Floor Statements

Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Madam President, I ask unanimous consent to add time to the order for morning business so I can speak for 25 minutes.

Madam President, it is a very important issue that is going to be coming before the Senate very shortly, and it deals with the Medicare prescription drug benefit and whether the Government ought to negotiate prices as opposed to what is in the Medicare Part D bill. I wish to speak on that subject because this issue is very important to the seniors of America. It is important for the public and for Medicare beneficiaries to fully understand these proposed changes. It is equally important we explore in depth the effects these changes are going to have on this program and particularly the negative impact on the senior citizens of our country. So I am going to spend some time this week dealing with this issue.

First, everyone should recognize that political opponents of the drug benefit have, in every way, done everything they can to tear apart and denigrate this new benefit that the vast majority of seniors find to their liking, based upon a lot of different polls that have been taken over the last 7 or 8 months. In fact, the opponents of this legislation have done this ever since the ink was barely dry on the bill we called the Medicare Modernization Act of 2003.

First they said that no plan would offer--meaning no benefit plan; the people, the administrators of the program--that none of these plans would offer the new drug benefit in the first place, that eventually the Government was going to end up doing it. Of course, we know that is not the fact. The plan is up and running, and the plans are offering so many.

Then, after it was up and running, these opponents of the legislation said, well, there were too many plans. They said it was too confusing, seniors would not be able to choose a plan. But 91 percent of seniors are covered by some plan that has prescription drugs in it, and surveys show overwhelming satisfaction by seniors with their plans.

Opponents suggested plans could change their prices and the drugs they cover at the drop of a hat without even almost any notice. This did not turn out to be the case. The opponents tainted beneficiaries' views of the benefits before it even got off the ground. You wondered whether the millions of people who signed up would ever sign up, hearing so much negative stuff about it. But they did sign up.

And, as we have heard from the opponents over and over again, one of the biggest criticisms about the drug benefit is that the Government does not negotiate with drugmakers for lower prices. So they have gone to great lengths to make it sound as if nobody is negotiating with the drug companies. It is, of course, correct that the Secretary of Health and Human Services does not do negotiation with drug companies. But it is absolutely not true there are not negotiations going on with drug companies. People who say that are completely nonsensical in their understanding of the legislation or maybe they have some ulterior motive of wanting to continue to degrade and denigrate a piece of legislation that seniors have accepted.

The idea behind the drug benefit is that multiple drug plans would compete with each other to get the lowest prices from manufacturers, to be the best negotiator, and to offer beneficiaries the best possible drug plan.

The pattern for this was the 40-year-old Federal Employees Health Benefit Plan that has worked so well for Federal employees. We patterned this program, Part D, after that: plans negotiating for Federal employees, getting a good price; plans that have membership of senior citizens negotiating with drug companies to get the best possible price for senior citizens who are in a particular plan.

But the opponents of this legislation do not like plans negotiating. They think the Government directly can do a better job of negotiating because they have a belief about Government always doing good, Government always doing the best. Their faith is in big Government because they lack faith in the American people. They find it very hard to believe anybody other than the Government could do a better job of negotiating.

Last week on the Senate floor, the senior Senator from Illinois said the law ``took competition out of the program so that [the drug companies] could charge what they want.'' Well, it did not take competition out of the program. Competition is what this program is all about.

In fact, the competition is working. Plans have no restrictions on the tools they can use to negotiate with drug companies. And, remember, these plans must be approved by the Secretary of Health and Human Services. Not every Tom, Dick, and Harry can go out and offer a plan and hoodwink seniors. There is control over these plans. But once the plan is approved, there are no restrictions on the tools they can use to negotiate. And, of course, this is very important because one thing we had learned is that Government is not actually a very good entity at figuring out what it should pay for drugs.

I have a chart in the Chamber with a quote from the Washington Post. They recognized this fact, that the Government cannot do a very good job of negotiating, where they said: ``Governments are notoriously bad at setting prices. . . .'' And then, as a matter of emphasis, it said: ``and the U.S. government is notoriously bad at setting prices in the medical realm.'' I will add to that: especially when it comes to medicine policy.

Now, we knew this because of the Government's experience for paying for drugs under another Medicare program, not Part D as in ``Donald,'' but Part B as in ``Bob,'' the one that pays for doctors. Those drugs are given during a physician's office visit, and they could be drugs such as oral cancer drugs.

Medicare payments for these drugs were based on what is called the average wholesale price. ``AWP'' is the moniker that is used for that. AWP is a little bit like the sticker price of a car. The sticker price on a car is not what you pay for the car. And the average wholesale price, AWP, is not what you pay for drugs. The joke was that AWP actually stood for ``Ain't What's Paid.''

Over the past decade, reports issued by the Office of the Inspector General, the Department of Justice, and the Government Accountability Office found that by relying on AWP, Medicare was vastly overpaying for these drugs.

So the Federal Government sets the price, and we end up wasting a lot of taxpayer money under Part B with the few drugs that Medicare was paying for before we passed Part D.

Recommendations were made to change payments so that they reflected actual market cost. The Clinton administration tried to make some of these changes, but after push-back from providers, it backed off. Congress took another run at this issue in 2003 in

the Medicare Modernization Act, and we were successful. Congress reformed how Medicare pays for these drugs under Part B as opposed to the drug program Part D. Medicare now based its payments for many of these drugs on what it ought to, a market-based price. This change is already saving taxpayers and beneficiaries, but it took years to get fixed. All that time Medicare and taxpayers paid too much for these drugs. Billions and billions of dollars were wasted.

I compliment President Clinton for trying to do something about it, but he couldn't get it done. Congress had to act. But when we had all of this track record, as we were writing the prescription drug bill, I, for one, didn't want to repeat that experience under the Medicare drug benefit. We also knew that Medicare overpays for a lot of other services and equipment. The bookshelves are full of other reports from the Government Accountability Office, from the Inspector General, from the Medicare Payment Advisory Commission, from the Congressional Budget Office, and others, about how Medicare is paying too much in too many areas where the Government pays for health care through Medicare.

For example, Medicare overpaid for durable medical equipment for years until the Republican-led Congress made changes in 2005 in what we called the Deficit Reduction Act. In fact, just 12 months ago, now, that was a big issue before the Congress.

Each year, the Office of Inspector General issues its Red Book which presents cost-saving recommendations. The books are usually 50 or more pages long, and the recommendations span all aspects of Medicare-- hospitals, physicians, home health, the Medicare Part D plans, among others. And this is more evidence on many areas where Medicare doesn't get the best deal, where the Government doesn't get the best deal. So Government doesn't always know best. In fact, the situation is so bad that several years ago, Congress created what is called the Medicare Payment Advisory Commission, also known as MedPAC, to provide advice to us in Congress and to the Center for Medicare Services on what we ought to pay for services. And every year Congress hears recommendations from MedPAC addressing Medicare overpayments; yes, trying to do something about wasting the taxpayers' money, paying more than we should for health care for our senior citizens.

But even though we have MedPAC, experts studying this, coming out with recommendations, it takes Congress or the Secretary of Health and Human Services far too many years to make the changes to save the taxpayers money--more evidence that Government doesn't always know best when it sets prices.

In making recommendations, MedPAC looks at profit margins as an example. One type of provider had been found to have a margin of 16 percent off of Medicare payments. Congress has been able to act on many MedPAC recommendations, but it is not easy. There is always some special interest out there fighting saving the taxpayers money. As chairman of the Finance Committee, I received letters from Members saying, ``Please don't cut benefits for this provider group or that provider group.'' So as the Clinton administration found, letters like that, where they come to Congress or to the administration, can make it difficult in very short order to solve a lot of these overpayment problems, despite compelling evidence of overpayment, despite the high profit margins, despite the fact that the proposed change could save the taxpayers billions of dollars.

The architects of the drug benefit--and I am one of them--were concerned that this same kind of dynamic would happen again. So 3 years ago, when we wrote the bill, we tried to deal with that problem. Political pressures on the Medicare drug benefit would tie the hands of the Secretary of Health and Human Services. If that happened, the program would be unmanageable, and the costs would skyrocket, just as they have in many of these other instances where the Government is setting the price. So, instead, Congress put competing private plans in charge of negotiating; again, following on the pattern of 40 years of the Federal Employees Health Benefits Program. So under the Part D Medicare prescription drug program, these health plans and their pharmacy benefit managers, because they have years of experience in this arena--it is what they do--they negotiate, and Health and Human Services has had very little experience and a very dismal track record in doing it.

These plans and managers have powerful bargaining clout in the market. They manage the drug coverage for tens of millions of people. There are plans that cover upwards of 50 million people--75 million in one case--far more than the 41 million Medicare beneficiaries. So, clearly, Medicare beneficiaries account for a large number of all prescriptions filled each year. Some might argue that 41 million beneficiaries have more clout than 75 million nonbeneficiaries. But numbers alone do not necessarily translate into lower cost. It is what is done to leverage those numbers that leads to lower costs.

That leverage comes from the plan being able to say to a drug company something like: I can get a better deal on a different drug that has the same clinical effect made by manufacturer Y. So thank you for your offer, but I am leaving the table.

Some plans get a better deal on drug A and put it on their formulary. Some plans get a better deal on drug B. But many experts agree, and experience suggests, that it would be difficult for Medicare itself to walk away from the table; in other words, the Government people doing the negotiating. There would be enormous pressure to cover everything and, if it did, the negotiating power lies then with the manufacturers and not with Medicare.

In fact, in a November 2 Wall Street Journal editorial, Dr. Allen Enthoven, an economist at Stanford University, wrote:

When the government negotiates its hands are tied because

there are few drugs it can exclude without facing political

backlash from doctors and the Medicare population, a very

influential group of voters.

Yesterday's New York Times quoted Dr. Alan Garber, the director of the Center for Health Policy at Stanford University, on the same subject. Dr. Garber said:

To obtain drugs at low prices, a purchaser must be able to

say no to covering a particular drug.

He went on to say:

[I]f you cannot walk away from a deal, there's no way you

can be sure of obtaining [the lowest possible] price.

Dr. Garber's point is exactly on point. The Medicare drug benefit recognizes that the Government would be a weaker negotiator. So as we set it up, it relies upon private sector plans to do the negotiating, as has been done for 40 years under the Federal Employees Health Benefits Program. We believed then that the private sector could be a tough negotiator, and we had a way to make competition work.

When Congress finished work on the new drug benefit in 2003, we knew it was an experiment. Nothing like this had been tried on this scale. Here is what we learned: Private competition works. It has been very successful in keeping costs down. These plans that negotiate their bids have come in lower than we even expected. This year they were down 10 percent from last year's bids. How many commodities do you see in America where you are going to find something 10 percent less this year than last year?

It happens that premiums are lower for people joining these plans; the premiums that they pay are lower than they were estimated to be. Before 2006, Medicare's chief actuary estimated that the average monthly premium would be $37 a month. But because of competition, it was actually $23 in 2006. That is 38 percent lower than expected. And because of the strong competition between plans, the average premium for beneficiaries is expected to be about $22. That is $1 cheaper this year than in 2006. The net cost to the Federal Government is also lower than expected. Just today the official Medicare actuaries are announcing that the net 10-year cost of Part D has dropped by $189 billion over the original budget window used when the Medicare Modernization Act was enacted in 2003. That is, in fact, a 30-percent drop in actual cost compared to what was projected when the bill was being written.

Cost overruns is the name of the game with most people doing business with the Federal Government. In this particular case, this is an exception to cost overruns. This is where things are

coming in $189 billion less than bureaucrats projected they would cost when the bill was written. Of course, States are involved in this as well because they had a lot of senior citizens on what we call Medicaid for low-income people. States are saving money in lower contributions. These are referred to as clawback payments. So State payments are now projected to be $37 billion less over a 10-year period, and that is 27 percent lower than what we thought they would be when the legislation was written.

Just in the year 2006, the 50 States saved $700 million. The plans are negotiating lower prices for drugs. Let's take the top 25 drugs used by seniors. Using them, the Medicare prescription drug plans have been able to negotiate prices that are, on average, 35 percent lower than the average cash price at the retail pharmacies. That is 35 percent lower. Some examples: Lipitor is 15 percent lower; Anetol, 63 percent lower; Norvas, 28 percent lower; Fosamax, 30 percent lower.

When the drug benefit was signed into law, we believed it would work. We believed it would hold down costs. That is certainly happening today, now going into the second year of experience with this legislation. At the time it was signed into law, we also said that if it did not work, if the negotiating model we wrote into the legislation did not hold costs down, then Congress would need to reexamine the whole setup. That makes sense. But if costs grew too fast, then the whole idea, obviously, would have to be revisited. Maybe we would have to restrict access to drugs. Maybe we would have to rely more on mail- order pharmacies, instead of liberal access to local retail pharmacies. Maybe more drastic cost-cutting measures would be needed. We thought of all those things as we were writing this legislation.

But as it turns out now, 3 years later, since the President signed the bill, that is not the case. Everyone has heard the old saying, ``If it ain't broke, don't fix it.'' That certainly applies here, and the evidence shows it. I would be the first one to say the Medicare drug benefit is not perfect. There are improvements that can be made. The Senate version of the drug bill had some important features that I hope we can revisit at some point. Congress should look at ways to make it easier for low-income beneficiaries to get the additional assistance they need by eliminating the low-income subsidy asset tax. We need to look at payments to pharmacies and make some reforms in that area. We need to look at ways to simplify the enrollment process. And there are other areas, too, where we can make improvements.

But to emphasize one area that is working very well, it is the negotiating power of the Medicare drug plans. They have shown their ability to hold down costs, so it is working. The pleas from the drug plans' opponents to put the Government--because they believe in big Government--in charge of negotiating are, quite frankly, about politics, not policy. These voices want to score political points with the drug benefit. It saddens me that we are going to start off this year with a new Democratic-controlled Congress playing politics with Medicare and raising issues that could harm our senior citizens as opposed to benefiting them.

But that is what this issue is all about; it is about politics. It is not about saving money because this program, through negotiations by the drug plans, is already saving money. It is surely not about improving the program. In fact, the Congressional Budget Office looked at the proposals made last year to have the Secretary negotiating drug prices, and they concluded they would not achieve any savings. So around here the Congressional Budget Office is like God. If they say something costs something and you don't have an offset for it, they are so much of a god around here, if you try to get it done, you have to have 60 votes to get it done. Now we have the Congressional Budget Office saying there are no savings, because the Government negotiates instead of having the plans negotiate. During the debate on the Deficit Reduction Act of 2005, Senators Snowe, Wyden, McCain, and Stabenow offered an amendment to give the Secretary authority to negotiate with drug companies.

Here is what CBO said about that amendment: It would produce zero savings. So what is this amendment all about? If you are going to save senior citizens some money by having Government negotiate instead of the plans, you should not get a big zero out of the CBO.

I want to have a second chart observed by my colleagues. This is a person a lot of people 3 years ago were expressing was competent when he was judging that this bill would cost more than the CBO said it would cost, and that somehow the administration was playing games with these figures. All these figures ended up being too high because they are $189 billion lower than they were saying they were going to be. There are no cost overruns in this program as in every other program. I am going to refer to the chief actuary for Medicare who examined these proposals we are talking about and having the Government negotiate. He came up with the same conclusion: Direct price negotiations by the Health and Human Services Secretary would be unlikely to achieve prescription drug discounts of greater magnitude than those negotiated by the Medicare prescription drug plans responding to competitive forces.

Competition in the marketplace is what getting the consumer the best buy for the money is all about. Every day consumers benefit from competition. We wrote competition into this program 3 years ago, and that competition is working for the seniors. Now we have people who want to come out here and screw it all up for the senior citizens of America.

I hope we can put politics aside here and focus on some of the real improvements we could be making in the drug benefit program that I pointed out today that need to be made, and not deal with things that are working. ``If it ain't broke, don't fix it.''

Madam President, since no other Members are here, I suggest the absence of a quorum.

Mr. President, I am pleased to speak today to honor the career of Dr. Philip Royal Shipp, Jr., a devoted public servant who has served the Congress for nearly 30 years at the Congressional Research Service, CRS. During his tenure at the CRS, Dr. Shipp has served in several key management and leadership roles, demonstrating extraordinary levels of competence, intelligence, and intellectual creativity in each of these positions.

Most recently, Dr. Shipp has served as the Director of the Domestic Social Policy Division. The Domestic Social Policy Division offers the Congress research and analysis in many programs and policies that under the jurisdiction of the Senate Finance Committee, including the Medicare, Medicaid, and State Children's Health Insurance Programs, as well as Social Security, pensions, welfare, child welfare programs.

I have been honored to serve as chairman of the Finance Committee for 4 years and am pleased to continue my service as the ranking Republican on the committee. Analysts under Dr. Shipp's supervision have worked closely with my Finance Committee staff, briefing them on complex programs and policies, helping them in the drafting of legislation and participating in Senate Finance Committee hearings.

We Members of Congress simply could not do our work effectively without the support we recelve from organizations like the Congressional Research Service. There is simply no other organization with the reputation and the credibility of CRS. The work provided by CRS is always first rate, oftentimes quantitative and impeccably nonpartisan. Dr. Shipp, throughout his career, has embodied these characteristics.

Dr. Shipp began his Federal service in 1964 as an economist with the Federal Reserve. He was subsequently a progr analyst with the Office of Management and Budget and later the Acting Administrator of the Food and Nutrition Service. Dr. Shipp made significant contributions to the Food and Nutrition Service, including an expanded view of the public policy purposes of food assistance programs such as food stamps. He also was instrumental in establishing and expanding the agency's in- house capacity to analyze programs, study their effects, and estimate the impact of legislative and regulatory changes.

Dr. Shipp joined the Congressional Research Service in 1977 as a Senior Specialist in Social Legislation in the former Education and Public Welfare, EPW, Division. He spent a significant part of the next decade leading teams of CRS analysts in high-level, committee- requested, legislatively relevant research studies focused on health and income issues. Topics included health insurance for the uninsured, retirement income for an aging population, and work incentives in income support programs. Under Dr. Shipp's direction, CRS developed a framework and quantitative model to compare legislative options for a new retirement system for Federal workers; this model was used in the development of the Federal employee retirement system that is in place today. During this period, in 1984, Dr. Shipp also served as Executive Director of the Congressional Panel on Social Security Organization, which was charged with developing an organizational and management framework for an independent agency for Social Security. The panel's principal recommendations were reflected in the legislation that eventually created the independent Social Security Administration.

In 1989, Dr. Shipp became Associate Director of CRS for Research Planning and Coordination, where he guided efforts to evaluate and improve CRS services and operations and led several of tge agency's first strategic management reviews. He returned to EPW as

Division Chief in 1994 and became head of the expanded Domestic Social Policy Division in 1999. As Assistant Director for Domestic Social Policy, the largest research division within CRS, Dr. Shipp emphasized the building of analytic capacities, with a special focus on empirical analysis, as a way to enhance CRS' legislative support to Congress. He was instrumental in building CRS capacities in all areas of domestic social policy, in particular health policy analysis, Social Security and disability analysis, homeland and border secur, public health preparedness, and housing and welfare policy. He organized and staffed the division to respond to new challenges, in particular the heightened need for expertise in domestic intelligence and counterterrorism after the attacks of September 11, 2001. Dr. Shipp also conceived and implemented an initiative to enhance CRS' strong analytic work in issues associated with the aging of the population, by expanding the division's staff to include new analysts with expertise in specific relevant disciplines. Under Dr. Shipp's leadership, CRS also obtained and developed the capacity to use a micro-simulation model for analysis of the distributional impact of alternative policy options for Social Security reform.

I am informed that Dr. Shipp was an exceptional manager with a clear vision of how CRS should be of service to the Congress. He leaves a strong legacy that will have a profound effect on the Congress for years to come. I know that my colleagues join me in thanking him for his service and wishing him well as he embarks on new challenges ahead.

Mr. President, I rise to pay tribute to a fallen soldier from Greenfield, IA, LCpl Clinton Jon (C.J.) Miller, who was killed while serving his country as part of an improvised explosive device detection team in Iraq. My thoughts and prayers go out to his wife Jackie, his mother Susan, his father Kerby, and all his family and friends. I am sure I speak for all Iowans when I say that I am proud to call C.J. one of us. By all accounts, he was a fine marine who felt called to, and liked, military service. Family members say that he joined the Marines during wartime because he just felt he had to serve. Where would our country be without patriotic young Americans like C.J. who feel a call to serve their country? All Americans owe a debt of gratitude to this brave Marine. As his father said, ``He was a hero.'' Lance Corporal Miller's tremendous service and sacrifice should never be forgotten.

Sergeant James P. Musack

Mr. President, I rise to pay tribute to SGT James P. Musack of Riverside, IA, who tragically died as a result of a noncombat related incident while serving his country in Iraq. I am sure that all Iowans shared the same sense of sadness I felt when learning of the death of this young Iowa native. According to family and friends, he had found his calling in the military and all Americans owe him our deepest thanks for his service. Everyone joining the military knows the risks involved, but all Americans are indebted to brave patriots like James Musack who voluntarily assume those risks in order to defend our freedom and way of life. My prayers go out to his mother Yvette, his father Jim, and all his family and friends.

Lieutenant Colonel Paul J. Finken

Mr. President, I rise to pay tribute to LTC Paul J. Finken who has given his life for his country while serving in Iraq. He was 40 years old. Paul Finken was raised in Earling, IA, and I know all Iowans share my pride as we also mourn his loss. As a career Army officer, Lieutenant Colonel Finken had dedicated his life to the service of his country and we can never thank him enough for his service and his final sacrifice on behalf of our freedom.

In remembering Paul Finken, his family said, ``Paul was a devoted husband, loving father and respected leader. He loved being a soldier and respected the soldiers he worked with. He always set the example and would never ask his soldiers to do anything he wouldn't do himself. He will be greatly missed by his family and by all who knew him.'' My thoughts and prayers are with his wife Jackie and his three daughters, Emilie, Caroline, and Julia, for their loss. I hope it will be of some comfort to them to know that Paul died a hero.

Mr. President, I would like to take this opportunity to offer my congratulations and gratitude to an extraordinary Iowan. Marvin Van Haaften is stepping down from his distinguished position as director of the State of Iowa's Office of Drug Control Policy. He assumed this position after being named by Governor Tom Vilsack in 2002 and has served the State with honor and distinction since accepting the appointment.

I would like to take this opportunity to show Marvin Van Haaften the appreciation that the country, the State of Iowa, and myself personally have for his extensive commitment as a public servant. With more than 32 years of law enforcement experience, Marvin has taught extensively in the field of rural law enforcement, particularly death investigation and domestic violence crimes. He has provided local and national leadership on the role of law enforcement in strategic victim safety and offender apprehension, and is presently on the board of directors of the National Center for Rural Law Enforcement. Marvin also served on many local and State committees such as the Iowa Criminal and Juvenile Justice Planning Advisory Council, the board of the Mid-Iowa Narcotics Enforcement Task Force, the board of the 18-county South Central Iowa Clandestine Laboratory Task Force, and was the third vice president on the board of directors of the Iowa Association of Counties. Marvin was named Sheriff of the year in 1991 by the Iowa State Sheriffs' and Deputies' Association and served as its president in 1996. He is also a graduate of the FBI National Academy and has attended the National Sheriffs' Association's National Sheriffs' Institute and the FBI Law Enforcement Executive Development Institute. In 1997 he became a licensed Iowa medical examiner investigator.

Marvin knows firsthand the true value and significance of a loving family. He has been married to his wife Joyce for 42 wonderful years and has the blessings of 5 grown children and the joy of 11 grandchildren. It is through Marvin's love of family and law enforcement experience that enabled him to expose the destruction that drug abuse wreaks on families.

I share my appreciation for Marvin Van Haaften along with my fellow Iowans for the invaluable service he has provided to our State and country. He has proven himself to be versatile and fully capable of accepting and mastering the tasks placed before him. His enduring commitment to the safety of Americans is cause for admiration.

Again, I offer my congratulations and sincere appreciation to Marvin Van Haaften for his remarkable achievements throughout his extensive and highly regarded career. His hard work and determination will be missed in Iowa and throughout the Nation.

Mr. President, pretty soon we will be taking up the tax bill that includes trade provisions and health provisions. I will start debate on that so we can use our time very efficiently.

We are at the end of a very long road on what should be routine business: The two tax-writing committees have many provisions that have either expired or will expire shortly. The provisions cover three major areas of our jurisdiction: tax, trade, and health.

The foundation of this bill is a tax-writing committee's agreement that goes back to last summer on the core package of expiring provisions and other items that were dropped from a reconciliation tax bill we passed early last spring.

These provisions that were dropped were put together in what is called a trailer bill. That is an odd name for a bill. The bill has been held up for so long that some people have probably forgotten the reason for the nickname. I will remind everyone it is a trailer bill because it covers tax provisions that were dropped out of the tax reconciliation conference agreement of last spring. That conference agreement includes the cornerstones of both House and Senate bills which now have been signed by the President more than half a year ago.

The cornerstone of the House bill was a 2-year extension of the lower rates on capital gains and dividends. The cornerstone of the Senate bill last spring was an extension of the hold harmless on alternative minimum tax. I was pleased we covered the cornerstone of both bills. We only had revenue room to cover those two provisions.

The other provisions, principally what we call tax extenders, and what now will soon be before the Senate, were decided to travel in a bill that would follow, or trail. Hence, the name trailer bill.

The two cornerstones, alternative minimum tax and capital gains and dividends, were very important achievements by this Senate last summer and when they were originally passed in 2003. The 2-year extension of capital gains and dividends was a key priority for my conference though we were pleased to garner some Democratic votes, as well. It was a priority for Senators Frist, Kyl, Lott, Gregg, and others. I was pleased we were able to deliver on that priority in that conference last spring.

The alternative minimum tax was the other cornerstone. The alternative minimum tax, everyone recognizes, is a widespread tax problem because at least 15 million families will be affected. It was necessary to help those families so they were not paying a tax that was never intended to be foisted upon them in the first place and would not have been if the original alternative minimum tax passed in 1969 had been indexed. We assured all of these 15 million families that their lives would not be unnecessarily complicated by the tax system.

The trailer bill took several weeks of intense negotiations. The negotiators were Chairman Thomas of the House and Senator Baucus and me in the Senate. They were tough negotiations, but they produced a fair agreement. That agreement, with some additions by the leadership, was included in the trailer piece of the trifecta bill that came up in July where we tried to pass a reform of the estate tax with, sort of cute processes that were put together but did not deliver the number of votes to break a filibuster. That, of course, occurred 4 months ago. A bill that should have passed 4 months ago we are still dealing with. That is the way the Senate sometimes works. That is the way the Congress sometimes works.

Chairman Thomas represented the House, Senator Baucus represented Democrats, and I represented Senate Republicans. It was a bicameral, bipartisan agreement. In our view, that agreement was closed. No items should be subtracted. No items should have been added. A deal made last summer is still a deal now. Changes would only occur if all the parties to the agreement consented.

When we returned, we all knew we didn't have another 5 or 6 weeks to renegotiate the trailer bill so we kept mostly to that original agreement. In getting to that agreement, I pushed hard for several Senate issues to be resolved. I am referring to items other than the basic 2-year extension of the provisions that expired on December 31, 2005. I will go through a few of those items.

First, there is a package of added incentives to enhance Hurricane Katrina rebuilding efforts. Senator Lott took the lead on that package along with support from Senators Vitter and Landrieu. We modified these provisions with the work of these Senators.

Second, there were tax relief incentives for mine safety. Senators Byrd, Santorum, and Rockefeller argued for these important provisions.

Third is an expansion of the veterans mortgage bond program. This is a program the States use to provide veterans who return from combat with low-interest loans so they can buy their families a home. Senators DeWine and Smith advanced these provisions.

Fourth, there is a proposal to provide a deduction for private mortgage insurance for low-income home purchasers. Senators Lincoln and Smith deserve credit for those provisions.

Fifth, there was a proposal to level the playing field between individual and corporate timber capital gains transactions. This provision would have ensured that timber-growing areas and related mill towns will not be disadvantaged if the timber company is a corporation. Most, if not all of the Senators from the timber-growing States of the Pacific Northwest, and the Southeast of the United States, had an interest in this provision. This proposal was dropped from the package, but I want my colleagues to know I argued for it.

These are a few of the proposals that were negotiated and resolved in the trailer package. In my role as chairman of the Committee on Finance, I protected these Senate provisions.

In the second round of negotiations, our Senate leadership backed me as we proceeded through the trailer issues. I appreciate Senator Frist's patience and support in our efforts to reach agreement.

Why have I pushed so hard for this trailer package? There are two basic reasons. The first is for the 19 million tax filers who may face compliance problems because of uncertain tax law. The second reason is the hundreds of thousands of business taxpayers who have been in limbo waiting for final approval of measures such as the research and development tax credit.

So let's look at some of those in detail. First, take a look at the Committee on Finance Web site. On September 13 and 26 of this year there are press releases that explain Committee on Finance tax staff research. At my request, the tax staff looked into the effects of delaying action on the three widely applicable expiring middle-income tax relief provisions: deduction of college tuition, teacher out-of- pocket classroom expenses, and State sales tax deduction. We are talking about a group of up to 19 million tax filers being affected. Tax filers mean families filing jointly and individually as singles. In other words, we are talking about a lot more than 19 million taxpayers.

The professional staff, all experienced tax practitioners who discussed this problem with the IRS, came to the conclusion that delaying action on extenders into the lameduck would have adverse consequences for that group of 19 million taxpayers. I won't go into the details. They are found on the Web site.

So everyone knows, I have a few charts to show the impact of these provisions on these 19 million people. First, we have the college tuition deduction on the chart behind me. Between 4 and 6 million families, students, took advantage of this deduction in 2004.

The next chart shows teachers benefiting from the educator expense deduction, where teachers pay out of their own pocket for materials for the classroom. For the last several years we have allowed a deduction. I suppose those supplies ought to be paid for by the school district but sometimes the school districts don't do it, the teachers need it, they want to help their kids, they pay for it out of pocket. We have allowed a tax deduction. That should not be allowed to expire. Nationwide, there are 3.3 million teachers who benefit from this deduction.

Finally, in the next chart I have the sales tax deduction chart. In 2004, almost 11 million families and individuals were helped by this deduction. If we do not get this bill passed, they lose that deduction.

Serving as chairman of this committee is a privilege and a responsibility. I might say to my friend, Senator Baucus, who will be incoming chairman because the Democrats won a majority in the last election, I look forward to returning to the chair in a couple of years.

I thank the people of Iowa and my friends and colleagues in the Senate Republican conference for that privilege. I have enjoyed every day I have served as chairman. It brings responsibilities as well. One of those responsibilities is tax policy.

Now, whether an individual Senator agrees or disagrees with a particular expiring tax relief matter is always debatable. We all have opinions on a multitude of things, and particularly on tax policy. Probably no two Finance Committee members, let alone two U.S. Senators not on the committee, agree on all expiring tax relief measures. What we ought to agree on is that we should not deliberately--and I underline that word, ``deliberately''--take actions to unnecessarily complicate taxpayers' efforts to comply with our admittedly complex tax system. That is what delaying action on these provisions means.

There are no ifs, ands, or buts--we need to act quickly. We are already about a year overdue. But if we get it done yet before we adjourn, we will take care of most of the problems taxpayers would otherwise have. The 2006 IRS forms were finalized, but the IRS hopefully can act to mitigate problems for these more than 19 million taxpayers with supplemental forms.

As chairman, I would not be doing my job if I stayed silent. I spoke out. It is my responsibility to these 19 million taxpayers. Some could call it complaining. Some might call it annoying. Others could call it persistence. It is just simply doing my job. When you are talking about up to 19 million middle-income taxpayers who are trying their best to comply with the tax system, I will complain until I run out of breath.

So that is the first reason I have been pushing for resolution of these matters, going back to the strong statements I made on the floor of this Senate at the time the trifecta bill was defeated last July and going back further since the reconciliation bill was passed in early spring.

The second reason I pressed for quick resolution was the expiring business-related tax incentives. These matter. Just think about what you have heard from your constituents about the need for the research and development tax credit to continue and not lapse. These are all overwhelmingly popular in the House and Senate, but they are also good for our economy. Businesses are in limbo on these provisions. We are talking about almost a year of being in limbo and at least another month yet to come by the time we work this through and the President gets this signed.

A lot of businesses in good faith relied on my assurances. They relied on assurances made by the congressional leadership in May of 2006. These business folks were assured these extenders would be done. In my own State of Iowa, for example, a major business, Rockwell- Collins of Cedar Rapids, IA, took a financial hit because we dilly- dallied around with the reauthorization of the R&D tax credit.

It is not just that management cares. Iowa is a manufacturing State, and we are proud of our research and development. Thousands of Iowa employees in these companies have a right to ask why this popular provision that does so much economic good has been delayed now at least 6 months--some people could argue 8 months--beyond the time it should have been signed by the President.

Aside from the new proposals I have talked about, the core tax extender package prevents tax increases on more than 19 million taxpayers and thousands of businesses. There is a revenue loss of $44 billion. Some have called this a budget buster. But a close examination of the facts will tell you that you ought to reach a different conclusion. I would remind the Senate that revenues have shown record levels of increase over the last 2 years. These increases were not accounted for in budget resolutions because, quite frankly, the money came in faster than anybody could have anticipated when the resolutions were adopted. And that is good because the economy is good, or else you would not be getting all this tax revenue coming in.

The tax relief here and in the reconciliation relief bill of last May are very small in comparison to the unexpected taxes that have come into the Treasury. So how can anyone call a bill that prevents tax increases a budget buster when the taxpayers are sending record levels of taxes into the Federal Treasury? So why would anybody penalize taxpayers with tax increases

when revenues are not the source of the deficit? I don't get it. Because if this bill does not pass, it is going to be an automatic increase on the taxpayers and the businesses of this country because of the sunsetting of those tax laws.

That is why these bills are before us, to get them reauthorized, not to decrease taxes but to keep the same level of taxation, the same policy. It just expired. Renew it. Our budget problems are not because of legislation that soon will be before this body. They are derived from out-of-control spending. That is where the budget busting is occurring.

Present tax policy is bringing in more money than anybody anticipated it would bring in. Although the Democratic leadership has blamed Republicans for the deficit, we all know that spending problem is not a Democrat or Republican problem, it is a bipartisan problem. It is a disease in the Congress of the United States.

I agree with the Budget Committee chairman that when Democrats gain control of Congress in a few weeks, we are going to see bigger spending problems. I am sure they would deny that tonight, but we have had evidence of it over the last decade.

My evidence is, take a look at the last 10 years. Try looking for a Democratic spending cut for deficit reduction. Guess what. You are not going to find one. You will find lots of proposed tax increases. You will find lots of opposition to tax cuts. You will not find spending cuts in their deficit-reduction proposals. I hope I am wrong. Maybe we will see folks on the other side offering spending cuts when they have the budget resolution up next March and when they have appropriations bills up in the summer of 2007. I might be wrong. I hope I am. But we will see.

So if you hear critics, Democrat or Republican, calling this bill a budget buster, keep the fiscal history in mind. Look at the numbers over the last 2 years. And take a look back for about a decade. The numbers do not lie.

The bill is not a budget buster. It prevents tax increases. Preventing tax increases is not a budget problem. Millions of hard- working, tax-paying families do not need tax increases, neither does the American business community.

When I am holding my town meetings in Iowa, I have people coming in complaining about overspending. I do not have people coming into my town meetings saying: Tax me more; I am undertaxed.

So I would then go on now, after talking about tax provisions here, to talk about the trade provisions. And we will start with the Generalized System of Preferences. This program offers developing countries duty-free access to U.S. markets. I have traditionally been a supporter of GSP. In recent years, however, I have come to question the merits of the Generalized System of Preferences. Too often, GSP benefits have gone to those who simply have not deserved them; in other words, meaning countries that have not deserved them.

Perhaps due in part to the GSP Program, some industries in some developing countries have reached world-class status. These successful industries clearly are not the struggling businesses in poor countries for which the Generalized System of Preferences benefits were originally intended.

In addition, I am concerned that the GSP has threatened U.S. interests in trade negotiations. Given that beneficiary countries already have duty-free access to the U.S. market for many of their products through the GSP Program, they have little incentive, then, to negotiate lower tariffs on U.S. exports. If they can get their product into our country under this program duty-free, they would consider themselves suckers to give our businesses and farmers the same advantage in their country.

But that is what negotiations are all about. Like the Colombia Free Trade Agreement, the Peru Free Trade Agreement--both things before Congress that we ought to be passing. Those products from those countries are coming in here duty-free. We can have the advantage now of sending our products back to those countries duty-free for the first time ever. And do you know what. There are people in Congress here, right now, questioning whether we ought to approve the Peru Free Trade Agreement. It is stupid to not level the playing field for the American worker, the American farmer, and our service industry. But GSP has encouraged these countries to come along. Now they have developed. We need the same rights, the same consideration from them that we have been giving them over the last 20 years through the GSP Program.

I am convinced that the lack of progress in the Doha Round of the WTO negotiations can be attributed, at least in part, to this GSP Program.

GSP is set to expire in 23 more days. Due to my concern over GSP, I considered dropping my support for this program altogether, not even renewing it, for the unfair reasons I have told you. But in negotiations this week over a trade package in this bill, I agreed to compromise with Senator Baucus and my counterparts on the Ways and Means Committee for a short-term extension of this program for 2 years. Discussions I have had with Senator Baucus figured in my decision to support this short-term extension. Senator Baucus has agreed to work with me during the next Congress to reexamine the GSP Program. I anticipate that a reexamination of the GSP will result in needed reforms to this program.

Today's legislation does take a very first step in making changes to GSP. It does so by allowing the President to limit the availability of GSP benefits for ``supercompetitive'' products. The word ``supercompetitive'' is a technical term. Imports of products from numerous countries, including Brazil, India, and Venezuela, will be impacted by this provision of the bill, which will become operative in July of next year. This new supercompetitive standard reflects the results of a review of the Generalized System of Preferences Program, the GSP Program, conducted by the U.S. Trade Representative.

Today's bill, in addition to extending the GSP under the proviso that we are going to review it next year, also extends the Andean Trade Preference Act, also expiring in 23 days. The Andean Trade Preference Act offers four Andean countries--Colombia, Peru, Ecuador, and Bolivia--duty-free access to the U.S. market for a variety of products. It was my strong inclination to extend benefits under this program to just two of the Andean countries, Peru and Colombia, for the reason they have been cooperating with us on this free-trade agreement. We have not adopted it yet. If we had adopted it, they would not need this program, and we would not be talking about it. But I would not be inclined to extend the benefits to Ecuador and Bolivia. Peru and Colombia have worked actively to strengthen their economic ties with our country by concluding free-trade agreements. It is only fitting for us to extend benefits to them until the point that these free-trade agreements are implemented.

But Bolivia and Ecuador is another circumstance. Those countries, in contrast, have gone out of their way to demonstrate they do not value increased economic ties with the United States--unless, of course, those ties involve one-way trade benefits through the Andean Trade Preference Act where they can get their products into our country very easily and it is very difficult and very expensive for us to get our products into their countries.

In order, however, to see that the Andean Trade Preference Act is extended to Peru and Colombia, where I said it ought to be for a short period of time, I had the opportunity to compromise with Senator Baucus and our House counterparts on an extension. This bill provides a straight 6-month extension of the program. Another 6-month extension will be provided if steps are taken to implement trade agreements with any of those countries, meaning if Ecuador or Bolivia want to get onboard and get into the act of cooperating in a bilateral way, they will get greater consideration in the future. But with their new Presidents nationalizing their industries, not having respect for personal property, not having respect for the growth that comes from the market economy, you wonder whether they are smart enough to think in terms of a free-trade agreement. But we hope they are.

We have another trade preference program that is very popular; it almost passes unanimously most times in the Congress--the African Growth and Opportunity Act. That is modified by this

legislation as well. This African Growth and Opportunity Act offers sub-Saharan countries duty-free access to the U.S. market. This program is instrumental in promoting economic growth in one of the poorest regions of the world. The third country fabric provision of the African Growth and Opportunity Act is going to expire October 2007. It allows beneficiary countries to keep preferential benefits on certain apparels made with fabric from countries other than the United States or Africa. This bill extends that third country fabric provision that will expire October 2007 until 2012.

Also, in order to remove disincentives to investment in fabric production in Africa, we included what we call an ``abundant supply'' exception to eligibility under the third country fabric provision with respect to fabrics and yarns that are available in commercial quantities from African suppliers.

The bill also provides tax benefits to Haiti, the poorest country in the Western Hemisphere, through the Haitian Hemispheric Opportunity Through Partnership Encouragement Act, also known by its acronym HOPE. This legislation provides new rules for origin for duty-free imports from Haiti. Haiti may only receive benefits under the bill if it meets certain political, economic, and labor criteria, as well as textile and apparel transshipment enforcement requirements. At this time, it is very important to recognize one of our colleagues who worked very hard on this, and that is Senator DeWine. He has contributed to advancing the economic development of Haiti during his tenure in the Senate.

The bill also extends unconditional normal trade relations to Vietnam--something that should have been passed in November before the President went to Vietnam. This provision will enable us to enjoy the benefits of Vietnam's imminent accession into the World Trade Organization. That translates into significant benefit for our farmers, including those in my State of Iowa, by reducing duties on U.S. exports of beef, pork, soybeans, and other products.

Our manufacturers and service providers also stand to benefit significantly from the Vietnam normal trade relation bill. And by engaging Vietnam through enhanced trade, we can best press the Vietnamese Government for continued progress with respect to where we don't think there is enough progress yet--religious freedom and human rights.

In addition, this legislation modifies U.S. law with regard to changes in the U.S. harmonized tariff schedule. The U.S. Trade Representative periodically makes changes to tariff lines in the U.S. harmonized tariff schedule. This year, due to the thousands of changes to be made and to administrative delays, the business community requested that Congress extend the usual 15-day window for implementation, so we have extended the deadline to 30 days. This will allow time for the private sector to incorporate all of the changes in their computer system and avoid costly, time-consuming errors to entry.

Finally, the bill includes numerous duty suspensions and reductions that have resulted from the Finance Committee's efforts to prepare a miscellaneous tariff bill. These provisions are noncontroversial in nature. They reduce tariffs on imported goods not produced in the United States. As a result, they will provide cheaper inputs for businesses operating in the United States and, thereby, increase the competitiveness of our firms and workers.

I will talk about health care now, the third major area of jurisdiction of our committee, and the third major area in this piece of legislation. Despite what some might characterize as a ``do-nothing Congress,'' the 109th Congress actually accomplished a great deal relative to health care. We enacted the Deficit Reduction Act of 2005, which greatly strengthened and improved the Medicaid Program. Most would acknowledge that this bill made the most significant changes to the Medicaid Program in three decades. Those changes should make it possible for the States to serve more low-income beneficiaries, families who cannot afford to provide health insurance and pay for it.

Significant challenges await us in the new Congress. We will need to take a serious look at the solvency of the Medicare Program. We have to develop a solution for the Medicare physician reimbursement system. The State Children's Health Insurance Program needs to be reauthorized. And there remain serious problems of the uninsured. I look forward to working with my partner and incoming chairman of the Finance Committee, Senator Baucus, on those issues and doing that in a bipartisan way.

However, before we can adjourn this Congress and before we go home to enjoy the holidays, there is still urgent work needed to be done, and that is the purpose of this piece of legislation. In the legislation we consider today, there are several provisions that rise to the level of ``must do.'' These include ensuring that physicians do not receive a drastic cut in the Medicare reimbursement that a formula in place for the last 15 years dictates they take and we generally don't let happen. There are a number of other expiring provisions that must be extended. I am very disappointed that this package doesn't include anything to address the coming shortfalls of the State Children's Health Insurance Program. The Senate package that I introduced with Senator Baucus included a proposal to address the shortfalls, but that proposal was rejected in the negotiations that Senator Baucus and I had with the House. We apologize for not winning on that.

Our legislation will, however, increase payments for providers while providing additional payments for physicians and other health practitioners who report quality measures in order to ensure both continued beneficiary access and improved quality of care. We must ensure that health care providers can afford to continue to practice medicine. We must preserve Medicare beneficiaries' access to physicians, and we must provide incentives for quality improvement.

The physician payment formula is deeply flawed. We need to reform the SGR formula's flawed payment system and develop a new way of paying physicians appropriately for their services. Last year, we included a provision in the Deficit Reduction Act to require the Medicare Payment Advisory Commission, known as MedPAC, to submit a report to Congress early next year on alternative mechanisms that could be used to replace the existing formula. It is a flawed formula. We must find a long-term solution that will stabilize physician payments in the future. Working to develop a better physician payment system will be one of my top priorities, and I am sure that under Senator Baucus's leadership, it will be a top priority as well.

The legislation before us today will eliminate the 5-percent cut in physician fees scheduled to take effect in January 2007 and, instead, keep physician fees at the same level as this year. In effect, this would provide a 5-percent increase in payment fees over what the formula would otherwise allow. Next year, we must face the challenge of producing a long-term solution to the physician payment formula. The one-year-at-a-time approach we have used over the last several years makes the problem worse and does nothing to address the longer term challenges.

We need to put better incentives into the health care system so providers are motivated to provide better quality care. So this bill before us establishes a quality reporting bonus for physicians and other eligible professionals--meaning nurse practitioners, physician assistants, podiatrists, and other health care professionals who submit data on quality measures from July through December in 2007.

Our legislation also creates a fund, effective in 2008, to help stabilize physician payments and promote physician quality initiatives. This new fund of $1.35 billion will be available in 2008 to help minimize fluctuations in physician payments and promote physician quality initiatives.

The physician payment changes will be offset by two adjustments to the Medicare Advantage stabilization fund. Our legislation does not repeal the fund but, rather, preserves the funds for future years. We adjust the funds in two ways.

First, the fund will be reduced by $10 billion to $3.5 billion. Second, the Secretary will be able to use the proceeds in the funds only in the years 2012 and 2013. There is strong participation in the program right now, and if more funds are needed to be added back to

the Medicare Advantage stabilization funds, Congress can add these funds in future years.

I have been working very closely with my colleague Senator Baucus on realigning incentives in Medicare to reward for quality of care, rather than paying physicians as we do now, on volumes of service, without any care about quality. We have been doing that under these formulas for a long time. We began the process of moving toward quality care reimbursement in the Medicare Modernization Act of 2003. This Medicare Modernization Act required hospitals to report 10 quality inpatient measures in order to receive full payment update. Now almost 99 percent of hospitals are reporting this data. Without this incentive, they would not have done so. Our legislation includes provisions to extend quality reporting for hospitals to hospital outpatient departments and ambulatory surgical centers as well, beginning no sooner than 2009.

Now that hospitals are reporting this data, it is time for other providers, such as physicians, to do that as well. The quality reporting measures in our bill today are a small step toward creating better incentives for quality care in Medicare. The transitional bonus payment policy included in this bill for reporting quality measures is a good first step for physicians and practitioners.

The physician quality measures in this legislation before us today have been developed primarily by physician organizations, including the American Medical Association and physician specialty societies. All of the measures adopted for 2007 have the support of the physician community and will be easily reported electronically with the submission of their claims. Those professionals who participate in the quality reporting program and voluntarily submit up to three quality measures that apply to their specialty will receive an additional 1.5 percent bonus incentive payment for services provided during the 6- month reporting period. I emphasize that that 1.5 percent bonus is on top of our filling it in so that there is not the 5-percent cut that the formula now applies for.

Ultimately, we should move toward rewarding quality through higher Medicare reimbursement for better health care outcomes. Once that principle begins to govern medical care, we will be able to better align payment incentives throughout our health care system to reward for quality of care. We are interested in quality because when doctors and hospitals and other health care professionals do it right the first time, it is the least expensive way to have it done. If it is done wrong the first time, it is very expensive to send people back to the doctor and the hospital a second time. We want to do in the Government, through the Medicare Program, what a lot of major corporations are doing--being concerned about quality. With that quality, we can get better health care, but you are going to save a lot of money, whether it is for Ford Motor Company or for the taxpayers of the United States, under a Federal Medicare Program.

In addition to reforming the manner in which Medicare pays for physician services, this legislation will extend several expiring provisions enacted in the Medicare Modernization Act of 2003 to help ensure that beneficiaries will continue to have access to needed medical care. This includes provisions applicable to rural payments to physicians, continued direct payments to independent laboratories for physician pathology services, and continuing Medicare reasonable cost payments for lab tests in small rural hospitals.

Our legislation also provides a 1-year extension of the therapy cap exceptions process that we included in the Deficit Reduction Act last year to ensure that beneficiaries receive physical, occupational, and speech language therapy services that they need.

We also give a 1.6 percent update for dialysis services effective April 1, 2007, thus helping to ensure continued access for beneficiaries who suffer from what is called end stage renal disease.

Our legislation also includes some new provisions to improve beneficiary access and provide additional protections. We have included additional reimbursement for important preventive medicine by reimbursing health professionals for administering vaccines covered under the new Medicare Part D prescription drug benefit. We also include a requirement for reporting anemia indicators in cancer patients receiving anti-anemia drugs to better manage these patients' care.

We have established a new postpayment review process to ensure the timely payment for drugs and biologicals that are delivered for patient use under the Competitive Acquisition Program.

This legislation includes several provisions to improve accountability in Medicare. There has long been a concern that the program is vulnerable to fraud and abuse, and certainly experience has borne that out, with billions of dollars being wasted. Even more significant, the program has not been able to effectively detect when it makes payment errors. This legislation contains several provisions to address these concerns of ferreting out abuse and fraud.

The Health Care Fraud and Abuse Control Program addresses fraud and abuse in the Medicare Program but has been funded at the same levels since 2003 despite significant increases in its responsibilities.

In order to ensure that the Federal Government has sufficient resources to effectively combat health care fraud and abuse, this essential program will receive annual funding updates for the next 4 years. And that investment has a good return. In other words, for a $1 investment, many dollars come back to the Federal Treasury from either recouping fraud or preventing fraud.

This legislation also includes a provision that addresses payment errors by adopting the Recovery Audit Contractor Demonstration as part of the Medicare Program and implements that program nationwide. Despite being implemented for a limited time in a limited number of States, this demonstration has already shown enormous potential for the identification of overpayments and underpayments and the recoupment of overpayments.

In fiscal year 2006, this demonstration has identified around $300 million in improper payments in just three States. By taking the recovery audit program nationwide, up to $10 billion in Medicare overpayments will be recovered in the next 5 years.

By passing this legislation, we will also take a big step toward making sure that the Medicare Program does not pay for substandard care provided to beneficiaries. The National Quality Forum has identified a number of serious and preventable adverse health care events called ``never events.'' The HHS inspector general will be required to conduct a study on Medicare payments for services related to never events and will provide guidance for CMS in setting policy regarding payments for services when never events are involved.

Let me explain never events. We are not going to pay when somebody is operated on and covered by Medicare if they cut off the wrong leg--and this has happened--or the wrong arm or other things that were never intended to be done to a patient. We are sick and tired of paying for things such as that.

This legislation will also promote more accurate hospital payments. One aspect of Medicare hospital payments that has been subjected to much criticism is the area wage index. Many say that the current method of calculating the wage index does not reflect the hospital's actual labor costs and is instead arbitrary in nature so that similarly situated hospitals can receive significantly different wage index values.

Since the enactment of the Medicare Prescription Drug Improvement Modernization Act of 2003, hospitals have been able to obtain relief from this unfair situation temporarily. But we shouldn't have to do this every year in a temporary way. So this legislation will provide limited extension of this relief. More significantly, major steps will be taken toward comprehensively reforming the wage index classification system by requiring a report on alternatives to the current methodology for calculating the Medicare wage index, as well as proposals for reforming this classification system so we don't have to mess with these inequities.

This legislation also includes several provisions relating to the Medicaid Program. These include codifying the provider tax rate paid by Medicaid providers at 5.5 percent and extending the transitional medical assistance and abstinence education programs. Throughout the year, we have heard from nursing homes, hospitals, and managed care

plans that lowering the maximum provider tax rate would make it harder for them to treat Medicaid recipients as States had to make up for lost revenue. This provision protects health care access for some of the most vulnerable in society.

While this legislation does not go as far as some would like, it accomplishes the goal of helping ensure the continuation of critical health care policies and programs.

I was disturbed when I heard one of my colleagues refer to this bill as an example of bad legislative practice. The critics imply that political defeat was somehow connected with this kind of legislative practice. With all due respect, these criticisms could not be more off the mark. This legislation was based on popular expiring provisions within the jurisdiction of the tax writing committees, provisions that were meant to expire so they are reviewed occasionally so we know the best possible tax policy is being pursued by the Congress of the United States.

The legislative business in this bill then is the people's business. Throughout the year, I pressed repeatedly to finish these matters. I was thwarted by others who sought to leverage these items for other purposes. I firmly believe that if we had dealt with these issues in a timely fashion, as was planned last May to do it in the pensions bill, we would have been rewarded politically.

We are where we are, but we are here because of politics on both sides of the aisle getting in the way of processing these items in a timely fashion.

I agree with the critics that this kind of omnibus bill is not the best way to finish this legislative business. The critics should know that the tax-writing committees had no choice.

In conclusion, I hope my colleagues will support this bill--a bill that should have been law last summer--to finally get it done to save the taxpayers and 19 million people from being adversely affected.

I yield the floor.

Mr. President, at this time I would like to recognize Brian Pomper, chief trade counsel for the Democratic staff on the Finance Committee. Today is Brian's last day with the committee. Brian has been a real asset to the Senate, and he will be greatly missed.

He has worked both with my staff and sometimes against my staff, but let me tell you this: He is the sort of person who, whether he is with you entirely or against you, is a wonderful person to work with. So at all times the lines of communication with him between our staffs always remained open, and it has always been a friendly relationship.

Brian is a very warm and decent person, and I wish him the best of luck in his future endeavors. It is my understanding that he is going to go into the private sector, the cold cruel world of the private sector. I hope he enjoys it, but I want to thank him for his cooperation with us.

I suggest the absence of a quorum.

I wish to engage my colleague Senator Baucus in a colloquy concerning the Tax Relief and Health Care Act of 2006. This bill contains a

Under current law, beneficiaries can decide to stay in the traditional fee-for-service program or enroll in Medicare Advantage plans during the annual open period, which lasts from November 15 to December 31. They can also make certain changes one time between January and March of the following year. I remember how much time and effort we spent designing these enrollment policies when we worked together on the Medicare Modernization Act of 2003. Wouldn't you agree this provision is a significant policy change?

That is exactly my concern, too. I am also disappointed in the process that led to the provision being included in the final bill. We had an understanding that we would only include agreed-upon extensions and must-do health items in the package and not make major policy decisions that had not gone through the regular process. This provision does not meet that standard.

It disturbs me, that this major policy change--one that treats some plans unfairly--was included at last minute by the House rules committee. I do not operate like that, and I know you do not, either. Unfortunately, we are stuck with this provision for the time being. But I assure of my commitment to working with you as soon as possible next year to revisit this provision.

Thank you, Senator Rockefeller. We share an interest in making sure that States have adequate Federal funding to cover children through CHIP. No one wants to see children lose coverage, and we hope the provisions in this bill will help States on a temporary basis until we have time to work out a more permanent solution to the CHIP financing structure. Now I know that there are a lot of concerns about this package. And I want to make it clear that Senator Baucus and I thought this was what we could pass right now. We are hopeful that we can pass this package here in the Senate and then get House agreement tonight or tomorrow so that we can forestall these shortfalls for the first part of the year.

I want to make it clear, however, that nothing in this package binds us for CHIP reauthorization next year. There is discomfort with the CHIP provisions on both sides of the aisle. But Senators are willing to compromise in order to get something done for children before we go home. Therefore, we should put aside our differences and individual gripes in order to get something productive passed.

I understand the concerns of our colleagues. Certainly, there are those who think we should have gone further in this proposal. There are Senators who support going from a 3-year allotment structure to a 2-year allotment structure immediately. And there are Senators who want to put greater limits on how CHIP dollars can be spent, to ensure program spending prioritizes children first. Senator Baucus and I developed a CHIP proposal that is somewhere in between but is a proposal that meets our ultimate objective of keeping children covered. We can have a policy debate about the merits of various proposals when we reauthorize the program next year. Nothing in this package precludes us from doing that.

Mr. President, I move to waive the budget point of order on the appropriate sections of this pending legislation.

Mr. President, I want my colleagues to understand that if this budget point of order is not waived, this legislation that we have been working on for a period of 8 months, and should have been passed in July--probably should have been passed in May, but for sure in July, and here we are still doing it--will not be passed.

I want to comment on why, without hearing my colleague yet--and going before him, but anticipating from some statements that have been in the press--why he is wrong about his point of order against this legislation.

Earlier today, there were comments made by my Republican colleague regarding the tax extenders bill. I would like to take a few minutes to clarify the record regarding the tax extenders bill.

Three points:

First is the claim that tax cuts are a budget buster, that it is tax cuts that are putting us in the red. Nothing could be further from the truth. We have seen tax receipts going up by a record amount. From 2004 to 2005, receipts went from $1.8 trillion to $2.1 trillion. The calculators at the Treasury needed new batteries to count the new dollars coming in this year, increasing from $2.1 trillion to $2.4 trillion--an 11.8-percent increase. These tax receipts far outpace what was projected in the budget, and, most importantly, the budget resolution we are currently operating under.

The bottom line: Taxpayers are sending checks to the Treasury well over $100 billion in excess of what was expected under the budget resolution. We are now taking action to prevent what is effectively a tax increase. I never thought I would hear a Republican advocating we ought to have a tax increase. If we do not pass this legislation, 19 million people are going to have tax increases.

And let my colleagues absolutely be clear in understanding that failure to pass this legislation, then, is not just about nothing, it is about allowing tax increases to go into effect. And they would go into effect without even a vote of the Congress. Taxpayers, then, will be writing checks even bigger than this unexpected amount of money that is coming into the Treasury already, if this legislation does not pass. Teachers, parents of college students, working families will all have to dig deeper into their pockets to pay for out-of-control spending in Washington.

Taxes are pouring into the Treasury. As I said earlier, it is not for the lack of tax receipts that we are seeing a deficit. It is because of the inability to control spending. In my time here in Washington, DC, I have never seen that the way to control spending is to keep taxes high. Higher taxes is a license to spend more money. And that is borne out by the facts. While tax receipts have gone up 11.8 percent in 2005-2006, spending has increased 8.6 percent.

It is important for my colleagues to also understand that much of the tax cuts that are in the tax extender package were expected to be included in the $70 billion tax cuts passed in the budget resolution-- the budget resolution out of the Budget Committee.

I find it extremely frustrating that those who come to the floor and decry this bill fail to note it is because we made room for other priorities, priorities they championed, such as capital gains and dividend cuts in the tax reconciliation bill, that we were unable to include the tax extender provisions in that reconciliation bill last spring. And it is for that reason that we now have to consider an extender bill.

It reminds me of the fellow who complains about not being able to get a BLT sandwich after he ate all the bacon. And speaking of bacon, one of the major pork products, I would now like to turn to the second point: the discussion on the floor earlier about earmarks.

I know my colleagues who serve on the Appropriations Committee have familiarity with the term ``earmark.'' Earmark is something that goes to one individual or one company. That is not what this bill is about. But they have tried to characterize it that way. This bill provides tax relief, and these provisions provide tax relief that is not for one individual or one company. They are not earmarks.

For example, the deduction for tuition will help--let me take a State at random. Let's take New Hampshire as an example. It helped 23,124 taxpayers in the year 2004. These tax policies, then, are not earmarks when you are helping 23,000 taxpayers in New Hampshire. And failure to extend the tax extenders means that these taxpayers are going to have an increase in taxes.

Earlier we heard on the Senate floor discussion about a tax provision that benefited songwriters. Again, this is not an earmark. As most Members who have been to a record store recently are aware, there is more than one songwriter in this country. But I raise the songwriter provision to respond to another point, which is that there are provisions in this bill that because of the Senate rules, Members will be prevented from effectively raising concerns.

The songwriter provision, supported by several Members on both sides of the aisle, was voted on by Members earlier this year in the tax reconciliation bill. It already passed the Senate. The extenders bill is now making that provision permanent. Members had ample opportunity to raise concerns about this provision when it was considered 6 months ago. Not a discouraging note was heard. In fact, colleagues who discussed this provision earlier today actually voted for the legislation that contained the songwriter provision. Talk about saying one thing and doing another. So I think those who sang the first verse earlier in the year should be cautious about complaining that we are now singing the second verse.

Finally, I want to comment about the point raised on the sales tax deduction. Again, you call that an earmark, when people in nine States who would not be able to deduct their State sales tax from their Federal income tax have the opportunity to do it? It is affecting 10 million people, and that is an earmark? I find the statements made about the sales tax to be of concern and a misrepresentation of policy.

First, my colleagues earlier heard complaints about the cost of the sales tax provision but then in the same breath complain that the sales tax provision does not cost enough, that the sales tax provision's flaw is it should be expanded to both itemizers and nonitemizers, which then would cost billions more.

The easy answer is that the intent is to roughly mirror the deduction for State income tax that residents of the rest of the States have. The State income tax deduction is only for itemizers. So why would you want the sales tax deduction to be expanded to include nonitemizers?

Second, the deduction for sales tax is only allowed in lieu of a deduction for the income tax. So the benefits that it provides to residents of States such as New York and California, who have both a State income tax and sales tax, is limited. But it does certainly provide real benefits to taxpayers who live in States without a State income tax but do have a State sales tax.

The provision means that the Federal Tax Code will not treat similarly situated taxpayers differently based on how the State decides to raise revenue. The Finance Committee has seen no evidence that States have responded to this provision by raising the sales tax.

I appreciate the opportunity to clear the record and separate facts from fantasy when it comes to this tax extender bill. These are important provisions that we need to act on now to ensure that taxpayers can properly file their tax returns and receive much-needed tax relief.

Finally, the Congressional Budget Office has scored the total health package as costing $1.7 billion over 5 years. The $1.7 billion stems from the cost the Congressional Budget Office has attributed to making the Recovery Audit Contractor Demonstration a permanent part of the Medicare Program and implementing it on a nationwide basis.

The 3-year demonstration project was authorized in the Medicare Prescription Drug Act of 3 years ago and requires the Center for Medicare Services to contract with the recovery audit contractors to detect Medicare overpayments and underpayments and to recoup overpayments. Typical overpayments involve improper coding or billing for services for which there is no medical necessity. Also, Medicare inadvertently pays for services when another payer, such as a worker's comp or auto insurance, should be a primary payer.

Despite being implemented for a limited time in three States, this demonstration has already shown enormous potential for the identification of overpayments and underpayments and the recoupment of overpayments. In fiscal year 2006, this demonstration identified around $300 million in improper payments in three States. It is estimated that implementing this program on a permanent basis nationwide would result in approximately $8 billion in recovered funds being returned to the Medicare trust funds over 5 years. And somebody is bellyaching about investing $1.7 billion to bring back $8 billion.

CBO has assigned a cost to this provision because of a budget scoring rule--some scoring rule that somebody ought to do something about-- called rule 14, which says that ``no increase in receipts or decrease in direct spending will be scored as a result of provision of a law that provides direct spending for the administration or program management activities.'' As a result, even though they are real and substantial, savings from this program will not be recognized for budget purposes.

Despite the potential of a budget point of order, we have included this provision in the package because it is simply good policy. It will recover billions that would otherwise be wasted in the Medicare Program--some of it fraudulently wasted. For all these years, Medicare has not been able to effectively detect payment errors. The nationwide adoption of this program will result in real savings for the Medicare Program and, ultimately, the taxpayers.

Mr. President, I wish to talk briefly about the issue of Red Cross reform. The Red Cross is one of the great institutions in this country. It is supported by millions of Americans with their volunteer work and contributions. Americans have a right to expect the best from this proud organization.

On Monday, I shared with leadership staff on both sides of the aisle as well as interested members copies of legislation that brings much needed reform to the governance of the Red Cross. The Red Cross is congressionally chartered and therefore any reforms to the governance require changes in statute.

As many of my colleagues know, I have been active in oversight of the Red Cross since problems came to light with the organization after the tragedy of 9/11. However, it was after the Katrina hurricane that it became evident that fundamental change was needed in how the organization was managed and governed.

In response to my oversight, the Chairman of the Board Ms. Bonnie McElveen-Hunter called for an Independent Governance Advisory Board. I thank her for her leadership and responsiveness to the concerns raised.

This board recently issued its report ``American Red Cross Governance for the 21st Century'' which can be found on their website. This report is based on the fine work of its Chair, Karen Hastie Williams as well as Peter Clapman, Professor Charles Elson, Margaret Foran, Professor Jay W. Lorsch, Patricia McGuire and Professor Paul Neuhauser. I thank them all for their service.

The legislation that I shared with colleagues on Monday is based on the findings of the report from the Independent Governance Advisory Board which was approved by the Red Cross Board of Governors and released to the public on October 30, 2006.

The legislation deals with such vital issues as the size and role of the board; the characteristics of who should serve on the board; the role of cabinet members in Red Cross governance; the creation of an ombudsman; the responsibilities of the Government Accountability Office and many other important matters.

However, while the statutory changes are important, much of the hard work of changing the culture and governance of the Red Cross will have to be done by the management and board of the Red Cross. I expect them to look to the findings of the report as a close guide for their actions on the details.

I am hopeful that this legislation, which has the support of the Red Cross, can be passed by unanimous consent quickly so that we can have in place a Red Cross that has effective and modern leadership for this Nation.

However, I am deeply discouraged that despite the fact that this legislation has been cleared for several days on the Republican side it still has not been cleared on the Democratic side, and this despite the fact that the legislation has been originally cosponsored by Democrat Senators Kennedy, Landrieu and Akaka as well as Senators on this side of the aisle, Santorum, Enzi, Isakson, Martinez and Dole. As my colleagues all know, Senator Dole was the former President of the Red Cross. I am pleased to have all their support.

But I am very frustrated that I have received no response or courtesies from the Democrat leadership of why this commonsense and needed legislation cannot be passed.

I have been informed that staff in the other body have stated to Red Cross officials that they do not want to pass this legislation because they want it to be an early victory for the new Congressional leadership. I do not want to believe that that is the reason why there is no action on these reforms.

The failure to act on these reforms is having a very real and very negative impact on the vital work of the Red Cross. I met with the Chairman of the Board of the Red Cross just two days ago and she informed me that the failure to pass this legislation quickly is hurting their efforts to successfully recruit and bring into place a new CEO. In addition, the needed changes to the governance structure at the Red Cross are also frustrated by the failure to make the necessary statutory changes.

We saw with Katrina the need for strong leadership and governance at the Red Cross. The Red Cross has taken the right steps to make reforms, reforms that will lead to better service for the American people in times of need. The Democrat leadership should be placing those same priorities first. I call on them to allow us to go forward with passing this legislation.

Mr. President, in connection with H.R. 6111, the Tax Relief and Health Care Act of 2006, the nonpartisan Joint Committee on Taxation has made available to the public the following document: Joint Committee on Taxation, Technical Explanation of HR. 6408, The ``Tax Relief and Health Care Act of 2006,'' as Introduced in the House on December 7, 2006--(JCX-50-06)--December 7, 2006. This technical explanation expresses the Senate Finance Committee's understanding of the tax and other provisions of the bill and serves as a useful reference in understanding the legislative intent behind this important legislation.

Senator Domenici wants a few minutes. How much time do I have?

The Senator can have 2 minutes.

How much time do I have?

I will give 4 minutes to the Senator from Louisiana.

Mr. President, I would like to discuss a tax policy matter that is important to several Senators. Although it is not a priority for me, I pursued the issue for those Senators during the ``trailer'' bill negotiations. On my side of the aisle, the interested Senators included Senators Smith, Lott, Cornyn, Dole, Graham, and Vitter. I know Senators on the other side of the aisle have similar interests, including Senators Lincoln, Pryor, Landrieu, Cantwell, and Murray.

Under current law, the tax treatment of capital gain income from timber activities varies. The variance depends to a great degree on the form of the business entity that holds the timber. The top individual capital gain rate of 15 percent applies to capital gain from timber if the timber is held by pass-through entities. By contrast, capital gains from timber held by regular ``C'' corporations are taxed at the top corporate rate of 35 percent.

Senators Smith and Lincoln filed an amendment for the Finance Committee reconciliation tax relief markup last year. The amendment aimed at addressing the differential treatment of timber capital gains among entities. A form of that amendment was included in the first round of negotiations on the trailer bill. The final form of the trailer bill agreement did not include the timber capital gains amendment.

Since this issue was not fully resolved, and many Members remain strongly interested in the issue I would like to ask my friend, the ranking Democrat and incoming chairman, Senator Baucus, if he plans to further examine the issue in the next Congress.

Mr. President, I rise in support of the Haiti trade provisions in this legislation. And I want to respond to some of the criticisms leveled at these provisions.

Right now over two-thirds of Haitian apparel exports to the United States are made from fabric made in either the United States or a beneficiary country under the Caribbean Basin Initiative.

Under the bill, it is true that Haiti can use fabric from third countries to produce apparel exports for duty-free entry into the United States.

But to be eligible for such duty-free treatment, at least 50 percent of the value of the apparel must be attributable to Haiti, the United States, or another regional qualifying country.

If, for example, Chinese-origin fabric is used to manufacture apparel in Haiti, only the value of the cutting and sewing counts toward the 50-percent

value-added requirement. The value of the Chinese fabric itself does not count toward the requirement.

And because fabric generally accounts for more than 50 percent of the value of a garment, the 50-percent value-added requirement will often mean that qualifying apparel must be made from fabric produced in a regional qualifying country to be eligible for preferential treatment.

Moreover, the benefits are capped in the first year at 1 percent of United States apparel imports, which is less than current apparel imports from Haiti and equal to only 20 percent of the total level provided under the African Growth and Opportunity Act.

Now, the bill does include a tariff preference level, but it is limited to woven apparel, not knits. And the level of the tariff preference level is equal to only 0.23 percent of United States apparel imports.

The Commissioner of Customs wrote a letter to Chairman Thomas of the House Committee on Ways and Means stating that Customs remains committed to enforcing all textile trade laws. The Commissioner further indicated that Customs can, and will, enforce the textile provisions in this bill if they become law.

The bottom line is that the Haiti trade provisions in this bill will help to spur economic growth and prosperity in the most impoverished country in this hemisphere. At the same time, these provisions do not threaten to significantly impact our domestic industry in an adverse manner.

In addition, these provisions have been endorsed by a number of non- governmental organizations, including Oxfam America and the International Policy Committee of the United States Conference of Catholic Bishops.

I urge my colleagues to support the Haiti legislation, as well as the other trade provisions in this bill.

Mr. President, I ask unanimous consent that my remarks be printed at the appropriate place in the Congressional Record, and I yield the floor.

Mr. President, I will reserve the remainder of my time.

I should have 2 minutes left. I gave the Senator from Louisiana 4.

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

Mr. President, my opposition to the cloture motion is as much about whether we are going to be able to fulfill our constitutional responsibilities of oversight of the administrative branch of Government as it is about the particular qualifications of the nominee. I intend to vote against cloture and I hope that Democrats who are listening--particularly those Democrats in the last election who were bellyaching because there wasn't any oversight on the part of Republicans toward the executive branch of Government--would pay attention to the fact that this nominee has something to do with and is an illustration of the lack of cooperation on the part of the executive branch, failure to cooperate with Congress on the issue of congressional oversight.

I have serious concerns about what this cloture vote means, then, to congressional oversight of the executive branch now and in the future, and what it means for Members such as me, who placed a hold on this nominee. This was not a secret hold. I made this hold public.

I am voting against cloture and ask my colleagues to join me because I believe we need to send a message to the executive branch that it is not OK to impede congressional investigations. It is not OK to limit the Senate's access to documents, information, and employees of the executive branch. In his book on congressional government, Woodrow Wilson, before he was President, when he was a professor at Princeton, wrote, in 1885: ``Quite as important as lawmaking is vigilant oversight of the administration.''

Our work as lawmakers does not end with the passage of a bill. This body has a responsibility to the American people to make sure that laws work and that they are being implemented effectively, efficiently, and economically. Congressional oversight serves very important goals, and we should not lose sight. They include reviewing actions taken and regulations adopted by executive agencies to make sure that the agencies are executing law according to the intent of Congress, and, second, ensuring that the Federal Government is not wasting taxpayers' dollars. Oversight work allows us to evaluate the ability of agencies and managers to carry out program objectives and improve the efficiency, effectiveness, and economy of Government programs; next, ensuring that executive policies reflect the public interest and that public interest is expressed in the laws of Congress; and, lastly, protecting the rights and liberties of the American people.

Woodrow Wilson also said in his book that:

It is the proper duty of a representative body to look

diligently into every affair of Government and to talk much

about what it sees. It is meant to be the eyes, the voice and

embody the wisdom and the will of its constituents.

In America, with our Government, the public's business ought to be public. But when you have coverups and the lack of information going to Congress, as demonstrated by this request for documents, and when we get a document back with practically 57 pages removed, what is in those 57 pages that we ought to have access to? That is just one example of lack of information and the lack of cooperation from this agency.

Throughout history, Congress has engaged in oversight of the executive branch. The right to congressional oversight has been asserted from the earliest days of our Republic. In 1792, the House invoked its authority to conduct oversight when it appointed a committee to investigate the defeat of General St. Clair and his Army by Indians in the Northwest and empowered the ``call for such persons, papers, and records as may be necessary'' for that inquiry.

In fact, the Constitution grants Congress extensive authority to oversee and investigate executive branch activities.

Congressional oversight was also recognized explicitly in the passage of the Legislative Reorganization Act of 1946,

which required the standing committees of Congress to exercise continuous watchfulness over programs of agencies in their jurisdiction. Numerous Supreme Court decisions will support all the precedents for Congress to see all aspects of the Federal Government.

In 1927, in McGrain v. Daugherty, the Supreme Court upheld congressional authority to conduct oversight of the Teapot Dome scandal. Justice Van Devanter writing for the unanimous Court stated:

We are of the opinion that the power of inquiry with the

process to enforce it is an essential and appropriate

auxiliary to the legislative function.

To do oversight, Congress needs access to information and people in the executive branch. And that is what I did not, and still may not, be getting from the FDA under the leadership of Dr. Von Eschenbach--as an example, 47 pages removed; another example, 43 pages removed.

How are you going to conduct oversight when you get answers such as that from the Food and Drug Administration?

I take exception to the statement made in support of the cloture motion. People ought to be ashamed of saying Dr. Andrew von Eschenbach has done a superb job in the position he is currently occupying with an answer such as that to the Congress of the United States. That is an insult. Before you cast your vote in favor of cloture, consider what is at stake--and particularly Members on the other side of the aisle who, during the campaign, in campaign commercial after campaign commercial after campaign commercial, said Congress is not doing its job of oversight, implying that Republicans were covering up wrongdoing by the administration. If you want to preserve your access to information and do the oversight that you think you are going to do, when you are in the majority and you get answers such as that, do you think you are going to be able to do the job of oversight?

In my interactions with the Department of Health and Human Services and the FDA these last 8 months, I have seen a complete and utter disrespect for congressional authority and hence the law. The department and the Food and Drug Administration have repeatedly failed to act in good faith in responding to congressional investigations--and the lack of 43 pages is just one example.

Although the Director's leadership at the FDA has failed to fully comply with two congressional subpoenas that were issued 7 months ago, efforts to accommodate the agency's concerns fall on deaf ears, and I wonder if I am dealing with dysfunction by design. Not only has the NEDA withheld documents that do not appear to be privileged, but it also says what has been withheld and why. The subpoenas compel a privilege log, but the FDA has not provided us with that privilege log.

For Democrats in the majority next year doing the oversight that they said they were going to do because Republicans weren't doing it--they didn't let me--let me ask you this: Are you going to be able to conduct oversight when you get answers such as that? Are you going to be able to conduct oversight when, for 7 months, you don't get your subpoenas responded to? What is the agency's explanation? The FDA has said that many documents have been withheld, that it is unduly burdensome to provide a privilege log. Even in the FDA, general counsel, as recently as Tuesday of this week, could not see why the agency needed to comply with the law and the terms of the subpoena which was issued by the committee.

In denying the committee access to the documents responsive to the subpoena, which the department and the FDA administration have claimed ``prosecutorial deliberative process'' or ``confidential communications'' or ``agency prerogatives'' to determine who will be interviewed and testify before a jurisdictional committee, when those on the other side of the aisle get answers such as that when you are going to be in the majority, what are you going to do about it? Are you going to keep your commitment to the American people when you won the majority? And are you going to be able to do the oversight when you get rationales such as ``prosecutorial deliberative process'' or ``confidential communications'' or ``agency prerogatives?''

I could not talk to a line agent named West because you can't talk to line agents, when 3 months before I talked to line agents? There was someone from the Justice Department before the Judiciary Committee, when Senator Kennedy said, ``I want access to line agents,'' unrelated to what I am talking about: Line Agent West, whom I wanted to talk to and I was told I couldn't talk to because you can't talk to line agents, the official at the Justice Department said to Senator Kennedy:

You can talk to line agents. We will get them for you.

I do not know whether that ever happened. But that was the answer.

When I went around doing my questioning of Justice Department officials, I said: What about my ability to talk to Line Agent West? It just seemed as if I was going to be able to talk to Line Agent West. But yet this very day the Justice Department is advising the Secretary of the Interior that we can't talk to Line Agent West, which is key to whether some of these investigations are allowing dangerous drugs on the market. In Cedar Rapids, IA, I have a family that lost an 18-year- old because of a drug that was on the market then and which is not on the market now.

It seems to me that if you are concerned about the safety of drugs, this information is important, and if you are going to have it covered up in the FDA, you aren't protecting the public. If Congress knows about it, you are not doing your job of oversight.

This past summer I asked the Congressional Research Service to look into the department's policies regarding this matter. And the Congressional Research Service told me that there is ``no legal basis'' for the department's executive branch assertion. The legal analysis provided by Congressional Research Service supports the committee's position that these executive agencies' claims have been consistently rejected and compliance with congressional requests in the past has been forthcoming. The CRS cites numerous court cases which establish and support Congress's power to engage in oversight and investigate activities and its access to executive branch personnel and documents in carrying out our powers of oversight.

The Department of Health and Human Services, the FDA within Health and Human Services, says it has been responsive because the agency made available hundreds of thousands--even millions--of pages of documents to the Finance Committee in response to its subpoena. But the agency can give me all of the books and all the documents housed at the Library of Congress and it won't matter if it is not what I have asked for and the pages are removed.

It is this type of cooperation that I am getting under this Director that you are now going to confirm. I am very concerned about the cooperation, if any, that we have once he becomes a permanent commissioner. Every Member of Congress should be equally concerned if they take their constitutional duty of conducting oversight of the executive branch seriously, and most importantly to the new majority when you are going to carry out your campaign promises to make sure that there is proper oversight, checks and balances against an executive branch of Government you think is exceeding authority. Every Member should be concerned. I cannot emphasis this enough.

A vote for cloture today is a vote against oversight, and that is not what this Senate should be doing. It is not what the American people sent us here to do. We need to step up congressional oversight to protect our Nation's system of checks and balances and not reward those who seek to impede our constitutional authority.

This body should not walk hand in hand with the executive branch and sit idly by as instances of abuse and fraud continue to endanger the health and safety of American people. This Senate needs to make it clear to the executive branch that Congress takes its oversight responsibilities seriously and to vote against cloture. If we do have cloture, I will have other remarks during postcloture debate.

Mr. President, I spoke earlier this morning against cloture. Cloture passed, which for the public listening means there are 60 percent or more in support of stopping debate, and there is under the rules the possibility of 30 hours of debate. I don't intend to probably speak for more than a half hour, so if anybody is interested in how long postcloture debate might go on, it won't go on very long from my point of view. But I do want to take some time to tell people, even though it is quite obvious this nominee will be approved, why I think he should not be approved.

I placed a hold on this nominee for quite a few weeks. That hold obviously was ignored by the leader when he filed cloture, which is his right to do. I voted against cloture because I take my constitutional duty to conduct oversight of the executive branch of Government very seriously, and I think the nominee is standing in the way of Congress doing its oversight of the agency of which he is now Acting Director and will probably soon be the confirmed Director. That sort of lack of cooperation violates the separation of powers and the checks and balances within our constitutional system.

I hope my colleagues know that I take a great deal of time to make sure that we do both jobs we have the responsibility to do here in the Congress. One is to pass laws. But the one we are never taught much about in political science classes is the constitutional job of oversight, which is the responsibility to make sure the laws are faithfully executed and money is being spent according to congressional intent, and the overseeing of the administrative branch of Government. So I take a great deal of my time in the Senate trying to make Government work not just by passing laws but by making sure they are faithfully executed. I don't do that all by myself as a single Senator. I have good staff. I charge my staff to conduct oversight rigorously and to investigate any areas where the Federal Government is failing to be transparent, accountable, and effective. Transparency is so important, because the public's business, which is everything about the Federal Government, ought to be public. If the work of the executive branch fails the

sniff test and the law is not being faithfully executed or the public's business is not being made public, that is when it is my constitutional responsibility to blow the whistle.

Quite frankly, I don't want to take credit for what I am able to blow the whistle on, because there are a lot of good, patriotic employees in the executive branch of Government who also know it is their constitutional responsibility to execute the laws and spend the money right. When they see it isn't happening, and particularly when they go up the chain of command and don't get results, or when taxpayers monies are being wasted and it seems nobody cares, then they exercise the right they have under laws to blow the whistle to Members of Congress.

So we obviously count on whistleblowers--in other words, patriotic Federal employees--who report something wrong when people above them don't care. They care enough to come to us and give us a lot of good information. So today I am blowing the whistle on this nominee. In good conscience, I did put a hold on the nominee, and I will not vote in favor of him for the reasons I have given before and reasons that will be more spelled out now. A vote for this nominee would be an endorsement of the stonewalling, but, more importantly, the disrespect for Congress he has shown by not cooperating with congressional oversight. I can say this not only because of his actions but because of his words which are on the record.

In response to a nomination question in which I asked this nominee if he would cooperate with congressional oversight, Dr. Von Eschenbach identified a number of ``executive branch interests'' as a basis for not complying with congressional requests, including ``matters pending before the agency.'' And ``predecisional deliberative process information,'' and ``open investigation information.'' You get this sort of gobbledegook as excuses for not giving information to Congress as they promised to do but, outside of that, that the Constitution requires they do; that is if you believe in the checks and balances of our Government and if you believe it is backed up by Supreme Court decisions. It seems to me it has a good basis.

This nominee was not well-served by whoever counseled him on these matters. He should know that during my years in the Senate, my investigators have obtained access to every single one of these categories of so-called confidential information. I would say to the distinguished chairman of the HELP Committee who is watching over this nomination process--confirmation process--he said to me before the vote on cloture it would help if we got Dr. Von Eschenbach approved because now he is an acting and maybe he can't do all the things that he can do as Director, and that may be true. But not once in my discussions or my staffs' discussions with people at FDA was there ever a hint from the nominee himself that once approved, he would be able to give us all of these documents. I use this chart as an example: You get an answer to a request and you get 57 pages removed. Another chart I had up here showed 43 pages were removed. And what is in those pages? Who knows what is in them. We don't even know why they were removed, and we don't know who made the decision to remove them.

That is cooperation with Congress? Not once, I say to Senator Enzi, did he ever tell me or my staff or people who are working for him that if we could get this confirmation over, we will be able to satisfy what you want done. So I don't see anything better, with a vote of approval by the Senate, of cooperation with us than before.

But he wasn't well-served by those who counseled him. He should know that during my years in the Senate, my investigators have obtained access to every single one of these categories of so-called confidential information. His answer is at odds with my belief that congressional oversight is one of the best ways to shake things up at a government agency and expose the truth. The truth will make Government look better, or if the truth doesn't make Government look better, at least you are being candid with the American people. Besides, it is the public's business, and whether it is good news or bad news, it ought to be public.

Dr. Von Eschenbach's answers happen to be at odds with my belief that congressional oversight is one of the best ways to get to the bottom of things. This is true not just of the FDA; it is true of any Government agency. If an agency is not doing the right thing, typically behind it there is an effort to keep information suppressed, an effort to keep people from doing what they think ought to be done, an effort to keep people from doing what their job requires them to do, or to not let them put out that information. The muzzling of dissent and information is too common throughout our Government. Things that should be transparent in Government simply are not. And under Dr. Von Eschenbach, the FDA has not only avoided transparency, it also has threatened those who are trying to desperately expose the truth.

That is not just under Dr. Von Eschenbach. For years before him, there has been intense pressure brought to bear upon scientists who want to do the scientific process. I say ``do the scientific process'' because the scientific process answers itself or gives the answer. That is what we want: answers on safety and efficacy of drugs.

There is a culture there--even prior to Dr. Von Eschenbach, for any serious Director who wants to change it--that is going to make it very difficult to change because you have an agency that is more interested in its public relations and how they look to the public-at-large than what their job is. That is when they end up getting egg on their face, when they are more concerned about their public relations than just doing the job. In most instances, if these agencies do what they are supposed to do, things get done and get done effectively, and then the public relations takes care of itself. Good policy, good administering of law, is good public relations. It will take care of itself.

I met with this nominee after the White House sent his nomination to the Senate last March. I hoped he would provide the kind of strong, permanent leadership this agency needs to change its culture, where scientists are intimidated from doing their work. Over the next 9 months, this nominee showed me that he is unlikely to provide that kind of leadership. My belief is what you see is what you get. I fear what we will get from this nominee is what we got from him where he is now as the Acting Commissioner. Let me tell you why, with just a few examples.

First, the doctor failed to live up to his word. In our meeting, he said he respected and understood the important role Congress plays as an equal branch of Government. But it didn't take long after that meeting before the first red flags appeared.

In April, the committee began its investigation of the Food and Drug Administrations's approval and postmarket surveillance of the Ketek drug, an antibiotic that came under renewed scrutiny last January. It looks as though it is another drug where the FDA was caught flatfooted. The Finance Committee issued two subpoenas in May after the FDA refused to provide documents related to Ketek. I referred to a family in Cedar Rapids, IA, who lost an 18-year-old son.

During this time, the Food and Drug Administration also refused access to Food and Drug Administration officials. The Finance Committee was forced to issue a subpoena to a special agent in the FDA's Office of Criminal Investigation. The FDA refused to allow my staff to speak to this Federal employee, citing a policy against providing access to line agents. Yet, only months before, just a few weeks before that, my staff interviewed two line agents from the Food and Drug Administration on another case. What rule was in place when I interviewed them, but a few weeks later you couldn't interview another? Apparently, the policy was abruptly changed. I have seen it change over the years with other investigations. This policy is not law, and it is typically enforced when the stakes are at their highest and there is something to hide.

I took this matter seriously enough that I went to the Department of Health and Human Services to meet with this agent. I was told that if this agent wanted to speak to me, he would have to assert his status as a whistleblower under Federal law. I ask today

what I asked that day: Why does this Government employee have to become a whistleblower to talk to me or anybody else in Congress if the public's business is really public?

So I have to ask my colleagues, is that acceptable? When you are doing your constitutional responsibility of oversight, is it acceptable to the rest of you in the Senate that they thumb their noses?

Also, this Government employee's supervisors put him in a no-win situation, and because of that he risked being in contempt of Congress. This is an agent who put a doctor in jail for fraud in the Ketek study.

You understand, I said this started back in January with Ketek and our getting involved in the oversight. There was fraud in this Ketek study. Did the agent do the right thing? It is a closed case. We want to talk to him about the closed case, and the Food and Drug Administration says no. So I have to ask, what does the FDA have to hide or cover up?

There are enough instances of political leaders and public servants being ruined by coverup. Can't lessons be learned, that when, in this town, two people know something about it, it is no longer a secret?

Under this Acting Commissioner, the Food and Drug Administration has also attempted to hide and cover up documents. The Finance Committee has received hundreds of pages that say, as I indicate here, ``57 pages removed.'' There is another poster behind it that looks exactly the same: ``43 pages removed.'' Other documents have whole pages, paragraphs, or sentences redacted, with no explanation as to why. Sometimes documents are marked ``redacted.'' Other times they are not marked, even when it is evident that information is missing. There is no explanation for what documents have been withheld or redacted. It is incomprehensible, and it looks like the work of the Keystone Cops rather than an agency responsible to the American public for the safety of drugs and devices and the efficacy of drugs and devices.

One of the Food and Drug Administration's most incompetent and absurd moments was when it sent one of my own request letters back to me with information redacted out of it. Let's get this clear. You folks are defending a person who is running an agency from which I asked for information and they redacted the letter I sent to them. The letter I wrote came back as part of the information. Does that meet the commonsense test? Does that meet the test of competency?

Recently, I wrote Secretary Leavitt and Attorney General Gonzales to explain the basis for some of these redactions. I don't know whether you call a blank page a redaction because you don't know what has been there to redact, but obviously there is no information on a blank page unless it is about the competency of the people who work within the agency.

Again, two copies of the same document were redacted differently. Think of this. They want to keep us from getting information. They send us two copies. One copy has one sentence redacted, and the other copy doesn't redact that sentence but redacts another sentence. So we got the whole document but presumably a basis for things we were not supposed to know but now we know. Do you think this guy with a medical degree, with this sort of background, is going to go in and change that culture even if there was nothing wrong with him? Even if he cooperated with me? So it calls into question the good-faith basis for redaction at all.

I could go on and on with examples showing the stonewalling and the withholding of information from legitimate congressional requests, pursuing our constitutional responsibility of oversight. What it boils down to is that this nominee has demonstrated he does not understand that Government truly is the people's business. He doesn't seem to understand that the people who finance it, the taxpayers, have a right to know what their Government is doing and how their money is being spent.

I will give one final example. I have been a longtime champion of whistleblowers. I was the lead Senate sponsor of the 1986 whistleblower amendments to the False Claims Act. Back then, we were interested in dismantling a too-cozy relationship between defense contractors and the Pentagon. Today, whistleblowers are once again the key to dismantling the cozy relationship between some drug companies and the Food and Drug Administration.

In June, Dr. Von Eschenbach held a meeting of FDA staff involving this drug I have been investigating, questioning how it was handled-- Ketek. FDA employees who were present say that he used a lot of sports metaphors regarding being a ``team player'' and keeping opinions ``inside the locker room.'' Basically, he said to not criticize the FDA outside the locker room, ``outside the locker room'' being his words. Apparently he stated that anyone who spoke outside the locker room might find themselves ``off the team.''

How are you going to do your job of congressional oversight if you have somebody you are getting confirmed who says that if you want to talk to anybody, they better not talk to you, at least not talk off note, because they are no longer on the team? Just think of the intimidation that brings throughout the Federal bureaucracy.

This nominee held this meeting in the midst of this ongoing congressional investigation of this drug Ketek. He called the meeting after a number of critical reports in the media about the FDA's handling of Ketek. A number of FDA employees interviewed by the committee were offended by his comments, found them highly questionable, inappropriate, and potentially threatening. I don't think there was any ``potential'' about it, they were meant to be threatening, and I agree with the employees.

Leaders of an agency should not hold a meeting to suggest that dissenters will be kicked off the team, particularly when the lives of American people are at stake, when drugs are going to be put on the line and they might not be safe. I can refer to the death of an 18- year-old in Cedar Rapids, IA. His is the type of action that shows the true stripes of the nominee. He broke his word that he respected whistleblowers--that is what he told me; quite obviously he doesn't respect whistleblowers--and that he would never raise even the appearances of retaliation. If this meeting isn't an example of retaliation, I don't know what it is. When it comes to health care and public safety, we need to empower whistleblowers more than ever. They demonstrate extraordinary courage in the face of extraordinary adversity. It is extremely difficult to be a whistleblower. As I like to say, they are about as welcome as a skunk at a picnic. Yet it is whistleblowers in Government who put their job security on the line to come forward and expose fraud or wrongdoing for the public good. My Finance Committee staff has been investigating serious allegations raised by whistleblowers at the FDA on various issues over a period of 3 years. Many of these allegations are very serious and call into question whether the Food and Drug Administration is fulfilling its mission to protect the health and safety of Americans. The way the Food and Drug Administration under this nominee has handled the investigation of Ketek shows the agency would like to keep its business secret. It doesn't want these issues made public or subjected to scrutiny. The culture at the FDA has been we will let the public know what we think they need to know.

The American people do not want the government making decisions about what is good for them behind closed doors.

The goal of the Finance Committee's oversight has been straightforward. As chairman, I wanted to bring out in the open the decisions made by the FDA. For too long the agency has been making its decisions behind closed doors.

This nominee is not likely to serve well because he just does not seem to get it. He has placed media relations over the mission of the FDA. First and foremost, he is supposed to do the right thing on behalf of Americans. Dr. Von Eschenbach has other interests to serve and they are not always the interests of John Q. Public.

I hear from time to time from other agencies that particular documents are especially sensitive or that the release of certain documents could jeopardize a criminal investigation--I understand that. But in those circumstances, I have reached accommodations. Unfortunately, in this case, my efforts to work with Dr. Von Eschenbach and his subordinates have been all but summarily dismissed.

As I am sure you know, I intend to keep pressing the FDA for greater

transparency and openness. I think there is going to be new leadership in the Congress which is going to be even more aggressive and has a history of being more aggressive in this area. I have been welcoming and I continue to welcome that sort of help.

As I continue with my constitutional duties to conduct oversight, I look forward to working with my colleagues to ensure transparency, accountability, and effective governance by the executive branch. The bottom line is Congress needs to stay committed to oversight of the executive branch. The public depends on Congress to fulfill its duty and hold executive agency leadership accountable. To sum up, that is what congressional oversight is all about.

I yield the floor.

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

Mr. President, for one final time, I wish to address the nominee before us, Dr. Von Eschenbach, who is up for Commissioner of the Food and Drug Administration and who I think should not be approved for the position by the Senate.

I have considered Dr. Von Eschenbach's performance on the job for more than a year now because he was appointed Acting Commissioner in September of 2005. In fact, over the last year I have closely monitored his actions, reactions, and his public and private comments to the FDA staff and to the public.

This nominee inherited a Food and Drug Administration plagued by cultural and structural and personnel problems, and I surely do not blame him for the problems, but I have to look at whether he is the person to correct those problems. Because this agency is plagued by these cultural and structural and personnel problems, FDA is in desperate need of a leader, a leader who can not only restore the public's confidence in the agency but also restore the agency's confidence in itself.

I met with Dr. Von Eschenbach more than once. We talked, and he seemed to be very nice. He has, of course, without dispute, excellent credentials. He promised me full cooperation in my oversight work I was doing and the investigations I was doing, but, in fact, it did not happen. Instead, I had to issue two subpoenas. So far, he has not complied with those subpoenas which were issued 7 months ago. This reflects a lack of respect for the authority of Congress conducting its constitutional responsibility of oversight of the executive branch of Government.

In addition, under Dr. Von Eschenbach's leadership, the FDA remains in a state of denial about all these cultural problems to which I have referred. A coherent action plan to address the problems is nowhere to be found. Dr. Von Eschenbach has told me that there is room for improvement in the area of technology, but it does not appear that he understands the depth and breadth of problems affecting the Food and Drug Administration.

The FDA is in serious trouble, and I am not the only one saying so. Over the last year, we have heard from the Government Accountability Office, the Union of Concerned Scientists, and just a few months ago we had a scathing report from the Institute of Medicine.

The Institute of Medicine completed a $3 million, 15-month study and set forth 25 recommendations. This report by the Institute of Medicine conveys a sense of urgency to fix the problems. Just last month at the Health, Education, Labor, and Pensions Committee hearing, the chairman of the Institute of Medicine committee that produced the report said:

If there ever was a time that it was critical to address

these issues, it is now.

The next Food and Drug Administration Commissioner must be a person who not only has excellent credentials, as I have said he has, but who also will accept the criticism of the agency and develop coherent solutions.

Here is what the Institute of Medicine reported:

The committee believes that cultural changes are urgently

needed to support a stronger, more systematic and more

credible approach to drug safety in the Center of Drug

Evaluation and Review and it recommends solutions to the

problems created or exacerbated by the elements of the

Center's management, structure and environment.

Now a short quote:

Many have observed signs of an organizational culture in

crisis.

Another quote:

The Center's leaders have to be prepared to address the

underlying cultural problems that divide and impair the

optimal functioning of the Center's staff and effectively use

the existing and new authorities and resources to achieve the

Center's public health and regulatory mission.

These criticisms of the Food and Drug Administration have come from outside the agency, not from whistleblowers reporting to me. But I also continue to hear from these employees inside and also from managers inside the Food and Drug Administration who were concerned about the integrity of the Food and Drug Administration's work. What is also troubling is that some of these employees have experienced intimidation or reprisals for voicing legitimate concerns.

I have fought long and hard over the last two decades to protect the rights of numerous whistleblowers who expose fraud, waste, and abuse. When I met with Dr. Von Eschenbach in March, he told me that he was ``committed to whistleblowers.'' Yet his actions seem to suggest otherwise.

The worst example may be when Dr. Von Eschenbach ordered a meeting with the FDA staff after the press reported information that was critical of how the FDA handled safety issues with the drug Ketek. I keep referring to Ketek because it is a drug involved in the death of an 18-year-old boy in Cedar Rapids, IA. As I understand it, Dr. Von Eschenbach sent a clear message at this staff meeting. Some suggested that this attempt was simply to boost morale among FDA employees, but some longtime FDA employees saw it differently. They took his word that anybody who spoke ``outside the locker room'' might find themselves ``kicked off the team''--literally. And I don't blame them for taking offense at that. People are trying to do their job, and you talk about what is wrong and you might be fired for it? People like that ought to be upheld and honored. In the final analysis, they ought to have their concerns addressed within the agency and not have to come to those of us in Congress because they are not getting any ear in the agency. So they took his message to mean: Your career is in jeopardy if you happen to come to Senator Grassley or outside the agency or to any Member of Congress. To me, it shows his poor judgment and intolerance for dissenting opinions and also for what is basic to American government, that the public's business ought to be public.

Dr. Von Eschenbach also told me that he was a man of ``discipline, rigor and precision.'' Those are his words. He used those same words in a speech:

We will retain all the rigor, all the discipline and all

the precision of regulation, but our efforts will be geared

so that things can move faster rather than slower.''

We can all agree that new drugs and devices should be available to the public as soon as possible, but there is also the issue of safety and the protection of the public. The FDA must do its job and ensure that the drug's benefits outweigh its risks before approval.

My other concern regarding Dr. Von Eschenbach is that he assured me of his commitment to respond promptly to requests from Congress. That is a promise which was never kept. So do I have a reason to be concerned about this person, regardless of the very good credentials he has? My oversight of the FDA has consequently been slowed by inaction on the part of his agency. In fact, he has not responded to a letter I sent to him 9 months ago, and my requests for interviews with some FDA officials were ignored for more than 3 months and some still have not been scheduled. As Acting Commissioner, he has ignored congressional requests, and I do not expect that will change if he is confirmed by the Senate.

Before I close my remarks, I ask unanimous consent to have printed in

the Record the full text of a letter I sent to the Acting Commissioner in September.

The letter lays out the major problems at the FDA. I encourage my colleagues to read it and, maybe more important, emphasize again reading the Institute of Medicine's criticism of the Food and Drug Administration.

The FDA needs a permanent commissioner to tackle these problems. Unfortunately, I believe the nominee is not the person for the job. Over the past year, the nominee has failed to step to the plate and failed to keep his assurances to me. He has said the agency needs to be a facilitator, but think what the word ``facilitate'' means or what ``being a facilitator'' means. It could mean a cozy relationship between the FDA and industry. What is called for is someone who recognizes that the FDA is supposed to be a regulator, not a facilitator.

I am also afraid he will allow FDA management to continue pressuring FDA scientists to change their findings or conclusions and to approve the products despite concerns about the safety and efficacy of the product. Dr. Von Eschenbach is not prepared to provide the leadership necessary to restore confidence in the FDA.

Given these concerns, I hope my colleagues will take them in consideration before they vote. I intend to vote no. I hope my colleagues will so that we can have a person in this position who will change the culture but also cooperate with the constitutional responsibilities of the Congress of the United States to oversee the executive branch.

I yield the floor.

Mr. President, I would like to take this opportunity to offer my sincerest congratulations and gratitude to retiring U.S. Attorney Charles ``Chuck'' Larson, Sr. While I could easily just focus on all Chuck has done in his years as the dedicated U.S. attorney for the Northern District of Iowa, this man has given so much more in over 40 years of Government service.

When his country has called, Chuck has been there. He served in the U.S. Army and Army Reserves for 40 years, retiring as a lieutenent colonel in 1989. Four U.S. Presidents have called on Chuck to serve in various capacities, and each time he has stepped forward and served with honor and distinction.

Chuck was first appointed as the U.S. attorney for the Northern District of Iowa by President Ronald Reagan in 1986 and continued to serve in this position under President George H.W. Bush through 1993. During his service at this post, Chuck went well above and beyond. He devoted himself to fighting the scourge of drug crime and abuse by bringing local, State, and federal agencies together. Chuck also recognized the need for community outreach, and he pioneered a number of programs that brought together community leaders, clergy, and citizens to explore approaches to reduce drug abuse in Iowa.

These ideas were recognized as very innovative at the time and led to President Clinton's call for Chuck to serve on the Commission on Drug- Free Communities, a post in which Chuck served with distinction and which his son, Chuck, Jr., fills today.

Following the tragic events of September 11, 2001, Chuck was again called to duty as the U.S. Attorney in the Northern District of Iowa by President Bush. He continued his aggressive and innovative strategies in this new and complex era of the war on terror. His efforts led to programs for the training of law enforcement and other emergency responders in dealing with and preventing terrorist attacks. Chuck extended this training effort to private industry and trade associations. Yet Chuck never ceased his efforts in Iowa in fighting crime and drug abuse. His past successes in community outreach programs and law enforcement coordination led to the creation of programs such as the ``Weed and Seed'' initiative in Cedar Rapids and the statewide ``Meth and More'' program. These programs not only helped put criminals behind bars but also provided help and support to thousands trapped in the destructive cycle of methamphetamine abuse and educated Iowa communities about the disastrous effects of drug abuse. His devotion to this cause can be summed up in Chuck's own words, ``if we can save one life, then our efforts are a success.''

In the midst of this, his country called yet again. In 2004, Mr. Larson was ask to serve as the senior Department of Justice representative in Iraq. Chuck was given the enormous task of directing and administering efforts to train Iraqi judiciary, law enforcement, and civilian contractors. He was tasked with nothing less than restoring justice and equity to the Iraqi judicial system. Despite the inherent dangers and complexities of his mission, Chuck yet again served with distinction.

Again, I offer my thanks and congratulations to U.S. Attorney Charles Larson, Sr. Chuck's dedication, devotion, and courage, again and again, provided invaluable service to our country and the great State of Iowa. Chuck, you are a true American and a model for all in Government service.