Veterans' Benefits Enhancement Act of 2007

Mr. President, Senator Alexander has not indicated to me the purpose of his presence on the floor, but we are most anxious to get started on the Indian Health Care Improvement Act. That was scheduled for 9:30 this morning. I wish to begin an opening statement at some point, and I know Senator Murkowski would, and we want to do a managers' package.

Senator Coburn is here, because I asked if he would be here at 9:30, and he has a number of amendments. I appreciate very much his work and his efforts on Indian health care. I am hoping we can work with Senator Coburn this morning to deal with some of his amendments. I know he has filed a number of them, and he and I have had many discussions about it. I appreciate his attendance. He has just walked into the Chamber.

Our interest is in getting a lot of work done this morning and this afternoon in order to try to see if we can finish this bill. This will be the third day that the Indian Health Care Improvement bill has been on the floor, so I wish to begin on that. I know Senator Alexander has appeared, though I don't know for what purpose, and perhaps I would be happy to yield to him if he would tell us if he is wanting to do something else on the floor.

If the statement is 5 minutes, I would not object to that, but I do want, at the end of that 5 minutes, to begin the bill. Again, Senator Coburn has arrived, and we have a lot of work to do. But I know Senator Alexander has worked on budget issues for a long while, so I ask unanimous consent that Senator Alexander be recognized for 5 minutes, and after that I will make some comments, Senator Murkowski then will make some comments, and we will begin a discussion with Senator Coburn.

Mr. President, we are going to turn now to the Indian Health Care Improvement Act, and I am going to be very brief, and I know my colleague will as well because we will have a chance later to speak at greater length.

The Indian Health Care Improvement Act has been the subject of reauthorization for many years, and the Congress has not been able to do it. The fact is we have very serious problems with respect to Indian health care. The Indian Health Service is a very important Federal agency. We have some people who work in that area who do important work and are good and dedicated people, but the fact is the system isn't working very well. We have American Indians--the first Americans, by the way--who are supposed to get health care as a result of treaties and trust responsibilities who are not getting the health care they deserve.

I will again, later today, describe the horrors of Indian health care that does not work. People are dying, people are routinely being denied the health care that every one of us would expect for ourselves and our family. We are trying to reauthorize the Indian Health Care Improvement Act after 8 years. Eight years ago, it was supposed to have been reauthorized. Eight years later, we are still on the floor of the Senate, struggling.

So my hope is, perhaps we will now succeed. Senator Murkowski and the Indian Affairs Committee have worked on a piece of legislation that is not giant reform, it is not a huge step forward, but it is a step forward in the right direction.

Some of my colleagues--I believe my colleague, Senator Coburn--will say we need much larger reform. I do not disagree with that. I am going to be supporting much broader reform in Indian health care. But if you cannot get a modest step in the right direction, how on Earth can you get big, bold reform?

This is the first step in a two-step process to fix what is wrong. I think this Indian Health Care Improvement Act will give us substantial opportunity to improve the health care in the lives of American Indians.

Let me make the point that is important. We owe this health care through treaties, through a trust responsibility. We have made commitments. We owe this health care to American Indians through promises the Federal Government has made.

Regrettably, it has not been adequately delivered. So I am going to talk a little bit later. I know my colleague, Senator Coburn, is on the Senate floor, and he has amendments. I am going to give him an opportunity to speak. I am as well, but I will have an opportunity later this morning to describe in much greater detail why there is an urgency and why this system must be improved. We cannot wait any longer.

I yield the floor.

I have no objection to that. The Senator and I have talked about this. He wants to get all of his amendments pending. But he will be

asking for discussion and votes on a number of them.

I have no objection.

Mr. President, the Senator from Oklahoma cannot possibly win a debate we are not having. I have given his speech 17 times on the floor of the Senate. There is no disagreement between us. I am going to give him a chance to be bold, however, as we go down the road on appropriations because that is what he started talking about: the need for the resources, the need for the money. We have to reform this system. I agree with that. Then we have to fund it. The fact is, we are going to have amendments that add sufficient money. You talk about the fact that we are spending twice as much per person on Federal prisoners for health care as we are to meet our responsibility for American Indians--twice as much for those we have incarcerated because we have a responsibility for their health care.

Now, we need additional money in this system, and we need an overhaul of the system itself. The Senator will find no controversy with me with respect to giving American Indians a card to show up at a health facility and get the health care they need. He knows, and I know, there are many American Indians who live far out on a reservation, 90 miles away from the nearest hospital, and they do not have competition in the health delivery system. They have one place to go when they are sick that morning or their child is sick that afternoon.

So we are going to have a chance to be bold. This is an authorization bill, not an appropriations bill. When appropriations come up, we will have a chance to be bold. I hope the Senator will join me on that.

Let me make a couple comments about this issue.

I am happy to.

Mr. President, I certainly will do that.

It is interesting, we are spending $16 billion a month, $4 billion a week to replenish the accounts for the war in Iraq and Afghanistan and other issues. There are plenty of places for us to decide it is time to fix things here at home.

But I wish to talk about a couple of issues. First of all, there are waiting lines. There is rationing. The Senator from Oklahoma is absolutely correct. Dr. Grim, by the way, came to the Committee in support always of the President's request, saying that was enough because he had a responsibility and a requirement to support the President's budget. But get him off the dais at the hearing and ask him the question, and he would admit there is rationing. About 40 percent of the health care that is needed by American Indians is not available. That is health care rationing. That would be scandalous if it were happening in other parts of the country. It ought to be front page headlines, but you will not hear and you will not read many stories about it, regrettably.

But the fact is, we have a circumstance that brings tears to my eyes. I disagree with the Senator from Oklahoma that this is not a worthy bill. This is a step forward in the right direction. It is not the reform we need, but this is a two-step process. If you cannot get this kind of thing done for 10 years, how on Earth are you going to decide to do something much bolder?

Now, we just faced a budget that came up last week that says not only do we not have enough money for Indian health care, let's cut it. The President says, let's cut what we do have, at a time when we have 40 percent rationing. So we are fighting a battle just to keep the money we have. We need much more if we are going to do what we promised we were going to do.

But let me show the Senator a photograph, if I might. Let me show him a photograph of Ta'shon Rain Littlelight because he says the system does not work. I showed the photograph before because her family has given me permission. This beautiful young 5-year-old girl is dead. She is dead, in my judgment, because of a system that does not work.

They took her again and again and again and again to the clinic. It was on the Crow Reservation in Montana, where I held a hearing and her grandmother stood up with this photograph. She told about little Ta'shon Rain Littlelight. You can see she loved to dance.

Ta'shon Rain Littlelight got sick, and they took her to the health clinic. They treated her for depression. Again and again, they treated her for depression. Even her grandparents said: Well, the way her fingers look, with the swelling of the fingertips, and so on, there must be something else wrong.

Well, one day, of course, they had to fly her to Billings, MT, and then immediately fly her to Denver, CO, where they discovered she had terminal cancer and about 3 months to live.

She asked if she could go see Cinderella's Castle, so Make-A-Wish gave her the opportunity, with her mother, to go to Orlando, FL, to see Cinderella's Castle. This little girl with terminal cancer, the night before she was to see Cinderella's Castle, in the motel room in Orlando, FL, told her mother, ``I am so sorry. I am going to try to be better, Mommy. I won't be sick anymore.'' And she died in her mother's arms that night. This little 5-year-old died because the system did not work.

I have shown a picture of Avis Littlewind. She was 14 years of age, lying in a fetal position in a bed for 90 days and then finally took her own life because there was no mental health treatment available on that reservation--no mental health treatment available to try to help that little girl who felt hopeless and helpless.

This is a photograph, by the way, of Avis Littlewind on the Spirit Lake Nation Reservation. Avis was 14, and she took her life. Her sister took her life. Avis took her life.

This is a photograph of Ardel Hale Baker. Ardel Hale Baker was having a heart attack, diagnosed as having a heart attack on an Indian reservation. They wanted to send her to a hospital an hour and a half away. She did not want to go in the ambulance because she knew if it did not get paid somehow, she would have to pay it, and she did not have any money. They put her in an ambulance anyway and took her to the hospital. As Ardel Hale Baker was being taken off the gurney in the emergency room in the hospital, to be put on a hospital gurney, here is what was taped to her thigh--a piece of paper taped to the thigh of this Indian woman; and it was to the hospital from the Department of Health and Human Services--it was saying, by the way, ``If you admit this woman, understand there is no money in contract health care to pay for her,'' warning the hospital: ``Admit this woman and it is very likely you will not be paid.'' This woman is having a heart attack, and shows up with a piece of paper taped to her leg, saying: ``There is no money for you to be paid, if you admit this woman to your hospital,'' or the woman who goes to the Indian Health Service with a knee that is so painful she cannot walk. It is bone on bone; an unbelievable problem with her knee that you or I or our family would get fixed by having a new knee joint put in. She goes to the Indian Health Service, and the Indian Health Service doctor says: ``Wrap it in cabbage leaves for 4 days.'' That is Indian health care. That is unbelievable, just unbelievable to me.

My colleague from Oklahoma says, well, he does not support this bill because it is not bold. I have been on the floor of the Senate. I have offered amendments to add $1 billion to Indian health care, and it gets defeated. I have seen the budget that came last week from this administration that says they want less money for Indian health care.

Let me put up something Chief Joseph said years and years ago. We took all this Indian land, took all those millions and millions of acres--hundreds of millions of acres--from the Indians, but we said to them: Trust us. We will make you a promise. We will sign treaties. We will tell you that we will provide for your health care. We believe we have a trust responsibility. You can trust us.

Well, regrettably, that responsibility has not been met. Those promises have not been kept. Here is Chief Joseph. He said:

Good words don't last long unless they amount to something.

Words don't pay for my dead people. . . .Good words cannot

give me back my children. Good words will not give my people

good health and stop them from dying.

I care a lot about this issue. In my State, we have four Indian reservations. I have spent a lot of time with them. The fact is, we have people living in the shadows. We have people living in abject, desperate poverty.

I sat with a young girl once at a table with her grandfather. This was a young girl who was put in a foster home at age 3. The woman who put her in a foster home was working 150 cases--150 cases. She did not have time to go check out the home, so she put a 3-year-old girl in a foster home. And on a Saturday night, in a drunken party brawl, a young 3-year-old girl got her arm broken, her nose broken, and her hair pulled out by the roots. That young girl will live forever with those scars.

One hundred and fifty cases a social worker is dealing with? There is such unbelievable difficulty because the resources do not exist. We have people living in Third World conditions.

We had a tribal leader, a chairman of a tribe, say: ``My two daughters live in used trailer houses that we moved from Michigan to the reservation in South Dakota. They don't have indoor plumbing. They have an outdoor rest room, outdoor toilet. One of them has a wood stove in the living room of the trailer house vented out through the window.'' I have seen all of these things. I have experienced all of this. My colleague has seen the same in Alaska. We have people living in Third World conditions in this country. There is a full-scale, bona fide crisis in health care, housing, and education. This bill deals with the question of health care. We have a special responsibility, unlike other responsibilities, because this country has

promised. We have signed treaties. The Supreme Court says we have a trust responsibility. We have not kept our promise, and we have not met our responsibility. I am just flat tired of it.

My colleague says: Let's be bold. Nobody wants to be bolder than I want to be, but we haven't been able to get a bill through here in 10 years, for God's sake. If you can't pass a bill in a decade, how on Earth are you going to be bold? Let's at least take a step in the right direction. I am going to follow that with step 2 on the Indian Affairs Committee, and that is bold, dramatic reform, because this system is not nearly as good as it can be.

He talks about: Why would you add new services? Well, services dealing with diabetes, with cancer screening, with mental health--let's add those services because they are needed, and then let's decide, when the appropriations bill comes around, to add the funding. My colleague knows this is an authorization bill, not a funding bill. We will have a chance to be bold. Let's see who is going to be bold. Let's add the funding to keep our promises, for a change.

My colleague talked a lot about Dr. Grim. I like Dr. Grim. He retired--resigned, I should say--from the Indian Health Service. Dr. Grim came every year, supporting the President's budget. He knew it was not adequate. We know we are rationing health care. The fact is, we all know it. We need to stop it. Are we rationing health care with incarcerated prisoners in Federal prisons? No, we are not, because we have a responsibility for them. We arrest them, we convict them, we send them to prison, and then it is our responsibility to provide for their health care in Federal prisons, and we do it. We spend twice as much per person for them as we do for American Indians. Yet we have the same responsibility for American Indians because we made the promise, signed the treaties, and told them we would provide for these needs. What gives us the right to continue to break our promises? We have done it for decades and decades over almost 200 years. What gives us the right to continue to do that in the face of little children who are dying and in the face of elders who can't get health care? What gives us that right?

I say to my colleague, if you want to be bold, we are going to have a chance to be bold together, because this country ought to stare truth in the face and look at what is happening on Indian reservations.

The other night, I was on an Indian reservation, having a listening session with Indians. There were two sisters sitting in the front row. One sister stood up to speak, and the other sister sobbed uncontrollably--cried and sobbed. It was an unbelievable story about the sister who desperately needed health care and couldn't get it and couldn't find it. She finally had her heart surgery, and of course it was charged back to her, because there was no contract health care. It has completely ruined her credit rating because she doesn't have anything to pay for it, and the Indian Health Service did not serve her needs. She was also treated for depression. She had a heart valve problem that needed surgery, and she was treated for depression. When she finally found a way to get the surgery, it could not be paid for by Indian contract health because they were out of funds. ``Don't get sick after June.'' We had one reservation tell us, don't get sick after January, because they didn't have the money. This poor woman sat there in the chair sobbing as her sister recounted the details of her desperate attempt to deal with a health care problem that was very acute.

So, yes, I am a little bit emotional about these issues. When we have people say, well, let's do much more, I say: Absolutely. Let's do much more than we are now doing. Let's do that in appropriations. That is an awfully good start.

This is an authorization bill which does a lot more than the current Indian Health Care Improvement Act. It does a lot more in areas we know are in urgent need.

We have teen suicide clusters on Indian reservations. In the northern Great Plains, there is a 10 times greater rate of suicide among teenagers--not double, triple, or quadruple, but 10 times the rate of suicide. I went and sat and talked with kids on that reservation, the one where we had a cluster recently. It was just me with some high school kids, talking about what is going on, what is their life like. It is unbelievable.

We need to address these things. That is what we try to do in this Indian Health Care Improvement Act. It is not perfect, but it is certainly a step in the right direction.

I have other things to say, and my colleague may wish to weigh in, as well. My hope will be at the end of the day today that we will be able to get the amendments up and get them voted on. Some of the amendments my colleague described, I likely will support, because I think we can improve this piece of legislation. I think at the end of the day, all of us will hope we will have done something we are proud of, to say to those who don't now have adequate health care or whom we promised health care that we have made a step forward in trying to meet those needs.

Mr. President, I yield the floor.

Mr. President, let me thank the Senator from Arizona. He has been working very hard with us to try to move this bill along. I would say to my colleagues on this side of the aisle as well: If you have amendments, please bring them. The majority leader has indicated we are going to finish this bill this week, and that will be a significant step forward. I thank the Senator from Alaska and the Senator from Arizona for their work to help us move this bill. He is correct that we had four or five very controversial issues that provoked some opposition. We worked through those, negotiated, and I think all of them are now resolved.

I think when the Senator from Alaska has completed any statement she is going to make, we do have the managers' amendment that amends the substitute we had offered, and that has been negotiated and agreed to on both sides. So when Senator Murkowski has completed her statement, we will ask that it be completed as well.

Mr. President, I object. I have not had a chance to visit with my colleague. I wish to do so first.

I object. I have not had a chance to visit with the Senator, and I will be glad to do so at some point.

Mr. President, I suggest the absence of a quorum.

Madam President, it is more than a little frustrating. We have been here for 3 hours this morning. We have amendments on this bill dealing with Indian health care. We have nongermane amendments that have been offered: Medicare, LIHEAP, earmarks for Berkeley, abortion.

This is a very serious issue. We have people dying in this country with respect to this health care question about American Indians. I spoke earlier this morning that the U.S. Government has a responsibility for health care for Indians. If you ask the question: Why? Because we signed up for it. We signed the treaties. We said: We promise, and we have a trust responsibility for it.

So we spend twice as much money to provide health care to Federal prisoners as we do for American Indians. We are not meeting the needs. We have people dying. So it takes 10 years to get a bill to the floor of the Senate--10 years to get a bill to the floor--to try to improve health care for Indians, and we get here, and we have unending appetites for amendments that have nothing to do with Indian health.

Look, I support low-income energy assistance. I support that. I support a lot of these issues. Many of them have nothing to do with Indian health. We are just trying to get a bill passed here.

Let me describe something I heard about a month ago to describe the urgency. I was at the Standing Rock Indian Reservation in North Dakota. It straddles the North Dakota-South Dakota border. The husband of Harriet Archambault came to a meeting I had--a listening session on Indian health care--and he described his wife Harriet and her battle to try to deal with this health care dilemma. They lived nearly 20 miles from a clinic in South Dakota. It was an Indian health care clinic. She would get up in the morning and drive 18 miles to the clinic because that clinic can take only 10 people in the morning and 10 people in the afternoon. So five times, she got up in the morning to drive to that clinic. All five times she got there, there were 10 people ahead of her.

Her medicine ran out on October 25, 2007, her husband said. Five times for the next month, she got up and drove to that clinic. She could not stay there, because she was also a day care provider for her grandchildren. So this woman went, tried to sign up, but there were 10 people ahead of her--that is all they would take--and she had to go home.

Five times she did that in a month. A month later, she died. Her medicine ran out October 25. She died November 25. She had called her sister about 3 weeks before, and she said: ``What do I have to do here to get the medicine I need? Die?'' Well, she did die because she could not get service in this Indian health system.

The fact is, people are dying. All we are asking is that we maybe have somebody come over and offer an amendment on Indian health care and start a debate on these amendments. If we have people who have these amendments, come over and offer them. We have some that are filed. Let's have some votes and try to get through this piece of legislation.

This is the third day we are on the floor of the Senate with this bill. I said earlier, it has taken 10 years to get here. Every single year we have worked on this. Senator McCain, who was chairman of the Indian Affairs Committee, worked on it with me--Senator Murkowski. We work on it and never get it to the floor. We finally get it to the floor of the Senate, and this is like a root canal, except a root canal hurts less, because at least you are accomplishing something.

Here we come to the floor of the Senate, and we cannot get amendments up. We cannot get amendments voted on. So my hope would be we can find a way to move through this legislation.

Madam President, I am happy to yield for a question.

Madam President, I yield for that purpose. I believe I understand what the Senator from Vermont is doing.

Madam President, let me say to the Senator from Vermont, I understand his passion. He knows I have a lot of passion about this bill, and I have expressed it this morning. I understand his passion about LIHEAP. Somebody from Vermont does not have to tell somebody from North Dakota about cold weather. I know about cold weather and my constituents do. LIHEAP is unbelievably important, and we need to find a way to get the money out for LIHEAP. I understand that. I am very sorry he was unable to get the yeas and nays and so on. But he also understands you have to try to offer amendments where you can to authorization bills. I understand that. He is a supporter of this bill, the underlying Indian health care bill we need to get done. It is also the case, I am sure, that the Senator from Alaska knows a little about cold weather. I have been to Alaska. So my hope is that working together in this Chamber we will fund the LIHEAP program, because it is very important. That also can be life or death for people, so my hope is we can get that done.

But having said all of that, again let me say we have a managers' package that perfects--after having negotiated now for several weeks on about five or six very controversial issues, we have negotiated in a way that we have reached a compromise on all of them, satisfactory to all of the parties. We now have that in a managers' package which we intend to offer next. It has not yet cleared. It has been a couple of hours since we have been able to clear that. My hope is that in the next 30 minutes or so we can clear that so at least we can get the managers' package done.

I believe Senator Coburn will be here. He has some amendments filed. I hope he will be here to call up amendments which I believe he will do reasonably soon, and I think Senator Tester wishes to speak on the bill generally.

I yield the floor.

Madam President, I make a point of order that a quorum is not present.

Madam President, let me say, I don't think anybody in the Congress, the Senate, or the House wishes our intelligence community to be blind or deaf. Obviously, we have a process in this country with the FISA Court that allows emergency actions. The opportunity to be able to engage in surveillance and the appropriate surveillance to make sure we are listening to terrorists and all of those things are available.

There is a debate about how wide should the drift net be, that the administration might want to gather almost every communication everywhere in the world and data mine to find out who is saying what. That is an important conversation because it deals with the basic rights in our Constitution. I think there is no one in this Chamber or in the other who believes we want our intelligence community to be blind or deaf and to not have the opportunity to do the kind of surveillance necessary to protect our country. That is very important to state.

Madam President, we are not in morning business, although we are doing some morning business. We are on the piece of legislation that we reported out of the Indian Affairs Committee, dealing with Indian health care improvement. I have always been enormously proud to serve in this body. I am privileged and proud to serve. I have occasionally told friends that the Senate is 100 bad habits--that includes myself, of course. We are not doing anything at the moment, I understand, because one Senator is downtown someplace, giving speeches, and the instruction is that nothing is to be done while that Senator is gone. Good for that Senator, but I don't think this place ought to come to a stop because somebody decides they are going to be gone for 2 or 3 hours, so they want others to object to everything on their behalf. That is, in my judgment, discourteous, and my hope is that the Senate could do a little business today on something that is urgent. That is not too much to ask for the Senate to perhaps consider legislation that is before it. We are now on the third day of the Indian Health Care Improvement Act, a very urgent and serious matter. This is the third day. We have been here for over 3 hours today, and we have had amendments on all kinds of issues, except issues that deal with this legislation.

Even just attempting to offer the managers' package, which has been negotiated over the last month or so, in which we successfully negotiated on about five or six very controversial issues--we negotiated an agreement between the sides, and even being able to offer that at this point is denied because someone who is not even on the Hill told their staff to tell others that the leadership cannot allow this. It is unbelievable to me.

One might expect, perhaps, that today we can make progress on this legislation. Everybody puts on a blue suit and shined shoes and comes to work, and one might expect we can get something done for a change. We will have additional morning business, and we will see if those who have left the Hill and want the entire world to stop and wait for their whims will show up at some point and maybe we can consider some amendments. I hope that will be the case.

I yield the floor.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

I know my colleague, Senator Coburn, is here. He is going to offer an amendment. I should tell you how pleased I am. Senator Coburn indicated he would be here around 2 o'clock. He was good enough to come this morning at 9:30 and engage in discussion on this bill.

But we have discussion about virtually everything about the bill on the floor of the Senate, Indian health care. The fact is we have had all kinds of amendments that have nothing to do with the bill. I hope we can finally get this moving.

I had spoken this morning of some people whose experience with the Indian health care system and the lack of health care for American Indians has been devastating. Some people died as a result of not having access to adequate care that we would take for granted in our country.

Let me mention my colleague from Oklahoma is on the floor and is going to discuss one of his amendments. You know, we have a trust responsibility. We have a responsibility to keep a promise we have made in treaty after treaty for Indian health care. I do not think there is a disagreement on the floor of the Senate about that.

There is no disagreement that we have a responsibility, that responsibility is in writing in all kinds of treaties. So we have made the promise; we have not kept the promise.

Let me make one final point. There is no group of Americans who have served this country in greater percentage of their population than American Indians. You take a look at the percentage of veterans who have served this country in wars and during peacetime, no population has had a greater percentage of people who have gone to serve America than American Indians.

I told my colleagues once previously about a Sunday morning in Fargo, ND, at the veterans health care facility, veterans hospital, where a veteran named Edmond Young Eagle was dying of lung cancer. I did not know it that day, but he would die 7 days later of lung cancer.

He was a man who lived on an Indian reservation. When called by his country, he served in Africa during the Second World War, at Normandy, throughout Europe, served with great distinction.

He came back. He never had very much, lived a tough life, didn't have many relatives. At the end of his life his sister asked if I could get his medals he had earned but never received. I did. I took them on a Sunday morning to the veterans hospital in Fargo, to this man who was in his mid- to late-seventies, a World War II veteran, had a tough life, never had very much, was dying of lung cancer. We cranked up his hospital bed to a seated position. He was a very sick man but very well aware of what was going on. I pinned a row of medals on his pajama top at the veterans hospital. The doctors and nurses from the hospital packed into his room. This proud man said to me, as I pinned his medals on his pajama top: This is one of the proudest days of my life.

This is a man who had a difficult time in life. He never had very much but served his country when asked in Africa, in Europe, fought for his country. Many years later, just prior to his death, he was recognized by his country, as I told him: A country that is grateful for your service. There are so many who have provided so much service from Indian reservations, from Indian nations.

We have made a solemn pledge to the Indians--we signed it into treaties; we have it as a trust responsibility--we will provide for your health care.

As my colleague from Oklahoma said this morning, take a look at Medicare, Federal prisons, Indian health, a whole range of things. Just to take Federal prisons as an example, we spend twice as much per person providing health care for prisoners as we do meeting our responsibility to provide health care for American Indians. That is a disgrace. It has to change.

I can't tell you how pleased I am to see my colleague from Oklahoma because we have had so many amendments that have so little to do with the underlying bill. I know my colleagues have offered a number of amendments that deal directly with it.

I yield the floor.

Will the Senator yield for a question?

This is an authorization bill. The Senator is amending it. Does his amendment anticipate an increase by $2 billion for the authorized level because we are authorizing expenditures? The Senator will perhaps offer a $2 billion appropriations measure. I will as well. I hope we will be able to work together on that. But we will also have to increase the authorization. Does the amendment increase the authorization?

Mr. President, why don't we do that, provide the authorized room? The Senator this morning indicated--and I agreed--that we are about $2 billion short of fully funding Indian health care. We have full-scale rationing going on. The amendment has a restriction in it. He limits the amount of funding in his amendment to the amount of funding that currently exists in Indian health. The President has just proposed a reduction in funding, even though we are only meeting 60 percent of current need. My question is, should we not then remove that restriction and actually increase the authorization because he and I have the same goal. Let's get the amount of money in the system that provides health care for Indians that we have promised.

If the Senator will yield further, one of the dilemmas in providing Indian health care, not so much in the State of Oklahoma but in other areas where there are reservations, is in many cases the only health care that is available is the Indian Health Service clinic, and you are 80 miles away from the nearest hospital. In many cases there will never be competition in an area where someone is desperately sick and needs to see a doctor quickly. I happen to agree the underlying notion of this amendment of providing a card to someone to say, take this card to a health care facility and get that need fixed, if you must--I happen to think that has merit. I will be working with the Senator on that with respect to the bolder approaches to Indian health care. But on page 4, line 4, is where you have budget neutrality: In conducting the program under this section, the Secretary shall ensure the aggregate payments made to carry out the program do not exceed the amount of Federal expenditures which have been made available. That is saying that we want to do all of this, which would expand contract care and so on but within the same amount of money that currently exists in Indian health care. It is kind of a chicken and egg.

Mr. President, I thank my colleague for coming and debating the amendment. I understand he has to leave.

The Senator from Oklahoma certainly is right, it is not more money necessarily that is only going to solve the problem. But I guarantee you that less money will not solve the problem. If we are 40 percent short of money needed now, I guarantee you that the same amount of money will not solve the problem. The amendment he has offered has a provision that says we are going to do something different, we are going to do something that is unique, and, by the way, you cannot spend any more money than you are now spending in a system that is already 40 percent short of money.

How can we have an amendment that restricts the amount of funding? When he says that--he started this morning by saying we are $2 billion short. It is interesting, I do not necessarily disagree with the proposition of trying to find choices, providing an insurance card, or some other mechanism by which we create some competition with the Indian Health Service. But this may be much better for Oklahoma than it might be for other States.

If you have an Indian Health Service area where you are in an Indian reservation 80 miles from the nearest hospital, and the only health care capability you have is to go to the Indian Health Service, well, you know what, we better have adequate funding for that, at least current funding for that. If you add another program on top of this for other Indians who can go somewhere else in a metropolitan area and be able to present a card, because they have now taken money out of the system and purchased their own insurance--you allow that to happen, then the American Indian who is living on the reservation with the current Indian Health Service clinic there has less money.

How does that work to help the folks who are stranded with no competition? It seems to me the way this is written, with a restriction that says there cannot be any additional resources beyond that which currently exist--and, by the way, the President wants to cut that. We have wide-scale health care rationing going on in this country, with people dying because of it, and the President's budget cuts it.

My colleague says: I will support--quoting him--increased funding, increased authorization. But the amendment he authors actually restricts the amount of money available. In order to do something new, if you are going to restrict the amount of money available to what is available now--if you are going to do something new--it is going to come from some place. I will tell you where it is going to come from. It is going to come from clinics out in those reservations where there is no choice.

There is only one opportunity for somebody who has broken an arm or developed an illness or disease and needs to go someplace quickly to find health care. They are going to go to the local Indian health clinic. This money is going to come out of their hide because this amendment offered provides a restriction that no additional resources can exist.

I do not denigrate the idea offered by the Senator from Oklahoma. But this clearly is not something that would be helpful to a lot of American Indians. In fact, I believe it would be hurtful to a lot of American Indians who are the ones who have no choice--who have no choice at all--but must try to get their emergency care and must try to get their basic health care met at those clinics.

I mentioned this morning a woman named Harriet Archambault whose health care was in McLaughlin, SD, in a satellite clinic of the Indian health care facility for the Standing Rock Tribe in Fort Yates, ND. That was her health care: the McLaughlin, SD, satellite clinic. They can handle 10 people in the morning and 10 people in the afternoon. That is it. If you are not on the list of 10, that is it, and you cannot make a reservation. You come and you sign in.

Well, she came five times, drove 18 miles one way each time. Five times she came, and 5 times she was too late to be in the top 10. She could not stay because she was taking care of her grandchildren. She was the daycare provider for her grandchildren. Her medicine had run out for hypertension and high blood pressure in mid-October. Five times she got up early in the morning to drive nearly 20 miles, and she did not get there in time. There were 10 people on the list ahead of her. One month later she died. She tried five times and never got there, in a remote satellite location.

The fact is, people are dying. Children are dying. Elders are dying. There is not nearly enough money to keep the promise this country made to American Indians. The amendment offered today is one I am very interested in working with the Senator from Oklahoma on in a significant reform package in which we dramatically increase the resources to keep our promise, and then try to provide some competition and some choice. I am interesting in doing that, frankly.

I am not interested in passing an amendment that says, let's do this in a

way that restricts funding for others, which is what this amendment does. There is a specific restriction on funding, and that means there is going to be less funding for those clinics, including the satellite clinics. That is not something I am willing to entertain.

But, again, I appreciate finally getting an amendment offered. My colleague indicated he will be back. I indicated earlier we are at parade rest because one of our colleagues apparently has an objection, through his staff, through leadership, and he is off, apparently, at a meeting downtown, and has a speech, and he will be back sometime around 3:30 maybe. But in the meantime, through his staff, we are told we are not able to move on anything.

I have a managers' package that is agreed to, I believe, and I want to send it to the desk in a moment. My understanding is, we cannot move to embrace it despite the fact it would be a unanimous consent, because one of our colleagues is downtown and will not be back for an hour and a half. That will make him gone for 3 hours. In the meantime, we sit here with our hands in our pockets trying to figure out how on Earth we explain this is a body that is supposed to get something done.

I said this morning I have often called this place 100 bad habits, despite the fact I feel enormously privileged to be here. I love the Senate. But I am not very happy about the way this place works today because we deal with an important issue that is life or death to some people, and we are having a difficult time.

Senator Murkowski has worked on this bill with me for a long period of time. Before her, Senator McCain worked on this legislation. We are finally on the floor of the Senate, and because of things that have nothing at all to do with this bill, we are standing here frozen because somebody is gone, apparently.

Mr. President, over the past weekend, our Nation observed Veterans Day, a day to commemorate the connection between the American people and America's veterans. This connection is something that the American people are always aware of at the bottom of their hearts, though it may not always be in the front of our minds as we go about our daily lives.

We Americans often define ourselves by the freedoms we enjoy. America's veterans are men and women who sacrificed some of their own freedoms to serve and defend our Nation. The connection between these two groups--the defended and the defenders--may not always be visible, but it cannot be denied. Veterans Day gave us the opportunity to recall that connection, to honor those who wore the uniform of our country.

As chairman of the Committee on Veterans' Affairs, it has been my privilege to work alongside other leaders in answering a simple question: How do we best honor veterans? Having so recently celebrated Veterans Day, I am pleased to report on the committee's work in the areas of legislation and oversight to try to answer that question.

The Committee on Veterans' Affairs has worked diligently to fulfill its oversight and legislative responsibilities, demonstrated in part by our hearing and meeting schedule. We have held 40 hearings and meetings, including 7 field hearings, since our organizational meeting in January. The committee has heard from 220 witnesses, and reported 4 nominees to the Senate, each of whom was later confirmed.

At our committee's very first meeting, I discussed my agenda to work with other members to bring the Department of Defense and the Department of Veterans Affairs together to provide a seamless transition for veterans from DOD to VA. We focused on seamless transition and set an agenda to pursue the issue in the coming year.

These actions were taken long before the horrible news reports about conditions at Walter Reed shocked the country into action. Our foresight positioned the committee, in collaboration with the Senate Armed Services Committee, to craft legislation that attacked the flaws within the DOD and VA systems. I am pleased that our legislative responses were incorporated into the National Defense Authorization Act. I look forward to seeing them become law.

Two weeks after the organizational meeting, the committee held its first hearing, which was on VA and DOD cooperation and collaboration. We heard testimony from officials from VA and DOD, as well as the personal stories of veterans who slipped through the cracks during their transition from military service to veterans status. This would be the first of a number of hearings the committee would hold on VA and DOD cooperation and collaboration. Later hearings on this issue focused on specific areas such as health care, education, information technology, and benefits.

In February, I contacted DOD on behalf of VA's Polytrauma Center health care providers so as to ensure that VA providers had easy and appropriate access to DOD's Joint Patient Tracking Application. This medical information sharing application is important to data sharing between VA and DOD. I was pleased when DOD responded shortly thereafter, providing assurance that they would resume their important data sharing practices.

The decision to focus on cooperation and collaboration between DOD and VA was made well before news broke on the deplorable conditions at Walter Reed. As these news stories moved questions about veterans care into the forefront of America's attention, our committee put our focus on the total system of care, involving DOD and VA.

Shortly after the press revelations of problems at Walter Reed Army Medical Center, I visited Walter Reed, along with my good friend and colleague, Senator Carl Levin, chairman of the Senate Armed Services Committee. On the way back to the Capitol from that visit, we agreed to hold an unprecedented joint hearing of the Armed Services and Veterans' Affairs Committee on the issue of DOD-VA cooperation and collaboration. On April 12, we held that hearing, further pursuing answers both about what was happening at Walter Reed and how we could fix it and about the overall state of the relationship between the two Departments.

From that hearing and subsequent work on the problems at Walter Reed and elsewhere in both the DOD and VA systems, and how those problems affected wounded servicemembers, it was clear that a commonsense approach was needed.

One specific focus of that effort was on how to reform the DOD disability system so as to promote greater uniformity among the services and between the services and VA. On April 30, I introduced S. 1252, a bill that would mandate a number of changes to the DOD disability evaluation system, including uniform use of the Veterans Affairs rating schedule across the military services, inclusion of all conditions which render a member unfit when making a disability rating, uniform training of Medical Evaluation Board/Physical Evaluation Board personnel, and accountability by DOD to ensure compliance with disability rating regulations and policies.

Just as veterans and servicemembers benefit when VA and DOD work together, the Committee on Veterans' Affairs and the Senate Committee on Armed Services saw an opportunity to collaborate on legislative solutions. All of the provisions of S. 1252 were included as part of S. 1606, the joint SVAC and SASC proposed Dignified Treatment of Wounded Warriors Act of 2007, which was later included in the 2008 National Defense Authorization Act.

While demands on VA have dramatically increased over recent years, VA funding has not. To allow the hard working men and women of VA to do their jobs without having to worry about whether there will be sufficient funding, we have sought a substantial increase to VA funding. I am pleased that the funding level in VA's fiscal year 2008 appropriations bill amounts to the largest funding increase in the history of the Department.

The appropriations bill also includes significant increases that will enable the Veterans Benefits Administration to pay for up to 3,100 new full-time employees. I hope the VBA will use these funds to attack the current backlog of veterans' claims aggressively. I will continue to work with my colleagues to enact this historic and long overdue increase in funding for veterans.

In working on the legislative front, the committee has taken a collaborative approach with other Members of the Senate and the House of Representatives. Our focus has been on getting good law enacted, whatever the vehicle. I am pleased to report on the committee's progress on many pieces of legislation, some of which have already been enacted into law.

As we continue to pursue adequate funds to pay for the true cost of war, we must also recognize that the nature of the battles our troops are fighting has changed as well. VA health care must be better prepared to address traumatic brain injury, the signature wound of the current war. To improve VA's diagnosis, treatment, and rehabilitation for traumatic brain injuries, I introduced S. 1233, the proposed Traumatic Brain Injury and Health Programs Improvements Act of 2007. This bill, amended to include a number of other health care provisions, was reported by the committee. In addition, many of the provisions of S. 1233 were later incorporated into the Wounded Warriors Act and the National Defense Authorization Act.

S. 1233 would increase access to VA health care for combat veterans, extending the period of eligibility during which recently released or discharged combat veterans have unfettered access to VA care from 2 to 5 years. This provision will help ensure that these newest combat veterans have more time to identify and deal with invisible wounds, such as traumatic brain injury and PTSD. Another key provision of the bill relating to the treatment of invisible wounds is a requirement that VA provide a servicemember with a mental health evaluation within 30 days of making such a request.

S. 1233 also would enhance care for older veterans already in the VA system. It would repeal the 2003 VA regulation which barred Priority 8 veterans, so-called ``higher-income'' veterans, from enrolling in the VA health care system, essentially re-opening the system to these veterans. Many issues have been raised this year with regard to access to VA care for veterans residing in more rural areas, and S. 1233 includes an entire section aimed at looking at ways to increase access for rural veterans.

I am also very proud of the provisions in S. 1233 that seek to expand and enhance services for homeless veterans. We all recognize the sad reality that veterans suffer disproportionately from homelessness. S. 1233 would not only increase the resources available to community-based entities that provide reintegration services to those who are already homeless, it would also provide supportive services to low-income veterans to help prevent homelessness.

This bill also contains a significant increase in the travel reimbursement benefit paid to certain veterans who are forced to commute long distances to access care at VA facilities. The current mileage reimbursement rate is only 11 cents per mile, and this rate has not been increased since 1978. The committee bill would increase the rate to 28 cents per mile--a substantial increase and one that will hopefully help ease the financial burden for those who have to travel sometimes hundreds of miles to get to a VA hospital or clinic.

Two other health care bills that I introduced this year are currently moving through the committee process--S. 2160, the proposed Veterans Pain Care Act of 2007, and S. 2162, the proposed Mental Health Improvements Act of 2007. The committee is scheduled to mark up both of these bills, along with two others, tomorrow. I hope to see each of them passed by the end of this year.

For too many veterans, returning home from battle will not bring an end to conflict. They will return home, but the things they have done and seen in combat will follow them. Invisible wounds such as PTSD are complicated and can manifest themselves in many different ways. Studies have estimated that as many as 1 out of every 5 Iraq

war veterans are likely to suffer from readjustment issues. It is clear that action is necessary on the part of Congress to ensure that VA is equipped to deal with these issues.

In April, the committee held a hearing dedicated to veterans' mental health concerns and VA's response. We heard very compelling testimony from witnesses who suffered the consequences of invisible wounds in their families and their own lives. Randall Omvig spoke of his son's suicide upon returning from Iraq. Tony Bailey spoke of his son's struggle with substance abuse, and of his ultimate death from it. Patrick Campbell shared his own experience with PTSD and the experiences of his fellow servicemembers. Their touching and often painful stories put human faces on an issue that is to often reduced to numbers.

The proposed Mental Health Improvements Act is a direct outgrowth of that hearing and the testimony given by those who have suffered with mental health issues and by their family members. The bill addresses the immediate needs of veterans by ensuring high quality mental health services at VA facilities and in their communities. The measure also seeks to address the plight of veterans who suffer both from PTSD and substance abuse.

S. 2160, the proposed Veterans Pain Care Act of 2007, would enhance VA's pain management program. It is estimated that nearly 30 percent of Americans--some 86 million people--suffer from chronic or acute pain every year. A recent study conducted by VA researchers in Connecticut found that nearly 50 percent of veteran patients that are seen at VA facilities reported that they experience pain regularly.

While pain increases in severity with age, it is also a growing problem among younger veterans who have been injured in the wars in Iraq and Afghanistan. Many of these veterans are coming home with severe injuries--often traumatic brain injuries--that require intensive rehabilitation. In some cases, younger veterans will have to live with the long-term effects of their injuries, of which pain is a large and debilitating part.

Pain management is an area of health care that by many accounts is not yet to up to par, in both the private and public sectors. S. 2160 would standardize VA's pain management program on a national, systemwide level, by requiring VA to establish a pain care initiative at every VA health care facility. Every hospital and clinic would be required to employ a professionally recognized pain assessment tool or process, and ensure that every patient who is determined to be in chronic or acute pain is treated appropriately. The bill also calls for comprehensive research on pain management to improve care for chronic pain.

During this session, I introduced S. 1163, the proposed Blinded Veterans Paired Organ Act of 2007, a bill that would offer enhanced benefits to veterans who suffer from service-connected impairment of vision. The bill was amended in committee and the language that was favorably reported to the full Senate was inserted into H.R. 797, the House companion, and passed on November 2. The Senate-passed H.R. 797 would broaden the benefit eligibility requirements for two distinct groups of veterans with impaired vision due to service--those with service-connected blindness in one eye who subsequently suffer loss of vision in the other eye later in life and those who receive special monthly compensation for multiple disabilities, including vision impairment.

The amended bill also includes a series of provisions that would enhance memorial and burial benefits for veterans and private cemeteries, including permanently authorizing VA to provide government headstones or markers for the privately marked graves of veterans interred at private cemeteries; instructing VA to design a medallion or other device to signify a decedent's veteran status, to be placed on a privately purchased headstone or marker, as an alternative to a Government-Furnished headstone or marker; extending the time limit for States to be reimbursed for the unclaimed remains of veterans; and authorizing $5 million for operational and maintenance expenses at State cemeteries. The provisions in the bill are fully paid for through legislative repeal of a Court of Veterans Appeals decision which inappropriately extended a needs-based benefit to a population that Congress did not intend to receive it.

Because inflation erodes the value of the dollar, Congress is responsible for adjusting compensation for service-connected disabilities. This year I sponsored S. 423, the proposed Veterans' Compensation Cost-of-Living Adjustment Act of 2007. The veterans' COLA legislation ensures that the purchasing power of veterans' benefits, including compensation for veterans and assistance for their survivors, is maintained. This annual COLA is done in recognition of the Nation's gratitude towards veterans young and old for their service and sacrifices.

As the sponsor of the Senate version of this bill, I was pleased to support the passage of the House companion, H.R. 1284. I applaud Congress and the President for their work in making it law as of Monday, November 5, 2007. I hope veterans, including the 17,000 recipients of compensation who are served by VA's Honolulu Regional Office, benefit from this demonstration of our appreciation.

Oversight investigations carried out by committee staff uncovered concerns in the veterans' benefits system as well. To improve the benefits system, the committee reported S. 1315, the proposed Veterans' Benefits Enhancement Act of 2007. This bill would improve veterans' life insurance, adaptable housing, education benefits, and provide the committee with more oversight data. It would also address a 60-year wrong that is still being done to Filipino veterans who served under the U.S. Armed Forces during World War II.

In the years since the end of the Second World War, Filipino veterans and their advocates, especially my distinguished colleague, Senator Inouye, have worked tirelessly to secure these veterans the status they were promised when they agreed to fight under U.S. command in defense of their homeland and to protect U.S. interests in the region.

This bill would also more than double the maximum amount of Veterans Mortgage Life Insurance that a service-connected disabled veteran may purchase from $90,000 to $200,000. The VMLI program was established in 1971 and is available to those service-connected disabled veterans who have received specially adapted housing grants from VA. In the event of the veteran's death, the veteran's family is protected because VA will pay the balance of the mortgage owed up to the maximum amount of insurance purchased.

The measure would also establish a new program of insurance for service-connected disabled veterans that would provide up to a maximum of $50,000 in level premium term life insurance coverage. This new program would be available to service-connected disabled veterans who are less than 65 years of age at the time of application. Under the new program, eligible service-connected veterans would be able to purchase, in increments of $10,000, up to a maximum amount of $50,000 in insurance.

S. 1315 would also increase the amount of supplemental life insurance available to totally disabled veterans by 50 percent, from $20,000 to $30,000. This provision stems from S. 643, the proposed Disabled Veterans Insurance Act of 2007, which I introduced in February of this year. Many totally disabled veterans find it difficult to obtain commercial life insurance. This legislation will give totally disabled veterans better life insurance, a small measure of support for veterans who sacrificed so much.

In addition, this bill would expand eligibility for retroactive benefits from traumatic injury protection coverage under Servicemembers' Group Life Insurance. This insurance program went into effect on December 1, 2005. All insured servicemembers under SGLI from that point forward were covered under traumatic injury protection regardless of where their injuries occur. However, individuals sustaining traumatic injuries between October 7, 2001, and November 30, 2005, which were not incurred as a direct result of Operations Enduring or Iraqi Freedom, are not eligible for a retroactive payment under the traumatic injury protection program. S. 1315 would expand eligibility to these individuals.

The reported bill would allow for home improvements for totally disabled servicemembers prior to release from active duty. This provision is very important because many servicemembers return home to finish their rehabilitation and recuperation prior to discharge from the military. Their homes need to be adapted so that they can live comfortably and independently.

S. 1315 also contains a number of provisions derived from S. 1215 which I introduced on April 25 that would make four small but necessary changes in existing laws relating to education and employment. First, it would restore the funding cap on the amount of funding available for State Approving Agencies to the fiscal year 2007 level of $19 million. Without this restoration, these entities that assist VA in approving programs of education would be facing a reduction of more than 30 percent beginning in fiscal year 2008. It is particularly important for SAAs to have adequate resources as more veterans return to civilian life and begin to use their educational benefits.

Second, it would update the special unemployment study required to be submitted by the Secretary of Labor to the Congress by requiring that it cover veterans of Post 9/11 Global Operations. It would also require the report to be submitted on an annual, rather than a biennial, basis. By updating this report, we will have more data available to us on more recent groups of veterans those who served and are serving in the Gulf War and Post 9/11 Global Operations. This should better help us assess the needs of current veterans entering the work force and develop appropriate responses.

Third, the bill would extend for 2 years a temporary increase in the monthly educational assistance allowance for apprenticeship or other on-the-job training. Eliminating the temporary increase would mean a monthly benefit rate cut on veterans enrolled in this type of training and remove marketable incentive to encourage individuals to accept trainee positions they might not otherwise consider.

Finally, the bill would provide for a waiver of the residency requirement for State veterans' employment and training directors. By giving the Secretary of Labor the ability to waive the 2-year residency requirement, this provision would help ensure that the best qualified individuals from any state may be considered for SDVET vacancies.

Both S. 1233 and S. 1315 were reported to the Senate in late August and have been pending floor action ever since. It is most unfortunate that we have been unable to reach agreement to proceed to their consideration, due in part to an abrupt and unexpected change in the minority committee leadership. Late last week, just days before Veterans Day, the other side of the aisle affirmatively blocked consideration of this important legislation that has the support of a majority of the members of the Veterans' Affairs Committee. Let me be clear--I do not expect all Members to support or agree with these bills, only to allow for their consideration by the full Senate. If members have amendments to offer, bring them forward. We can then craft an agreement under which the Senate might do its work and debate these bills.

One final legislative item that I wish to mention--recently, I worked with my colleague Senator Webb on a matter of symbolic and real importance to servicemen and women as well as to veterans. Concerned that the Department of the Army was in a rush to replace the Tomb of the Unknown at Arlington National Cemetery, I introduced an amendment to the National Defense Authorization Act requiring the Army to prepare a comprehensive report for Congress before any further action could be taken. I am hopeful that this provision will be in the final agreement on the NDAA and look forward to the report, and its recommendations on how to best steward this national treasure.

As chairman of the Senate Veterans' Affairs Committee, I am mindful of the employment issues facing veterans, members of the Guard and Reserves, and their families as they seek to move from the military to the civilian workforce. Making this transition is never easy, and for younger veterans it can be particularly difficult. For members of the National Guard and Reserves, returning to a job they previously held may be challenging for a variety of reasons. For family members, the uncertainty of multiple and extended deployments poses different obstacles. Finally, the obstacles facing those who are disabled during their service can sometimes seem overwhelming. The needs of these individuals deserve our utmost attention and resources.

The committee has held two oversight hearings on employment issues this session. The more recent of the two hearings focused specifically on the Uniformed Services Employment and Re-employment Rights Act of 1994, or USERRA. As our troops are returning home from battle, many of them seek to return to the jobs that they held prior to their military service, particularly those serving in Guard and Reserve units. I must admit to being particularly upset at the volume of USERRA claims related to Federal service. It is simply wrong that individuals who were sent to war by their government should, upon their return, be put in the position of having to do battle with that same government in order to regain their jobs and benefits.

It is well known that veterans make good employees. Despite the challenges many face, veterans across the country are working and excelling in the labor force. They know how to work and they bring with them a wealth of expertise and experience. I believe the employment data supports my belief since rates of unemployment for veterans generally are lower than their nonveteran counterpart. However, the rate of unemployment for younger veterans and those recently separated from active duty tends to be higher than their nonveteran peers. I pledge to continue to pursue these issues aggressively in the months ahead.

The issues regarding veterans' educational benefits are especially important to me. Having attended college at the University of Hawaii under the original World War II GI bill, I know the value of this important benefit first hand.

The complexity and the importance of the issues surrounding the various education assistance programs administered by VA have been heard at two hearings this session. I plan to build off of the findings from both hearings for the committee's future work in this area. Educational assistance benefit has an important role in terms of a readjustment benefit for returning veterans and servicemembers. Properly tailored, these same benefits form an important keystone in recruiting and retaining high caliber young men and women in the Armed Forces. The balance between these twin goals is very complex and needs careful examination.

I am concerned that the current structure of benefits has some flaws. It is disturbing to me that servicemembers who are in the line of fire and who place their own safety in jeopardy in service to our country have to pay for their educational benefits. It is also disturbing that members of the Guard and Reserve who complete multiple deployments in combat situations run the risk of having no educational benefits available to them.

I do not expect to see a quick or easy answer for veterans' education benefits reform. I believe we will need to build a foundation for cooperation, compromise and consensus building. That will take some time. But I believe this process has begun, and that by working together, we will be able to develop something that is really meaningful to veterans, their families, and their futures.

As I noted earlier, the committee held seven field hearings over the year. The first, chaired by Senator Brown, was held on May 29, 2007, in New Philadelphia, OH, and focused on the issues facing veterans in the rural areas of Appalachia. Two months later, the committee held its second field hearing, chaired by Senator Testor, again focusing on the needs of rural veterans. This hearing was held on July 21, 2007, in Great Falls, MT. These hearings, along with the insights of our committee members, enabled the committee to develop and mark up legislation to address certain issues facing rural veterans.

On August 17, 2007, Senator Murray chaired a field hearing in Tacoma, WA. The hearing focused on the mental health care services available to veterans and servicemembers in the State of Washington.

In August, I chaired a series of field hearings in my home State of Hawaii, on the islands of Maui, Oahu, and the Big Island. These hearings brought high-ranking VA officials from Washington, DC, to examine the state of VA services for Hawaii's veterans and returning servicemembers.

On August 28, 2007, the committee held a field hearing in Augusta, GA, on cooperation and collaboration between VA and DOD, chaired by Senator Isakson. The specific focus of the hearing was on VA and DOD care for wounded servicemembers returning from Afghanistan and Iraq.

The committee has also carried out aggressive oversight activity during this session. Since January, the majority staff has conducted 95 days of oversight involving 28 trips to 18 states as well as to Korea, Guam and American Samoa. Oversight investigations have included visits to nine separate VA regional offices.

During these nine visits, oversight staff reviewed a total of 119 individual veteran claim files, including 45 claim files for members of the National Guard and various Reserve units. Claims were selected for review based upon claims for service-connected disability due to traumatic brain injuries, posttraumatic stress disorder, or musculoskeletal conditions. In particular, the reviews were conducted to identify any systemic problems impeding the fair and efficient adjudication of veterans' claims.

On a national level, one of the most critical issues identified by the claims review was a VA regulation which resulted in the denial of a rating higher than 10 percent for almost all traumatic brain injuries, or TBI, claims. As noted earlier, TBI has been described as a signature wound of the current conflicts. Medical evidence supports the view that severe long-term consequences can result from blast injuries involving improvised explosive devices, or IED, such as those used in Iraq and Afghanistan. Despite this, VA adjudicators believed that they could not authorize a rating in excess of 10 percent, or $115 per month, because of a current VA regulation.

Upon learning of this problem, I contacted VA's Under Secretary for Benefits, Daniel Cooper, to ask why veterans with migraine headaches were eligible for higher disability ratings than combat veterans with TBI. I was pleased when Under Secretary Cooper informed me that VA adjudicators have been instructed to stop limiting ratings to 10 percent if not warranted. However, because Under Secretary Cooper's instruction is not binding upon the Board of Veterans Appeals or the United States Court of Appeals for Veterans Claims, I also wrote to the Acting Secretary for Veterans Affairs, Gordon Mansfield, to ask that the ``10 percent and no more'' regulation be rescinded. I understand that VA is now working on new regulations for the adjunction of TBI claims which will hopefully resolve this matter. I will continue to monitor these claims and VA's actions.

In addition to the restrictive instruction in the rating schedule, it appears that neither the military services nor VA are providing comprehensive and thorough evaluations of veterans with mild and moderate TBI. While veterans who are being treated at polytrauma centers appear to be getting appropriate diagnosis and treatment, this is not true for veterans with significant, but less severe injuries. I believe that it is imperative that veterans with silent wounds, such as mild and moderate TBI have a comprehensive evaluation of their signs and symptoms by appropriate medical specialists. New data, such as the recently released information from VA that nearly 6 percent of the veterans from Iraq and Afghanistan screened have sustained traumatic brain injuries, adds to the importance of legislation that improves VA's ability to respond aggressively.

Review of service medical records for claims involving PTSD indicated poor follow-up, assessment and referral of servicemembers who endorsed symptoms of PTSD on postdeployment surveys. This matter has been noted by the GAO and others. In some cases, veterans were discharged for a ``personality disorder'' which was not manifested prior to combat exposure and with no evaluation of classic PTSD symptoms. In other cases, veterans with significant psychiatric symptoms were not considered for a military disability retirement, but were awarded benefits by VA upon discharge.

The committee's oversight investigations indicate that VA generally did a better assessment of claims for service-connected PTSD than the military services. However, for some disorders, VA will not grant service-connection for the small number of veterans who were diagnosed with PTSD during military service without independent verification of the stressor which gave rise to the diagnosis by military doctors. Some veterans who served in Iraq, but did not receive a medal acknowledging their participation in combat, have experienced difficulty establishing their ``personal participation in combat'' in order to validate the existence of a combat stressor.

Under current law, veterans who allege disabilities related to their combat experience may prove their claim without presentation of official military documents. In order to clarify this issue and provide combat veterans with the benefits intended, I recently introduced S. 2309, the proposed Compensation for Combat Veterans Act. This bill would provide that service in a combat zone, recognized as such under the Internal Revenue Code, shall be sufficient proof that the veteran engaged in combat for purposes of the relaxed evidentiary requirement. I hope that we will be able to address this issue in the coming months.

There is no question that the Guard and Reserve have experienced difficulties due to our current combat engagements, in a fashion quite similar to branches such as the Army and Marine Corps. There is some concern that members of the National Guard and Reserve units receive less favorable consideration of their service-connected claims than members of the Armed Forces. While oversight investigations did not substantiate allegations of less favorable treatment for Guard and Reserve claimants, other issues may require further analysis. Many regional office staff reported significant difficulties in obtaining copies of the medical records of members of the Guard and Reserve. As a result, I wrote to the National Guard Bureau to express my deep concern about a policy that I had been told exists in some states that requires National Guard members to sign a release form before their Service Medical Records can be shared with VA for purposes of adjudicating a claim for compensation benefits. Acting upon my request, the National Guard Bureau sent guidance to the field that removes the requirement that servicemembers sign release forms to have their records provided to VA.

VA cannot be expected to end the benefits backlog if it lacks the staff to adjudicate veterans claims. While VA froze hiring in this area, there has been an increase in the number and complexity of claims received. As a consequence, the backlog has ballooned beyond already disconcerting levels. Although the infusion of additional monies for staff should improve the situation, some offices have too few experienced staff compared to the number of new hires. Oversight studies have found that less experienced staff is more likely to make errors on veterans' claims.

In some cases, service medical records are maintained in an electronic format and are not provided to VA adjudicators in any form. In other cases, medical reports are scanned into the Veterans Health Administration electronic records, but are not able to be viewed by VA adjudicators who use a CAPRI system to access VHA records. I have questioned VA about the need to make these records available to VBA and am awaiting a response.

While the committee does much direct oversight, as chairman, I also rely on the VA's inspector general. Indeed, the IG has consistently served as the committee's right hand in the execution of our oversight responsibilities. In the last year alone, the IG has provided us with a number of professional inquests and reports on issues of critical importance to veterans' health care. In the areas of traumatic brain injury, mental health, and substance abuse, among others, the IG has identified the problems and solutions with an insightfulness that few can match. The IG has also responded to my investigation requests in an efficient and collegial manner. The IG is, without question, the central gear in VA's internal

controls and quality assurance mechanism.

All American's have a role to play in honoring veterans. Ordinary citizens give in extraordinary ways, such as volunteering at VA hospitals and VA shelters, and supporting local Veterans Service Organizations. For those of us who serve in Congress, we have a special privilege and responsibility to honor veterans by ensuring that they receive the benefits and care they have earned through service. This Congress has done much for veterans already, but there is more to be done.

The Committee on Veterans' Affairs will continue to do its share throughout this Congress. To name just two items of pending business, we will hold a markup tomorrow on pending legislation, including a bill that is designed to improve significantly VA's programs which address the mental health needs of veterans, especially those recently returned from combat, and second, the Committee is preparing to consider the nomination of Dr. James Peake to become Secretary of Veterans Affairs.

I close with this thought: On the battlefield, one never leaves behind a fallen comrade. Similarly, veterans should never be left behind by a system designed to care for and honor them. We cannot stand by while veterans who have fought for our country have to fight to get the care and benefits they have earned through their service. The Committee on Veterans' Affairs will respond to whatever challenges may arise in our work on behalf of those who rose up to defend and serve our Nation. To our veterans: Our thoughts, prayers, gratitude, honor and pride are with you, not only on Veterans Day, but always.

Mr. President, first of all, let me thank the chairman and ranking member, Senator Murkowski, for their work on this effort.

Amendments Nos. 4024 through 4037 to Amendment No. 3899

Oklahoma is the No. 1 State in the country as far as tribal members. Indian health care is an issue on which we are struggling, and there are all sorts of components for it. I am going to ask unanimous consent now to bring up my amendments numbered 4024 through 4037 as if brought up individually and ask that each be set aside so they will be considered pending. I ask unanimous consent that be carried out at this time.

Far less than what I bring up.

Let me start by saying, improving the health care of Indians in this country is a widely supported goal. Senator Dorgan's heart is in the right place on this issue. He knows the problems we have, and he spent countless hours trying to get to this point with this bill. I do not want to be seen--I have told him, and I committed to him my goal is not to block his progress on this bill.

However, I believe this legislation as drafted does not fix the underlying problems. He and I have had several conversations about that. It does not fix rationing that is going on today. It does not fix waiting lines that are going on today. It does not fix the inferior quality that is being applied to a lot of Native Americans and Alaskans in this country. It does not fix any of those problems. In fact, it authorizes more services without making sure the money is there to follow it. The average Native American in this country has $2,100 per year spent on them.

Now, let's put that in perspective. The average veteran we take care of has $4,300. The average individual per person, per capita, expenditure in our country is $7,000. Yet we are going to pass a bill that does not fix anything. It does not fix the real problems about addressing the No. 1 problem which is, we are not sending enough dollars to meet the treaty obligations that we have with Native Americans. So really what this bill is, it is called the Indian Health Care Improvement Act, but it improves our position with tribes because we have done something, but it does not improve health care. It is not going to improve health care. It is going to increase the availability of services without the money, without the control, without the quality, without eliminating the waiting lines.

As a matter of fact, it is going to add to the waiting lines as I read this bill, as somebody who is somewhat experienced in medicine. Those who say a failure to reauthorize the Indian Health Care Improvement Act is a violation of our trust obligations are correct. However, I believe simply reauthorizing this system with minor modifications is an even greater violation of that commitment. It is a greater violation. Dozens of tribal leaders are not expressing enthusiasm for the current structure.

Chuck Grim, an Oklahoman, head of this service, knows what is broken. I have had lots of conversations with him. We know what is broken, we know how to fix it, but we have to be bold in how we go about fixing it. We are not bold in this. We are not changing it. We are not doing the structural changes that have to happen for us to live up to the commitment that we have made to Native Americans.

The myriad of problems facing Indian health care in Indian country are many of the same issues that are facing health care delivery throughout rural America. They are compounded, however, in this system by a system that refuses to recognize its own role in holding back health care delivery for Native Americans.

In designing health care reforms, markets work when they are allowed to. They lower the price of all goods and services, and they attract much needed outside investment. Many tribes in Oklahoma are at the forefront of new and innovative health care delivery systems. They are poised to become a model for delivery throughout the system.

Congress must ensure, however, that their efforts are not discouraged or stopped altogether by the current system. Furthermore, there is no good reason that forward-thinking tribal governments should not be prevented from developing market-driven health care centers of excellence that will attract researchers, physicians, and patients for cutting edge lifesaving treatments. We do not do that in this bill.

Furthermore, this legislation fails to focus on empowering individual tribal members. Individual patients tend to receive better care and more effective care when they are empowered to make their own health care decisions. Congress should explore ways to accomplish this objective and give tribal citizens a reason to invest in their own health. Long lines, bureaucratic headaches, and rationed substandard care completely disallow this sort of investment. That is what we have.

Our Chairman has been on the Senate floor multiple times showing how we are rationing care, how we have lines, how we do not give quality care, how we take contract health care--it runs out in 4 or 5 months. And so what happens? People who need care do not get it, and we have not fixed that in this bill. Yet we are calling this health care improvement.

The health care status of tribal members ranks below the general population. The Federal Government has been providing health care to tribal members for 175 years. The first time was to give them a smallpox vaccine in 1807. That is when we started Indian health care. And what we are doing today in comparison to what our treaty obligations are--in comparison, it is the same thing we are doing to the veterans when we tell the veterans: We are going to give you health care and do not give it. It is the same thing we tell schools: We are going to have an IDEA program and then not fund it. It is morally bankrupt legislation that does not meet the commitments that we say we have.

The Snyder Act of 1921 provided a broad and permanent authorization for Federal Indian programs, including--and this is an important thing--the conservation of health; in other words, the prevention of disease, which Chuck Grim was just starting to get into, but we do not have the funding to do it the way we need to do it. We know the manifestation of diabetes and addiction and hypertension and heart disease among our tribal members is higher than any other group in our country. Yet the conservation of health has not been exploited, the paradigm shift that has to happen in Native American care to where we go to prevention instead of treatment of disease. It is not in here. We are not doing it.

Last year, we spent $3.18 billion doing this. If we just funded it at the level we fund per capita veterans care, we should be funding $6.5 billion in Native American health care. That is just on a per capita basis, let alone any structural changes on how we might make preventative care, quality care, timely care, and compassionate care a part of Native American care. But we are not doing that. Indians in comparison with the general population are 6.5 times more likely to die from alcoholism. That is a disease we need to be preventing. That is a health care problem. They are six times more likely to die from tuberculosis, a preventable disease; three times more likely to die from diabetes, a controllable and now preventable disease, it is a preventable disease; 2.5 times more likely to die from an accident.

Now, how can we look those statistics in the face and say we have met our treaty obligations? We have failed. We have absolutely failed. Only 71 percent of Native Americans receive prenatal care. That means one out of four Native American moms who get pregnant do not have any prenatal care. We ought to be ashamed. We have failed. We have failed.

Eighteen percent of Native Americans who are pregnant smoke. That is twice the rate of others. Where is our prevention? Where is our education? Where is the priority on what we can do something about?

American Indians suffer from a great death rate from chronic liver disease and cirrhosis. It is 22.7 per 100,000. That is twice what it is for Whites and three times what it is for African Americans in this country. We know what causes it. We do not put the dollars there. We have not put in a streamlined prevention program.

My words are harsh. They are not intended for either the chairman or the ranking member. I passionately care that we meet our commitments, and so I do not want you to take the words I say as directed toward you because I know you care as well.

Where we have a difference is in the ``now.'' What do we do now rather than what do we do later? I think we should be doing it all now. I think we should radically change how we approach our obligations in Native American health care in this country.

Rationing plagues Indian Health Services. It is rationed care. That is

why it is not good care. That is why it is not consistent care. That is why it is not preventative care, because we don't have the resources. We haven't applied the resources to the need. Senator Dorgan has had numerous hearings. He has spoken on the floor about this rationing crisis. But if we don't radically change the system, if we don't change incentives in the system, improving the old will just bring more failure.

The job vacancy rate for dentists is 32 percent. They don't have 80 percent of the nurses they need. They don't have 85 percent of the optometrists, and they only have 86 percent of the doctors, based on the present system. I am proposing a better system with better care based on prevention, a paradigm that says it is a whole lot cheaper to prevent your illness than it is to treat it once you get it. It is common to hear in Indian Country--and I have heard the chairman say it--``don't get sick after June. Contract money is gone. If you get sick after June, nothing will happen. You will not get the referral to the center to take care of you because we don't have the money.

A quote from Dr. Charles Grim, who has been a stellar leader for the

Mr. President, will the chairman yield for a couple moments?

Mr. President, I wish to make a couple comments, and then I have to go to a markup.

You will find me an ally on appropriations if we have the courage to make priority choices on where we fund money. You know that. That has been my history. But we do not have extra money, so that means we have to take it from something else. My goal will be that we take from the waste we

all know is there and we put it to the commitments.

So I look forward to that debate. I think you are right. I think we need to up the ante, and we need to add the money. But there is plenty of money for us to go get, and I hope the chairman will help me go get it so we can put it there.

Thank you.

Mr. President, every amendment I have has something to do with this bill. They are all germane, not meant to delay. I am happy to vote for cloture right now to prove that I don't want to delay this bill. What I am going to ask is unanimous consent for the regular order and discuss my amendment No. 4034, after which I will ask for a vote. Then if the leadership wants to stack votes, I am fine with that.

This is a simple amendment. I know the chairman is critical of it because he thinks it is false in terms of its intent. During our budget debate, I plan on adding $2 billion to Indian health care. I also plan on making us make the tough decisions on where we take it from. We don't have extra money, so it is about priorities, about keeping commitments. I will be offering that when we get to the budget to make sure there is an extra $2 billion for Native American care, and then we will decide whether we think that is a priority as we vote on the budget and on the appropriations bills.

This is a straightforward amendment. This allows tribal members to get insurance. If they want to use the IHS service, great. But if they have to wait in line to wait in line to get care, maybe they can go somewhere else. Then we are keeping our commitment. If they know that the care for a certain type of disease is terrible at IHS, they can go where it is better. We are going to put the security of our promise in real terms, and we are going to put choice, the same thing every Member of this body has, and security in health care, into the hands of the Native Americans. That is what the amendment does. The reason it doesn't cost anything is because we are going to charge IHS for what it costs. We have designed the amendment. We are waiting to see what the budget chairman does with the budget and where we are going to find this $2 billion. But I promise you, we are going to get a chance to vote on my amendment to put in $2 billion. So it is not an empty promise.

One of the things we know that improves everything is competition. One of the ways to get rid of some of the waste that is in IHS and to put a priority back in is to start competing.

I am happy to.

It does not at this time. I will give a commitment to the chairman. Under our rules, when I want to take money away from something else, I have to deauthorize it. We don't have enough money in Indian health so we have to deauthorize something else. If we get it under the budget, I have every intention of making us make a choice. I will vote for an increased authorization at this point in

time right now for $2 billion. But I will also come back and say we have to find the money to pay for it.

I will happily vote for that. But what we have to do is deauthorize something else. I know you disagree with my thoughts on increased authorizations versus offsets. I believe we have a commitment. I believe we have a treaty obligation. I believe we have a moral obligation. But I also believe it has to be balanced with the obligation that Members of Congress refuse to do, which is to make judgments about priorities. An empty promise to authorize that is not offsetting some authorization somewhere else without coming around and doing it; tons of bills go through this place authorizing things so we can send a signal out there that we did something, knowing that we never intend to fund it.

Right now we have over $8 trillion a year in authorizations. It can't be hard to find $2 billion to deauthorize to increase the authorization for Indian health. We have to have a vote, and we have to decide what that is.

I will commit to the chairman, I will vote for that, as long as we are decreasing somewhere else. I am willing to go find where that is for the chairman. I will commit that I will offer an amendment to increase the spending for this in our budget. I also will commit that when the appropriations come through, although I may not vote for the whole appropriations bill because it is not going to just be for Indian health care, I will vote for amendments that will increase the amount of money that goes to Indian health care as long as it is within the budget. That is why I said my goal is to do that within the budget where we could have a debate about priorities.

I would like to reclaim my time if I might. The fact is, we appropriate $280 billion a year in stuff that is not authorized right now. So we will not have any problem appropriating this money if we don't authorize it. A quarter of the discretionary budget is not authorized right now. We will not have any problem with that. My amendment says, on the areas the Senator just described, to do it only if it is geographically feasible. I recognize there are some places where we have isolated reservations and we have IHS. I am willing to put the money behind it, but I also realize more of the same doesn't get it done. So if we double Indian health care money, we are still going to have an inefficient system that will deliver care at a lower level than what you can get in the private sector.

What I am saying with my amendment is, let's have both. We ought to do both. I am making a statement on the Senate floor--and the Senator will recognize, I believe, that I usually keep my word about coming back and doing what I say I will do--I will work to get the extra $2 billion, but an extra $2 billion in a broken system is not just money that is broken with IHS. I believe the chairman will agree. What I wanted to do is fix the system and increase the money, increase the choice and security that Native Americans are entitled to that all the rest of us have.

The fact is, if the only place a Native American can get care is IHS, that is not freedom. That is not the promise kept in its fullest bloom. It is saying, here is the only place you can get care. If the care happens to be great, super. But if the care happens to be average and they need better, they don't have that opportunity. If the care happens to be--and sometimes we know it is, like some of the cases the chairman has presented--when it is substandard and that is the only choice they have, that is not acceptable.

Let me finish my deal, and I will let you go and you can hammer me. I hope I can get you to come around. Maybe I would not get your vote. I know I will get your commitment to work toward it in the future. But I think just adding more money to IHS doesn't fix the problem. I described that earlier when I talked about 30 or 45 minutes. What this does is, it treats Native Americans like every other American. That is what this amendment does. It gives them choice. It gets them out of the prison we have placed them in that says: You only have one place you can go. And, by the way, if we run out of contract funds, even if you need to go somewhere else, you can't go.

Contract funds actually have run out on average in June. So for 5 months of the year, when we need to send Native Americans somewhere else, we don't have the money to do it. So who suffers?

Under this system, you would not run out of contract money because you bought an insurance policy. You have given them the average cost of an individual insurance cost with what we are spending now on care.

By the way, I have another amendment where we describe what an Indian is because, in my State, we have people who are \1/512\th stepping in front of a full blood. And most people don't think somebody that is \5/ 11\th out of \5/12\th ought to be getting full pay for their health care. And in fact, there are .12 of 1 percent Native blood. We call that light blood in Oklahoma. We have whole blood, mixed blood, and light blood in our State. It actually is very complicated because what is happening now, we have tribes that have quantums and say: If you are not a quarter or an eighth, you are not eligible. But under the IHS system, from some of the other tribes who have members who are \1/ 512\th, they come down to their area and they get into IHS. So here is somebody with \1/512\th taking Indian dollars away from somebody who is a quarter or somebody who is a full blood.

What we have said is: Tribes, you have to decide who is an Indian. We actually have some people who are a thousand and 24th that we are giving full blown care to in Oklahoma. They have access to care somewhere else, but they don't want to pay the deductible or the copay. So they step in line in front of a full blood. We have to change that. We have to fix that. We have to fix that because our obligation has to be to the person with the most and then come down. So if we really have restricted dollars, what we have to say is, if you are below a certain level, you have to contribute something. That is the other way that we solve this problem. That doesn't demean the heritage of our Native Americans.

What that says is, the reality is, in 2016 in this country, we are going to be cutting spending all over the place because that is the year interest rises through the roof. That is the year we run out of Social Security with which

to pay for Medicare. That is the year in which for the projected spending, based on revenues, based on growth even at 4 percent, we start running trillion-dollar deficits--trillion-dollar deficits.

Have we ever asked ourselves why gold is worth four times more against the American dollar than it was 10 years ago? Do you think it has anything to do with people thinking we cannot pay back our debt?

So this idea that we are going to have more money in the future to do more things is not going to be there. We need to come to the reality of the situation. We need to start making some of the hard choices. To me, keeping our commitment to Native Americans has to be set up now; otherwise, it is not going to happen, and the funding is not going to get increased between now and 2016. Other than what we do this year, it is going to be hard. The money is going to be hard to get, even if we get out of Iraq.

We are going to get notice today on what I have been working on for 2 years, talking to the Census Bureau about that they are going to be out of control and spend a whole lot more money. I am getting ready to get notice by the Secretary of Commerce--I have a meeting with him this afternoon--that there is going to be a close to $3 billion more pickup to do something we have to do because it has been totally mismanaged-- totally mismanaged. We have been having hearings for 2\1/2\ years on it, where they have been denying it, and now they are coming to say it has been mismanaged. They are coming to agree.

It is why oversight matters. Had we gotten some of the amendments through this body that we offered on the census, we would not be here. But, instead, we are going to spend $2 billion to $3 billion more because we did not pass the amendments offered based on oversight that we did in my committee.

The whole goal--I am not perfect. I am not right, necessarily, on how I want to do that. I will admit that to the chairman and ranking member. But I know more money does not solve the problem on this, and unless we create real freedom, real choice, and real health care security for Native Americans, we will never have an efficient IHS system, and we will never meet the commitments that we say we have.

So I will ask for the yeas and nays on this amendment. I will listen to the chairman. I do have a meeting at 2 o'clock I have to be at. Whenever the chairman would like to stack the votes, if we run others, I will be happy to work with whatever is his pleasure.

Mr. President, I ask for the yeas and nays.

I ask that amendment be brought up, No. 4034 be made pending, and ask for the yeas and nays.

I inquire of the Chair, earlier this morning I made all my amendments pending.

Mr. President, I ask for the regular order on amendment No. 4034.

Mr. President, I ask for the yeas and nays on the amendment.

If the Senator will yield for a quick question?

I wanted to ask the distinguished Senator, earlier before he was able to come to the floor, there was a unanimous consent request offered with regard to the ALS registry, and I, on his behalf, lodged an objection, although I have no personal objection. I just want to ask the distinguished Senator from Oklahoma if it is his understanding it was on his behalf?

Mr. President, I understand why we find ourselves in this terrible posture today and why some people are calling this Congress the broken Congress, the dysfunctional Congress. If you look at the chart that was alluded to a moment ago about the last 31 days of the Senate, we have had 15 days of the last 31 days actually in session. We have had 10 rollcall votes. We have had 10 rollcall votes in the last 31 days. As a matter of fact, we should be having rollcall votes now on the farm bill, which is the bill I thought was before the Senate. But, instead, our colleagues from the other side of the aisle decided to put on this show for the American people to try to portray themselves as passing legislation, although they knew it could not be done in the manner in which they proposed--while we should be passing the farm bill.

Let me talk for a moment about the opportunities that they have squandered by their mismanagement of the calendar over this last year. I asked the Senator from Illinois, Mr. Durbin, if he would agree to a unanimous consent request, and also the majority leader, to help fund our troops who are in harm's way during a time of war. They objected to that.

As a matter of fact, Republicans attempted to call up the Veterans appropriations bill before the Veterans Day holiday, and the Democrats objected to bringing up that bill. Just to be clear, this is the appropriations bill that funds veterans affairs and military construction and is important not only to keeping our commitments to our veterans but to maintaining a decent quality of life for the families who are left behind while their loved one is in harm's way in Iraq or Afghanistan and other dangerous places across the world.

Our colleagues on the other side of the aisle blocked that appropriations bill like they blocked the emergency funding for the troops that is needed in order to avoid the 100,000 notices to civilian employees of the Department of Defense that they are going to be laid off. They are going to get those notices before Christmas that they are going to be laid off by mid-February unless Congress does the job it should have done a long time ago. That is not even to mention--which I will mention--the funding necessary for the Department of Defense to operate in Iraq and Afghanistan to root out al-Qaida and other foreign fighters, Islamic extremists who are trying to kill American

soldiers and who, if given an opportunity to reorganize themselves in Iraq, would use that as another launching pad to carry out murderous attacks against Americans and our allies.

Just to be clear, the Senator from Illinois, Mr. Durbin, asked me about a meeting where the Secretary of Defense and Secretary of State were present. I explained, as I have just explained here today, what the situation would be like if we failed to act, and as a result of their objection, we are not acting on a timely basis.

I ask unanimous consent to have printed in the Record a letter from the Deputy Secretary of Defense to the Republican leader that is dated December 7, 2007, signed by Gordon England to the Honorable Mitch McConnell.

Mr. President, as the letter makes clear, while the Department of Defense has the ability to fund the troops in the field until mid-February--around March for the Marine Corps--this comes at great expense to those in the Department of Defense, both in and out of uniform. The only reason the Department of Defense can basically rob Peter to pay Paul in terms of paying its bills is because other activities will not be funded, to include training, repair of equipment, and salaries. This letter makes clear that under the current law, furlough notices must soon be issued, potentially right around the time Christmas hits.

This is not any way to run the business of our Nation. Unfortunately, because of the way our colleagues have led the Senate, we have squandered a tremendous opportunity to solve the problems the American people sent us here to solve.

We have had 66 votes on cloture motions--in other words, efforts to force legislation down the throat of the minority without an opportunity for debate or amendment. That is a guaranteed recipe for failure. As everyone in this body knows, under the rules of the Senate, neither the majority nor the minority can have their own way without bipartisan cooperation. That is the way to get things done. But, rather than get things done for the American people, what we have seen is a ``my way or the highway'' approach on the part of the leadership on the other side of the aisle. That is the reason we have had 63 votes, 63 votes so far this session, on the war in Iraq, with various attempts on the other side of the aisle either to attach strings to that money or to impose arbitrary deadlines on our commanders in the field or what I would submit is basically to insist on surrender dates.

These are the same folks who called the surge a failure before it even started. They have said they supported the troops but yet, when it comes time to show their support by making sure they have the funding for the equipment and the training, to pay salaries, and to maintain a decent quality of life for their loved ones who are left behind, instead of acting on that stated support for the troops, have failed to act.

I know the other side of the aisle has given us a copy of various unanimous consent requests to give us fair notice of their intention to ask for unanimous consent, and we have done the same.

On behalf of this side of the aisle, I would ask unanimous consent that the Senate proceed to the immediate consideration of S. 2363, which is funding for military construction and veterans affairs.

I further ask unanimous consent that the bill be read a third time and passed and the motion to reconsider be laid upon the table and that any statements relating to the bill be printed in the Record.

Mr. President, I am disappointed to hear the objection. This is the same Veterans appropriations bill and Military Construction bill that was passed this summer by the Senate and this summer as well by the House. Why is it that it has been delayed all this time? This is funding for the very veterans who have sacrificed so much and given so much in the service to this country who are being told: No, we are going to hold that money back because essentially you are part of our political plans to put together a huge Omnibus appropriations at the end of the year and try to force the President and the minority to accept bloated Washington spending, when, in fact, there is no objection to passage of that Veterans bill or Military Construction bill, and it should be passed today by unanimous consent without further delay.

Mr. President, I have one other unanimous consent request I would like to offer. I ask unanimous consent that the Senate proceed to the immediate consideration of H.R. 3997, a bill to provide tax relief for our troops. I further ask that the amendment at the desk, which is the text of S. 2340 and provides for full funding of our troops, emergency funding for our troops, be agreed to and that the bill, as amended, be read a third time and passed.

Mr. President, I regret the obstruction on the part of the majority. This provision, the Heroes Earnings Assistance and Tax Relief Act, would ensure that our military members are treated fairly under our own tax laws. It would make clear that combat pay can be treated as income for purposes of qualifying for the earned-income tax credit. It would also make improvements to the rules for mortgage bonds for veterans, clarify rules regarding survivor and disability payments, and continue to provide pay and benefits to National Guard and Reserve members called to Active Duty. I have already mentioned the component of it that would provide full funding on an emergency basis to our troops who are currently fighting and, unfortunately, some being wounded and dying in service to their country and protection of our freedoms, which has now been objected to once again.

I will finish my remarks for this period where I started and say that we have squandered our opportunities to govern. The only way you can govern

in the Congress is by building a governing coalition, Democrats working with Republicans to try to solve the Nation's problems. When one side or the other tries to jam their agenda down the throat of the other side, it does not work, and exhibit A is the dismal record of this broken Congress during this last year.

I see why our colleagues on the other side of the aisle are getting nervous, why their desperation to pass legislation is beginning to show, because they realize they had the opportunity to lead, they realize they had the opportunity to govern, but they have squandered that opportunity. So now, in the last week and a half before the Christmas recess, they are out here trying to act as if the minority has obstructed them, when, in fact, if they had only met us halfway and worked with us to solve some of the big issues that confront our country in a bipartisan and constructive way, we would have met them halfway and we would have solved many of those problems.

I will.

The distinguished Senator from New Hampshire is exactly correct. My recollection is only 1 out of the 12 appropriations bills has actually been signed by the President, and that was after the fiscal year ended, meaning that essentially Congress is doing what no business, what no family could get away with; that is, basically to pay the bills on a timely basis. So it is another example of this broken Congress and squandered opportunity to work together to do our basic duty.

Unfortunately, I think what we have seen now is an unfortunate game being played out where, rather than pass those bills on an individual basis, there is going to be an attempt to roll them into a giant Omnibus appropriations bill, which someone observed the other day is Latin for ``hold on to your wallet.'' The President has insisted that he is going to hold the line, as he well should, on wasteful Washington spending which would require tax increases on the American people at a time when the economy is entering into a flat period. It is exactly the wrong time--if there is ever a right time--to raise taxes.

I would.

Mr. President, the Senator from New Hampshire is absolutely correct.

I would further say in response to his question, you know there is a marked contrast to the tone that was set at the very beginning of this Congress with the new majority in charge. The Senator from Illinois, Mr. Durbin, who was on the floor earlier, said:

I think the people across America said to us in this last

election, we want you to compromise, we want you to find

solutions, we do not want you to play to a draw with nothing

to show for it.

Well, that is in the Congressional Record on January 4, 2007. I agreed with that statement then. But, as I say, it stands in marked contrast to what we have seem demonstrated this last year.

The Senator from New York, Mr. Schumer, who was on the floor earlier, on that same date said:

All too often we in Washington get lost in the world of

Washington, the focus on getting something done, something

done for the American people gets lost.

Well, I wish they had heeded their own advice because what we have to show for this last year is very little, indeed. Failing to take care of our most basic responsibilities, as the Senator from New Hampshire has pointed out, to fund the Government on a timely basis--the fact is, we find ourselves in a terrible position now, with just a few days remaining until the Christmas break to get that work done.

Mr. President, I agree again with the statement made and respond in the affirmative to the question propounded by the Senator from New Hampshire. This Congress has spent 11 months holding Iraq political votes that have had no chance of becoming law.

We have had 63 votes thus far this session. In the meantime, while the majority has been fiddling, the business of the American people has not been done. I think about the issues besides those of national security that cry out for solutions, things such as border security and immigration reform. Couldn't we have used some of this time more constructively to solve one of the biggest domestic issues confronting the country today? How about energy policy? We have an energy bill that raises taxes on domestic producers and encourages our dependence on foreign oil, when we could have worked together to pass an energy policy that would have prepared us for the future. We have not done that. Health care, which is a tremendous concern of my constituents in Texas and elsewhere, we could have acted to deal with the health care access cost and quality crisis in this country, but we have not.

I know there are other colleagues who wish to speak.

I reserve the remainder of my time and yield the floor.

Mr. President, how much time remains in morning business on our side?

Mr. President, in a moment I am going to yield and ask unanimous consent that the Senator from Alabama be recognized for up to 10 minutes, followed by the Senator from Wyoming, Dr. Barrasso, for up to 10 minutes.

To be clear, we have had objections from the majority, from our Democratic friends, to legislation that is vitally important to our veterans and to our active-duty military: the Veterans' Administration and military construction funding bill that was passed by both Houses of the Congress last summer and which has been held up and held hostage to the political games here in Washington, as well as the emergency troop funding that is needed to fund ongoing operations in Afghanistan and Iraq, which we have discussed as well. This is a personal issue, as 1.7 million veterans live in my State in Texas. We have 15 major military bases where military families live and work. One out of every 10 active-duty military members who wears the uniform of the United States calls Texas home, and we have guards and reservists who are also serving valiantly in Iraq and elsewhere.

The bill which has been blocked by the majority would provide $20 billion in military construction funds important for our troops and quality of life for our military families, and it is important to my State of Texas because of our support for the troops and military families. It contains almost $90 billion for our veterans, which includes their health care, upgrading facilities, money to hire additional claims processors so veterans don't have to wait so long to get the benefits to which they are entitled. As I said, there are about 1.7 million veterans in Texas and they need these funds, and they shouldn't be held hostage to the political games here in Washington with regard to an omnibus appropriations bill.

Mr. President, I yield the floor and reserve the remainder of our time.

Mr. President, may I ask how much time remains on this side?

Mr. President, I ask unanimous consent that the time remaining be evenly split between the Senator from Wyoming and the Senator from Oklahoma and the Senator from Arizona.

Mr. President, how much time remains?

Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of S. 2318, a bill that provides permanent relief from the alternative minimum tax, which extends the 2001 tax cuts and the 2003 capital gains dividends tax relief, and that the bill be read the third time and passed.

I further ask that the bill be held at the desk until the House companion arrives, and that all after the enacting clause be stricken and the text of the Senate-passed bill be inserted, and the House bill, as amended, be read the third time and passed.

Mr. President, I am disappointed, and I think the American people are going to be disappointed if we don't deal with the alternative minimum tax, which, of course, was targeted at the ``rich'' when it was passed but which now affects 6 million taxpayers and which, if we don't act, will affect 23 million middle-class taxpayers next year.

My distinguished colleague didn't mention the capital gains and dividends tax relief, which has been so important as a stimulus to the economy, which has resulted in 50 months of uninterrupted job growth since we passed that legislation. I hope we will continue to work on that.

Unfortunately, given the compression of time due to the squandering of opportunities earlier this year to act on this important legislation, I am afraid we are not going to get it done before we break for Christmas. The IRS is going to have to send out notices to many new taxpayers of their increased tax bill under this AMT, unless we act promptly.

I yield the floor and yield back the remainder of my time.

Mr. President, I thank the Senator from Georgia and the Senator from Texas for their leadership. With that leadership comes a very clear voice about the problems this current Congress is facing. They are problems that are historic in character. I was once in the majority. It was the minority who said: We can do better and, therefore, we should run the Congress. In the last election, the American people listened and they changed the Congress. While I was chairing the Veterans' Affairs Committee at that time, we lost the Congress--we, the Republicans--by a reality of dropping to 32 percent in the minds of Americans as to an effective and responsible Congress. The minority played on that. They became the majority. They took over the leadership. They made a great deal of promises. Here we are in the eleventh and a half hour headed toward the twelfth hour of this session of Congress. They have not accomplished it. They have dropped below 11 percent in favorable rating among the American people.

The American people do want to see us get along. At the same time, they want their Government to function in a timely and responsible way. That is exactly what this Congress has failed to do.

I come to the floor to speak about two issues specifically. The assistant majority leader came to the floor earlier today and asked unanimous consent that S. 1233 and S. 1315 be allowed to come to the floor under unanimous consent or to come to the floor with debate and final passage. The reason he had to do that was before the Thanksgiving recess, I came to the floor and objected to the movement of those bills. The Senator from Oklahoma also now objects to the movement of those bills. I think it is very important that not only does the record bear why we objected but the American people clearly understand why we are objecting, because these are veterans bills.

These are bills that deal with critical needs of America's veterans. I was once chairman and ranking member of the Veterans' Affairs Committee, and I am not going to suggest that I need to add credentials to my record as supporting America's veterans. My responsibility is to make sure the services to our veterans get delivered in a responsible and timely way, that the truly needy service-connected and poor veteran gets served, and that the needs of those coming in out of Afghanistan and Iraq, who then become veterans out of our active service, are met in an immediate way. That is the responsibility of this Congress. It is not to keep adding and adding and adding new programs that may or may not be necessary and adding and adding and adding billions of dollars that anyone in service to veterans can say is at best questionable. It is for those reasons that I objected to those bills.

Now, let me break down why because there are some very real issues here.

S. 1233 is an important piece of legislation that a majority of those of us who supported the legislation to begin with agreed to. It is called the Veterans Traumatic Brain Injury and Health Programs Improvement Act of 2007. Any bill with that title would capture your imagination. One of the great concerns we have today is the traumatic brain injuries our men and women in service are coming out of Iraq with, especially because of the types of bombs that are being used over there. Oftentimes, this kind of injury does not show up in a veteran until he or she becomes a veteran.

If you look down through the priorities of that bill, you look at increased veterans' travel benefits--yes, rural veterans coming to veterans centers to be served; a major medical facilities project; adding to the expanded services of veterans health care; professional scholarship programs; extended time for preferred care; help for low- income veterans; traumatic brain injury program enhancement; assisted- living pilot program enhancement--all of those very valuable and very meaningful, strongly supported by the Veterans' Affairs Committee and strongly supported by this Senate.

But what happened at the last minute was that a Senator on the other side added a new program. They said: We are going to allow Priority 8 veterans to become eligible for the full service of health care under the veterans health care system. What is a Priority 8 veteran? A Priority 8 veteran is one who has no service-connected disability or injury or health care concern. Did they serve? Yes, they served. Did they sustain any injury or physical needs as a result of their service? No. Are they at the poverty level or below? No. They are above it. And in most instances--in fact, in a high percentage of them--through their own employment, they have health care.

So for a good number of years, because of costs, we who watch the veterans issues and Presidents and Secretaries of the VA have said we will not serve them. They will not be eligible for the full benefits. This President, President Bush, said: I will make them eligible, but they need to pay a small fee, a couple hundred bucks a year, to have access to the greatest health care program in the world. The minority at that time, the Democrats, said: No. They get it free of charge or they don't get it.

Well, all of a sudden into this very valuable bill they parachuted Priority 8 veterans. What does that do? Well, if you go talk to the Secretary of the Veterans' Administration, they are going to tell you that it might cause a substantial problem. Why? Because all of a sudden in this health care system there could be 1.3 million more Americans eligible for health care--not planned for, not anticipated, not budgeted for, but parachuted in, I have to believe all in the name of trying to show a concern for veterans and to demonstrate that maybe we are a little more sensitive than the other side.

What does that mean? Well, it also means the potential of between $1.2 billion more expended in 2008 and up to $8.8 billion more by 2012. Did they fund it? No. Have they stuck it in the bill? Yes. Are they trying to create a priority? Yes. Are they trying to create a new expenditure? Yes. And I said: No. Let's serve our poor and our needy and our disabled first and our traumatically brain injured and our post-traumatic stress syndrome veterans. Let's serve them now. Let's put money into the bill to do that.

So the Senator from Texas talked about the VA-MILCON bill that is right at the desk right now, sent out by the ranking minority member of the VA-MILCON Subcommittee, on which I serve, of Appropriations, Senator Hutchison. We are trying to get a vote on it. That bill--that bill alone--has nearly $8 billion worth of new spending in it for veterans. That is a near 17.5-

to 18-percent increase over last year. I believe it can be said, other than defense, to be the largest increase in a budget of all of Government for this year. But the money I am talking about, the new money for Priority 8, is not even in that one. All of this new money for veterans needs that is in the bill that we are being told cannot be passed, that we keep trying to get a vote on, does not even include the $1.5 billion to $8 billion necessary to fund this new program for veterans who are not needy, who are not service connected, and who have not been eligible for a good number of years.

That is why we are saying no. You take Priority 8 out of this, and the Veterans Traumatic Brain Injury and Health Programs Improvement Act, S. 1233, could pass, and it would pass on a voice vote because the Senate--Democrats and Republicans--have always supported our veterans. But we will not nor will I allow us to get caught in the game of first you argue on the other side that we have a war nobody likes and a President who is not managing it well, and then on the other side you are saying we are not taking care of our veterans. I reject that, and I reject it totally for these reasons.

While I was chair and ranking member of the Veterans' Affairs Committee, and throughout the Bush administration, we have increased the funding for veterans on an annualized basis anywhere from 10 to 12 percent. When I talk about the appropriations bill that is at the desk for veterans being a historically large increase, well, the one the year before was a historically large increase. We have never ducked our responsibility to veterans. But we must prioritize, and we must focus on the truly needy, and we must focus on those who are coming out of Iraq and Afghanistan and traumatic brain injury and all of those who continue to suffer today. That is the first bill, and it will continue to be objected to until they take out those kinds of add-ons.

Let's talk about the second bill. The second bill is S. 1315. Now, that is an interesting bill because if you look at it on its face value, you say: Yes, that makes some sense. We are going to give a veterans' benefit enhancement to a certain class of veteran. Let me tell you who that veteran is.

The bill includes roughly $900 million in new entitlement spending on an array of veterans' benefits, but what is interesting is, it is moving money away from poor, elderly, disabled and wartime U.S. veterans. It is taking effectively $2,000 annually from our veterans and moving it over to a veteran who does not even live in the United States and is not a citizen of the United States--a Filipino veteran.

Mr. President, I ask unanimous consent for 3 additional minutes.

Why I object to this--and I call this bill the ``Robin Hood in reverse'' bill--is quite simple. If any of you have watched the Ken Burns PBS series ``The War,'' there is one whole segment of that about the war in the Philippines and the Filipinos who came forward to fight with Americans and even serve in American uniforms in defense of their land and ours during World War II. They did not become American citizens. They were Filipinos, and they have always received benefits. But this bill now reaches in and takes money away from our veterans, our poor veterans, because of a court case and is giving it to them.

Here is my problem. First of all, they do not live in this country, and they are not U.S. citizens. They are currently receiving benefits. But for the average U.S. veteran, their benefits, right now under law, cannot exceed $10,929 a year. That is roughly 24 percent of the average U.S. household income. But this benefit which is in this bill gives to a veteran--a non-U.S. citizen, living in the Philippines--100 percent of the average household income in the Philippines. They are taking that money away from our veterans to do it. That is the ``Robin Hood in reverse'' effect. At least Robin Hood, when he took money, left it in Nottingham. He spread it out amongst his own. Here we are taking money from our own and sending it all the way to the Philippines.

Now, let me say, and let me be very clear, Americans have treated Filipino veterans fairly. After the war, the United States provided $620 million--or $6.7 billion in today's dollars--to repair the Philippines. The United States provided $22.5 million--$196 million in today's dollars--for equipment and construction. We have a hospital in the Philippines, and Filipino veterans legally residing in the United States--in the United States--are fully eligible for all VA veterans' benefits based on their level of service. Survivors of Filipino veterans who died as a result of their service are eligible for educational assistance and all kinds of programs.

That is why I object. First of all, because we are taking money away from ours, but also because we have been more than generous since that war ended to our comrades, the Filipinos, who fought side by side with American men and women, who were in the Philippines at the time, after we were able to reclaim the Philippine Islands. So we have done wonderfully by them, and we have been very supportive of providing them with programs.

Remember, the average U.S. veterans' benefit--24 percent of U.S. average household income--is limited. Yet we are taking that money away from them now, giving it to Filipino veterans who are non-U.S. citizens, and increasing their benefit to over 100 percent of the average household income in the Philippines. U.S. dollars spent in the Philippines at that amount lifts--there is no question about it--lifts that Filipino dramatically. The question is, Is it fair? Is it equitable? My answer is, It is not. I offered to say, yes, we can bump them a little bit, but let's take the rest of this money and put it into educational benefits for our veterans coming out of Iraq and Afghanistan. The answer in the committee was no.

So that is why these bills are in trouble on the floor. They have loaded them up. They are too heavy. The tires are blowing out from under the trucks of these bills simply because too much is too much. In the instance of this, Disabled American Veterans--that great organization which is a loud spokesperson for our veterans--is saying: Whoa, wait a moment here. Enough is enough, and this is too much. They themselves oppose this legislation as it is currently written.

So here we have a funding bill on the floor with a 17.5- to 18- percent increase over last year's funding for veterans, and we are not allowed to vote on it. We have funding at the highest level ever for America's veterans, as we should and as we must, but these bills take us well beyond it in an unfunded environment or in one instance reaching in the pocket of our poor and disabled veteran and taking that money out and putting it into the pocket of a veteran living in the Philippines, who never became an American citizen, and who never came to this country, who has chosen to stay in his homeland. We now give them benefits, but this is a benefit well beyond what is even currently being offered to our own. Those are the fundamental reasons why we have objected.

I was pleased when the Senator from Texas said to the Senator from Illinois, the assistant majority leader: No. Yes, we will object, and we are not embarrassed about doing it, because there have to be priorities to our funding, especially at a time when the VA budget that is at the desk is the largest increase of a veterans' budget, to my knowledge, ever. We are proud of that, but there is a point when enough is, in fact, enough.

I yield the floor.

Would the Senator yield for a unanimous consent request for material to be inserted in the Record?

Mr. President, I ask unanimous consent that minority views on S. 1233 and minority views on S. 1315 be printed in the Record.