Floor Statements

Mr. President, I ask unanimous consent that Oliver Kim, a fellow in my office, be granted floor privileges during the consideration of S. 1.

Mr. President, I thank my colleague from Louisiana, who I know has spent years focusing on the issue of health care and Medicare prescription drug coverage.

First, while I present an opposing view in terms of some of what is discussed here, I share the commitment and desire of all of us to do what is right in terms of the seniors and those with disabilities who are on Medicare who have waited for too long for us to come together and act as a body, along with the President.

I will start by commending my colleagues on both sides of the aisle who have been diligently working through a number of issues and a number of obstacles to come up with an approach they believe is the best approach or the most doable approach right now before the Congress. Certainly, Senator Grassley, Senator Baucus, Senator Breaux, Senator Jeffords, who just spoke, Senator Snowe, and many others have been involved in these discussions.

As one who has spent a tremendous amount of time myself focusing on Medicare and the need for updating and strengthening Medicare to cover prescription drugs, I commend them for their desire and concern and hard work in coming to this point. I do not believe we are doing all we can do and should do as a country or as a Congress for our seniors under Medicare.

I do believe Medicare has been a great American success story since 1965. I agree that it needs to be modernized, and not just prescription drugs but I agree with the Secretary of Health and Human Services who focuses on prevention. I commend him for his efforts and agree with him that we need to modernize Medicare to focus more on prevention and other options that can streamline the system and make it more efficient.

I do not believe, however, that we save dollars or create a more efficient system by turning over prescription drug coverage to private insurance companies. At the appropriate point, I will be offering an amendment that will give true choice to seniors by allowing them to choose a private sector option but to also be able to remain in traditional Medicare and get the help they need if that is their choice. If we are truly talking about choice, I believe the choice should be with the senior.

This really is a question of whom we are designing the system for, whether we are designing it for the insurance companies, for the pharmaceutical companies, or for the people who are covered under this system. I am concerned that we can do a better job for our seniors if, in fact, we offer them a true range of choices.

I find it interesting at a time when I am back home in Michigan talking to the big three automakers or small businesses or others who are struggling with insurance premiums in the private sector, the premiums are skyrocketing. The average small business has seen its health insurance premiums double in the last 5 years. The automakers and other manufacturers in my State have seen their premiums go up 20 to 30 percent a year, forcing them to freeze pay increases for employees, asking them to pay a larger share of the cost, cutting salaries or, in some cases, people losing their jobs because their business cannot afford to maintain the skyrocketing premium increases in the private sector.

Given that fact, I find it ironic that we are suggesting we would save dollars by going to a private for-profit insurance model where, in fact, the premiums have been rising two or three times faster than those under Medicare; that when we look at the administrative cost difference, it is less under Medicare. When we look at the current choices we have between Medicare+Choice, which is Medicare HMOs, or traditional Medicare, we hear that studies have shown that to provide the same service through the

HMO, on average, costs 13.2 percent more than if it were provided through traditional Medicare.

So I question, as we have precious few dollars to work with to be able to provide the services and the care for which our seniors are asking, the wisdom of moving to a model that is rising in cost faster than Medicare. I have not seen evidence where, in fact, it will provide the kind of competition to lower the prices, which we are all looking for from the private sector at this time. In fact, what I am hearing from the business community is they want us to partner more with them, the public sector and the private sector. Because we now have our global economy and businesses competing around the world and because we are the only employer-based health insurance system among the industrialized countries, they find themselves at a competitive disadvantage and are asking to partner with the private sector to both contain costs and be able to help them compete and continue to be able to provide insurance coverage.

So in light of all of these discussions that are going on, we look at Medicare, which is the one piece of a health system that Congress in its wisdom back in 1965, along with the President, said we are going to make sure is available, universal, once one is 65 or if they are disabled, regardless of where they live; if they are in the Upper Peninsula of Michigan, Detroit, or in Benton Harbor, they know they will be able to have insurance coverage, be able to choose their own doctor, be able to get the care they need. They know what it costs. They can count on it. That is the miracle. That is the reason so many seniors overwhelmingly choose traditional Medicare rather than other private sector options.

So we come to the difficult choice now of how to provide prescription drug coverage, and there is a difference of view certainly about whether we should strengthen traditional Medicare or provide incentives, encouragement, a carrot stick--whatever one wishes to call it--for those to go into managed care. I commend my colleagues for attempting to find that balance in the middle. I believe the balance really is not struck unless we make sure that traditional Medicare is part of that choice.

I also am very concerned that we hear constantly that, in fact, we have a situation where we can only afford to go a part of the way. It is my understanding, when all is said and done, we are talking about providing most seniors--certainly middle-income seniors--with 20 or 25 percent to help with their drug bill over time. I do commend the structure for low-income seniors, but overall we know we are not providing a comprehensive prescription drug benefit with the dollars involved. It is half of what it would take to provide the same coverage we have as Senators through Blue Cross and Blue Shield under the Federal employee health system. So we certainly are not providing what we, other Federal employees, receive for a comprehensive benefit.

I have often heard, well, we cannot afford to do that. I feel it necessary to indicate for the record one more time why it is we are talking about a system that is not comprehensive, will end for several months of the year for seniors, will not provide them what they need, and is complicated and convoluted, I believe, and that is because of another set of policies that were debated in this Congress not long ago, coupled with what happened in 2001, and that is the question of making a determination, a value judgment, that it is a bigger priority to provide tax cuts for the wealthiest, the privileged few of our country, rather than helping the many of our seniors and the disabled to be able to put money in their pockets through prescription drug coverage.

It is astounding to look at what that decision has done. We are told that the 2001 tax cuts made permanent and the other proposals passed over the next 75 years will, in fact, cost $14.2 trillion, where the projected Medicare and Social Security deficit combined--not just Medicare but Medicare and Social Security deficit--is $10 trillion.

This has been a conscious choice to make a decision to spend dollars in one way to help a few people in our country rather than to keep the commitment of Social Security and Medicare that we have had for many decades in our country. The fact that we are talking about an inadequate benefit that ends, that leaves coverage gaps of 3 or 4 months a year for our seniors, the fact that we are talking about an approach that does not do what they have asked us to do, is because of decisions made to take revenue and instead of investing it in health care for older Americans, instead of investing it in strengthening Social Security for the next generation, the decision was made to eliminate that revenue.

By the way, that decision has resulted this year in the highest single-year deficit in the history of our country. Unfortunately, a hole has been dug. I fear it will continue to be dug deeper and deeper with the decisions that will be made.

It is not too late to decide in this debate we will do it right--real choice, a real benefit--that we make decisions that are best for the majority of the people we represent. They are counting on us to do this right.

Mr. President, I appreciate a moment to have a chance to give an alternative view. I thank my colleague from Louisiana. He has worked diligently on the issue of prescription drug coverage for many years, as have other of my colleagues on the floor regarding this issue. I wish to take this moment following his presentation to speak to the fact that there is much work left to be done by this body before we have prescription drug coverage that in fact meets the needs and the desires of the seniors of America.

The plan being put forward tomorrow in the Finance Committee basically does two things. It offers two structures. The majority of those supporting it will openly indicate that they would prefer that the seniors of America go into managed care rather than stay in traditional fee-for-service Medicare, where the senior determines their doctor, pharmacy, and other choices.

There is a desire to move people into what are called PPOs and HMOs and other managed care. We have experience with this because, since 1997, there has been the choice on behalf of American seniors to stay in traditional Medicare, choose their own doctor and pharmacies, and so on, or to go into a Medicare HMO. We know as of today that 89 percent of the seniors who chose--they made their choice--have chosen to remain in traditional Medicare, which I believe is a very strong message about the confidence seniors have in the current system, the stability of it, the dependability of it. They know what the premium is, they know what the services are, and they decide their doctor. This has been in place and serving the seniors of the country since 1965.

So the plan the committee is intending to report out tomorrow would create more choices of HMOs and PPOs and other managed care, and I support that for seniors. But what it does not do is add a prescription drug benefit

under traditional Medicare as an integrated part of the traditional fee-for-service Medicare.

All of the prescription drug plans that are part of this report tomorrow involve private insurance first. If private insurance is available in your State, or available in the region, if there are two or more companies there, regardless of the premium they choose, the benefits they choose, and how they structure it, the pharmacies that they will let you go to, however they structure it, you would have to choose one of those two private insurance plans.

Now, technically, they are saying it is under Medicare but this is not a Medicare prescription drug benefit as the seniors of the country have asked to have provided to them. The seniors, potentially every year, would get paperwork in the mail about two different insurance companies--if that is available in their area--and they would have to wade through the paperwork and decide which of the two is best for them. The next year, if those two companies were not both available--if there was only two and one decided it didn't want to cover seniors anymore; it was too costly--then there would only be one insurance company; and the senior would have the ability, then, to go to a backup plan--something administered through Medicare.

Then the next year, if there were two companies that decided they wanted to try their hand in covering Medicare prescription drug coverage in their region, they could not get the Medicare plan anymore; they would have to pick between those two companies.

Potentially, this could happen every single year for a senior. Seniors are not asking for more paperwork or more choices of insurance companies. They already picked--89 percent of them--traditional Medicare, run through Medicare. Yet we are not giving 89 percent of them that choice.

That is a major concern I have about this plan. There is a better way to do this, to give people more choices, but make sure one of the choices is traditional Medicare.

I find it quite amazing that we are even talking about the structuring of a plan in this way at this time when we look at the fact that Medicare has been rising in cost about 5 percent a year and private insurance is going up 15 to 20 percent a year. In fact, I have small businesses, as well as large businesses, including auto manufacturers and many others, coming to me concerned about the explosion in their private health insurance premiums every year instead of choosing an approach that costs less so we can take some of those pressures off and put them into the best benefit, the best way to provide medicine for seniors. This approach uses what is a more expensive model--arguably, putting more dollars into the pockets of insurance companies but certainly not more dollars into the pockets of our senior citizens in the form of access to more lower cost medicines.

This is a deep concern of mine. Why are we going through all this convoluted process? Well, I think there are two reasons. One is there are those who philosophically believe we should move to private insurance, managed care. I respect that. I have a disagreement with that but I respect the philosophical difference. Some don't believe we should have universal health coverage under Medicare. I disagree.

I think Medicare has been a great American success story since 1965. In fact, it is the one part of the universal health care we have in this country, and it concerns me deeply if we are going to roll that back. There is a difference in philosophy--and I appreciate that--on the part of colleagues on both sides of the aisle.

We know there is something else at work here, and that is a very large and powerful prescription drug lobby, which I believe, at all costs, wants to make sure our seniors are not in one insurance plan together--40 million seniors and disabled people in our country, who would then be able to negotiate big discounts in prices. By dividing folks up into lots of different insurance plans, making it more confusing for people to stay in traditional Medicare and get prescription drug help, and trying in every way to move people more to managed care, the prescription drug companies know they will not be put in a position of having to substantially lower their prices for our seniors. I have deep concerns about this. I agree with my colleagues that we have to work together in a bipartisan way if we are going to put forward a bill. I am hopeful that through amendments we can, in fact, provide a better bill. I will be offering an amendment that will set up a real choice for seniors, allow them prescription drug coverage under Medicare, which is what they want, and then also allow the other options colleagues have put together in the legislation that will be in front of us.

I believe that is a true choice, and I believe it is a choice that will allow prescription drug prices to go down, and that is a more cost-effective choice overall for Medicare as a system as well as for our seniors.

I will also be working with colleagues, as we have been for the last 2 years, on other efforts to lower prices for everyone. I am very proud of the fact that on this side of the aisle, we have brought the issue to this Chamber of lowering prices through greater competition in the marketplace and, in fact, we are seeing headway in that area.

I commend my colleagues on both sides of the aisle who have been coming together in agreement on the issue of generic drugs. I commend the leader of the HELP Committee, the Senator from New Hampshire, Mr. Gregg, for his leadership, the Senator from Massachusetts, Mr. Kennedy, and the Senator from New York, Mr. Schumer, who helped lead this effort with Senator McCain to close loopholes that have allowed brand-name companies essentially to game the system, to keep lower cost medicine off the market, unadvertised brands called generics.

There is a coming together that is very positive and bipartisan to pass legislation to close loopholes and allow greater competition. I believe this is one of the most important ways we will, in fact, lower prices more than anything else to get more competition for unadvertised brands in the marketplace.

There are two other issues about which we have been offering amendments that I encourage colleagues to support as a part of this process. One is to open the border to Canada for prescription drug coverage. From the State of Michigan, it is frustrating for the seniors, families and, in fact, the businesses in Michigan to literally look across the river and know that on the other side of that river they can get their American-made prescriptions at half the price and, in some cases, at even deeper discounts.

I urge we come together and open the border to Canada, and for colleagues who have resisted that, I ask that we look between now and 2006, when the prescription drug bill takes effect, at the idea of a pilot project of opening the border to Canada until 2006 so that we can drop prices immediately.

Our seniors have waited long enough. They do not need to wait another 2\1/2\, 3 years to see prices go down and Medicare help come. Let's open the border now. Let's sunset the pilot project when this bill takes effect, and then we can evaluate any concerns that have been raised about that process. That is something we can do right now that would have 10 times the effect of lowering prices than another discount card for seniors.

The other issue I am hopeful we can support on a bipartisan basis is to support States that are being creative in their purchasing power to get discounts for their citizens; efforts such as in the State of Maine to use their discount power to lower prices for the uninsured.

There are very positive steps we can take together. The generic drugs bill is a very positive initiative. I appreciate the leadership on both sides of the aisle for bringing that forward and coming together in a positive way.

To conclude, when it comes to Medicare prescription drug coverage, I remain deeply concerned about the direction in which we are going. I believe we are moving in a direction that actually dismantles the only part of universal care we have; that, in fact, will end up with more subsidies and more money in the pockets of insurance companies and drug companies as opposed to putting money in the pockets of our seniors who desperately need help with their prescription drugs.

I hope that as we enter into amendments in the next week, we will come together in a way that improves this

bill and strengthens it, keeping in mind that our first priority should be the people right now who need the help. We can do that if we are willing to work together.

I yield the floor.

Mr. President, I wish to follow what my friend and colleague from Iowa was speaking about earlier in terms of the importance of Medicare. I think his comments were so right on point.

I find interesting--I was not around at the beginning for the debate--the debate on Medicare. I understand that in 1960, originally, there were proposals to provide a broad universal care for all Americans and that, in true compromise form, the Congress and the President, when there was not support for that, ended up with a plan called Medicare for seniors and the disabled in this country. So it was a compromise. It was viewed as a first step, not a last step, in providing universal care for all Americans.

I believe Medicare has been a great American success story. We have seen both Medicare and Social Security bring our seniors out of poverty. Today, we have about 10 percent of our seniors in poverty rather than close to 50 percent prior to Social Security and Medicare.

During that debate, if one reads the Record, there was a major concern about who could provide health care to seniors better--the private sector or the public sector through Medicare.

The reason the Congress, in its wisdom, decided to move forward with Medicare was because at least half the seniors could not find or could not afford health care insurance in the private sector. Seniors and all of us who are getting older and using more medications and going to the doctors more frequently understand that older Americans require more health care, more costs, and are not exactly the prize group an insurance company goes for. They want my son and daughter in their twenties and younger healthier people to balance out those of us who are getting older and needing more care.

We believed, as a great American value, it was important that older Americans have health care. It was important that those who are disabled have health care, be able to pick their own doctor, be able to go where they choose to receive their care but that they would know it was always there, it was stable, a constant premium; they would know what it would cost; they could pick their own doctor; and it has worked.

Since that time, there have been a lot of debates, and we have one going on today, about how to provide Medicare prescription drug coverage. But the real issue is beyond that. It is about how to provide health care for older Americans.

The next big change that happened of which I was aware in 1997 when I was in the House was to offer private Medicare HMOs. Also at that time, there were major cuts made in Medicare for providers. I believe they went way too far. Many of us have been trying to change that ever since. There were cuts to hospitals, home health agencies, and doctors that have affected people being able to get care.

At that time, something was put in place that was touted as this great new program. In fact, Tom Scully at the time predicted an Oklahoma land rush of moves to private health plans in 1999. He said: You are going to see seniors pouring into managed care Medicare.

In fact, that did not happen. That is not what happened. But what we have seen happen, unfortunately, is what the former Speaker, Newt Gingrich, talked about in terms of a strategy of cutting off resources so Medicare would wither on the vine, an effort to convince people that Medicare was not working, even though the majority of seniors know it is because they use it every day.

I found it interesting that back in 1997 there was a strategy paper put out by the Heritage Foundation, an extremely conservative organization that I know does not support Medicare as we have it today, advising my Republican colleagues. They recommended a strategy to move to the private sector by doing four things: First, to convince Americans that Medicare provides inferior medicine and poor financial security. They set out to do that. We are

going to hear a lot about that in this Chamber, that it is inferior medicine, even though seniors know that is not true. There is not evidence that is true, but we are going to hear a lot of talk--and we have for 5 years--about how Medicare is not as good.

Second, convince Americans that Medicare cannot be sustained for long. We have heard continually that we cannot afford it anymore. As my colleague from Iowa pointed out, if there is concern about being able to afford it, it is only because we are spending the money on tax cuts for the privileged few instead of beefing up Medicare and Social Security. So it is a conscious choice. It is a question of values and priorities that we have to decide every day, just as American families do.

Third, compare or reform the Medicare system to the Federal Employees Health Benefits Program. We hear a lot about that now: Seniors should have the same kind of plan that we do. I happen to agree with that, but during the tax debate I offered an amendment that simply said we are going to defer the tax cut to the privileged few at the very top, less than 1 percent of folks who already received a tax cut 2 years ago; we are going to defer the next one until we can fund Medicare at the level that Senators and House Members and other Federal employees receive. My colleagues voted no on that issue. It would cost twice as much as in the budget resolution--$800 billion instead of $400 billion--and, unfortunately, the majority voted no. But we are going to continue to hear about how we should have private sector plans instead of Medicare, and it should be the same as we receive.

I agree with that, and I am happy to offer my amendment any time folks want to support it so we can pay for that benefit and make it real for our seniors.

Finally, fourth, they said protect current beneficiaries. They said the calculation was the private alternatives generated by the voucher- style option, private HMOs, would be so much more efficient and so much more attractive that fewer and fewer seniors would decide to remain in the traditional system. Hence, Speaker Gingrich's remarks that the traditional Medicare system would wither on the vine because the demand for that option would decline sharply over time.

Obviously, that is not true. Nine out of ten seniors in this country, when given a choice, have picked Medicare. Seniors have made their choice. Since 1997 when they were given the option of private HMOs, they have overwhelmingly said no.

It is very interesting; 89 percent of the seniors in this country right now are covered under Medicare, and 11 percent are covered under a private sector HMO. Some do not have that option. In Iowa, there is not a private sector HMO. In Michigan, only 2 percent of beneficiaries have that option. Of the 64 percent of the seniors who have that option, only 11 percent of them have chosen to go into a private sector

Mr. President, I ask unanimous consent for an additional 10 minutes.

I thank the Chair.

Mr. President, today I wish to debunk the myths we have heard and are going to keep hearing so that we can get through what is fact and what is myth and focus on what we need to be doing, which is to strengthen Medicare to cover prescription drugs.

I agree with Secretary Thompson who says we need to focus more on prescriptions. We can do that through traditional Medicare in which seniors overwhelmingly have voted to remain. We can make sure they have their own doctor, the stability of knowing what their cost is for their premium and their copay, and still update the system to modernize it, using more technology, making sure we have more prevention, and making sure we have prescription drugs.

Fundamentally, I do not believe that is what this debate is about. If we can agree that we are going to do it through Medicare, then I believe we can sit down with the dollars available and work up something together, and I hope we will because the seniors of this country have waited long enough. I am very hopeful we will be able to do that.

I will briefly debunk what we are going to hear, unfortunately, and that we have to get beyond.

First, seniors want the choice to be in a private plan. Obviously, not true.

The private sector plans will offer seniors more choices, including prescription drugs. Unfortunately, many seniors do not have access to the private plans, and there is not one offered in 80 percent of the counties nationwide. So the choice is not available to them.

I find it interesting that my mother, who is a very healthy 77-year- old woman and plays on three golf leagues--I am so glad I have her genes. I am very hopeful I will have the same opportunity she has had to enjoy her retirement. As a retired nurse, she chose an HMO. She is very healthy. She wanted prescription drug coverage. She could get it through an HMO, so she chose a Medicare HMO. The problem was she got dropped. This has happened to thousands of seniors where the HMO decides it is no longer financially viable for them to cover older adults under Medicare, and so they drop them. So my mother lost her doctor. She liked the HMO she was in. It worked for her. She lost that opportunity.

So even in situations where people chose Medicare+Choice, the HMOs go in and out of the market. Forty-one thousand people in Michigan chose Medicare+Choice, and they were dropped because the plans go in and out. So it is not dependable, it is not reliable. That is why the majority of seniors did not pick it--because they wanted the reliability of their own doctor, knowing it would be there, knowing it was not going to be complicated by new systems and new paperwork. They like Medicare.

We also hear that private plans will give seniors more choices while letting them continue to use their own doctor. Of course, that is not true because if one goes into an HMO or even a PPO and their doctor is not part of that system, they do not have the opportunity to go to that doctor or they may have to pay more to go to that doctor.

The private sector Medicare plans will save money; how many times have we heard that? We hear that they are more efficient. In fact, it is just the opposite. They are not more efficient and, in fact, cost more money than being in traditional Medicare.

In the year 2000, the General Accounting Office estimated that payments to Medicare HMOs exceeded the costs that would have been incurred by treating patients directly through traditional Medicare by an annual average of 13.2 percent. So it cost more for the folks who went into the HMO, it cost Medicare more than if they had stayed in traditional Medicare.

Two recent studies found that private health plan fees are about 15 percent higher than Medicare: This is the other part of the myth. Frankly, I think our providers would love it if we funded Medicare at the same level as private insurance does because on average they would get 15 percent more dollars. We are cutting our doctors, hospitals, home health agencies, and nursing homes. In the private sector, on average, in some cases it is much higher than 15 percent more for the same services. Surgical procedures I believe are closer to 25 percent more in the private sector. So in terms of dollars, we would see higher costs and higher rates.

The private sector plans have lower administrative costs than traditional Medicare: How many times have we heard that? Many studies have shown that Medicare has a lower overhead rate than private plans. Medicare has a 2 to 3 percent administrative cost. Private Medicare HMOs, on average, spend 15 percent on administrative costs, and some spend as much as 30 or 32 percent. So, again, it does not cost less. The administrative costs are not less under private plans.

Finally, the myth that we can provide a Medicare drug plan like Federal employees benefits for under $400 million over 10 years, which is in the budget resolution--in fact, the numbers we have been given indicate to us that it would cost twice as much as what is in this budget resolution. When given the opportunity, our colleagues on the other side of the aisle voted no on funding the same level that we receive through Federal employee health insurance.

So let's talk about myth, let's talk about facts, and let's get beyond all of this and say seniors of this country have chosen overwhelmingly to stay in Medicare. They like Medicare. It works. It just does not cover prescription drugs.

I am happy to yield.

That is correct.

Well, I think my colleague is very wise in pointing that out. I often say that seniors made their choice and now our colleagues on the other side of the aisle have said: We do not like that choice. Pick again. You cannot have this choice. Door No. 1 is closed and locked. You can only pick door No. 2. That is really what is happening. Even among the fancy words, now we are hearing that under Medicare there will be the same prescription drug proposal, the same plan as our private plans; we are going to give the same prescription drug plan. But then we hear, but other things will be better in the private sector plans, such as we will have more prevention; we will have a better catastrophic cap; we will have other things that are better. So they are moving the words around.

It may appear that the prescription drug part is the same, but other things will be better because of the belief--and there is a genuine philosophical difference, there is a divide, about what is the best way to proceed. There are colleagues who believe that probably Medicare should never have been enacted. I have heard it said it is a big government program, it should be private insurance run, and they would like very much to get back as close as they can to a privately run system.

Absolutely.

Absolutely.

Absolutely.

I think the Senator is absolutely correct. It is not that there is not a place for private sector insurance, but when Medicare came into place, it was because half the seniors in the country could not find a private plan that would cover them or they could not afford it. So there was such a huge need.

We as Americans have a basic value about making sure older Americans can live in dignity and have access to health care and a quality of life that they deserve, as well as those who are disabled. This is a great American value. I believe it is a great American success story. Even though there are those who since that time have been trying in some way to undermine it, we should be proud as a country. I absolutely agree with colleagues who say it needs to be modernized. We can focus more on prevention strategies.

In addition to prescription drug coverage, there are other ways we can make the system better. We can use more technology, less paperwork, all of which are good. If we could get beyond the debate that says we should move back toward the private sector, and somehow that is cost effective and saves money and the dollars will go further--none of which is true; there is no evidence of that--if we could get beyond that, we could come up with a bipartisan plan that would be meaningful. The seniors have been waiting for us to get the message. They want Medicare. They just want prescription drug coverage. They want it modernized. But they want Medicare. They have been saying that loudly and clearly.

I hope we can get the message and work together to actually get it done.

We appreciate the opportunity to share this today.

We have a real opportunity here, as Members on both sides of the aisle, to do something very meaningful. I hope we will do that rather than debate whether or not Medicare has been successful and seniors want choices. I believe we should look at the choice they made. It is very clear. They want us to work together and get something done, and do it in a way that will allow seniors to know that medicine, which is such a critical part of their lives and a great cost to their pocketbook, will be covered or partially covered and they will receive some assistance to be able to afford such a critical part of health care today, which is outpatient prescription drugs. It is too important to people. We do not want them choosing between food and medicine in the morning. We want them to have confidence that Medicare will cover and help with the costs of prescription drugs.

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

Mr. President, I ask unanimous consent that Oliver Kim, a fellow in my office, be granted floor privileges today.

Mr. President, I believe ``home'' is one of the warmest words in the English language. At the end of a long day, I think the favorite phrase of every hardworking working man and woman in this country is: ``Well, I'll see you tomorrow. I'm going home now.''

That is why I rise today to introduce the First Time Homebuyers' Tax Credit Act of 2003.

The bill I am introducing will spread that warmth by opening the door to homeownership to millions of hardworking families, helping them cover the initial down payment and closing costs.

This initiative is in keeping with our longstanding national policy of encouraging homeownership.

Owning a home has always been a fundamental part of the American dream.

We, in Congress, have long recognized the social and economic value in high rates of homeownership through laws that we have enacted, such as the mortgage interest tax deduction and the capital gains exclusion on the sale of a home.

Over the life of a loan, the mortgage interest tax deduction can save homeowners thousands of dollars that they could use for other necessary family expenses such as education or health care.

These benefits, however, are only available to individuals who own their own home.

It is important also to note that owning a home is a principle and reliable source of savings as homeowners build equity over the years and their homes appreciate.

For many people, it is home equity--not stocks--that help them through the retirement years.

In addition, owning a home insulates people from spikes in housing costs.

Indeed, while rents may go up, the costs of a monthly mortgage payment, in relative terms, will go down over the course of the mortgage.

In my own State of Michigan, the homeownership rate of 74 percent is the third highest in the Nation and well above the national rate of 66 percent.

In Oregon, the home State of my bill's lead Republican sponsor, Senator Gordon Smith, the homeownership rate is 64.3 percent--about 2 percent below the national average.

However, as impressive as these numbers may initially sound, not everyone enjoys the benefits of homeownership.

For example, homeownership in Michigan among whites is 78 percent; Native Americans 60 percent; Hispanics 55 percent; African Americans 51 percent; and Asians 50 percent.

A national study by the Fannie Mae Foundation found that in the top third of income levels, 44 percent of people under the age of 31 owned their own home.

But, for the lowest third on the income scale, only 15.6 percent owned their own home--a 28 percent gap!

Why do we face these disparities? Clearly, one of the biggest barriers to homeownership for working families is the cost of a down payment and the costs associated with closing a mortgage.

According to the Mortgage Bankers Association, typical closing costs on an average sized loan of $175,000 can approach approximately $4,000.

Even with relatively recent mortgage products that allow a downpayment of as little as 3 percent of the value of a home, total costs can quickly approach over $9,000.

This is an impossible amount to save for those who are scraping by, working hard to make ends meet.

To address this problem, I am introducing the First Time Homebuyers' Tax Credit Act of 2003.

My bill authorizes a one-time tax credit of up to $3,000 for individuals and $6,000 for married couples.

This credit is similar to the existing mortgage interest tax deduction in that it creates incentives for people to buy a home.

To be eligible for the credit, taxpayers must be first-time homebuyers who were within the 27 percent tax bracket or lower in the year before they purchase their home. That is $67,700 for single filers, $96,700 for heads of household, $112,850 for joint returns. There is a dollar-for-dollar phase-out beyond the cap.

Normally, tax credits like this are an after-the-fact benefit. They do little to get people actually into a home.

What is particularly innovative and beneficial about the tax credit in this bill, however, is that, for the first time, the taxpayer can either claim the credit in the year after he or she buys a first home or the taxpayer can transfer the credit directly to a lender at closing.

The transferred credit would go toward helping with the down payment or closing costs. This is cash at the table.

As mandated in the bill, the eligible homebuyer would have the money for the lender from the Treasury within 30 days of application.

I am happy to say that this legislation already has strong support. Among those who have already written to me in support of this concept are:

The American Bankers Association; America's Community Bankers; the Housing Partnership Network; the National Housing Conference; the National Congress for Community Economic Development; the National Council of La Raza; the National Association of Affordable Housing Lenders; the Manufactured Housing Institute; Fannie Mae; Freddie Mac; National Community Reinvestment Coalition; Standard Federal Bank; Habitat for Humanity, and, the National American Indian Housing Council.

I ask unanimous consent that copies of their letters be printed in the Record.

Mr. President, I believe ``home'' is one of the warmest words in the English language. At the end of a long day, I think the favorite phrase of every hardworking working man and woman in this country is: ``Well, I'll see you tomorrow. I'm going home now.''

That is why I rise today to introduce the First Time Homebuyers' Tax Credit Act of 2003.

The bill I am introducing will spread that warmth by opening the door to homeownership to millions of hardworking families, helping them cover the initial down payment and closing costs.

This initiative is in keeping with our longstanding national policy of encouraging homeownership.

Owning a home has always been a fundamental part of the American dream.

We, in Congress, have long recognized the social and economic value in high rates of homeownership through laws that we have enacted, such as the mortgage interest tax deduction and the capital gains exclusion on the sale of a home.

Over the life of a loan, the mortgage interest tax deduction can save homeowners thousands of dollars that they could use for other necessary family expenses such as education or health care.

These benefits, however, are only available to individuals who own their own home.

It is important also to note that owning a home is a principle and reliable source of savings as homeowners build equity over the years and their homes appreciate.

For many people, it is home equity--not stocks--that help them through the retirement years.

In addition, owning a home insulates people from spikes in housing costs.

Indeed, while rents may go up, the costs of a monthly mortgage payment, in relative terms, will go down over the course of the mortgage.

In my own State of Michigan, the homeownership rate of 74 percent is the third highest in the Nation and well above the national rate of 66 percent.

In Oregon, the home State of my bill's lead Republican sponsor, Senator Gordon Smith, the homeownership rate is 64.3 percent--about 2 percent below the national average.

However, as impressive as these numbers may initially sound, not everyone enjoys the benefits of homeownership.

For example, homeownership in Michigan among whites is 78 percent; Native Americans 60 percent; Hispanics 55 percent; African Americans 51 percent; and Asians 50 percent.

A national study by the Fannie Mae Foundation found that in the top third of income levels, 44 percent of people under the age of 31 owned their own home.

But, for the lowest third on the income scale, only 15.6 percent owned their own home--a 28 percent gap!

Why do we face these disparities? Clearly, one of the biggest barriers to homeownership for working families is the cost of a down payment and the costs associated with closing a mortgage.

According to the Mortgage Bankers Association, typical closing costs on an average sized loan of $175,000 can approach approximately $4,000.

Even with relatively recent mortgage products that allow a downpayment of as little as 3 percent of the value of a home, total costs can quickly approach over $9,000.

This is an impossible amount to save for those who are scraping by, working hard to make ends meet.

To address this problem, I am introducing the First Time Homebuyers' Tax Credit Act of 2003.

My bill authorizes a one-time tax credit of up to $3,000 for individuals and $6,000 for married couples.

This credit is similar to the existing mortgage interest tax deduction in that it creates incentives for people to buy a home.

To be eligible for the credit, taxpayers must be first-time homebuyers who were within the 27 percent tax bracket or lower in the year before they purchase their home. That is $67,700 for single filers, $96,700 for heads of household, $112,850 for joint returns. There is a dollar-for-dollar phase-out beyond the cap.

Normally, tax credits like this are an after-the-fact benefit. They do little to get people actually into a home.

What is particularly innovative and beneficial about the tax credit in this bill, however, is that, for the first time, the taxpayer can either claim the credit in the year after he or she buys a first home or the taxpayer can transfer the credit directly to a lender at closing.

The transferred credit would go toward helping with the down payment or closing costs. This is cash at the table.

As mandated in the bill, the eligible homebuyer would have the money for the lender from the Treasury within 30 days of application.

I am happy to say that this legislation already has strong support. Among those who have already written to me in support of this concept are:

The American Bankers Association; America's Community Bankers; the Housing Partnership Network; the National Housing Conference; the National Congress for Community Economic Development; the National Council of La Raza; the National Association of Affordable Housing Lenders; the Manufactured Housing Institute; Fannie Mae; Freddie Mac; National Community Reinvestment Coalition; Standard Federal Bank; Habitat for Humanity, and, the National American Indian Housing Council.

I ask unanimous consent that copies of their letters be printed in the Record.

Mr. President, today I rise to introduce the Fair and Impartial Rights, FAIR, for Medicare Act and bring attention to growing concerns I have heard about the possible politicization of the Medicare appeals process.

The Administrator of the Centers for Medicare and Medicaid Services, CMS, has indicated that the Administration would like to alter the current practice of requiring that Medicare beneficiaries or Medicare providers be granted a hearing before an independent Administrative Law Judge, ALJ, when their initial claim is denied.

Instead of taking the side of beneficiaries and providers, this proposed action would seek to inject political interference in the Medicare appeals process to try to deny benefits to claimants. When Medicare beneficiaries and Medicare providers are denied payment for services, the 2000 BIPA law allows them a five-step process for them to appeal this decision.

Unfortunately, the first two steps of this appeals process has been working against beneficiaries and providers. In the last five years, ALJs have reversed 53 percent of these preliminary rulings. This means that 53 percent of all cases were decided incorrectly by the preliminary steps in the Medicare appeals process. It was only when beneficiaries or providers appealed to an independent ALJ that they received the proper ruling.

ALJs serve an essential role in the claims review process because there is often conflicting and confusing information to guide beneficiaries and providers. In its 2001 report as part of its ongoing review of CMS communications, the General Accounting office described the information CMS's carriers gives to providers as ``often incomplete, confusing, out of date, or even incorrect.'' GAO found that ``the norm'' for many carriers were documents over 50 pages that ``often contained long articles, written in dense language and printed in small type.'' Documents ``were also poorly organized, making it difficult for a physician to identify relevant or new information.'' ALJs base their decisions on administrative rules, which have the benefit of being open to public comment and review, as well as case law and statutes.

Unfortunately, the Administration is seeking to undermine the independent role of ALJs who hear Medicare cases and replace ALJs with Federal employees, perhaps even political appointees,

with closer ties to the Administration's policy goals. The Administration's plan is not just an abstract proposal. It would hurt Medicare beneficiaries and Medicare providers.

The FAIR for Medicare Act would stop this political attempt to weaken the role of independent ALJs. Specifically, it would: Prohibit non- ALJs, like political appointees, from performing the duties of ALJs. Transfer Medicare ALJs from the Social Security Administration to the Department of HHS, just like a bipartisan bill introduced in the House by Congresswoman Nancy Johnson. Ensure ALJs are organizationally and functionally separated from CMS and all other political appointees other than the Secretary of HHS.

Similar legislation has been introduced in the House by Representative Nancy Johnson, and it received bipartisan support. I hope that my proposal will achieve the same result.

I ask unanimous consent that the text of the bill and several articles be printed in the Record.

Mr. President, today I rise to introduce the Fair and Impartial Rights, FAIR, for Medicare Act and bring attention to growing concerns I have heard about the possible politicization of the Medicare appeals process.

The Administrator of the Centers for Medicare and Medicaid Services, CMS, has indicated that the Administration would like to alter the current practice of requiring that Medicare beneficiaries or Medicare providers be granted a hearing before an independent Administrative Law Judge, ALJ, when their initial claim is denied.

Instead of taking the side of beneficiaries and providers, this proposed action would seek to inject political interference in the Medicare appeals process to try to deny benefits to claimants. When Medicare beneficiaries and Medicare providers are denied payment for services, the 2000 BIPA law allows them a five-step process for them to appeal this decision.

Unfortunately, the first two steps of this appeals process has been working against beneficiaries and providers. In the last five years, ALJs have reversed 53 percent of these preliminary rulings. This means that 53 percent of all cases were decided incorrectly by the preliminary steps in the Medicare appeals process. It was only when beneficiaries or providers appealed to an independent ALJ that they received the proper ruling.

ALJs serve an essential role in the claims review process because there is often conflicting and confusing information to guide beneficiaries and providers. In its 2001 report as part of its ongoing review of CMS communications, the General Accounting office described the information CMS's carriers gives to providers as ``often incomplete, confusing, out of date, or even incorrect.'' GAO found that ``the norm'' for many carriers were documents over 50 pages that ``often contained long articles, written in dense language and printed in small type.'' Documents ``were also poorly organized, making it difficult for a physician to identify relevant or new information.'' ALJs base their decisions on administrative rules, which have the benefit of being open to public comment and review, as well as case law and statutes.

Unfortunately, the Administration is seeking to undermine the independent role of ALJs who hear Medicare cases and replace ALJs with Federal employees, perhaps even political appointees,

with closer ties to the Administration's policy goals. The Administration's plan is not just an abstract proposal. It would hurt Medicare beneficiaries and Medicare providers.

The FAIR for Medicare Act would stop this political attempt to weaken the role of independent ALJs. Specifically, it would: Prohibit non- ALJs, like political appointees, from performing the duties of ALJs. Transfer Medicare ALJs from the Social Security Administration to the Department of HHS, just like a bipartisan bill introduced in the House by Congresswoman Nancy Johnson. Ensure ALJs are organizationally and functionally separated from CMS and all other political appointees other than the Secretary of HHS.

Similar legislation has been introduced in the House by Representative Nancy Johnson, and it received bipartisan support. I hope that my proposal will achieve the same result.

I ask unanimous consent that the text of the bill and several articles be printed in the Record.

Mr. President, the contributions of women in the U.S. Armed Forces stretches back to the battlefields of our Revolution and continues in the deserts of Iraq today.

But those contributions have not always been recognized.

Today, I rise to note another milestone for women in the military and pay tribute to COL Mandi Murray who recently became the first woman to command a brigade in Michigan's Army National Guard

Colonel Murray now commands the 2,433 soldiers of the 63rd Troop Command based in Jackson, MI.

The missions of the 63rd Troop Command include maintenance, transportation, administration, Army aviation, and Airborne Ranger duties. One unit of the 63rd Troop Command is now serving in Iraq and-- sadly--one of its servicemen was killed there last month.

Colonel Murray has had a remarkable career as both a civilian and an officer in her 22 years with the Army National Guard.

She joined the Guard when she was 17. At one time she juggled full- time duties as a neonatal intensive care nurse, full-time studies at the University of Detroit Law School, and her obligations to the military.

She is married to a fellow officer--LTC Martin Murray with the Michigan Army National Guard's State Area Command--and now outranks him.

But that is not a problem for this couple.

``My husband and I are truly in this as a team,'' Colonel Murray said recently. ``Sometimes one has to step back for the other. He knows I wouldn't be here without him.''

The Murray's have two children, and both hold demanding full-time careers. She works as a lawyer for the St. Joseph Health System, and he is an operations director of a 23-physician medical practice.

Our Nation is grateful to have such fine men and women willing to serve, and I am proud this couple hails from my home State.

Women have come a long way since 1778, when Mary Ludwig Hays--also known as Molly Pitcher--manned a cannon at the Battle of Monmouth in place of her wounded husband.

For her bravery, General George Washington made her a noncommissioned officer, and for the rest of her days she was known as Sergeant Molly.

Now, when the armed services are called to duty, almost 200,000 women from all branches of the armed services stand ready to defend their Nation--women like Colonel Murray.

I salute their bravery and their sense of duty as I do all who choose to wear our Nation's uniform with pride.

Mr. President, I rise today to reflect on this year's Memorial Day commemorations and the importance of this holiday in American life.

As I attend Memorial Day parades and commemorations, I'm struck by the spirit of national unity on display because I know that across Michigan--and across our Nation--our fellow Americans are taking part in similar gatherings where we take the time to reflect on our history and the sacrifice that brought us to where we are today.

Memorial Day is unique among American holidays. On Memorial Day we do not honor a particular date or event--a battle or the end of a war. On Memorial Day we do not honor an individual leader--a president or a general. On Memorial Day we do not even honor ourselves--at least not in the present tense.

On Memorial Day we pay homage to the thousands and thousands of individual acts of bravery and sacrifice that stretch back to the battlefields of our Revolution and are on display today in the deserts of Iraq and the mountains of Afghanistan.

We honor the brave men and women who answered their Nation's call to duty. And--making that ultimate sacrifice--never returned to their families and loved ones.

As part of this year's Memorial Day commemorations, I have been paying special respects to our Korean war veterans because this July marks the 50th Anniversary of the armistice that ended that war.

Notice I said Korean war. I did not say ``the Korean Conflict.'' I did not call it a police action. I've met too many Korean war veterans. I've heard too many of their stories.

It was the Korean war.

About 2 million Americans served on active duty with the United States

Armed Forces during the Korean war. And nearly 55,000 never came home.

The Korean war is often called ``the forgotten war.'' Well, it is not forgotten by me. I've met too many Korean war veterans and heard the stories of the hardships they endured defending--in the words of the plaque at the Korean War Memorial--``a country they never knew, and a people they never met.''

So I think that one of the most fitting ways to pay homage to our fallen patriots is to treat their living comrades with the respect and honor they deserve.

Michigan is home to 875,000 veterans, and in personal conversations, letters, phone calls and e-mails I have heard from many who are not being treated fairly by the veterans' health care system or by present pension regulations.

Right now, we are underfunding veterans' health care by close to $2 billion. This means it can take months to see a doctor and delays of a year or longer for some surgical procedures.

I am cosponsoring the Veterans Health Care Funding Guarantee Act of 2003--S. 50--that would order a 20 percent increase in funding for the Veteran's Health Administration by 2005, and adjust the amount upwards every year after that to take into account new enrollees.

Also, antiquated laws have also created an unfair situation wherein a veteran's pension can be reduced by the amount of their disability payment for a service-related disability. In some cases the pension can be wiped out entirely.

This is unfair. Pension and disability payments are two separate and distinct benefits. Our veterans have earned their pensions. And if they also suffered a service-related disability that has cut their ability to earn money outside the military, they are entitled to a separate disability payment as well.

I am cosponsoring the Retired Pay Restoration Act of 2003--S. 392. This bill would require that veterans receive their full pension plus all disability payments to which they are entitled. This issue is also known as full concurrent receipt.

As we observe this holiday we call Memorial Day, let us remember the centuries of sacrifice by thousands and thousands of men and women that this day represents. And let's make sure that all who served with honor are honored in return.

Mr. President, I ask unanimous consent that Senator Mikulski be added as a cosponsor of the amendment.

Mr. President, I urge my colleagues to support this very important amendment for the seniors of this country. This does that. First and foremost, before we pass the dividend tax cut and the top rate tax cut, we will proceed to develop and pass a comprehensive prescription drug benefit that is equivalent to what we receive in the Senate. I have heard many colleagues express the concern I share, which is that the seniors and the disabled of this country ought to have the same ability to have the prescription drug coverage we as Federal employees do.

This amendment simply sets our priorities straight. It says before we proceed with these two tax cuts, we will pass a comprehensive prescription drug benefit based on FEHBP, the most common portion of which is used by Senate and House Members. I urge my colleagues to support this amendment.

Due to the fact the budget resolution does not contain enough revenue to do what our distinguished chairman has just indicated, this amendment is necessary to make that happen. Pursuant to section 904 of the Congressional Budget Act of 1974, I move to waive the applicable sections of that act and the budget resolution for the consideration of the pending amendment. I ask for the yeas and nays.

Mr. President, I rise today to support the United States Leadership against HIV/AIDS, Tuberculosis, and malaria Act of 2003.

This legislation authorizes $15 billion over 5 years, $3 billion per year through 2008. This bill also establishes an HIV/AIDS response coordinator and advisory panel, and requires a 5-year comprehensive, integrated, global strategy to fight this deadly disease. I am pleased to join a bipartisan group of Senators supporting this legislation.

According to the United Nations, more than 65 million people worldwide have been infected with HIV, more than 25 million have died of the disease, and more than 14 million children have been orphaned.

At the end of 2002, an estimated 42 million people were infected with HIV or were living with AIDS, of which more than 75 percent live in Africa or the Caribbean. AIDS is the leading cause of death in sub- Saharan Africa, where more than 19.4 million have died.

Basic interventions to prevent new HIV infections and to bring care and treatment to people living with AIDS have achieved meaningful results. Nonetheless, of the more than 30 million people in Africa with HIV, only 50,000 receive necessary medicines.

We must do everything to reverse this horrible trend and fight this pandemic. But we can't do it on the cheap. Fighting this disease will take a lot of money because the problem is so widespread.

The Global H.I.V. Prevention Working Group, funded jointly by the Kaiser Family Foundation and the Gates Foundation, has issued a report stating that: ``Globally, fewer than one in five people have access to basic HIV prevention programs--the information and services that can help save lives and reverse the AIDS epidemic.''

The Working Group's analysis of global HIV prevention funding finds that annual spending from all sources in 2002 was $3.8 billion short of what will be needed by 2005.

The report also finds that access to proven prevention interventions is extremely limited, and highly variable, depending on region and the intervention.

As you can see, this problem is bigger than what our response will be here today. We must view this legislation as the first step in an ongoing battle to end the AIDS epidemic once and for all.

The bill before us is an important bill, but it is only an authorization bill. Now, we must focus on the upcoming appropriations bills to make good on the promise of the bill before us today.

Madam President, I send an amendment to the desk and ask for its immediate consideration.

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

Madam President, I rise this evening to offer an amendment that seeks to set the right priorities for us in the Senate and in the Congress as we move forward this year with the budget. My amendment is simple. It says before the dividend tax cut and the acceleration of the top tax rate go into effect, Congress must pass a Medicare prescription drug bill that is actuarially equivalent to the value of the Blue Cross standard option under the Federal Employees Health Benefits Program, known as FEHBP, for all Medicare beneficiaries.

This is a question of our values and priorities. My amendment is a promise to our Nation's seniors. It says you are as important as the elite in this country; we are finally going to get something done; and that it will be something that is equal to what we receive in the U.S. Senate. This is the third consecutive Congress that has considered adding an outpatient prescription drug benefit under Medicare. In the last two Congresses we were unsuccessful. To be fair, we were unsuccessful with a Democratic President, a Republican President, a Democratic Congress, a Republican Congress. The reality is we have not yet been able to

deliver for our seniors the promise of prescription drug coverage under Medicare.

I believe the time is up. Our seniors and those who are disabled, who depend on Medicare, are counting on us to get this done this year.

In order to be able to do that, we need to impose some discipline on ourselves. We have to hold our feet to the fire in order to get this done. This amendment says to the House and Senate and the administration that we must all work together to pass a meaningful prescription drug benefit or a major component of the tax cut that is supported by the majority will not go into effect.

I would like to make it clear that my amendment does not eliminate the tax cuts on dividends or those for the people who pay the highest rates. As long as we pass a meaningful prescription drug benefit, these tax cuts would take effect as scheduled.

Having said that, I want to also indicate that I do not believe, from an economic standpoint, that is the best way to stimulate the economy. I agree with the over 450 economists who have said this will not create jobs; it will not create growth. But if in fact there is support to pass the tax breaks geared to the elite in the country, I ask my colleagues to at least be willing to hold off. At least be willing to hold off until we can fulfill the promise of an outpatient prescription drug benefit under Medicare.

My amendment says this should be available to all seniors, not just seniors in private insurance, as has been proposed by the President and by others, but all seniors should be able to get the same prescription drug coverage.

In addition, this amendment says the prescription drug benefit we pass should be actuarially equivalent to the plan that is most often used by Federal employees, including Members of Congress. In other words--and I have heard other colleagues say this--the seniors of this country should get no less in prescription drug help than we get through our insurance plan. That is what my amendment says, simply. The tax cuts geared to the most wealthy among us, the elite in the country, should wait until we can fulfill the promise of a prescription drug benefit that is equal to what we receive as Members of the Senate.

I have heard many friends on the other side of the aisle extol the virtues of our plan, the FEHBP plan. I have also heard the President and members of his administration make similar comments. They say a new prescription drug benefit should be modeled after the benefit in the Federal employee plan. In fact, on May 6 my distinguished colleague from Idaho, Senator Craig, held a hearing in the Aging Committee, which I am on, that highlighted the Federal employee program, its benefits, and so on. While the witnesses disagreed on whether it would be appropriate to go to the structure of that plan--and I have great concerns about anything outside of Medicare--they all agree that this plan that we and other Federal employees have offers excellent prescription drug coverage for Federal employees.

I think most of us agree our seniors deserve the same opportunity to have prescription drug coverage equal to what we or other Federal employees receive. However, the current budget resolution does not allow for that. It does not provide for the resources to do that. So despite the comments I have heard on a number of occasions from colleagues that, in fact, we ought to be providing similar coverage, the budget resolution does not provide the resources. So this, again, is a question of priorities. It is a question of values. What should come first, fulfilling the promise of a quality prescription drug benefit for our seniors under Medicare or proceeding with a tax cut geared to the elite in this country?

I think it is particularly of concern that we focus on this, particularly in light of the overwhelming evidence that those particular tax cuts will not stimulate the economy in the short run, will not create jobs, will not create growth. No matter how many times Members say that, with all due respect, we have overwhelming evidence-- 450 economists, 10 Nobel laureates, concerns by Chairman Greenspan--and only 13 economists on the side, saying it is a good idea.

Before we go ahead with something we know is not a short-term stimulus, doesn't create jobs, doesn't create growth, and, in fact, created red ink as far as the eye can see, I ask that we stop.

Whether Members wish to have a dividend tax cut and a top rate cut or wish not to, we should come together and agree we would not proceed until we provide prescription drug coverage that is quality and is similar to what we have as Members of the Senate.

This is a trigger. As I indicated, it is not eliminating those parts of the tax bill. It is simply a trigger on those.

If I might take just another moment on the broader issues of Medicare, on this question of whether we will have the resources to update Medicare to provide a real prescription drug benefit, one that we could probably support because it would be similar to what we are able to receive as Members of the Senate. The larger issue is where we are going in terms of the huge national debt projected for the future. The actual question is whether we will be able to meet our obligations overall for Medicare and Social Security in the long run without going into more and more deficit.

I refer to the study that was recently done that indicates if we were to take the proposals that have been put forward by the President--I realize in the Senate there is a modified version of that. We don't have exactly this amendment in front of us. But if we are to take what the President has suggested in totality over the next 75 years, we would see a cost of over $14 trillion.

At the same time, the projected Medicare and Social Security deficit is $10 trillion.

I go back again to my concern that this an issue of priorities. We have one proposal that creates a $14 trillion cost. At the same time that we know we have an unfunded liability in Social Security and Medicare of $10 trillion, why in the world would we do that? Why in the world would anybody? This is what the economists are talking about. Over 450 economists have come out against this, saying it will not create jobs; it will just create more massive debt; it will create instability long term in the economy; it jeopardizes Medicare and Social Security.

These are the numbers they are looking at. Why in the world would anybody with common sense looking at this say we ought to go in this direction? If we didn't go in this direction, and if we agreed to the amendment we are talking about, we would be sending a clear message that we are committed to really providing Medicare prescription drug coverage and not just talking about it for another session but really providing it for our seniors and for the disabled. And we would be sending a message that we are making a long-term commitment to Medicare and Social Security.

My fear is, if we proceed down the road as we currently are as a Congress, that we are creating a situation which will lend itself to the argument of those who say we can't afford Medicare and Social Security anymore. We heard that. We heard we can't afford prescription drug coverage; we can't afford Medicare as we know it; we can't afford Social Security as we know it. We can afford to update it for prescription drugs if we do not pass irresponsible tax policy that creates trillions and trillions of dollars in debt.

That is my concern overall. I am hopeful that we will reconsider this. I am very hopeful that in the meantime, regardless of the broader picture, colleagues will join to be able to send a strong message that we are going to put the seniors of the country first and a real prescription drug benefit first. As many colleagues have said, our seniors deserve the same kind of benefit that we receive in the Senate. This amendment would allow that to happen.

With the passage of these other provisions, it then would allow them to take effect after the prescription drug benefit is passed.

I reserve the remainder of my time. I yield to my colleagues who are possibly wishing to speak. I would like the opportunity to respond at the appropriate time.

I yield the floor.

Mr. President, I rise today as we are beginning the discussion in earnest about how to create jobs in our country, how to help the economy, how to be responsible as we do that and how to help the States. Certainly my home State of Michigan, as most States, is finding financial crisis.

As we do that, we hear a lot of words, a lot of rhetoric, a lot of slogans. One of those is that the President's proposal is a job and growth package and that colleagues on the other side of the aisle are involved in a job and growth package. Nothing could be further from the truth. In fact, we have 450 well-known economists in the country, 10 Nobel laureates, Chairman Greenspan, many around the country, saying this will not create jobs and it will not create growth. It is not a jobs program. It is not a growth program. We have 13 economists saying it is; 450 economists versus 13 economists.

I suggest the overwhelming opinion of those who have studied this question of how to create jobs, how to move the economy, and how to do it in a responsible manner, without creating a sea of red ink as far as the eye can see, the majority of those who have locked at this issue, the vast majority have said the plan by the White House and by the Republican majority does not do that.

In fact, it adds to what we unfortunately are on track to do, which is to

see the worst job creation in 58 years. It is astounding what has happened in a very short time, going from budget surpluses, a boom in the economy in the 1990s, and now, in a very short time, to a turnaround where we are plummeting into debt. We are seeing close to the worst job creation in 58 years. What we are seeing from this record, over and over again, is the plan to give tax breaks for the privileged few will not create jobs. It did not create jobs in the 1980s when it was done. The bill that was passed 2 years ago, in 2001, was the first round of the Bush tax breaks for the privileged few, and it has not created jobs. Now they are saying do it again.

In my home State just this last month, 17,700 workers lost their jobs. That is 17,700 families who lost income, possibly--probably losing health care, losing the opportunity to pay into a pension fund, losing the opportunity to buy that new home, that new car squeezing them in terms of being able to send their children to college.

Mr. President, that is 17,700 people in just 1 month in Michigan. In fact, we have had, since this administration came into power, over 178,000 people who have lost their jobs in my home State alone-- 178,000-plus people. Again, many of them lost their health care, lost the ability to care for their families and do what they need to do to create opportunity and security for their families.

In the last 2\1/2\ years we have seen an astounding 2.5 million private sector jobs lost. You have to go back over 50 years to see that kind of a record in this country. We certainly do not want to be going in that direction as a country.

What should we do? We do need to work together. We need to work across the aisle to do what is necessary to get the economy going, create jobs, and protect Social Security and Medicare for the long haul. Unfortunately, what we are seeing is a replay of the 1980s that put us into double digit unemployment, double digit interest rate increases, and tripled the national debt. We are seeing a replay of what was passed 2 years ago now that has caused us to plummet in terms of the budget situation and the economy and unemployment.

My question is, Why in the world are we going to do this again? Why in the world would we use the same policies that have not worked? We have this saying we use a lot in Michigan: The first step in getting out of a hole is to stop digging. What we are seeing is the digging of a deeper and deeper hole. In fact, we have seen a $7 trillion fiscal collapse in just the last 2 years. I find this most disturbing. It is extremely worrisome, and every single American I know shares this concern.

When we combine the tax policies 2 years ago, the tax cut for the privileged few passed 2 years ago--and by the way, I am all for putting money in people's pockets. The question is, Whose pockets? We want to make sure it goes into the pockets of the majority of Americans who will spend and drive this economy. That is not what happened 2 years ago.

But if we were to make that permanent and we were to take the other proposals that have come forward in some variation, certainly from the President, what we see as we look to the future is that $14.2 trillion is taken out of Federal resources. There is $14.2 trillion of projected loss or deficit.

Compare that to the projected Medicare and Social Security deficit over the same time. That is $10 trillion. So we are talking about a hole that is bigger than Social Security and Medicare combined, in terms of the deficit for the future.

I sit on the Budget Committee. We look at these numbers. We are seeing red ink proposed as far as the eye can see, red ink that is far greater than what is projected on Medicare and Social Security. We see the baby boomers retiring in just a few years in large numbers. Many of us ask the question: How in the world can this be justified? How in the world can anyone look at these numbers and say we are going to put our country in this huge debt, greater than the liability of Medicare and Social Security, and then meet our obligations to our seniors, to those retiring, those who have paid in throughout their working years into a system that has, in fact, brought people out of poverty and guaranteed health care once you are age 65 or are disabled?

The pattern I have heard back too many times, and it is extremely worrisome, is that you assume Medicare and Social Security will be there as we know it.

I do assume Medicare and Social Security will be there as we know it. Fundamental to this debate right now on this tax cut, when we know economists say overwhelmingly say it is not going to work, it is not going to create growth, it is going to give tax cuts to the privileged few in our country at the expense of everyone else--why in the world, then, would someone propose this? Why in the world would someone propose something that would create massive debt, jeopardize Social Security and Medicare, for a tax break for only a few people?

I believe the real purpose is to privatize Medicare and Social Security. We see over and over again disparaging comments being made, particularly now, about Medicare. Just recently Tom Skully, the administrator of the Center for Medicare and Medicaid Services, said when he was in Pennsylvania at a public meeting--this was quoted in the press and others who were there heard this and responded accordingly; many seniors were very upset and were disagreeing with this, but Mr. Scully said, when talking about the Medicare Program:

It was an unbelievable disaster.

And:

We think it's a dumb system.

So we have a situation now where we are seeing a setup to create this huge debt and then we are being told we can't afford Medicare and Social Security as we know it. We can't afford to provide real prescription drug coverage for our seniors on Medicare right now. That is too expensive to do. We can't afford it. We can't afford Medicare as we know it.

I believe what is fundamentally happening is a situation to set up the ability to eliminate Medicare as we know it because of a belief that it is ``an unbelievable disaster'' and ``a dumb system.''

I do not believe Medicare is a dumb system. I believe that Medicare and Social Security are great American success stories. They have brought the majority of seniors out of poverty in this country. They have created a safety net so when an Enron employee finds that his or her entire life savings are wiped out, there is at least a foundation on Social Security that they have paid into throughout their life.

I also believe that when we are seeing millions of Americans without health care, an explosion in prices on private sector health care for large and small businesses, Medicare seeing a smaller rate of growth-- the only part of universal health care we have where you are guaranteed that when you reach age 65, you will have health care, or if you are disabled, you will have health care--this is not the time to be rolling back that system or eliminating that system.

When we hear the words ``reform,'' ``dumb system,'' it is a ``disaster,'' it ``doesn't work and we can't afford it,'' I would say to my colleagues that the only reason we will have to have a discussion about the financial viability and whether or not we can afford it is the tax proposals currently on this floor. If we choose as an American value to put the quality of life of all of our citizens first and access to health care first for seniors, prescription drug coverage, a foundation of Social Security that will be there for all of us--if we put that as a value first, we can make sure that it is there for the future.

I believe we need to modernize Medicare. I believe, as Secretary Thompson said in our Budget Committee, that we need to focus more on prevention. I share his belief that this is a system which needs to be moved and modified, focusing more on prevention; that there are ways to streamline it with less bureaucracy and paperwork for our doctors and hospitals and other providers. And it needs to be updated to cover medication. There is not a health care policy today that would be designed without prescription drugs coverage, if it is going to be a real health care policy. That is the major way we provide health care today.

There is no question, it needs to be updated. But it is not a ``dumb'' system, it is not an ``unbelievable disaster,'' and it is not unaffordable if we make the right decision.

I ask my colleagues to consider what is really going on in the broadest sense as we debate the tax bill. We have an alternative. We don't have to set up a situation where we take $14.2 trillion out of Federal resources at a time when we will have a projected deficit in Medicare and Social Security of $10 trillion. We don't have to do that. We have an alternative.

I am proud to be supporting the Democratic alternative that in fact creates more jobs, gives a tax cut to every taxpayer--not just a privileged few--and that helps our States so they don't have to raise local taxes, creates a situation where we can help small business and help individuals in the short run but does it responsibly. We can create jobs, opportunity, and prosperity without creating a situation where Medicare and Social Security are jeopardized for the future.

That is what this is about. This tax bill cannot be debated in isolation. I know what is going to happen. If this tax bill passes, we will have another debate on Medicare, and we will be told we can't really provide prescription drug coverage to everybody, we don't have the money, and, by the way, we have to change Medicare, we have to reform Medicare, we have to privatize it, and we have to put it back in the private sector because we can't afford to provide Medicare as we know it anymore for our seniors. That debate will have been done after we have created this deep hole, which would be done on purpose.

I urge that we take another look. There is a way to create jobs. There is a way to create opportunity. There is a way to create prosperity. We would very much like to join with our colleagues on the other side of the aisle to do that. There is a way to do that which is fiscally responsible and which protects Medicare and Social Security.

I urge the support of all of my colleagues for that approach which will be put forward. I urge my colleagues to take another look at what is being suggested here and stand with us to protect the long-term solvency of Medicare and Social Security.