservations and concerns, because they see the
attempt by the Federal Government to take over one-sixth of the
American economy, to essentially nationalize it--whatever you want to
call it. In any

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event, it will mean greater government intervention and greater
government involvement and an expansion of government in Washington,
DC. I think they are starting to react in a negative way against that,
and more and more members in Congress, in the House and Senate, are
hearing that.
I think that is why it is becoming increasingly difficult now to move
in the quick way in which the Democratic leadership in the House and
Senate wanted to in order to enact some form of health care reform
before the August break.
The way I view this issue is that we ought to look at starting over.
Clearly, what has been proposed and rolled out so far is not working.
It is not working in terms of winning the minds of the American people,
in terms, in Washington, DC, of putting together what ought to be a
bipartisan solution to probably one of the biggest challenges and
crises facing the American people and our economy.
So far, we have seen a bill being debated at the committee level in
the House of Representatives, and perhaps scheduled for the floor--if
not this week, when we get back--and we have seen action by the HELP
Committee in the Senate on a bill that, by CBO's estimate, is about a
trillion dollars in new costs. Somehow, it will have to be paid for.
It seems as if we ought to push the reset button and figure out, OK,
how can we do this in a way that achieves savings to the American
people and the health care costs in this country, as opposed to
actually adding new costs by increasing government spending in
Washington, DC, expanding the size of government, and putting the
government in the way of--I guess intervening in that fundamental
relationship between physicians and patients.
There are a number of things that are, in my view, wrong with the
current plan, the plan that passed the HELP Committee in the Senate, as
well as the one currently being considered in the House of
Representatives. The first fundamental test it flunks is that it
doesn't do anything to reduce costs. To me, reform ought to be finding
efficiencies, streamlining, looking at ways of doing things in a less
costly way to achieve savings. We know that is not the case with the
bill that passed the HELP Committee in the Senate, and we know the
House of Representatives, in their bill, according to the most recent
Congressional Budget Office estimates, also does nothing to find
savings or achieve any sort of savings as a result of all these changes
being proposed. So it flunks the first fundamental test of reform; that
is, it does nothing to reduce costs.
Secondly, it does cut payments, reimbursements, under Medicare to
providers, whether it is hospitals, whether it is the cost of
pharmaceuticals. All of these things in this country that add to the
overall cost of health care are obviously going to take a nick in this.
We don't want to see the health care currently provided under Medicare
to American senior citizens somehow be hurt by the fact that they are
trying to find money to pay for this whole new expansion of government
health care in this country. So you have the issue of cuts to
reimbursements currently under Medicare, which very likely would impact
the delivery of care, the quality of care for America's seniors.

The third thing, and another big problem, is that it adds new
Medicaid costs to our States. States currently are participants.
Medicaid is a shared program between the Federal and State governments,
and there is talk about a significant expansion, the size of the
Medicaid Program, which obviously costs the Federal taxpayers a lot
more money. But it also passes on an incredible new and costly mandate
to State governments. Many States are figuring that out and are
starting to react to it.
My State of South Dakota is a good case in point. Our State
legislature, Governor, and people who looked at this have concluded it
would cost South Dakota an additional $45 million a year in Medicaid
costs, which may not sound like a lot of money in Washington, DC, but
in a State such as South Dakota, where there is a requirement to
balance the budget every year, that represents a lot of money.
Obviously, it will have to be paid for somehow. When you get to the
larger States, the numbers increase in multiples.
You are talking about new taxes on States, in addition to the new
taxes being talked about in Washington, DC, to pay for all this. You
have new Federal and State taxes, again, at a time when already many
State governments and budgets are strapped and they are trying to
figure out how to balance their budgets currently.
Another reason why the current plan is such a big problem, and why we
need to start over and hit the reset button, is because you are going
to have a lot of people who are going to lose employer-provided
insurance. Most of the studies conclude--and the House bill is a good
example--that about 83 million people would lose their private health
insurance under the bill that is under consideration in the House of
Representatives. There are other studies that have been done. This was
a Congressional Budget Office estimate. Other studies suggest that the
number of people who could lose insurance on some of these plans under
consideration in Congress could be in the 120 million range.
If you consider that we have 177 million people today who get their
insurance through their employer, that is a significant number of
people who are going to lose their privately provided health insurance
and be pushed into a government plan.
That brings me to the next point of why the current health care plan
being debated is the wrong direction in which to head and creates
problems; that is, you are going to have more people going into the
government-run plan--literally millions of people, the ones who are
going to lose their insurance in the private marketplace. They are
going to be pushed into a government-run plan. Obviously, there are a
lot of people who would like to see that. I don't happen to be one of
them. We ought to preserve what is best about the market and
competition we have and allow people to have more choices. We don't
want to, by default, shove more and more people into a government-run
plan, when there are opportunities out there available to them today
where they can get their health care coverage and insurance in the
private marketplace. That is a much better model and has worked very
well for a long time.
That isn't to say there are not things we can do better. I don't know
of any Senator on either side of the aisle who doesn't acknowledge that
there are things we need to do to reform health care in this country,
to get costs under control, provide access to more people. But
certainly taking away private coverage and pushing people into a
government-run plan is not a reform of the health care system that
makes sense to me or, I argue, most Americans, especially when it will
cost trillions of dollars to do it.
As I said, I think most people look at reform as something that would
actually reduce or somehow eliminate costs or create greater
efficiencies and savings in the health care system in this country. You
have a lot of people who will lose private insurance, and millions of
Americans would be pushed into a government-run program.
As I said before, another big problem with this idea is that for
employers, during a recession, it imposes new taxes and fines, both of
which would be very costly, and both of which would deprive them of the
opportunity, as the economy hopefully starts to recover, to hire new
people, create new jobs, which is what small businesses do best. They
are the economic engine of this country. We are talking about imposing
new taxes and fines on them, at great cost, and so that takes away a
lot of the resources, as they generate revenue that they can be able to
devote or allocate toward capital investment or hiring more people.
They are going to be paying fines and taxes to the Federal Government
to underwrite this new expansion of government in Washington, DC.
Logic would dictate, and history would suggest, that the worst thing
you can do in the middle of an economic recession is to raise taxes on
the job creators in the economy. Raising taxes on small businesses is a
bad idea. In fact, the House bill that is under consideration, with the
surcharges and increased taxes, would actually increase marginal income
tax rates from the top rate today of about 35 percent to about 37
percent. Think about that. The size of the increase in marginal income
tax rates that would occur in

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State and Federal marginal tax rates, under the plan under
consideration in the House of Representatives, and how that would
impact the economy, would be the largest tax increase we have seen
since the end of World War II.
Frankly, if you think about most Americans and most small businesses,
when you start paying half, or 50 cents out of every dollar, in taxes,
you are getting to a point where it is going to be very difficult for
these businesses which might say: Why should I continue to try to
create jobs and provide health care coverage for my employees, when the
government takes more and more of the profits I make in this business?
I think that is the risk we run with the job creators, the small
businesses, which are the economic engine and create as many as two-
thirds to three-quarters of all of the jobs in our economy, in a
recession. When you put new taxes and fines on them, you are layering
them and burdening them with more costs that will make it very
difficult for them to lead us out of the recession and start to expand
the economy and create jobs. Intuitively it makes no sense for us to
head in this direction.

Finally, I think the last problem--and, as I said, there are many
with the current health care proposals--is we will have to start
dealing with the lines and the rationing that so often occurs when we
see a system such as they have in Europe or the Canadian system. Some
here actually believe that is the best way to do this. They believe in
a single-payer system. They believe we ought to nationalize our health
care system in this country. Inevitably, what we will end up with is
people ending up in lines. We will have government making decisions
about what procedures will be covered, what the reimbursement will be
for this procedure, that procedure. It is a disaster and a train wreck
in the making, and it is a direction I don't think we ought to go.
These are all issues that I think point to the need for us to hit
that reset button and to sit down and actually figure out what can we
agree upon that will be a bipartisan solution to the challenge of
increasing costs and a lack of access for millions of Americans.
That being said, we have a large number of proposals out there which,
I submit, we ought to be able to debate. As the HELP Committee and the
Finance Committee go through their deliberations, there are many things
that have bipartisan support in the Congress for which we could get big
majorities and which would address the fundamental issues of access to
health care and cost of health care but none of which are being
considered because right now the only plan out there is the one that
has been written by the Democratic leadership, which consists of this
government plan or this government takeover of the health care system.
We believe the principles in this debate ought to continue to
maintain: People ought to be able to keep their health care; it ought
to be health care they can afford; it ought to provide choices; and it
ought to be patient centered.
I yield the floor.

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