Mr. President, what is the parliamentary situation? Mr. President, I ask unanimous consent to be permitted to proceed as in morning business. Mr. President, later I want to speak for a few minutes about our colleague Senator Lugar. First,…
Mr. President, what is the parliamentary situation?
Mr. President, I ask unanimous consent to be permitted to proceed as in morning business.
Mr. President, later I want to speak for a few minutes about our colleague Senator Lugar.
First, I want to comment about what the Senator from Wyoming was saying on the health bill.
Very quickly, I could not disagree more with the Senator from Wyoming in his comments with respect to the health care bill. This morning we had a meeting with Secretary Kathleen Sebelius, who was outlining to us all of the gains we are making with respect to health care in America as a result of the legislation.
What is interesting is that our colleagues who keep coming to the floor and saying repeal the health care bill never offer alternatives to Americans. I hope Americans who are buying into this notion that somehow the health care bill doesn't serve them because they are angry about one thing or another will look at what the health care bill does because, in point of fact, if you were to repeal the health care bill, and they have no alternative to replace it, here are some of the things that happen: One, you immediately add $2 trillion to the deficit of our Nation. Bang, done deal. That goes right away on that. The health care bill is judged by the CBO to reduce the deficit. It has specific savings in it. If you get rid of it, those savings go away and, bang, the deficit goes up.
No. 2, 47 million to 50-some million Americans who have no health care or didn't have it before the bill will return to the status of having no health care.
Now, does everybody in America think it is better to have 50-some million Americans walking around without health care who, when they walk into a hospital--perhaps they get hit by a car or have an accident and go to a hospital--receive care that everybody is paying for but they are paying for it in the most inefficient way possible? The burden is being paid for by people who have the health care. It goes into their premiums. It isn't shared by people buying their insurance and sharing the risk of getting sick. So all of a sudden, if you get rid of the health care bill, we return America to the days when millions of Americans had no care. And guess what happens when they have no care. They jam the emergency rooms because that is the only place to get the care. The emergency room becomes the place of primary care. But my colleagues do not answer that question. They never deal with reality. They deal with politics and ideology and they throw a lot of baloney at people.
The fact is, if we were to get rid of the health care bill, all those people who used to get sick and would get a letter from their insurance company saying: Gee, sorry to hear you have terminal cancer, but you are not covered--and that is what happened all the time in America-- that would start happening again. People were thrown off their policies that they had been paying for for years, and all of a sudden they had no coverage. But they do not address that.
There is another issue: preexisting conditions. Again and again and again, people would be denied the ability to buy health care coverage because they had a preexisting condition of some kind. So if 10 years ago someone had a cancer, even if they were cured of their cancer, the insurance company could either refuse them or charge them a higher set of premiums. People were denied coverage--they just didn't get it. Women who were pregnant and were applying for insurance heard: Oh, sorry, that is a preexisting condition. You are pregnant. We are not going to cover that.
So in America we drove people into poverty for a long period of time. They had to sell their homes or sell down everything they had to become impoverished in order to get to a point where they could get some help.
What about kids in school today? Under the health care bill, up until the age of 26, a child can now be covered by their parents' program. It is not free, it has to be paid for, but they can be covered by it. That would be eliminated.
So all of a sudden we would have a whole bunch of people who would be automatically eliminated and going out fighting to get insurance in the marketplace.
Let me tell you what else happens. There are a whole bunch of reforms to the health care system that our friends never talk about. Today Kathleen Sebelius, the Secretary of Health and Human Services, laid out for us the enormous gains we are making in Medicare fraud. We are beginning to make huge savings for people. The average senior is now saving over $4,000 on their health care bills because of what has been put in place by the health care bill. There are a whole series of things. I don't have them all here at my disposal now because I wasn't planning to talk about this when I came to the floor, but there are a series of reforms about how we pay hospitals, bundling the payments to a hospital, requiring greater accountability from hospitals. I mean, don't we want greater accountability from hospitals? That will vanish. That will be gone if we do away with the health care bill.
We also have greater coordination of care for patients from the beginning of their private care through their admissions and into their discharges. What happens today is there is no coordination of that care, and so a lot of people are discharged, and the readmission rate is staggering because there isn't the coordination between their postoperative, postsurgery care and their
primary physicians and the hospitals. Now there are a number of different pilot projects in place to help coordinate that.
Similarly, we are coordinating the care of what are called dual eligibles--the people who are eligible for Medicare but also eligible for Medicaid. That care has not been well coordinated, so we have huge duplication, enormous costs we don't need, and the result is a waste of money. All of that is being eliminated and/or reduced to a significant level.
There are so many other examples. Let me cite another one. The Senator talked about wanting to take money out of preventive medicine. Preventive medicine? We are told by the doctors, who are the experts and who deal with diabetes, that if we had early screening, which comes by having health care coverage, we could eliminate an enormous amount-- maybe as much as $100 billion--of surgery costs and dialysis costs as a result of people not discovering they have this ailment until it is too late for treatment by the more accessible and easier means. There are some oral medications and other things people can take to deal with this disease, but they have to get there at the early stage. If they get there too late, they wind up having to do amputations of limbs or the patient winds up on dialysis, all of which is far more expensive.
There are also pilot projects in the health care bill for helping people receive care at home and not be forced into a higher priced care environment, such as a nursing home or a longer term care kind of environment. This allows them to receive care at home and be in the dignity of their own home and independent and, obviously, with much less cost. All of those things would be wiped out by this notion that we are just going to get rid of this bill.
What this whole notion is built on is the early negative branding-- very effective negative branding--that took place and was wrapped around the so-called death panels and the other things, none of which are in this legislation. It is not in it. So this is political. That is why they call it ObamaCare, not health care. They call it ObamaCare to make it a pejorative and to do their best to try to wrap it up in the negativity of politics in our country today. And it is a tragedy because it doesn't do justice to the kind of thinking that ought to go into and did go into this bill in terms of how we do things that really create competition in the marketplace and allow people to get better health care.
What is astonishing is that we spend something like, I think, $15,000 per patient in America. I think that is the average cost. There are countries spending half of that and a lot of countries spending around $11,000 a patient that, I am sad to say, are getting better health outcomes than we get in the United States of America. The United States of America is not No. 1 in health outcomes for the money we are spending in the system, and there are a whole lot of reasons for that, but that is part of why this reform is so critical to our country.
I could say a lot more about this, but I am not going to say it now. Every time we hear from people who are just talking now about how we have to get rid of the health care bill, we have to stand and make it clear to people why this bill is good. A lot of Americans have not heard enough about how this legislation works for them, works for the country, and will improve our system. Is it the cure-all--no pun intended--of the health care system? No. I don't pretend it is. We will have to do more. We will have to tweak it. But it is a beginning step, with critical components that take 4 and 5 and 6 years to put into place so that we can get the full measure of their impact.
I will say this. We have it in Massachusetts. We have it now, and businesses are not complaining. In fact, we have one of the best economies of any State in the country. I think our unemployment rate is now down around 4.9, 5 percent, somewhere in that vicinity. So we have this program. We have had it for a few years now, and 98.6 percent of the people in our State are covered. It has been mandatory since the beginning, and it is working. It is beginning to bring down costs in the individual marketplace. The premiums have gone down by something like 45, 50 percent.
So I think we have to look at facts, as we do on a whole lot of issues here facing this country today, rather than continuing this silly talking past each other, completely contrived, political, ideological debate that is calculated to win power and not calculated necessarily to serve the best interests of our Nation. I hope we are going to engage on this over these next months, and I look forward to defending this health care bill because I think the bill is good for America. I think this bill, while it obviously needs some refinement, some changes, and some tweaking here and there, has accomplished an enormous amount already and is on track to accomplish an enormous amount going forward.
I think the administration has a much better story to tell about it than has been told, and I am glad the President has said he looks forward to going out and talking to the country about it because I believe that as the country learns more about it, in fact, they will say: Wow, that makes sense; that seems like a pretty sensible thing to do.
For our opponents who want to just get rid of the legislation, they have an absolute obligation to put the full deal on the table about what they are going to do in return, and not just Medicare, with the Ryan proposal--which makes it more expensive for seniors and undoes Medicare as we know it, not just that part of it--but the whole of it. How are they going to cover the uninsured? What will they do to take care of all those medical institutions that are struggling to teach doctors for the future? How are they going to hold those folks in a way that continues medical education in our country and so forth? They owe it to the Nation to answer those questions.
Mr. President, that concludes the portion of my remarks I wanted to make in response to the Senator from Wyoming.
Tribute to Senator Richard Lugar
Mr. President, I wish to take a few moments to share a few thoughts, not about the results of the election last night in Indiana per se, but I do wish to talk about the consequences for the Senate of the loss of Senator Lugar as of next year and particularly for the Foreign Relations Committee.
It is no secret that Dick Lugar's loss last night is going to be particularly felt by all of us who have had the privilege of working with him on the Senate Foreign Relations Committee, whether he was the chairman of the committee--and I served under him when he was chairman--or whether as a member of the committee and the ranking member, as he is now and as I am now privileged to serve with him.
Whether we agreed with him or not, whether he had the gavel or he didn't have the gavel, Dick Lugar had an approach to the Senate and to governing that was always the same: He was serious, he was thoughtful, and he refused to allow this march to an orthodoxy about ideology and partisan politics to get in the way of what he thought was the responsibility of a Senator and, indeed, the need of the country to have people come together and find the common ground. He dug deeply into some of foreign policy's most vexing issues, and his expertise on complicated issues that were honed over 36 years really can't be replicated. That is something we are going to lose--the institutional experience, the judgment, and the wisdom of the approach on some of those issues, such as the constitutional questions he would call into account when no one else would, the question of not being stampeded by popular opinion with respect to the use of force in one instance or another. All of those are essential to making this institution live up to its full capacity.
Already since last night's news, we have been hearing again and again on some of the news shows and elsewhere about the work of the Senator from Indiana on nuclear nonproliferation. It is no secret his Nunn- Lugar efforts have become almost shorthand for bipartisanship in foreign policy, and they should be recognized. But I want to emphasize here and now that is not all Senator Lugar contributed to this field of foreign policy. He is a leading expert on some of the urgent issues that are off the beaten path, from food security and the eradication of hunger worldwide, to his work with Joe Biden and then with me, I am privileged to say, to change our relationship with
Pakistan, helping prevent their economy from unraveling and encouraging them to cooperate with interests vital to America--indeed, to the stability of that region--and to establishing what he called a ``deeper, broader, long-term strategic engagement'' with Pakistan.
I am privileged to say, for me, the personal journey with Dick Lugar began before that, and I think it epitomizes who he is and why he will be missed. It has nothing to do with ideology.
Back in 1980, shortly after I came here--I was elected in 1984, and I started on the Foreign Relations Committee in 1985. Right away, we began to work together on the issue of the Philippines, free and fair elections in the Philippines. I had traveled over there a number of times as a freshman Senator. I had met with Ferdinand Marcos. I was concerned about the torture taking place and the political prisoners and other violations of rights. Yet we were sort of aiding them notwithstanding our values and our standards.
Well, Dick Lugar joined with me in that effort. He didn't have any reason to join with a freshly minted Senator, wet behind the ears, but he did. Together we sort of became a team that started to focus on the Philippines to figure out how we could hold Marcos accountable. He was serious and he was fair-minded, and I saw firsthand during our trip to the Philippines which we made at the time of the election--after we had done a whole lot of groundwork to set up an accountability system for that election--that he had a very personal and special understanding of what the United States meant to the rest of the world with respect to our values. That cause animated this man whom we all know is dignified and reserved and humble but who proudly came back and recounted with some animation to President Reagan the difference that the United States of America makes when it gives voice to people's aspirations for freedom--and, in this case particularly, the people of the Philippines.
The fact is it was that discussion with Ronald Reagan and the results that came out of the accountability in that election that forced Ferdinand Marcos to leave and we saw Cory Aquino come to power and the Philippines move back into genuine democracy.
I saw the same commitment with Senator Lugar a number of times over the years, but never more so than 2 years ago when we worked together on the New START treaty. His wisdom and his patience was invaluable in laying out the case, particularly in building support across the aisle so we could find the path to 71 votes.
I said then, and I say it again today, given the bitter, divisive, partisan, continual political squabbling that seems to dominate life in the city today, 71 votes is probably the equivalent of the 98 votes we used to get on those kinds of efforts. So I am grateful to him for his willingness to work to do that. He worked to give Members more time to work through problems, to find a way to solve individual objections. It reminded me of the way you actually work in what is now sometimes, unfortunately, sarcastically referred to as the world's greatest deliberative body. He deliberated and he helped us deliberate.
I thought it was one of the finer and prouder moments of the Senate in recent years.
I am confident Dick Lugar's record in our committee is going to be one of those which is remembered for a long time. Sadly, last night it was remembered in the context of Senator Fulbright, who also came to lose a primary in the end and paid a high price for his concern about global affairs and his involvement with those issues. But I think he is also remembered significantly for the enormous legacy he built about American foreign policy and how to make our country stronger.
Dick Lugar does that, and I think he has made it clear--there is no doubt in the mind of anybody on our side of the aisle--that Dick Lugar is a conservative and his votes through the years have shown that. He is a proud Republican.
But I think probably because he served as a mayor before he came here, he applied what we call the LaGuardia rule to foreign policy-- which is the rule that Theodore LaGuardia applied to doing things in New York. It didn't matter whether you were a Republican or Democrat as long as the streets got cleaned and the potholes got filled, and they didn't have any labels on them. That is pretty much the way foreign policies ought to be.
It used to be under Arthur Vandenberg that we said that politics ends at the water's edge, and we do what is in the best interests of our country. Only in the last years in the Senate have I seen a complete diversion from that where, unfortunately--as has been true on both sides--politics has entered into choices people have made with respect to major issues of conflict, potential war and peace, and interests of the security of our country.
So about 4 years ago this time, Dick Lugar received the Paul Douglas Award just off the Senate floor over in the Mansfield Room, and he summed up his approach to the Senate. I think after last night it is important for all of our colleagues to be mindful of his words and to think about them as we go forward in these next 6, 7, 8 months.
Dick argued that bipartisanship isn't an end to itself, and it is sometimes mistaken for centrism and compromise when, in fact, it is the way he called being a constructive public servant. It is the way a constructive public servant approaches his or her job--with self- reflection, discipline, and faith in the goodwill of others.
He said:
Particularly destructive is the misperception in some
quarters that governing with one vote more than 50 percent is
just as good or better than government with 60 or 70 percent
support. The problem with this thinking is that whatever is
won today through division is usually lost tomorrow. The
relationships that are destroyed and the ill will that is
created make subsequent achievements that much more
difficult. A 51 percent mentality deepens cynicisms, sharpens
political vendettas, and depletes the national reserve of
good will that is critical to our survival in hard times.
That is actually about as fundamentally, philosophically, as conservative as one could ask for. I think every one of us who have seen the difficulty of the last few years of our politics, who have been frustrated by the sheer inability of the institution to work, would agree there is nothing liberal or conservative or moderate about what Dick said. It is just common sense about how human nature works, about how people work. It seems to me we would do well to get back in touch.
I often hear people talk about how we need to change the rules here in order to get something done. Actually, we don't. These are the same rules we operated with when Everett Dirksen was here, when Bob Dole was leader, George Mitchell was leader. But we got things done.
In the 1990s, we balanced the budget of our Nation four times in a row without a constitutional amendment. It didn't take a piece of paper to tell us to do it or new words written in the Constitution. It took the common sense and courage of people on the floor of the Senate to do what was right. We don't have to change the rules. We have to change the thinking--or change the people who don't want to do it.
But every great moment in this great institution, when people look back at the history with pride and point to the Missouri Compromise or point to Henry Clay or Daniel Webster or all these great Senators--or Ted Kennedy more recently and others on the other side of the aisle-- when they do that, they are talking about people who operated by the same rules but found the common ground because they had the intelligence and willpower to put the country and its interests ahead of everything else.
So that is what Dick Lugar's loss last night means to us. I don't know who will replace him. We certainly know the cross-currents of some of the campaign, and we certainly know what Senator Lugar himself chose to say last night about his opponent's quest for more partisanship, not less.
So the alarm bells have been sounded. My prayer is that this election year is going to help purge this country of this incredible waste of opportunity that we are living through.
This Congress isn't over. For those of us who were here and remember 1996, it bears repeating that even in Presidential years the Congress can actually defy conventional wisdom and get some things done. That is why I know that Dick Lugar is going to finish out his
sixth term in the Senate with the same determination and effectiveness that has marked every year of his service. He is going to have a lot more contributions to this institution that he reveres and that respects him so enormously.