Floor Statements

Mr. President, I call up amendment No. 1903.

I ask unanimous consent that reading of the amendment be dispensed with.

Mr. President, this amendment addresses the issue of district heating which has incredible potential as a force for sustainable energy. Specifically, what this amendment would do is provide $15 million in technical assistance grants to institutional entities such as municipal utilities, institutions of higher learning, public school districts, local government or a designee of any of these entities through section 399A of the Energy Policy and Conservation Act as incorporated by the Energy Independence and Security Act of 2007. It would do this by directing $15 million within the $100 million for the DOE industrial technologies program to be directed toward district energy and combined heat and power.

This Nation has a huge opportunity to reduce greenhouse gas emissions, create jobs, and provide reliable energy for heating and cooling and electricity by moving toward district energy and combined heat and power. District energy systems provide heating and cooling to two or more buildings or facilities through underground pipes. These systems can efficiently meet the heating and cooling needs of towns and cities. Much of Copenhagen, for example, is now heated through district heating. It can provide electricity and heating for college campuses, for hospitals, public buildings, and other facilities.

Combined heat and power refers to the production of both electricity and thermal energy. You are creating electricity and heat from the same powerplant. Combined heat and powerplants can provide thermal energy for district energy systems.

In my city of Burlington, VT, where I had the honor of being mayor for 8 years, we built the largest wood chip burning plant in the State of Vermont. This plant has a 50-megawatt capacity that runs on wood chips and wood waste. Roughly 60 percent of the energy produced by this plant is lost as wasted heat. Burlington, similar to other cities around the country, could capture that waste heat and use it to provide heating and cooling to multiple buildings downtown.

According to a 2008 Department of Energy report, combined heat and power systems, particularly in coordination with district energy systems, could make a huge impact in meeting our energy needs while lowering greenhouse gas emissions. Approximately 40 percent of our energy consumption is for heating and cooling of our buildings as well as industrial process heat. Combined heat and power represents roughly 9 percent of our electric power capacity today. If we can move to 20 percent combined heat and power by 2020, we could, according to the DOE, create more than 1 million new jobs and avoid more than 800 million metric tons of carbon dioxide emissions. This would avoid more than 60 percent of the projected growth in carbon dioxide emissions between now and 2030. In other words, this is a big deal. We are talking about real technology that is deployable today, not 50 years in the future. It is here today, ready to be utilized.

In Copenhagen, district energy provides clean heating to 97 percent of the city. This has saved energy, reduced fossil fuel consumption, and avoided greenhouse gas emissions. In our own country, in St. Paul, MN, district energy and combined heat and power provide 65 megawatts of thermal energy and 25 megawatts of electricity from renewable urban wood waste. That is an extraordinary development. This

heats more than 185 buildings, 300 homes, and cools an additional 95 buildings. This has reduced emissions and provided exceedingly reliable energy for St. Paul. Same story, smaller scale, Jamestown, NY.

I offer amendment No. 1903, which will provide $15 million for technical assistance grants under a program authorized in the 2007 Energy Independence and Security Act. These grants will help with engineering studies and feasibility studies. The grants do require a match of between 25 and 60 percent so we are leveraging Federal dollars wisely. These grants were authorized but have never received funding. In fact, we have long neglected district energy and combined heat and power systems. We should be providing Federal support for these efficient technologies.

Interestingly, according to the Biomass Resource Center and the International District Energy Association, there are hundreds of shovel-ready projects that need capital for infrastructure to go forward right now. We are on the verge of putting people to work, cutting greenhouse gas emissions, making these systems more energy efficient. We also have many programs around the country that are in need of money for feasibility studies. By providing for technical assistance grants, we are taking an important step to move these projects forward.

I ask the chairman of the committee, I have offered this amendment. How does he suggest we proceed?

I thank the chairman.

I thank the Senator.

Amendment No. 1895 to Amendment No. 1813

Mr. President, I have an amendment at the desk.

Mr. President, today I honor a renowned Vermont landmark and business, Thunder Road International SpeedBowl, which is celebrating its 50th anniversary this season.

Thursday nights every summer, short track races take place on Thunder Road's uniquely configured quarter-mile paved track. Thunder Road has been recognized as one of the finest short tracks in the Nation. Built in 1959 on farm land in Barre, VT, by longtime network sports commentator Ken Squier and his partners, Thunder Road is an American institution of which Vermont is proud.

Thunder Road has offered inexpensive family entertainment for five decades. This revered race track has brought international racing stars to the Green Mountain State while also offering opportunities for Vermonters

to compete in front of passionate and knowledgeable fans.

After World War II, there were more than 22 short tracks in the State of Vermont. With only three tracks remaining, Thunder Road stands out as the largest spectator sports venue in the State.

Today, some drivers at Thunder Road can recall watching their grandfathers drive the same track. ``Thunder Road is just about racing--there's no politics, no marketing--it's just racing and it's always been that way,'' said Steve Letarte, a Maine native and crew chief for NASCAR star Jeff Gordon.

Vermonters appreciate Thunder Road for its longtime contributions to its community. For 50 years, this short track has been an invaluable institution for the people of Vermont and throughout the Northeast.

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

Madam President, as soon as this amendment logjam is broken, it is my intention to offer an amendment which is cosponsored by Senators Carper, Casey, and Kerry. This amendment deals with an issue of significance to all 50 States in our country and maybe especially rural America.

In the midst of the financial crisis we are facing, our capabilities to support fire departments--both professional and volunteer--and the EMS services they provide is under great stress.

What my amendment would do is add $100 million for the Assistance to Firefighters Grant Program as well as for another important program for fire departments, the Staffing for Adequate Fire and Emergency Response, or SAFER, Grant Program--$50 million for each program. In the $50 million for the SAFER Grant Program would be included $30 million that would go for addressing the real crisis rural volunteer fire departments are facing.

I say to the Presiding Officer, I do not know what the situation is in New Hampshire, but in Vermont--and I think in many parts of the country--we are seeing a real problem with recruitment and retention. Many people in urban areas may not understand that. But in rural America, most folks get their fire service and most folks get their EMS, their first responder service, from volunteers. If there are not volunteers available for one or another reason--and we have seen both recruitment and retention problems in volunteer fire departments--if those volunteers are not there, what is going to happen is, when fires happen, those fires are not going to be able to be contained. When somebody has a heart attack and dials 911, they are not going to get the kind of speedy ambulance service they need.

In the midst of this recession, what we are seeing is not only a reduction and a real stress on volunteer firefighting departments all over this country, and their EMS services, we are also seeing, in terms of professional firefighters, reductions in one part of the country after another part of the country, after another part of the country. Cities and towns under stress are cutting back, and they are doing it in ways which are certainly endangering the well-being and the health of the people in their communities.

Surveys by the International Association of Fire Fighters say that up to 5,000 firefighting jobs are in jeopardy. In Prince George's County, MD--not far from here--there is a new phenomenon called ``brownouts.'' This is where fire stations are closed, five at a time, to save money. In Atlanta, GA, the economic crisis has resulted in the shutting of five firehouses. In Flint, MI, 22 firefighters were laid off. Proposals in Columbus, OH, include laying off 238 firefighters. In Warren, OH, 17 firefighters received layoff notices. Orlando, FL, plans on laying off 46 firefighters. In Spokane, WA, up to 15 firefighting positions could be eliminated. There is also a serious problem about funding the equipment our firefighters need.

So we have a real problem. It seems to me at this moment this is a priority for this Nation, and it is something we should be addressing.

This amendment is supported by the volunteer firefighters of America.

Madam President, I ask unanimous consent to have printed in the Record a letter from the National Volunteer Fire Council. The National Volunteer Fire Council is strongly supporting this amendment, and they represent thousands of volunteer firefighters throughout this country.

Madam President, I will be speaking about this amendment at a later time, but I wanted to let my colleagues know this issue is of great concern all over this country. It is a concern to the firefighting community, it is a concern to the EMS community, and it is certainly a concern to rural America.

I look forward to my colleagues supporting this amendment.

Madam President, I yield the floor.

I suggest the absence of a quorum.

Mr. President, this amendment is cosponsored by Senator Casey, Senator Carper, and Senator Kerry. It is also supported by the National Volunteer Fire Council representing the interests of over 800,000 volunteer firefighters.

At a time when due to the economic crisis fire departments all over this country are laying off firefighters, and in rural America volunteer fire departments are finding it increasingly difficult to attract and retain those firefighters who not only help us, saving our property and our lives, but also are involved in EMS services, we are putting some of that $100 million directly into recruitment and retention for volunteer firefighting efforts. The offset is the science and technology fund, which I have nothing against, but I think the priorities now have to be for firefighting and for volunteer fire departments.

I yield 15 seconds to Senator Casey.

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

Mr. President, I rise today to commemorate the 25th anniversary of the return of professional baseball to Burlington, VT.

I recall that moment 25 years ago with great clarity, as it occurred when I was mayor of the city of Burlington. After a series of lengthy, but eventually productive, negotiations with the Eastern League and the owner of one of its teams, my administration with the

help of some local and very dedicated baseball buffs--was successful in bringing the Vermont Reds to Burlington. This AA-league team thrilled baseball fans--young and old, who watched them play at Centennial Field, which boasts a grandstand that is the oldest complete grandstand structure in use in Minor League Baseball. We watched Barry Larkin, Jeff Montgomery, Rob Dibble, Chris Sabo, Paul O'Neill and Norm Charlton play for the Vermont Reds. These fine athletes later went on to become the core of the 1990 World Champion Cincinnati Reds. Larkin won the National League MVP Award in 1995 and O'Neill won four more World Series rings with the New York Yankees. The Reds eventually left, to be replaced by the Vermont Mariners, and Vermont spectators had the thrill of watching certain Hall-of-Famer Ken Griffey Jr. speed around the bases as he played for our new team.

When the Mariners left, the Single-A Expos took their place; when Montreal's franchise moved to Washington, the Expos became a Washington Nationals farm team and were renamed the Vermont Lake Monsters. Today, the Lake Monsters fill the stands during the summer months, as baseball fans come to watch America's pastime in picturesque surroundings.

It is worth celebrating this quarter-century of baseball in Burlington, as Centennial Field has been called home by some outstanding players and amazing Minor League teams. Apart from those I have already mentioned--many of our players continued their careers in the Big Show. The scenic setting, the welcoming stands, the fan-based promotions, and of course the thrill of professional baseball all combine to make this a great family-friendly arena. Throughout the years, more than 2 million fans have enjoyed rooting for the home team.

As mayor of Burlington, my work was centered on building civic life and creating a vital community. Baseball proved to be an excellent catalyst for bringing people together and helping to foster a greater sense of community. Perhaps Minor League Baseball would be taken for granted in a big State or a big city, but in Burlington, VT, it is cherished by many. It is a source of pride to me that, working with a citizens committee led by local businessmen, I was able to bring Minor League Baseball to Vermont and that it has continued to thrive in the quarter of a century since.

As we look for a new dawn in this time of economic difficulty, the past 25 years of professional baseball in Burlington are a shining example of how important community-based activities are, and how much they can enrich a city and a State.

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

Mr. President, I think most Americans understand that our current health care system is disintegrating. Today, 46 million Americans have absolutely no health insurance, and even more are underinsured, with high deductibles and high copayments. At a time when 60 million people, including many with insurance, do not have access to a medical home--do not have access to a doctor of their own--close to 20,000 Americans die every single year from preventable illnesses because they do not get to a doctor when they should. This is six times the number of people who died during the tragedy of 9/11, but these deaths occur every single year.

I can vividly recall talking to physicians from Vermont--and I am sure the same is the case in Delaware and every other State in this country--who told me that patients walked into their office very sick, and they would say: Why didn't you come in here before? You are very ill. And they said: Well, I didn't have any insurance. I didn't want charity. I thought I would get better.

By the time people ended up walking in the door, their situation was so bad that the doctors lost those patients--people who should not have died. This is happening close to 20,000 times every single year in this country.

Recently, the Boston Globe had a big story--and this is in the State of Massachusetts, which supposedly has universal health care--which reported that patients with chronic illnesses, such as diabetes and heart disease, were not taking their medicines or not getting the treatments they needed because they couldn't afford the 25-percent copay. Yet Massachusetts has almost everybody covered.

So when we talk about the health care crisis, it is not just the number of people who have no health insurance, it is people who are underinsured. When you add that together, we have huge numbers of people who are not getting the medical care they need when they need it. The result is not only personal suffering, the result is that they end up going to the emergency room, costing the system far more than it should or they end up in the hospital at a highly inflated medical cost. This makes zero sense and is a manifestation of a dysfunctional health care system.

In the midst of all of this, somebody may say: Well, you have 46 million uninsured, you have more underinsured, people are dying needlessly, but at least you are not spending a lot of money. If you bought an old broken down car and you started complaining that it doesn't work well, I would say to you: Hey, what do you expect? You didn't spend a whole lot on your car.

The reality is--and this is an important point to make, because people say that Canada has problems. Canada does have problems. They say the United Kingdom has problems. Sure, they have problems. France has problems. Every country has problems. But the reality is that we are spending almost twice as much per capita on health care as any other nation. We should be doing far better in terms of health care outcomes than every other country on Earth, and that is certainly not the case. The reality is we are spending close to $2.7 trillion on health care, which is 18 percent of our GDP, and the skyrocketing cost of health care in America is unsustainable both from a personal point of view and a macroeconomic point of view.

At the individual level, the average American today is spending about $7,900 per year on health care. Do you believe that? How many people do you know in Delaware who are making $25,000, $30,000 a year who are spending $8,000 a person on health care? That is beyond comprehension.

Here is an important point to make. Despite this huge outlay, a recent study found that medical problems contributed to 62 percent of all bankruptcies in the year 2007. That means that this year there will be approximately 1 million Americans who are going bankrupt because of medically related problems. Stop and think: a million Americans going bankrupt because they can't pay their medical bills.

On a personal level, what does it mean? Imagine dealing with cancer, dealing with diabetes, dealing with heart disease, and at the same time having to stress out and worry about how you are going to pay the bill. I am not a doctor, but I can't help believing that it doesn't make one's recovery process any better when you are sitting around wondering whether you are going to go bankrupt. We are the only country in the entire world--the entire industrialized world--where people are worrying about having to go bankrupt because they committed the crime of getting sick. This is unacceptable, and we as a nation can and must do much better than that.

That is from the personal point of view. What about the macroeconomic point of view, the business perspective? Well, we know that large corporations, such as General Motors, for example, having so many economic problems, spends more on health care per automobile than they do on steel. That is a big corporation. We also have small businesses in the State of Vermont and around the country that are forced to divert hard-earned profits into health coverage for their employees rather than into new business investments. That is what they are faced with: Do they spend the money growing their business or do they provide health insurance to their workers?

Because of rising costs, it is no secret that many employers, many businesses, are cutting back on the level of their coverage, and passing more of the cost on to their workers. In more and more instances, you know what employers are saying? Sorry, can't do it anymore; we are not going to provide any health care coverage to the workers.

What we are looking at is a situation which is disastrous for millions of

Americans on a personal level, and disastrous for our economy, making us uncompetitive with countries all over the world that have a national health care program.

There is one other point that should be made and that we don't talk about very often. Nobody knows what the exact figure is, but there are some estimates that as many as 25 percent of American workers are staying at their jobs today. You know why they are staying at the job they are at today? It is not because they want to stay at their job. They are staying in their job because they have a good health insurance policy which covers themselves and their families.

Stop and think from an economic point of view, from a personal point of view: Does it make sense that millions of people are tied to their jobs simply because they have decent health insurance policies? What sense does that make?

It is important--and I am sorry to say we don't do this enough--to ask a very simple question: How could it be that, according to the OECD in 2006--the best statistics that we have--the United States spent $6,700 per capita on health care--we are now spending more--Canada spent $3,600, and France spent $3,400? France spends about one-half of what we spend per capita, and most international observers say that the French system works better than our system. So as we plunge into health care reform, it would seem to me the very first question we should ask ourselves is: How do the French, among others, spend one-half of what we are spending and get better outcomes than we do?

In terms of how people feel about their own systems, according to a five-nation study in 2004 by the well-respected Commonwealth Fund, despite paying far more for our health care, it turns out that, based on that study, Americans were far more dissatisfied than the residents of Australia, Canada, New Zealand, and the UK about the quality of care they received. In that poll, one-third of Americans told pollsters that the U.S. health care system should be completely rebuilt--far more than the residents of other countries. Does that mean to say they do not have problems in Canada or the United Kingdom? Of course they do. Their leaders are arguing about their systems every single day. But according to these polls, more people in our own country were dissatisfied about what we are getting, despite the fact that we spend, in many cases, twice as much as what other countries are spending.

It seems to me, as the health care debate heats up--and we hope more and more Americans are involved in this debate--that we as a nation have to ask two fundamental questions. In one sense, this whole issue is enormously complicated. There are a thousand different parts to it. On the other hand, it really is not so complicated. The two basic questions are, No. 1, should all Americans be entitled to health care as a right and not a privilege--which is the way, in fact, every other major country treats health care. Should all Americans be entitled to health care as a right, universal health care for all of our people?

That, by the way, of course, is the way we have responded for years to police protection, education and fire protection. We take it for granted that when you call 911 for police protection, the dispatcher does not say to you: What is your income? Do you have police insurance? We can't really come because you do not have the right type of insurance to call for a police car or to call for a fire truck. When your kid goes to school, we take it for granted that no one at the front desk of a public school says: Sorry, you can't come in, your family is not wealthy enough. What we have said for 100 years is that every kid in this country is entitled to primary and secondary school because they are Americans and we as a nation want them to get the education they deserve. Every other major country on Earth has said that about health care as well. Yet we have not.

I think right now and I think what the last Presidential election was all about is most Americans do believe all of us are in this together and all of us are entitled to health care as a right of being Americans.

The second question we have to ask is, if we accept that, if we assume all Americans are entitled to health care, how do you provide that health care in a cost-effective way? There are a lot of ways you can provide health care to all people. You can continue to throw money at it.

I ask unanimous consent for 5 more minutes.

You can continue to throw billions and billions of dollars into a dysfunctional system. That is one way you can do it. I don't think that makes a lot of sense.

I think the evidence suggests that if we are serious about providing quality health care to every man, woman, and child in a cost-effective way, then our country must move to a publicly funded, single-payer, Medicare-for-all approach. Our current private health insurance system is the most costly, wasteful, complicated, and bureaucratic in the world. The function of a private health insurance company is not-- underline ``not''--to provide health care to people, it is to make as much money as possible. In fact, every dollar of health care that is denied a patient, an American, is another dollar the company makes.

With 1,300 private insurance companies and thousands of different health benefit programs designed to maximize profits, private health insurance companies spend an incredible 30 percent of each health care dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions. Aren't we all delighted to know our health care dollars are now circulating all over the Halls of Congress, paying outrageous sums of money to lobbyists, making sure we do not do the right thing for the American people? Public programs such as Medicare and Medicaid and the Veterans' Administration are administered for far, far less than private health insurance.

Let me conclude by saying that I understand that the power of the insurance companies and the drug companies, the medical company suppliers--the medical equipment suppliers--is so significant, so powerful that we are not going to pass a single-payer, Medicare-for-all program. But at the very least, what polls overwhelmingly show is that the American people want a strong, Medicare-like public option in order to compete with the private insurance companies. That is the very least we can and must do for the American people.

I yield the floor.

Madam President, will the Senator yield?

Madam President, first, I thank my friend from North Dakota for his efforts on the very important issue of tourism but also for consistently standing up for consumers who are sick and tired of paying artificially high prices at the gas pumps. I wish to take this moment, if I might, to explain what my amendment is.

Madam President, I thank my friend.

Let me begin by saying this amendment enjoys widespread support from a very diverse coalition of organizations throughout this country that share the common concern that the price of gas and oil is soaring and they do not understand why. What they do know is that it is hurting consumers, especially in rural areas in North Dakota and Vermont and throughout this country, and it is hurting business groups throughout this country. These groups, among others, include the Petroleum Marketers Association of America, Public Citizen, the Gasoline and Automotive Service Dealers of America, the United Egg Producers, the Western Peanut Growers, Friends of the Earth, and the New England Fuel Institute. All of these organizations, for different reasons, are worried about the impact of rapidly rising oil prices on consumers.

All of us took economics 101, and what they told us in economics 101 is when supply is low and demand is high, prices go up. When supply is broad and demand is minimal, prices go down. Well, right now, unfortunately, it seems we can throw economics 101 right out the window, because at this moment the supply of oil in the United States is as high today as it was 20 years ago and demand for oil in this country is lower than it was a decade ago. So the question we are wrestling with now is: If supply is high and demand is low, why are oil prices soaring?

Up until today, as a matter of fact, gasoline prices increased for 54 straight days--the longest streak on record dating back to 1996. Today the national average for a gallon of gasoline is $2.69 a gallon--up more than $1 since late last year.

There is mounting evidence that the runup in oil and gas prices has little to do with the fundamentals of supply and demand and has everything to do with excessive speculation by some of the same Wall Street firms that received the largest taxpayer bailout in the history of the world. They are back again, not having caused enough damage by driving our country and much of the world into a deep recession. Now they are back into their speculation and driving up oil prices which are having an enormously negative impact on consumers all over our country.

Clearly, as a Congress, as a Senate, we have a responsibility to do everything we can to prevent the manipulation of oil and gas prices so that they reflect the basic economics supply and demand curve, not excessive speculation. This would not only help Americans struggling to fill up their gas tanks this summer, but it would have a positive impact, by the way, in expanding the number of international travelers visiting the United States, the fundamental purpose of the Travel Promotion Act that our amendment is a part of--would like to be a part of.

The amendment I am offering or wish to offer would simply require the Commodity Futures Trading Commission to use its emergency authority to prevent the manipulation of oil prices. What is so horrible about that? What has caused our Republican friends to jump up in fear and say this amendment can't be offered?

Let me mention to my Republican friends that last July the House of Representatives passed an identical bill by a vote of 402 to 19--the same bill. An overwhelming majority of Republicans in the House voted for that bill, but for some reason our Republican colleagues here do not want to give us the opportunity to vote for it today.

I thank Majority Leader Reid and Senator Dorgan for trying to work out a compromise with the Republicans that would have enabled a vote on this amendment. Under this agreement, as Senator Dorgan has said, the Republicans would have been able to receive a vote on their top five nongermane amendments. They had five and we had one major nongermane amendment. It is very hard for me to understand--and maybe my friend from North Dakota has some thoughts on this one--I have a very hard time understanding what their fear is. What are they afraid of, if this amendment passes? Are they afraid we would be able to take action against the excessive speculation that is currently taking place on Wall Street?

That is the only answer I can think of, and it is a pretty poor and unfortunate answer. The American people are hurting. We are in a recession. People have lost their jobs. People have seen a decline in their income. The American people are sick and tired of paying artificially high prices at the gas pump, and people in New England are worried about what happens next winter when they have to heat their homes with oil.

I wish to mention in conclusion, interestingly enough, just yesterday--just yesterday--the Guardian, a British newspaper, reported:

Staff at Goldman Sachs can look forward to the biggest

bonus payouts in the firm's

140-year history after a spectacular first half of the year.

I don't mean to pick on Goldman Sachs. There are a number of other financial outfits that may be engaged in excessive oil speculation as well, but Goldman Sachs is the leading trader of oil and gas derivatives. So here we are, Goldman Sachs, among others, now paying out huge bonuses after having been bailed out by the taxpayers of this country and they are back at their same old tricks of engaging in excessive speculation, which is what my amendment begins to address.

I am amazed our Republican friends would refuse to allow an amendment to come to the floor of the Senate that was passed overwhelmingly in the House with very strong Republican support in that body.

With that, I yield the floor.

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

Mr. President, I think virtually everybody in our country understands that America is in the midst of a major health care crisis. We have 46 million Americans without any health insurance. We have even more who are underinsured, and we have, in addition to all of that, some 60 million Americans--20 percent of our population--who do not have access to a doctor on a regular basis. The result of that particular fact is that we lose over 18,000 Americans every year, Americans who die needlessly--who should not die--because they do not go to the doctor when they should and get the treatment they need. That is six times every single year the number of people we lost on 9/11-- people who should not die because they do not have access to a doctor.

Mr. President, in the midst of this horrendous lack of coverage-- unique, I should mention, among major nations on Earth--the United States spends far more per capita on health care than any other nation, and those costs continue to soar. So when people make international comparisons of the United States with other nations on how well or not well we are doing--and that is good to do--we should always remember we are spending almost twice as much per capita on health care as any other country. There is certainly something wrong and dysfunctional about a system which spends so much and yet leaves so many people uninsured, underinsured, or without access to a doctor or a dentist or other preventive health care.

At $2.4 trillion and 18 percent of our gross domestic product, the skyrocketing cost of health care in this country is unsustainable both from a personal point of view--the needs of individual Americans--and also from a

macroeconomic perspective of what is happening to our entire economy. At the individual level, the average American today spends about $7,900 per year on health care. Can you believe that? Close to $8,000 per person on health care?

We all know folks who are out there making $20,000, $25,000, or $30,000 a year, and we are spending, on average, almost $8,000 per person.

Despite that huge outlay--unprecedented in the world--a recent study found that medical problems contributed to 62 percent of all bankruptcies in 2007. I should add that most of the people who went bankrupt had health insurance. They had health insurance. But what they had was inadequate health insurance.

From a business perspective--as opposed to the needs of an individual--General Motors spends more money on health care per automobile than they do on steel--more money on health care than on steel--which might lead us to understand why they are where they are today.

Small business owners in the State of Vermont and around this country are forced to divert hard-earned profits into health coverage for their employees rather than new business investments. Many small businesses are trying to do the right thing for their employees, spending more than they have for health coverage so they do not have the money available to make the investments they need to make their businesses grow. The result of that, of course, is as a result of soaring health care costs--going up 10, 15, 20 percent a year--many small- and medium- size businesses are cutting back drastically on their level of health care coverage or, in some cases, they are doing away with it entirely.

More and more businesses in America are simply saying: I cannot afford to provide health insurance to my workers. Despite all of that-- that we spend almost twice as much per person on health care as any other country--people will say: Since you spend all that money, the results must be great. But that is not the case. The bottom line is we get poor value for what we spend.

According to the World Health Organization, the United States ranks 37th in terms of health system performance. We are far behind many other countries in terms of such important indices as infant mortality, life expectancy, and preventable deaths.

So we are spending almost double what any other country on Earth is spending. We have 46 million without any health insurance, we have more who are underinsured, we have thousands who die because they cannot get to a doctor, and then in many other health care outcomes we are behind many other countries around the world--some of which are spending far less per person than we are spending.

It seems to me, as the health care debate in Congress heats up, we as a nation have to ask two fundamental questions. Different people will have different answers to them, but here are the two questions I think we have to ask: First, as a nation, should all Americans be entitled to health care as a right? That is the first question.

Honest people will have differences of opinion. Some people will say: You know what. Some people have big cars, some people have small cars. Some people have big houses, some people have small houses. Some people have good health insurance, some people have no health insurance. That is the way life goes. Some people hold that view.

I do not. I think in America we should understand that every single person should be entitled to quality, comprehensive, affordable health care. In fact, I think most Americans believe the same thing.

Second, if we are to provide quality health care to every man, woman, and child in this country, how do we do it in a way that does not bankrupt the Nation? How do we do it in a cost-effective way? Those are the two questions that we have to ask ourselves.

I think the answer to the first question is pretty clear and, in fact, it is one of the reasons Barack Obama was elected President of the United States. Most Americans do believe all of us should have health care and nobody should be left out of the system. We have a hard time understanding that Joe Smith who works for one company has good health care, and his neighbor, Mary Evans, who works for another company, does not have any health insurance at all. What sense is that?

I think as a nation we are coming to understand all of our people are entitled to health care as a right, as Americans, and the challenge we face is how do we do it in a cost-effective way. In that regard, I think--and I obviously speak just for myself--the evidence is overwhelming that we must end the private insurance company domination of health care in our country and move toward a publicly funded, single-payer, Medicare-for-all approach. I think the evidence is overwhelming that if you want universal, comprehensive, quality health care for all people, that is actually the only way you can do it.

Our current private health insurance system is the most costly, wasteful, complicated, and bureaucratic in the world. Just today--not yesterday, just today--I spoke to an individual who has a law degree, a very smart guy. His wife has a Ph.D. They went through the Federal employee benefit package. Between a Ph.D. and a lawyer, they spent hours trying to figure out what particular program could work best for them.

All over America, people are spending countless hours trying to figure out: Is it this program? Is it that program? I am young; I might not get sick but, you know, I have a history of cancer in my family. Should I get comprehensive? Should I get a high deductible? If I am a small business I can only negotiate this, if I am General Motors I can self insure. What should I do?

The answer is, there are 1,300 separate private insurance companies in America peddling thousands and thousands of different plans. Let's be very clear, if in fact, anybody has not caught on yet; the function of a private health insurance company is not to provide health care. It is to make as much money as possible. That is what its reason for existence is about.

In fact, when a private health insurance company denies health care, it makes more money. In fact, the record is pretty clear that private health insurance companies have given bonuses to people, their own employees, who are successful in throwing people off of the insurance policy because those people were running up high health care costs. Thus, we have the insane phenomenon of something called a preexisting condition.

What a term that is, preexisting condition--meaning a person cannot get coverage for the illness they need to be covered for most. The person who had cancer 3 years ago and is worried about a recurrence of cancer--sorry, we can't provide insurance to you.

Then you have other circumstances where somebody gets really sick, runs up a high medical bill, and the insurance company says: Oh, we don't want to continue your policy because we had to pay out so much money. We want to go to some young guy who can run the marathon and promises us never to get sick. Those are the guys we want to cover.

This is an insane system. It is a wasteful system. It is a bureaucratic system. How many people are spending half their lives on the telephone, arguing with insurance companies to cover the claims they thought they were covered for? So people on one end of the phone are spending huge amounts of time and money doing that, and at the other end of the phone we are paying someone to tell us we don't have coverage for what we thought we did have coverage.

With thousands of different health benefit programs designed to maximize profits, not provide health care, private health insurance companies spend an incredible 30 percent of each health care dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions.

One of the lovely things the insurance companies do and the pharmaceutical companies do is, after they rip you off and they make huge profits, they take some of that money to hire all these fancy guys in Washington, DC, to protect the status quo.

The bottom line is--and all of the evidence makes this clear--public programs such as Medicare, Medicaid, the SCHIP Program, and the Veterans' Administration are administered for far less money than are private health insurance companies.

In recent years, while we have experienced an acute shortage of primary

health care doctors, nurses, and dentists, we are paying for a huge increase in health care bureaucrats and bill collectors. Here is the insanity, the dysfunctionality of the current system: We do not have enough primary health care doctors, we don't have enough dentists, we do not have enough nurses, we do not have enough medical personnel--we don't have enough of those people, but over the last three decades we have seen an explosion in the number of health care bureaucrats and people who are bill collectors.

To my mind, I would rather see somebody hired who can help somebody get well or prevent disease, not somebody on the telephone billing or arguing about what we owe or do not owe. The fact is, over the last three decades the number of administrative personnel has grown by 25 times the numbers of physicians--25 times more bureaucrats than physicians. We do not need health care bureaucrats pushing paper. We need primary health care doctors delivering babies, taking care of the elderly, and taking care of those people who are sick.

Not surprisingly, while health care costs are soaring, so are the profits of private health insurance companies. From 2003 to 2007, the combined profits of the Nation's major health insurance companies increased by 170 percent. Health care costs are soaring, profits of the health insurance companies are also soaring, and while more and more Americans are losing their jobs and health insurance, the top executives in the industry are receiving lavish compensation packages. It is not just William McGuire, the former head of United Health, who several years ago accumulated stock options worth an estimated $1.6 billion.

OK, $1.6 billion a few years ago for the CEO of United Health and we do not have enough money to provide health care to people who are uninsured? It is not just the head of Cigna, Edward Hanway, who made more than $120 million in the last 5 years. The fact is, CEO compensation for the top private health insurance companies now averages over $14 million apiece.

Moving toward a national health insurance program which provides cost-effective, universal, comprehensive, and quality health care for all will not be easy. It is the major political struggle that we face right now. The powerful special interests--and they are all over Capitol Hill. The lobbyists are here. In the midst of the recession, I would suggest that while unemployment in general is soaring, my strong guess is that unemployment for health care lobbyists and pharmaceutical industry lobbyists is going down. Those guys have plenty of work, and they are making plenty of money. I am quite confident that those lobbyists will wage an all-out fight to make sure we maintain the current dysfunctional system which enables them, the insurance companies and the drug companies, to make millions and billions of dollars in profits.

In recent years they have spent hundreds of millions on lobbying, campaign contributions, and advertising with unlimited resources. We have no reason to believe they will not continue to spend as much as they need. But at the end of the day, as difficult as it may be, the fight for a national health care program will prevail. Decade after decade, all over this country people fought for a civil rights movement which said we will judge human beings not on their color but on their character, who they are as a human being. The struggle for women's rights went on decade after decade before women had the right to vote or had a seat at the table.

In my view, the struggle for health care is the civil rights struggle of today, and I believe 30 years from now, 50 years from now, people will look back and say: I don't believe there was a time in America where people who got sick couldn't find a doctor, where people went bankrupt because they committed the crime of being sick or having cancer. I do not believe that.

Our job is to bring that day when every American has health care as a right in a comprehensive, cost-effective manner. Our job is to make that day come sooner rather than later. If we work together and if we have the courage to stand up to the big money interests who want to maintain the status quo, we, in fact, can do that.

Mr. President, I yield the floor.

Mr. President, I am pleased to introduce legislation to establish a Home Energy Retrofit Finance Program. My office has worked closely with a number of stakeholders and experts in developing this Program. It is supported by the Vermont Energy Investment Corporation, the National Trust for Historic Preservation, Green for All, the Apollo Alliance, and the Union of Concerned Scientists, because they know that improving residential sector energy use is a strategy to address global warming, save families on their utility bills, and create jobs.

Households across the Nation will be able to lower their energy bills and generate their own renewable energy through the Program. It would provide initial capital to States, according to the established State energy program formula, to set up state revolving finance funds. These State funds would in turn provide financial support for local government programs, such as clean energy district financing, and energy utility programs, such as on-bill financing.

There are already a number of innovative programs to help finance residential energy efficiency and renewable energy across the country. For example, States such as Vermont, New Mexico, California, Virginia, Texas, and Maryland have authorized local governments to provide financing to homeowners for energy improvements. Homeowners then can pay back the cost of the improvements over time on their property tax bills.

The Home Energy Retrofit Finance Program would give these efforts a boost by supporting local government and utility programs that provide households with cost-effective financing for energy efficiency measures and renewable energy. This Program offers a win-win situation where we can achieve our economic and environmental goals. I ask that my colleagues consider the merits of the Home Energy Retrofit Finance Program as we move forward with comprehensive energy and climate change legislation.

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

Mr. President, I am pleased to introduce legislation to establish a Home Energy Retrofit Finance Program. My office has worked closely with a number of stakeholders and experts in developing this Program. It is supported by the Vermont Energy Investment Corporation, the National Trust for Historic Preservation, Green for All, the Apollo Alliance, and the Union of Concerned Scientists, because they know that improving residential sector energy use is a strategy to address global warming, save families on their utility bills, and create jobs.

Households across the Nation will be able to lower their energy bills and generate their own renewable energy through the Program. It would provide initial capital to States, according to the established State energy program formula, to set up state revolving finance funds. These State funds would in turn provide financial support for local government programs, such as clean energy district financing, and energy utility programs, such as on-bill financing.

There are already a number of innovative programs to help finance residential energy efficiency and renewable energy across the country. For example, States such as Vermont, New Mexico, California, Virginia, Texas, and Maryland have authorized local governments to provide financing to homeowners for energy improvements. Homeowners then can pay back the cost of the improvements over time on their property tax bills.

The Home Energy Retrofit Finance Program would give these efforts a boost by supporting local government and utility programs that provide households with cost-effective financing for energy efficiency measures and renewable energy. This Program offers a win-win situation where we can achieve our economic and environmental goals. I ask that my colleagues consider the merits of the Home Energy Retrofit Finance Program as we move forward with comprehensive energy and climate change legislation.

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

I yield the floor and suggest the absence of a quorum.

Madam President, I rise today to introduce the Energy Market Manipulation Prevention Act.

Did you know we are in the midst of the worse economic crisis since the Great Depression? Millions of our fellow Americans are losing their homes, losing their jobs, losing their life savings, losing the ability to send their kids to college and, in many ways, they are losing the hope that their own children will have a brighter future and a better life than they have had. It is a very unusual moment in the history of our country.

In the midst of all of this concern and decline in the standards of living of millions of Americans, the last thing that our country needs right now is to see our people be ripped off at the gas pump this summer because of the speculators on Wall Street. Some of the very same people who caused this recession and have received the largest taxpayer bailout in American history are allowed to jack up oil prices through price manipulation and outright fraud.

This is obviously not only an issue for the moment for millions and millions of people who drive to work every day, but for truckers and farmers and all people who are dependent upon gas; and it is also an issue for many parts of our country, such as Vermont, where a lot of our people heat with oil. We are not going to sit around idly and watch the price of oil artificially rise so that elderly people who heat with oil are unable to adequately heat their homes in the wintertime.

Unfortunately, this artificial increase in oil and gas prices is exactly what is happening now, as it occurred similarly last summer, when the price of oil hit $147 a barrel. The price of gas at the pump was over $4 a gallon, and truckers paid more than $5 a gallon for diesel fuel. That is where we were last summer, and we are heading back there right now, unless Congress moves in an aggressive way to say no to speculation on oil futures.

As you know, the price of oil is supposed to be based on the fundamentals of supply and demand, not by excessive speculation. What all of us learned in economics 101 is that if there is limited supply and a lot of demand, the price of the product goes up. If there is a lot of supply and limited demand, the price goes down. That is one of the basic tenets of free market capitalism.

But interestingly, last month, crude oil inventories in the United States were at their highest level on record, while demand for oil in the United States dropped to its lowest level in more than a decade. In other words, there was a record amount of supply and less demand than we have seen over the last 10 years. Further, the International Energy Agency recently predicted that global demand for oil will drop this year to its lowest level since 1981.

What is going on? Demand is going down, supply is high, and what the fundamentals of economic theory tell us is that gas and oil prices will go down. But as everybody who fills up their gas tank today understands, that is certainly not the case, because gas and oil prices are going up.

Despite the record supply of oil and reduced demand, prices are going up, not down. In fact, the national average price of gasoline has jumped from $1.64 a gallon late last year to over $2.60 today. Crude oil prices recently reached a 7-month high.

The American people have a right to ask why is this happening, in contradiction to the basic economic process of supply and demand, and we have a right and the obligation to act to protect those consumers. The increased prices that millions of motorists are currently seeing have caused severe financial hardship for American families, truckers, small businesses, airlines, and farmers. It is putting enormous strain on an economy already in the throes of a deep recession.

We passed the stimulus package in order to create millions of jobs, in order to put money into the hands of working people, many of whom had lost their jobs. And now what we are seeing, as a result of this artificial increase in the price of gas and oil, is that those tax breaks we gave to working families are going not into the local economy, they are going right back to Wall Street and speculation, and they are going to the oil companies.

All of us have a responsibility to do everything we can to lower oil and gas prices immediately, so that they reflect supply and demand fundamentals, not excessive speculation. Therefore, the legislation I am introducing today will require the Commodities Futures Trading Commission to use its emergency powers to prevent the manipulation of oil prices and empower the CFTC with new authority to prohibit excessive speculation in the oil market.

Last July, the House of Representatives passed similar legislation by a vote of 402 to 19--widely bipartisan.

But that legislation, unfortunately, did not become law. In addition, this legislation would also require the CFTC to, No. 1, immediately classify all bank holding companies and hedge funds engaged in energy futures trading as noncommercial participants and subject them to strict position limits.

No. 2, this legislation would eliminate the conflict of interest that arises when a firm, a large Wall Street financial institution, has employees under one umbrella responsible for predicting the future price of oil--the so-called analysts--while the same company controls physical oil assets and trading energy derivatives.

No. 3, this legislation would immediately revoke all staff no-action letters for foreign boards of trade that have established trading terminals in the United States for the purpose of trading U.S. commodities to U.S. investors.

I am delighted that Bart Chilton, one of the commissioners at the U.S. Commodity Futures Trading Commission, has supported this legislation.

Madam President, I ask unanimous consent that his letter to me be printed in the Record.

Let me briefly quote from the letter.

He says:

As you know, the Commodity Exchange Act provides the CFTC

with broad emergency authority to take action, in its

discretion, in order to maintain or restore orderly trading.

In your proposed legislation, you have identified critically

important areas of concern--excessive speculation in energy

commodities, classification of bank holding companies and

limits on their energy trading, hedge fund registration,

classification and trading limits, conflicts of interest by

entities that both trade and advise in the energy arena, and

foreign market access. I wholeheartedly agree with you that

the time to act on these issues is now, and the CFTC should

aggressively utilize all available authorities as

appropriate, including but not limited to emergency authority

as currently defined in the CEA, to address these pressing

issues.

Madam President, I thank the Commissioner for his support of this legislation.

On May 28, I wrote to Gary Gensler, the new Chairman of the CFTC, urging him to undertake many of these initiatives. Last week, in my office, I discussed this issue with Mr. Gensler. He indicated that he has instructed his staff to give him a list of all of the options available to the CFTC to respond to these concerns. While I appreciate Mr. Gensler's efforts on this issue, I hope this legislation will spur the CFTC to take immediate action to lower oil prices.

The bottom line is, right now, at a time when unemployment is soaring, when the middle class is struggling to keep its head above water, the prices at the gas pump are soaring, and we worry about what oil prices in the northern parts of our country will be in the wintertime, there is very strong evidence to suggest that what we are talking about is not supply and demand but excessive speculation on the part of Wall Street in terms of pushing up oil futures.

This Congress must act to protect the middle class and working people of this country, the consumers of this country. It is time for us to demand that the CFTC take the action that is necessary.

Madam President, I rise today to introduce the Energy Market Manipulation Prevention Act.

Did you know we are in the midst of the worse economic crisis since the Great Depression? Millions of our fellow Americans are losing their homes, losing their jobs, losing their life savings, losing the ability to send their kids to college and, in many ways, they are losing the hope that their own children will have a brighter future and a better life than they have had. It is a very unusual moment in the history of our country.

In the midst of all of this concern and decline in the standards of living of millions of Americans, the last thing that our country needs right now is to see our people be ripped off at the gas pump this summer because of the speculators on Wall Street. Some of the very same people who caused this recession and have received the largest taxpayer bailout in American history are allowed to jack up oil prices through price manipulation and outright fraud.

This is obviously not only an issue for the moment for millions and millions of people who drive to work every day, but for truckers and farmers and all people who are dependent upon gas; and it is also an issue for many parts of our country, such as Vermont, where a lot of our people heat with oil. We are not going to sit around idly and watch the price of oil artificially rise so that elderly people who heat with oil are unable to adequately heat their homes in the wintertime.

Unfortunately, this artificial increase in oil and gas prices is exactly what is happening now, as it occurred similarly last summer, when the price of oil hit $147 a barrel. The price of gas at the pump was over $4 a gallon, and truckers paid more than $5 a gallon for diesel fuel. That is where we were last summer, and we are heading back there right now, unless Congress moves in an aggressive way to say no to speculation on oil futures.

As you know, the price of oil is supposed to be based on the fundamentals of supply and demand, not by excessive speculation. What all of us learned in economics 101 is that if there is limited supply and a lot of demand, the price of the product goes up. If there is a lot of supply and limited demand, the price goes down. That is one of the basic tenets of free market capitalism.

But interestingly, last month, crude oil inventories in the United States were at their highest level on record, while demand for oil in the United States dropped to its lowest level in more than a decade. In other words, there was a record amount of supply and less demand than we have seen over the last 10 years. Further, the International Energy Agency recently predicted that global demand for oil will drop this year to its lowest level since 1981.

What is going on? Demand is going down, supply is high, and what the fundamentals of economic theory tell us is that gas and oil prices will go down. But as everybody who fills up their gas tank today understands, that is certainly not the case, because gas and oil prices are going up.

Despite the record supply of oil and reduced demand, prices are going up, not down. In fact, the national average price of gasoline has jumped from $1.64 a gallon late last year to over $2.60 today. Crude oil prices recently reached a 7-month high.

The American people have a right to ask why is this happening, in contradiction to the basic economic process of supply and demand, and we have a right and the obligation to act to protect those consumers. The increased prices that millions of motorists are currently seeing have caused severe financial hardship for American families, truckers, small businesses, airlines, and farmers. It is putting enormous strain on an economy already in the throes of a deep recession.

We passed the stimulus package in order to create millions of jobs, in order to put money into the hands of working people, many of whom had lost their jobs. And now what we are seeing, as a result of this artificial increase in the price of gas and oil, is that those tax breaks we gave to working families are going not into the local economy, they are going right back to Wall Street and speculation, and they are going to the oil companies.

All of us have a responsibility to do everything we can to lower oil and gas prices immediately, so that they reflect supply and demand fundamentals, not excessive speculation. Therefore, the legislation I am introducing today will require the Commodities Futures Trading Commission to use its emergency powers to prevent the manipulation of oil prices and empower the CFTC with new authority to prohibit excessive speculation in the oil market.

Last July, the House of Representatives passed similar legislation by a vote of 402 to 19--widely bipartisan.

But that legislation, unfortunately, did not become law. In addition, this legislation would also require the CFTC to, No. 1, immediately classify all bank holding companies and hedge funds engaged in energy futures trading as noncommercial participants and subject them to strict position limits.

No. 2, this legislation would eliminate the conflict of interest that arises when a firm, a large Wall Street financial institution, has employees under one umbrella responsible for predicting the future price of oil--the so-called analysts--while the same company controls physical oil assets and trading energy derivatives.

No. 3, this legislation would immediately revoke all staff no-action letters for foreign boards of trade that have established trading terminals in the United States for the purpose of trading U.S. commodities to U.S. investors.

I am delighted that Bart Chilton, one of the commissioners at the U.S. Commodity Futures Trading Commission, has supported this legislation.

Madam President, I ask unanimous consent that his letter to me be printed in the Record.

Let me briefly quote from the letter.

He says:

As you know, the Commodity Exchange Act provides the CFTC

with broad emergency authority to take action, in its

discretion, in order to maintain or restore orderly trading.

In your proposed legislation, you have identified critically

important areas of concern--excessive speculation in energy

commodities, classification of bank holding companies and

limits on their energy trading, hedge fund registration,

classification and trading limits, conflicts of interest by

entities that both trade and advise in the energy arena, and

foreign market access. I wholeheartedly agree with you that

the time to act on these issues is now, and the CFTC should

aggressively utilize all available authorities as

appropriate, including but not limited to emergency authority

as currently defined in the CEA, to address these pressing

issues.

Madam President, I thank the Commissioner for his support of this legislation.

On May 28, I wrote to Gary Gensler, the new Chairman of the CFTC, urging him to undertake many of these initiatives. Last week, in my office, I discussed this issue with Mr. Gensler. He indicated that he has instructed his staff to give him a list of all of the options available to the CFTC to respond to these concerns. While I appreciate Mr. Gensler's efforts on this issue, I hope this legislation will spur the CFTC to take immediate action to lower oil prices.

The bottom line is, right now, at a time when unemployment is soaring, when the middle class is struggling to keep its head above water, the prices at the gas pump are soaring, and we worry about what oil prices in the northern parts of our country will be in the wintertime, there is very strong evidence to suggest that what we are talking about is not supply and demand but excessive speculation on the part of Wall Street in terms of pushing up oil futures.

This Congress must act to protect the middle class and working people of this country, the consumers of this country. It is time for us to demand that the CFTC take the action that is necessary.

Mr. President, let me be very clear. Our health care system is disintegrating. Today, 46 million Americans have no health insurance and even more are underinsured with high deductibles and copayments. At a time when 60 million people, including many with insurance, do not have access to a doctor of their own, over 18,000 Americans die every year from preventable illnesses because they do not get the medical care they should. This is six times the number of people who died at the tragedy of 9/11, but this occurs every single year, year after year. In the midst of this horrendous lack of coverage, the United States spends far more per capita on health care than any other Nation, and health care costs continue to soar. At $2.4 trillion and 18 percent of our GDP, the skyrocketing cost of health care in this country is unsustainable, both from a personal and macroeconomic perspective.

At the individual level, the average American spends about $7,900 per year on health care--$7,900 per individual every year. Despite that huge outlay, a recent study found that medical problems contributed to 62 percent of all bankruptcies in 2007. From a business perspective, General Motors spends more on health care per automobile than on steel--more on health care than on steel--while small business owners are forced to divert hard-earned profits into health coverage for their employees rather than new business investments. Because of rising health care costs, many businesses are cutting back drastically on their level of health care coverage or they are doing away with it entirely.

Further, despite the fact that we spend almost twice as much per person on health care as any other Nation, our health care outcomes lag behind many other countries. We get poor value for what we spend. According to the World Health Organization, the United States ranks 37th--37th--in terms of health system performance, and we are far behind many other countries in terms of such important indices as infant mortality, life expectancy, and preventable deaths. In other words, we are spending huge amounts of money, but what we are getting for that investment does not compare well to many other countries that spend a lot less than we do.

As the health care debate heats up in Washington, we as a nation have to answer two fundamental questions.

First, should all Americans be entitled to health care as a right and not a privilege? That is the way every other major country treats health care and the way we respond to such other basic needs as education, police, and fire protection. One hundred or more years ago, this country decided that every young person, regardless of income, is going to get a primary and secondary education because that is the right thing to do and good for the country. But unlike every other major industrialized Nation, we have not come to that same conclusion that health care is a right.

Second, if we are to provide quality health care to all, the next question is, how do we accomplish that in the most cost-effective way possible? We can provide health care to all people in a lot of ways, but some of those ways will essentially bankrupt this country. What is the most cost-effective way to provide quality health care to every man, woman, and child in this country?

In terms of the first question I asked: Should all Americans be entitled to health care as a right, I think the answer to that question is pretty clear and is, in fact, one of the reasons Barack Obama was elected President of the United States. Most Americans do

believe all of us should have health care coverage and that nobody should be left out of the system. The real debate is how we accomplish that goal in an affordable and sustainable way. In that regard, I think the evidence is overwhelming that we must end the private insurance company domination of health care in our country and move toward a publicly funded, single-payer, Medicare-for-all approach.

Our current private health insurance system is the most costly, wasteful, complicated, and bureaucratic in the world. Its function is not to provide quality health care for all of our people but to make huge profits for the people who own the companies. That is what private health insurance is about. With thousands of different health benefit programs designed to maximize profits, private health insurance companies spend an incredible 30 percent of each health care dollar on administration and billing. Thirty cents of every dollar is not going to doctors, nurses, medicine, medical personnel; it is going to bureaucracy and administration. Included in that spending are not only general administration and billing but exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions. Public programs such as Medicare, Medicaid, and the VA are administered for far less money.

In recent years, while we have experienced an acute shortage of primary health care doctors as well as nurses, as well as dentists, and many other health care personnel, we are paying for a huge increase in health care bureaucrats and bill collectors. Over the last three decades, the number of administrative personnel has grown by 25 times the number of physicians. Instead of investing in primary health care, instead of investing in doctors, instead of addressing the nursing shortage, where our health care dollars are going is to health insurance bureaucrats who spend half their lives on the telephone telling us we are not covered for the procedures we thought we had paid for. That is a dumb way to spend health care dollars.

Further, and not surprisingly, while health care costs are soaring, so are the profits of private health insurance companies. From 2003 to 2007, the combined profits of the Nation's major health insurance companies increased by 170 percent. Health care costs are soaring; people can't afford health insurance. Yet the profits of the private health insurance companies have gone up by 170 percent from 2003 to 2007. While more and more Americans are losing their jobs and their health insurance, the top executives in the industry are receiving lavish compensation packages. It is not just William McGuire, the former head of United Health, who several years ago accumulated stock options worth an estimated $1.6 billion, or CIGNA CEO Edward Hanway, who made more than $120 million in the last 5 years. It is not just them. It is the reality that CEO compensation for the top seven health insurance companies now averages $14.2 million. Forty-six million Americans have no health insurance, more are underinsured, and we apparently have the money to pay exorbitant compensation packages to the heads of private health insurance companies.

Moving toward a national health insurance program, which provides cost-effective, universal, comprehensive, and quality health care for all, will not be easy. That is an understatement. It will not be easy. The powerful special interests, the insurance companies, the drug companies, and the medical equipment suppliers, among others, will wage an all-out fight to make sure we maintain the current system which enables them to make billions and billions of dollars every year in profits.

In recent years, these special interests have spent hundreds of millions of dollars on lobbying, on campaign contributions, and advertising, and with unlimited resources. They can make out a check as big as they need. They will continue to spend as much as they need in order to preserve this dysfunctional health care system from which they profit so much.

But at the end of the day, as difficult as it may be, the fight for a national health care program will prevail. Like the civil rights movement, the struggle for women's rights, and other grassroots efforts, justice in this country is often delayed, but it will not be denied. We shall overcome.

Mr. President, I yield the floor and suggest the absence of a quorum.