Floor Statements

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, this is the week of two more 1,000-page bills. The House has produced a nearly 2,000-page health care bill which we are all looking forward to reading. The Senator from New Mexico and I are members of the Environment and Public Works Committee, and this week we have been spending almost all day each day on a nearly 1,000-page bill on climate change.

As I said on Tuesday when the bill was presented, I have no problem acknowledging the problem, but I do have a problem with the proposed solution. The National Academies of Science of 11 major industrialized countries, including the United States, have said that climate change is real and that humans are causing most of the recent warming. If fire chiefs with the same reputation said my house was likely to burn down, I would buy some fire insurance. I would buy fire insurance that worked. But I wouldn't buy insurance so expensive that I couldn't pay my mortgage or I couldn't pay my hospital bill. That is my concern about the

solution that is a part of the Kerry-Boxer bill which we have been working on this week.

The Kerry-Boxer bill is a high-cost clean energy plan that will make it hard for Americans to support their families.

When the Boxer-Kerry cap-and-trade Bill is put together with the Energy Committee's Renewable Electricity Standard, it will be even bigger. It will be a combination of an economy-wide cap and trade and narrowly defined energy mandate. It will be a 1,000-page-plus bill of taxes, mandates, and surprises. But some things will not be a surprise.

We have heard this week a good deal of detail about the costs. At a time of 10 percent unemployment in America--and that is likely to continue for a while--it will impose a new national energy tax that will raise utility bills and send manufacturing jobs overseas looking for cheap energy. It will collect hundreds of billions of dollars each year from American taxpayers for use in a Washington slush fund for politicians to play with. Already we have corporations all over the country with their hands out looking for their share.

The economy-wide cap-and-trade, as has been said before our committee by very distinguished scientists, will be ineffective against fuel. Fuel is 30 percent of our carbon emitted today, which is a contributor to global warming. So the idea is that we put cap and trade on carbon, and it raises the price of fuel. But the testimony before our committee has been that it doesn't do much to reduce carbon emissions because even the large price increase in gasoline, for example, which will be passed on to those of us who drive cars, trucks, and fly in airplanes, would not be enough. It will be enough to cause a lot of pain, but it would not change much human behavior and reduce the amount of fuel consumed. The net result is higher prices but the same emissions.

The EPA has done a quick look at this nearly 1,000-page bill. Its conclusion is that its costs and benefits are much like the Waxman- Markey bill passed by the House of Representatives a few months ago. We know what people have said about that bill. President Obama's Budget Director, Peter Orszag, said in March that by giving the allowances to industry for free--instead of auctioning them--would result in the ``largest corporate welfare program in history.'' That is President Obama's Budget Director.

The Congressional Budget Office said that the House-passed Waxman- Markey bill would cut up to 3.5 percent of our GDP by 2050. In other words, it will make us poorer than we would otherwise be. The Brookings Institute said the cost is likely to be $300 billion annually by 2030. Former Senator Wirth of Colorado has criticized the bill as a cap-and- tax revenue raiser and said instead, it ought to focus primarily on utilities. James Hansen at NASA, who feels passionately about climate change and believes it is a problem, as I do, says the bill is less than worthless.

So taken altogether, the strategy of this bill to deal with climate change is, taxes, expensive energy, and mandates, plus the President's goal of a national windmill policy--a combination of subsidies and incentives and mandates that would have as a goal making 20 percent of our electricity from giant wind turbines.

Mr. President, I believe our dream for energy ought to be just the reverse. We should want large amounts of reliable, clean, low-carbon, or carbon-free energy, but it should be cheap energy not deliberate high-cost energy because that is the way we create jobs and avoid hardships for American families. Our dream throughout our existence in this world has been that someday we would have cheap, energy for the people of the world so they could get out of poverty. We are fortunate in this country. We are just 5 percent of the people in the world, and we have 25 percent of the wealth, and we use about 25 percent of the energy. We should be leading the way and not have a policy that deliberately raises the price of energy. We ought to deliberately lower it.

So before we deliberately embark on a program to send manufacturing jobs overseas, which this unquestionably will--if you work in an auto plant or auto supplier plant or cement plant or aluminum plant, if this bill passes, your job is more likely to go overseas. Before we deliberately make ourselves poorer, we should try a low-cost strategy, and we have one.

Republicans--all 40 Republicans--have a 4-point, low-cost clean energy strategy, which I believe many Democrats agree with, and I believe President Obama agrees with a lot of it. So rather than this economy-wide, high-cost energy strategy, why not the following 4-point strategy:

No. 1, create the environment in which we could build 100 new nuclear powerplants in the next 20 years. That is the same number we have today--104. We built those in 20 years, between 1970 and 1990. Those plants produce 70 percent of our carbon-free electricity today. Wind and all of the renewable energies--except for hydropower produce 4 percent. So 100 more nuclear powerplants is No. 1.

No. 2, electrify half our cars and trucks in the next 20 years. This can happen. Almost every major automobile manufacturer is making hybrid-electric cars today. I drive a plug-in hybrid. I plug it in every night when I go home, and I put gas in my car about every 6 weeks. So we can electrify half our cars and trucks in 20 years. We can do it by plugging them in at night, when we have so much spare electricity. We can do it without building one new powerplant. That is according to the testimony of a former Brookings Institute scholar who is now in the Obama administration as Assistant Secretary of Energy.

No. 3, we can explore offshore for low-carbon natural gas and for our own oil. Natural gas has suddenly become in abundant supply, and the price is low. We can use more of it for energy, for electricity. We need to be careful with that. We did that once before and the price went up to $15. But we have a new abundant supply of natural gas. It is our own and it is not overseas. We should find it and use it. It is low carbon. While we are at it, we should find our oil. Even if we drive half our electric cars--which will reduce our oil from overseas by one- third--we will still be using 12 or 13 million barrels of oil a day just for transportation, and we will be better off if we use our oil instead of oil from places overseas, from countries who don't like us.

The fourth item is to launch four mini Manhattan Projects like the one we had in World War II. Secretary Chu, the distinguished physicist who is President Obama's Secretary of Energy, calls them ``innovation hubs.'' We can launch four Mini Manhattan Projects, or innovation hubs, to find ways to recapture carbon from coal plants. We know how to take nitrogen, sulfur, and mercury out of coal plants. We need to find a commercially viable way to take the carbon out.

A mini Manhattan Project could make solar power costs competitive. Today, it costs four or five times as much as other electricity. It is too expensive to use in a widespread way.

Germany, which has invested much of its future in solar power, gets less than 1 percent of its electricity from solar power. We are nearly at zero in the United States. We need a mini Manhattan Project to make electric batteries better so that our cars can go 400 miles instead of 100 miles with electricity, a mini Manhattan Project to recycle used nuclear fuel in a way that doesn't isolate plutonium.

This strategy, as I said, is supported by all 40 Senate Republicans, and many Democrats and, I believe, some of that the President embraces: nuclear powerplants, electric cars, offshore exploration for natural gas and oil, and double energy R&D for four mini Manhattan Projects for carbon recapture, solar power, electric batteries, and recycling used nuclear fuel. This strategy doesn't drive manufacturing jobs overseas. It doesn't put an ineffective cap and trade program on fuel and raise the price of gasoline without reducing much carbon.

That is much better than a national windmill policy, which is what the Obama administration and our current subsidies basically have in store for our future. Let me say what I mean by that. To produce an additional 20 percent of our electricity from nuclear power, we would need 100 new nuclear reactors on 100 square miles. Most of them could be built on sites where we now have reactors. We have been doing this successfully since the 1950s. We have a nuclear Navy. We produce 19 percent of our electricity from the 104

reactors we have today. But the proposal of the administration is to build 20 percent of our electricity from wind power. That would require 186,000 50-story wind turbines whose blades are the size of a football field. It would require 19,000 miles of new transmission lines from remote places, through your backyard, over your scenic viewscape, to bring that electricity to your house. It would require $170 billion in taxpayer subsidies over the next 10 years, while the subsidy for the same amount of nuclear power would be about $6.8 billion, according to current law.

It would turn our ridge tops and coastlines and treasured landscapes into junkyards in the sky. According to statistics from the American Bird Conservancy these turbines could kill more than 1 million birds a year. These turbines would work one-third of the time. That means we would have to build nuclear power natural gas plants, or coal plants, to back up these 186,000 turbines that would cover an area the size of West Virginia. That is a project for our country that ranges from impractical, to expensive, to preposterous, especially when we have available the possibility of doing what we did before--adding 100 new nuclear reactors, which the rest of the world is doing.

What happened to nuclear power? If we were going to war with the successful nuclear Navy created 60 years ago and it was doing exactly what we wanted it to do as the world's leading military, with thousands of our sailors living safely on top of those reactors, why would we stop building nuclear ships and start using sailboats for our national defense? That is tantamount to what the current administration's energy policy is doing with a national windmill policy.

We should build 100 new nuclear powerplants as rapidly and as safely as we can. It is the cheapest and most reliable way to reduce carbon and deal with climate change, and it is the fastest way to do that-- just as electrifying half of our cars and trucks would be a fast way to reduce foreign oil and reduce emissions in the transportation sector. We invented nuclear power. It is one of our great technologies--maybe the most important technology in the last 100 years, and we haven't built a new nuclear powerplant in 30 years--even though the old ones we have are producing 70 percent of our carbon-free electricity.

What is the rest of the world doing? China is building 132 new nuclear powerplants. The head of a French company that makes large turbines for powerplants was in my office the other day. He told me China is starting a new nuclear plant every 2 to 3 months. France is 80 percent nuclear and has among the lowest electric rates and carbon emission rates in Western Europe.

We hear a lot about green jobs. Spain has a lot of green jobs. Unfortunately, many of the rest of Spain's jobs are going to France because the electricity rates are lower in France, and they are high in Spain because they favor unreliable and expensive renewable electricity over nuclear power. Japan is 35 percent nuclear and growing. Taiwan, India, and the United Arab Emirates are building them. Russia is building two nuclear plants a year so they can use their natural gas as currency with the rest of Europe. But we invented nuclear technology and we haven't started a new nuclear powerplant in 30 years.

Why don't we go full speed ahead? We believe this is a more sensible, practical, low-cost solution for dealing with climate change. I will speak for myself; we have many different views on climate change in the Republican caucus. We have the whole spectrum. Not everybody agrees with me that it is a real problem and humans are causing it and we ought to deal with it as rapidly as we reasonably can. But here is the way we should do it.

If we, by 2030, build 100 new nuclear plants, and if we electrify half of our cars and trucks, we would be producing about 40 percent of our electricity from nuclear. Natural gas would be about 25 percent, hydro would be 10, wind and solar maybe 5 to 10. With these two efforts--nuclear power and electric cars--we would reach the Kyoto protocol goals for carbon emissions by 2030 without a significant increase in energy prices.

If in the meantime our mini-Manhattan projects for research, solar, carbon recapture, recycling nuclear waste, and electric batteries worked, we would be even more successful in reducing emissions, all without a national energy tax.

One might say: What is going to make all that happen? I would say two words: Presidential leadership. President Obama is very persuasive. He can set a goal and mobilize the country. That is part of the President's job: See a need, develop a strategy, and persuade half of us he is right. I think he can get a lot of Democrats.

He could start removing barriers to nuclear plants, speed up approval of designs for them. If China can start them every 2 or 3 months, we ought to be able to do so as well. He could provide incentives, such as $100 billion in loan guarantees--and those would all be paid back not just for nuclear but for all clean energy. His budget could fund the mini-Manhattan projects. Dr. Chu has recommended we do that.

At a town hall meeting recently, President Obama said the United States would be ``stupid''--those were his words--not to use nuclear power. I was glad to hear him say that. I was disappointed when he went to the United Nations Climate Change Conference in New York and lectured the other countries about not doing more about climate change and he didn't mention the words ``nuclear power.'' Meanwhile, Chinese President Hu Jintao said his country would ``vigorously'' develop nuclear power to combat climate change and they are building 132 nuclear plants. But I was glad to hear what President Obama said in New Orleans.

As we move through the Senate on the debate on climate change, I ask colleagues on both sides to look carefully at this economy wide cap and trade. We have had some experience with cap and trade on small dollars for coal plants and sulfur. That does not translate very well to what is being proposed here. It does not work on fuel, which is 30 percent of our carbon. It raises the price without reducing carbon emissions, it drives manufacturing jobs away, and it raises utility bills. We don't need to do it.

With Presidential leadership, we could build 100 nuclear plants, electrify half our cars and trucks, find new low-carbon natural gas, launch the mini-Manhattan projects, and meet our clean energy goals without a national energy tax, without running jobs overseas looking for cheap electricity.

All 40 Republican Senators agree with this agenda. So do many Democrats. President Obama agrees with much of it. Then why are we pushing a high-cost national energy tax and subsidizing 186,000 windmills when we should all agree on a low-cost, clean energy plan that will create good jobs and power our economy for the 21st Century?

I yield the floor.

Madam President, I have an important announcement to make on another subject which is of interest to the American people. The era of the thousand-page bill is over. We now have a 2,000-page bill, a new health care bill introduced in the House of Representatives today by Speaker Pelosi. What we will do on the Republican side, and what I hope our friends on the Democratic side will do as well, and what every American expects us to do, is read all 2,000 pages and know exactly what it costs before we begin to vote on the congressional Democrats' health care bill.

For example, while we know just a few things about the bill, we know the price tag is likely to be more than $1 trillion. So it is 2,000 pages, more than $1 trillion.

We know the physicians Medicare reimbursement rate, which is important to all of us to be included, is scheduled to be treated separately there. Well, it wasn't treated separately here. On what was the first vote on health care a week ago, 13 Democrats joined with 40 Republicans to say we are not going to begin the health care debate by increasing the deficit by $\1/4\ trillion. That was an important statement to the American people.

One of the questions we will be asking is how is the physician Medicare reimbursement plan, which is an essential part of any plan for health care over the next 10 years, how is it paid for? Does it add to the debt? We will be looking--and I know the distinguished Senator from New Hampshire who is the ranking Republican on the Budget Committee already is looking--at not just what happens in the first 5 years of this proposed bill but in the second 5 years and the 10 years after that, because our goal is to reduce the cost of health care, the cost of premiums to each of us and to our government. A preliminary look suggests that while the cost may go down to the government in the first 5 years, it might go up in the second 5 years as the plan is implemented.

Third, we want to look at the new taxes on small businesses we have been told about.

Next, we want to look at the provision in the bill which seems to say that an employer might have to pay 8 percent of his payroll as a penalty if the employer does not provide health care to his employees. Does that mean all employees? Does that mean full-time employees? Does that mean part-time employees? We want to read the bill. We want to know exactly what it says. We want to see a Congressional Budget Office estimate--a formal estimate--of what it costs.

There is in the bill a new government-run insurance plan. We have said before that our view on the Republican side--and I know some Democrats have concern about this as well--is the effect of a government-run insurance company--some call it the government option-- is no option because if you are one of the 170 million or 180 million Americans who have health insurance through your employer, the combination of a bill such as this is you are more likely to lose your insurance and the government option is likely to be your only option. We will be asking that question and see what it costs.

There is a provision in the bill that expands Medicaid. This is the government-run program for the low-income we already have that has 60 million Americans in it. The State and the Federal Government share the cost of it. My preliminary understanding of this provision is, it increases the cost of the Medicaid expansion, which Governors all across the country are deeply concerned about, and it adds a provision to require that physicians be reimbursed for Medicaid services at the same level as Medicare, which would basically double the cost of the Medicaid expansion. How much of this will the States pay?

There are a number of questions to be asked, but the news of the day is this: The era of the 1,000-page bill is over. We have a new 2,000- page health care bill. We will be reading the bill, and we will be trying to understand exactly what it costs.

I will be glad to yield.

I don't know. The Senator from New Hampshire has a wide variety of experiences and may understand the weight of bricks better than I do. I just know the era of the 1,000-page bill is over. We have a 2,000-page bill, and we will need to read it.

I ask the Senator from New Hampshire how long should it take the Congressional Budget Office to provide a formal estimate of a 2,000- page bill, based upon his experience--I ask through the Chair--as former chairman of the Budget Committee and the ranking Republican member.

I thank the Senator from New Hampshire. Our concern has been, with the bills we have seen so far, that a bill that is supposed to reduce costs actually raises the cost of premiums, cuts Medicare, and raises taxes. The new government insurance plan will cause millions to lose their employer-based insurance and become a part of the government option and, unless the physicians Medicare reimbursement payment is a part of the plan, it also adds to the debt.

It seems to me it will.

I am always glad to yield for a question by the assistant Democratic leader.

That is a very good question. I saw the Senator from Illinois on the floor the other day saying: A 1,000-page bill, who cares about a 1,000-page bill?

I don't think Americans like the idea of a 1,000-page bill. I think they will like even less a 2,000-page bill. I don't think we do comprehensive very well here.

I think what the American people want us to do, if I can say to the Senator from Illinois, is not have a comprehensive bill full of higher premiums, taxes, and surprises but to focus on reducing the cost of health care premiums and reducing the cost to the government and go step by step on things----

I am trying to answer his excellent question. Go step by step to meet that goal, such as a provision that would allow small businesses to combine resources and offer their employees insurance, such as provisions that would get rid of junk lawsuits against doctors, which virtually everyone agrees drives up the costs.

Yes.

I thank the Senator from Arizona for his excellent question. I am sure there is no one in this Chamber who more vividly remembers that promise than the Senator from Arizona. We all would like to know what is in this bill and what is going on behind closed doors.

Only if----

Without yielding the floor, I certainly would be glad--if I may reclaim the floor. I have the floor. I will be glad to allow the Senator from California to say whatever she would like, if I can have consent to have the floor back.

I thank the chairman. I look forward to moving over there and working on the Interior appropriations bill. I think Senator McCain is here to speak about it. I was only, in an extravagant gesture of courtesy, trying to answer the question of the distinguished assistant Democratic leader from Illinois.

Knowing the Senator is a very able trial lawyer, it is only because I am courteous that I will do that. Of course I do.

The Republican health care reform bill, Madam President, if I may talk about it, has been offered in a series of proposals. The proposal for a small business health insurance program is less than 1,000 pages, by several hundred pages.

What I think I will do is not take so much more of the Senator's time, but I will enumerate the proposals and give him the number of pages. While he is reading our proposals, I will read his, and we will see who gets through first. Of course, we will have to wait until they come out from behind closed doors with their bill.

I will get the small business proposal. I will get the proposal to end junk lawsuits against doctors. I will get the proposal to allow people to buy insurance across State lines, which will reduce the cost of insurance. I will get the proposal that would adjust tax incentives. There is a proposal that would also expand technology on which we have proposals on both sides of the aisle. So I will get five or six of the Republican proposals, most of which we hope will gain bipartisan support.

I see the assistant Democratic leader every day at the beginning of the day. Maybe we can even read them together, and then whenever his bill comes out from behind closed doors and we get the House bill, we can all read that 2,000-page bill.

I am going to accede to the wishes of the chairman of the Interior Appropriations Subcommittee, because I am her ranking minority member, and cease talking about the end of the era of the 1,000-page bill and let us get to Interior appropriations.

Madam President, if I had to choose an appropriations subcommittee to serve on, this would be it. It includes the things I care the most about: the great American outdoors, clean air, our national parks. I couldn't have the privilege of working with a finer chairman than Senator Feinstein. I like her especially because she says what she thinks. She was a mayor. A former Governor, as the Presiding Officer was, appreciates that. She can make a decision, and she sticks to it. She cares about the great outdoors. She has a long record of work on clean air and the environment, about our forests, about our deserts, so we see eye-to-eye about a great many things.

Senator McCain is here to speak on our side in a few minutes. I think Senator Sessions would like 5 minutes. I would say to my Republican colleagues, I don't plan to take but 3 or 4 minutes. After they speak, I don't have any other remarks to make. We may be able to give back some of our time.

I thank the full committee, Chairman Inouye and Vice Chairman Cochran and Senators Reid and McConnell for their allowing us to move forward. I am glad this bill will not be part of the omnibus. That is not the way to do business. There were lots of differences of opinion, both in the Senate and with the House--the chairman outlined those and talked about those. My preference, if I were the king, I wouldn't spend this much money on this bill this year. This is a tough time. But I doubt Americans will begrudge spending on national parks, on clean water, and on firefighting.

This is the 75th anniversary of the Great Smoky Mountain National Park that was created in the midst of the Great Depression. Each State appropriated $2 million, and then schoolchildren gave their pennies. Even in tough times--maybe especially in tough times--we care about our national parks. President Bush set us on the road with the Centennial Initiative to properly fund them by the time we get to 2016, and this bill continues that.

It is also good it includes within the budget the firefighting costs which were outside the budget as emergency appropriations. That is a good way to do business. We do not want the U.S. Forest Service to become the U.S. Fire Service, even though we greatly value its work in firefighting. We want it to also be able to perform other important functions.

I am glad to see the support for Land and Water Conservation Funds. Local parks, city parks, are our most popular parks, the ones down the street.

The Senator mentioned the Davis-Bacon State revolving funds. I strongly object to that being in the bill. This is the first time it has ever been in. We have applied the Davis-Bacon Act to these state revolving funds. This will mean fewer jobs, higher costs, fewer projects. The States provide 20 percent of the match. They should be able to decide what the wage rates are in their States.

The bottom line is that we are appropriating $3.5 billion to get done what last year would have only cost us $2.6 billion to do. We are making a mistake. I fought hard to change that. I appreciate the fact that the conference committee supported my effort to move this from a permanent change to a 1-year change. This is appropriately being considered by the Senate Environment and Public Works Committee on which I serve. I will make my views known there.

I thank the chairman again for her courtesies. I see the Senator from Arizona is here. I will yield the floor and give him and other Senators a chance to speak on the bill.

The Senator from Arizona may take as much time as he wishes.

I certainly have no objection at all. The Senator from Alabama is here. As far as I know, he is the only other Republican Senator who wishes to speak at this time. I have no further comments. So if any other Republican Senator wishes to speak, they should come over. After Senator Sessions speaks, we will waive the rest of our time.

Madam President, I see no other Republican Senators who wish to speak, so I yield back our time.

Madam President, could I add my thanks to the staff. They have worked hard. This hasn't been a very easy bill to do. Senator Feinstein mentioned all of their names. I add my thanks to her thanks.

Mr. President, I enjoyed the comments of the distinguished Senator from Rhode Island. He is one of the most thoughtful and intelligent Members of the Senate. I always enjoy listening to him. But I have a different characterization of what we are doing in the Senate.

He pointed out that the majority leader believed it was necessary to cut off debate 82 times; that was a record. I do not believe I would be bragging about that. This is the Senate. What that means is the majority leader has said to the minority: Be quiet. Don't debate. We don't want your amendments--82 times.

The House of Representatives is the place where we have the train that runs through according to the majority. That is not the Senate. Senator Byrd, the senior Democrat, the senior Senator, has written four big volumes about the history of this body and what is unique about the Senate. Our Founders said: We will have one popular body where there is one man one vote, one woman one vote, and whoever has the majority the train runs through. So whatever Speaker Pelosi wants, Speaker Pelosi gets. That was the view of the Founders more than two centuries ago. But we are going to have a little bit different Senate.

Do you know what the idea of the Founders was, the Founders, whom we revere and admire? Unlimited debate. Unlimited amendment. That is the Senate. That is the only reason we have it. There is no need for the Senate if we do not have that.

When Alexis de Tocqueville, the young Frenchman, came to this country in the 1830s and wandered around our Nation and wrote that perceptive book, ``Democracy in America,'' which every serious student of the American Constitution in our country discovers, he saw one thing he worried most about in the new American democracy, and it was, in his words, the tyranny of the majority. He said the Senate was the one institution which helped work against the tyranny of the majority.

So this is the body that protects the minority view. It does slow things down. In the case we are talking about, unemployment compensation, we have already voted to limit debate on unemployment compensation. That is what we are talking about today.

I see the Republican whip on the Senate floor. As I recall, the vote to limit debate on unemployment compensation was overwhelmingly bipartisan, was it not?

Of course.

Mr. President, I ask unanimous consent that the Senator from Arizona and I be allowed to engage in a colloquy on this subject.

I believe the answer is no. If I am not mistaken--if I am not mistaken--I say to my friend from Arizona, the Democratic side has a nongermane amendment they would like the Senate to bring up, and I believe the Republican side has a nongermane amendment we would like to bring up. They are saying: Because we are in the majority, we are going to run over you. That is the tyranny of the majority. That is what Alexis de Tocqueville warned against, and we are saying: No, you are not. We are elected from Arizona and Tennessee to represent our constituents. If you are going to run over us, we might as well go home.

Mr. President, I think the Senator is exactly right, and we on the Republican side--and I believe some Democrats do as well--have some proposals about how to restart housing. We would like to deal with that on this issue as well. But the Senator is exactly correct. The No. 1 issue for most Americans is what to do about jobs. Unemployment is about at the rate of 10 percent.

The Senator from Arizona is correct. And as a member of the Finance Committee, he has once again come up with a very good suggestion. He understands better than some appear to that if we add taxes to payrolls, it makes it more likely that payrolls will be smaller or there will be fewer jobs. So if we can find a way to pay for unemployment compensation that does not add to the debt and does not add to payroll taxes, that is worth taking a little time to do.

Mr. President, if the Senator from Arizona has another minute, I thank him for coming to the floor because he has pointed out the value of taking a little time on these important pieces of legislation. He has suggested a way we can not only extend unemployment compensation benefits, which almost all of us want to do, but a way to pay for it in a way that creates more jobs rather than fewer.

There is another example. The Senator from Rhode Island was complaining about the 82 times that the majority leader has invoked cloture, and I was saying that was nothing to brag about. We should be complaining about that, because that is 82 times he has cut us off. In general, he has allowed during this year a fair amount of amendments, a fair amount of debate. But take the health care bill for a moment. It takes a little time. Over in the House I hear they may run that through in 3 days. That is not going to happen here. When we have time to stop and think about it--the same thing happens on this floor that happened last week. We had our first vote on health care and the question was, Shall we raise the debt \1/4\ trillion dollars?, and 13 Democrats joined all Republicans and said no.

We have another important vote coming up soon that might be called a procedural vote but, in fact, is a vote for or against a bill.

We are here every day. We want to do what the Senator from Arizona said. We want to read the bill and we want to know what it costs because when we hear about it--and the Senator from Arizona was a part of the Finance Committee that developed one bill; I was a part of the HELP Committee that developed another bill. What we hear is that instead of lowering premiums, which is the idea for 250 million Americans, it will probably raise premiums; that it will raise taxes; that it will cut Medicare by $450 billion.

Now we learn from the majority leader this week that there will be a new government-run insurance program. We are going to put the government in the insurance business with a ``State opt-out,'' whatever that might mean. I am a former Governor. I am wondering, Does that mean we can opt out of the taxes as well as the benefits? So the Senator from Arizona is right. We are here. We are ready to go to work. We are anxious to read the bill, but it is being written behind closed doors.

If I could ask one more question of the Senator from Arizona, who is giving a lot of time to this discussion. I thought this health care debate was supposed to be about reducing costs--the cost to the government and the cost to people buying premiums. Whatever happened to that goal?

I thank the Senator from Arizona. All of this got started because the Senator from Rhode Island had complained that the Democratic leader had to cut off debate 32 times, and my response was that was nothing to brag about; that is what the Senate is for. That is how the Founders created it.

I appreciate the Senator from Arizona pointing out that in the case of unemployment compensation, we all want to extend the benefits. We think we may have a way to do that in a way that creates more jobs rather than taxes on jobs. In the case of health care, yes, we want to go slow enough to be able to do two things: Read the bill, know what it costs, because we want to make sure that if we pass a health care bill, we are not the Congress of higher premiums, higher taxes, Medicare cuts, and adding to the debt. I think the American people want to make sure we do that as well. So I am grateful that we have the Senate. We are always a little more grateful for those rules when we are in the minority, because they protect our rights to represent the people who elect us and to ask us to offer amendments. But the American people have been served very well by a Senate that has different rules and procedures.

Student Loans

I wish to say a word about a subject which has nothing to do with health care and nothing to do with climate change, which is the other subject I have been in hearings on today, but it is a subject that will affect millions of families in America, and that is the question of going to college and student loans.

All of us can imagine the anxious moments in our family lives--and there are a number of them, including when a baby is born or when the daughter goes out on her first date; when someone is sick; when a child goes off to college. But one of the most anxious moments comes just after the first of every year when, in millions of homes across America, students and their parents wait to see if they have been admitted to college and to which college. The next anxiety comes when they turn to the various options they have to see whether they can afford to go to that college.

Fortunately, in America we have the best system of higher education. We not only have the best colleges; we have almost all of the best colleges. We have 6,000 autonomous institutions of one kind or another--public, private, religious, secular, profit, for-profit--among which students may choose. Second, even though prices have been going up, we have bent over backward in this country to try to make it possible for the largest number of Americans to attend college. Seventy-seven percent of Americans who attend college--nearly 20 million--have a Federal grant or Federal loan to help them do that.

So just after January--and I want to paint this picture--in homes across America, we have millions of students, millions of families who are waiting for their college admissions and then will turn to the question of: Can I get some help paying the bills. Specifically, we have 14 million--if next year is anything like last year and the year before--14 million of those students who will be going to college on 35 campuses who will be borrowing $60 million through the Federal Family Education Loan Program--what we call the traditional student loan program.

We have two types of loan programs. We basically have one through two thousand lenders, profit and nonprofit, across the country. For example, we have an organization called Edsouth in Tennessee that is nonprofit. It offers a variety of student loan options to Tennessee students. It has five regional outreach counselors to provide college and career planning, financial aid training, college admissions assistance, and financial literacy. It makes 443 presentations at Tennessee schools through college fairs, guidance visits, and presentations. It works with 12,000 Tennessee students to improve their understanding of college admissions and the financial aid process. Last year, Edsouth provided training to over 1,000 school counselors and distributed 1.5 million financial aid brochures.

The various lending institutions--profit and not-for-profit--are usually in these communities and easy for these 14 million students to get to. There is another group of students--about a fourth to a third in total--who choose to go another route in getting a student loan, called direct lending. They borrow directly from the government. This was set up as a pilot program when I was the Secretary of Education in the early 1990s. It was set up to see whether the traditional student loan program, which is through your local bank or nonprofit, was working right, and what was best for students.

Students and colleges have voted over the years with their practices. For

example, in Tennessee, most Tennessee campuses and most Tennessee students choose the traditional student loan program. At the University of Tennessee, where I was once president, in Knoxville, there are 30,000 students, and 11,000 have a Federal loan. They get that through the traditional loan program, not the government direct loan program. At Maryville College, in my hometown, where my parents went, 824 of 1,100 students have a Federal loan. They get that through the traditional loan program. At Carson-Newman, at Jefferson City, where I am going Friday to help inaugurate a new president, with 2,000 total students, 1,259 have a Federal loan. I can go through each of the institutions in our State. You can see the number of families that any change in the student loan program affects, and if you add the anxiety that comes with receiving your college admission and worrying about whether you can pay the bill--you can see the problem that causes.

The reason I came to the floor is that for those 14 million students--more or less--who, in January, February, and March, would be expected to turn to the traditional student loan program, we are about to have a 14-million car pile-up on the interstate highways of American education because of action taken by the U.S. Department of Education.

The Secretary of Education--a man I greatly admire--has sent a letter to the various schools--3,500 or so campuses--that now use the traditional loan program, and he said you better get ready for the government-run program, and you need to do it because I may not be able to continue to offer the traditional loans.

That is a big mistake. I want to point out the reasons. First, there is not time to switch, even according to a New York Times article.

I ask unanimous consent to have printed in the Record the Secretary's letter to the campuses and the New York Times article.

The Secretary's assistant says it takes at least 3, 4 months for colleges to switch their computers around, so instead of offering aid through a traditional program, they offer it through the government direct loan program. There will be a lot of confusion in January, February, March and April. There is not time to switch.

Second, the Secretary has gotten ahead of himself. The President has proposed a Washington takeover of the student loan program, but this Washington takeover requires congressional approval. We have more than one branch of government in this town. I know the House of Representatives has passed the President's request, but there's one more--the United States Senate has not approved the President's request, and I hope it does not. It is a bad idea.

So I hope the Secretary will write another letter and say I have changed my mind, given the lateness of the situation in the year--we are almost to November--and the fact that it takes up to 4 months for any college to make a changeover, and because most students will begin to receive their college admissions in January and February, et cetera. I hope the Secretary will say I am going to take a little different approach and work with Congress, recognizing that the Congress has to approve this proposal as well.

First, we are going to extend the law that was passed a couple of years ago,

which provides emergency financing to back up all of the traditional student loans that are made. That has worked out very well. The institutions participating have paid large fees to the government and students have gotten their loans. We can extend that another year. It doesn't expire until June.

Second, the Secretary might say that I am going to work with Congress to make some changes in the existing student loan program to make it right. We can talk about ways to do that.

Third, I hope he will say I am going to work with Congress to set up a transition time that is appropriate for any colleges that want to move from the traditional student loan program to the government-run direct loan program.

When time comes for us to debate and act on whether there should be a Washington takeover of student loans, I am going to say, no, there should not be. I have a little history here. I think the American people have had enough Washington takeovers--banks, insurance companies, General Motors, et cetera. The President can argue that he inherited a lot of that. But this takeover is truly voluntary.

Nobody is asking the Secretary of Education to become the banker of the year. I would rather he become the Secretary of the year. I think he could do that. I think he is an outstanding Secretary, one of the best appointees--maybe the best--of the new President. The Presiding Officer is from Illinois, and he knows Arne Duncan very well. I would like to see him reward teachers and setting higher standards, instead of making 20 million student loans every year. I want him to be the educator of the year, not the banker of the year. Deep in his heart, maybe he wishes that as well.

The administration has told us about this latest Washington takeover that is starting next year, and that the nearly 20 million students who want government-run direct loans should all line up at offices designated by the U.S. Department of Education. This will, the argument goes, save taxpayers $87 billion in subsidies that now go to greedy banks. In anticipation, Members of Congress--we--have already spent the $87 billion for more Pell grants, community college improvements, and other new programs. That sounds very good. Banks are punished, students are helped and, most important, Congressmen look real good.

Here is what they have not told you. Your friendly government, for all this, will overcharge you, the student--and use the profit to pay for the new programs that make the Congressmen look good. Yes, those of you who borrow student loans--the 20 million--the Education Department is going to borrow the money at 2.8 percent from the Treasury and loan it to the students at 6.8 percent, and spend the difference on administrative costs and new government programs. That means a student will spend a few more months or years working to pay off the student loan in order to help pay for someone else's education and help the Congressmen's reelection.

There are a few other things the government ought to tell you. The $87 billion isn't real. According to a letter in July from the nonpartisan CBO to New Hampshire Senator Gregg, the savings are closer to $47 billion. If we use the same cost scoring analysis that the CBO required when we passed the Troubled Assets Relief Program, or TARP, the savings I think are less than that, since the government assumes it can make 19 million loans each year for what it now costs to make 4 million loans.

Finally, the government needs to disclose to these 20 million students who are thinking about going to college next year that getting your loan will become about as enjoyable as waiting in line for your driver's license. Today there are 2,000 lenders--banks and nonprofit institutions--competing to offer government-backed students loans at 4,400 campuses. I mentioned earlier the kinds of services they provide. That is all about to change. There will only be one student loan banker under this proposal, the U.S. Secretary of Education. I wouldn't have wanted that job when I was in that position, and I cannot imagine any Education Secretary wanting that job. There will be no competition to make it easier to get your loan.

Imagine 20 million students and families trying to call a Federal call center to make their arrangements to go to college. It is true that during the last 20 years subsidies the government paid to lenders to make student loans were excessive. Congress took steps to correct that 2 years ago. If there is still $87 billion, or $47 billion, in real savings, then the subsidies are too high and we should lower them and give the savings to students, not trick students by overcharging them to pay for more government programs and run up the Federal debt in the process. Seven-eighths of the students who applied for Federal aid using the Free Application for Federal Student Aid had an average loan of about $25,000. Assuming a standard 10-year repayment at 6.8 percent, which is the rate set by Congress, these students would pay roughly $9,400 in interest. But we could use the savings to reduce the interest rate by as much as 1.5 percent--down to 5.3--and those students would pay only $7,100 in interest, a savings of $2,200.

If this Washington takeover goes through, every one of the 19 million-plus student loans made in 2010 should carry this warning label: Beware, your Federal Government is overcharging you so your Congressman can take credit for starting a new government program. Enjoy the extra hours you work to pay off your student loan.

Mr. President, I see my colleague from South Dakota on the floor and my colleague from Nebraska, so I will conclude.

The Secretary of Education should change his mind, withdraw his letter, and work with Congress to extend the temporary law and improve the student loan program and reassure students that they don't have to be anxious about standing in line in January for a loan.

I yield the floor.

Mr. President, I will let the majority leader make his own announcements, but there are a lot of discussions in the news media today that in a short period of time he intends to hold a press conference announcing that he will push ahead with the so-called public option in the health care legislation--one that currently includes an opt-out provision for States.

I don't know whether he intends to do that or whether he doesn't. He is entitled to make his own announcement, as I said. But it provides a good opportunity to talk about what we mean by a public option in health care, or a government-run health care plan, putting government in the health care business, and how it already works, and how it might work if States were allowed to opt out.

The reason it is easy to talk about this is--and the former Governor of Virginia, who is presiding, knows this as well as I do, and maybe better because he has been Governor more recently--we already have in existence in the United States today a public option health insurance program which States may opt out of. It is called Medicaid.

Medicaid is the largest government-run program we have in health care--even larger than Medicare. Medicare, for older people, has about 40 million persons who depend on it. Medicaid,

which sometimes offers confusion, is a different program. It is a program for low-income Americans. It started out for women and children, but it gradually expanded, and today it has nearly 60 million Americans who depend on it. The health care legislation, which is coming forward in the Baucus bill out of the Finance Committee and the HELP Committee, on which I serve, and the bills in the House of Representatives--all those pieces of legislation would expand the Medicaid Program--not Medicare for seniors but the Medicaid Program-- and send part of the bill for that expansion to the State.

So let's talk about that a little bit, particularly if it is true that the majority leader is about to propose that we have yet another government-run insurance program, giving the States the right to opt out, which sounds pretty good. Let's see how this one works that we already have, especially since the health reform bill that is headed our way would expand Medicaid, and according to the Congressional Budget Office, cost States an additional $33 billion in State dollars and add 14 million people to Medicaid.

I guess the first thing to know about a government-run health insurance program which States can opt out of is that they can't. I mean, in the real world, they can't. Not one has. Every State in America has Medicaid. The Federal Government pays roughly 60 percent of it; State taxpayers pay the rest. Most of the rules are written in Washington. States can ask for exemptions from the rules, but it is a long and burdensome process. It is not realistic to say the States can opt out of the Medicaid Program for low-income Americans. I suppose it might not be realistic, therefore, to say the States would be able to opt out of a new government-run program--a government-run, public- option program--that may be suggested by the majority leader. We should wait and see what he proposes, but I think we would be wise to pay attention to the fact that in the current government-run program we have today, no State finds it realistic to opt out.

Expanding Medicaid, which is what the health reform bill coming toward us on the floor proposes to do, is not just an expensive item for the Federal Government and for States, it is a terrible vehicle for health care reform. The current Governor of Tennessee--Governor Bredesen--a Democrat--has said putting more low-income Americans into Medicaid is not health care reform. Why would he say that? Because it makes it worse for those Americans as they seek to get access to care from doctors and hospitals and as they seek to get good, quality care. Plus, the program is riddled with so much fraud and abuse that, according to the Congressional Budget Office, $1 out of every $10 is stolen or wasted.

Most Governors who have struggled with Medicaid--and I am one of them--agree that its expansion is a bad idea. They unanimously have said to us in Congress that if you in Washington want to expand Medicaid, then you in Washington need to pay for Medicaid. That is the theory of no more unfunded mandates that every Governor whom I know about has agreed with for years. In fact, there was nothing that used to make me angrier as a Governor than for a distinguished politician in Washington to stand, make a speech, come up with a good idea, hold a press conference declaring a problem solved, and then send the bill to the States. So what does the Governor and the legislature and the mayor and the city council have to do? They have to cut services, they have to raise taxes, they have to run up tuition, they have to cut out some classes because somebody in Washington thought it was a good idea to do this. Well, that is what we are proposing to do with Medicaid. We are saying to the States: We have a great idea. We want to expand Medicaid by dumping another 14 million low-income Americans into this program, but congratulations, we are going to send you the bill to help pay for it.

The Washington Post quoted my home State Governor, Governor Bredesen, to whom I just referred, this way in regard to health care reform:

I can't think of a worse time for this bill to be coming. I

would love to see it but nobody is going to put their State

into bankruptcy or their education system into the tank for

it.

One of the most painful letters I have ever read was from Governor Bredesen, which he sent on October 5, when he wrote about Tennessee's fiscal situation--similar to the condition in most States. He said:

By 2013 we expect to return to our 2008 levels of revenue

and will have already cut programs dramatically--over $1

billion. At that point we will have to start digging out--we

will not have given raises to State employees or teachers for

5 years. Our pension plans will need shoring up. Our rainy

day fund will be depleted . . . we will not have made any

substantial investments for years . . . There will be major

cuts to areas such as children's services. On top of these,

there are the usual obligations that need to be met--

Medicaid, for example, will continue to grow at rates in

excess of the economy and our tax revenues.

Our idea of health care reform is to expand Medicaid and send Governor Bredesen a bill for $735 million over the next 5 years, which we can't afford.

The other legislation, from the HELP Committee, would cost the States even more. According to an actuarial report from the Centers for Medicare and Medicaid Services, Medicaid represented 40 percent of the Federal Government's cost expenditures for health care; 41 percent of State health care costs. It is the largest source of general revenue- based spending in health services--larger than Medicare.

I can vividly remember, 25 years ago, 30 years ago, as Governor, every time I made up a budget, I would start with roads. That comes from the gas tax. I would go to prisons. The court said to fund that. I would go to K-12 grades. Our Presiding Officer, the former Governor of Virginia, has had this experience. That is pretty much a set thing. Then you get down to the end and what are you choosing between? You are choosing between higher education--the University of Tennessee or the University of Virginia--and Medicaid. What is happening? Medicaid is going up like a rocket and State spending for higher education is flat. Our great higher educations systems across this country are under great stresses because of poor State funding because we have allowed Medicaid to grow out of control.

Not only do we do that, we are now about to expand it--about to expand it and send more of the bill to the States. The Governors are saying: Don't do that. Their revenues are down 17, 18, 20, 35 percent in some States. If you are going to pass it, they say: Pay for it. That is a question Governors should have a chance to ask and get an answer to.

According to the Texas Medicaid office, the current proposal to expand Medicaid will cost the State $20 billion over the next 10 years. We are passing it, they are paying for that much of it. According to the South Carolina Governor's office, $1.1 billion over 10 years. Governor Schwarzenegger has said for California it could be as high as $8 billion a year.

A New York Times article, in late September, said this:

The recession is driving up enrollment in Medicaid at

higher than expected rates, threatening gargantuan State

budget gaps even as Congress and the White House seek to

expand the government health insurance program for the poor

and disabled . . .

The New York Times went on to say:

. . . enrollment in state Medicaid programs grew by an

average of 5.4 percent in the previous fiscal year, the

highest rate in 6 years. . . . In eight states, the growth

exceeded 10 percent.

So States have headlines such as this: ``State Looks at $1 Billion in Cuts.'' Their Medicaid is already growing at a rate faster than they can pay for, and we are sending them more bills than they can pay for.

I will be happy to yield.

I thank the distinguished assistant Democratic leader for raising the point. It is a point I would be delighted to address.

I voted against that proposal. That proposal was a backdoor effort in what was a so-called jobs bill to spend $85 billion over 2 years for Medicaid. That is one reason why we have 10 percent unemployment today, because the money that was supposed to be for the stimulus was borrowed from the biggest deficits we have ever run up in history and spent on something other than jobs.

What it also did was it unrealistically lifted the level of Medicaid spending in Tennessee and every other State, forcing an expansion of that program, which I will go on to show in a minute is nearly cruel to the people who are dumped into the program because doctors and hospitals will not serve them.

So I was glad to vote against that program. I was sorry it passed because it borrowed money we don't have to spend on programs that didn't create jobs, and it artificially lifted and expanded Medicaid, which is already bankrupting the States.

Medicaid expansion is not real health care reform. One reason is because 40 percent--according to a 2002 Medicare Payment Advisory Committee survey--of the physicians restrict access for Medicaid patients; meaning they will not take new Medicaid patients because reimbursement rates are so low. Only about half of U.S. physicians accept new Medicaid patients compared with more than 70 percent who accept new Medicare--those are the seniors--patients.

According to a 2002 study in the Journal of American Academy of Pediatrics, the national rate for pediatricians who accept all Medicaid patients was 55 percent. In Tennessee, it was lower than that. Why is that? It is because reimbursement rates are so low. Today, doctors who see patients who are on Medicare get paid about 80 percent of what private insurers pay. Doctors who see patients who are on Medicaid get paid about 61 or 62 percent of what private insurers pay. For doctors who see children, it is sometimes lower than that. So doctors don't see those patients. What is going to happen if we dump 14 more million low- income Americans into a system such as that? Those patients--especially those children--are going to have a harder time finding doctors and hospitals to take care of them. It would be akin to giving somebody a ticket and a pat on the back to a bus line that only operated 50 percent of the time.

Further, the quality of care for Medicaid patients is significantly lower than those with private insurance and even those with no insurance. According to a survey by the National Hospital Ambulatory Medical Care, Medicaid patients visit the emergency room at nearly twice the rate of uninsured patients. A 2007 study by the Journal of the American Medical Association found that patients enrolled in Medicaid were less likely to achieve good blood pressure control, receive breast cancer screening, have timely prenatal care than similar parents in private plans, and they had lower survival rates.

I mentioned this a little earlier. According to the Government Accountability Office, Medicaid--the program we are seeking to expand, the government-run insurance program that sounds so good, the so-called largest public option plan we have to date, the plan where about half the doctors will not take new patients who are on the program--had $32.7 billion in improper payments in 2007 alone; 10 percent of the program's total spending is wasted.

So as we consider a so-called public option, I hope we will look at the public option we already have--called Medicaid--one which already has an opt-out provision for States, one which already has 60 million low-income Americans in it, one into which we plan to put 14 million more Americans, so that 50 percent of the doctors will say to new patients: I can't see you because the reimbursement rates are so low. Medicaid is the public option we have right now. States could opt out of it, but quality is low, fraud is high, costs are up, and Governors of States on both sides of the aisle are saying: We are headed toward bankruptcy at the present rate. If you are sending us more bills, if you want to expand it, pay for it. And doctors are turning away patients.

The American people deserve better than that. I am a cosponsor of a bipartisan bill that would actually reduce the number of patients on Medicaid. It is called the Wyden-Bennett bill. It adds no cost to the government. That bill is not being seriously considered.

The other approach that we Republicans believe we should take is focusing on reducing costs to the government, focus on reducing the cost of premiums; take four or five steps in the right direction and expand services to uninsured patients as we go. One way to do that, of course, would be the Small Business Health Insurance bill, which has broad support in both Houses, which would permit small businesses to come together and pool their resources. The estimates are that at least 1 million more Americans would be covered by employer insurance if that were to happen. Some estimates say many more millions.

But especially on a day when the press has it rumored that the majority leader may offer a new government-run insurance program with the States having the opportunity to opt out, I hope Americans will look carefully at the current government-run insurance program which States have the option to opt out of, but none do, and note that it has 60 million Americans--it is soon to have 74 million; half the doctors won't see new patients because of reimbursement rates; and $1 out of $10 is wasted. It is not a solution to health care and neither is a new public option.

I yield the floor and thank the Senator from Illinois for his question.

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

Mr. President, is now the time to begin the Republican part of morning business?

Mr. President, first impressions are important. Depending on one's age, we remember different things. When I was a young teenager, the first college football game was broadcast on a television network. It was Tennessee versus Alabama with Lindsey Nelson, who had gone to Tennessee, and Mel Allen, who had gone to the University of Alabama, as the announcers. There have been a lot of good football games since that time, but everyone remembers the first broadcast.

I can remember the first one-hour evening news program. I think it was ``Huntley-Brinkley'' on NBC. There have been a lot of distinguished newscasters before and since, but that was the first one-hour news program with two anchors.

I can remember watching basketball games and getting a glimpse of a coach and forming an impression of the whole university from a short glimpse. An experience we've all had is meeting someone for the first time and getting a first impression that is usually a fairly accurate impression of that person. It usually lasts a long time, and it is hard to get over a first impression.

Yesterday was the first vote on health care reform. I think the American people got a very strong first impression from that vote. What the majority leader, the Democratic leader, sought to do was add $\1/4\ trillion to the national debt on the first health care vote. The Senate said: No, we are not going to do that, even for a worthy cause, which in this case was fixing the doctors reimbursement procedure; which the Senator from Maryland just discussed and which we all agree needs to be attended to. But the Senate--all 40 Republicans, and 13 Democrats--said no, we are not going to start by adding $\1/4\ trillion to the national debt on the first vote of health care reform. Especially not at a time when we just finished a year which added $1.4 trillion to the national debt, three times as much as the year before, and as much as we added to the entire national debt in the first 200 years of the Republic.

People are very worried about the growth of the debt, and that was reflected yesterday in the first vote on health care reform. I think that reminds us of the importance of reading the bill and knowing what it costs. That also is a bipartisan approach here. All the Republicans have said we want to be able to read the bill and know what it costs before we start voting. And even though Senator Bunning's amendment, which would have allowed this, was voted down in the Finance Committee by Democrats, eight Democratic Senators wrote the Democratic leader and said: We agree; put the bill on the Internet, the complete text, for 72 hours and let's have a formal calculation of exactly what it costs before our first vote.

We had a first vote yesterday, even before we have a complete bill. Because we had a chance to read this one provision and time to think about it, we came to the right conclusion and voted it down.

In the next several months of discussion there will be many other issues such as this about how we reform health care. My view--and I think the view of most Republicans and I believe most Americans--is to reduce costs. We have to reduce the cost of health care to our government, otherwise it is going to go broke.

The President hosted a summit on entitlement spending early in the year which I was invited to it. I appreciated receiving the invitation and I attended the summit. Everybody there said if we do not control health care spending, we are going to go broke as a government. Then millions of Americans are saying: I cannot afford my own health care; 250 million of us have a health care premium we pay or someone helps us pay or some combination, and it is too expensive for individuals and for small businesses. So our goal is to reduce the cost of health care to government and reduce the cost of health care to Americans. Yet our first vote yesterday was to increase the debt, and we said no.

Let's read this bill as it comes to us. Right now it is being written behind closed doors in the majority leader's office. With such a controversial issue I am not sure that is the best way to go about writing this bill. Usually it helps to have bipartisan support in the Congress, even if you have big majorities, so that you can get broad bipartisan support in the country any time you have a complex issue.

When I was a young Senate aide in 1968, we had a very controversial issue before the Senate called the civil rights bill. Lyndon Johnson was President of the United States, and Everett Dirksen was the Republican leader sitting over where Mitch McConnell sits today. The Democratic majorities were bigger than they are today. President Johnson did not have the Democratic leader write the civil rights bill in a closed room in the Democratic leader's office. What did he do instead? He was very wise. He had it written in the Republican leader's office.

So in Senator Everett Dirksen's office for several weeks in 1968, I recall, the bill was written in the full light of day, with Senators, staff members, and hangers-on going in and out. In the end, the bill-- more difficult than this health care bill--passed. Senator Dirksen, the Republican leader, got some of the credit. He deserved it. President Johnson got what he wanted. And the country supported it because it saw, looking at Washington, DC, a broad level of support and they felt better about that.

I don't think people are going to feel as good about a bill that restructures one-sixth of our economy, that affects every single American's health, and the health care bill is being written behind closed doors, in the Democratic leader's office. We will see. But at least whatever emerges, we want to read the bill. We want the American people to be able to read the bill. And we want to know exactly what it costs before we go ahead.

For example, what is it going to do to Medicare? The Republican leader has talked about that issue. If the concept paper is any indication we know what it is going to do to Medicare. It is going to cut Medicare by $\1/2\ trillion to pay for a new entitlement program.

Some of my friends on the other side say: You are scaring seniors when you say that. It may be scaring seniors, but it is the truth. This bill, when implemented, is going to cost $1.8 trillion and $\1/2\ trillion is going to come from Medicare cuts. We are going to be cutting grandma's Medicare to spend on somebody other than grandma--a new entitlement program.

We are doing that at a time when the Medicare Program, the program that serves more than 40 million older Americans, is going broke. We need to be careful in the Senate not to overstate issues. So let's not take my word for it. The Medicare trustees say that the Medicare Program, upon which more than 40 million seniors rely, is going to run out of money between 2015 and 2017. That is not too far away. The

Medicare trustees--it is their job to watch out for these things--said:

We need timely and effective action to address Medicare

financial challenges.

I think what they are saying to us is if you are going to cut grandma's Medicare, you ought to at least spend it on grandma instead of spending it on somebody else. That is basically what we are doing. We are cutting Medicare $500 billion, and instead of spending it to strengthen the Medicare Program, the proposal is to spend it to create a new entitlement program.

What are the cuts? Nearly $140 billion in Medicare Advantage; $150 billion in cuts for hospitals that care for seniors; $40 billion for home health agencies; and $8 billion from hospices.

The President said that people who are currently signed up for Medicare Advantage are going to have Medicare at the same level of benefits. That is why we need to read the bill and know what it costs because something has been lost in translation between what the President said and what appears to actually be in the bill. The Director of the Congressional Budget Office, the nonpartisan Congressional Budget Office, said in testimony that fully half of the benefits currently provided to seniors under Medicare Advantage would disappear in the Baucus proposal. The same Baucus proposal which is being amended and written and merged with other bills behind closed doors in the Democratic leader's office. The head of the Congressional Budget Office said the changes would reduce extra benefits such as dental, vision, hearing coverage, that would be available to beneficiaries. Humana advised its customers who are Medicare Advantage beneficiaries that their benefits would be cut, causing the Obama administration to put a gag order on this large health care organization.

I made a little speech on the floor yesterday talking about the dangers of developing an enemies list, of boycotting television networks, of calling out Senators with whom you disagree, taking the names of bondholders who do not go along with the General Motors or Chrysler bailout, threatening an insurance company for switching from supporting your proposal to opposing your proposal or a large health care company that tells its customers the truth--your Medicare Advantage is going to be cut.

Another reason to read the bill is the provision that will make additional cuts to Medicare above and beyond the $500 billion that is specified. At least that is the assumption of the Congressional Budget Office when it looked over the bill and said that it was in balance, which it has turned out not to be.

The Congressional Budget Office assumed that a Medicare commission would make even more Medicare cuts. Those do not seem to be realistic assumptions. We have had a provision in law since 2003 that would provide an automatic mechanism for making Medicare cuts. Nobody has ever wanted to use it.

We saw what happened yesterday, recognizing that it was unrealistic to expect that doctors would take a 21-percent cut in their pay in a year. The Democratic leader tried to borrow $\1/4\ trillion to try to take care of that problem.

If we read the bill and now what it costs we find out that either doctors are going to pay for a big part of this new Medicare Program or seniors are going to pay for a big part of it or our grandchildren are going to pay for a big part of it by increasing the debt. The Washington Post said this was a shell game.

I think the lesson here is first impressions count. We got a good first impression yesterday of the direction of this health care bill. The proposal was: Let's borrow $\1/4\ trillion, and the Senate, in a bipartisan way, said: We are not going to do that, no. That was the correct vote.

Now we see another reason to read the bill is because we want to make sure we know what it does to Medicare. What we have seen so far is that it will cut grandma's Medicare by $\1/2\ trillion, not to spend on grandma but to spend on some somebody else, even though the Medicare Program, its trustees say, will go broke in the year 2015 to the year 2017. That is one more good reason not just to read the bill but to start over in this health care reform.

We have been saying on the Republican side for months that we should not be trying to do this comprehensive, full-of-surprises, trillion- dollar health care reform, that restructures one-sixth of our economy, in the middle of the greatest recession we have had since the 1930s. We should focus instead on reducing the costs of health care to the government and to Americans who pay for premiums, and go step by step to re-earn the trust of the American people to reduce costs. We suggested how to do that. We would start by allowing small businesses to come together, pool their resources, and offer insurance to their employees. It has been estimated that would produce at least coverage for 1 million more Americans and probably many million more Americans.

Second, we have suggested saving money by reducing the number of junk lawsuits against doctors which drive up the cost of health care.

Third, we have suggested allowing insurance to be sold across State lines. That creates more competition that should reduce costs.

We have suggested creating health insurance exchanges--many of our Democratic friends agree with that--to make it easier to shop for health care. We have suggested enrolling individuals in existing programs. There are up to 11 million people who are already eligible for programs that we now have, and that is one way to add people without increasing cost in a huge way, or creating a great new program. We have suggested incentivizing health care technology, changing tax incentives, and expanding health savings accounts. These are steps we can take to reduce costs.

It appears many of the American people agree with that Republican strategy. A new Gallup poll out yesterday said that 58 percent of Americans would generally prefer to see Congress deal with health care reform on a gradual basis--over several years--rather than to try to pass a comprehensive health care reform bill this year.

So first impressions count.

The health care debate was defined yesterday by the attempt to borrow $\1/4\ trillion to add to the debt. I am glad it failed. The health care debate, as the President himself said, is actually a proxy for a larger debate about the role of our Federal Government in American life. Increasingly, Americans are skeptical of this comprehensive trillion-dollar-plus, full-of-surprises proposal that is being written in the back room approach. Instead they hope we will focus clearly on reducing the cost of health care premiums, reducing the cost to our government, and then going step by step in the right direction to make health care affordable for all Americans.

I thank the Chair, and I yield the floor.

Mr. President, in 1969 and during the first half of 1970, I was a wet-behind-the-ears, 29-year-old staff aide in the West Wing of the Nixon White House. I was working for the wisest man in that White House whose name was Bryce Harlow. He was a friend of President Johnson, as well as the favorite staff member of President Eisenhower and President Nixon's first appointee.

Based upon that experience and my 40 years since then in and out of public life, I want to make what I hope will be taken as a friendly suggestion to President Obama and his White House, and it is this: Don't create an enemies list.

As I was leaving the White House in 1970, Mr. Harlow was heading out on the campaign plane with Vice President Spiro Agnew, whose job was to vilify Democrats and to help elect Republicans. The Vice President had the help of talented young speechwriters, the late Bill Safire and Pat Buchanan. In Memphis, he called Albert Gore, Sr., the ``southern regional chairman of the eastern liberal establishment,'' and then the Vice President labeled the increasingly negative news media as ``nattering nabobs of negativism.''

These phrases have become part of our political lore. They began playfully enough, in the back and forth of political election combat. But after I had come home to Tennessee, they escalated into something more. They eventually emerged into the Nixon's enemies list.

In 1971, Chuck Colson, who was then a member of President Nixon's staff and today is admired for his decades of selfless work in prison reform, presented to John Dean, the White House Counsel, a list of what he called ``persons known to be active in their opposition to our administration.'' Mr. Dean said he thought the administration should ``maximize our incumbency . . . [or] to put it more bluntly''--and I am using his quotes--``use the available Federal machinery to screw our political enemies.''

On Colson's list of 20 people were CBS correspondent Dan Schorr, Washington Star columnist Mary McGrory, Leonard Woodcock, the head of the United Auto Workers, John Conyers, a Democratic Congressman from Michigan, Edwin Guthman, managing editor of the Los Angeles Times, and several prominent businessmen, such as Howard Stein of the Dreyfus Corporation, Arnold Picker, vice president of United Artists. The New York Times and the Washington Post were made out to be enemies of the Republic.

Make no mistake, politics was not such a gentlemanly affair in those days either. After Barry Goldwater won the Presidential nomination in 1964, Daniel Schorr had told CBS viewers that Goldwater had ``travel[led] to Germany to join up with the right wing there'' and ``visit[ed] Hitler's old stomping ground.'' Schorr later corrected that on the air. What was different about Colson and Dean's effort, though, was the open declaration of war upon anyone who seemed to disagree with administration policies. Colson later expanded his list to include hundreds of people, including Joe Namath, John Lennon, Carol Channing, Gregory Peck, the St. Louis Post-Dispatch, Congressional Black Caucus, Alabama Governor George Wallace. All this came out during the Watergate hearings. You could see an administration spiraling downwards, and, of course, we all know where that led.

The only reason I mention this is because I have an uneasy feeling only 10 months into this new administration that we are beginning to see the symptoms of this same kind of animus developing in the Obama administration.

According to Politico, the White House plans to ``neuter the United States Chamber of Commerce,'' an organization with members in almost every major community in America. The chamber had supported the President's stimulus package and defended some of his early appointments, but has problems with his health care and climate change proposals.

The Department of Health and Human Services imposed a gag order on a large health care company, Humana, that had warned its Medicare Advantage customers that their benefits might be reduced in Democratic health care proposals--a piece of information that is perfectly true. This gag order was lifted only after the Republican leader, Senator McConnell of Kentucky, said he would block any future nominees to the Department until the matter was righted.

The White House communications director recently announced that the administration would treat a major television network, FOX News, as ``part of

the opposition.'' On Sunday, White House officials were all over talk shows urging other news organizations to boycott Fox and not pick up any of its stories. Those stories, for example, would include the video that two amateur filmmakers made of ACORN representatives explaining how to open a brothel. That is a story other media managed to ignore until almost a week after Congress decided to cut ACORN's funding.

The President himself has not stopped blaming banks and investment houses for the financial meltdown, even as it has become clear that Congress played a huge role, too, by encouraging Americans to borrow money for houses they could not afford. The President was ``taking names'' of bondholders who resisted the General Motors and Chrysler bailouts. Insurance companies, once allies of the Obama health care proposal, have suddenly become the source of all of its problems because they pointed out--again correctly--that if Congress taxes insurance premiums and restricts coverage to those who are sicker and older, the cost of premiums for millions of Americans is likely to go up instead of down. Because of that insubordination, the President and his allies have threatened to take away the insurance companies' antitrust exemption.

Even those in Congress have found ourselves in the crosshairs. The assistant Republican leader, Senator Jon Kyl of Arizona, said to ABC's George Stephanopoulos that the stimulus plan wasn't working. The White House wrote the Governor of Arizona and said: If you don't want the money, we won't send it. Senator McCain said this could be perceived as a threat to the people of Arizona.

Senator Bennett of Utah, Senator Collins, Senator Hutchison and I, as well as Democratic Senators Byrd and Feingold, all have questioned the number and power of 18 new White House czars who are not confirmed by the Senate. We have suggested this is a threat to constitutional checks and balances. The White House refused to send anyone to testify at congressional hearings.

Senator Bennett and I found ourselves ``called out,'' as they say, on the White House blog by the President's communications director.

Even the President, in his address to Congress on health care, threatened to ``call out'' Members of Congress who disagree with him.

This behavior is typical of street brawls and political campaign consultants. It is a mistake for the President of the United States and for the White House staff. If the President and his top aides treat people with different views as enemies instead of listening to what they have to say, they are likely to end up with a narrow view and a feeling that the whole world is out to get them. And, as those of us who served in the Nixon administration know, that can get you into a lot of trouble.

This administration is only 10 months old. It is not too late to take a different approach, both at the White House and in Congress. And here is one opportunity: At the beginning of the year, shortly after the President's inauguration, the Republican leader, Senator McConnell, addressed the National Press Club. He proposed that he and the President work together to make Social Security solvent.

Senator McConnell said he would make sure the President got more support in that effort from Republicans than President George W. Bush got from Democrats when he tried to solve the same problem.

President Obama held a summit on the dangers of runaway costs of entitlements. I was invited and attended. Every expert there said making Social Security solvent is essential to our country's fiscal stability. There is still time to get that done.

Or on clean energy, Republicans have put forward four ideas--build 100 nuclear plants in 20 years, electrify half our cars and trucks in 20 years, explore offshore for low-carbon natural gas and for oil, and double energy research and development for alternative fuels. The administration agrees with this on electric cars and on research and development. We may not be so far apart on offshore exploration. At his town meeting in New Orleans last week, the President said the United States would be, in his words, ``stupid'' not to use nuclear power. He is right since nuclear power produces 70 percent of our carbon-free electricity.

So why don't we work together on this lower cost way to address clean energy and climate change instead of enacting a national energy tax?

On health care, the White House idea of bipartisanship has been akin to that of a marksman at a State fair shooting gallery: hit one target and you win the prize. With such big Democratic majorities, the White House figures all it needs to do is unify the Democrats and pick off one or two Republicans. That strategy may win the prize but lose the country.

Usually on complex issues, the President needs bipartisan support in Congress to reassure and achieve broad and lasting support in the country.

In 1968, I can remember when President Johnson, then with bigger majorities in Congress than President Obama has today, arranged for the civil rights bill to be written in open sessions over several weeks in the office of the Republican leader, Everett Dirksen. Dirksen got some of the credit; Johnson got the legislation he wanted; the country went along with it. Instead of comprehensive health care that raises premiums and increases the debt, why should the White House not work with Republicans step by step to reduce health care costs and then, as we can afford it, reduce the number of Americans who do not have access to health care?

The President and his Education Secretary Arne Duncan have been courageous--there is no better word for it--in advocating paying teachers more for teaching well and expanding the number of charter schools. These ideas are the Holy Grail for school reform. They are also ideas that are anathema to the labor unions who support the President. President Obama's advocacy of master teachers and charter schools could be the domestic equivalent of President Nixon going to China. I, among others, admire that advocacy and have been doing all I can to help him.

Having once been there, I can understand how those in the White House feel oppressed by those with whom they disagree; how they feel besieged by some of the media. I hope the current White House occupants will understand that this is nothing new in American politics--all the way back to the days when John Adams and Thomas Jefferson exchanged insults. The only thing new is today there are multiple media outlets reporting and encouraging the insults 24 hours a day.

As any veteran of the Nixon White House can attest, we have been down this road before, and it will not end well. An enemies list only denigrates the Presidency and the Republic itself.

Forty years ago, Bryce Harlow would say to me: Now, Lamar, remember that our job here is to push all the merely important issues out of the White House so the President can deal with a handful of issues that are truly Presidential. Then he would slip off for a private meeting in the Capitol with Democratic leaders who controlled the Congress and usually found a way to enact the President's proposals.

Most successful leaders have eventually seen the wisdom of Lord Palmerston, former Prime Minister of the United Kingdom, who said:

We have no eternal allies, and we have no perpetual

enemies.

The British writer Edward Dicey was once introduced to President Lincoln as ``one of his enemies.'' ``I did not know I had any enemies,'' Lincoln answered. And Dicey later wrote: ``I can still feel, as I write, the grip of that great bony hand held out to me in token of friendship.''

In conclusion, here is my point. These are unusually difficult times, with plenty of forces encouraging us to disagree. Let's not start calling people out and compiling an enemies list. Let's push the street brawling out of the White House and work together on the truly Presidential issues--creating jobs, reducing health care costs, reducing the debt, creating clean energy.

That is a word I had not thought of. What I am seeing is some of the same signs I saw as a young man in the early stages of the Nixon administration. I am seeing those same signs in the Obama White House, and I am suggesting that going down that road leads to no good end. ``Nixifying'' is an interesting way to describe it.

I think it will. That is good.

Mr. President, how much time is remaining on the Republican side?

Mr. President, I ask unanimous consent to speak in morning business.

Mr. President, after a lot of serious debate and discussion, we apparently are about to come to the point where we have our first vote on health care reform.

What is it the Democrats--those on the other side--propose we do? Add one-quarter of a trillion dollars to the national debt. I thought this debate was supposed to be about reducing costs--reducing costs to the government and reducing costs to individuals across this country who cannot afford to pay for health care insurance. And then, as we find ways to reduce the costs of what we are doing, we can begin to expand health care coverage to the Americans who do not have insurance. But it is as big a problem--or bigger--today that those who do have health care insurance--and that is about 250 million of us out of 300 million--that many Americans cannot afford their health care.

So our focus is, I thought, on cost. How do we reduce costs to the government and costs to the American people? What we see is that the very first vote on health care reform will be on a proposal to increase the debt by $247 billion over 10 years in order to pay for Medicare doctors reimbursements. This is not the insurance companies talking. This is not the Republicans talking. This is not one news commentator talking. This is the proposal by the Democratic side, that the first vote will be to increase the debt by a quarter of a trillion dollars.

I wish to talk for a few minutes about this bill as we see it. Here we are supposed to be having legislation to reduce the costs to the government, and we apparently are going to, as the first step in the wrong direction, add a quarter of a trillion dollars to the government. The second thing we are trying to do is to reduce your costs--the costs that each of us pays for our health care insurance. The outlines of the bill we see coming through the Congress would actually increase premiums.

I would ask the American people and ask my colleagues: If our goal is to reduce costs--and we are adding to the debt and increasing premiums instead of reducing premiums and reducing the debt--why are we doing this?

Let me start first with adding a quarter of a trillion dollars to the debt. Here is what the proposal would be. You will remember a few days ago there was a great deal of congratulations when the Finance Committee finished a lot of hard work, and they said: This is a deficit-neutral bill. It doesn't add anything to the debt. That is what the Congressional Budget Office said based on a series of assumptions. That is something to be proud of because the President himself has said he won't sign a piece of legislation that adds one dime to the debt, and then he added to that, ``and I mean it,'' like a parent who wanted to make sure he was being heard by unruly Members of Congress.

I am glad he said that. I heard him say it earlier in the year when he had a summit on the condition of the Federal budget. Democrats and Republicans--we all went down to the White House. People came in and said: If we don't do something about the increasing debt in our country, our children and grandchildren aren't going to have a country. That was not overstating it. Everyone at the President's summit agreed that the principal cause of runaway debt in America is health care. It is Medicare and Medicaid.

Just these past few days--here is the weekend newspaper in Tennessee. This is the Nashville Tennessean on Saturday: ``Deficit leaps to $1.4 trillion.'' I think most Americans--I know at least most Tennesseans-- are deeply concerned about this. But lest you think a Republican Senator is exaggerating the problem, let me just read a few paragraphs from the Associated Press story:

Deficit leaps to $1.4 trillion. Economists warn of crisis

if U.S. fails to act.

This is an Associated Press story.

What is $1.42 trillion? It's the federal budget deficit for

2009, more than three times the most red ink ever amassed in

a single year.

It's more than the total national debt for the first 200

years of the Republic, more than the entire economy of India,

almost as much as Canada's, and more than $4,700 for every

man, woman and child in the United States.

Yet the first proposal, the first vote on health care is going to be to add to that debt.

The Associated Press article continues:

As a percentage of U.S. economic output, it is the biggest

deficit since World War II. And, some economists warn, unless

the government makes hard decisions to cut spending or raise

taxes, it could be the seeds of another economic crisis.

Yet the first vote on the health care reform bill will be to add a quarter of a trillion dollars over the next 10 years to the national debt.

Quote:

``The rudderless U.S. fiscal policy is the biggest long-

term risk to the U.S. economy,'' said Kenneth Rogoff, a

Harvard professor and former chief economist for the

International Monetary Fund.

Quote:

``As we accumulate more and more debt, we leave ourselves

very vulnerable.''

Yet the first vote that is proposed on the health care reform bill is to add a quarter of a trillion dollars to the national debt. This seems unbelievable.

I ask unanimous consent to have printed in the Record following my remarks the article by the Associated Press from the National Tennessean of last Saturday.

Mr. President, the issue at hand is something with which we are all very familiar. It is called the doctors reimbursement problem. When the 40 million seniors on Medicare go to see a doctor, the doctor is paid at a rate set by the government. That rate is only about 80 percent of what the doctor would be paid if the doctor was seeing a person with private health care insurance.

There is a complicated formula in the law that says those doctor payments will go down over the next several years--by as much as 25 percent over the next 2 years. The Congressional Budget Office has estimated that over the next 10 years, just to pay physicians the same they are being paid today, which I don't think very many physicians would be happy with, will cost $247 billion more than is accounted for in the Baucus bill that came out of the Finance Committee. So they just assumed it wouldn't be paid to physicians and the doctors would be, in effect, paying for the health care bill.

Well, suddenly some people on the other side of the aisle said: Oh, we can't do that, so we will just separate it from the health care debate. Actually, I think they have done us all a favor because they have made it the first vote on the health care reform bill. So we will have a chance to vote up or down on whether we want to add a quarter of a trillion dollars to the national debt. My experience in life is that most people remember their first impression, and if their first impression of voting on the health care reform bill is that the Congress starts off by just brazenly adding a quarter of a trillion dollars to the national debt at a time when the deficit has just leaped to $1.4 trillion in 1 year, then I think the American people will have a pretty good idea of what we are about here.

I think the President doesn't--I can't imagine him wanting this, based upon his saying, ``I will not sign health care reform that adds even one dime to our deficit.'' And this is part of health care reform, make no mistake about that. This is part of the bill. It is part of the problem. We are looking at health care over the next 10 years. That is the way our budget cycles work. Everyone is scoring it or estimating its costs based upon what it costs over the next 10 years. To pay doctors 10 years from now what they are being paid today--which I doubt many doctors would be very happy with--will cost $247 billion.

So instead of saying, let's find ways to cut other programs or raise taxes, we say, let's add a quarter of a trillion dollars to the debt. Adding a quarter of a trillion dollars to the national debt as the first step in the health care reform debate is the first step in the wrong direction. Of course we need to fix the problem of doctors reimbursement. It needs to be a part of what we do this year in health care reform. But just as with other parts of health care reform, we don't add to the debt to do that. At least that is what the President has said. At least that is what Republicans have said. And at least that is what the American people are saying at a time when the debt goes up and up and up.

The next problem is that not only is the cost to the government going up and our first vote on health care reform about to be to add to the debt, the outlines of the bill we are seeing increases premiums.

Over the weekend, the President said: Well, it is those mean old insurance companies trying to mislead you.

You don't have to be an insurance company to understand that the premiums are likely to go up. In the first place, the Finance Committee reduced the penalty you pay if you don't buy insurance to a level that will cause a lot of people not to buy insurance--at least that is the estimate of many--and if younger people especially don't buy insurance, the pool of people who do buy insurance gets smaller and the people in that pool find their premiums going up.

No. 2, the bill says--the outlines of the bill; of course we don't really have a bill. We will have a bill within the next several weeks, I imagine, or maybe several days. The bill says it is going to make it more expensive for my sons--one who is 30 and one is 40--to buy insurance and closer to what it costs for me. Right now across the country, I might pay eight times as much for my insurance as younger people do, but under this law it is going to say: We don't like that big gap between younger people and older people, so it might have to be two to one or three to one. Basically, it raises the cost of insurance for young people as a way of reducing it for older people. That means the premiums of younger people will go up, and it also means they may elect to get out of the system, make the pool smaller, and as a result of that, all premiums would go up.

No. 3, there is a provision in the law that says you must buy in many cases a government-approved health care insurance. Many people choose a high-deductible insurance where you only buy insurance for the big problems you know you can't afford and you pay less for your monthly premiums that way. A government-approved insurance policy might make it not as easy for you to do that. One estimate in Tennessee is that the cost for one of these high deductible plans would go from $50 a month to $400 a month--a big increase for those who buy high-deductible insurance policies. That is the third way your premium might go up.

Then the fourth way and final way, in addition to this concept we see coming from the Finance Committee that your premiums might go up, is there are $955 billion in new taxes. They say that is if we are taking a 10-year period after the program is fully implemented. They say: Well, those are taxes on other people. But they are taxes on your insurance company, taxes on the person you buy a medical device from, taxes on other people in the health care industry. What do you suppose companies do in any area that get additional taxes? For the most part, they pass those taxes on to you.

So there have been a number of independent observers who have said that because the individual mandate has been weakened, because young people are going to have to pay more for their insurance as compared to older people, because the government-approved policy is not going to allow so many high-deductible policies that many Americans like, and because nearly $1 trillion in taxes is eventually going to be over 10 years passed on to people who buy insurance, for all of those reasons, premiums are likely to go up.

So we are about to begin the debate on this floor on health care reform. It is one we need. What Republicans believe--and I see my friend from Delaware who I gather wishes to speak, and I will wind up so he can. But here is what we should do. We need health care reform, but health care reform is first and foremost about reducing costs, first to the government and next to individuals. To re-earn the trust of the American people on this score, we should start step by step with specific proposals that reduce costs; for example, allowing small businesses to pool their resources and offer insurance to their employees. Our own committees have estimated that this could add millions of people to the insured rolls. Second, reduce junk lawsuits that drive up costs. We disagree about how much it drives up the cost of insurance, but we don't disagree that it does. Third, allow people to buy insurance across State lines. That would create more competition. Fourth, create more

health insurance exchanges so people can shop and find more different kinds of policies. Fifth, most all of us agree we need to encourage more health information technology and make health care simpler in that way. Perhaps we could even agree to change the tax incentives so that they don't all go to one group of people and are not going to lower and middle-income people.

There are four or five or six or seven ideas we could go step by step with to reduce costs. If we did that, we would be moving in the right direction. It is the wrong direction to start the health care debate with a vote that adds a quarter of a trillion dollars to the national debt at a time when we just added $1.4 trillion to the national debt in the past year. Of course we need to fix the doctors reimbursement, but it needs to be paid for by--it can't be added to the debt.

Whatever steps we take ought not just reduce the cost to the government; they need to reduce the costs to Americans, all of us who have health care insurance. Let's find ways to go step by step to reduce costs to the government and to reduce costs to premium holders and not start off by adding a quarter of a trillion dollars to the national debt.

Exhibit 1

[From the Tennessean]

Deficit Leaps to $1.4 Trillion

(By Martin Crutsinger)

Washington.--What is $1.42 trillion? It's the federal

budget deficit for 2009, more than three times the most red

ink ever amassed in a single year.

It's more than the total national debt for the first 200

years of the republic, more than the entire economy of India,

almost as much as Canada's, and more than $4,700 for every

man, woman and child in the United States.

As a percentage of U.S. economic output, it's the biggest

deficit since World War II.

And, some economists warn, unless the government makes hard

decisions to cut spending or raise taxes, it could be the

seeds of another economic crisis.

Treasury figures released Friday showed that the government

spent $46.6 billion more in September than it took in, a

month that normally records a surplus. That boosted the

shortfall for the full fiscal year ending Sept. 30 to $1.42

trillion. The previous year's deficit was $459 billion.

``The rudderless U.S. fiscal policy is the biggest long-

term risk to the U.S. economy,'' says Kenneth Rogoff, a

Harvard professor and former chief economist for the

International Monetary Fund. ``As we accumulate more and more

debt, we leave ourselves very vulnerable.''

Forecasts of more red ink mean the federal government is

heading toward spending 15 percent of its money by 2019 just

to pay interest on the debt, up from 5 percent this fiscal

year.

President Barack Obama has pledged to reduce the deficit

once the Great Recession ends and the unemployment rate

starts falling, but economists worry that the government

lacks the will to make the hard political choices to get

control of the imbalances.

Friday's report showed that the government paid $190

billion in interest over the last 12 months on Treasury

securities sold to finance the federal debt. Experts say this

tab could quadruple in a decade as the size of the

government's total debt rises to $17.1 trillion by 2019.

Without significant budget cuts, that would crowd out

government spending in such areas as transportation, law

enforcement and education. Already, interest on the debt is

the third-largest category of government spending, after the

government's popular entitlement programs, including Social

Security and Medicare, and the military.

As the biggest borrower in the world, the government has

been the prime beneficiary of today's record low interest

rates. The new budget report showed that interest payments

fell by $62 billion this year even as the debt was soaring.

Yields on three-month Treasury bills, sold every week by the

Treasury to raise fresh cash to pay for maturing government

debt, are now at 0.065 percent while six-month bills have

fallen to 0.150 percent, the lowest ever in a half-century of

selling these bills on a weekly basis.

The risk is that any significant increase in the rates at

Treasury auctions could send the government's interest

expenses soaring. That could happen several ways--higher

inflation could push the Federal Reserve to increase the

short-term interest rates it controls, or the dollar could

slump in value, or a combination of both.

Spending likely to increase

The Congressional Budget Office projects that the nation's

debt held by investors both at home and abroad will increase

by $9.1 trillion over the next decade, pushing the total to

$17.1 trillion under Obama's spending plans.

The biggest factor behind this increase is the anticipated

surge in government spending when the baby boomers retire and

start receiving Social Security and Medicare benefits. Also

contributing will be Obama's plans to extend the Bush tax

cuts for everyone except the wealthy.

The $1.42 trillion deficit for 2009--which was less than

the $1.75 trillion that Obama had projected in February--

includes the cost of the government's financial sector

bailout and the economic stimulus program passed in February.

Individual and corporate income taxes dwindled as a result of

the recession. Coupled with the impact of the Bush tax cuts

earlier in the decade, tax revenues fell 16.6 percent, the

biggest decline since 1932.

Immense as it was, many economists say the 2009 deficit was

necessary to fight the financial crisis. But analysts worry

about the long-term trajectory.

The administration estimates that government debt will

reach 76.5 percent of gross domestic product--the value of

all goods and services produced in the United States--in

2019. It stood at 41 percent of GDP last year. The record was

113 percent of GDP in 1945.

Much of that debt is in foreign hands. China holds the

most--more than $800 billion. In all, investors--domestic and

foreign--hold close to $8 trillion in what is called publicly

held debt. There is an additional $4.4 trillion in government

debt that is not held by investors but owed by the government

to itself in the Social Security and other trust funds.

Inflation is a threat

The CBO's 10-year deficit projections already have raised

alarms among big investors such as the Chinese. If those

investors started dumping their holdings, or even buying

fewer U.S. Treasurys, the dollar's value could drop. The

government would have to start paying higher interest rates

to try to attract investors and bolster the dollar.

A lower dollar would cause prices of imported goods to

rise. Inflation would surge. And higher interest rates would

force consumers and companies to pay more to borrow to buy a

house or a car or expand their business.

Most economists say we have time before any crisis hits. In

part, that's because the recession has erased worries about

inflation for now. In its effort to stimulate the economy,

the Fed cut a key interest rate to a record low last December

and is expected to keep it there possibly through all of next

year. Demand for loans by businesses and consumers is so weak

that low rates are not seen as a recipe for inflation.

Robert Reischauer, a former head of CBO, said that in an

optimum scenario, Congress will tackle the deficits next

year. A package of tax increases and spending cuts could be

phased in starting in 2013 and gradually grow over the next

decade.

I thank the President, and I yield the floor.

Madam President, I congratulate the Senator from Arizona for identifying so well, among other things, how Republicans would like to approach the health care reform costs. We want to reduce costs for individuals who are buying insurance, and we want to reduce the cost of our government. Rather than a comprehensive 1,000-page, trillion-dollar bill filled with surprises, we prefer to go step by step in the right direction; that is, reducing costs.

The Senator from Arizona has mentioned ways to do that. Whether it is allowing small businesses to pool their resources, which could add millions of people to the rolls of the insured in the country, whether it is reducing junk lawsuits against doctors, whether it is allowing for the buying of insurance across State lines or health insurance exchanges or using health information technology, we can take steps in the right direction to regain the trust of the American people and move toward reducing costs.

The Senator also did a very clear job of pointing out how the Baucus bill may actually increase costs. There has been a lot of squirming around on the other side because it has been suggested that instead of premiums going down--which is the whole point of this exercise, reducing costs--they might go up. I would like to talk about that a little bit today.

Premiums, your premiums--and let's talk about who the ``you'' is. We have about 170 million Americans who have employer-based insurance, and we have a total of about 250 million Americans--that is most of us--who have some kind of insurance premium that either we pay or is paid for us. I think our goal is to make it easier to afford those premiums; in other words, to reduce costs. But the Baucus bill, in at least four ways, increases costs, and raises premiums.

One way is it reduces the penalty for individuals and families who are required to buy insurance so they might not buy insurance, and if the young and healthy go out of the insurance pool, premiums of everybody who is in the insurance pool go up.

No. 2, the Baucus bill will say--and so do the other bills the Democrats have presented--that my children, who pay lower premiums than I do, will have higher premiums because under the law there can't be as much difference between what an older person pays and what a younger person pays. So for most young Americans who buy insurance--and in this case they will be required to buy insurance or pay a penalty, so their premiums go up.

There is a third reason premiums go up. Premiums will go up because, when you buy insurance, you don't just get to buy any kind of insurance; you buy a government-approved, basic policy. It sounds like a little more Washington takeover to me. When you go out to buy your government-approved, basic policy, what you will find under this bill is that for millions of Americans, it will cost you more. Your premiums will go up. There are a great many Americans who make the sensible decision of buying a high deductible policy. They say: I will pay most of my health care costs up to a point, but I will buy the insurance for the catastrophe in my life that I could never afford. Well, those policies will not be as available.

Then, finally, there are going to be $955 billion in new taxes. The bill is very careful about not placing them directly on you; it puts them on everybody you buy things from. It puts them

on people from whom you buy your medical devices; it puts them on people from whom you buy your health insurance. We all know what will happen when we put taxes on people from whom we buy things. If we put taxes on oil companies, what happens? They pass it on to us at the gas pump. If you put taxes on all these health care services, what happens? Our insurance premiums go up.

So one does not have to be an actuary to figure this out. If the individual mandate penalty is weaker, premiums go up. If young people can't buy cheaper policies--cheaper than mine if there is a rule--their premiums go up. If we all have to buy government-approved policies, or most of us do, that are richer than what many of us want to buy today, our premiums go up. If we have $955 billion in new taxes when the bill is fully implemented, most of which are passed along to us, our premiums go up.

So I would ask this question: What is this exercise all about? I thought it was about reducing costs. I thought it was about lowering the cost of our insurance premiums. But it looks as though it will increase the cost of our insurance premiums and, if that is true, we ought to reject this bill for that one reason alone. Of course, we haven't even seen the bill. It is not written yet. It has to be combined by the majority leader in a dark office somewhere and then we will see it. But that is what we should be looking for.

It is often said that--that is another reason why the Republican idea of a step-by-step approach to reduce costs makes a lot more sense than these big, comprehensive, 1,000-page, $1 trillion bills. We want to reduce the cost of insurance, but we don't want to pass a bill that raises premiums to do that.

It has been said there is not much bipartisanship.

Madam President, I hope you will please let me know when I have consumed 9 minutes.

Again, it has been said there is not much bipartisanship in this debate. That is not true. There has been a partisan rejection of a bipartisan bill. Fourteen of us signed up on the bill which Senator Wyden, a Democrat, and Senator Bennett, a Republican, offered.

There is another option the various committees had. It didn't increase the debt a penny. It gave people more choices. It didn't have a new government program. It had a lot of good principles in it, but that was rejected. That didn't get the time of day, no more than the Republican step-by-step proposals, but there are other bipartisan efforts other than Wyden-Bennett. There is the Reid amendment offered by the majority leader. He became concerned about how the Baucus bill was going to transfer to the State of Nevada big, new Medicaid costs that might result in new taxes. Every single Governor in the country is concerned about that, Democratic or Republican. So the majority leader fixed the problem for Nevada and three other States. We will call that the Reid amendment and when this bill comes to the floor we are going to introduce a Reid amendment and we are all going to support it because we want it for Texas, we want it for South Dakota, we want it for New York, we want it for California. If the Federal Government is going to expand Medicaid, the Federal Government needs to pay for the Medicaid expansion and not send it to the States. So that will be a bipartisan step.

Then there is another bipartisan step, and that was from eight Democratic Senators who wrote in and said: We want to be able to read the bill and know what it costs before we start voting on it. All 40 of us agree with that on the Republican side and we believe that is the right thing to do: Put it on the Internet for 72 hours. Senator Bunning has offered an amendment for that. That now has bipartisan support.

That means, when this bill is finally written--it is not a bill yet-- when it comes out of the back rooms, it will at least be on the Internet for 72 hours. Then we will need to have a complete fiscal estimate. That ought to take a couple or 3 weeks. Then we need to come to the floor and debate it because we need to know: Are your premiums going up or down? Are taxes going up or down? What about these Medicare cuts: $500 billion in Medicare cuts not spent to restore Medicare but for a new government program, I think. My point is, there are a number of questions that need to be answered.

Let me conclude in this way: We have a bipartisan approach. We want to read the bill and know what it costs. Enough of us do that, so I think we will do that, and we will have at least as good a debate as we did on the farm bill. That took a month. The Energy bill took 2 or 3 months. This is one-sixth of the economy, and we will need several weeks to talk. What will we be talking about? We will be talking about--at least I will be talking about--whether this bill is reform; whether it will reduce costs, and whether it will raise your premiums or lower your premiums. If it weakens the individual mandate; if it says young people can't buy inexpensive policies anymore; if it says millions of us have to buy government-approved, richer policies instead of policies with high deductibles; and if it imposes $955 billion of taxes that will be passed on, raising our premiums; if it raises our premiums instead of lowering our premiums, then why are we doing this?

That is not health care reform. That is not reducing costs. We should instead take the Republican approach and go step by step to reduce costs starting with small business health care plans, reducing junk lawsuits, allowing insurance to be sold across State lines, creating health insurance exchanges, implementing health information technology, and changing tax incentives.

I yield the floor.

Mr. President, the Senator from Oklahoma, a practicing physician who has delivered hundreds or thousands of babies----

Thousands of babies is one of the most eloquent spokesmen for what needs to be done in health care in the Senate. I am delighted he took time to come to the Senate floor today. It helps to have someone here who has such a passion for patients and who can talk to the American people on this complicated subject in terms of what this health care plan means for us. That is why so many of us on the Republican side agree with what eight Democratic Senators wrote to the majority leader the other day.

They said: We would like to read the bill and know what it costs before we start voting on it. That seems so sensible that maybe the American people would laugh out loud if that would be a request, but it is. It is important to us and them and many more of the Senators--I believe virtually all of the American people--that we honor that request.

What that means is that the legislative text being put together by Majority Leader Reid somewhere--the merging of the Finance bill and the HELP bill--that full text, and as the Democratic Senator said, the complete budget scores should be made available for 72 hours on the Internet before we begin to vote.

The Director of the Budget Office has said it might take 2 weeks, 3 weeks, to have complete budget scores so we can know what the bill costs. But if it takes 2 weeks, if it takes 3 weeks, if it takes 4 weeks, we need to know. The President has said we cannot add a dime to the deficit. How are we going to know if we are adding a dime to the deficit if we do not read the bill and do not know what it costs? We cannot guess what is in the bill. We cannot guess at what it costs when we are talking about huge numbers--hundreds of billions, trillions of dollars.

We have our work cut out for us. We can stay here and do this. We are prepared to do this. We Republicans agree with the Democratic Senators that we need to read the bill and know what it costs. We need to see the complete legislative text and the complete budget numbers.

Why is that so important? Among other reasons, what we are hearing is that what the bill coming out of the Finance Committee does is, among other things, three big things. Instead of reducing costs, it has higher premiums, it has higher taxes, and it has Medicare cuts. That is not health care reform if it has higher premiums, higher taxes, and Medicare cuts for more government.

What is the goal of this exercise? The first goal is reducing costs for each person who buys insurance. How many of us go home and hear that every weekend? I cannot afford my insurance; do something about it. Reducing costs.

What else do we hear? People are saying: I cannot afford my government. You guys are running up the debt trillions of dollars, hundreds of billions of dollars.

What we need to do is to reduce the cost of health care for individuals across America and for the government of individuals. But this bill raises premiums, raises taxes, and cuts Medicare to create more government.

How does it drive up premiums? The Congressional Budget Office has said the obvious, which is that when we impose taxes on medical devices and on the insurance companies, what do they do with it? It is $900 billion-plus worth of taxes. They pass it on to us. So our premiums go up.

Or there are new ``government approved'' policies that we will need to buy. If you are one of those Americans who likes to buy a catastrophic policy--that is, pay a lower premium so that you pay your own medical expenses unless something really terrible happens to you or your family--that is a pretty wise choice for many Americans. You may not be able to do that quite so easily under this bill because you will have to buy a government-approved plan or pay a fine. And then younger Americans may be surprised by the amount of money they have to pay. So it is very likely that for millions of Americans this bill will raise their premiums instead of reducing their cost, and 250 million Americans either pay premiums or have premiums paid for them.

Then raising taxes. Here we are in the middle of a recession, 10 percent unemployment, and we are talking about nearly $1 trillion of tax increases that will be passed on to us in one way or the other. There is a $1,500 penalty per family if you don't buy insurance. There is an employer mandate. So if you are a small business, you will have to either provide insurance or pay that penalty.

Then the governors of both parties--Democrats and Republicans--are in a near cardiac arrest over the prospect of the Medicaid expansion. I mean 14 million new people--low-income Americans--dumped into State Medicaid Programs. I say ``dumped'' because doctors and hospitals are reimbursed so poorly that only 40 percent of doctors will see Medicaid patients. So we are going to say: Congratulations, Mr. and Ms. Low- Income American, into the Medicaid you go in your State.

Not only is it not health care reform for those individuals, but the governors can't manage it, the legislators can't manage it, and the taxpayers can't manage it. I have read, on the floor, comments from most Democratic Governors and most Republican Governors. They are in a situation where their States' budgets are in the worst shape since the 1960s. Medicaid is going up at 6 and 7 percent. They are taking money from higher education and K-12 grades and spending it on Medicaid, and now we are about to dump not only more low-income Americans into Medicaid, but we are going to send a part of the bill to the State governments which can't afford it. So that is State taxes, and it cuts your Medicare.

The question I would like to raise is, what about those Medicare cuts and are doctors themselves going to be paying for this bill? There is an article today, or October 13, the former head of the Congressional Budget Office, Douglas Holtz-Eakin. These Congressional Budget Office heads are known to be pretty straight. This one was appointed by the Republican Congress; Mr. Elmendorf, whom we all respect, was appointed by a Democratic Congress, but they are all nonpartisan. Mr. Holtz-Eakin says:

. . . the plan proposed by the Democrats and the Obama

administration would not only fail to reduce the cost burden

on middle-class families, it would make that burden

significantly worse. The bill creates a new health

entitlement program that the Congressional Budget Office

estimates will grow over the longer term at a rate of 8

percent annually. To avoid the fate of the House bill . . .

the Senate did three things: It promised that future

Congresses would make tough choices to slow entitlement

spending, and it dropped the hammer on the middle class.

Mr. President, could you let me know when I have consumed 10 minutes?

I thank the Chair.

Here is what Mr. Holtz-Eakin said:

One inconvenient truth is the fact that Congress will not

allow doctors to suffer a 24 percent cut in their Medicare

reimbursements.

Doctors today are paid about 80 percent of what private insurers will pay if they see Medicare patients and, under the law, that gets cut every year and every year we come in and fix that. Continuing to read from his article:

Senate Democrats chose to ignore this reality and rely on

the promise of a cut to make their bill add up. Taking note

of this fact pushes the cost of the bill well over $1

trillion and destroys any pretense of budget balance.

In other words, Mr. Holtz-Eakin is saying he doesn't believe we in Congress are going to cut doctors' pay when they serve Medicare patients by roughly $250 billion over the next 10 years. That is about the amount of money it would take just to pay doctors 10 years from now what they are being paid today, and most wouldn't be happy with that. So either the doctors are going to pay for this bill--$250 billion of it--or you are, because it is going to add to your debt, or your children or your grandchildren are. It is

one way or the other. It is either doctors pay or your kids pay because it is not deficit neutral.

He says:

It is beyond fantastic to promise that future Congresses,

for 10 straight years, will allow planned cuts in

reimbursements to hospitals, other providers, and Medicare

Advantage--thereby reducing the benefits of 25 percent of

seniors in Medicare.

His point is these are not only cuts in Medicare--$\1/2\ trillion worth of cuts--the cuts are being used to start a new government program. And here, as both Senator Harkin and Senator Coburn reminded us, Medicare in 5 or 6 years is going bankrupt--belly up.

I thank the Chair very much. I will conclude my remarks.

What we are proposing to do is cut Medicare--take money from grandma--and instead of spending it on grandma by making Medicare more solvent, we are going to take that money, while the program is about to go insolvent, and create a new program. So these are the kinds of questions the American people have a right to ask and have answered.

That is why we want to read the bill. Because we see, as we look at this bill, higher premiums, higher taxes, Medicare cuts for more government, and we don't believe that is health care reform.

Mr. President, I ask unanimous consent to have printed in the Record the entire article from which I quoted.

I thank the Chair, and I yield the floor.

Mr. President, would the Chair please advise when I have consumed 9 minutes.

Mr. President, I congratulate the Republican leader for his comments. If it weren't so serious, he and I and the Senator from Texas would probably all be amused to hear the Democratic leader come here day after day and say the Republicans don't have a health care plan and then attack our plan. That is typical of the kind of talk we are getting about health care reform from the Democratic side. We are getting double-talk.

It reminds me, a few years after I was Governor of Tennessee--it must have been the early 1990s--I was driving along in Nashville as a private citizen. I had the radio on. It might have been an Arkansas radio station, but I think it was a Nashville station. The announcer said: Big news. The Tennessee legislature has passed a new law creating a Medicaid program called TennCare. Here is what it will do. It will cover twice as many people for the same amount of money.

Everybody was happy about that. Nobody had to raise taxes. Nobody had to pay any more money. Twice as many people get health care. I remember what went through my mind: I bet that doesn't happen. That sounds too good to be true.

The same idea went through my mind when I picked up a paper this morning and read: The Senate Finance Committee has finished its work. We are going to give 29 million more Americans health care. It is going to cost hundreds of billions of dollars more, and it is going to reduce the Federal deficit all at once. What went through my mind was: That sounds too good to be true. It sounds like the TennCare story.

Let's remind ourselves what the Republican leader said a minute ago. The focus is reducing cost. We all know there are people who don't have health care and who need it. We would like to extend it to them. But we can't afford to do that until we reduce the cost of the health care we have. It is going to bankrupt us as individuals if we don't reduce the cost of our health care premiums. It is going to bankrupt our government if we don't stop the growth of health care. Our first goal is reducing cost, which is why the Republican plan for health care is to take several commonsense steps in the right direction--reducing cost--that will get us where we want to go. We have said those on the floor time after time after time.

They include allowing small businesses to pool their resources so they can offer insurance to more of their employees. They include taking steps to stop junk lawsuits against doctors, which are driving up malpractice premiums and causing problems for patients. For example, many women who are pregnant in rural West Tennessee counties have to drive all the way to Memphis to see a doctor because doctors would not practice there anymore because of the high cost of medical malpractice premiums, which is driving up the cost of health care. We could create exchanges in each State so people could shop for individual insurance. We could allow people to buy their insurance across State lines. We all believe that if we did a better job of encouraging technology, we could reduce cost and reduce paperwork. All doctors and nurses and medical assistants know that.

Those are five steps we could take together to reduce cost, and we could begin to add to our rolls the 11 or 12 million people who are already eligible for programs we have today. That would make a big difference.

Instead, what our friends on the other side want to do is transform the system at a cost of closer to $1.6 to $1.8 trillion, when fully implemented. The question will be, Will it reduce our costs? That is why we want to read the bill. We want to know what it costs. This is not a bill. This is some pages of concepts. This is not a formal, complete estimate of its cost. That only comes when we have a bill.

We have had 8 Democratic Senators who have written to the majority leader and said what all 40 Republicans have said. The legislative text and the complete budget scores from the Congressional Budget Office that are going to be considered should be available on a Web site for 72 hours prior to the first vote. Democrats voted that down in the Finance Committee. They voted down the idea of allowing 72 hours to read a 1,000-page bill and to find out what it costs. Apparently, some Democrats are coming to their senses and saying: No, we would like to have the bill. We would like to read it. We would like to have a formal, complete score--their words--of what it costs, and then we will start voting. This is not a bill. These are concepts.

Then the majority leader is going to put this all together into another bill or create a bill. Then it will take a couple weeks to find out what that costs. We have some questions to ask in the meantime. First, we would like the Democrats to join us in step-by-step solutions to reduce cost. Next, we want to know whether it is going to reduce the cost to government and whether it will reduce the cost to each of us who is buying health insurance. As I look at the outlines, I think it might not. For example, as the Republican leader said, we know it is going to cost about twice as much as the $800 billion advertised because it doesn't start taking effect for a few years. The taxes start right away, but the benefits don't start for a few years. That is the first thing.

The second thing is, it is going to put 14 million more people into the Medicaid Program--not Medicare, this is the Medicaid Program. This is the program States operate that is paid for two-thirds by the Federal Government and a third by the States, about which all the Governors have said: If Washington is going to expand the Medicaid Program, Washington ought to pay for it. I suspect when we start asking questions, we will find Medicaid Program costs are underestimated. All the Governors think so. We had one of the most painful letters I have ever read from the Democratic Governor of Tennessee. Senator Corker put it in the Record. He talked about how Tennessee's condition was similar to the condition of most States.

He said: For example, by 2013, we expect to return to our 2008 levels of revenue. We will already have cut programs dramatically. We will have to start digging out. We haven't given raises to State employees or teachers for 5 years. Our pension plans will need shoring up. Our rainy day fund will have been depleted. We would not have made any substantial investments in years. There will be major cuts to areas such as children's services.

We are going to expand a program that is already causing the State of Tennessee and most other States to go toward bankruptcy. That is the way we are going to achieve reform. That is half the reform. Most Governors who have had anything to do with the Medicaid Program say that dumping low-income Americans into the Medicaid Program, where 40 percent of the doctors would not see them, is not health care reform. Medicaid costs are underestimated.

Also, I don't think the Congressional Budget Office estimate of these concepts we saw includes what we inelegantly call the doc fix. Every year the system we have reduces payments to doctors who work on Medicare patients. So we come back and raise the amount of money. If we only pay doctors 10 years from today what we are paying them today to serve Medicare patients, it will cost $285 billion, and that is not in this bill. When we ask our questions and read the bill and find out what it costs, we will find it doesn't reduce the deficit. Even if it did, it is going to cost $1.6 or $1.8 trillion. Who is going to pay for it? Half of it is going to come from cuts in Medicare, which serves seniors. Instead of putting any savings in Medicare to strengthen that program, which is going bankrupt in 2015-2017, we are going to spend it on a new program. Eight hundred billion will come in new taxes. Our insurance premiums are likely to go up instead of down because we will all be buying new government-approved programs.

If Speaker Pelosi is successful in adding the government-run option into the bill before it finally gets through, millions of Americans will be losing their insurance because employers will be paying a fine, instead of the insurance, because their employees can go to the government program. We are going to be paying for it. If you are a Medicare beneficiary, if you pay taxes, if you are a State taxpayer, if you buy insurance, you are going to be paying for this program. So it is important for the next 3 to 4 weeks that as we debate this, we ask these questions.

Mr. President, I see the Senator from Texas on the floor, and I wonder, as I conclude my remarks, whether he has thought a little bit about whether it is going to be possible to ensure 29 million more people, spend hundreds of billions of dollars, and still reduce the deficit and reduce costs to the American people who are trying to afford their insurance premiums today.

Mr. President, I ask unanimous consent to have printed in the Record remarks I made this weekend on the Saturn car company, which has lived and apparently passed away in the State of Tennessee but has contributed a lot to our State over the last 20 years.