Floor Statements

How much time remains on both sides?

I yield 3 minutes to the Senator from Florida.

Mr. President, I understand there will be debate until 2 o'clock, and then a vote on the consolidated--consolidated-- appropriations conference report. What does ``consolidated appropriations conference report'' mean? It means there are six bills, three which were never considered on the floor of the Senate. That is what the Senate means by ``consolidated,'' my friends. So for three of the bills, we were never allowed to debate, to amend, or accept, or reject.

They are now spending $450 billion, loaded up with 4,752 earmarks, totaling $3.7 billion, 1,350 pages long, and of that 409 pages are dedicated to listing congressional porkbarrel spending.

I know most Americans are watching NFL football today and they probably do not pay much attention to what we do on a Sunday afternoon here on the floor of the Senate. But if they knew--if they knew what we are about to pass: a bill that has increased spending by 14 percent over last year's level, with the exception, of course, for our veterans care, which is only increased by 5 percent.

Here we are with a $1.4 trillion--now a $1.5 trillion debt this year, an aggregate of over $12 trillion, unemployment at 10 percent, and 900,000 families who lost their homes in 2008, and the numbers for 2009 will be greater.

So what do we do here? We spend and spend and earmark and earmark. The Consumer Price Index went down 1.3 percent, so we are going to increase spending by 5 percent.

What could the American people do with the $3.7 billion in earmarks that are in this bill? Let me tell you a few of them, and you will not believe it, and I am not making it up: $2.7 million to support surgical operations in outer space at the University of Nebraska.

I know Trekkies all over America will approve of that. I know Dr. Leonard McCoy--``Bones''--and even Dr. Spock and Captain Kirk will call them all to the bridge and be happy to know that $2.7 million is going to go to Dr. Leonard McCoy and his friends to support surgical operations in outer space, while thousands of Americans are losing their homes.

Another one I have been unable to describe adequately without violating the rules of the Senate: $655,000 for Cedars-Sinai Medical Center, Los Angeles, CA, for equipment and supplies for the Institute for Irritable Bowel Syndrome Research. The only thing I can say is, that problem will not be reduced when people read this legislation, so there may be a need for it.

So here we are. The list goes on and on. It is crazy stuff: $200,000 for a visitors center in Bastrop, TX, population 5,340; $292,200 for elimination of slum and blight in Scranton, PA--the cast of ``The Office'' is rejoicing--$200,000 for ``design and construction of the Garapan Public Market'' in the Northern Mariana Islands. The Woodstock Film Festival Youth Initiative is going to get $30,000.

It is beyond imagination when you put it into the context that Americans are suffering more than they have at anytime in their lives. Thanks to the greed and avarice of Wall Street, Main Street is under tremendous duress. This is shameful.

I want to remind my colleagues, last March--not that long ago--the President of the United States signed another pork-laden omnibus bill. The President of the United States said:

I am signing an imperfect omnibus bill because it is

necessary for the ongoing functions of government. But I also

view this as a departure point for more far-reaching change.

He also said:

The future demands that we operate in a different way than

we have in the past. So let there be no doubt: this piece of

legislation--

The one he was signing last March loaded with pork--

this piece of legislation must mark an end to the old way of

doing business, and the beginning of a new era of

responsibility and accountability that the American people

have every right to expect and to demand.

If the President of the United States is going to carry out those words, he will veto this bill. He will veto this bill and send it back and tell them to get rid of this pork, tell them to get rid of it.

So what is going to happen? In a few minutes--we all know what is going to happen in a few minutes--by a very large vote, the Senate of the United States is going to vote in favor of this bill. There will be, on this side of the aisle--the party of fiscal conservatives that lost the last two elections--one major reason being because we let spending get out of control--there will be Members on this side of the aisle who will vote for this porkbarrel bill. On the other side of the aisle, a majority over there--an overwhelming majority; all but maybe one or two--will also vote for the bill. Then they will go home--if we ever get out of here--they will go home, and they will say: I am a fiscal conservative, and I am all for a commission to cut spending. Let's appoint a commission. Let's not take any responsibilities ourselves. Let's appoint a commission, and that commission will recommend how we can reduce spending.

If you want to reduce spending and eliminate unnecessary and wasteful spending, vote against this bill that increases spending over last year by some 14 percent. If you want to vote for it, fine, but isn't it a little hard, with a straight face, to go back and tell your constituents you are for the elimination of this wasteful and porkbarrel and corrupting spending? It corrupts, my friends. It is a gateway drug to corruption. We have former Members of Congress in Federal prison because of this.

First, since it is going to be passed, I urge the President of the United States--I do not urge--I demand the President of the United States to keep his word when he signed another porkbarrel-laden bill last March, to veto this bill. I urge my colleagues--I urge my colleagues--let's stand up against this for once: a bill that has $3.7 billion in earmarks.

Immediately, colleagues remind us: Well, this is a legitimate earmark. This is important; that is important. The problem with it is, nobody ever saw it before. It never competed. Maybe we need to support surgical operations in outer space. Do we need it at the University of Nebraska? No. It is earmarked for the University of Nebraska.

By the way, I do not think, except for Trekkies, many Americans think we need to spend $2.7 million to support surgical operations in outer space.

All I can say is: Do not be surprised when the American people, less than a year from now, next November, rise up and reject this kind of behavior and practice of irresponsible spending, while they are hurting more than they have ever been in their lives. They deserve better than what we are getting out of this legislative process, and they have every right to demand something different.

Let's show some courage and vote against this bill, send it back to the President, get rid of the porkbarrel spending, and send it back, and let us vote for it. We could do it immediately. I urge my colleagues, look at this bill and vote against it.

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

Madam President, I rise to speak on the pending bill before us, one of the great porkbarrel, earmark-filled pieces of legislation I have seen come before this body.

I would like to quote from ABC News, by Jonathan Karl and Devin Dwyer, ``Tis the Season of `Pork': Congress Gifts $4 Billion in Earmarks.''

Just weeks before returning to their districts for

Christmas, Congress is poised to give the gift of pork--

roughly $4 billion of it.

More than 5,000 earmarks were included in the $447 billion

omnibus spending bill passed yesterday by the House, funding

``pet projects'' of key members of Congress from both parties

and all regions of the country. The Senate will vote on the

bill this weekend. . . .

Independent analyses of the bill reveal a whopping 12

percent increase in government spending for 2010 while the

inflation rate in the country remains near zero.

Really, isn't that remarkable? A 12-percent increase in spending when people are out of jobs, out of their homes. They cannot afford, basically, what they need to sustain their lives, and we have increased spending by 12 percent and 4,500 earmarks, about $4 billion of it.

``This Congress has not shown that they are at all serious

about the budget deficit in any way,'' said Brian Riedl of

the Heritage Foundation. ``The spending spree is continuing

even as the deficit escalates to $2 trillion.''

The earmarks are all explicitly listed in the bill--right

next to the members of Congress who inserted them: $800,000

for jazz at New York's Lincoln Center, for Rep. Jerold

Nadler, D-N.Y., and Sen. Tom Harkin, D-Iowa. Harkin, and Rep.

Leonard Boswell, D-Iowa, got $750,000 for exhibits at the

World Food Prize Hall in Iowa. Hawaii Democratic senators Dan

Inouye and Daniel Akaka helped get $3.4 million for a rural

bus program in Hawaii.

``The country needs to be tightening its belt, just like

the rest of America,'' said Steve Ellis of Taxpayers for

Common Sense.

Republicans have criticized the spending package, but many

Democrats say it funds key priorities.

Two of the biggest earmarks are from Republican senators

Thad Cochran and Roger Wicker of Mississippi at a cost of $8

million for improvements to four rural State airports. One

airport serves fewer than 100 passengers a day and another--

the Mid-Delta Regional Airport--sees even less.

By the way, I have seen the pork extended to both of those airports over the years.

The new funds would come on top of $4.4 million the

airports just received from the stimulus package.

I am not making this up.

``We obviously have huge aviation and transportation needs

in this country and stuffing millions of dollars in small,

little-used airports in Mississippi is not a wise use of

funds,'' said Ellis.

President Obama had promised to curb the inclusion of

earmarks in government spending bills but he has yet to issue

the threat of a veto.

My friends, do not wait for the threat of a veto.

In March, Obama signed a $410 billion spending package that

contained nearly 8,000 pet projects.

``I am signing an imperfect omnibus bill because it's

necessary for the ongoing functions of government,'' Obama

said at the time. ``But I also view this as a departure point

for more far-reaching change.''

What has changed? What has changed? Nothing. Nothing has changed.

Senate majority leader Harry Reid said about the last omnibus: We have a lot of issues we need to get to after we fund the government-- something we should have done last year but could not because of the difficulty we had working with President Bush.

Difficulty working with President Bush? Whom did the majority leader have trouble working with this time?

Again, I repeat, a 1,350-page Omnibus appropriations conference report, 6 bills, spends $450 billion, 4,752 earmarks totaling $3.7 billion, and a full 409 pages of this conference report are dedicated to listing congressional pork-barrel spending. Spending on domestic programs in this bill is increased 14 percent over the last fiscal year, while spending on military construction and care for veterans has increased by only 5 percent.

Let's look at a little bit of it. Transportation, Housing and Urban Development contains 1,400 earmarks totaling over $1 billion. Commerce- Justice-Science contains 1,511 earmarks totaling $715 million. The list goes on and on. Here we are with a deficit of $1.4 trillion, a debt of $12 trillion, unemployment at 10 percent, nearly 900,000 families lost their homes in 2008, yet there is every indication that the aggregate numbers for 2009 will be worse. With all this, we continue to spend and spend and spend. Every time we pass an appropriations bill with increased spending and load it up with earmarks, we are robbing future generations of Americans of the ability to obtain the American dream. Forty-three cents out of every dollar spent in this bill is borrowed from our children and our grandchildren and, unfortunately, generations after theirs. This is the greatest act of generational theft committed in the history of this country.

Let me go through a few of these, if I might, and remind people of the context this is in. In my home State of Arizona, 48 percent of the homes are ``underwater,'' meaning they are worth less than the mortgage payments people have to pay. We have small businesspeople losing credit everywhere. Instead of trying to fix their problems and helping them out, it is business as usual in the Senate of the United States of America and the Congress.

For example: $200,000 for the Washington National Opera, Washington, DC, for set design, installation and performing arts at libraries and schools; $13.9 million on fisheries in Hawaii--there is always Hawaii-- nine projects throughout the islands ranging from funding bigeye tuna quotas, marine education and training, and coral research; $2.7 million--one of my favorites--to support surgical operations in outer space at the University of Nebraska. As I have said many times--the common theme--you will always have a location designated for these projects. That is why some of them may be worthwhile, but we will never know because they don't compete them. They earmark them for the particular place they want to help. Unfortunately, that shuts out other people. There may be other places besides the University of Nebraska that can support surgical operations in outer space. I suggest we get Dr. Spock and Bones out there to help at the university. I don't know if they live in Omaha or not. I am sure to them and all the others on ``Star Trek,'' surgical operations in outer space may be one of their priorities. It certainly isn't a priority of the citizens of my State.

One of the great cultural events that took place in the 20th century was the Woodstock Festival. In order to do a lot more research on that great cultural moment, we are going to spend $30,000 for the Woodstock Film Festival Youth Initiative; $200,000 to renovate and construct the Laredo Little Theater in Texas--people from all over America are flocking to the Laredo Little Theater, and they want to invest $200,000 of their tax dollars into the Laredo Little Theater. The money would be used to replace worn auditorium seating and soundproofing materials. Anybody got a little theater that warrants soundproofing? Maybe they should apply to the Senator from Texas.

Continuing: $665,000--I am not making this one up--for the Cedars- Sinai Medical Center in Los Angeles for equipment and supplies for the Institute for Irritable Bowel Syndrome Research. I have a lot of comments on that issue, but I think I will pass so as not to violate the rules of the Senate. There is $500,000 for the Botanical Research Institute of Texas in Fort Worth. I am sure the Botanical Research Institute in Fort Worth is a good one. I would like to see other botanical research institutes able to compete. There is $600,000 for water storage tower construction in Ada, OK, population 16,008; $200,000 for a visitor center in Bastrop, TX, the population is 5,340; $292,200 for elimination of slum and blight in Scranton, PA--that may have been put in by the cast of the office--$229,000 for elimination of slum and blight in Scranton; $200,000 for design and construction of the Garapan Public Market in the Northern Mariana Islands; $500,000 for development of a community center--$\1/2\ million--in Custer County, ID, population 4,343; $100,000 for the Cleveland Municipal School District--they just picked one and gave them $100,000--$800,000 for jazz at the Lincoln Center; $300,000 for music programs at Carnegie Hall; $400,000 for Orchestra Iowa Music Education, Cedar Rapids, IA, to support a music education program; $2.5 million for the Fayette County Schools in Lexington, KY, for a foreign language program; $100,000 to the Cleveland Municipal School District in Cleveland, OH, to improve math and language skills through music education; $700,000 for the National Marine Fisheries Service for the project Shrimp Industry Fishing Effort Research Continuation; $1.6 million to build a tram between the Huntsville Botanical Garden and the

Marshall Flight Center in Alabama--how many places need $1.6 million to build a tram, it will probably go out to the statue of Vulcan--$250,000 for the Monroe County Fiscal Court for the Monroe County Farmers Market in Kentucky; $750,000 for the design and fabrication of exhibits to be placed in the World Food Prize Hall of Laureates in Iowa; $500,000 to support creation of a center to honor the contribution of Senator Culver, an Iowa State Senator, at Simpson College; $400,000 to recruit and train closed captioners and court reporters at the AIB College of Business in Iowa; $250,000 for renovating the Murphy Theatre Community Center in Ohio.

There is a lot more, and I will go through them briefly. The point is, you will notice several things. One, the preponderance of these pork-barrel and earmark projects is allocated to members of the Appropriations Committee, which is fundamentally unfair. Second, you will find these are designated to a certain place, to make sure none of that money is spent somewhere else where the need may be greater. Third, it breeds corruption. It is a gateway drug. What we are talking about is a gateway drug. It is especially egregious now.

Continuing: $300,000 to monitor and research herring in Maine; $200,000 to study Maine lobsters; $250,000 for a Father's Day rally parade in Philadelphia. I scoff and make fun of a lot of these but $250,000 for a Father's Day rally parade in Philadelphia. There is $100,000 for the Kentler International Drawing Space, an art education program in Brooklyn. Here is a deprived area, $75,000 for art projects in Hollywood Los Angeles Park; $100,000 for a performing arts training program at the New Freedom Theater in Philadelphia; $100,000 to teach tennis at the New York junior tennis league in Woodside, NY; $2.8 million to study the health effects of space radiation on humans at the Loma Linda University, Loma Linda, CA; $200,000 for the Aquatic Adventures Science Education Foundation in San Diego; $100,000 to archive newspaper and digital media at the Mississippi Gulf Coast Community College in Perkinston, MS; $3.9 million on researching weaving and knitting at Clemson University, Raleigh, NC, Philadelphia University, UC Davis in Davis, CA; $90,000 for a commercial kitchen business incubator at the El Pajaro Community Development Corporation in Watsonville, CA; $500,000 to study vapor mercury in the atmosphere at Florida State; $1 million to examine sea scallops fisheries at the Massachusetts Marine Fisheries in Bedford; $300,000 for seal and stellar sea lion biological research; $300,000 for Bering Sea crab management; $500,000 to upgrade the Baldwin County Courthouse security in Fairhope, AL; $900,000 for the operational costs and capital supporting the Alien Species Action Plan cargo inspection facility in Maui; $2 million to streetscape the city of Tuscaloosa, AL; $100,000 for an engineering feasibility study of a bike connector in Hiran, OH; $400,000 for a pedestrian overpass in Des Moines; $300,000 for a bike path in Cuellar, TX; $900,000 for a river freight development study in Missouri; $800,000 for a scenic trail in Monterey Bay, CA, another deprived area; $750,000 for the Philadelphia Museum of Art Transportation Improvement Program, Brady, PA; $500,000 for park-and- ride lots at Broward County, Meek, FL; $487,000 to restore walkways in Newport Cliff, RI, another low-income area; $974,000 for Regional East- West and Bikeway in Albuquerque.

The list goes on and on and on, up to nearly $4 billion. The problem is, among other problems, in the last campaign, the President campaigned for change, change you can believe in. There is no change here. It is worse. It is worse because of the conditions Americans find themselves in--out of their homes, out of jobs, high unemployment, tough economic conditions. It is business as usual, spending money like a drunken sailor, and the bar is still open.

I tell my colleagues, again, what I keep saying over and over: There is a peaceful revolution going on. They are sick and tired of the way we do business in Washington. They don't think their tax dollars should be spent on these pork-barrel earmarked projects. They are mad about it. We are not getting the message. We are not hearing them. We are not responding to the problems and the enormous challenges the American people have. We are continuing this kind of obscene process, which not only is wrong on its face but breeds corruption in Washington.

I ask unanimous consent that the AP story ``Senate Set to Advance $1.1 trillion Spending Bill'' be printed in the Record, as well as the ABC News story and the FOX News story ``Watchdogs Cry Foul Over Thousands of Earmarks in Spending Bills.''

Madam President, I am sorry to be repetitive. I know my colleague is waiting, so I will end with this: This is wrong. We all know it is wrong. The American people know it is wrong. People who vote for this kind of porkbarrel spending are going to be punished by the voters, and we are going to end this obscene process, and we are going to end it soon, as early as the next election.

Madam President, I yield the floor.

I wish to say to my colleague, first of all, as is well known, side-by-sides have been one side of the aisle and the other side of the aisle. If the Lautenberg amendment were in order on the Dorgan amendment as a side-by-side, that would obviously be a change from what we have been doing.

Basically, what my amendment does is make some perfecting changes to the underlying Dorgan amendment. It has some sense-of-the-Senate provisions and several other provisions which I think would help make it more effective. I have to be very honest with my friend from Illinois, it doesn't undermine the Dorgan amendment. I think it supplements the Dorgan amendment, just as the Bennet amendment to Medicare costs supplemented the position we had that Medicare benefits wouldn't be cut.

So side-by-side amendments aren't necessarily in contrast with each other; sometimes they perfect, and I think my amendment makes it a better amendment--makes the Dorgan amendment a better proposal.

Yes, plus some perfecting language, as far as the Senate is concerned, about other procedures that would expedite the Dorgan amendment as well.

No, obviously not, because I don't agree with the Lautenberg language in my amendment, as you know. But what we are trying to do is, obviously, make the Dorgan amendment better, just as other amendments that are side-by-sides have tried to make amendments better. They do not necessarily cancel them out but make them better.

Yes, a proud cosponsor.

I guess what I am not sure--if I understand my friend, I am offering an amendment as a side-by-side in order to, in my view, improve the Dorgan amendment; again, in all candor, not to undermine but to make it better.

And I withdraw, with great reluctance and great anger, my amendment, because I think the Lautenberg amendment would be in violation of what we have agreed to.

Could I be clear with the Senator from Illinois that what this means is we would move forward with the side-by-side Dorgan and Lautenberg--we would agree to that--and then we would also expect agreement on following amendments so that we could lock those in for debate and votes?

Mr. President, while my friend from Illinois----

I ask for an additional 10 minutes of morning business so I could maybe engage in a colloquy with my favorite combatant here.

Maybe we can talk a little bit about his remarks.

I have to say, I appreciate the eloquence and the passion the Senator from Illinois has brought to this debate. He makes some very convincing points. One of the major points--and I would be glad to listen to the Senator. I think it is fair for us to respond to each other's comments very quickly. The Senator from Illinois said we have been engaged in the negotiations and inputs have been made into the formulation of this bill.

I have to tell the Senator from Illinois, I have been engaged in many bipartisan compromises, whether it be issues such as campaign finance reform, whether it be--a whole large number of issues, including defense weapons acquisition reform. I say to the Senator from Illinois, do you know what the process was? People sat down

at the table together when they were writing the legislation. I am a member of the HELP Committee, OK? I say to the Senator from Illinois, do you know what the process was--because I am on the committee. A bill was brought before the committee without a single--Senator Enzi will attest to this--without a single period of negotiations, where we sat down together with the chairman of the committee, where they said: What is your input into this legislation?

We had many hours of amendments in the committee, all of which, if they were of any real substance, were rejected on a party-line vote.

I have to tell the Senator from Illinois he can say all he wants to that there have been efforts to open this to bipartisanship. There have not. My experience in this Senate--I know how you frame a bipartisan bill and that has not been the process that has been pursued by the majority.

I understand what 60 votes mean. But in all due respect, I say to the eloquence of my friend from Illinois, that has not been the process which I have successfully pursued for many years, where people have sat down together at the beginning, where you are there on the takeoff and also then on the landing.

I would be glad to hear the response of the Senator from Illinois.

I ask unanimous consent if the Senator and I could engage in a colloquy.

Respectful but vigorous.

I will be glad to correct the Senator from Illinois. Senator Enzi is here. None of those amendments were of any significant substance that would have a significant impact on the legislation, I have to say to the Senator from Illinois. For example, medical malpractice, we proposed several amendments that would address what we all know, what the Congressional Budget Office says is $54 billion-- other estimates as much as $100 billion--in savings. There were no real fundamental amendments.

I have to say that some of those amendments were accepted. But it still doesn't change the fact that at the beginning, as the Senator from Illinois said--the bill came to the committee without a bit, not 1 minute of negotiation before the bill was presented to the committee. The ranking member is on the floor. He will attest to that. Please go ahead.

May I ask my friend, wasn't the reason the public option was abandoned was not because of a Republican objection, it was because of the Democratic objection? The Senator from Connecticut stated, unequivocally, the public option would make it a no deal.

I appreciate the fact that Republican objections were observed. But I don't believe the driving force behind the abandonment of this public option, if it actually was that--we have not seen the bill that is going to come before us--was mainly because of the necessity to keep 60 Democratic votes together.

We are hoping not.

Could I ask my friend about the situation as it exists right now? Right now, no Member on this side has any idea as to the specifics of the proposal the majority leader, I understand, has sent to OMB for some kind of scoring. Is that the way we want to do business, that a proposal that will be presented to the Senate sometime next week and voted on immediately--that is what we are told--is that the way to do business in a bipartisan fashion? Should we not at least be informed as to what the proposal is the Senate majority leader is going to propose to the entire Senate within a couple days? Shouldn't we even know what it is?

Could I ask my friend from Illinois--and by the way, I would like to do this again. Perhaps when he can get more substance into many of the issues.

I admit these are unusual times. But isn't that a very unusual process, that here we are discussing one-sixth of the gross national product; the bill before us has been a product of almost a year of sausage-making. Yet here we are at a position on December 12, with a proposal that none of us, except, I understand, one person, the majority leader, knows what the final parameters are, much less informing the American people. I don't get it.

I ask unanimous consent for 5 additional minutes.

I say to my friend, everything he said is absolutely correct. I am deeply concerned about the situation of health care in America. I know the Senator from Illinois is deeply concerned about the fact that it is going to go bankrupt, about the fact that the Medicare trustees say that within 6 or 7 years it is broke. From what we hear, there is now a proposal over there to extend eligibility for Medicare, which obviously puts more people in the system, which obviously, under the present setup, would accelerate a point of bankruptcy, at least from what I know of this.

But the fundamental difference we have, in my opinion, is not what we want--we both share the deep ambition that every American has affordable and available health care--it is that we believe a government option, a government takeover, a massive reorganization of health care in America will destroy the quality of health care in America and not address the fundamental problem. We believe the quality is fine.

We think the problem is bringing costs under control. When you refuse to address an obvious aspect of cost savings such as malpractice reform, such as going across State lines to obtain health insurance, such as allowing small businesses to join together and negotiate with health care companies, such as other proposals we have, then that is where we have a difference. We share a common ambition, but we differ on the way we get there. I do not see in this bill, nor do most experts, a significant reduction in health care costs except slashing Medicare by some $\1/2\ trillion, which everybody knows doesn't work, and destroying the Medicare Advantage Program of which in my home State 330,000 seniors are a part.

First, obviously I want to preserve those programs. But every one of those the Senator pointed out is going broke. They are wonderful programs. They are great things to have. But they are going broke. He knows it and I know it, and the Medicare trustees know it. To say that we don't want these programs because we want to fix them is obviously a mischaracterization of my position, our position. We want to preserve them, but we all know they are going broke. It means cost savings. It means malpractice reform. It means all the things I talked about. The Senator mentioned Medicare Advantage. That is called Medicare Part C. That is part of the Medicare system. There are arguments made that there are enormous savings over time because seniors who have this program, who have chosen it, who haven't violated any law, are more well and more fit and have better health over time, thereby, in the long run, causing significant savings in the health care system which is what this is supposed to be all about. I ask in response: How in the world do you take a Medicare system which, according to the trustees, is going broke and then expand it to people between age 55 and 64? The math doesn't work. It doesn't work under the present system which is going broke. To add on to it, any medical expert will tell you, results in adverse selection and therefore increases in health care costs.

The Senator has seen the CMS estimates this morning that this will mean dramatic increases in health care costs. You may be able to expand the access to it, but given the dramatic increase, one, it still affects the Medicare system and, two, there will obviously be increased costs, if you see the adverse selection such as we are talking about.

I see the staff is getting restless. I ask my friend, maybe we could do this again during the weekend and during the week. I appreciate it. I think people are helped by this kind of debate. I respect not only the passion but the knowledge the Senator from Illinois has about this issue.

Mr. President, one of the troubling aspects of this conference report is that the appropriators air dropped three very significant spending bills into the text during conference. In other words, three bills without any debate, discussion or amendment were air dropped into this pending legislation. The three bills are the Labor- HHS-Education, financial services and general government, and the State-Foreign Operations appropriations bills. Combined, these three bills spend over $237 billion and contain 2,019 earmarks. It is remarkable and unacceptable that the Senate is willing to approve expenditure of such huge sums without the opportunity to debate and amend their content.

I see the Senator from Hawaii, who will say: This is the way we have had to do business before. We have to do this because of the pressure of time, the fiscal year ended, et cetera, et cetera. Again, we get back to this old line that we heard for an entire year and even early this year about change, about how we were going to change things in Washington. We are going to change the way we do business.

President Obama said about the last omnibus bill passed last March, 3 months into the Obama administration:

The future demands that we operate in a different way than

we have in the past. So let there be no doubt: this piece of

legislation must mark an end to the old way of doing business

and the beginning of a new era of responsibility and

accountability that the American people have every right to

expect and demand.

What are we doing today? The exact same thing that we were doing before.

Here is a quote from the White House Chief of Staff Rahm Emanuel about the last omnibus bill. This is the one we weren't going to do anymore.

Second, this is last year's business.

He was talking about the one we passed in March.

And third, most importantly, we are going to have to make

some other changes going forward to reduce and bring more--

reduce the ultimate number and bring the transparency. And

that's the policy that he enunciated in his campaign.

Bob Schieffer:

But it sounds to me like what you're--what he's about to

do, here, is say, well I don't like this but I'm going to go

ahead and sign it--

Talking about the last omnibus bill--

but I'm going to warn you, don't ever do it again. Is that

what's about to happen here?

Emanuel:

In not so many words, yes.

And then, of course, the Senate majority leader said about the last omnibus:

We have a lot of issues we need to get to after we fund the

government, something we should have done last year but we

could not because of the difficulty we had with working with

President Bush.

I wonder if we are going to blame President Bush for this one. If it rained, if it didn't rain? We blamed him for almost everything. Whatever it is, let's blame President Bush. The point is, what this bill is, and another one that will be coming up in a couple days, is exactly the same business as usual, a porkbarrel-laden bill with increases in spending when the American people are hurting in the worst possible way. The American people are hurting and the Labor, Health and Human Services and Education appropriations bill has $11.3 billion or a 7-percent increase in spending over last year's spending level. Where are we? This is America. Americans are hurting. There is 10 percent unemployment. People can't stay in their homes. They can't keep their jobs. We are passing a piece of legislation with 1,749 earmarks just in the Labor, Health and Human Services piece of over $806 billion.

Do you want to hear a few of them? They are fascinating. Here is my favorite of all--there are a lot of good ones--$2.7 million to support surgical operations in outer space at the University of Nebraska. I assure my colleagues, I am not making that up. That is an appropriation in this bill. Let me repeat: $2.7 million to support surgical operations in outer space. There are a lot of compelling issues before the American people. Surgical operations in outer space at the University of Nebraska? I guess the University of Nebraska has some kind of expertise that they need $2.7 million so we could support surgical operations in outer space. I wonder when the next surgical operation is scheduled in outer space? Maybe we ought to go into that.

I will be spending more time on the floor on this. But $30,000 for a Woodstock film festival youth initiative? Woodstock was a pretty neat experience, but do we need to spend $30,000 to revisit that one? There is $200,000 to renovate and construct the Laredo Little Theater in Texas. The next time you are in Laredo, be sure to stop by the theater and see $200,000 of your money which is going to renovate and construct this little theater. There is $500,000 for the Botanical Research Institute of Texas in Fort Worth; $200,000 for a visitors center in Bastrop, TX, a visitor center there in Bastrop with a population of 5,340 people. We are going to spend $200,000 of my taxpayers' dollars to build them a visitor center. There is $200,000 for design and construction of the Garapan public market in the Northern Mariana islands; $500,000 for development of a community center in Custer County, ID, population 4,342. If my math is right, that is about $100 per person. Right here in our Nation's Capital, $200,000 to the Washington National Opera for set design, installation and performing arts at libraries and schools. They have an operating budget of $32 million. Their Web site says the secret of its success is due to its position without the crucial government support typical in most world capitals. Then, of course, we always get back to Hawaii: $13 million on fisheries in Hawaii, nine projects throughout the islands ranging from funding the bigeye tuna quotas, marine education and training, and coral research.

The list goes on and on. The next time you are in New York, go to Lincoln Center. We are spending $800,000 of your money for jazz at the Lincoln Center. Jazz lovers, rejoice. For those who are not jazz lovers, we have $300,000 for music programs at Carnegie Hall; $3.4 million for a rural bus program in Hawaii. Apparently, the $1.9 million in the 2009 omnibus was not enough. In other words, we gave $1.9 million for this rural bus program in Hawaii so we have to now give them $3.4 million more.

Custer County, ID, with a population of 4,342, as of the year 2000--I am sure they have grown since--$500,000 for development of a community center in Custer County, ID.

The list goes on.

Then, of course, it is loaded with controversial policy riders that should have been debated in the Senate.

In the Department of Labor bill, the conference rescinds $50 million from unobligated immigration enforcement funds under section 286(v) of the Immigration and Nationality Act. This will result in a decrease in the enforcement of immigration law. I guarantee you, if that provision had been debated here on the floor of the Senate, that $50 million would never have been removed.

The conference agreement includes new language providing authority to the International Labor Affairs Bureau, the agency charged with carrying out the Department of Labor's international responsibilities. This may be a worthy program, but it should be addressed in legislation.

There are so many other policy provisions in this bill which have not been authorized, which is supposed to be done by authorizers.

The conference agreement provides $35 million for the Delta Health Initiative. The Delta Health Initiative provides a service to individuals in only one area of the country, the delta region of Mississippi. I have visited the delta region in Mississippi, and there are severe health needs. But couldn't we authorize this program? Couldn't we authorize it? Couldn't we have the proper debate and discussion?

The list goes on and on.

Of course, there is $25 million ``for patient safety and medical liability reform demonstrations'' that was not included in the House or Senate. Medical liability reform demonstrations--there is a demonstration project already in being. It is called the State of Texas, where they have reduced medical malpractice costs dramatically, and the physicians and caregivers are flowing back into the State of Texas.

Mr. President, I will be talking more later this afternoon about all the pork and earmarking that is in this bill.

I have to tell you that the anger and the frustration out there is at an incredibly high level. Those of us who--I am sure most of us do-- spend a lot of time at townhall meetings and hearing from our constituents know there is a level of anger out there, the likes of which I have not seen before. Here they are, hurting so badly because they cannot keep their homes and their jobs. My home State of Arizona is No. 2 in the country of homes where the mortgage payment is higher than the home value--48 percent of the homes in my State. So here we are with 10-percent unemployment, with deficits--this year of $1.4 trillion--and there are dramatic increases, a 7-percent increase in spending in one, a 14-percent increase in spending in the other, and they do not get it. They do not get it. They do not get it. Americans are having to tighten their belts.

My home State of Arizona is in a fiscal crisis. They are having to cut services to our citizens because we cannot print money in Arizona. They only print money here. And here we are with Omnibus appropriations bills with as high as a 14-percent increase in spending, loaded down with billions of dollars worth of porkbarrel projects.

I predict to my colleagues that the anger out there will be manifest in a number of peaceful ways, including in the ballot booth. They are sick and tired of this. I saw a poll yesterday where the approval rating of Members of Congress has fallen below that of the approval rating for used car salespersons. I think it was at 4 percent, as I recall the poll. I have not met any of the 4 percent. I have not met anybody who approves of what we are doing.

This exercise we are in right here, on December 11, 2009, with a pork-laden Omnibus appropriations bill which frivolously and outrageously spends their dollars when they are struggling to keep their heads above water is something that is going to be rejected sooner or later by the American people. I have warned my colleagues that the American people are sick and tired of this. They did not like it before. Now they are fed up with it.

We will be hearing more this afternoon.

So, Mr. President, I rise today to raise a point of order under rule XXVIII against H.R. 3288, the Omnibus appropriations bill. I do this to ensure that this bloated legislation is not permitted to proceed to full consideration by the Senate.

Specifically, rule XXVIII precludes conference reports from including policy provisions that were not related to either the House or the Senate version of the legislation as sent to conference. Several provisions included in division D--the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act--of this omnibus bill are out of scope and were never considered on the floor of the Senate.

Mr. President, I raise a point of order that the conference report violates the provisions of rule XXVIII.

Mr. President, I yield the floor.

Will the majority leader yield for a question?

And the disposition of the pending Dorgan amendment, could we have some idea about that?

Will the Senator yield for a question?

The answer is, obviously, that I don't know.

I would like to say to the Senator from Tennessee--and Dr. Barrasso is here as well--a lot of Americans have heard of the Congressional Budget Office. I am not sure many have heard of the Centers for Medicare and Medicaid Services, which is part of the Department of Health and Human Services. Are they not the people whose entire focus is not on the entire budget, as CBO's is, but just on Medicare and Medicaid, so that they can make determinations as to the future and the impact of various pieces of legislation on specifically Medicare and Medicaid? Is that a correct assessment?

I thank my friend. Because the findings as of December 10, 2009, which is entitled ``Estimated Financial Effects of the `Patient Protection and Affordable Care Act of 2009,' as Proposed by the Senate Majority Leader on November 18, 2009,'' have some incredibly, almost shocking results, I say to my friend from Tennessee.

We know the bill before us does not bring costs under control. But as I understand this--and it is pretty, may I say, Talmudic in some ways to understand some of the language that is in this report, but is it not true that the Reid bill, according to this report--this is not the Republican policy committee but the Centers for Medicare and Medicaid Services--doesn't it say:

The Reid bill creates a new long-term insurance program--

Called the CLASS Act--

that the CMS actuaries found faces ``a very serious risk'' of

becoming unsustainable as a result of adverse selection by

participants. The actuary found that such programs face a

significant risk of failure and expects that the program will

result in ``net Federal cost in the long term.''

I would like to mention two other provisions to my friend from Tennessee and Dr. Barrasso, who is very familiar not only with this center but with Medicare and Medicaid services.

The Reid bill funds $930 billion in new Federal spending by

relying on Medicare payment cuts which are unlikely to be

sustainable on a permanent basis. As a result--

According to CMS--

providers could ``find it difficult to remain profitable and,

absent legislative intervention, might end their

participation in the Medicare program.''

The Reid bill is especially likely to result in providers

being unwilling to treat Medicare and Medicaid patients,

meaning that a significant portion of the increased demand

for Medicaid services would be difficult to meet.

They go on to say:

The CMS actuary noted that the Medicare cuts in the bill

could jeopardize Medicare beneficiaries' access to care. He

also found that roughly 20 percent of all Part A providers

(hospitals, nursing homes, etc.) would become unprofitable

within the next 10 years as a result of these cuts.

Finally, he goes on to say:

The CMS actuary found that further reductions in Medicare

growth rates through the actions of the Independent Medicare

Advisory Board--

Which is one of the most controversial parts of this legislation--

which advocates have pointed to as a central lynchpin in

reducing health care spending, ``may be difficult to achieve

in practice.''

This is a remarkable study, I say to my friend from Tennessee.

May I also ask, in addition to that question, has Dr. Barrasso ever heard of the CMS being biased or slanted in one way or another? Isn't it one of the most respectable and admired objective observers of the health care situation as far as Medicare and Medicaid are concerned?

This is the information on the bill as it is; correct-- the original bill? This is without the expansion of Medicare taken into this study, which already, as the Senator quoted from the New York Times and other health care experts, is going to increase costs even more. As you expand Medicare, among other things, you run the risk of adverse selection, which means the people who are the sickest immediately enroll, which then increases the cost, and then who would be paying the increased Medicare payments? The young and the healthy. I

ask my friend from Wyoming, should we do that to the next generations of Americans?

Mr. President, I ask unanimous consent the Senator from Montana be given 2 additional minutes.

I ask unanimous consent to enter into a colloquy with the Senators from Oklahoma, Tennessee, and Tennessee, both of them.

Mr. President, we are here, obviously, as we are on a daily basis, to discuss the issue of health care reform. But we are in a rather unusual situation this morning because we don't know what we are discussing or debating. We find ourselves in an interesting situation.

After almost a year of consideration of health care reform, with a measure that has been--at least a couple of the outlines of it we know but, frankly, we have had no details except that Medicare is going to be extended, eligibility for Medicare is going to be extended to age 55.

I just would quote: There was a meeting yesterday amongst Senate Democrats. Many Senate Democrats emerged from yesterday's caucus meeting saying they had learned little about the public option agreement and there were many outstanding concerns.

Senator Mary Landrieu called the agreement ``a very good idea.'' Senator Blanche Lincoln said, ``More information is needed.'' And Senator Ben Nelson said, ``I just want to know what the costs are.''

So do the rest of us. So do the rest of us. Here we have a proposal after nearly a year that is being assessed by the Congressional Budget Office, and here we are with no knowledge of what that bill is about, with the exception of some bare essentials that have been leaked.

What did this have to do with change? What does this have to do with bipartisanship? What does this have to do with anything?

Frankly, we have an editorial in the Washington Post this morning that calls it ``Medicare Sausage?''

I ask unanimous consent the editorial from the Washington Post be printed in the Record.

``The emerging buy-in proposal could have costly unintended consequences.''

But we don't know what it is. But we know that never before in this entire year--I ask my colleagues--have we seen a proposal that would change eligibility for Medicare down to age 55, never before.

The majority leader came to the floor this morning and said if we accept

an omnibus, a multitrillion-dollar bill by unanimous consent--by the way, the Omnibus appropriations bill is six bills totaling $450 billion, 1,351 pages long, with 4,752 earmarks totaling $3.7 billion. And, by the way, spending on domestic programs is increased by 14 percent except for veterans, which is increased by only 5 percent.

The majority leader wants us to go out for the weekend, after keeping us in all last weekend. Here we have an unspecified proposal--none of us know the details or the cost--so I am supposed to go home to Arizona this weekend and say: My friends, we have been working on health care reform for a year. And guess what. I can tell you nothing.

We need to stay in, we need to know what the proposals are, we need to have votes on it, and we need to tell the American people what is going on behind closed doors.

Gladly.

And vote.

If we are not going to have a vote, maybe we ought to have a vote to table the pending amendments, at least to have the Senate on record.

Could I finally say, I know New Orleans is very nice this time of year, but perhaps we ought to stay here and get this job done?

Not only are there questions--not only is there opposition from the Mayo Clinic but the American Hospital Association and the AMA. They have all come up steadfastly against this.

Could I ask my colleague from Oklahoma--and I quote from this editorial. Here we are supposedly going out for the weekend and the editorial from the Washington Post says:

Presumably, the expanded Medicare program would pay

Medicare rates to providers raising the question of the

spillover effects on a health-care system already stressed by

a dramatic expansion of Medicaid. Will providers cut costs--

or will they shift them to private insurers, driving up

premiums? Will they stop taking Medicare patients or go to

Congress demanding higher rates? Once 55-year-olds are in,

they are not likely to be kicked out and the pressure will be

on to expand the program to make more people eligible. The

irony of this late-breaking Medicare proposal is that it

could be a bigger step toward a single-payer system than the

milquetoast public option plans rejected by Senate moderates

as too disruptive of the private market.

There are many who believe the Senator from Oklahoma could not have a heart attack.

Apparently, I would ask my colleague from Tennessee, we do not know what we would be voting on because there has been a whole rewrite of this health care reform here after a year. We do not even know what the provisions of that bill are except what has been leaked. Apparently, my colleagues on the other side of the aisle, with the exception of the majority leader, don't know what it is either.

I thank the Senator. May I ask the Republican leader, again, to be very clear that it is his view and that of all Republican Members that we will stay in for as long as it takes to get this issue resolved and we are prepared to vote throughout the entire weekend. If the majority leader moves to the Omnibus appropriations bills, we will have a conference report, and we will certainly have discussion about a bill that has 4,752 earmarks totaling $3.7 billion. But we should not get off this, should we?

May I point out, again, as the Senator from Maine, Ms. Snowe, pointed out--and it was highlighted in the Wall Street Journal-- no major reform in the modern history of this Senate has been enacted without bipartisan support, a reason for us to go back to the drawing board.

I know the Senator from Texas has been heavily involved in the issue of

hospitalization and the American Hospital Association's reaction to what appears to be an expansion of Medicare.

May I say, having stood fifth from the bottom of my class at the Naval Academy, I cannot explain it. But perhaps before I turn to the Senator from South Dakota, maybe we could get a response from Dr. Coburn to that question.

I yield to the Senator from South Dakota.

I thank the Senator from South Dakota. I have to say I have never, in the years I have been here, seen a process such as this. It is incredibly bizarre that after a year, after hundreds of hours in the HELP Committee, after how many hundreds of hours in the Finance Committee, products are here on our desks. Yet there is a meeting yesterday of the Democrats. They come out, and they don't know what the proposal is either. Apparently, there is only one Senator who knows what the proposal is and that is the majority leader. Also, then it is OK to go home for the weekend. I honestly say to my colleague from South Dakota, I have never seen anything quite like this, especially when we are talking about one-sixth of the gross national product. Of course, already from what they know, the hospitals and doctors and others have come out in strong opposition to expansion of a program, as the Senator points out, that is going broke.

Mr. President, I ask unanimous consent that a list of physician organizations that oppose this act, representing nearly one- half million physicians, be printed in the Record.

Mr. President, I thank the Senator from Montana for his courtesy.

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

Madam President, it is my understanding we are now on the fiscal year 2010 Consolidated Appropriations Act. I will have a lot to say about this 3,000-page omnibus appropriations bill, but I would point out to my colleagues that it is loaded down with 4,752 earmarks, totaling $3.7 billion; six bills, totaling $450 billion; 1,351 pages long, with 409 pages of earmarks. Spending on domestic programs is increased by 14 percent. Veterans spending is increased by 5 percent. That shows the priorities around here. Let me repeat that. Domestic spending programs are increased by 14 percent. Military construction and veterans spending is increased by only 5 percent.

Here we go again. Just a matter of months ago, in March, the Senate passed a monstrous $410 billion, 3,000-page omnibus appropriations bill that was loaded up with over 9,000 earmarks. At that time, those of us who complained about the ridiculous amount of waste were ignored. In fact, the President's Director of the Office of Management and Budget, Peter Orszag, said in an interview that ``this is last year's business. . . . We want to just move on''--a truly remarkable statement coming from the man the President put in charge of the government's budget.

In March, the majority leader placed the blame for the omnibus spending bill at the feet of President Bush. Senator Reid said:

. . . we have a lot of issues we need to get to after we

fund the Government--something we should have done last year

but we could not because of the difficulty we had working

with President Bush.

So what is the excuse this time? Where will the blame be placed now? Is the majority leader having difficulty working with President Obama? We have had all year to work on 12 annual spending bills, and we only enacted 5 of them through the regular order, and 1 of those 5 was passed and sent to the President before the new fiscal year began.

We should be embarrassed by this process. Here we go again--faced with a whopping 1,350-page omnibus appropriations conference report, which contains six bills, spends $450 billion, and is loaded up with 4,752 earmarks, totaling $3.7 billion. Meanwhile, people are out of jobs, they are out of their homes, unemployment in my home State is 17 percent, and we are going to spend money on things such as $2.7 million--get this; I am not making it up--$2.7 million for supporting surgical operations in outer space--supporting surgical operations in outer space--at the University of Nebraska Medical Center, Omaha, NE; $30,000 for Woodstock Film Festival Youth Initiative; $13.9 million for fisheries in Hawaii--the list goes on and on and on and on--$200,000 to renovate and construct the Laredo Little Theatre.

We should not be spending American taxpayer dollars to replace worn auditorium seating and soundproofing materials. The list goes on and on and on: $800,000 for jazz at the Lincoln Center; $3.4 million for a rural bus program in Hawaii--you will note that Hawaii pops up all the time here--$1.6 million to build a tram between the Huntsville Botanical Garden and the Marshall Flight Center in Alabama; $750,000 for the design and fabrication of exhibits to be placed in the World Food Prize Hall of Laureates in Iowa.

I am not making these up. This is the same party and President that promised to scrub each one of these appropriations bills and get rid of the unnecessary ones.

So we will be talking a lot about this bill. But I want to point out again what is before us to the American people: six bills--not one--six bills, totaling $450 billion; 409 pages of earmarks, 4,752 earmarks, totaling $3.7 billion; and spending on domestic programs is increased by 14 percent; MILCON and veterans spending is increased by 5 percent.

I have met recently with the Governor of my State. We are suffering under incredible economic difficulties. We are having the greatest financial crisis in the history of my State. Couldn't they use some of this $3.7 billion in earmarks to pay for some of the essential services that are having to be cut back, not only in my State but all over America? No. The beat goes on. It is business as usual here in Washington.

And do not be surprised at the anger of the American people over this way of doing business--bills 1,351 pages long, filled with earmarks and pork that have nothing to do with the betterment of our Nation.

So we will be talking a lot more about many of these porkbarrel amendments that are in it. But it is awful: $200,000 for ``design and construction of the Garapan Public Market'' in the Northern Mariana Islands. We will be hearing a lot more about it.

I will be glad to yield.

The CPI was minus 1.3 percent, not to mention 10 percent unemployment in America, not to mention people not being able to stay in their homes, not to mention the hardest economic conditions in history, certainly, since the Great Depression.

Spending on domestic programs is increased by 14 percent. What brings that down to 12 percent is they only increased veterans spending-- veterans spending--by 5 percent. But opera houses, rural bus programs, music programs--$300,000 for music programs at Carnegie Hall. Do you think Carnegie Hall needs $300,000 for music programs?

The stimulus bill has nothing to do with that, I would say to my colleague, and we all know that. This is entirely new, six appropriations bills, totaling nearly $450 billion which, by the way, the majority leader wanted to pass by unanimous consent. Remarkable.

I would also respond to my friend, it has to be in the context of a revision over 10 years, recently, by the Office of Management and Budget from a $10 trillion to a $12 trillion deficit. The deficit for this year is $1.4 trillion, and I am not sure what it is next year. But they could not have known that in the Appropriations Committee when they passed spending measures such as this.

The point is, in the face of massive, unprecedented deficits, unfunded liabilities in Social Security and Medicare, where we are asking Americans all over to tighten their belts--in my State essential services are being cut because they do not have enough money--this is the same business as usual that we have seen for years.

I saw a poll yesterday--it was in a Hotline poll or one of those-- that the approval rating of Members of Congress is below that of used car salesmen. I have not met those who express their approval. So we should not be surprised at some very interesting things that may take place in the elections coming up this November. But it is unfortunate, that is all.

Forty-three cents. And do you know who they borrowed it against? Our kids and our grandkids. They are the ones who are going to have to pay for it. I do not think I will. It is our kids and our grandkids whom we are laying it on. This is a colossal act of generational theft that we have committed. And believe it or not, the American people have figured it out.

The Senator is correct.

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

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

Is there a previous agreement on time?

Mr. President, I rise on behalf of the amendment which, according to the Congressional Budget Office, would provide an estimated $100 billion or more in consumer savings over 10 years. That is unique to this bill. It is unique to this legislation. It actually saves the taxpayers money.

I think it is important for us to go back and see how we got here-- again, with the administration and the President reversing his previous position in favor of drug reimportation, the President's Chief of Staff, Mr. Rahm Emanuel, reversing his position on drug reimportation.

Again, a lot of it has to do with the deals that have been made. I refer, to start with, to the August 6, 2009, New York Times article.

Pressed by industry lobbyists, White House officials on

Wednesday assured drug makers that the administration stood

by a behind-the-scenes deal to block any Congressional effort

to extract cost savings from them beyond an agreed-upon $80

billion.

Then it goes on to say:

``We were assured: We need somebody to come in first. If

you come in first, you will have a rock-solid deal,' Billy

Tauzin, the former Republican House member from Louisiana who

now leads the pharmaceutical trade group, said Wednesday.

``Who is ever going to go into a deal with the White House

again if they don't keep their word? You are just going to

duke it out instead.''

The pressure from Mr. Tauzin to affirm the deal offers a

window on the secretive and potentially risky game the Obama

administration has played as it tries to line up support from

industry groups typically hostile to government health care

initiatives, even as their lobbyists pushed to influence the

health measure for their benefit.

Here is the important part of the article--and I ask unanimous consent the entire article from the New York Times be printed in the Record.

The important quote is:

Mr. Tauzin said the administration had approached him to

negotiate. ``They wanted a big player to come in and set the

bar for everybody else,'' he said. He said the White

House had directed him to negotiate with Senator Max Baucus,

the business-friendly Montana Democrat who leads the Senate

Finance Committee.

Mr. Tauzin said the White House had tracked the

negotiations throughout, assenting to decisions to move away

from ideas like the government negotiation of prices or the

importation of cheaper drugs from Canada.

My goodness.

``They blessed the deal,'' Mr. Tauzin said.

That is how we got here, with the administration coming over with a letter last night basically saying they would oppose or certainly impede the ability of Americans to import drugs from Canada. What have we seen happen in the interim? Here again is a New York Times article entitled ``Drug Makers Raise Prices in Face of Health Care Reform.''

Here is a graphic demonstration of it. This little line right here, I would say to my colleagues, is inflation in this country. If you look at it for the year 2009, inflation is actually minus 1.3 percent.

Now look at the wholesale drug prices. The annual change is 8.7 percent. While inflation has gone down 1.3 percent, actual costs of drugs have gone up 8.7 percent.

The article from the New York Times says:

Even as drug makers promise to support Washington's health

care overhaul by shaving $8 billion a year off the nation's

drug costs after the legislation takes effect, the industry

has been raising its prices at the fastest rate in years. In

the last year, the industry has raised the wholesale prices

of brand-name prescription drugs by about 9 percent,

according to industry analysts. That will add more than $10

billion to the nation's drug bill. . . .

Let's get the math right. The drug companies have offered to save the American consumer $8 billion a year, and guess what. They have increased their prices, where it will add more than $10 billion to the drug bill of America's citizens, including our seniors.

The math is, they agreed to an $8 billion reduction. They actually already this year have seen an increase of more than $10 billion. So they are on track to make a $2 billion profit off their deal. No wonder they made a deal.

That will add more than $10 billion to the nation's drug

bill, which is on track to exceed $300 billion this year. By

at least one analysis, it is the highest annual rate of

inflation for drug prices since 1992. . . .

This is the consumer price index right here, which has fallen by 1.3 percent.

Drug makers say they have valid business reasons for the

price increases. Critics say the industry is trying to

establish a higher price base before Congress passes

legislation that tries to curb drug spending incoming years.

That is what this is all about. They increase the prices so it reaches a certain level, and that is what they will negotiate on. They already are in line to experience $2 billion more in profits than the $8 billion they say they intend to cut. What a Ponzi scheme this is.

``When we have major legislation anticipated, we see a run-

up in price increases,'' says Stephen W. Schondelmeyer, a

professor of pharmaceutical economics at the University of

Minnesota. He has analyzed drug pricing for AARP, the

advocacy group for seniors that supports the House health

care legislation that the drug industry opposes.

A Harvard health economist, Joseph P. Newhouse, said he

found a similar pattern of unusual price increases after

Congress added drug benefits to Medicare a few years ago,

giving tens of millions of older Americans federally

subsidized drug insurance. Just as the program was taking

effect in 2006, the drug industry raised prices by the widest

margin in a half-dozen years.

We have seen this scam before. What is the administration going to do? The administration sends a letter, I believe last night--not to the sponsor of this legislation, Senator Dorgan, but to another Member basically saying they would have to examine the health and safety.

Since when is a prescription drug imported from Canada a threat to Americans' health, since they obviously have the same standards that we do? The letter is to Senator Carper. It is signed by Margaret Hamburg, Commissioner of Food and Drugs. It is--I am not making this up. I am not making this up. ``The Dorgan importation amendment seeks to address these risks.'' It talks about our amendment.

We commend the sponsors for their efforts to include

numerous protective measures in the bill that address the

inherent risks of importing foreign products and other safety

concerns relating to the distribution system for drugs within

the U.S. However, as currently written, the resulting

structure would be logistically challenging to implement and

resource intensive.

Let's get this straight. According to the CBO, if we pass this, we would save consumers $10 billion--excuse me--$100 billion. According to CBO, we would provide an estimated $100 billion in consumer savings over 10 years. That is what the CBO says.

But what this obviously heavily overburdened Margaret Hamburg, the Commissioner of Food and Drug, says is:

However, as currently written, the resulting structure

would be logistically challenging to implement and resource

intensive.

Oh my God. I am going to have to include, for the Record, the number of employees over at the Food and Drug Administration. I am sure they are full up with their responsibilities at present.

In addition, there are significant safety concerns related

to allowing the importation of non-bioequivalent products,

and safety issues relating to confusion in distribution and

labeling of foreign products--

When we see something come in from foreign countries, it is so confusing when you look at the labeling of it. It is remarkably challenging for the American consumer----

relating to the distribution and labeling of foreign products

and the domestic product that remain to be fully addressed in

the amendment.

``But''--she goes on to say, to Senator Carper, who is a fine and great Member of this body but not the sponsor of the amendment----

I ask for an additional 30 seconds to finish.

``We appreciate your fine leadership on this important issue and would look forward to working with you as we continue to explore policy options to develop an avenue for the importation of safe and effective prescription drugs from other countries.''

Translated: The fix is in. We will be back on the floor on this. I strongly urge the adoption of the amendment.

I yield the floor.

Will the Senator yield for a question?

The Senator, I know, is aware and has talked about this. How does the Senator account for the fact that there is a nearly 9- percent increase in the cost of pharmaceutical drugs, while the consumer price index this year has gone down 1.3 percent?

I understand this is the highest increase in the history, or in most recent years, in the cost of prescription drugs. What is the explanation between the divergence of those two lines?

Would that have anything to do with the anticipation of incoming reductions or reductions in the increase of costs of pharmaceuticals?

May I ask the Senator another question. We understand you can buy lettuce from overseas. You can buy many other products from overseas. You can buy dairy products. You can buy almost any item except perhaps prescription drugs. Yet the Canadians, in particular, as well as the countries that are included in the Senator's amendment, all adhere to the same standards or higher standards than the United States of America does.

Now I understand one of the Senators--not the Senator from North Dakota--has received a letter saying this is still a problem.

I don't get it. Maybe the Senator from North Dakota can explain it a little better.

May I ask the Senator another question. Isn't it true a letter was written to one of our colleagues from the Administrator of the FDA, the organization that would basically make sure any product that goes to American consumers along these lines, that go through that bureaucracy, said it would require a significant amount of assets and resources?

I have since been told there are 11,000 employees of that bureaucracy. I wonder what he thinks about that argument; and, again, was the Senator from North Dakota informed about this position, which, by the way, is the same position as the previous administration?

So it would require no additional funding from the taxpayers.

Do these countries that are included in the Senator's amendment--do we have absolute assurance, can we look at the American people and say: Those countries and the agreements we would have with them, you can have products that are safe, you can safely buy, and it would not pose any hazard to anyone's health?

Wouldn't the pharmaceutical companies say it costs $424 because we have to absorb the cost of all the research that went into developing Nexium?

Do the seniors from his State and other citizens from his State travel to Canada and buy these prescription drugs because they know and are confident that they are getting, at a much lower price, the same product? Unfortunately, citizens in my State have to go south, and it is unfortunate when they have to do that because we do have a much larger problem there, I am sorry to say.

May I ask the Senator, isn't it true the Congressional Budget Office has determined that this measure of the Senator from North Dakota, this modest measure of only countries that are of the highest level of quality of inspection, of all the standards that we have, would save the American consumer $100 billion; is that true?

Finally, I wish to ask the Senator, what is the basis of the argument against the Senator's amendment? What possible reason, frankly, except for the influence of a special interest in this, our Nation's Capitol?

Mr. President, I ask unanimous consent to make an additional comment.

I thank the Senator from North Dakota who has been pursuing this issue for a number of years. I believe we are on the verge of success.

I appreciate his eloquence, I appreciate his passion, but most of all, on behalf of the citizens of my State who can't get up to Canada, who now are experiencing unprecedented economic difficulties, and who need these lifesaving prescription drugs--many of them senior citizens--I just wish to say thank you for your advocacy.

I think you have made an eloquent case, and I hope my colleagues have paid attention and will vote in the affirmative for the Senator's amendment today.

Madam President, I wish also to add my words of congratulations to the new Members for their eloquence, their passion, and their well-informed arguments, although they are badly misguided. But I do congratulate them for bringing forth their ideas and taking part in this spirited debate. We welcome it, and I hope that someday we will be able to agree on both sides for us to engage in real colloquy between us, back and forth. I think the American people and all Members would be well informed.

Madam President, I ask unanimous consent for the next 30 minutes to engage in a colloquy with my colleagues.

Madam President, I talk a lot about C-SPAN. I am a great admirer of C-SPAN. And the President--at least when he was running for the presidency--believed in C-SPAN as

well, because he said C-SPAN would be in on the negotiations. Here is what was posted by a reporter from Politico last night at 5:48 p.m., entitled ``No C-SPAN Here.''

Right now a group of moderate Senators is meeting behind

closed doors to try to hash out a compromise on the public

option. Reporters, waiting for the meeting to break, were

just moved out of the corridor nearest the meeting and

shunted around the corner, making it harder for the press to

catch Senators as they leave. C-SPAN this is not.

I would remind my colleagues that the amendment we are discussing here is drafted to prevent drastic Medicare Advantage cuts from impacting all seniors in Medicare Advantage. The amendment says simply: Let's give seniors who are members of Medicare, who have enrolled in Medicare Advantage, the same deal that Senator Nelson was able to get for the State of Florida--at least most of the seniors who enrolled in the Medicare Advantage Program. There are 11 million American seniors who are enrolled in the Medicare Advantage Program. This amendment would allow all 11 million to have the same benefits and there would be no carve-out for various groups of seniors because of the influence of a Member of this body.

I want to quote again the New York Times, my favorite source of information, from an article entitled ``Senator Tries to Allay Fears on Health Overhaul.''

. . . Mr. Nelson, a Democrat, has a big problem. The bill

taken up this week by the committee would cut Medicare

payments to insurance companies that care for more than 10

million older Americans, including nearly one million in

Florida. The program, known as Medicare Advantage, is

popular--

And the article lists the benefits, and then continues as follows:

``It would be intolerable to ask senior citizens to give up

substantial health benefits they are enjoying under

Medicare,'' said Mr. Nelson, who has been deluged with calls

and complaints from constituents. ``I am offering an

amendment to shield seniors from those benefit cuts.''

He is offering an amendment to shield senior citizens. Well, I am offering a motion that deals with all of the 11 million seniors who are under Medicare Advantage, as the Senator from Florida said, to shield seniors from benefit cuts. That is what this motion is all about. We should not carve out for some seniors what other seniors are not entitled to. That is not America. That is not the way we should treat all of our citizens, and I hope my colleagues will understand this amendment is proposed simply in the name of fairness.

I ask the Senator from Tennessee and the Senator from Texas, who have a large number of enrollees in the Medicare Advantage Program, whether they feel this would be unfair?

As the Senator points out, a few days ago, by a vote of 100 to 1, we voted to pass an amendment proposed by the Senator from Colorado, Senator Bennet, which included words such as ``protecting guaranteed Medicare benefits'' or ``protecting and improving guaranteed Medicare benefits.'' The wording was: ``Nothing in the provisions of or amendments made by this act shall result in the reduction of guaranteed benefits under title XVIII of the Social Security Act.''

Is there any Member on the other side who can guarantee that seniors in his or her State in Medicare Advantage will not lose a single benefit they have today--not the guaranteed benefit the other side goes to great pains to talk about. I think those who are enrolled in the Medicare Advantage system believe that since they receive those benefits, they are guaranteed benefits as well.

I would ask our two physicians here on the floor, who both have had the opportunity to deal directly with the Medicare Advantage Program, if you have a patient come in and you say: By the way, you are having your Medicare Advantage Program cut, but don't worry, we are protecting your guaranteed Medicare benefits, do you think they understand that language?

So a preponderance of people who enroll in Medicare Advantage are low-income people, and a lot of them are rural residents?

May I also point out, for the record, on September 20, 2003, there was a letter to the conferees of Medicare, urging them to include a meaningful increase in Medicare Advantage funding for fiscal years 2004-2005--a group of 18 Senators, including Senators Schumer, Lautenberg, Clinton, Wyden, et cetera, including Senator Kerry, who now obviously wants to reduce the funding for Medicare Advantage. Again, perhaps he was for it before he was against it.

I would also like to point out, as short a time ago as April 3, 2009, a group of Senators, bipartisan, including Senators Wyden, Murray, Specter, Bennet, Klobuchar, and others, wrote to Charlene Frizzera, acting administrator of the Centers for Medicare and Medicaid Services:

We write to express our concerns regarding the Centers for

Medicare and Medicaid Services' proposed changes to Medicare

Advantage rates for calendar year 2010. The advance notice

has raised two important issues that, if implemented, would

result in highly problematic premium increases and benefit

reductions for Medicare Advantage enrollees across the

country.

Again, as recently as last April, there was concern on the other side about cuts in the Medicare Advantage Program.

The point of all this is, the Senator from Florida, a member of the Finance Committee, felt so strongly that Medicare Advantage was at risk he decided to carve out, and was able to get the majority on a party-line vote of the Finance Committee to carve out a special status for a group of seniors under Medicare Advantage in his State. My motion simply says, everyone whom the Senator from Oklahoma made reference to deserves that same protection. That is all this motion is about.

So seniors, by losing Medicare Advantage, would then lose certain provisions Medicare Advantage provides and then they would be forced, if they can afford it, which they are now paying zero because it is covered under Medicare Advantage, then they would have to buy Medigap policies that would make up for those benefits they lost when they lose Medicare Advantage.

Guess who offers those Medigap insurance policies. Our friends at AARP, which average $175 a month. We are telling people who are on Medicare Advantage today, when they lose it, they can be guaranteed, if they want to make up for those benefits they are losing, they would be paying $175 a month, minimum, for a Medigap policy. A lot of America's seniors cannot afford that.

They can't afford it.

How much time remains, Madam President?

I ask Dr. Barrasso, have you treated people under Medicare Advantage?

So you are making the case that even though it may cost more, the fact that you have a weller and fitter group of senior citizens, you, in the long-run, reduce health care costs because they take advantage of the kind of care that, over time, would keep them from going to the hospital earlier or having to see the doctor more often.

I ask the Senator from Tennessee, do you know of any expert economist on health care who believes we can make these kinds of cuts in Medicare Advantage and still preserve the same benefits the enrollees have today?

Madam President, I ask unanimous consent for an additional 30 seconds for the Senator.

I wish to finally point out what Dr. Coburn said. Medicare Part C, which is Medicare Advantage, is part of the law, and to treat it in any way different, because those on the other side do not particularly happen to like it, I think is an abrogation of the responsibilities we have to the seniors of this country.

I thank my colleagues and yield the floor.

Mr. President, this amendment is about an earmark. It is about a special deal cut for a special group of people who happen to reside in the State of Florida. I am never so presumptuous. I have lost too many votes trying to eliminate earmarks. But what I am trying to do is allow every American citizen who is enrolled in Medicare Advantage to have the same protection of their Medicare Advantage Program as the Senator from Florida has carved out in this bill. That is all it is about. It is about equality. It is about not letting one special group of people who reside in a particular State get a better deal than those who live in the rest of the country. That is all this amendment is about.

It will probably be voted down on a party-line vote. But what you have done is you have allowed a carve-out for a few hundred thousand people in the State of Florida and have disallowed the other 11 million who have Medicare Advantage from having their health care cut. That is what this is all about.

I object.

Madam President, as is the agreed-upon procedure by the two leaders, I send a motion to commit to the desk with instructions, as part of the side-by-side procedure that has been agreed to by the majority leader and the minority leader, and ask for its consideration.

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

Madam President, the motion I am offering would simply commit the bill back to the Finance Committee for a short period to apply the same grandfathering provision in this legislation to all Medicare Advantage beneficiaries, the provision in the bill as it is specifically drafted, to prevent the drastic Medicare Advantage cuts from impacting some seniors in Florida, which compare to the cuts facing Medicare Advantage enrollees in the rest of Florida and the rest of America, including the 330,000 Medicare Advantage enrollees in my State.

Basically, this motion says that the same benefits that have been granted in the legislation to citizens in Florida would also apply to citizens who are enrollees in the Medicare Advantage Program all over America. It is pretty simple.

Specifically, starting in 2012, this motion would accomplish a fix that allows all Medicare Advantage enrollees to maintain the current levels of benefits on the date of enactment. That would be in keeping with the sense-of-the-Senate resolution that was agreed to by the Senator from Colorado, Mr. Bennet, that called for all Americans to be able to keep the same level of benefits as they presently have today under Medicare and Medicaid.

During the Finance Committee markup, the senior Senator from Florida advocated in favor of treating certain Medicare Advantage enrollees in Florida better than the rest of America's seniors under Medicare Advantage.

Let me read from two articles written at the time of the Senate Finance Committee's deliberation. From the New York Times, ``Senator Tries to Allay Fears on Health Overhaul,'' September 24, 2009:

But Mr. Nelson, a Democrat, has a big problem. The bill

taken up this week by the committee would cut Medicare

payments to insurance companies that care for more than 10

million older Americans, including nearly one million in

Florida. The program, known as Medicare Advantage, is popular

because it offers extra benefits, including vision and dental

care and even, in some cases, membership in health clubs or

fitness centers.

``It would be intolerable to ask senior citizens to give up

substantial health benefits they are enjoying under

Medicare,'' said Mr. Nelson, who has been deluged with calls

and complaints from constituents. ``I am offering an

amendment to shield seniors from those benefit cuts.''

Pretty simple. The Senator from Florida believes there would be cuts to the Medicare Advantage Program, and he was able to get into this bill an exemption for some 950,000 enrollees in Medicare Advantage in Florida. Admirably, the Senator from Florida was able to insert in this bill protection for 800-some or 900-some thousand constituents of his who are Medicare enrollees. There are 330,000 of them in my State who are seniors, who have paid into Medicare, who have the Medicare Advantage Program which, under the legislation, with the exception of the carve-out for the citizens in Florida by Mr. Nelson, would also then lose their benefits.

Similar concerns exploded into public view on Wednesday as

members of the Finance Committee slogged through a mammoth

health care overhaul bill for a second day.

Senator Nelson said Republicans were waging a ``scare

campaign,'' but he shares some of their concerns. His

predicament highlights the political risks for Democrats

eager to reassure older Americans who vote in large numbers.

There are risks for President Obama as well. He cannot

afford to lose Mr. Nelson's vote. White House officials have

offered to work with him to address his concerns. Mr. Obama

has said repeatedly that ``if you like your health care plan,

you will be able to keep it.''

That is one of the remarkable statements that is obviously contradicted by anybody who reads this bill. Any one of 11 million Americans, with the exception of Senator Nelson's constituents, who are under Medicare Advantage will see cuts in Medicare Advantage. That is a fact. If those 11 million Americans like their health care plan, they will not be able to keep it.

The cost of Mr. Nelson's proposed fix--to preserve benefits

for many people enrolled in the private Medicare plans--could

total $40 billion over 10 years, and that could also be a

problem for the White House. Mr. Obama has promised not to

sign a health bill that increases the deficit, and so far Mr.

Nelson has not said precisely how he would pay for his

amendment.

Approval of the amendment could invite other Democrats to

ask for similar deals that might make the bill more palatable

to their constituents, but more costly as well.

Well, since that September article, obviously other Senators have asked for the same shielding of their constituents who are enrolled in Medicare Advantage.

An October 20, 2009, Bloomberg story, ``Reid Leads Democrats into Carving Out Favors for States on Health.''

Democrats such as Senator Bill Nelson of Florida and Ron

Wyden of Oregon secured provisions setting aside $5 billion

to shore up benefits for constituents who participate in

Medicare Advantage. That program allows private insurers to

contract with the government to provide Medicare benefits.

Nelson said the aid isn't directed solely at Florida. ``It

affects several States, including New York,'' he said.

``We're trying to grandfather in seniors so they don't lose

the benefits they have.''

Well, I am trying to carry out Senator Nelson's ambition. Senator Nelson said that, in effect, several States, including New York, are trying to grandfather in seniors so they don't lose the benefits they have. That is exactly what this motion is all about.

I assume I can expect Senator Nelson's affirmative vote, along with all others listed in the motion of the 11 million people who are under Medicare Advantage in their States.

And the deal-making continues. We have now learned about the special provisions in the 2,000-page legislation designed for certain Senators--I might add, at the expense of Medicare Advantage members in other States and the American taxpayer. We have had to read about such deals because they have been cut in secret closed meetings without the benefit of the C-SPAN cameras, as promised. Just the other day, it came to light that this legislation has special provisions for Oregon, New York, and a special one in Florida. I have had a conversation with Senator Wyden of Oregon, and he says that is not the case. I will certainly take Senator Wyden's word for it.

I want the same protections extended to all seniors. That is all this motion is about--the same protection for all seniors, no special deals for any constituents related to the State in which they reside or the influence of their elected representatives. That is not the way we should treat seniors who have paid into Medicare Advantage.

The special carve-out for some Florida seniors is quite interesting. Despite beneficiaries in Florida hearing the President's promises about being able to keep what you have, it appears the 950,000 Medicare Advantage enrollees in Florida aren't satisfied with the Democrats' promises to protect so-called guaranteed benefits. Medicare Advantage beneficiaries in Florida thought

they would be able to keep the Medicare Advantage benefits that provide protection from high cost sharing in traditional Medicare, wellness programs, and vision, hearing, and dental benefits upon which they have come to rely.

However, when Florida beneficiaries learned they were not going to be able to keep what they have--in fact, they were going to see a 64- percent cut in benefits--a deal benefiting some at the expense of other Medicare Advantage beneficiaries and taxpayers was added in exchange for support to move forward on the cuts.

Let me point out, despite attempting to protect hundreds of thousands of Florida seniors from benefit cuts, Senator Nelson's deal still leaves approximately 150,000 Florida seniors and seniors across the country unprotected. So even in the proposed deal that was cut, Senator Nelson was willing to leave 150,000 beneficiaries subject to Medicare Advantage cuts.

The Medicare Advantage Program is a program that had bipartisan support and the support of 11 million seniors who are enrolled in the program.

Just a few short years ago, when Congress enacted the Medicare Modernization Act, new funding was intentionally provided to stabilize the Medicare health plan program. This was one of the few issues on which there was strong bipartisan agreement during the 2003 Medicare debate. It was done to ensure seniors all across America had access to an option in the Medicare Program, an option for additional, better benefits than are available under the traditional Medicare Program.

In June 2003, several of our colleagues, including Senator Schumer and Senator Kerry, offered a bipartisan amendment on the Senate floor to provide additional funding for benefits under the Medicare Advantage Program. So I find it a little interesting that Members on the other side want to cut benefits to seniors now. Even though they supported the funding before, they now want to cut them.

Later in 2003, as the Medicare conference committee was completing its deliberations, a bipartisan group of 18 Senators signed a letter urging the conferees to provide a meaningful increase in Medicare Advantage funding. This letter was signed by a diverse group of our colleagues, including Democratic Senators such as Dianne Feinstein, Christopher Dodd, Ron Wyden, Frank Lautenberg, Patty Murray, Arlen Specter, Mary Landrieu, and Maria Cantwell.

Here is a letter dated September 30, 2003. It says ``United States Senate,'' and it is signed by a number of Senators, including my colleague, Senator Kerry. It says:

Dear Medicare conferee:

We are writing to ask you, as a member of the Medicare

conference committee, to ensure that the final Medicare bill

includes a meaningful increase in Medicare+Choice funding in

fiscal years 2004 and 2005.

So I guess my friend and colleague, Senator Kerry, was against cuts in funding before he was for them. He was against them before he was for them. So anyway it goes on to say:

We strongly support additional Medicare+Choice funding for

two very important reasons: (1) to protect the health care

choices and benefits of the nearly 5 million Medicare

beneficiaries who are currently enrolled in private sector

health plans; and (2) to strengthen the foundation for future

health plan choices.

We believe that the Medicare+Choice funding provisions . .

. are critically important to preserving choice and quality

for America's seniors. We urge you to include these

provisions in the final bill reported out of the Medicare

conference committee.

Since then the Medicare Advantage Program has been popular enough so that 11 million of our senior citizens have joined the program. I think that is a pretty impressive number of people who have decided to join the program. So I urge my colleagues to vote for this motion, just to give equal access to a very popular program to all citizens rather than just give it to several hundred thousand who happen to live in a certain part of the country.

I am not sure.

So, Madam President, recently there was an article in the North County Times from San Diego, dated Saturday, December 5, 2009.

I would say to the Senator from California, in response to her question, this is a very important issue, as the Senator from California just pointed out. I have a lot to say on it, and I have waited my turn to speak. In keeping with the procedures that are in keeping with the agreement between the two leaders, I do not expect to be too much longer, but I do not expect to curtail my remarks on this very important issue at 5:20 p.m. in the afternoon.

So here is an article from the North County Times from San Diego, dated December 5, 2009: ``REGION: State ends subsidy for mammograms to low-income women under 50.'' I repeat: ``State ends subsidy for mammograms to low-income women under 50.'' It goes on to say:

The eligibility age for state-subsidized breast cancer

screening has been raised from 40 to 50 by the California

Health and Human Services Agency, which will also temporarily

stop enrollment in the breast cancer screening program.

Advocates for low-income women, whose health care the

department helps pay for, say the cuts put a two-tier system

in place that is based on money rather than medical

standards.

The cuts will greatly harm the clinic's mammogram program,

said Natasha Riley, manager of Vista Community Clinic's

Breast Health Outreach and Education Program.

The clinic and others like it in San Diego County provide

reduced-cost care, mostly to low-income people, with money

from the state and some private donations.

``More than 50 percent of the women we give breast exams

and mammograms to are in their 40s,'' Riley said. ``The

majority of our current breast cancer survivors are women in

their 40s.''

The state's decision, announced Dec. 1 and effective Jan.

1, follows a controversial federal recommendation last month

that mammograms before the age of 50 are generally not

needed.

So now we see the Federal recommendation that was made last month-- that mammograms before the age of 50 are generally not needed--is now being implemented in the State of California.

Moreover, private health care systems such as Scripps

Health have rejected the federal task force's recommendation,

choosing instead to keep the existing standard, which calls

for a mammogram at age 40, with annual mammograms thereafter.

That means doctors will be using two medical practice

guidelines, distinguished not by knowledge but by the

pocketbook, said Dr. Jack Klausen, a gynecologist and

obstetrician who practices at Vista Community Clinic.

``If we are in a situation where we don't screen, but the

private-practice doctor can screen, then we are actually not

practicing to the standard of care,'' Klausen said.

Madam President, I ask unanimous consent that this entire article be printed in the Record. I certainly hope that a decision like this would not be implemented in discrimination against low-income women in the State of California.

Madam President, I have found that the debate on the floor has been invigorating. I have found it to be educational not only to the Members of this body, and this Senator in particular, but I think to all Americans. Believe it or not, a lot of the deliberations and the debate and discussion we have had on the Senate floor have been vigorous. They have been sometimes passionate because this is such an important issue--issues such as the one I just discussed--and they have been sometimes tough.

But I must say, I have always tried to be respectful of the views of my colleagues, even though we have had some--especially the Senator from Illinois, the distinguished whip of the Democratic Party, whom I have engaged vigorously--but they have always been respectful debates. I intend to maintain that respect, as I have throughout my career. But I do not mean that means I will not be passionate.

So I was astonished--I was astonished--and taken aback to see a foxnews.com article that just crossed my desk titled: ``Reid Compares Opponents of Health Care Reform to Supporters of Slavery.''

Senate Majority Leader Harry Reid took his GOP-blasting

rhetoric--

I am quoting from the article--

to a new level Monday, comparing Republicans who oppose

health care reform to lawmakers who clung to the institution

of slavery more than a century ago.

Senate Majority Leader Harry Reid took his GOP-blasting

rhetoric to a new level Monday, comparing Republicans who

oppose health care reform to lawmakers who clung to the

institution of slavery more than a century ago.

The Nevada Democrat, in a sweeping set of accusations on

the Senate floor, also compared health care foes to those who

opposed women's suffrage and the civil rights movement--even

though it was Sen. Strom Thurmond, then a Democrat, who

unsuccessfully tried to filibuster the Civil Rights Act of

1957 and it was Republicans who led the charge against

slavery.

So not only was Senator Reid wrong in his accusations, Senator Reid was also incorrect in who opposed slavery and who supported the Civil Rights Act. But that is not the important point. The important point, as the article goes on to say:

But Reid argued that Republicans are using the same

stalling tactics employed in the pre-Civil War era.

And I quote from the article that is quoting Senator Reid:

``Instead of joining us on the right side of history, all

the Republicans can come up with is, `slow down, stop

everything, let's start over.' If you think you've heard

these same excuses before, you're right,'' Reid said Monday.

``When this country belatedly recognized the wrongs of

slavery, there were those who dug in their heels and said

`slow down, it's too early, things aren't bad enough.' ''

He continued: ``When women spoke up for the right to speak

up, they wanted to vote, some insisted they simply, slow

down, there will be a better day to do that, today isn't

quite right.''

``When this body was on the verge of guaranteeing equal

civil rights to everyone regardless of the color of their

skin, some senators resorted to the same filibuster threats

that we hear today.''

That seemed to be a reference to Thurmond's famous 1957

filibuster--the late Senator switched parties several years

later.

Sen. Orrin Hatch, R-Utah, said Reid's remarks were over the

top.

``That is extremely offensive,'' he told Fox News. ``It's

language that should never be used, never be used. . . .

Those days are not here now.''

Sen. Saxby Chambliss, R-Ga., suggested Reid was starting to

``crack'' under the pressure of the health care reform

debate.

``I think it's beneath the dignity of the majority

leader,'' Sen. Tom Coburn, R-Okl., said. ``I personally am

insulted.''

So this is a debate which has been spirited. This has been a debate which has been passionate. This has been a debate that I think has been very helpful to the American people. Some of the back and forth that I have seen I think has been excellent. It has been excellent debate and discussion. I enjoyed it when the Senator from Montana and I had a discussion about various endorsements. I appreciated the fact that Senator Durbin brought my record to light and questioned it. But, most importantly, most of the conversation has been about the components of this bill and its impact on the future of America.

So to somehow compare--as this article says--we who believe firmly in the principles that are being violated by this 2,000-page legislation to people who supported slavery, I would very much appreciate it if Senator Reid would come to the floor and, if not apologize certainly clarify his remarks that he was not referring to those of us who believe we are carrying out and performing our constitutional duties; that is, acting in the best interests of our constituents on an issue that will impact the future of the United States of America for years and years and years.

Madam President, I ask unanimous consent that the foxnews.com article be printed in the Record.

So if I could return to my amendment. My amendment would make sure every beneficiary is protected and receives equal treatment. I would expect strong bipartisan support, since I think we would all like to see the same protections guaranteed for our own constituents. I know the Senator from Pennsylvania will appreciate this amendment, since he filed his own amendment to spend $2.5 billion in taxpayers' dollars to protect Medicare Advantage beneficiaries in Pennsylvania. I guess the 864,000 Medicare Advantage beneficiaries in Pennsylvania weren't satisfied with the promise to protect so-called guaranteed benefits either.

This motion to commit is straightforward and will help the President keep his promise that if you like your health insurance you have today, the policy you have today, you can keep it, and will protect 10.6 million Medicare Advantage beneficiaries from at least a 64-percent cut in benefits.

May I say, again, I think it has been an important debate we have engaged in. I do not and will not impugn the motives or the integrity of those who are sponsors of this legislation. Yes, I will argue we didn't keep the President's promise and commitment over a year ago during the Presidential campaign when he said he would have the C-SPAN cameras in, that there would be bipartisan negotiations with the C-SPAN cameras in, with Republicans and Democrats sitting down together so, in his words, the American people could see who is on the side of the health insurance companies and the special interests and who is on the side of the American people. I think that is a legitimate statement and a legitimate questioning as to the process that is taking place today, where there have been no negotiations with the Members on this side and there has been no C-SPAN camera included where these negotiations are taking place. So I hope there will be. I hope this legislation is defeated. I hope we can go back and sit down together, Republicans and Democrats, and agree on medical malpractice reform, on crossing State lines to be able to get the best insurance policy for every citizen and their family, to emphasize wellness and fitness and reward it, and to enact outcome-based treatment for our patients. I hope we can produce a lot of measures and take a lot of significant steps that would truly reduce the cost of health care in America, not enact a $2.5 trillion new entitlement program that is a scam. It is a scam because of the way the budgetary process has been set up. Right now, today, I can go out and buy an automobile, and I don't have to make a payment for a year. Under this proposal, you start making the payments and 4 years later you get the benefits. That is Enron accounting.

I hope my colleagues will allow us to continue this spirited debate and discussion. I say, with the greatest respect, these are tough issues and there are strong differences of opinion. But I think, overall, this debate and discussion is good for the American people and, hopefully, the outcome will be one where we will be better informed and can better address the issue of the skyrocketing costs of health care in America and our ability to provide them with affordable and available health care.

I yield the floor.

Mr. President, I suggest the absence of a quorum.

Mr. President, I am pleased to see my friends on the floor again today--very intelligent people, such as the Senator from New Hampshire and my friend, Senator Enzi, who is an expert on this issue, and the rest of us who know that a fight not joined is a fight not enjoyed. I look forward to another spirited discussion with my colleagues.

Maybe if I could, to start with, I will take up a point about the debate and discussion we had yesterday on the floor with the Senator from Montana, the chairman of the committee, where he asked me why did I think that certain groups supported this legislation pending before the Senate. I said I didn't know what kinds of deals had been cut. I referred to the deal made with PhRMA and others. I didn't know exactly why because I am not taken into the discussions and negotiations off the floor in the office of the majority leader.

There seems to have been some blowback on that, and somebody said maybe that wasn't appropriate to talk about deals that were cut. This morning, on the front page of the Washington Post, it says:

Deals Cut with Health Groups May Be at Peril.

Perhaps the Washington Post is impugning the reputation of someone or staffers or others. They have certainly impugned mine from time to time. But the fact is, this is a news story.

Again, I go back, very briefly, because we have a lot to talk about, my colleagues and I. The fact is, there have been deals cut, just like is reported in the Washington Post this morning, as has been reported all over America about the deals cut with various interest groups that don't necessarily represent the people they claim to represent. I know the American Medical Association does not represent the majority of physicians and caregivers. In the State of Arizona, I know too many of them. I also know they have a very large lobbying presence in our Nation's Capitol, as do the other interested groups that have ``cut deals'' that may be at peril now, according to the Washington Post.

With that, I will mention, again, that the doctor is in. Would the doctor care to give us some enlightened information, before we give our various opinions on this issue?

My absolute favorite.

To be clear, the amendment of the Senator from New Hampshire is exactly the same as the White House sense-of-the-Senate amendment and the Bennet amendment, only it has the actual force of law.

May I ask the Senator from Texas, is it not true that it is the State of Texas that is the demonstration project for medical malpractice reform?

May I say in the immortal words of Howard Dean, the former chairman of the Democratic National Committee--he put it simply:

The reason why tort reform is not in the bill--

Talking about this bill--

The reason why tort reform is not in the bill is because

the people who wrote it did not want to take on the trial

lawyers in addition to everybody else they were taking on,

and that is the plain and simple truth. Now, that's the

truth.

I totally agree with Howard Dean. I could not agree with him more.

The Senator from Alabama.

Our Republican leader is here on the floor of the Senate, and he can speak for himself, but I am sure he would appreciate the opportunity if the President would come and sit down and meet with us. I think we are all ready to have a meeting with him. Perhaps we would be able to give our input and recommendations as to what we need to do to get this bill unstuck.

That was, as I recall, the campaign. And I am getting tired of going down memory lane here, but that was going to be the ``change.'' That was going to be the change in Washington. We are going to change the climate. We are all going to sit down together, Republicans and Democrats. Well, I think on this Sunday afternoon, we are all available, are we not, I would ask the Senator from Kentucky?

And we could do that, perhaps in the most effective fashion, if we sat down with the President and made some of the very points he made in his State of the Union Message.

I want to turn to the Senator from South Dakota, but I want to mention something first on this issue of tort reform I have never quite gotten over. One of the most famous cases of the 1970s, and I think it spilled over into the 1980s, was agent orange, the defoliant that was used during the Vietnam war and which caused so many physical problems for our Vietnam veterans who were exposed to it. It was a big class action suit the trial lawyers won. The trial lawyers got paid off first, and Vietnam veterans died before the money was distributed to them. I will never get over that.

I will recognize the Senator from Texas, who will be presiding next, and wish to add one more comment.

Mr. President, I ask unanimous consent that the Senator from Utah, the Senator from Kentucky, the Senator from New Hampshire, the Senator from Georgia, the Senator from Florida, and the Senator from Wyoming be allowed to participate in a colloquy.

Mr. President, very quickly, I wish to remind my colleagues that the AARP continues to be referred to as endorsing this legislation and supporting it and opposing amendments that would have done things that they in the past have supported. So I urge my colleagues to look at this Washington article--one of my favorite sources of information and opinion, the Washington Post:

But not advertised in this lobbying campaign have been

AARP's substantial earnings from insurance royalties and the

potential benefits that would come its way from many other

reforms.

So we have been looking into that, and guess what. The AARP endorsement of more than $400 billion in Medicare savings--according to its own financial statements from 2008, AARP generated 38 percent of its $1.1 billion in revenue or more than $414 million in royalty fees. They also obviously will--if we take away Medicare Advantage, then Medigap sales will have to go up because that provides for the services that are being taken away. So under the AARP, they would generate in their endorsements--they have generated $414 million, putting them in fifth place of all of the health insurance companies in America behind United Health, Wellpoint, Aetna, and Humana. So we have before the body an amendment that would modify any health insurer's remuneration to the same level as the salary of the President of the United States.

So I ask unanimous consent at this time that the AARP executives be added in under the effect of this pending amendment from the Senator from Arkansas.

Mr. President, I also understand that Walmart sells health insurance policies. They are based in Arkansas. I ask unanimous consent that Walmart be included in this curb on excessive remuneration that will now place them under the same level.

It is not complicated. It is pretty simple. It is people who sell health insurance.

I am sorry the Senator from Montana cannot understand that they are people who sell health insurance as well. AARP does, Walmart does. If we are going to have this kind of demagogic amendment, then we should include them, especially Walmart, that does a lot of business.

I would say to my colleague they not only opposed it, they got all of their members fired up in opposition to it. We all heard from them back in 2005. These were reductions in spending. This was not $438 billion taken out of Medicare and put in to create a new entitlement program of $2.5 trillion.

As I recall, that is exactly it. I think the Senator from New Hampshire recalls that debate.

One would think so. There are two doctors in the Senate; there are lots of lawyers, two doctors. Both of them have hands-on experience. I don't know if Dr. Barrasso has seen this morning's New York Times, another of my favorite sources of news information and opinion. On the front page this morning: ``Home Care Patients Worry Over Possible Cuts.''

I understand the purpose of health care reform as proposed by the other side is to reduce health care costs. Is there a way to reduce health care costs better than treating people at home than instead of in a hospital? I am curious about the Senator's experience.

If it is taken out of your time, just exactly as you responded when someone asked if you would yield for a question from them yesterday. Is it taken out of your time?

I ask unanimous consent that the time for the Senator's question not be taken out of the time that is allotted to us.

My response is, I don't know what deal has been cut in Senator Reid's office, as the deal was cut with the pharmaceutical companies and the deal was cut with the AMA and the deal was cut with the hospital association. But I know what the effect is. I know what the effect is. The bill would slice $55 billion----

The House bill would slice $55 billion over 10 years for projected Medicare spending on home health services while the Senate bill would take $43 billion. I know that. But I don't know the details of the deal that was cut over where the white smoke comes out. I don't know what the deal was. I know what the deal was with PhRMA. I know what the deal was with PhRMA. They told them they would oppose drug reimportation from Canada, and they told PhRMA they would not allow competition for Medicare patients.

So I don't know the deal that was cut that bought them, but I know deals have been going on, and I know they are unsavory. I know people, such as the lady who was just referred to, Bertha Milliard, are not too interested in seeing their home health care cut.

I don't know what the deal was----

I don't know what the deal was, but we will find out, just like the deals that were cut with all of these other organizations.

This place is full of lobbyists. I can't walk through the hallway without bumping into one of their lobbyists. If the Senator keeps interrupting, he is violating the rules of the Senate. He needs to learn the rules of the Senate.

I would like to finish my answer to you, if I may; that is, I don't know the deal that was cut with them, but we will find out. I know Bertha Milliard was not there when the deal was cut that generated that letter. That is my answer.

I will yield for one more, but we have other Senators who wish to speak.

My quick answer is, I don't know what the deal was, but I know the people who are in the home health care business, who will see $43 billion in cuts to their business, the funding for their business, were not there when the lobbyists showed up.

We have already heard the stories of the meetings you and the majority leader have had with these people saying: Get on board or when we shape the final parameters of this bill, we are going to hurt you.

We know they have been threatened.

As is often said, it is what it is.

The Senator from Georgia has a comment.

They will probably be called up to Senator Reid's office very soon.

Let me remind the Senator from Montana, sometimes there is good news and sometimes it is bad. There was an article earlier this year where the staff of the Senator from Montana called in the high- paid lobbyists and told them not to meet with Republicans, saying that if they did, it would be treated as a hostile act. I can provide that article for the Record. I hope it is not true, but I think it is.

I yield to the Senator from North Carolina for a question and then the Senator from Tennessee.

It seems to me, yes.

I yield to the Senator from Tennessee.

It is a lot of fun, isn't it?

Based on the principle that a fight not joined is a fight not enjoyed.

I do not understand it. Perhaps my other colleagues can explain it better.

I also want to return for a second to the question of the Senator from Montana. The AMA is a classic example. When I go back to Arizona and talk to doctors and providers, they say: What is going on? You made a deal with the lobbyists. That is my answer to you. You made a deal with the lobbyists--not the home health care providers, not the nurses, not the doctors, the people who are the users of pharmaceuticals who, this year, have seen an 8- to 9-percent increase in the cost of prescription drugs--because your deal is going to protect them. My answer to you is, I don't know what you bought that letter for, but it was probably a pretty high price.

The Senator from----

I know the answer to it. I just gave you the answer.

I yield to the Senator from Wyoming.

Mr. President, how much time remains?

The salary of William B. Novelli, who has since stepped down--an old friend--last year was $1,797,751. Mr. Tauzin, a pharmaceutical research and manufacturers lobbyist, only made $1.5 million last year. Scott Serota, of BlueCross BlueShield, made $1.6 million. Chicken feed.

I yield to the Senator from Utah.

I ask the Senator from New Hampshire very quickly, is it your understanding that AARP does sell health insurance and Wal-Mart sells health insurance?

Then would it make sense they would be included in the amendment to modify the limit on excessive remuneration paid by certain health insurance providers to set the limit at the same level as the salary of the President of the United States? Wouldn't the CEO of Wal- Mart and the head of AARP, who only made $1.8 million last year, fall under that umbrella?

The Senator from Georgia.

The Senator from Tennessee.

I thank the Senator from Tennessee. I am very reluctant to take a trip down memory lane again. Could I say, one of the phrases throughout the campaign was: If you like the insurance policy you have, you can keep it. You tell me how people who now have Medicare Advantage can keep it under this proposal? It is impossible.

Maybe the other side is right. Maybe these reductions have to be made in Medicare Advantage. Maybe those changes have to be made. I don't happen to agree, although cost savings should be there. But no one can believe that you can keep the same Medicare Advantage policy that 11 million seniors in America have today under this proposal. It is impossible.

The Senator from Florida.

Thanks to our crack staff who are a good example of the success of work release programs, I remind my friend from Montana, a Rollcall article as of June 11:

Top aides to Senate Finance Chairman Max Baucus called a

last-minute, pre-emptive strike on Wednesday with a group

of prominent Democratic lobbyists, warning them to advise

their clients not to attend a meeting with Senate

Republicans set for Thursday.

Russell Sullivan--

Whom I don't happen to know--

the top staffer on Finance, and Jon Selib, Baucus' chief of

staff, met with a bloc of more than 20 contract lobbyists,

including several former Baucus aides.

Who have made a nice transition.

``They said, `Republicans are having this meeting and you

need to let all of your clients know if they have someone

there, that will be viewed as a hostile act,' '' said a

Democratic lobbyist who attended the meeting.

``Going to the Republican meeting will say, `I'm interested

in working with Republicans to stop health care reform,' ''

the lobbyist added.

Again, PhRMA, the New York Times, again my favorite. Tauzin, the $1.5-million-per-year representative of PhRMA said:

``We were assured: `We need somebody to come in first. If

you come in first, you will have a rock-solid deal,' '' Billy

Tauzin, the former Republican House member from Louisiana . .

. said. ``Who is ever going to get into a deal with the White

House again if they don't keep their word? You are just going

to duke it out instead.''

They cut a deal. That is, again, in answer to the Senator from Montana, that is probably how they got the letter, the same way Tauzin wrote his letter.

The majority leader--the minority leader, hopefully majority leader soon.

The Senator from North Carolina.

Wouldn't that mean that AARP executive would naturally fall under the Lincoln amendment?

The Senator from Utah?

Dr. Barrasso from Wyoming.

And put more people in the hospital.

The Senator from Tennessee.

Not to mention the chief executives of the pharmaceutical companies. Why wouldn't we want to bring them in on it? After all, they are paying for lobbyists at $1.7 million every year to cut these deals at the White House that they describe on the front page of the New York Times.

I would hope the Senator would be glad to modify her amendment to include all these other people who have gotten extremely wealthy-- PhRMA, an 8-percent increase in drug prices in the last year. Again, I refer to the New York Times.

Anyone else? Senator Burr.

Mr. President, how much time remains?

Senator Burr will wrap it up.

It has been a great time. We are going to do it again, a lot, between now and the time the vote is forced, and the American people are on our side.

We are here.

Madam President, as much as I would like to put the last Presidential campaign behind me, we seem to be continuing to dredge it up in a totally false manner, time after time.

I ask unanimous consent that my campaign position paper on a specific plan of action lowering health care costs be printed in the Record.

Then I ask unanimous consent to have printed in the Record a statement from FactCheck.org, of October 20, 2008, that says: ``Obama's False Medicare Claim,'' which were the attacks on me which were not based on fact. I quote from FactCheck.org:

These claims are false, and based on a single newspaper

report that says no such thing. McCain's policy director

states unequivocally that no benefit cuts are envisioned.

McCain does propose substantial ``savings'' . . .

I did propose savings, and we can make savings. Nowhere in my wildest imagination did I ever believe we were going to cut benefits in order to create a $2.5 trillion new entitlement program when the system is already going broke. I will have those put in the Record.

The Senator from Massachusetts wants to distort my record, and that is fine. But it gets a little----

As Ronald Reagan once said: Facts are stubborn things.

I ask unanimous consent that the Senator from Massachusetts be allowed 3 additional minutes and I be allowed 2 additional minutes.

Madam President, I thank the Senator from Massachusetts. This has been a vigorous debate. I see my prime adversary, the Senator from Illinois, on the floor, whom I look forward to doing battle with additionally, as well as my friend from Massachusetts. The fundamental point, I would say to my friend from Massachusetts, is that I never envisioned, nor do I believe the American people ever envisioned, we would be ``cutting'' benefits or, as the Senator says, making savings in order to transfer that to a brand new entitlement program. That is what the debate is about, whether we are going to take a failing system that in 7 years is going bankrupt, according to the Medicare trustees, and then take all this money, no matter how these savings are made--and I believe they are cuts of huge magnitude--and then fund a brandnew entitlement program.

That is what this real debate is about.

I thank my friend from Massachusetts for his courtesy. I look forward to the rebuttal from the Senator from Illinois, as well as the Senator from Montana. Thank you.

I yield the floor.

Several Senators addressed the Chair.

Yes. For those who missed Senator Hatch's important statement last night, which he will add to today, I point out that he was able to take a trip down memory lane. In June 2003, when the Medicare Modernization Act was before the Senate, several of our colleagues, including Senators Schumer and Kerry, offered a bipartisan amendment on the floor to provide additional funding for benefits under the Medicare Advantage Program.

But amnesia is not confined to one side of the aisle around here. I ask my friend from Tennessee--you know this discussion about Medicare Advantage--we have to better understand what is this program and why is it so popular. Is it because it offers seniors a chance to get additional benefits? Maybe the Senator can give a short definition of that. I think the American people may not be totally clear on what we are discussing here and why 11 million Americans--over 300,000 citizens in my own State--have chosen Medicare Advantage, and that has prompted, according to Bloomberg, Senator Casey of Pennsylvania, to say, ``We are not going to be able to say 'if you like what you have, you can keep it.''' ``That basic commitment that a lot of us around here have made will be called into question.''

The title of that is ``Dem Senator Says Medicare Advantage Cuts Break President's Pledge.''

Maybe the Senator from Tennessee can give me a brief outline of what seniors get under Medicare Advantage and why it is so popular with 330,000 senior citizens in my State and 11 million in the country.

Lower income seniors.

I thank my friend. The reason I ask this, he mentioned that Medicare Advantage would allow seniors to have dental care, vision care, hearing care, physical fitness--it is fascinating. This allows our senior citizens to have dental, vision, hearing, and physical fitness care, and that is a little strange because, as was pointed out to me, that is exactly what we have here in the Senate. About 100 paces from here, if I need some doctor care immediately, if I need some vision care, if I need some dental care, I can get it. Next to my office in the Russell Senate Office Building, for the last several months--and I don't know at what cost, but I would like to get entered into the Record how many tens of millions of dollars it is. But they are renovating a gym. So my colleagues yesterday voted against keeping the Medicare Advantage Program, when we have, right here, the best Medicare Advantage Program ever heard of in the world--free hearing, free vision, free dental--and they are expanding a gymnasium in a many- months-long project. I will get the cost of that, although that may be hard to do.

Let me get this straight. Again, the American people should understand this. We voted to cut drastically a program that seniors have taken advantage of, which gives them additional hearing, vision, dental, and physical fitness care, while we practice it here every single day. Every day, there is a physician on duty--more than one--not very far from where I speak, who is ready to give us instant care. If hospitalization is needed, we can get instant transportation to the Bethesda Naval Hospital, where we will get free care. Incredibly, the Senate, on largely partisan lines, yesterday voted against senior citizens in this country, most of whom have paid a lot more into the program than we have. We are going to deprive them of what we have every single day we are members of the Senate.

That is an exercise in hypocrisy. The Senator from Pennsylvania has it right, because the President, time after time, said to the American people: If you like the insurance policy you have today, you can keep it. How many hundreds of times have we heard him say that at townhall meetings? And his administration mouthpieces say the same thing. The Senator from Pennsylvania is right when he says, ``We are not going to be able to say if you like what you have, you can keep it. That basic commitment that a lot of us around here have made will be called into question.''

I will say a couple words, and I will talk more about this later. Every time the Senator from Montana and others are on the floor, they talk about the fact that AARP now supports this blatant transfer of funding from the Medicare Program, which the seniors have earned, into a brandnew entitlement--a $2.5 trillion entitlement program. That is what this bill is all about.

For your information, AARP has received $18 million in stimulus money. There is a job creator for you. AARP, which has given its full- throated support to the Democratic health care legislation, even though seniors remain largely opposed, received an $18 million grant in the economic stimulus package for a job training program that has not created any jobs, according to the Obama administration's recovery.gov Web site. That is astonishing to me because from everything I have ever seen, they have created millions of jobs, including in the ninth congressional district of Arizona, where they said they created thousands of jobs. Unfortunately, we only have eight congressional districts, but that is OK.

In February, Politico reported that AARP was putting pressure on Republican Members of Congress to support the stimulus package. Since then, AARP has moved on to lobbying for passage of health care legislation, even though Democratic proposals have called for several hundred billion dollars in cuts to Medicare--a program that the group typically defends tooth and nail when Republicans propose cutting it. It turns out that AARP is also in a position to benefit financially if the health care legislation passes, because seniors losing benefits as a result of cuts to Medicare Advantage will be forced to buy Medigap policies, which is the main source of AARP revenue. Barry Rand, chief executive of AARP, was a big donor to the Obama campaign and has retained a cozy relationship with the administration. That is shocking news.

So, my friends, also I might add that in 2006, AARP received $18 million from the Federal Government, and we are reserving additional Federal moneys that they get.

The most important thing is this, and let's make it clear: AARP will receive direct benefits because seniors

who have cuts in their Medicare Advantage and other Medicare programs can buy--guess what--a Medigap insurance policy from AARP--in other words, to cover the things being cut back under this legislation, and it costs $175 a month. The Medicare Advantage premiums are zero for most seniors or $35 a month. Again, if the Medicare Advantage plans go away, people would have to buy a Medigap plan sold by--you got it-- AARP. And some low-income seniors could not afford $175 a month.

That is why the Senator from Tennessee stated that if we drive people out of Medicare Advantage, we are harming low-income seniors all over this country. We are harming them. We are doing them a great disservice. If you think with 17 percent real unemployment in my State that seniors who are unemployed and down on their luck are going to be able to afford the AARP Medigap policy for $175 a month, come and visit my State and I will tell you they can't.

It is interesting, the conversation about high-income seniors, and how we are going to tax people with Cadillac plans and all of those things, when what we are doing is harming the lowest income seniors in rural areas of America.

Yes.

All of the things we routinely use in the Senate. I hope those who voted to harm the seniors in this country and not allow them to have dental, vision, and other health care would unilaterally disavow the use of the physician care and vision care and hearing care available to all of us 24 hours a day right here in the Senate.

Could I mention one other thing? I will not spend that much more time on AARP. But the reason I do is because every time the Senator from Montana stands up, he talks about AARP endorsing this rip- off of the American people.

Let me quote again from a Bloomberg article entitled ``AARP's Stealth Fees Often Sting Seniors With Costlier Insurance.'' I quote from the Bloomberg article just briefly:

Arthur Laupus joined AARP because he thought the nonprofit

senior-citizen-advocacy group would make his retirement years

easier. He signed up for an auto insurance policy endorsed by

AARP, believing the advertising that said he would save

money.

He didn't. When Laupus, 71, compared his car insurance rate

with a dozen other companies, he found he was paying twice

the average. Why? One reason, he learned, was because AARP

was taking a cut out of his premium before sending the money

to Hartford Financial Services Group, the provider of the

coverage. . . .

AARP uses the royalties and fees to fund about half the

expenses that pay for activities such as publishing brochures

about health care and consumer fraud--as well as for paying

down the $200 million bond debt that funded the association's

marble and brassstudded Washington headquarters.

In addition, AARP holds clients' insurance premiums for as

long as a month and invests the money, which added $40.4

million to its revenue in 2007. . . .

During the past decade, royalties and fees have made up an

increasing percentage of AARP's income, rising to 43 percent

of its $1.17 billion in revenue in 2007 from 11 percent in

1999, according to AARP data.

This is a Bloomberg article. This is not from the Republican Policy Committee.

The point is, who gains? Who gains from this legislation? Who is going to make hundreds of millions of dollars more because they provide the Medigap policies people will be deprived of when we kill off Medicare Advantage? AARP.

May I ask the Senator again, he described the benefits that are provided under the Medicare Advantage program that seniors can have if they want, right? Are those same benefits--dental, vision, hearing, and fitness care--available under regular Medicare today?

In Montana, there are 27,000 enrollees who will see a 24- percent decrease. In Connecticut, there are 94,000 enrollees who will see a 14-percent decrease. By the way, some special deals have been cut for three States I understand--Oregon, New York, and Florida. We are going to try to fix that. There is no reason one State should be shielded any more than another from these draconian measures. We are going to try to fix that situation.

The reason I bring up this issue, present-day Medicare beneficiaries do not have vision, they do not have dental care, they do not have fitness. Yet we in the Senate enjoy it every single day. So yesterday we voted to deprive seniors from the ability to have the same privileges that we enjoy every single day in the Senate. I would argue that is an exercise in hypocrisy.

May I say it is my understanding that Dr. Barrasso has actually seen Medicare Advantage patients. He and Dr. Coburn are probably the only two. Maybe we could let him give us the benefit of his experience and also not only the benefit of his experience, but I am sure he is going to tell us what the impact is going to be on the low-income seniors from his State.

Just as we do.

I don't think they have as nice a gym, though, as we are going to get.

Let me get this straight. Basically, by removing the choices that seniors have as a part of Medicare Advantage--dental, vision, hearing, fitness--we are taking away from them what we ourselves enjoy every single day in the Senate?

Could the Senator from Texas and I go back to one of the things I mentioned earlier, because in Texas, how many are under Medicare Advantage?

Five hundred thousand in your State, and there is no ``shielding.'' According to this Bloomberg article and according to our knowledge, it says:

Senators Charles Schumer of New York, Bill Nelson of

Florida, and Ron Wyden of Oregon are among those who secured

special provisions shielding constituents from cuts. Casey--

Referring to Senator Casey of Pennsylvania--

says he wants ``very comparable'' protections for his State--

surprisingly enough--where more than one-third of Medicare

beneficiaries participate in Medicare Advantage. ``It's the

kind of thing that will likely be addressed on the floor,''

he said.

Well, I eagerly look forward to working, on the other side of the aisle, with all the Members from those States, with the exception of New York, Florida, and Oregon, who have earned special shielding from these cuts. I look forward to working with them, and let's fix it for all of us; right, Senator Hatch?

And was that shielding done on the floor of the Senate, in open debate and in discussion of the issue?

It was done in an office over here, where we still await the white smoke.

I would say this is probably the classic hometown protectionism that we see in earmarking and benefits that we see in the earmarking process.

But also, I would remind the Senator from New Hampshire, as we have all discussed several times, a year ago last October, our then- candidate for President said: It is all going to be on C-SPAN. Well, the C-SPAN cameras are still waiting outside Senator Reid's offices to go in and film these negotiations so that, as President Obama said, all Americans can see who is on the side of the pharmaceutical companies and who is on the side of the American people.

C-SPAN, keep waiting. We are going to try to get you in.

Isn't the vitally important point in this discussion that this massive mountain being carved out of Medicare is not being used to save Medicare? It is creating a huge new entitlement program. So here we are with Medicare going broke in 7 years, and we are taking money out of it in order to create a new program. That is the crime that is being committed here.

Could I say again that we have had spirited debate and discussion on this floor, but it is clear the majority of the American people do not support the proposal that is before us, and they do not support meeting in private, mostly in secret, closed negotiations.

Again, I renew our offer to the Democrats and to the administration: Let's get together in a room with the C-SPAN cameras and any other outlet, and let's sit down and do some serious negotiations on the areas we can agree on, which there are many, and let's save Medicare, let's fix this system, and let's do it together in the way the American people want us to--in a bipartisan fashion, not behind closed doors, so the American people can see us work together for a change.

I thank all of my colleagues for their many contributions. We are ready to talk. We are ready to talk, but we won't be driven.

Could I ask the Senator from New Hampshire, the senior member on the Budget Committee, a person who is well-known for his knowledge of the economy, of the budgetary situation in America, what happens if we pass this massive bill? What happens to America's economy?

Go ahead.

On that point I think Senator Crapo wishes to exactly emphasize the point of Senator Gregg.

Has the Senator from New Hampshire ever heard of legislation where you pay in the first 4 years before a single benefit comes about? Nowadays I see these advertisements that you can buy a car and you don't have to make a payment for a year and then you can start making payments. In this deal it is the reverse; you make payments and then perhaps you get the benefits after some years.

The Senator from Tennessee, I think, wishes to comment, too.

Senator Hutchison will conclude.

I thank my colleagues. It has been a lot of fun. I yield the floor.

Mr. President, I understand the Senator from Pennsylvania, Mr. Casey, filed an amendment designed to spend $2.5 billion to protect Medicare Advantage benefits for Pennsylvanians. What is going on? What is going on here? Why can't we protect every citizen? That is five States that are ``protected'' and spending extra billions of dollars. Let's have an amendment that every State is treated the same. Let's do that. I tell my colleagues, I intend to introduce an amendment that will do so. That will take away the special exceptions that are taken for special States to have special influence around here.

Mr. President, I ask unanimous consent that my colleagues and I--the Senator from Tennessee, Mr. Alexander; the Senator from Oklahoma, Mr. Coburn; Senator LeMieux from Florida; Senator Enzi; and Senator Crapo--be allowed to engage in a colloquy.

Mr. President, how much time do we have?

Thank you. I will let those minutes run together, if there is no objection.

Mr. President, I wish to begin our conversation with a brief comment about the American Association of Retired Persons, known as the AARP, that has now come out against this amendment, incredibly.

It is a fascinating history of that liberal Democratic group because, in 1993, when we had some savings in Medicare, the AARP said:

If we're talking about Medicare cuts alone as a way of

financing health reform, we would fight that with all our

strength--we've gone as far as we can go down that road.

The AARP, on $6.4 billion Medicare cuts in 2005, said: ``Strongly Opposes.'' They said the:

. . . conference agreement . . . undermines the critical

protections built into both the Medicaid and Medicare

programs. Instead of . . . shared sacrifice to achieve

budgetary savings. . . .

Every time there has ever been a savings in Medicare or Social Security in any way, shape, or form, the AARP has come out against it, except now when there is the most massive cut in Medicare in history and a transfer of those funds to a vast new $2.5 trillion entitlement program. It was described as $2.5 trillion just yesterday by the chairman of the Finance Committee.

I say shame on the AARP. I say to my friends, especially those who are under the Medicare Advantage Program, the 330,000 in my State, for whom, admittedly, they are going to cut their Medicare Advantage benefits, take your AARP card, cut it in half, and send it back. They have betrayed you.

Absolutely.

Mr. President, I mentioned the AARP and their opposition to this amendment. There is an organization called 60 Plus that has millions of supporters and members. They also feel very different from the AARP. Their message is:

Soon you [the Senate] will vote on the McCain motion to

commit with instructions. The motion would commit it to the

Senate Committee on Finance--

Et cetera.

I and the 5.5 million supporters of 60 Plus urge you to

support this motion. The Patient Protection and Affordable

Care Act is nothing of the sort. It would cut Medicare by

$500 billion. These cuts would harm seniors who have paid

into the program and expect it to be there to help them with

their health care needs. At 60 Plus, we pride ourselves on

advocating for the best interests of seniors. That is a

``yes'' vote on this motion.

Let's pay attention to 60 Plus.

I don't believe so.

Most people believe this would be a windfall of tens of millions of dollars for AARP if the legislation is passed as presently crafted.

Our figures are that 330,000 people in my State of Arizona are on Medicare Advantage. I noticed yesterday, when the distinguished chairman of the Finance Committee and the Senator from Connecticut were talking, they were disparaging the entire program, saying how it wasn't any good, talking about the cost overruns and saying it was a bad program. They have opposed it from the start.

So the message to the 330,000 Americans in Arizona who are on Medicare Advantage is that they are out to get you.

I will respond again. There are cost problems with Medicare Advantage, but those cost problems can be fixed. Those cost problems can be brought under control. But the fact is, to do away with a program that allows them a choice in how they receive their care is, of course, again, an effort to have the government make the decisions for people, which flies in the face of everything we stand for and believe in.

Mr. President, I yield 2 minutes to the Senator from Iowa.

Mr. President, this motion sends the legislation back to the Finance Committee for a short period of time with instructions to report back with cost offsets other than Medicare cuts. The motion says we should retain the provisions in the legislation addressing fraud and abuse and retain those savings to strengthen the Medicare trust fund. Instead of cutting over $450 billion from Medicare providers and beneficiaries, the committee should do what it should have done in the first place--protect seniors' benefits and access to providers. It is much needed.

Mr. President, I say to my friends, let's save seniors who have paid into the Medicare Program their whole lives from these damaging cuts. I hope my colleagues will vote in favor of this motion. Let's use Medicare savings to save Medicare, not to fund a whole new $2.5 trillion entitlement program. I urge a vote in favor of the motion.

I yield back the remainder of my time.

Mr. President, have the yeas and nays been ordered?

I ask for the yeas and nays.

Please go ahead.

Mr. President, this motion proposes to send the legislation back to the Finance Committee to remove the nearly $\1/2\ trillion in cuts that will severely impact all seniors who are eligible for Medicare. As the Senator from Montana mentioned, the system is going to go broke in 7 years. So what does this legislation contemplate? That we take $\1/2\ trillion out of their savings and use it to fund a $2.5 trillion new entitlement program. What does that do for the Medicare trust fund? Nothing.

I urge my colleagues to vote in favor of this motion and send it back to the Finance Committee. Do the right thing for the seniors of this country.

Will the Senator yield?

Isn't it, shall we say, Enron accounting when you have a proposal that, as soon as the bill becomes law, you begin to raise taxes and cut benefits, and then you wait 4 years before any of the benefits are then extended to the beneficiaries? That, on its face, is a remarkable piece of legislation. My experience, which has only been 20-some years, is that we haven't passed legislation that says we are going to collect taxes on it for 4 years, and then we are going to give you whatever benefits that may accrue from this legislation. Again, there has been no time in history where we have taken money from an already failing system to create a new entitlement program.

I believe the Senator from Tennessee has the floor.

I was addressing the person who has the floor, which I am sure the Senator from Montana should understand by now.

Isn't it true--and the Senator from Montana is on the Senate floor and wants to enter into this. Maybe he can respond to his comments of 14 years ago. We weren't trying to create a new entitlement program, which is the object of the Senator's bill. We were just trying to enact some savings in the Medicare system.

What did Senator Baucus say? He said:

And above all, we must not use Medicare as a piggy bank.

What are we using the $483 billion in cuts in Medicare for?

Then he said:

That is disgraceful. Perhaps some changes lie ahead. But if

they do, they should be made for the single purpose of

keeping Medicare services for senior citizens and people with

disabilities.

Isn't it true that now that we are taking $483 billion out of a failing system the Medicare trustees say is going to go bankrupt, and the Senator from Montana, 14 years ago, said:

Seniors could easily be forced to give up their doctor, as

doctors begin to refuse Medicare patients and hospitals--

especially rural hospitals--close.

Isn't that the effect of taking $483 billion in cuts in Medicare? Then the Senator from Montana went on to say:

Equivalent to blowing up the house and erecting a pup tent

where it used to be.

Instead of blowing up a pup tent, I would say what they are doing is like a hydrogen bomb. Finally, Senator Baucus said:

Staggering. The leadership now proposes something like $250

billion in Medicare cuts. It is staggering. It is a reduction

of nearly a quarter in Medicare services by the year 2002.

All of us here learn about the issues. Apparently, the Senator from Montana didn't learn much, because he was deeply concerned 14 years ago about a very small savings in Medicare. Now he wants to spend $2.5 trillion and taking $483 billion out of Medicare to create a new entitlement system.

Mr. President, may I just mention again, $70 billion in fraud, abuse, and waste, and Senator Coburn, the doctor, can tell you, that is nowhere in this bill. The fact is, maybe some of the providers have been bought off, jawboned, or had their arms twisted or given a good deal, like PhRMA has. Recipients have not. Medicare recipients know you cannot cut $483 billion without ultimately affecting their benefits, and that is a fact.

Again, conspicuous by its absence, I say to the Senator from Montana, totally conspicuous by its absence is any meaningful malpractice reform, which has been proven in the State of Texas and other States to reduce costs and to increase the supply of physicians and caregivers. There is nothing in this bill that is meaningful about medical malpractice reform.

I had a townhall meeting with doctors in my State, and everyone stood up and said: I practice defensive medicine because I fear being sued.

If you are really serious, I say to the Senator from Montana, if you are really serious about this, medical malpractice should be a key and integral part of it. Even the CBO costed it out at about $54 billion a year. When you count in all the defensive medicine, it could be as much as $200 billion over 10 years. That is conspicuous by its absence. I think it brings into question the dedication of really reducing health care costs across America.

Will the Senator yield? Very briefly, the Senator from Montana talked about the support the bill gets. AARP makes more money from Medigap plans they sell to seniors. AARP should be opposing the bill, but other groups such as 60 Plus are educating seniors.

The AMA endorsement of the bill--shocking. The bill puts the government in charge, but AMA cut a deal to get their Medicare payments addressed by increasing the deficit by $250 billion.

PhRMA--my God, if there ever was an obscene alliance made that will harm seniors because it has the administration against drug reimportation from Canada and competition for treatment of Medicare patients.

So now we understand a little bit better why these special interest groups, 500-some of them, have visited the White House in recent months, according to White House logs.

May I ask my colleague's indulgence for just a moment because, as you know, the majority leader seems to appear more and more frantic as he, perhaps, is reading the same polls we are that more and more Americans, when they figure out this legislation, are becoming more and more opposed to it.

Yesterday, the majority leader came out and directly addressed me, saying:

This man talks about earmarks, but his amendment is one big

earmark to the insurance industry. And in addition to that,

the sponsor of the amendment--

Talking about me--

during his Presidential campaign talked about cutting these

moneys.

Mr. President, I hate, I say to my colleagues, to take a trip back down memory lane, but at the time--of course, this was echoed by a DNC spokesperson, who then echoed it throughout the blogosphere and leftwing liberal blogs. The fact is, on October 20, FactCheck.org says:

He accuses McCain of proposing to cut benefits. Not true.

This is from FactCheck.

In a TV ad and in speeches, Obama is making bogus claims

that McCain plans to cut $880 billion from Medicare spending

and to reduce benefits.

A TV spot says--

A very well-funded campaign, I might add--

McCain's plan requires ``cuts in benefits, eligibility, or

both.''

Obama said in a speech that McCain plans ``cuts'' that

would force seniors to ``pay more for your drugs, receive

fewer services, and get lower quality care.''

A second ad claims that McCain's plan would bring about a

22 percent cut in benefits.

FactCheck.org says:

These claims are false, and based on a single newspaper

report that says no such thing. McCain's policy director

states unequivocally that no benefit cuts are envisioned.

Mr. President, I ask unanimous consent to have printed in the Record the entire FactCheck.org article.

Mr. President, I hope the Senator from Nevada will stop making false claims--repeating the false claims that were in attack ads on me throughout the campaign, funded by tens of millions of dollars, about my positions on health care in America which the fact checkers found to be totally false.

As the narrator says that McCain's plan ``means a 22

percent cut in benefits,'' the ad displays a footnote citing

an Oct. 6 Wall Street Journal story as its authority.

FactCheck:

But, in fact, the Journal story makes no mention of any 22

percent reduction, or any reduction at all.

I hope, among other things, in his, may I describe, frustration, that the Senate majority leader would at least not repeat false accusations about what I wanted to do in the Presidential campaign. It is unfortunate.

And I hope that maybe, instead of attacking David Broder, instead of attacking me, instead of attacking others who are in support of this amendment, maybe we could have a more meaningful discussion about the facts surrounding this legislation.