Federal Employees Electronic Personal Health Records Act of 2006

Mr. President, the remarks President Bush delivered yesterday

about the war against the radical Islamist terrorists was a historic speech, the clearest statement to date of the nature of the struggle we face.

Probably there were two factors that entered the President's decision to give the remarks today: First, the fact that we will soon, next Monday, have the fifth anniversary of the heinous attack of September 11 on the United States of America; second, because of the increasing calls by partisans to abandon part of the conflict--namely, the Iraq front--in this war.

It was important for the President to define who the enemy is and to make it clear that the enemy is not terrorism. People in the media have called this the war on terrorism. We could have just as easily called the war in the Pacific and World War II the war on kamikaze terrorism, as kamikaze is a suicide tactic by evil people. The war, then, was against Nazism, Fascism, the imperial Japanese, and later communism. It was not against a tactic.

The same thing is true today. It was important for the President to define the nature of the enemy we face in order to be able to adequately confront that enemy. The President made a comparison with a couple of the enemies in World War II. He talked about Adolph Hitler and the fact he was not taken seriously at first. At first, Adolph Hitler was a crazy paper hanger. Then he was greatly underestimated. Eventually, there were those who thought he could be appeased because the world did not want to fight again, with World War I so fresh in everyone's mind. But he did have to be confronted.

And the same later with respect to communism. At first it was Uncle Joe Stalin who helped us win World War II. But it became clear, after the Berlin blockade and his explosion of an H bomb, that communism was a clear and present danger for the United States. Eventually, America understood, and the cold war confronted communism, eventually succeeding in defeating that threat.

There is a big difference between the Soviets of the Communist era and the radical Islamists. One difference is that the Soviets could be deterred. Radical Islamists are not going to be deterred. There is a particular reason why. The Soviets were rational about life itself. Radical Islamists seek to bend us to their will, to kill us or to die trying. Either way, in their view, they win.

I ask my colleagues: What did Steve Centanni and Olaf Wiig have to do before they were released in Gaza just a couple of weeks ago? They had to bend to the will of Allah. They had to convert to Islam before they were released. This is the goal of these radical Islamists, as the President explained--to either bend the rest of the world to their will, to kill us or to die trying.

We will only win this war if we take the threat seriously. The sooner we commit to victory, the fewer our losses will be. The best strategy is to take the fight to the enemy. The worst strategy is to leave in the middle of a battle, for example, in Iraq. It would be difficult, if not impossible, to win the war if we abdicate the battle. What ally in the war will stand with us if we decide that the fight is too tough? How would that help us influence the mullahs who rule in Iran?

I will read from parts of the President's speech to illustrate the clarity with which he described the nature of our enemy, the nature of this conflict, and the absolute necessity that we confront it strongly now in order to save future generations from the scourge of this continuing conflict.

The President said:

Five years after our nation was attacked, the terrorist

danger remains. We're a nation at war.

And he said:

. . . we've also learned a great deal about the enemy we

face . . .

We know what the terrorists intend to do because they've told us--and we need to take their words seriously.

And he proceeded to describe, in the terrorists' own words, what they believe, what they hope to accomplish, and how they intend to accomplish it.

Listen to these words of the President:

The terrorists who attacked us on September 11, 2001, are

men without conscience--but they're not madmen. They kill in

the name of a clear and focused ideology, a set of beliefs

that are evil, but not insane. These al Qaeda terrorists and

those who share their ideology are violent Sunni extremists.

They're driven by a radical and perverted vision of Islam

that rejects tolerance, crushes all dissent, and justifies

the murder of innocent men, women, and children in the

pursuit of political power. They hope to establish a violent

political Utopia across the Middle East, which they call a

``caliphate,'' where all the world would be ruled according

to their hateful ideology. Osama bin Laden has called the 9/

11 attacks--in his words--``a great step toward the unity of

Muslims and establishing the righteous caliphate.''

The President went on to describe that this caliphate would be a totalitarian Islamic empire, and using the words of the terrorist Zawahiri, al-Qaida second in command, declaring that al-Qaida intends to impose its rule ``in every land that was a home for Islam, from Spain to Iraq.'' And he went on to say:

The whole world is an open field for us.

The President also described what such a world would look like, referring to the situation in Afghanistan before its liberation as exemplifying the rule of these kinds of terrorists: Under the Taliban and al-Qaida, Afghanistan was a nightmare, a land where women were imprisoned in their homes, girls could not go to school, religious police roamed the streets, and women were publicly whipped. In fact, summary executions were held in Kabul's soccer stadium in front of cheering mobs. And Afghanistan was turned into a launching pad for the horrific attacks against America and other parts of the civilized world.

The President said:

The goal of these Sunni extremists is to remake the entire

Muslim world in their radical image. In pursuit of their

imperial aims, these extremists say there can be no

compromise or dialogue with those they call ``infidels''. . .

.

These radicals have declared their uncompromising hostility

to freedom.

And the President said:

It is foolish to think that you can negotiate with them.

The President also quoted from some of the al-Qaida documents that illustrate the precise nature of this threat. One is the al-Qaida charter that was secured by coalition forces searching a terrorist safe house. The charter states:

There will be continuing enmity until everyone believes in

Allah. We will not meet the enemy halfway. There will be no

room for dialogue with them.

The President also noted that the goal of al-Qaida is to cause Americans to tire of the conflict, ``hoping that the American people will grow tired of casualties and give up the fight.''

The President said:

And they are targeting America's financial centers and

economic infrastructure at home, hoping to terrorize us and

cause our economy to collapse.

He quoted the words of Osama bin Laden, who calls this his ``bleed- until-bankruptcy plan,'' and noted that Osama bin Laden was very impressed with the relatively small investment he had to make to cause such a large amount of damage to the United States and to our economy.

The President also noted the enemy has a propaganda strategy. Osama bin Laden says al-Qaida intends to ``launch,'' in his words, ``a media campaign to create a wedge between the American people and their government.''

I would submit that the evidence of that campaign is there for all to see.

The President said:

Bin Laden and his allies are absolutely convinced they can

succeed in forcing America to retreat and causing our

economic collapse. They believe our nation is weak and

decadent, and lacking in patience and resolve.

The President also said that ``they've made clear that the most important front in their struggle against America is Iraq--the nation bin Laden has declared the `capital of the caliphate.'

The President said:

Hear the words of bin Laden: ``I now address the whole

Islamic nation. Listen and understand. The most serious issue

today for the whole world is this Third World War that is

raging in Iraq.'' He calls it ``a war of destiny between

infidelity and Islam.'' He says, ``The whole world is

watching this war,'' and that it will end in ``victory and

glory, or misery and humiliation.''

The President noted:

For al Qaeda, Iraq is not a distraction from their war on

America--it is the central battlefield where the outcome of

this struggle will be decided.

The President said:

Bin Laden and his terrorist allies have made their

intentions as clear as Lenin and

Hitler before them. The question is: Will we listen? Will we

pay attention to what these evil men say?

And then the President noted that there is a second group of these radical Islamists who, combined with the first, represent the axis of evil that we face in this war, the threat posed by Shia extremists.

The President said:

The Shia strain of Islamic radicalism is just as dangerous,

and just as hostile to America, and just as determined to

establish its brand of hegemony across the broader Middle

East. And the Shia extremists have achieved something that al

Qaeda has so far failed to do: In 1979, they took control of

a major power, the nation of Iran, subjecting its proud

people to a regime of tyranny, and using that nation's

resources to fund the spread of terror and pursue their

radical agenda.

Then the President went on to describe the clear aims of the Iranian regime: wanting to drive America out of the region, to destroy Israel, and to dominate the broader Middle East. Among the ways in which they intend to achieve their goals is by the creation and supporting of terrorist groups such as Hezbollah.

The President said:

Just as we must take the words of the Sunni extremists

seriously, we must take the words of the Shia extremists

seriously.

He went on to quote the Hezbollah leader, the terrorist Nasrallah, and also the President of Iran, President Mahmud Ahmadi-Nejad, who declared in a speech that some people ask, and I am quoting, ``whether a world without the United States and Zionism can be achieved. I say that this goal is achievable.''

Everyone is aware of Ahmadi-Nejad's threats to wipe Israel off the face of the Earth.

He said:

If you do not abandon the path of falsehood, your doomed

destiny will be annihilation.

He delivered this message to the American people. And I am quoting:

If you would like to have good relations with the Iranian

nation in the future, bow down before the greatness of the

Iranian nation and surrender. If you don't accept to do this,

the Iranian nation will force you to surrender and bow down.

The language is always: Bow down. Surrender to their radical, perverted view of Islam.

And now the Iranian regime is pursuing nuclear weapons. Imagine if this nation acquires nuclear weapons, a nation that sponsors terrorism around the world, is the chief sponsor of terrorism, according to the U.S. State Department. And were they to provide nuclear weaponry to terrorists, the result is unthinkable.

What the President concluded was:

The Shia and Sunni extremists represent different faces of

the same threat. They draw inspiration from different

sources, but both seek to impose a dark vision of violent

Islamic radicalism across the Middle East.

The President said:

And armed with nuclear weapons, they would blackmail the

free world, and spread their ideologies of hate, and raise a

mortal threat to the American people. If we allow them to do

this, if we retreat from Iraq, if we don't uphold our duty to

support those who are desirous to live in liberty, 50 years

from now history will look back on our time with unforgiving

clarity, and demand to know why we did not act.

The President then went on to reiterate the five basic elements of the strategy he has discussed before. He pointed out that the enemy is a flexible and agile enemy that adapts and changes its ways of dealing with us, and that we have to do the same, and pointed out how we are doing that.

In fact, the President said:

During the last five years we've learned a lot about this

enemy. We've learned that they're cunning and sophisticated.

We've witnessed their ability to change their methods and

their tactics with deadly speed--even as their murderous

obsessions remain unchanging.

He also noted--and I think this is important--that one of the things they have accomplished over the last several years is the slaughtering of huge numbers of innocent Muslim men and women around the world. And you have but to look at the daily casualty count in Iraq, where it is primarily violence on other Muslims in Iraq that represents this terrible news we wake up to every morning.

The President said, as he has said before:

The road ahead is going to be difficult, and it will

require more sacrifice. Yet we can have confidence in the

outcome, because we've seen freedom conquer tyranny and

terror before.

I would say that we have a choice to make. We can understand the nature of this conflict and its seriousness and the required sacrifice now or we can come to that realization after we have suffered far too many more casualties and far too much loss in blood and treasure. Eventually the world will join us in this struggle and we will succeed. But the question is, How many have to die? How much loss has to occur before the world wakes to the nature of this threat?

I harken back to the days just before World War II as a good lesson in history to remind us that we need to take the words of these evildoers to heart. They just may mean what they say. History has proven that to be the case in the past, and recent history leaves no doubt that this is what they mean today.

Next Monday, we will stand on the Capitol steps at 6 o'clock, as we did exactly 5 years before, to demonstrate to the American people that the attacks on America will not deter us from our business or our commitment to protect the American people. When we do that, we need to mean what we say. Our ability to make good on that commitment will depend, first and foremost, on our understanding of the nature of this threat and our ability and willingness to confront it.

The President concluded his remarks with these statements. He said:

This time, we're confronting them--

Meaning the enemy--

before they gain the capacity to inflict unspeakable damage

on the world, and we're confronting their hateful ideology

before it . . . takes root.

That is the point I was making, that we have a choice today to take this fight to the enemy and win rather than waiting until more damage has been inflicted upon us to understand and appreciate the nature of the threat.

The President concluded by saying:

This is the great ideological struggle of the 21st

century--and it is the calling of our generation. All

civilized nations are bound together in this struggle between

moderation and extremism.

Mr. President, this is the challenge which confronts us. It confronts us as leaders of this country, and it requires of us the discussion, honestly and forthrightly, of the serious nature of this struggle. It will not be won by papering over differences. It will not be won by deciding that the fight is too difficult and that there are places where this struggle is occurring where we just cannot prevail. We cannot send a message to our enemies, let alone to our allies, that we are not up to the struggle, wherever it may break out.

The way to win this struggle is to win it. And that is the point the President was making in his remarks yesterday.

Mr. President, I urge my colleagues to review the President's remarks. I ask unanimous consent that the full text of the speech he made yesterday be printed in the Record.

Mr. President, I rise today to announce the introduction of a piece of legislation that Senator Voinovich of Ohio and I have worked on for a while. It is called the Federal Employees Electronic Personal Health Records Act of 2006. This bill makes available--or would make available--electronic personal health records for every enrollee of a Federal health benefits plan who wishes to have one. That is, potentially, as many as 8 million people. That includes those of us who work in Federal agencies, large and small, across the country and, actually, around the world. It includes their families and includes Federal retirees and their families as well.

Our health care sector is the most innovative in the world, but it has not kept up with the information age. Our excessive reliance on paper record keeping makes our health care system less efficient, more costly, and more prone to mistakes. Expanding the use of health information technology shows promise as a way to improve both the cost and the quality of health care in our country.

In 2004, the United States spent some $1.9 trillion on health care costs.

That is more than any other industrialized country on this planet. In 2005, health care premiums continued their upward trend, increasing by an average, I am told, of some 9 percent. We are literally spending trillions of dollars on health care, but I am sorry to say we are not getting the gold standard of treatment or results.

A 2005 survey conducted by the Commonwealth Fund, a private foundation that focuses on improving health care, found that medical error reports rates in the United States far exceed those of western countries. In that survey, one in three Americans reported getting the wrong dosage of medication, incorrect test results, mistakes in treatment, or late notification of test results. That is nearly 15 percent higher than similar results in Britain and Germany.

I believe some of the problems--though certainly not all of them--can be blamed on the fact that health care providers don't have full and real-time access to patients' medical records. Doctors in this country wait days sometimes for couriers to deliver lab tests or x rays. They diagnose patients without knowing their full medical history, what they are allergic to, what kinds of surgeries they have had, or whether they have complained about similar symptoms before.

Time constraints, or medical necessity, often force doctors to perform a quick diagnosis. Sometimes that diagnosis wrong. Sometimes those errors prove to be costly. The widespread use of health information technology, the ability to immediately access one's full medical history from a computer, can help doctors and nurses provide better care less expensively. It has the potential to dramatically transform the way we provide health care in America--saving lives, saving costs.

If we are looking for success stories on how health care professionals have integrated the use of electronic health care records into their daily routines, we don't have to look any further than our own Department of Defense and our Department of Veterans Affairs.

Times have changed since I retired from the Navy some 15 years ago. I remember that as an ensign I used to carry my medical health records in a brown manila folder from duty station to duty station--from the time I left Ohio State, on to Pensacola, Corpus Christi Naval Air Station, out to California, across the seas and back again, and, finally, getting off of active duty and coming to Delaware to enroll in graduate school, on the GI bill, at the University of Delaware in the business school. I went up the road to the VA hospital. I still had my folder with the records. I turned them in and asked: What kind of benefits am I eligible for?

Over a decade ago, the Department of Defense and VA decided there was a better way, and the results have been nothing short of phenomenal. Today, when a patient enrolls in the Department of Defense's military health system, they no longer need the kind of brown manila folder I carried all those years. Instead, we have electronic health care records to keep track of the medical histories of those who serve our country in the military. This health record is managed electronically, and you don't have to remember to pack it up on your next tour of duty, whether it is in Southeast Asia, or Iraq, or Afghanistan.

Instead, one's electronic health care record follows them wherever they go--both during the time they are in the military and when they leave and join our veterans community as a veteran.

The result is that the Department of Defense and VA have been impressive, especially when you consider that they have only used these electronic health records for about a decade or so.

The VA health system has transformed itself from a troubled, sometimes bloated and inefficient operation to one of the best health care operations in the country.

Researchers and doctors now laud the VA for having the foresight to use electronic health records to improve patient care.

What is the cost? That is a good question. It is about $78 per patient. That is roughly the cost of not repeating one blood test. In other words, it is money well spent.

The VA now regularly outperforms Medicare and other private health plans when it comes to providing patient care for diabetes, high blood pressure, and heart attack victims.

In January, the National Quality Research Center concluded that for the sixth consecutive year, the VA health care system outranks the private sector for customer satisfaction.

I have witnessed that new-found satisfaction in my own backyard, at the Veterans Medical Center in Elsmere, DE. That is the place I went in 1973 fresh out of the Navy. Veterans from neighboring States are now coming to our hospital in Elsmere to seek care instead of going to regular civilian hospitals near them.

In 2004, the Elsmere facility, as well as popular satellite clinics in Millsboro and Seaford, DE, served more than 22,000 veterans and had more than 150,000 outpatient visits. Both totals are about 20 percent higher than just 4 years ago.

Normally, you would think the busier a hospital is, the less satisfied customers are because of longer waits and other hassles. But it turned out that the opposite is true. As the workload has climbed, so has patient satisfaction. I might add, so has the satisfaction of those providing the care to the patients.

More than 85 percent of Delaware's VA outpatients said they were ``highly satisfied'' with the care they received. Planning is now underway to open a third outpatient clinic for veterans in Kent County next spring--probably in Dover where we have another 15,000 veterans.

What is keeping the rest of our Nation's health care system from following the lead of the Department of Defense and the VA? The answer is the high cost of implementing the latest information technologies, as well as the lack of uniformity among various technology products.

A physician can spend up to $30,000 implementing an electronic health records system. A hospital can spend up to five times that amount. If that weren't enough of a reason to say no thanks, there is one more reason; that is, we don't have a set of national standards in place to make sure that once health care providers have made the switch, their new system can communicate with the hospital or doctor on the other side of town. The result: Only 15 percent of doctors and about 30 percent of hospitals have fully functional electronic health care systems today.

A new study by a number of health care scholars estimates there will be another 20 years before the majority of physicians are using an electronic health care system.

Let me say this. Our Presiding Officer is from Louisiana where they went through a terrible situation a year ago with Katrina. The folks who happened to be civilians and were in hospitals or nursing homes, for the most part, they had paper health records and they were destroyed. The veterans who were on the gulf coast when Katrina struck--either in nursing homes, VA nursing homes, or VA hospitals-- were evacuated from the area as civilians were; but when the veterans got to another VA facility inland, or a nursing home, or a VA hospital, their electronic health records were available immediately, and whoever provided care for them had access to the records and were able to provide excellent care.

I am sorry to say that the same wasn't true for the civilians whose paper records were largely destroyed at the time of the evacuation.

As a nation, we cannot afford to rely solely on health care providers to bring the health care industry into the 21st century. We must think outside of the box and build on the health information technology issues already underway in other areas of our health care industry.

The Federal Employee Electronic Personal Health Records Act of 2006-- the legislation Senator Voinovich and I introduce today--does just that. How? By requiring all carriers that contract with the Federal Employees Health Benefits Program to make available an electronic personal health record for those of us who are enrolled in that program. As I said earlier, it is some 8 million people.

Electronic personal health records will provide enrollees with a tool to better access and control their health information. Via the Internet, an enrollee will be able to log on to their

electronic personal health record to keep track of such things as their medications, cholesterol, glucose levels, allergies, and immunization records.

An enrollee will also be able to review a comprehensive, easily understood listing of their health care claims. Health care providers, payers, and enrollees will be able to add this information onto the electronic personal health record. Enrollees will benefit, I believe, significantly from such a tool.

An enrollee can easily share sections of the electronic personal health record with their health care provider, ensuring that their provider has the most up-to-date and accurate health information when making clinical decisions.

In the case of an emergency, an enrollee can also grant others the ability to access their electronic personal health record. Again, it is the decision of the patient, the enrollee in the Federal Employee Health Benefits Program, to decide what kind of access to grant to a provider or a member of the family or another person in the wake of an emergency.

Having health information readily available will increase the efficiency and safety of health care for enrollees by eliminating unwarranted tests, procedures, and prescriptions.

Most important, the legislation ensures that the electronic personal health records provided for through this act are kept private and secure.

The electronic personal health records are required to include a number of security features. They include, among other things, user authentication and audit trails.

The legislation also requires that carriers comply with all privacy and security regulations outlined in the Health Insurance Portability and Accountability Act, which we call HIPAA.

Mr. President, what Senator Voinovich and I are introducing today will help demonstrate the importance and utility of health information technology--not just the importance of the technology but the importance of harnessing the technology--in the delivery of health care in this country today. In this case, the potential is as many as 8 million additional Americans.

This bill is designed to jumpstart this new technology by requiring some of the largest health insurance companies to offer these electronic personal health records, which many are beginning to do today. As more insurance companies, health care providers, and consumers use this new technology, I am convinced that more people will recognize its advantages, and we can more quickly move America's health care industry into the 21st century.

We view this initiative as the next necessary step for the Nation's largest employer-sponsored health insurance program that prides itself on being a model for best practices in health care.

I invite my colleagues to join Senator Voinovich and me as we introduce this legislation. We look forward to talking with our colleagues about it. With luck, maybe we will have a hearing. Senator Voinovich may hold one in his subcommittee this month.

Mr. President, I rise today to announce the introduction of a piece of legislation that Senator Voinovich of Ohio and I have worked on for a while. It is called the Federal Employees Electronic Personal Health Records Act of 2006. This bill makes available--or would make available--electronic personal health records for every enrollee of a Federal health benefits plan who wishes to have one. That is, potentially, as many as 8 million people. That includes those of us who work in Federal agencies, large and small, across the country and, actually, around the world. It includes their families and includes Federal retirees and their families as well.

Our health care sector is the most innovative in the world, but it has not kept up with the information age. Our excessive reliance on paper record keeping makes our health care system less efficient, more costly, and more prone to mistakes. Expanding the use of health information technology shows promise as a way to improve both the cost and the quality of health care in our country.

In 2004, the United States spent some $1.9 trillion on health care costs.

That is more than any other industrialized country on this planet. In 2005, health care premiums continued their upward trend, increasing by an average, I am told, of some 9 percent. We are literally spending trillions of dollars on health care, but I am sorry to say we are not getting the gold standard of treatment or results.

A 2005 survey conducted by the Commonwealth Fund, a private foundation that focuses on improving health care, found that medical error reports rates in the United States far exceed those of western countries. In that survey, one in three Americans reported getting the wrong dosage of medication, incorrect test results, mistakes in treatment, or late notification of test results. That is nearly 15 percent higher than similar results in Britain and Germany.

I believe some of the problems--though certainly not all of them--can be blamed on the fact that health care providers don't have full and real-time access to patients' medical records. Doctors in this country wait days sometimes for couriers to deliver lab tests or x rays. They diagnose patients without knowing their full medical history, what they are allergic to, what kinds of surgeries they have had, or whether they have complained about similar symptoms before.

Time constraints, or medical necessity, often force doctors to perform a quick diagnosis. Sometimes that diagnosis wrong. Sometimes those errors prove to be costly. The widespread use of health information technology, the ability to immediately access one's full medical history from a computer, can help doctors and nurses provide better care less expensively. It has the potential to dramatically transform the way we provide health care in America--saving lives, saving costs.

If we are looking for success stories on how health care professionals have integrated the use of electronic health care records into their daily routines, we don't have to look any further than our own Department of Defense and our Department of Veterans Affairs.

Times have changed since I retired from the Navy some 15 years ago. I remember that as an ensign I used to carry my medical health records in a brown manila folder from duty station to duty station--from the time I left Ohio State, on to Pensacola, Corpus Christi Naval Air Station, out to California, across the seas and back again, and, finally, getting off of active duty and coming to Delaware to enroll in graduate school, on the GI bill, at the University of Delaware in the business school. I went up the road to the VA hospital. I still had my folder with the records. I turned them in and asked: What kind of benefits am I eligible for?

Over a decade ago, the Department of Defense and VA decided there was a better way, and the results have been nothing short of phenomenal. Today, when a patient enrolls in the Department of Defense's military health system, they no longer need the kind of brown manila folder I carried all those years. Instead, we have electronic health care records to keep track of the medical histories of those who serve our country in the military. This health record is managed electronically, and you don't have to remember to pack it up on your next tour of duty, whether it is in Southeast Asia, or Iraq, or Afghanistan.

Instead, one's electronic health care record follows them wherever they go--both during the time they are in the military and when they leave and join our veterans community as a veteran.

The result is that the Department of Defense and VA have been impressive, especially when you consider that they have only used these electronic health records for about a decade or so.

The VA health system has transformed itself from a troubled, sometimes bloated and inefficient operation to one of the best health care operations in the country.

Researchers and doctors now laud the VA for having the foresight to use electronic health records to improve patient care.

What is the cost? That is a good question. It is about $78 per patient. That is roughly the cost of not repeating one blood test. In other words, it is money well spent.

The VA now regularly outperforms Medicare and other private health plans when it comes to providing patient care for diabetes, high blood pressure, and heart attack victims.

In January, the National Quality Research Center concluded that for the sixth consecutive year, the VA health care system outranks the private sector for customer satisfaction.

I have witnessed that new-found satisfaction in my own backyard, at the Veterans Medical Center in Elsmere, DE. That is the place I went in 1973 fresh out of the Navy. Veterans from neighboring States are now coming to our hospital in Elsmere to seek care instead of going to regular civilian hospitals near them.

In 2004, the Elsmere facility, as well as popular satellite clinics in Millsboro and Seaford, DE, served more than 22,000 veterans and had more than 150,000 outpatient visits. Both totals are about 20 percent higher than just 4 years ago.

Normally, you would think the busier a hospital is, the less satisfied customers are because of longer waits and other hassles. But it turned out that the opposite is true. As the workload has climbed, so has patient satisfaction. I might add, so has the satisfaction of those providing the care to the patients.

More than 85 percent of Delaware's VA outpatients said they were ``highly satisfied'' with the care they received. Planning is now underway to open a third outpatient clinic for veterans in Kent County next spring--probably in Dover where we have another 15,000 veterans.

What is keeping the rest of our Nation's health care system from following the lead of the Department of Defense and the VA? The answer is the high cost of implementing the latest information technologies, as well as the lack of uniformity among various technology products.

A physician can spend up to $30,000 implementing an electronic health records system. A hospital can spend up to five times that amount. If that weren't enough of a reason to say no thanks, there is one more reason; that is, we don't have a set of national standards in place to make sure that once health care providers have made the switch, their new system can communicate with the hospital or doctor on the other side of town. The result: Only 15 percent of doctors and about 30 percent of hospitals have fully functional electronic health care systems today.

A new study by a number of health care scholars estimates there will be another 20 years before the majority of physicians are using an electronic health care system.

Let me say this. Our Presiding Officer is from Louisiana where they went through a terrible situation a year ago with Katrina. The folks who happened to be civilians and were in hospitals or nursing homes, for the most part, they had paper health records and they were destroyed. The veterans who were on the gulf coast when Katrina struck--either in nursing homes, VA nursing homes, or VA hospitals-- were evacuated from the area as civilians were; but when the veterans got to another VA facility inland, or a nursing home, or a VA hospital, their electronic health records were available immediately, and whoever provided care for them had access to the records and were able to provide excellent care.

I am sorry to say that the same wasn't true for the civilians whose paper records were largely destroyed at the time of the evacuation.

As a nation, we cannot afford to rely solely on health care providers to bring the health care industry into the 21st century. We must think outside of the box and build on the health information technology issues already underway in other areas of our health care industry.

The Federal Employee Electronic Personal Health Records Act of 2006-- the legislation Senator Voinovich and I introduce today--does just that. How? By requiring all carriers that contract with the Federal Employees Health Benefits Program to make available an electronic personal health record for those of us who are enrolled in that program. As I said earlier, it is some 8 million people.

Electronic personal health records will provide enrollees with a tool to better access and control their health information. Via the Internet, an enrollee will be able to log on to their

electronic personal health record to keep track of such things as their medications, cholesterol, glucose levels, allergies, and immunization records.

An enrollee will also be able to review a comprehensive, easily understood listing of their health care claims. Health care providers, payers, and enrollees will be able to add this information onto the electronic personal health record. Enrollees will benefit, I believe, significantly from such a tool.

An enrollee can easily share sections of the electronic personal health record with their health care provider, ensuring that their provider has the most up-to-date and accurate health information when making clinical decisions.

In the case of an emergency, an enrollee can also grant others the ability to access their electronic personal health record. Again, it is the decision of the patient, the enrollee in the Federal Employee Health Benefits Program, to decide what kind of access to grant to a provider or a member of the family or another person in the wake of an emergency.

Having health information readily available will increase the efficiency and safety of health care for enrollees by eliminating unwarranted tests, procedures, and prescriptions.

Most important, the legislation ensures that the electronic personal health records provided for through this act are kept private and secure.

The electronic personal health records are required to include a number of security features. They include, among other things, user authentication and audit trails.

The legislation also requires that carriers comply with all privacy and security regulations outlined in the Health Insurance Portability and Accountability Act, which we call HIPAA.

Mr. President, what Senator Voinovich and I are introducing today will help demonstrate the importance and utility of health information technology--not just the importance of the technology but the importance of harnessing the technology--in the delivery of health care in this country today. In this case, the potential is as many as 8 million additional Americans.

This bill is designed to jumpstart this new technology by requiring some of the largest health insurance companies to offer these electronic personal health records, which many are beginning to do today. As more insurance companies, health care providers, and consumers use this new technology, I am convinced that more people will recognize its advantages, and we can more quickly move America's health care industry into the 21st century.

We view this initiative as the next necessary step for the Nation's largest employer-sponsored health insurance program that prides itself on being a model for best practices in health care.

I invite my colleagues to join Senator Voinovich and me as we introduce this legislation. We look forward to talking with our colleagues about it. With luck, maybe we will have a hearing. Senator Voinovich may hold one in his subcommittee this month.

Mr. President, Mount Hood is a cherished wild place that is often photographed, visited and enjoyed by scores of Oregonians and many non-Oregonians as well. Today, I am introducing, along with my colleague Senator Smith, a new bipartisan Oregon Wilderness bill: the ``Lewis and Clark Mount Hood Wilderness Act of 2006.'' In tribute to the great river-dependent journey of Lewis and Clark, our legislation adds nine free-flowing stretches of rivers to the National Wild and Scenic River System. This reflects the Oregonian wish to protect but also actively experience our State's treasures.

This bill contains many elements of the bill I introduced two years ago while incorporating many of the provisions adopted in the House- passed version of Mount Hood Wilderness protections, HR 5025. My bill builds upon the House version by adding more wilderness, more wild and scenic rivers, and providing a recreation area to allow diverse recreational opportunities. It protects the lower elevation forests surrounding Mount Hood and the Columbia River Gorge as Lewis and Clark saw them. These forests embody the natural beauty of Oregon. They provide the clean water necessary for the survival of threatened steelhead, Coho and Chinook salmon. These forests provide critical habitat and diverse ecosystems for elk, deer, lynx and the majestic bald eagle. And these are the forests that provide unparalleled recreational opportunities for Oregonians and our visitors.

But the bill I introduce today differs from the bill I introduced two years ago because it responds to the many comments I heard in the ensuing years. I received thousands of comments on proposed Mount Hood legislation. Some comments came as a result of the general public meetings I held in Oregon. Many of the meetings lasted over 3 hours, and everyone who wanted to speak was given an opportunity to do so. Other comments came from the second Mount Hood Summit held at Timberline Lodge hosted by Representatives Walden and Blumenauer. I and my staff met with over 100 community groups and local governments, the members of the Oregon congressional delegation, the Governor, and the Bush administration. And still more comments came from letters and phone calls from Oregonians.

Overwhelmingly, these comments urged me to protect and build on Oregon's Wilderness system. This goal is as important today as it was in 1804, 1964 or 1984--if not more so. To succeed, we must provide the tools that help us create a planned future on Mount Hood. This bill does both.

The Mount Hood National Forest is the seventh most visited National Forest in the United States. In the 22 years that have elapsed since any new wilderness has been designated in the Mount Hood area, the population in local counties has increased significantly--25 percent in Multnomah County, 24 percent in Hood River County, and 28 percent in Clackamas County.

The predominant public use of this urban forest is non-mechanized activity like hiking, camping, and fishing. With increasing emphasis on wild scenery, unspoiled wildlife habitats, free flowing rivers, wilderness and the need for opportunities for diverse outdoor recreation sometimes it seems we are in jeopardy of ``loving our wild places to death.''

A few years ago, the Forest Service made a proposal to limit the number of people that could hike the south side of Mount Hood and the public outcry was enormous. Seems to me, rather than tell people that they are going to be restricted from using our public lands, part of the solution for the future of the Mountain lies in providing more opportunities for them to enjoy the Mountain's great places. We should ensure the Mount Hood National Forest can meet the increased use and demand for outdoor experiences--my bill will provide those opportunities.

Of the hundreds of people who attended the meetings I held throughout the State of Oregon, the vast majority spoke in favor of more wilderness. Additionally, I have received more than 2,500 written comments supporting additional wilderness for Mount Hood.

This is what I have heard: More Wilderness: First and foremost, I heard that Oregonians in astonishing numbers support protecting Mount Hood and the Columbia River Gorge with additional wilderness. A large number of Oregonians didn't think that enough wilderness areas had been included in the House proposal.

Mountain Biking: Some mountain bikers expressed concerns that their recreation opportunities not be unfairly curtailed.

Fire Protection and Forest Health: Some people were worried about forest health and those living in towns on the mountain and in the gorge were concerned about fire protection for their communities.

Developed Recreation: Some people were worried about maintaining a role for developed recreation, like skiing, on Mt. Hood.

This is what my bill does to address those concerns: More Wilderness: There are currently 189,200 acres of designated wilderness on the Mount Hood National Forest. The House legislation

would have added approximately 77,200 acres of new wilderness on the Mountain. The bill I am introducing today increases wilderness on Mount Hood by designating approximately 128,385 new acres of wilderness-- incorporating all the areas the House bill included and building upon them.

This bill adds the areas surrounding the oldest Mt. Hood Wilderness-- the mountain itself--which was designated in the original Wilderness Act of 1964. These additions include cathedral old growth forests, the historic Tilly Jane trail, lava beds that were created during the Mt. Hood eruptions, and much of the legendary route that Oregon's pioneers used when they were settling our great state. To the north and west of the mountain, I would add the viewshed of the Columbia Gorge to the current Mark O. Hatfield wilderness. These areas encompass the spectacular ridges framing the Gorge that we all marvel at from I-84 and include perhaps the greatest concentration of waterfalls in North America. To the southwest of the mountain I add lands to the current Salmon Huckleberry Wilderness to conserve their diverse wildlife and protect unique recreational areas like those around popular Mirror Lake. These lands include Alder Creek, the source of drinking water for the City of Sandy, which unanimously endorsed the draft proposal. Over to the east are proposed additions to the Badger Creek Wilderness. These areas provide a critical link between Westside forests and Eastside ecosystems. This area is known for beautiful fall color and the best deer and elk hunting in the entire Mount Hood National Forest. Among the areas we are protecting is the newly designated Richard L. Kohnstamm Memorial Area. It is dedicated in honor of Mr. Kohnstamm who restored the historic Timberline Lodge--built originally by the Works Progress Administration in 1937--to its former grandeur.

Wild and Scenic Rivers: My proposal seeks to protect over 81 miles of wild and scenic rivers on nine free flowing rivers. This includes some of the most pristine and beautiful rivers in Oregon. Among those proposed rivers are the picturesque waterfalls and glacial outwash of the East Fork of the Hood River, and the ancestral hunting and fishing grounds of Fish Creek. Over 17 miles of superb salmon and steelhead habitat on the Collowash River have also been proposed for protection. My bill again incorporates all the House proposed protections and builds upon them.

Mountain Biking: I believe that local riders raised some valid concerns, so I did two things. I have proposed Mount Hood National Recreation Area. It will offer greater, permanent environmental protections to those beautiful areas, while providing mountain bikers, and other recreational users, an opportunity to continue to recreate in these areas. Additionally, I made boundary adjustments to ensure all open mountain biking trails were not included in my proposed wilderness.

Fire Protection and Forest Health: I protect wilderness, where there are healthy, older trees that should never be harvested on Mount Hood or in the Gorge. Older, healthy stands are the most resistant to fire and disease. However, there is an enormous backlog of over-crowded, plantation, second-growth that should be thinned. My bill incorporates House provisions that would give the Forest Service a mandate to prepare an assessment for promoting forests resilient to fire, insects and disease. This also includes provisions to study and encourage the development of biomass in conjunction with forest health work. In addition, I added fire safe community zones so that the Secretary will construct a system of fire safe buffer zones around the communities of Cascade Locks and Government Camp.

Developed Recreation: In order to facilitate developed recreation opportunities I have adopted the House provisions establishing a ``fee- retention'' provision that will establish an account for the Mount Hood National Forest. In addition, in order to help address growth while ensuring access to recreational opportunities, I have adopted House provisions directing the Secretary and the State of Oregon to develop an integrated transportation plan for the Mount Hood region.

Local and Tribal Relationships: I have also incorporated the House provisions on local and tribal relationships emphasizing the rich history of the Mount Hood region and affirming the rights of Native peoples to access the mountains resources, as they have for generations.

The protection of these important Oregon places will depend on the hard work and dedication of all Oregonians and particularly that of my Oregon colleagues here in the Congress. I am especially pleased that Senator Smith has joined me in developing this bipartisan legislation and putting forth our proposal for wilderness. I am hopeful everyone will pull together: county Commissioners, environmentalists, entrepreneurs, chambers of commerce, state elected officials, the Governor, and the Oregon delegation here in the Capitol. I look forward to perfecting legislation together in the coming weeks, and seeing its swift adoption by Congress thereafter. Then the grandeur of Mount Hood and other Oregon treasures can be assured for future generations.

Soda Mountain Wilderness: In addition, I wish to offer my cosponsorship of legislation to be presented by Senator Smith, creating the Soda Mountain Wilderness and authorizing the voluntary cancellation of grazing leases in the Cascade-Siskiyou National Monument. This bill would establish a 23,000-acre Soda Mountain Wilderness in the backcountry of the Cascade-Siskiyou National Monument. In addition, it provides for the negotiated voluntary grazing permit lease buyout in the Monument. This proposed wilderness area lies at the intersection of the Siskiyou and Cascade mountain ranges, and the Oregon Desert, California chaparral, High Cascade and coastal Westside forests. It is truly where east meets west meets north meets south. This makes it a truly unique and biodiverse ecosystem and a key wildlife corridor--one that is used by ten rare, threatened or endangered species, including the northern spotted owl, Ashland thistle, and the Siskiyou fritillary. It is also home to populations of trout, elk, bobcats, black bears and falcons. The grazing buyout in this bill also provides a win-win situation. It provides a good deal for the ranchers--the negotiated agreement between the Bureau of Land Management grazing lessees and the conservationists includes an agreed-upon conservationist premium to be paid to the lessees. This premium enhances the compensation lessees receive from the federal government as part of the legislation. It also ensures this special place will be protected. I commend Senator Smith for introducing this legislation and am happy to join him in introducing this bill.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise to introduce legislation to give private developers more time to complete planning and financing for a complex of three high-mountain lake-tap hydroelectric projects that promise to provide at an electric power for Southeast Alaska and for the Pacific Northwest.

Today, I introduce legislation to extend by a total of six years the time for developers to secure data necessary to determine the feasibility and prepare a development application for three individual hydroelectric projects, all located up Thomas Bay in Southeast

Alaska, near Petersburg, AK. This legislation will give time for construction of the estimated $75 million, 45-megawatt Cascade Creek project, the $56 million, 30-megawatt Scenery Creek, and the $40 million, 20-megawatt Delta Creek hydroelectric projects to be built.

The extensions are needed and justified since the three renewable energy projects can only proceed after a $30 million, 27-mile high- voltage transmission line is constructed in Alaska to the U.S.-Canada border, after another $130 million is spent for 150 miles of new line are built in Canada, after $120 million is spent for 140 miles of transmission line upgrades are finished on the Canadian side of the border to move the excess power to Skeena near Terrace in Canada, and after portions of the proposed Southeast Alaska, Electric, Intertie are finished to also permit excess power from the existing Swan Lake and Tyee Lake hydroelectric projects, and the proposed Mahoney Lake project near Ketchikan, AK, to be shared among Panhandle communities and to connect to export transmission lines.

The developers of the Thomas Bay project, Cascade, LLC., deserve a time extension since the company, so far, has focused all of its planning efforts on winning approval and financing for the vital electrical interconnection between Southeast Alaska and Canada, not on finishing the three individual power projects. The State of Alaska only in early summer 2006 approved a grant of $3.2 million to pay for planning to develop a comprehensive plan and review the economic feasibility of using several of Southeast Alaska's nearly 100 potential hydroelectric sites to provide power for both local needs and for export of the surplus power to the Pacific Northwest power grid to help with financing of the 95 megawatts of installed capacity, 410 gigawatt, power project.

These hydroelectric projects all involve tapping high mountain lakes for power. They do not require the damming of fish streams, so they have no negative environmental impacts. They will produce electricity at substantial savings over the 40- to 50-cents per kilowatt hour cost of generating power from expensive diesel fuel in the region and they will also reduce the effects of local air pollution and reduce carbon dioxide generation through the avoidance of fossil fuel combustion.

Congress routinely extends the three-year deadline for worthy potential FERC-licensed power projects to provide additional time for completion of preliminary planning, financing and design. It is certainly appropriate to grant these three projects that are so interconnected this additional time to work out the contractual and financial planning and to finish the environmental studies needed for construction permits to be obtained.

Developing renewable energy that can be produced without any environmental impacts on streams and the fish and wildlife they support is an increasingly important task of government. This bill will help such environmentally-sensitive development occur and will help reduce the nation's dependence on foreign fossil fuels. I hope for speedy passage of this measure.