Hospice Protection Act of 2008

Mr. President, our Government agencies collect and report a range of economic information but much of what we see or hear is most suited to describing the general state of the country's economy. This information does not reflect what is happening in and what matters most to our families and the quality of our lives. For example, our national unemployment figures don't tell us that those who are employed may not have benefits, or that they are working two or three jobs to earn the income that they report, or that their mortgage debt and college loans are jeopardizing their ability to repay their credit card debt or their medical bills. By knowing and reporting this kind of information we can not only more accurately reflect what our families are experiencing economically, we can better inform policymakers about what matters most to people and the steps that need to be taken to address household economic needs and concerns.

To address this need I am introducing the Commission on Measures of Household Economic Security Act of 2008. The bill would establish a bipartisan congressional commission of 8 economic experts to look at existing government economic data and identify the possible need for new information, more accurate methodologies and better ways to report these economic measures to give a more accurate and reliable picture of the economic well being of American households. As part of their effort, the Commission will be asked to meet with representative groups of the public so that their views are taken into account in the Commission's recommendations.

In doing this, the Commission will look at such things as the current debt situation of American individuals and households, including categories of debt such as credit card debt, education related loans and mortgage payments; the movement Americans between salaried jobs with benefits to single or multiple wage jobs with limited or no benefits with a comparison of income to include the value of benefits programs such as health insurance and retirement plans; the percentage of Americans who are covered by both employer-provided and individual health care plans and the extent of coverage per dollar paid by both employers and employees; the savings rate, including both standard savings plans and pension plans; the disparity in income distribution over time and between different demographic and geographic groups; and the breakdown of household expenditures between such categories as food, shelter, medical expenses, debt servicing, and energy.

In addition, the Commission will consider the relevance of certain non-market activities, like household production, education, and volunteer services that affect the economic well being of households but are not measured or valued in currently reported economic statistics. As Robert F. Kennedy has famously said, some of our economic indicators measure ``everything in short, except that which makes life worthwhile.'' We need to make an effort to value more than just our gross domestic product and sales receipts. We need to better measure and understand what matters to American households.

This effort to improve how we measure what matters in our economy is very much in the Wisconsin tradition of accountable good Government. It was Senator Robert LaFollette, Jr. who, in 1932, introduced a resolution requiring the U.S. Government to establish a more scientific, specific and accurate set of measures of the health of the U.S. economy. From his request, Simon Kuznets, a University of Pennsylvania economics professor, developed the first set of national accounts which form the basis for today's measure of GDP and other economic indicators. Kuznets won the 1971 Nobel Prize in Economics ``for his empirically founded interpretation of economic growth which has led to new and deepened insight into the economic and social structure and process of development.'' His work was the basis for much of the New Deal reform policies. Yet Kuznets specifically acknowledged that his measures were incomplete and did not go far enough to measure what may really matter. In his 1934 report to the Senate on his compilation of statistics associated with Gross National Product he concluded: ``The welfare of a nation can . . . scarcely be inferred from a measurement of national income as [so] defined . . . .'' This bill is intended to advance these earlier efforts to make our economic statistical measures more reflective of the welfare of our families and our nation.

The cost of this commission will be fully covered by amounts already authorized and appropriated to the Bureau of Labor Statistics. I urge my colleagues to support my legislation

Mr. President, our national energy situation is continuing to deteriorate. Petroleum and gasoline prices have set all time records, and our oil imports are responsible for an incredibly large wealth transfer from America to global oil producers. Our most immediate and visible energy challenges are adequate supplies and record prices for fuels in our transportation sector, but natural gas and coal prices also have risen to new plateaus, and these are impacting both electricity prices and manufacturing and delivery costs across our economy and society. We have yet to tackle the problem of reducing greenhouse gas emissions, the large majority of which result from the combustion of fossil fuels. The environmental impacts of energy use, especially from autos and power plants, are still a major health concern. In short, we need to initiate a major transition of our energy sector, to one that is far more efficient, is much less reliant on fossil fuels and imported oil, and is utilizing vastly more domestically produced renewable fuels and energy.

Americans recognize the magnitude and the urgency of our energy challenges. They rightfully expect us to adopt policies to move this energy transition forward. In particular, we need to reduce dependence on oil in transportation, and we have broad agreement on two fundamental approaches--increasing efficiency of vehicles and increasing use of alternative fuels. However, in expanding the use of alternative fuels, we face the challenge of needing both alternative fueling stations and vehicles that can use these fuels. The Energy Independence and Security Act of 2007 calls for a brisk expansion of the production and use of biofuels, and it promotes the expansion of the ethanol distribution and sales infrastructure. In parallel, we need to rapidly expand the number of dual fuel automobiles, including in particular autos that can be fueled with any blend of gasoline and ethanol ranging from zero to 85 percent ethanol.

Today I am joined by my esteemed colleague, Senator Lugar of Indiana, in introducing the Dual fuel Automobile Act of 2008. This bill will expand the number of dual fuel automobiles at a rapid pace while not imposing undue production cost challenges or our auto manufacturers. It calls for 50 percent of all light-duty vehicles manufactured for sale in the United States to be dual fuel automobiles by 2011. It increases that to 90 percent of all light-duty vehicles manufactured for U.S. sales by 2013. These requirements are reasonable because it is known that gasoline vehicles require relatively minor changes in fuel system designs to be able to use blends of gasoline and ethanol which qualify them for dual fuel designation.

This mandate will ensure that the number of dual fuel automobiles in our transportation fleet is expanding apace with the expansion of ethanol production and use in our national fuel supply over the next 15 years and beyond. Taken together, our increasing production of biofuels, our incentives for installation of alternative fuel infrastructure, light-duty vehicle requirement will provide Americans the option of choosing clean, domestically-produced fuels for their personal transportation needs in the future. This represents a critical component in the transition of our energy systems away from fossil and imported fuels toward reliance on sustainable domestic fuel sources.

Today I urge my Senate colleagues to join us in taking action to boost the transition to a cleaner, more resilient, and more secure energy economy. I request support for this bill and its rapid enactment.

Mr. President, I ask unanimous consent that the bill be printed in the Record.

Mr. President, A few days ago I returned from a two week engagement abroad which included stops at Azerbaijan's oil and natural gas rich Caspian Sea coast, through Georgia, Turkey, Romania, Ukraine, Germany, and finally to Brussels, Belgium.

While my visit was planned well in advance of the conflict between Georgia and Russia, recent events have amplified the importance of energy as a strategic priority in capitals across this region. States dependent on Russian gas to fuel their economies and ways of life understand that turning off the tap may be as effective a weapon as the tanks and armies that rolled across Georgia. For example, the Russian suspension of gas supplies to Ukraine 2 years ago spurred significant discussion of energy security amongst European friends. Yet only modest changes in planning and preparation have occurred. Meanwhile, Russia has aggressively sought to increase its dominance over energy supplies.

In the U.S. we are largely dependent on foreign governments for our transportation energy needs, which leaves our own security and prosperity in jeopardy. Accordingly, we must attain genuine energy security with supplies sufficient enough to grow our economy and insulate us from foreign manipulation. We are fortunate to have the means to bolster both renewable and conventional energy sources.

Realizing this potential will take leadership and vision. Renewable energy offers the greatest hope to wed our energy security needs with economic growth and environmental stewardship. However, one of the major impediments to expanding renewable energy, such as biofuels, is a lack of appropriate infrastructure. Currently our automobile fleet is largely built to run on petroleum based gasoline and up to 10 percent ethanol blends. This means that even though ethanol makes up a relatively small portion of our fuel source, greater production from the next generation biofuels, such as cellulosic ethanol, will be severely hampered, if not prevented.

This is why I join Senator Harkin of Iowa in introducing the Dual Fuel Automobile Act of 2008. This bill calls for 50 percent of all automobiles manufactured for sale in the U.S. to be dual fuel automobiles by 2011, meaning that the purchaser of the vehicle would have a choice in which fuel they choose to power their vehicle. It would increase to 90 percent of all automobiles manufactured for U.S. sales by 2013. Relatively minor and inexpensive changes in fuel system designs allow blends of gasoline and ethanol to be used dependent on the consumer's choice each time they fill up.

Mr. President, I have sought recognition today to introduce the Medicare Hospice Protection Act, which will place a one- year moratorium on a final rule issued by the Centers for Medicare and Medicaid Services, CMS, reducing payments to hospice providers and ensure Medicare beneficiaries' access to hospice care.

More than 1.3 million Americans depend on hospice for high quality and compassionate end-of-life care each year. Unfortunately, on August 1, 2008, CMS issued a final rule to reduce hospice reimbursement rates in Medicare. This reduction of the hospice wage index will take $2.3 billion out of hospice care over the next 5 years if this Congress allows it to be implemented as scheduled on October 1, 2008.

The Medicare Payment Advisory Commission, MedPAC, is currently examining the payment system for hospice care. We must allow the MedPAC to complete this important review of the hospice Medicare benefit and make payment recommendations, which is expected in 2009. The Hospice Protection Act, introduced by myself and Senators Harkin, Wyden, Roberts, Rockefeller and Smith, will provide that time with a one-year moratorium on implementation.

Hospice is an efficient and cost-effective health care model. Hospice provides individuals at the end of their lives, as well as their families, with comfort and compassion when they are needed most. Hospice care enables a person to retain his or her dignity and maintain quality of life during the end of life. An independent Duke University study in 2007 showed that patients receiving hospice care cost the Medicare program about $2,300 less than

those who did not, resulting in an annual savings of more than $2 billion.

In April 28, 2008, just before the Notice of Proposed Rule Making was released, a bipartisan group of more than 40 Senators wrote to Secretary Leavitt and asked him to stop further action and wait for MedPAC recommendations on hospice payment issues. On July 28, 2008, before the final rule was released, Senators Harkin, Wyden, Roberts and I wrote to the White House, to urge them to stop the regulation from being finalized and to consider the burden that this regulation will put on the hospice community.

Our repeated requests have been ignored, so we are introducing this legislation to keep CMS from implementing a short-sighted and irresponsible cut to end-of-life care. I ask my fellow Senators to join me in support of the Hospice Protection Act and to work toward its swift passage.

Mr. President, I have sought recognition today to introduce the Medicare Hospice Protection Act, which will place a one- year moratorium on a final rule issued by the Centers for Medicare and Medicaid Services, CMS, reducing payments to hospice providers and ensure Medicare beneficiaries' access to hospice care.

More than 1.3 million Americans depend on hospice for high quality and compassionate end-of-life care each year. Unfortunately, on August 1, 2008, CMS issued a final rule to reduce hospice reimbursement rates in Medicare. This reduction of the hospice wage index will take $2.3 billion out of hospice care over the next 5 years if this Congress allows it to be implemented as scheduled on October 1, 2008.

The Medicare Payment Advisory Commission, MedPAC, is currently examining the payment system for hospice care. We must allow the MedPAC to complete this important review of the hospice Medicare benefit and make payment recommendations, which is expected in 2009. The Hospice Protection Act, introduced by myself and Senators Harkin, Wyden, Roberts, Rockefeller and Smith, will provide that time with a one-year moratorium on implementation.

Hospice is an efficient and cost-effective health care model. Hospice provides individuals at the end of their lives, as well as their families, with comfort and compassion when they are needed most. Hospice care enables a person to retain his or her dignity and maintain quality of life during the end of life. An independent Duke University study in 2007 showed that patients receiving hospice care cost the Medicare program about $2,300 less than

those who did not, resulting in an annual savings of more than $2 billion.

In April 28, 2008, just before the Notice of Proposed Rule Making was released, a bipartisan group of more than 40 Senators wrote to Secretary Leavitt and asked him to stop further action and wait for MedPAC recommendations on hospice payment issues. On July 28, 2008, before the final rule was released, Senators Harkin, Wyden, Roberts and I wrote to the White House, to urge them to stop the regulation from being finalized and to consider the burden that this regulation will put on the hospice community.

Our repeated requests have been ignored, so we are introducing this legislation to keep CMS from implementing a short-sighted and irresponsible cut to end-of-life care. I ask my fellow Senators to join me in support of the Hospice Protection Act and to work toward its swift passage.