21st Century Wellness Trust Act

Mr. President, I rise today to introduce legislation, the Harmonizing America's Energy, Economy, Environment, and National Security Act, that I believe can lead our Nation out of the current energy crisis.

Much of the Nation's attention has understandably been focused on the financial turmoil taking place on Wall Street. Since the very beginning, I have been hard at work in addressing the financial crisis and I will be supporting the economic stabilization bill when the Senate votes tonight.

But I will vote with a heavy heart, for I have spent my entire career focusing on eliminating debt at the local, State and Federal level. While deciding to vote for a package of this magnitude feels like being punched in the gut, the thought of what would happen to average Americans if we did nothing is much more painful. I am, however, very pleased to see that any profit we may make off this deal will be used to pay down the national debt.

This is affecting not only Wall Street but Main Street and my street. Ohioans depend on credit to buy a home, drive to work and send their children to school. If this doesn't pass, the possible ramifications are staggering. Imagine if you can, businesses laying off staff or closing completely because they can't make payroll; retirement funds that have already taken a dramatic hit being reduced to nothing; parents unable to get a loan to pay for child's college tuition; families unable to get credit for a car or a house; cities unable to float bonds to build hospitals or schools; and home prices continuing to plummet.

We must act Mr. President. We must set aside our differences and our ideologies and do what is right. But our work cannot stop here. We must make a full-court press to stabilize the housing market and secure our energy supplies. While we have been debating and acting on the financial crisis, our energy crisis has not only continued, but in many ways grown worse. It remains an issue that needs to be addressed sooner rather than later, and if our economy is to quickly recover, a comprehensive energy policy will need to be part of the equation.

I have heard loud and clear from thousands of Ohioans how this energy crisis is directly affecting them and their loved ones. They are expecting that we work together in bipartisan fashion to craft legislation that will address our Nation's long-term energy requirements.

Take for example, the severe fuel supply disruption created by our shortsighted offshore drilling policy and hurricanes Ike and Gustav. Both hurricanes followed paths that paved straight through the heart of our Nation's offshore oil production and home to the bulk of our refining capacity. Due to the frequency of gulf hurricanes, many oil experts have pointed to this as a reason we need to open additional areas of the Outer Continental Shelf outside of the Gulf of Mexico. With 25 percent of our oil production currently taking place within the Gulf of Mexico, gulf hurricanes frequently lead to wild price spikes in the gasoline market as oil rigs and refineries are taken off line to avoid damage and loss of life.

According to the Energy Information Agency, Ike and Gustav lead to a 25 percent drop in our domestic oil production compared to this time last year, from 5.1 billion barrels a day to 3.8 billion barrels per day. The loss in refining capacity cut our gasoline inventories to levels we have not seen since 1967, resulting in widespread fuel shortages that left many in the Southeast driving from gas station to gas station, desperate to find fuel for their cars. Much of the reason why these supply disruptions have not spread across the country is that we have reached out and imported large quantities of gasoline from overseas. Some of which has undoubtedly come from countries like Venezuela, that do not have our best interests at heart.

This situation is cause for concern in its own right, but is also underscored by the current financial crisis and the fact that this is no longer a question about the price of oil. Energy security is a matter of national security.

We have clearly ignored our financial situation for far too long. The national debt stands at $9.6 trillion, almost double the $5.4 trillion debt that existed when the senator came to the Senate in 1999. By the end of 2009, the national debt is expected to have grown to $10.5 trillion. The Congressional Budget Office said the Federal Government will finish the fiscal year with a near-record deficit of $407 billion. These numbers do not include borrowing from the Social Security Trust Fund which would put the overall number close to $600 billion and $700 billion by next year.

We cannot overlook our ballooning national debt. Today, 51 percent of the privately-owned national debt is held by foreign creditors--mostly foreign central banks. Foreign creditors provided more than 70 percent of the funds that the U.S. has borrowed since 2001, according to the Department of Treasury. And who are these creditors?

According to the Treasury Department, the three largest foreign holders of U.S. debt are China, Japan, and OPEC Nations.

This is insane and it has to stop. We cannot afford to allow the countries that control our oil and our debt to control our future.

Americans are hurting from our addiction to oil, I'm not sure they fully realize the extent our national security, and indeed our very way of life, is threatened by our reliance on foreign oil.

Every year we send billions of dollars overseas for oil to pad the coffers of many Nations that wish our demise. In fact, in 2007, we spent more than $327 billion to import oil, and 60 percent of that, or nearly $200 billion, went to the oil-exporting OPEC nations. In 2008, the amount we will spend to import oil is expected to double to more than $600 billion, $360 billion of which will come from OPEC. Let's take a moment to put those import figures into context. When compared to our FY2008 budget for our Nation's defense, which was more than $693 billion, the $600 billion we will spend to import oil in 2008 is nearly equal to our entire defense budget.

There is no question that our dependence on foreign oil has serious national security implications. In addition to funding our enemies--as I just explained--we cannot ignore the fact that much of our oil comes from and travels through the most volatile regions of the world.

A couple of years ago, I attended a series of war games hosted by the National Defense University. I saw firsthand how our country's economy could be brought to its knees if somebody cut off our oil.

In 2006, Hillard Huntington, Executive Director of Stanford University's Energy Modeling Forum testified before the Senate Foreign Relations Committee, and based on his modeling, ``the odds of a foreign oil disruption happening over the next 10 years are slightly higher [than] 80 percent.'' He went on to testify that if global production were reduced by merely 2.1 percent due to some event, that it would have a more serious effect on oil prices and the economy than hurricanes Katrina and Rita.

Let us take a moment to think of our Nation like a business. Our feedstock is oil, and our of competitors control the cost of our oil. We have debt, but our competitors also control our debt. What's to keep our competitors from raising prices, calling in our debt and running us out of business?

I hope this scenario scares you as much as it scares me.

But also keep in mind, that as Congress sat here and twiddle its thumbs over simply expanding domestic drilling within our own borders, Russia and China were actively and aggressively laying claim to energy resources around the globe.

Russia, the world's second biggest oil exporter, has its sights on a large section of the Arctic seafloor that is believed to contain billion of barrels of fuel equivalent. The country has also made moves to control a larger portion of the world's natural gas reserves. Russia, which has significant reserves of natural gas, is considering the creation of a natural gas cartel similar to OPEC. Venezuela and Iran have expressed interest.

Russia has proven it has no qualms with using energy as a weapon. In 1990, Russia tried to suppress independence movements in the Baltics by cutting energy supplies. In all, Russia has used energy as a tool to further their foreign policy goals on no less than six countries. Energy is believed to be one of the driving reasons for Russia's military action in the independent nation of Georgia.

China as well is moving ahead in securing its energy future. In Africa, China is handing out loans and funding

expansive infrastructure projects in an effort to lay claim to lucrative oil reserves. With the help of Chinese investment, Angola recently passed Nigeria to become the largest petroleum producer on the continent.

I am going to be brutally honest with you folks, the future of our country is in jeopardy. We cannot continue to transfer our wealth overseas to this degree without expecting serious consequences. Rather than addressing these national security concerns we have been living the life of Riley, and allowed the environmental movement to run wild.

Congress let them get away with. We let them get away with it Mr. President. Why? Because oil was cheap and so Congress felt no urgency to act. Well, oil is not cheap anymore. While detrimental to our economy and competitiveness, the high price of oil finally spurred some of my colleagues into action and I am proud that Congress has taken some steps to address the energy crisis.

The recently passed fiscal year 2009 Continuing Resolution removed the moratoria on oil exploration in the Outer Continental Shelf and moratorium on regulations for the development of oil shale. Reserves in the Outer Continental Shelf are believed to equal 8.5 billion barrels of oil, and undiscovered resources could equal ten times that. There are currently 800 billion barrels of technically recoverable reserves locked up in our Nation's oil shale. This is three times larger than the total proven oil reserves of Saudi Arabia.

The Senate has also passed a tax extenders package that includes many incentives to develop advanced alternative energies that will lead our country to a future free of oil. Included in the package were popular tax credits for the wind and solar industry that have helped foster strong emerging industries in my home State of Ohio.

Congress needs to continue to act. I believe the Harmonizing America's Energy, Economy, Environment, and National Security Act is the vehicle for a bipartisan effort to develop a meaningful comprehensive energy plan.

Addressing this crisis requires nothing less than a Second Declaration of Independence--to move us away from foreign sources of energy in the near term and away from oil in the long term.

As you know, oil is not easily found nor substituted, and it will remain an integral component to our economy in the short-term. But we must make investments today that will help us achieve our goal tomorrow. To do this I believe we must find more, use less, and conserve what we have.

In order to find more and stabilize our Nation's energy supply, my legislation would encourage the development of oil resources within the Outer Continental Shelf and with regards to our oil shale reserves. It would also open ANWR to responsible development, where it is believed that there is over 10 billion barrels of oil.

While these resources will not physically come online for a number of years, moves to expand development will send a clear signal to the market that we are serious about meeting our future energy demands and begin to drive down the cost of oil because investors will know that gas won't be worth as much in the future and will therefore sell it off today--lowering the cost immediately.

And while we must increase our production of fossil fuels to relieve costs and reestablish our independence in the short term, in the long term we must reduce our demand for oil.

With that goal in mind, it is essential that we explore alternative means to meet our Nation's energy needs.

It is long past time for our government to provide the spark to rekindle our Nation's creativity and innovation. Following Russia's launch of Sputnik, President Kennedy challenged our country to be the first in the world to land a man on the moon. We must now undertake a similar Apollo-like project to establish clean, reliable and domestically abundant energy alternatives and in turn usher in a new era of American freedom and independence.

My legislation would help to fund such a project by setting aside a portion of the federal revenues raised through lease revenues in the Outer Continental Shelf and ANWR to be used for the development of advanced alternative energies, like wind, solar, fuel cells, advanced batteries, and advanced biofuels. It would also set aside funds to be explicitly to boost funding for the Low-Income Home Energy Assistance Program and to pay down our national debt.

The bill will also repeal Section 526, a provision that places our domestic coal-to-liquid industry in jeopardy. We have the largest coal reserves in the world, and at current rates of consumption, U.S. coal deposits will last for more than 240 years.

Coal can provide significant new supplies of affordable synthetic fuels for transportation. A lot of Americans don't understand that many country's get their oil from coal. In fact, South Africa gets nearly 70 percent of their oil from coal. But we are beginning to make advances here. In fact, Baard Energy is planning a CTL and biomass facility in SE Ohio that will produce 53,000 BPD of jet and diesel fuel, and other liquid production from coal and biomass feedstocks.

Last but not least, as we look to increase our supply and spark new innovation, we must also be more responsible with the energy we currently use. My legislation would fund the development of new conservation technologies and practices and would help to disseminate these across the country.

Americans today demand action and they demand we come together in a bipartisan fashion to solve our energy crisis. For 10 years I have been a member of the Environmental and Public Works Committee and for 10 years I have tried to coax Congress into harmonizing our energy, economy and the environment. Congress has refused and now the chickens have come home to roost.

I believe that the best message we can send to OPEC, those investing in the oil market, and indeed the entire world, is that we get it. We must demonstrate that we are going to find more by going after every drop of oil that we can responsibly drill and that we are going to use less by undertaking a new Apollo project to make the U.S. the most oil independent nation in the world.

I envision an America ten years from now where we have enough oil to take care of our needs. I imagine an America that is the least reliant country in the world on oil, an America where our economy is not threatened by our reliance on foreign energy sources. It will be an America that has created hundreds of thousands of jobs through the responsible development of our Nation's resources and the through the creation of new industries in the field of alternative energy.

Wouldn't it be great for our children and grandchildren to one day celebrate the time America put aside its differences and came together to reaffirm its independence a second time and rekindled the American spirit of self reliance, innovation and creativity to usher in new era of prosperity?

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

Mr. President, I rise to introduce the Over-the- Counter Swaps Speculation Limit Act, a bill to establish workable speculative position limits that apply to both bilateral over-the- counter swaps transactions and on-exchange transactions.

The Over-the-Counter Swaps Speculation Limit Act would close the ``over-the-counter swaps loophole'' once and for all by requiring the Commodity Futures Trading Commission--or CFTC--to apply the position limit system to bilateral swaps, not just the on-exchange transactions that are limited today.

Let me explain what the bill would do:

CFTC would enforce ``aggregate'' position limits so that a trader's positions on and off exchange would be combined. Swaps would no longer be exempt from position limits.

CFTC would be allowed to grant hedge exemptions for bone fide hedging. This exemption would be limited to trading that hedges against price risk exposure related to physical transactions in that energy commodity.

Neither institutional investors hedging against inflation, nor swaps dealers hedging their secret dealings would qualify for a hedge exemption.

The bill would give CFTC the power to issue civil fines to enforce position limits when unwinding a speculative position would be disruptive to the marketplace.

This legislation is the missing piece to otherwise comprehensive anti-speculation legislation debated in the Senate in July and adopted by the House of Representatives in September.

Both of the House and Senate bills included vital provisions to protect our markets, including provisions to close the London Loophole by imposing speculation position limits on trading conducted on Foreign Boards of Trade.

It would grant CFTC the authority to collect data and monitor trading in Over-the-Counter Swaps markets, shining the bright light of oversight onto a previously un-watched market.

It would improve the data collection systems at CFTC to distinguish between swaps dealers, institutional investors, and genuine speculators;

It would assure no true speculator is exempted from speculative position limits; and increase CFTC's staffing levels.

Reacting to congressional pressure, the CFTC took many of the steps through administrative action that our bills in Congress would have required.

CFTC largely closed the London Loophole and began monitoring London trading of American crude oil.

CFTC began collecting detailed data on OTC swaps trading, especially by swaps dealers and institutional index traders, and it began monitoring these markets.

CFTC reclassified a major swaps dealer as a speculator and proposed a rulemaking to revise its system for granting speculative limit exemptions.

This is true progress, but the swaps loophole--exempting voice brokered bilateral swaps from the speculative position limit system-- remains in place. Traders are able to hold positions far above speculative position limits simply by executing their trades through a voice broker.

Until this summer, the Federal Government knew very little about OTC swaps, which have been exempt from CFTC oversight since 1993. But thanks to CFTC's increased oversight this summer, published in its September 2008 ``Staff Report on Commodity Swap Dealers and Index Traders,'' we know that traders do in fact use these swaps markets to hold positions above the speculative position limits on regulated exchanges.

The CFTC report found that on a single day in June there were:

``18 noncommercial traders (speculators) in 13 markets who appeared to have an aggregate position . . . that would have been above the speculative limit or an exchange accountability level if all the positions were on-exchange.''

CFTC discovered that a few traders held positions that would have ``significantly exceeded'' an aggregate position limit.

What is the purpose of speculative position limits if traders know they can buy the equivalent product in unlimited quantities from a voice broker?

The Over-the-Counter Swaps Speculation Limit Act puts an end to this flawed system by instructing CFTC to establish a system of aggregate position limits. As the staff report demonstrated, CFTC knows how to calculate such limits.

I believe this legislation avoids the pitfalls of previous efforts in the 110th Congress to limit speculative positions in swaps.

It is simple, granting CFTC the broad mandate to impose aggregate position limits across positions held on registered entities, foreign boards of trade, and OTC markets that impact the price discovery function of a regulated market. It grants the regulator proper discretion to determine which contracts are functionally equivalent and what the limits should be.

It applies speculative position limits only to swaps that impact the price discovery function on regulated markets. By focusing CFTC efforts only on the major, standardized swaps contracts, the bill maintains legal certainty for unique financing agreements and other private bilateral transactions.

The bill also prevents speculators from migrating to less regulated contracts. CFTC will only be allowed to exempt contracts from position limits after it determines that the contract is not functioning as a haven from regulation. CFTC must impose speculative position limits on any contract that: is highly standardized; settles on the price of a contracted traded in a regulated marketplace; has its prices widely published and referenced; or traded in significant volumes.

Finally, the legislation addresses CFTC staff concerns that enforcing position limits on bilateral swaps contracts would be too cumbersome. In recent briefings, CFTC staff argued that the primary reason CFTC was not calling for speculative position limits on swaps is that position limits on swaps would force parties to void existing contracts, which harms the counterparty as much as the trader who is over their limit.

Regulators should not force a trader to break a contract if such action would punish the counterparties as well as the speculator. To address this, this legislation gives CFTC the power to enforce position limits with fines instead of forcing a trader to unwind a position.

Over the past 6 months, OTC swaps markets have been exposed, and it has become increasingly apparent that speculative position limits are both appropriate and feasible in order to protect regulated markets from manipulation and excessive speculation.

The regulated and unregulated energy markets are fully integrated. With traders moving back and forth freely, it is no longer reasonable to believe that bad behavior in swaps can be isolated.

A manipulated swaps market would likely impact the price discovery function of a futures market, and in turn affect consumer prices.

If we want fair play in the energy markets, we cannot continue to instruct the CFTC to swallow its whistle when it sees violations at the Swaps' end of the court.

We need to allow CFTC to call foul when it sees excessive speculation, whether on an exchange or in a voice brokered swaps market.

The Over-the-Counter Swaps Speculation Limit Act would give the CFTC back its whistle. It would allow the Commission to use the speculative position limit system in existence since the 1930s--to reel in excessive speculation in American energy markets.

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

Mr. President, I rise today to introduce the Short- term Analog Flash and Emergency Readiness Act. This simple piece of legislation will help make sure those consumers who fail to make the transition to Digital Television, DTV, by February 17, 2009 are not left without access to emergency information. This bill will also allow those consumers to understand what steps they need to take in order to restore their television signals.

I voted against the Deficit Reduction Act of 2005, which directs that on February 18, 2009, over-the-air full-power television broadcasts, which are currently provided by television stations in both analog and digital formats, will become digital only. I voted against this bill in both the Commerce Committee and during its consideration by the full Senate because it failed to address the core policy questions of the implementation of the transition to DTV. Specifically, it did not adequately address the minimization of consumer disruption and the establishment a national interoperable communications network with the analog spectrum that broadcasters were vacating. I was one of only three ``No'' votes in Committee.

When the Commerce Committee passed its portion of the Deficit Reduction Act of 2005, the then-Republican majority on the Committee did not want to spend significant resources on the DTV transition to minimize consumer disruption. Nor, did they want to spend any resources on building a national interoperable public safety communications network. The only thing that mattered to Republicans in 2005 was generating sufficient money to meet our budget reconciliation instructions. Because the Committee failed to set forth coherent policy objectives in 2005, consumers and our Nation's first responders will bear the brunt of that failure.

I believe that many have forgotten why we moved forward with the DTV transition. It was to free up much needed spectrum to create a national interoperable public safety communications network. I know the people of West Virginia strongly support their first responders and would have gladly accepted that transition to make sure that in times of crisis our local police, fire, and emergency response teams could communicate. Instead, the DTV transition has been sold as nothing more than having a better television picture. That is unfortunate because we are making this transition to address a critical public safety need--one identified by the 9/11 Commission.

Unfortunately, the Federal Communications Commission still has not devised a plan to establish this national public safety communications network. The spectrum has been auctioned and the big wireless companies have secured their futures. But our nation's first responders, which should have been this Administration's first priority, are not much closer to achieving interoperable communications.

As my good friend FCC Commissioner Michael Copps has stated, ``the question of public safety is . . . the first obligation of the public servant.'' In a

more perfect world, our nation's first responders would already have access to an interoperable and fully-funded broadband network that makes use of dedicated public safety spectrum. We are still a long way from developing this network for public safety, and that is something of which we all should be ashamed. If we fail to establish this network quickly and in a manner that works for the public safety community, I am afraid we may have lost the opportunity forever.

This Administration has failed consumers as well. In 2005, Congress left almost all of the implementation of the transition to the private sector--broadcasters, cable and satellite companies, and consumer electronics retailers. Although well-heeled industries state that they have devoted hundreds of millions of dollars to making Americans aware of the DTV transition, I am not sure that it is going to minimize the disruption.

The recent DTV transition test market of Wilmington, North Carolina demonstrated that, even with extraordinary levels of outreach, some did not know about the DTV transition. I would note that Wilmington received far more attention than any market in West Virginia is likely to receive, or any other part of the country for that matter.

Even if a consumer was aware of the DTV transition, several thousand people called into the FCC for assistance--they could not set up their box, they could not receive certain digital signals, or their antennae needed adjustment, to name just a few of the problems. Consumers, especially the elderly and those with limited English proficiency, are going to need help in managing the transition.

Among its many shortcomings, the DTV Act did not require the Federal agencies charged with administering the transition to develop a program to assist consumers with attaching the converter boxes to their sets. By contrast, in the United Kingdom, there is an assistance program, known as ``Help Scheme,'' that will assist a many as 7 million households with selecting, installing, and using DTV equipment.

Unfortunately, in the remaining time before the transition, we are not going to be able to replicate the United Kingdom's consumer assistance plan. But, we may be able to take small steps that can help consumers.

My legislation is one such step. It simply allows the FCC to permit analog television signals to be broadcast for thirty days after the transition so that, at a minimum, one station in a market can send a signal explaining what has happened to a consumer's television signal and how to restore that signal. Far more importantly, it will allow the broadcast of emergency information so that people are aware of impending storms, floods, or other emergencies.

This was done in the Wilmington television market and people found it to be beneficial. A hurricane almost hit Wilmington around the time of its DTV transition. Because it was a test market, the government would have had the luxury of postponing the transition if a hurricane struck the region. On February 18, 2009, Americans left in the dark will not have that luxury. They would not know if a Nor'easter is on its way, or catastrophic flooding is occurring, or if a terrorist has once again truck our Nation.

We cannot let that happen. We must pass this legislation before we adjourn for the year.

Mr. President, reforming the healthcare system is a top priority for me. I have been on the frontlines in the fight for healthcare for every single American for as long as I have been in public service. And every passing day, and year, the task becomes both more urgent and more difficult--success more expensive and failure more costly.

The United States spent about $2.1 trillion on healthcare in 2006, twice what we spent 10 years ago, and half of what we're projected to spend 10 years from now. Preventable and chronic diseases are this century's epidemic. The number of people with chronic conditions is rapidly increasing and it is estimated that if we do not intervene now, by 2025 nearly half of the population will suffer from at least one chronic disease.

The wellness gap also affects health care costs. About 78 percent of all health spending in the United States is attributable to chronic illness, much of which is preventable. Chronic diseases cost the United States an additional $1 trillion each year in lost productivity, and are a major contributing factor to the overall poor health that is placing the Nation's economic security and competitiveness in jeopardy.

Unlike some health care challenges, proven preventive services and programs exist. If effective risk reduction were implemented and sustained, by 2015 the death rate due to cancer could drop by 29 percent. Improved blood sugar control for people with diabetes could reduce the risk for eye disease, kidney disease, and nerve disease by 40 percent. Similarly, blood pressure control could reduce the risk for heart disease and stroke by 33 to 50 percent. Yet, only half of recommended clinical preventive services are provided to adults. About 20 percent of children do not receive all recommended immunizations, with higher rates in certain areas. Nearly 70 percent of people with high blood pressure do not now control it. And racial disparities in the use of prevention exist.

The country faces low use of preventive services because of the low value placed on prevention, a delivery system bent toward fixing rather than preventing problems, and financial disincentives for prevention. Insurers have little incentive to invest in preventive services today that will benefit other insurers tomorrow. This is especially true for those preventive services that reduce chronic diseases that develop over a period of several years or decades. The costs of prevention are incurred immediately but most of its benefits are realized later, often by Medicare. The United States spends only an estimated 1 to 3 percent of national health expenditures on preventive healthcare services and health promotion.

In addition, the workforce to deliver prevention is also insufficient. The supply of providers who are trained to emphasize prevention is shrinking. Between 1997 and 2005, the number of medical school graduates entering family practice residencies dropped by 50 percent. There is an acute shortage of community health workers. Between 25 and 50 percent of the existing Federal, State and local public health workforce is eligible for retirement in the next 5 years. Today, more than 75 percent of the existing public health workforce has no formal public health or prevention training. There is no national, uniform credentialing system for public health or prevention workers that would ensure that these workers are trained in the basics of preventive care.

A system that promoted full use of high-priority prevention could save lives and reduce costs. For example, complete, routine childhood vaccination could save up to $40 billion in direct and societal costs over time. Promoting screenings and behavioral modifications in the workplace can lower absenteeism and, in most cases, health costs to firms. Preventive health care services could reduce government spending on health care. If all seniors recommended to received a flu vaccine did, health costs could be reduced by nearly $1 billion per year. Over 25 years, Medicare could save an estimated $890 billion from effective control of hypertension, and $1 trillion from returning to levels of obesity observed in the 1980s.

So today, I am pleased to introduce The 21st Century Wellness Trust Act. This legislation is a critical part of the broader effort we will undertake next Congress to cover every single American and bring reforms to our delivery system that make it more efficient and improve health outcomes.

The 21st Century Wellness Trust Act would create a Wellness Trust at the Centers for Disease Control and Prevention at the Department of Health and Human Services to refocus the efforts of our healthcare system on prevention and wellness. Through the Trust Fund Board, the Wellness Trust will become the primary payer for priority prevention services, as well as ensure an adequate and appropriately trained and credentialed prevention health workforce. The Trust will also serve as a central source of prevention information and ensure the inclusion of prevention and wellness in the development of a nationwide, interoperable health IT infrastructure.

We cannot afford to wait any longer and I am proud to introduce The 21st Century Wellness Trust Act which will be an important part of the solution. We must undertake reforms that move us from a system of sickness to a system of wellness. From a system that is tilted towards institutional and emergency care to one that not only covers everyone, but is designed to promote prevention of disease and wellness.

Mr. President, reforming the healthcare system is a top priority for me. I have been on the frontlines in the fight for healthcare for every single American for as long as I have been in public service. And every passing day, and year, the task becomes both more urgent and more difficult--success more expensive and failure more costly.

The United States spent about $2.1 trillion on healthcare in 2006, twice what we spent 10 years ago, and half of what we're projected to spend 10 years from now. Preventable and chronic diseases are this century's epidemic. The number of people with chronic conditions is rapidly increasing and it is estimated that if we do not intervene now, by 2025 nearly half of the population will suffer from at least one chronic disease.

The wellness gap also affects health care costs. About 78 percent of all health spending in the United States is attributable to chronic illness, much of which is preventable. Chronic diseases cost the United States an additional $1 trillion each year in lost productivity, and are a major contributing factor to the overall poor health that is placing the Nation's economic security and competitiveness in jeopardy.

Unlike some health care challenges, proven preventive services and programs exist. If effective risk reduction were implemented and sustained, by 2015 the death rate due to cancer could drop by 29 percent. Improved blood sugar control for people with diabetes could reduce the risk for eye disease, kidney disease, and nerve disease by 40 percent. Similarly, blood pressure control could reduce the risk for heart disease and stroke by 33 to 50 percent. Yet, only half of recommended clinical preventive services are provided to adults. About 20 percent of children do not receive all recommended immunizations, with higher rates in certain areas. Nearly 70 percent of people with high blood pressure do not now control it. And racial disparities in the use of prevention exist.

The country faces low use of preventive services because of the low value placed on prevention, a delivery system bent toward fixing rather than preventing problems, and financial disincentives for prevention. Insurers have little incentive to invest in preventive services today that will benefit other insurers tomorrow. This is especially true for those preventive services that reduce chronic diseases that develop over a period of several years or decades. The costs of prevention are incurred immediately but most of its benefits are realized later, often by Medicare. The United States spends only an estimated 1 to 3 percent of national health expenditures on preventive healthcare services and health promotion.

In addition, the workforce to deliver prevention is also insufficient. The supply of providers who are trained to emphasize prevention is shrinking. Between 1997 and 2005, the number of medical school graduates entering family practice residencies dropped by 50 percent. There is an acute shortage of community health workers. Between 25 and 50 percent of the existing Federal, State and local public health workforce is eligible for retirement in the next 5 years. Today, more than 75 percent of the existing public health workforce has no formal public health or prevention training. There is no national, uniform credentialing system for public health or prevention workers that would ensure that these workers are trained in the basics of preventive care.

A system that promoted full use of high-priority prevention could save lives and reduce costs. For example, complete, routine childhood vaccination could save up to $40 billion in direct and societal costs over time. Promoting screenings and behavioral modifications in the workplace can lower absenteeism and, in most cases, health costs to firms. Preventive health care services could reduce government spending on health care. If all seniors recommended to received a flu vaccine did, health costs could be reduced by nearly $1 billion per year. Over 25 years, Medicare could save an estimated $890 billion from effective control of hypertension, and $1 trillion from returning to levels of obesity observed in the 1980s.

So today, I am pleased to introduce The 21st Century Wellness Trust Act. This legislation is a critical part of the broader effort we will undertake next Congress to cover every single American and bring reforms to our delivery system that make it more efficient and improve health outcomes.

The 21st Century Wellness Trust Act would create a Wellness Trust at the Centers for Disease Control and Prevention at the Department of Health and Human Services to refocus the efforts of our healthcare system on prevention and wellness. Through the Trust Fund Board, the Wellness Trust will become the primary payer for priority prevention services, as well as ensure an adequate and appropriately trained and credentialed prevention health workforce. The Trust will also serve as a central source of prevention information and ensure the inclusion of prevention and wellness in the development of a nationwide, interoperable health IT infrastructure.

We cannot afford to wait any longer and I am proud to introduce The 21st Century Wellness Trust Act which will be an important part of the solution. We must undertake reforms that move us from a system of sickness to a system of wellness. From a system that is tilted towards institutional and emergency care to one that not only covers everyone, but is designed to promote prevention of disease and wellness.