Floor Statements

Mr. President, I rise in opposition to the nomination of Patricia Smith to serve as the Solicitor of the Labor Department. I have got to tell you, this is my 14th year in the Senate, and this is the first time I have taken the lead in opposition to a nomination that has come through my committee.

I take this very seriously. When the Founding Fathers drafted our Constitution, they were very concerned about concentrating too much power in any branch of the government. That is why they carefully crafted the system of checks and balances to ensure that each branch of the government has a method of checking the work and operations of the other.

Here in the Senate, one of our great checks has been our duty to provide our advice and consent to the nomination of the executive branch. That is a responsibility I take seriously. That compels us to ensure that nominees who were brought before us are qualified and they have presented their credentials to us completely, thoroughly, and honestly.

Each nominee must pass the vetting process to ensure he or she possesses the strength of character and the experience to ensure that the public can trust in his or her ability to carry out the duties of the office for which they have been nominated. My Senate colleagues know I rarely oppose Presidential nominees. I believe the President is ultimately responsible for the conduct of his administration and is also answerable to the Nation's voters, so he has the right to select the members of his team, up to a point. That is where the advice and consent comes in.

Before I elaborate on her nomination, I do want to recognize her accomplishments as the Commissioner of Labor in New York and the commitment she has shown to serving the people of New York. Her prior service would ordinarily have earned her our support and make her a bipartisan choice to lead one of our most important offices in the Labor Department. Unfortunately, there are other considerations which must be taken into account in reviewing her credentials for this position, which I believe disqualify her for this position. I have released a ranking

member's report detailing my concerns with Ms. Smith's nomination and posted them on the HELP Committee's Web site. Today I will explain the factual inconsistencies between what Ms. Smith said before the HELP Committee, for the record, compared to what is recorded in the official documents I have received from the State of New York.

The Solicitor of Labor is an important role. He or she is the chief legal officer of the U.S. Department of Labor, the third ranking official in that Department, General Counsel to the Secretary, and is asked to manage one of the largest legal offices in the Federal Government, with more than 400 attorneys serving on the Solicitor's team.

Unlike most legal offices in Cabinet agencies, the Solicitor of Labor has independent litigating authority from the Department of Justice and exercises that authority on behalf of the Department of Labor. The Solicitor is also responsible for ensuring that all stakeholders, including small businesses, are treated fairly.

In the course of conducting a thorough review of Ms. Smith's background and qualifications, the committee discovered a program in New York State called Wage and Hour Watch that she announced in January of 2009. The program was established to recruit and train union organizers and public interest groups to leaflet businesses with compliance literature and to interview employees in an effort to find violations of the law that could be used to bring State actions against businesses.

As part of the program, Ms. Smith committed to providing the groups with a direct pipeline to senior State enforcement personnel to report any violations found. Participants were given official cards by the State of New York identifying them and their group as being part of the program. Here is a copy of one of the cards. You will find down there across from ``date'' that this is for a 2-year period starting on February 7, 2009. You got one of those cards after 1 day of training.

According to the New York State Department of Labor's press release on January 26, 2009, Wage and Hour Watch is:

modeled in part after Neighborhood Watch, [the program] will

help promote labor law compliance through formal partnerships

between the New York State Labor Department and community

groups

and

provide ordinary people with a formal and systematic role in

the fight against wage theft.

That sounds good, except Neighborhood Watch was set up so that people would notify law enforcement authorities of things they thought were strange and should be looked at. They did not have permission to go into people's homes and investigate unannounced.

The release also identifies the six groups, two labor unions and four community organizing groups, chosen by Ms. Smith for the program and explains that they have been active in labor issues and referred cases to her agency.

Upon the conclusion of my remarks, I will ask unanimous consent that all documents referenced be made part of the Record.

In addition to her May 7 confirmation hearing, Ms. Smith also participated in a committee staff interview and answered questions for the record. In her responses, Ms. Smith suggested the committee seek relevant documents from New York, which I did obtain through a Freedom of Information request.

My staff reviewed the several thousand pages of documents eventually produced by New York, and we sent Ms. Smith some additional questions that she answered in late July, and former Chairman Kennedy sent questions that she answered in September.

My concerns with the nomination relate primarily to four areas where Ms. Smith provided at best incomplete and factually inaccurate testimony to the HELP Committee, both during her May confirmation hearing as well as in the followup questions.

The first inconsistency I wanted to highlight is with Ms. Smith's plan to expand this program. In the May 7 hearing, Ms. Smith was asked by Senator Burr about her plans to expand Wage and Hour Watch. She responded that there were no such plans.

His question was: Have you had any discussions relative to your being at the Department of Labor that would extend Wage Watch in any fashion on a Federal level?

Ms. Smith said: No, we have not had any discussions of that. I have not had any discussions with the Department of Labor in New York about whether we would extend it across New York State. Again, it is a pilot program which we just did in January. We specifically limited it to a small number of groups, and we limited it to a small geographic area. We limited it to basically New York City, Long Island, the lower Hudson Valley, so we could assess what the successes would be, what the problems would be.

On May 13, 2009, Ms. Smith made a similar statement in writing in response to three separate questions from committee members, including me. She said:

This initiative was designed as a local model in a limited

geographic area in a state, for a particular issue under a

particular statute. It was not designed for other laws or to

be used on the Federal level. Until the pilot is completed

and evaluated--

As she said up here--

I would not advocate expanding it to other areas in New

York, to other areas of the country, to the Federal level or

to other Federal or state laws.

That is what she said. The problem here is that many documents, including press releases, Ms. Smith's talking points for her own speeches, and e-mails she was copied on, show there were plans in place to expand the program in virtually every instance, many with June 2009 deadlines. Documents show that in April 2009, the State was maintaining lists of possible new entrants into the program.

I have a copy up here of groups that were being solicited with the Wage Watch expansion, and that is in April of 2009. That is before she testified. The State even sent out applications to a number of groups to join Wage and Hour Watch during May, when Ms. Smith had just testified to the HELP Committee there were no plans to expand the program.

This was the plan to expand the program:

Dear friend, we are preparing to expand Wage and Hour Watch

beyond the original groups in the pilot program. We are

writing to you because you have expressed an interest in

becoming or joining a Wage and Hour Watch group, as are a

number of other organizations and individuals.

Later on it says:

In order to allow us to plan for the next stage of the

program, please return the completed application form with

the reference letter by Monday, June 15.

The records show that Ms. Smith's department also planned to expand the scope of Wage and Hour Watch into investigating occupational safety and health matters from day one. That is not the original intent. The original intent was a Wage and Hour Watch group. But we can show where it was intended to investigate occupational safety and health matters.

Of course, originally it was not sold as enforcement of wage, it was sold as an educational program. But it changed to enforcement, infiltration, and spying, and then added investigating occupational safety and health matters.

In a January 15, 2009 e-mail from Ms. Smith to dozens of staff announcing the program, she states:

After 6 months, once we have had the chance to get the

program rolling, we would like to expand to other groups

(particularly upstate), including community based

organizations, student groups; churches and other faith-based

organizations and labor unions. . . . This is an exciting new

initiative and one which we could potentially replicate

elsewhere in the country.

In the press release issued to announce the program, Ms. Smith's agency states:

After a six-month pilot period . . . , the Labor Department

will begin seeking additional groups who wish to participate

statewide. . . .

The release also directs the public to contact her agency by telephone or through a dedicated e-mail address to establish additional New York Wage and Hour Watch groups. In an article, the New York Times noted the plans for expansion. They said:

After the first experiment in New York City and on Long

Island, the Labor Department will seek additional groups for

the program. The groups must be nongovernmental and nonprofit

and can include religious organizations, student groups,

labor unions, business associations and neighborhood groups.

Here is a sampling of other program expansion activities before Ms. Smith testified on May 2009: A December 1, 2008, e-mail to Ms. Smith listed potential expansion groups in upstate New York. A February 2, 2009, e-mail from Ms. Smith's deputy to two individuals explained how to set up a Wage and Hour Watch group. A February 18, 2009, e-mail from Ms. Smith's deputy to an outside group noted plans to expand the program. A February 23, 2009, e-mail from Ms. Smith's deputy memorialized a meeting with the six pilot groups and included a paragraph on training in June in both New York City and upstate for purposes of expansion. An April 9, 2009, e-mail exchange among Ms. Smith's subordinates listed several groups for expansion.

After Ms. Smith testified and answered written questions in May denying expansion plans, her department continued to promote expansion and looked to recruit new members. For example, a May 15, 2009, e-mail to over 20 outside individuals requested that application forms be submitted by June 15; a June 1, 2009, e-mail to outside parties announced preparations to expand Wage and Hour Watch; a June 3, 2009, e-mail from an outside public interest group offered over 40 individuals the opportunity to join Wage and Hour Watch; a June 9, 2009, formal application was submitted to Ms. Smith's department by the Laborers International Union of North America's Organizing Fund to conduct wage watch activities in the construction industry.

Contrary to Ms. Smith's responses to written questions that the program was only about wage and hour laws, her subordinates expanded the program to occupational safety and health enforcement. It says:

Thank for your offer to insert something about safety and

health enforcement in the training the DOL is conducting on

Saturday. Unfortunately, given the late notice and training

schedules and grant deadlines, we will not be able to put it

together by Saturday. However, what we would like to do for

you is to announce that we will contact each of the

participating groups and offer their organization a training

on what safety and health issues they should be looking for

while conducting the oversight for wage and hour issues. If

that works for you, it would be great for us.

It wasn't supposed to be oversight. It was supposed to be education so that people would know what they were supposed to get and be able to take the kinds of actions that individuals could take. But you can see it has changed dramatically.

An e-mail from the New York Committee on Occupational Safety and Health, a safety and health public interest group closely tied to organized labor, sent to Ms. Smith's deputy on February 6, 2009, notes that:

We will contact each of the participating groups and their

organization training on what safety and health issues they

should be looking for while conducting the oversight for wage

and hour issues.

In response, Ms. Smith's deputy solicits a list of things to train wage and hour watchers to look for, and they respond, as well as suggesting that the groups take pictures of working conditions they believe unsafe. Sounds like an investigation.

Ms. Smith's own public pronouncements contradict her testimony to the Senate. A May 19, 2009, National Public Radio article quoting Ms. Smith and her deputy states:

New York's Wage Watch is just a few months old, and

officials say it is too soon to measure success. But the

pilot program is set to expand across the state this summer.

A set of talking points for Ms. Smith to deliver to an upstate coalition group sometime after January 2009 but before she testified at her confirmation hearing states that the program ``will'' be expanding and solicits volunteers.

We have it here:

They are currently expanding with six distinct labor unions

and advocacy organizations in New York City and plan to roll

it out across the state in the coming months and years. We

will be expanding this program and when it does come upstate,

we will need the help of many of you to roll it out.

There also does not appear to be any document that supports Ms. Smith's statement that there were no plans for expansion. Indeed, I am told the public documents actually contain more than 50 specific references to expanding the Wage and Hour Watch Program. All of these red tabs are references to expanding the program. All of the red tabs talk about expanding the program. It doesn't look incidental.

Concerns about the factual inconsistencies in Ms. Smith's testimony are not solely held by the minority. Former Chairman Kennedy's staff submitted questions about the expansion of the program. Ms. Smith responded at the time of the confirmation that she had had ``no discussions about a potential expansion with anyone, other than generally indicating that if it were proved successful, my goal would be to expand to it other areas of New York.''

Despite all of this evidence, Ms. Smith's defenders have claimed that she misspoke and that she delegated a small program to a deputy. However, the documents show Ms. Smith herself promoting expansion and recruiting members in her own speeches and media interactions.

In addition, I question Ms. Smith's ability to lead the Solicitor's Office if her subordinates, including her deputy, were allowed to act outside of their authority as suggested by earlier explanations. It is difficult to see how it would be appropriate to blame a breakdown between Ms. Smith and her deputy for inaccuracies regarding program expansion plans. Ms. Smith worked with her deputy for more than 5 years. When Former Governor Spitzer appointed Ms. Smith to the New York Labor Department, news articles noted that she brought her deputy and protege with her. I find the explanation even more surprising because of Ms. Smith's pedigree. Her prior boss, former attorney general and Governor Eliot Spitzer, was known for his aggressive prosecution of corporate officials, including some who were accused of not overseeing their subordinates properly. I find it unlikely that the State of New York would accept ignorance as an excuse if an executive on Wall Street tried to use it as a defense. Why should we accept a similar excuse now?

A little more information about her background and the Spitzer education program and her participation there. Some have also suggested that this program was reasonably beneath Ms. Smith's notice, noting that her agency has an $11 billion budget with almost 4,000 staff. If confirmed, Ms. Smith would be in charge of legal compliance for a department whose budget projects spending 10 times what she oversaw in New York, $104.5 billion in 2010. Leaving aside the extensive documentation showing she was heavily involved in this program, I ask my colleagues, why would we consider expanding her responsibility tenfold if she was unable to oversee her subordinates effectively in New York?

Former President Harry Truman had a sign on his desk that read ``The buck stops here'' to show that responsibility for the conduct of subordinates ultimately rested with him. Ms. Smith ought to own up to the responsibility that ultimately rests with her.

With regard to the second inconsistency, Ms. Smith stated that the program was developed internally and only then did the New York Department of Labor approach or recruit outside groups. However, e- mails obtained by the committee directly contradict this statement, instead showing much of the driving force and even legal research for a program model came from organized labor and its allies. Here are a couple of examples: an April 16, 2008, e-mail from Mr. Jeff Eichler, coordinator for retail organizing projects for the Retail Wholesale and Department Store Union, RWDSU, to Ms. Smith's deputy regarding an ``Enforcers'' program, with four pages of attached research explaining potential models for their ``concept of wage and hour enforcers;'' an August 18, 2000, e-mail in which Ms. Smith's deputy responds to Mr. Eichler's ideas that the State consider allowing participants to infiltrate businesses that are part of the program.

Most disturbing, however, to me about this inconsistency is the fact that Ms. Smith admitted in her response to a question that she apparently saw the e-mails contradicting her testimony in July but did not correct the problem until directly asked in September about this issue by majority staff; that is, 2 months later.

A third inconsistency is that Ms. Smith also characterized Wage and Hour Watch as an educational program in testimony. However, the record shows it was designed and intended to be enforcement from the very beginning, with the union organizers and

community organizer participants serving as amateur investigators and informants. The very first documents discussing the program describe potential participants as ``community enforcers.'' I refer to the previously introduced April 2008 e-mail from union official Mr. Eichler describing this as an enforcers program and a November 28, 2008, e-mail from one of Ms. Smith's subordinates disseminating draft training material stating:

The one day session [of training] will not turn enforcers

into labor law experts but will assist them in identifying

labor law violations and make the referral of greater value.

The ``role of community enforcer'' is where we will have to

come up with original material . . .

Notably, Ms. Smith is personally copied on that e-mail.

Ms. Smith's own words, her subordinates' internal and public statements and deliberations, the media, and the groups involved in the program all emphasized and portrayed wage and hour watch as an enforcement from its very beginning. It was only when she was questioned by HELP Committee members about the program that Ms. Smith chose to portray the program's substance as educational in nature. Quite a difference.

Finally, Ms. Smith stated that the two unions that were selected for the pilot program, United Food and Commercial Workers Local 1500 and RWDSU, were told not to use the program for organizing. However, the agreement created by Ms. Smith and entered with the unions and special interest groups specifically allows the pilot groups to make use of information gathered for ``community organizing,'' which Ms. Smith also admitted in response to a written request.

The committee has a copy of the United Food Commercial Workers, UFCW, Local 1500 work plan sent to Ms. Smith's deputy which also directly contradicts Ms. Smith. The plan states that the union intended to use wage and hour in ``all of our organizing campaigns,'' including those outside their designated Wage and Hour Watch area. UFCW Local 1500 also published plans to target nonunion workplaces as part of the program in its publicly available union newsletter.

It is difficult for me to believe Ms. Smith and her department did not know union organizing was intended by those joining the pilot program. All the participants and signatories from two labor unions involved appear to be employed as full-time organizers. Other individuals and groups purely responsible for union organizing also applied to join when the program was expanded.

It is clear that Ms. Smith's testimony and responses to follow-up questions are repeatedly contradicted by documents I received from the State of New York. It is particularly troubling that inconsistent statements to the committee were in each instance an attempt to downplay concerns about the Wage and Hour Watch Program raised by Republican members. At best, the inconsistencies in her testimony lead me to question her ability to interact with Congress in a candid manner and manage the enforcement of labor laws by the Office of Solicitor in an evenhanded and fair manner.

I have tried for months to resolve these concerns. In August, I asked President Obama to withdraw Ms. Smith's nomination and offered my assistance in ensuring a replacement would be confirmed quickly. I also joined all my nine Republican colleagues on the HELP Committee in urging Chairman Harkin to refrain from approving this nominee in committee and made the same offer to him of assistance in ensuring a qualified replacement being given swift review and confirmation. I mentioned I joined all nine. As to a couple people on there, I do not know that they have ever opposed a Presidential appointment.

Because the President and the majority did not consider it a problem that Ms. Smith provided factually inconsistent information to the Senate, I am forced to insist on a full debate on her nomination. Giving my consent to a Presidential nominee is not something I take lightly, even with the benefit of the doubt I have always given to the candidates sent over to us by the White House. However, the integrity of the Senate committee process and the responsibility of advice and consent demands honest and accurate testimony when the witnesses come before us.

For that reason, I have lost confidence in Ms. Smith's ability to manage the Solicitor's office. I urge my colleagues to oppose this nomination, and I ask unanimous consent that documents referred to in my speech be printed in the Record.

I yield the floor.

Mr. President, in light of the 20 minutes that we just heard in defense, and he had spoken previously before I spoke, I ask unanimous consent for an additional 5 minutes to briefly comment.

Mr. President, there are so many places that a person needs to go if Ms. Smith does make it through the cloture vote. Of course, I have a lot more documents and information I will be sharing with people. I don't even know where to begin on the rebuttal to what has been said.

Internally crafted, no. It was brought to them by the unions. We can show where that came from. The Senator from Iowa mentioned that she met with small businesses in March. The program started in January with no input from small business. This is going to affect small business. They should have had the opportunity to comment on how the program would work, because there are a lot of privacy and other related issues in this.

When somebody comes to you with a State card from the Department of Labor of New York, they could probably go anywhere in the business they want to. They have only had 1 day of training in order to be able to do this. Does that make them an expert in OSHA and in wage and hour law? I don't think so. But there are safety and security and invasion of privacy issues that were ignored, or it was consciously decided they weren't important.

We asked about background checks on those who were trained and gave the State identification cards to:

There is no formal vetting process for the New York

Department of Labor to partner with an entity. Instead, the

Department relies primarily on prior experience working with

the group. For the Wage and Hour Watch pilot, the Department

selected the groups that were asked to join based on prior

experience working with them on a more informal basis.

They did consider the possibility of a background check on the groups but ultimately rejected that idea after inquiring as to whether Neighborhood Watch groups are subjected to backgrounds checks. The Department was informed that the groups participating in this more sensitive crime prevention partnership were not subject to a background check.

In her Senate response, Ms. Smith in part explains the lack of a background check because the program is modeled on the National Sheriff Association's Neighborhood Watch program. Notably, however, unlike Wage and Hour Watch, Neighborhood Watch is purely an observe and report program. Participants do not investigate crimes and are strongly cautioned against doing so, nor are they allowed to enter private property or businesses in conducting their operations. Calling the police about suspicious activity in a public area is significantly different than investigating the wages and hours of individual employees and recording their personal contact information.

This decision to allow those who may have criminal records--no backgrounds check--or may not be legal residents--no background check-- in the United States to be trained and gather information under cover of New York State authority is also compounded by the types of information being gathered. That is a little different than Neighborhood Watch too. Ms. Smith authorized the training provided to participants that directed them to gather the personal telephone number, vehicle license plate, and home address of business owners they visited. As noted above, the State also allowed that information to be kept and used for other purposes outside of Wage and Hour Watch.

I have more things I could go into. For instance, in a memorandum to Ms. Smith in January 2009, NYDOL officials point out that all pilot groups would be taught ``guidance on what level of information is needed for `anonymous' Wage and Hour Watch tip.'' They wouldn't be able to tell if an anonymous tip was inaccurate. In other words, it could be used for harassment.

There are a lot of problems with the program. I will be going into them tomorrow if cloture is successful.

I yield the floor.

Mr. President, we have debated whether to increase the amount of money the Federal Government can borrow at the same time that we created a massive new entitlement program that will cost the Federal taxpayer trillions of dollars over the coming decade.

Sponsors of the Reid bill have claimed that their bill would reduce the deficit and extend the solvency of the Medicare trust fund. We heard today from the nonpartisan Congressional Budget Office that these claims are false.

In reviewing the Reid bill, CBO stated that claims that the bill would both improve the government's ability to pay future Medicare benefits and financing new spending outside of Medicare would double count a large share of those savings and overstate the improvement in the government's fiscal position.

My Republican colleagues and I have argued for 3 weeks now that the Reid bill takes money from Medicare and spends it on a new, unsustainable health care entitlement. Instead of strengthening the Medicare Program, today we received confirmation that the Reid bill robs Medicare to the tune of nearly $\1/2\ trillion and threatens its solvency.

CBO has said that this robbery does not really strengthen the solvency of the Medicare Program. Instead the bill uses government accounting gimmicks to merely make it look like it is doing something to help the Medicare Program.

The Reid bill cuts $470 billion from the Medicare Program. Rather than reserving those monies to pay for future Medicare benefits, the bill spends those monies to pay for a new program to provide health insurance for the uninsured.

But because of government accounting rules, any savings are assumed to be used to purchase government bonds that will be saved to pay for future expenses. That allows sponsors of the bill to claim that they are extending the solvency of the Medicare trust fund.

As the only accountant in the Senate, I find it disturbing to see the government using its accounting rules to allow it to spend these savings twice. The sponsors of the Reid bill are counting the savings towards the Medicare Program at the same time those monies are being spent to pay for other Federal spending.

This would constitute fraud in the private sector. If they had to come under the same laws as private business, the administration and Congress would go to jail.

If there is any doubt, listen to what the Congressional Budget Office said:

Unified budget accounting shows that the majority of the

[Medicare] trust fund savings would be used to pay for other

spending under the [Reid bill] and would not enhance the

ability of the government to redeem the bonds credited to the

trust fund to pay for future Medicare benefits.

This means the claim that the Reid bill strengthens Medicare is false. The bill robs Medicare to pay for new spending.

Unfortunately this example of government accounting is just one example of the growing problems that our Nation faces. Our Nation's debt is now more than $12 trillion and our deficit for fiscal year 2009 was over $1.4 trillion. As a percentage of the economy, our deficit is 10 percent of GDP--the highest it has been since the Second World War. We are faced with increasing the debt limit at a time when our Nation's credit card is maxed out.

I worry about the country that I am leaving for my children and grandchildren. Our Nation is being buried under a mountain of debt, which poses

a deadly threat to the future of our Nation.

The government will make up the current deficit by borrowing more money, mostly from China and other foreign governments. These levels of debt are not sustainable. The Chinese Government already made it very clear that they are growing apprehensive about our ability to pay these debts.

As China's apprehension grows, the interest rates we pay on our debt will grow. That means that it will soon cost us considerably more to allow Washington to continue to borrow the money it needs to fund its current spending binge.

As the Chinese Government grows concerned about financing Washington's appetite for rampant spending, it should give everyone in this Chamber pause. Our most fundamental duty as Members of Congress is to wisely manage the power of the purse for our Nation. Congress is currently failing to carry out this obligation.

According to David Walker, the former head of the GAO, at the end of fiscal 2000, the Federal Government had about $20.4 trillion in total liabilities, commitments, and unfunded promises for Social Security and Medicare. That number rose to $56.4 trillion at the end of fiscal 2008--a 176-percent increase in just 8 years. By the end of this year, that number is expected to have risen to $63 trillion.

On January 15 of this year, the Senate Budget Committee held a hearing on the long-term outlook for Federal debt. We heard testimony from a bipartisan panel of experts, including Dr. Richard Berner, chief global economist for Morgan Stanley; Dr. Allen Sinai, president and chief global economist/strategist for Decision Economics, Inc.; and Dr. Douglas Holtz-Eakin, former Director of the Congressional Budget Office.

Some of these economists were Democrats and some were Republicans, yet all three agreed that the long-term outlook for U.S. debt was grim and that our Nation's creditworthiness was at risk without a plan to address the costs of future entitlements and the multiple bailout/ stimulus proposals Congress has passed.

All three panelists endorsed bipartisan commission concepts to address entitlement spending such as the one sponsored by Senators Conrad and Gregg. And the experts all agreed that the current budget process needs to be reformed to remove incentives to deficit spend. Yet none of those recommendations are evident in the legislation we are voting on today.

Dr. Sinai--one of the Democrat's invited witnesses from that day-- testified that we have exceeded several tipping points in creditworthiness in the U.S. economy, but the only reason we don't feel the effects of it now is because ``everyone else is drowning too'' and investors are fleeing to quality. But how long can that continue?

Further, Dr. Sinai states:

The deficit and debt prospects under almost any scenario

are daunting, with deficit-to-GDP and debt-to-GDP ratios not

seen before in a G-7 country. This territory is uncharted

with no real historical analogue to this kind of financial

situation for a major global economic power. . . The answer

to whether the U.S. can afford all of the initiatives on its

wish list--economic, societal, defense, and otherwise--is no.

Dr. Holtz-Eakin echoed similar statements from other panelists and strongly urged Congress to adopt a plan that conveys to markets a clear path for stabilizing and reducing the debt burden.

That panel appeared before us in January, but we still lack any coherent plan to stabilize our debt. Just last week on Tuesday, Dec. 14, the Peterson-Pew Commission released its first report, Red Ink Rising: A Call to Action to Stem the Mounting Federal Debt, which encourages lawmakers to act immediately to stabilize the national debt.

Crafted over the past year by former heads of the CBO, OMB, GAO, and the congressional budget committees, the report strongly urges Congress and the President to commit immediately to stabilize the debt at 60 percent of GDP by 2018 and develop a specific and credible debt stabilization package in 2010. But there is nothing in this debt limit bill that does either of these things.

Some Senators will argue today that raising the debt ceiling is the only fiscally responsible choice before us. I disagree. A vote to raise the debt ceiling is merely a vote to raise taxes on our children and grandchildren.

This cycle of kicking our responsibilities to the next generation must stop and it must stop today. In my view, the only fiscally responsible choice is to live within our means and balance our Federal budget.

A newspaper columnist, Diane Badget from Lovell, WY, said it best when she wrote how her mother would react to what is happening in Washington today. Diane wrote, ``Momma always said, `If you don't have enough money to buy a quart of milk you don't take someone else's hard- earned cash and buy ice cream.' ''

If we fail to heed that warning, we will be responsible for passing along unsustainable costs and obligations to our children and grandchildren. That is where the Reid bill is taking our country.

The only remaining question is whether we will have the courage to stop this process and preserve our Nation's strength for future generations.

I ask unanimous consent that our time be extended in the same amount as their time was extended.

I yield myself 15 minutes.

Mr. President, the majority has voted to cut off further amendments to this bill. Senator Reid has used a procedural tool that prevents Republicans from offering amendments. Several of my Democratic colleagues have come to the floor to argue that Republicans don't have any ideas on how to improve the bill. Nothing could be further from the truth. Republicans have filed over 200 separate amendments. Yet the majority is refusing to allow us to vote on any. On a bill that will affect the health care of every American and one sixth of the Nation's economy, the majority has not allowed us to have more than 10 votes to try to improve the bill.

This bill needs to be fixed. We know this bill currently will cut Medicare, raise taxes, and increase insurance premiums. If we had the chance to offer amendments, I believe we could make changes to fix the problems. I filed nine amendments, but I have not been allowed to offer any. I believe any reform should reflect the following core principles: reducing health care costs so that all Americans get the quality, affordable care they need, ending discrimination based on preexisting conditions, ensuring everyone has access to at least catastrophic care, preserving the right of patients to choose the doctors and health insurance plans that meet their needs, eliminating junk lawsuits and reforming our medical liability system, reducing health care costs for all Americans, improving patient safety, encouraging incentives for healthy behaviors by allowing insurers to charge low premiums to people who eat healthy, exercise regularly, and abstain from tobacco use, protecting Medicare for seniors by ensuring that any savings found in Medicare, a program that is going broke, are used to strengthen that program, not to create new entitlements, and helping all Americans afford health care coverage by fixing the flawed Tax Code so that all Americans can get tax benefits for purchasing health insurance.

Unfortunately, the bill fails to do these things. I know most Members agree on those principles for reform. The hard part is making the principles come to life by translating them into bill language. I did that a few years ago when I introduced 10 steps to transform health care. Once the bill was introduced, I went on a tour of Wyoming in March of 2008 and hosted town meetings to talk about health care to my constituents. Some of the ideas I included in my 10 steps plan I also filed as amendments to the Reid bill. We need to end discrimination based on preexisting conditions. No one that has at least catastrophic coverage should

be denied coverage for a preexisting condition. Everyone should have catastrophic coverage, but no one should be forced to buy anything. If someone does not at least have catastrophic coverage, then they should have to pay more if they want coverage in the future.

Everyone should get the choices for health care that Senators get. Senators get to choose between competing private plans. So should all Americans. Senators get the same choices as any other Federal employee. No more, no less. The janitor in the building, the mailman, the forest ranger, we all get the same choices. All choices are from private insurance. The Federal Government does not have its own plan. Like other employers, the Federal Government does pay part of our health care, but not all of it. Our choices allow us to pick a plan with a higher premium at a lower deductible or a plan with a lower premium and a higher deductible. Everyone should have these same choices, but they would have to work for a company willing to make a contribution to be personally willing to make that contribution and pay the remaining premium and deductible.

No matter how the health care reform bill comes out, there will not be free insurance. Everyone will pay something. The amount we pay should have a relationship to the choices we make. Insurance costs will only come down if we are encouraged to make the best choices.

Speaking of choices, there is no reason shopping for health insurance should be any more complicated than purchasing an airline ticket. Everyone should be able to fire up their computer and look up health insurance options as they look up airline flights. Each State should set up a Web site or an exchange where consumers can find the listing of all the health insurance plans sold in their State. The public should be able to pick their health insurance using the information on the Web site. Each health plan would list what is covered, the premium, the deductible, and the copay, not what Washington says they have to put on there. Every insurance company should be allowed to list their plan on any exchange, and the State could certify whether the plans meet the minimum requirements and whether subsidies could be used for those plans. There could also be ratings for how well the company provides for its insured customers, but people could buy from any company, having been warned.

Everyone could use the transparencies of the exchange to find the insurance that best suits them. Transparency would also bring the costs down. Another thing that will bring down cost is changing the system from one that provides sick care to one that provides health care. One way to do this is to focus more on preventing preventable diseases. We know that incentives to encourage changes in behavior can result in lower costs for patients and employers. We know this because 70 percent of all health care costs are driven by behaviors. If you provide incentives to change those behaviors, you have a potential decrease in cost of 70 percent of all of the health care costs for an organization.

Companies such as Safeway have designed plans that focus on personal responsibility and provide targeted incentives that lead to behavior changes that can reduce the risk of developing four of the most costly chronic conditions. Safeway's model, focused on four chronic conditions, can be attributed to 75 percent of all health care costs: Cardiovascular disease, which is 80 percent preventable; cancer, some types are 60 percent preventable; type 2 diabetes, which is 80 percent preventable; and obesity. As a result, Safeway has seen their health care costs remain flat over the past 4 years, while other employers experience annual cost increases as high as 6.3 percent. This is a huge accomplishment for Safeway and its employees, and the employee satisfaction is fantastic. Senator Harkin and I had an amendment that would do that. It was inserted into the HELP Committee bill and then pulled out without talking to us before it was printed in September. Never heard of that being done to Senators before.

Health care reform legislation should include the necessary provisions to ensure that companies can continue to provide successful prevention programs that lead to better health and lower costs but also allow those programs to be replicated across public and private health programs. We should encourage these programs and allow people to reap the benefits of better health outcomes and lower health costs. Additionally, people who smoke should have to pay more. People who don't smoke should pay less. People should be encouraged to quit smoking, start exercising, and eat healthy. To put it simply, allow folks who follow healthy practices to pay less for their health insurance.

People should be able to buy insurance across State lines. Companies should be able to sell insurance anywhere in the United States. Policies should be listed on the State exchanges with a disclaimer stating the policy is an out-of-State policy. The exchanges would also say whether the policy meets minimum credible standards according to Washington and the State. Insurance commissioners in both the insurance company's State and consumer's State, each get their usual amount for the sale--originators, because they can be consulted, and purchaser State, as they have to handle complaints.

We need to help small businesses. I have been working on health care reform for some time. Small business owners are seeing their insurance premiums go up and up every year. They need real help. What they don't need is for the Federal Government to make their insurance even more expensive. CBO says the Reid bill will drive up insurance costs for small businesses. I have proposed a bill that CBO scored as saving small businesses money by lowering their health insurance premiums by up to 6 percent.

Small business health plans allow businesses to join together through their trade association across State lines even nationwide so they can form big enough purchasing pools to effectively negotiate with the insurance companies and providers. Ohio has enough people they were able to do this within their State. It is effective. It brought down the cost of health care. They were able to save 23 percent just on administrative costs. They were sure if I could get my bill through, they would save even more by going across State borders. That is one that has been in the lab. It has been proven to work. Not in the bill.

Small Business Health Plans, which was S. 1955, drafted by myself and Senator Nelson of Nebraska, former Governor and insurance commissioner, was voted out of the committee in March 2006. On May 2006, cloture on the bill was not allowed in the Senate by a vote of 55 to 43. I know how tough health care reform is to pass. I had a majority of the votes but not enough to begin debate. At the same time, Senator Snowe was poised to do a single amendment that would have solved the objection for 80 percent of those who voted against it. Without cloture, that amendment could not be offered. The Snowe amendment would have solved the question of what health plan mandates would be required. The desire for mandate clarification was the objection that had the disease groups working against the bill. The insurance companies worked against the bill and successfully defeated other versions called associated health plans for over a decade. I was able to neutralize much of the insurance lobby.

By creating Small Business Health Plans, we can put small business owners in the driver's seat instead of the Federal Government or insurance companies. Through their associations, small business owners will have the kind of clout in the marketplace needed to negotiate high-value and high-quality health insurance for their members on a regional or even national basis.

Additionally, throughout the health care debate, we have heard Democrats say we need a public option in order to keep insurers honest and to have more choices for Americans. However, the only place where we don't currently have competition is for the millions of Americans who are currently trapped in the Medicaid Program. Democrats believe it is OK to lock 54 million poor American people into Medicaid and have them languish in a system that is broken and they are unwilling fix. Their solution is to keep adding more Americans to this broken system. A 2007 Wall Street Journal article stated that Medicaid beneficiaries have poorer

health than their peers with private insurance. A study published in the Journal of the American College of Cardiology found that Medicaid patients were almost 50 percent more likely to die after coronary artery bypass surgery than patients with private coverage. Merritt Hawkins found that in 15 major metropolitan areas and in seven particular cities, including Washington, DC, Medicaid acceptance was below 50 percent.

A 2002 MedPAC report stated that 40 percent of physicians--let me repeat that: 40 percent of physicians--will not treat Medicaid patients because of their concerns about reimbursement and the time and added cost of completing the billing paperwork. Even the Office of the Actuary at the Centers for Medicare and Medicaid Services has stated that providers will accept more patients with private insurance than government-run health care due to the more attractive private physician payment rates. If you cannot see a doctor, you do not have insurance, no matter what the special name.

As we increase dramatically the number of people eligible, we should find a way to offer them regular insurance so they do not have the stigma of being on Medicaid. They should be able to choose between the usual Medicaid and a private policy with a subsidy.

Unfortunately, the Reid bill expands Medicaid, and the reason is because it is cheap. According to the Congressional Budget Office, it costs 20 percent more to cover a person in the exchange, funded by Federal dollars, than through Medicaid, which is shared between Federal and State governments.

One of my amendments would change all of this. Senators and their staffs all have the ability to choose between competing private plans, and I believe we should give that same kind of choice to low-income Americans. Instead of trapping people in a broken Medicaid Program, my amendment would provide individuals who would otherwise be enrolled in Medicaid through the expansion in this bill the right to choose to be covered by Medicaid or a qualified private health plan offered through their State exchange. Every American should be able to choose to enroll in private insurance, and my amendment would provide real choice access to a network of physicians and fix this problem. It would also assure them they would have coverage for an entire year, not just while their income fluctuates.

On the topic of expanding government programs, I would also like to mention that if you save money in Medicare, it should only be used to help Medicare because it is already going broke. The current bill takes money from Medicare and uses it for other government programs. This bill takes $466 billion from Medicare and uses it to start new entitlements that have nothing to do with Medicare. Yet they start a new commission to figure out where to make additional Medicare cuts in order to keep the system going--doesn't that seem counterproductive-- after limiting where the cuts can come from because of hidden deals to get support for the bill.

Whatever we do has to reduce costs for all individuals and be deficit neutral. It has to truly be paid for. Why does it have to be paid for? Because America is going broke. We have maxed out the credit cards, and now we are driving down the value of our money. We have to use honest cost, not gimmicks such as the doc fix delay or collecting revenues before the benefits kick in and showing years of revenue for a shorter time benefit.

What ways can the government pay for anything? Unfortunately, they can cut benefits, cut payments to doctors and other providers, increase taxes, or cut waste, fraud, and abuse--which government seldom does and even more seldom does effectively--or, more honestly, allow a checkoff for donations to other people's insurance--perhaps even a tax-free donation--so people who want a bigger role in seeing that everybody has insurance could directly participate. People who argue that it is imperative we extend health benefits to everyone should put their money where their mouth is. People should have an opportunity on their income taxes to make an instantly deductible gift to the health care of others. If the deductible size of the gift is a refund, then they would not have to include a check.

On the subject of taxes, taxes have to be fair to everyone. Right now, big companies can write off the health care they provide their employees, so those employees are getting health care with zero income tax. Individuals who buy insurance pay income tax on all the money they use to buy insurance. That is not fair.

I have covered just a few of the ideas I have. I have several more ideas I have been talking about time and time again, none of which show up in the bill. These meet the promises that were made. The bill does not meet the promises that were made.

Health care is too complicated and encompassing to be done by a single bill. I have never worked on a bill that affects 100 percent of America. Adequately done, rather than assigning details to agencies, a comprehensive bill has to contain details. Assigning the tough parts to the Secretary of Health and Human Services makes it easier to legislate, but you don't know what the final outcome will be. Done in smaller incremental steps, the bill would be more understandable. More importantly, with the huge, more comprehensive bill, the more people who each don't like a particular part will defeat the whole bill over a few parts.

We need to start over. We need to pursue a step by step, bipartisan, approach. We need to match up a Republican idea with a Democrat idea. We need to leave out a Republican idea and leave out a Democrat idea. Pursing this type of strategy, what I call the 80-percent rule, would likely mean broad support from both sides. This would mean that the rigid ideologies of both sides would oppose such a bill, but I am confident that majority of the American people would support a bill like this.

We need health care reform, but it has to be done the right way. The best way to reform our health care system is to do it step by step. We need to start by focusing on the issues where we already have broad, bipartisan agreement.

I know how to pass bipartisan legislation. Since I came to the Senate 13 years ago, I have worked with both Democrats and Republicans to reform our Nation's health care system. Over my years in the Senate, there have been several times when I have worked across the aisle to get health care bills signed into law.

When I joined the Senate, the Health, Education, Labor, and Pensions Committee was one of the more contentious committees. I believe that people can agree on 80 percent of the issues 80 percent of the time and, if they leave the other 20 percent out, they can get a lot done. With that in mind, Senator Kennedy and I worked to make it one of the most productive and bipartisan committees, with a substantial number of bipartisan bills signed into law each year.

Whether it is the reauthorization of the National Institutes of Health or the renewal of the Ryan White and PEPFAR programs for people with HIV/AIDS here and abroad, I am committed to working across the aisle on issues of importance. Working together, we got patient safety, mental health parity, and genetic nondiscrimination legislation over the finish line. These proposals had been pending for years. We were also able to have a strong bipartisan bill to overhaul the drug safety functions at the FDA. By working together, instead of against each other, we can achieve passage of many more pieces of critical legislation.

Everyone agrees we need real changes that will allow every American to purchase high-quality, affordable health insurance. Not a single one of my Senate colleagues on either side of the aisle supports the status quo. The argument that Republicans support the status quo is simply false. We understand that the current system fails too many Americans. We want to support reforms that will provide real insurance options to all Americans and help lower the cost of that insurance.

But I have said from the start of this year, and frankly throughout my 13 years in the Senate, true reform should be developed on a bipartisan basis, so that the legislation will incorporate the best ideas from both sides and will have the broad support of the America. That should be a prerequisite for any proposal that will affect the nearly 20 percent of our Nation's economy and the health care of every American.

We have only had 10 votes on Republican amendments. It is not because Republicans agree the status quo is acceptable or because we think the health care system works fantastically; quite the opposite. Republican Members have filed 223 amendments to this bill. Unfortunately the majority leader has blocked us from offering our amendments.

This bill is too important to get wrong. We need the opportunity to improve this bill, and I would urge my colleagues in the Democrat leadership to allow us the opportunity to do so.

Madam President, I ask unanimous consent that an editorial by David Broder, ``One Is the Loneliest Number for President Obama,'' be printed in the Record. It mentions some of the editorials and key points of editorials that I put in my speech last night.

Madam President, I also ask unanimous consent that an editorial by George Will from the Washington Post titled ``The Indispensable Dispenser Opens Up'' be printed in the Record. It shows how Medicare is left up in the air after the Reid bill.

Madam President, I yield the floor and reserve the remainder of our time.

Mr. President, since that was the broader context of that intent and there are other States that are hurting as well, I ask unanimous consent that the pending amendment be set aside in order to offer an amendment to the extent that Colorado and Montana and Virginia would get the same benefit that provides 100 percent Federal funding to the State of Nebraska forever for their expanded Medicaid Program, which would give the same treatment to these other States that I have mentioned that currently only Nebraska would enjoy under the bill.

Mr. President, reserving the right to object, we are not the party that spent 8 weeks putting this together to delay everything. We are not the party that spent all the time putting this amendment together that we are trying to do without any input from the Republicans. We are trying to have time to both review this and let America know what is happening. We know the Democrats have kept people from going home now for 3 weeks so they wouldn't have to listen to the voters at home who are really upset with this bill.

So we would agree to the request to set the vote at 9 a.m. if the Senator will modify and strike the retroactive cloture time. We want the time.

I object.

Mr. President, the reason I wasn't on the floor for a large part of yesterday is I was wading through this amendment and also the CBO score and also the Joint Tax score. Then I had to talk to experts who could interpret what is in there. The American people don't have that privilege. They have to rely on the stuff they are hearing on the floor. I can tell you, they are pretty upset. I get letters and calls from all over the country saying: Stop this bill any way you can. Make them get it right. I have to tell you, some of those from other States, they are saying: My Senator is not listening to me. I am counting on you.

I rise to speak on the issue of the health care reform. I rise with a great sense of disappointment as I reflect on the debate that might have been. From the very start, I have said we need to reform our health care system. Everyone agrees we need real changes that will allow every American to purchase high-quality, affordable health insurance. Not a single one of my Senate colleagues on either side of the aisle supports the status quo. The argument that Republicans support the status quo is simply false. We understand the current system fails too many Americans. We want to support reforms that will provide real insurance options to all Americans and help lower the cost of that insurance. I have said from the start of this year--and, frankly, throughout my 13 years in the Senate--that true reform should be developed on a bipartisan basis so the legislation will incorporate the best ideas from both sides and will have the broad support of the American people. That should be a prerequisite to any proposal that will affect nearly 20 percent of our Nation's economy and the health care of every single American.

Unfortunately, that was not the process followed in developing this bill. Instead, we have the Reid bill, which was developed in secret without the input of a single Republican. This morning an adviser to President Obama was asked about the partisan nature of this bill and the overwhelming opposition of the American people. His response spoke volumes of what is wrong with Washington today. He essentially responded that the American people don't understand what is in this bill and that once it is implemented, they will come to support it. In plain English, the White House is saying: Washington knows best. That attitude is part of the reason why support for Congress is at a historic low and why public support for this bill is so weak.

Instead of having a bill that will provide greater choices and reduce costs, we have a bill that will do the opposite. The Reid bill will deny consumers the ability to make choices and instead substitute the judgment of government bureaucrats who will decide what kinds of insurance you will be allowed to purchase. The bill also fails to address the most important issue for the majority of Americans. It fails to do anything to help reduce the cost of health care. President Obama promised the American people that health care reform would reduce health care costs. Yet this bill fails to deliver on the President's promise.

According to the President's own independent Medicare Actuary, this bill will actually increase how much we spend on health care. According to Rick Foster, the person from the administration who keeps track of all Medicare and Medicaid spending, the bill increases health care costs $234 billion more than if we did nothing. That is a huge cost.

In addition to increasing total costs, the Reid bill will increase our national debt and threaten the health care provided to millions of Medicare beneficiaries. Some of my Democratic colleagues are going to come down to the floor and argue that the Reid bill will reduce the deficit and extend the solvency of the Medicare Program. They have been doing that for days. They will even cite the Congressional Budget Office to support their arguments. I hope every American hears those arguments and remembers a few inconvenient truths my Democratic colleagues are going to forget to mention. The way my colleagues on the other side of the aisle were able to force CBO to conclude that the Reid bill will not increase the deficit was by requiring them to use budget gimmicks and assumptions that would make Bernie Madoff blush.

Every time you hear one of my Democratic colleagues argue that the bill reduces the deficit, you should ask that Senator if he believes that Medicare will cut physician payments by 21 percent in March. That is right. While the Reid bill cuts over $470 billion from the Medicare Program, it will also require that every doctor treating Medicare patients have his or her payments cut by 21 percent in just 2 months. That is what CBO had to assume when they did their estimate. If you believe Congress will never allow this to happen--and we never have-- you cannot believe this bill will actually reduce the deficit. The truth is Congress has never allowed that level of cut. Senate Democrats, however, chose to ignore this reality and relied on the promise of a cut to make their bill add up. You should also ask my Democratic colleagues if they believe that Medicare payments to doctors will be cut more than 45 percent over the next decade.

Again, that is what the Reid bill required CBO to assume. If you don't think that will happen, then you cannot believe this bill reduces the deficit.

You should also ask my Democratic colleagues if they think that within a decade one out of every five hospitals, nursing homes, and home health agencies will be operating at a loss because of the unsustainable payment cuts in this bill. We just got a revised CBO estimate that says there was a little error there, and so there will be less savings by $600 billion. According to

the administration's Actuary, Rick Foster, that is exactly what is going to happen if the Reid bill is enacted. He said if these policies have to be modified, such changes would likely result in smaller actual savings. This means this bill will not reduce the deficit.

Finally, you should ask anyone arguing that this bill reduces the deficit whether they believe Medicare patients will not be able to get the care they need. Again, the administration's own Actuary says payment cuts in the Reid bill could jeopardize access to care for beneficiaries. I do not know if my colleagues believe these things will happen. Taking note of these facts pushes up the total cost of the bill well over $1 trillion and destroys any pretense of budget balance. Unless all the things CBO was required to assume actually happen, this bill will actually increase the deficit.

Health care reform has to be truly paid for. Why? Because the Federal Government has maxed out its credit cards. Our out-of-control spending is now even driving down the value of our money. As the government borrows more money to finance even more spending, the devalued dollar will drive up the cost of goods. Oil is a good example. Take a country such as Saudi Arabia, which is already raising prices for their oil to compensate for the lower value of our dollars. This means every American will end up paying more for a gallon of gas because of our failure to address growing deficits. If we are going to enact real health reform, we need to use honest accounting and not budget gimmicks and fake assumptions that we all know will not happen.

We should pay for expenses such as fixing doctors' Medicare payments, and we should not delay the start of spending 4 years after the start of the new taxes just to make the bill look good over 10 years.

The problem for the President and my Democratic colleagues is their bill is being sold on the strength of accounting tricks that make it appear that it will not add to the deficit. In case they have not noticed, they are not fooling the American people. It showed up in August. It showed up every time since then. That is why we are not getting to go home on weekends. We don't want the Democrats to hear from the people at home who are upset about this.

In a recent poll, 68 percent of Americans said they believe the Democrats' health reform bill will increase the deficit. They are right. The American people understand that if the Reid bill is enacted, deficits will increase. They are right. The same is true for the claims that the Reid bill will extend the solvency of the Medicare Program or reduce beneficiary premiums. That can only happen if you make all the assumptions I previously described. If you don't believe those things will actually happen, then this bill will do nothing to extend Medicare or lower premiums.

Besides driving up the deficit, the Reid bill will also eliminate more than 1 million jobs. The mandate that employers offer health insurance or pay a penalty will be a massive new job-killing tax. Our national unemployment rate is at 10 percent. The majority leader is attempting to cut off debate on a bill and force its passage before Christmas, again, because he doesn't want the people to hear what is happening, but we are going to see that that does happen--that will force employers to eliminate jobs and reduce wages. Businesses do not deny health care to their employees because they are cruel or mean- spirited. They do it because they can't afford it.

Most businesses that do not provide coverage do so because they cannot afford health insurance. They can't afford it for their employees or for their own families. They have looked at the cost and figured out they cannot pay for health care and still stay in business. The Reid bill fails to do anything to actually lower the cost of health insurance, which might mean these businesses could actually afford health insurance. Instead, it will place a new tax on these businesses, which the CBO has said will lead to these businesses reducing wages for their workers and eliminating jobs. That is why the National Federation of Independent Business, which represents small business across America, estimated the Reid bill would cause 1.6 million jobs to be eliminated. That is why they said the Reid bill will create a reality that is worse than the status quo for small business.

The worst thing about the Reid bill is not how it will increase the deficit or kill 1 million American jobs. The worst thing about the Reid bill is it will reduce the quality of health care we all receive. No longer will you and your employer be able to choose the health insurance that best meets your needs. The government will tell you what kind of insurance you have to buy, and if you don't, you are told the government will place a fine on you. Under the Reid bill, the government will tell your health plan which types of doctors they have to contract with, irrespective of whether that is a doctor you want or need to see. The Reid bill also traps 15 million Americans in the worst health care program in America. Approximately half the people who get the promised health care coverage under the Reid bill will get it through the broken Medicaid Program.

States already use price fixing to limit how much they have to pay doctors under the Medicaid Program. That is why as many as 40 percent of all doctors will not see Medicaid patients. I have said, if you can't see a doctor, you don't have health care. Yet that is exactly what the Reid bill will do: Promise 15 million people coverage but trap them in a system where we know they will not be able to get the care they need.

If anyone doubts what effect the Reid bill will have, they only need to look at Massachusetts. The Massachusetts plan was the model for many of the reforms in this bill. The problems they are encountering give us a good indication of what will happen to us all if the Reid bill is enacted.

To make the Massachusetts reforms work, they now have a 10-member commission trying to impose a global payment system. Under this system, doctors and hospitals will be forced to join large networks and be paid at a set rate for each patient. This is the same kind of government control we already see with Medicaid. The results of these changes are equally predictable. Fewer doctors will be willing to see people at the exact time when the number of people seeking care is increasing.

These are just some of the more serious problems with this bill. Because many of my colleagues want to be able to discuss the problems with this bill, I have limited my remarks for now. Because the bill was drafted behind closed doors and thrust upon the American people without time to consider all the ramifications, I am sure we will find more problems with the legislation after this rushed vote.

Over the next few days, I plan to lay out specific and concrete alternatives to how we could do better. I have been doing that for a long time, but they have not been accepted. Republicans have many ideas on how to make this bill better, including several that have bipartisan support. However, if Senator Reid is successful in cutting off debate, we will never get the chance to discuss any of these ideas.

Health care reform is too important for too many Americans to be rammed through the Senate with little or no debate on the weekend before Christmas. It appears my colleagues understand how deeply unpopular this bill is with the American people, and they want to force it through when they believe most Americans are not paying attention. I wish to assure my Democratic colleagues that the American people are watching, and the voices of August will only grow louder. They will remember the vote to cut off debate on this bill for a long time because they understand what it will mean for their health care and the future of this country. The person with whom I served in the Wyoming Legislature sent me a little note and said: If it is broken, don't break it more. That is what we are doing.

I have some articles I wish to include in the Record. One is by Howard Dean that suggests this reform falls short. Of course, he is the former chairman of the Democratic National Committee. Another is an editorial by Matthew Dowd, a political analyst for ABC News, who talks about the danger of success and where the polls are on this and says:

If this legislation passes, Democrats will be held

accountable for any failures or problems in the system. So if

any Americans' insurance premiums rise, they will blame the

Democrats. If patients have to wait in line at

emergency rooms, it will be seen as the Democrats' fault. If

health care costs don't drop, the Democrats will face the

wrath of the electorate.

I also have an editorial by E.J. Dionne, Jr., about Democratic fratricide and an article by George Will, where he says ``More talk, less support.'' The more we talk, the less support there is for this bill.

Finally, I have an editorial by David Broder, of December 18, 2009.

I ask unanimous consent to have these articles printed in the Record.

There being no objection the material was ordered to be printed in the Record as follows:

[From the Washington Post, Dec. 17, 2009]

Reform That Falls Short

(By Howard Dean)

If I were a senator, I would not vote for the current

health-care bill. Any measure that expands private insurers'

monopoly over health care and transfers millions of taxpayer

dollars to private corporations is not real health-care

reform. Real reform would insert competition into insurance

markets, force insurers to cut unnecessary administrative

expenses and spend health-care dollars caring for people.

Real reform would significantly lower costs, improve the

delivery of health care and give all Americans a meaningful

choice of coverage. The current Senate bill accomplishes none

of these.

Real health-care reform is supposed to eliminate

discrimination based on preexisting conditions. But the

legislation allows insurance companies to charge older

Americans up to three times as much as younger Americans,

pricing them out of coverage. The bill was supposed to give

Americans choices about what kind of system they wanted to

enroll in. Instead, it fines Americans if they do not sign up

with an insurance company, which may take up to 30 percent of

your premium dollars an spend it on CEO salaries--in the

range of $20 million a year--and on return on equity for the

company's shareholders. Few Americans will see any benefit

until 2014, by which time premiums are likely to have

doubled. In short, the winners in this bill are insurance

companies; the American taxpayer is about to be fleeced with

a bailout in a situation that dwarfs even what happened at

I yield the floor.

I suggest the absence of a quorum and ask unanimous consent that the time be divided equally.

Mr. President, I yield up to 20 minutes to the Senator from Alabama out of the leader time.

Reserving the right to object, we have had constant speakers over here, so we have used a lot of our time. If we had known there was more vacant time, and if we could have had some of the majority's time, we could have had a steady stream of speakers over here the whole time. So we would reluctantly agree to the time being divided between the two sides, as we have done that in all the times in the past, but we want to reserve some time for our speakers as well. We could have easily had people over here to speak.

Yes, the Senator objects.

Mr. President, I rise today to talk about prescription drug importation. As my colleagues know, I oppose this proposal.

It is our job as Senators to debate the issues, put forward our ideas, and show where we stand. I was disappointed that Democratic leadership chose to prevent the Senate from voting on amendments to improve this bill for the past 6 days. I am, however, glad the impasse has finally been resolved.

I am not afraid to show where I stand on this issue. Some of my colleagues on both sides of the aisle support importation. Some, like me, oppose it. But my position is clear, and does not change with the political winds.

The winds I am referring to include the arrangement that was reportedly negotiated with the drug manufacturers. Under the terms of this backroom deal, the drug manufacturers have reportedly agreed to $80 billion in price cuts and provided a commitment to spend $150 million in ads supporting the Reid bill.

In exchange, Senate Democratic leadership and President Obama have reportedly agreed to block efforts to enact drug importation from Canada.

According to one Wall Street analyst's report, the Reid bill is expected to increase drug company profits by more than $137 billion over the next 4 years. Let's do the math on that: $80 billion in cuts, leading to $137 billion in increased profits.

While this may be a good deal from the drug manufacturers and Senate Democrats, it certainly is not a good deal for the American people. Part of the reported deal will actually increase Medicare costs to the taxpayer, because it creates an incentive for Medicare beneficiaries to continue using brand-name drugs.

According to the Congressional Budget Office, Federal Medicare costs will be increased by $15 billion over the next decade as a result of this deal. In the last few days, there have been new press reports highlighting how the drug manufacturers may have agreed to provide even deeper discounts on their brand-name drugs. No one knows how much more this deal will cost the taxpayers.

In addition to increasing the price Americans will pay for the Reid bill, this deal appears to have also undermined Democratic support for a drug importation amendment.

My colleagues who believe importation is the right way to lower drug

costs say that it will save the government $19 billion and consumers $80 billion over the next 10 years.

The majority leader has previously voted for drug importation. President Obama supported drug importation when he was in the Senate. The supporters of drug importation should be able to easily pass this amendment without any limitations.

Yet it looks like the supporters of drug importation will not succeed today. It appears likely that safety certification language, similar to language included in prior years, will be added to this proposal.

My colleagues each know where they stand on the issue. But the deal with the drug manufacturers is apparently so important that supporters of drug importation are going to vote against the proposal.

It is important for the American people to understand why there has been this change of heart on this issue. The drug manufacturers are one of the few remaining health care groups that still support the Reid bill. They have committed to spend $150 million to buy television ads to support the Democrats efforts on health reform.

If my Democratic colleagues fail to adopt drug importation without the safety language, it is because the Senate Democratic leadership and the White House have decided they will do whatever it takes to keep the support of the drug manufacturers. They believe that the money these companies will spend will be enough to convince the American people to support their efforts.

The American people already understand that the Reid bill is not a good deal for them. They understand how this bill will raise their taxes, increase their insurance premiums and cut Medicare benefits for millions of seniors.

That is why over 60 percent of Americans now oppose the Democratic health reform proposals. No amount of advertising, funded by the drug companies or anyone else, is going to change that reality.

Mr. President, I thank the Senator from South Dakota for his enthusiasm and passion and ability to explain things. The passion we have seen throughout the day from the Republicans who have spoken is a reflection of the passion we are hearing in our telephone calls and in our e-mails and in our letters. Our volume is much higher than the 61 percent the CNN poll says. Of course, we wouldn't expect the CNN poll to necessarily reflect our constituents. That enthusiasm across America, that passion, that concern should be reflected in this Chamber.

I get a lot of mail and even phone calls from other States, and they say: How come my Senator isn't listening to me? How come he is not listening to all of my friends? Thank you for what you are doing on health care.

What we are doing on health care, of course, is asking that it be done step by step so that we can get the confidence of the American people, not do something grandiose that can't be well thought out because it is so big.

I spent time as the ranking member of the Health, Education, Labor, and Pensions Committee in an extensive markup on a bill that we had no input in writing. The other side says we had input into the amendments, and we did do some amendments and some were accepted. There were even some that were fairly significant that were accepted.

Of course, what was disappointing was that after the August recess-- they didn't print it before the August recess because they didn't want people to know what was actually in it at that time. But following the August recess, when they finally printed it, we found out that provisions we had put in by agreement had been ripped out. Never have I had that happen in my 12 years in the U.S. Senate.

Then I was part of the Gang of 6--the Group of 6, my mother would prefer to call it because she told me never to join a gang. But over a period of at least 60 days, we spent a lot of time and effort from morning until night trying to get a health care bill that would work for America.

One of the things we discovered is that it is very extensive. Nobody can comprehend how big health care is in America. We talked about it being 16 percent of the whole economy. Well, does that register with you? We talk about the trillions that are involved. I don't understand trillions. We spend billions around here, but trillions is a whole other level. I don't even think the kids who work on billions understand trillions. When we say 1 trillion, a lot of people say: Well, that is just 1. Well, it is a thousand billion, and a billion is a thousand million. So it is a lot of money.

But when we were doing this in this Gang of 6, what we did was kind of divide the issues up into 13 different parts--you might call them steps.

We started working through those. Sometimes we would have to leave one because we had basic questions we needed to ask about those sections so we would have a big enough understanding to be able to draft legislation for it. Basic questions. Basic questions. We only made it through slightly more than half the 13 areas before we were faced with a phony deadline. They said September 15 is the drop-dead date for this group to finish work. If you don't have it done by then, we will put something together anyway.

If you are still getting basic questions answered, don't you think you ought to work on it a little longer and have a few more people in? One of the groups we had in were the Governors. We were going to have a vast expansion of Medicaid--not quite as vast as is in here, and what is in this new bill that we have not yet seen, even though we are quite a ways into this, but a vast expansion of Medicaid. Medicaid works through the States and the States have to pick up part of the costs-- actually, they pick up a lot of the costs. As we have expanded Medicaid and expanded the rolls on Medicaid, we have put a greater burden not only on the Federal Government, though it is on the Federal Government, too, but also on the State governments. The State governments don't get to vote on it at all.

The Senator from Tennessee, Mr. Alexander, who used to be a college president and was also a Secretary of Education, pointed out a number of times that when Governors are faced with this budget crunch on Medicaid, what do they do? Virtually the only place they can cut is universities and colleges. That is why there has been this dramatic increase in college tuition--because of what Medicaid has done to the States.

Now we are talking about another drastic increase in the number of people in Medicaid. We thought it would be a good idea if we got the Governors on the phone--we hoped the Governors task force on Medicaid would meet with us, and I think they might have, but we were trying to rush it into a short period of time, so we did conference calls. They wanted to know how it was going to affect their States. We knew how many billions it was going to cost as a whole for those States, but we didn't have a breakdown individually. CBO and the Joint Tax

Commission don't do breakdowns by States. But we had some people on staff--Democratic staff--who thought they could break that down, and they did. They presented us with these numbers, and I called my Governor and said: I know this is going to be a problem, and I will see what I can do about it, but it is a lot of money. Of course, if I am talking about how much it was for Wyoming, it would not sound nearly as much as for New York, but it is the same kind of percentages, we just have less population.

Another surprising thing that happened to us was it looked like Nevada and New York would be hit real hard. The next day we got numbers and--we had the same CBO and Joint Tax score. That didn't change a bit. There was one set of numbers. But the evaluation, the next day, looked a lot better for Nevada and New York. It didn't bring it down enough, so there was a special provision that has been put in the bill--it was not done in the Gang of 6--that made it much nicer for Nevada and New York. We said: Wait a minute, why are you doing that for Nevada and New York? Some of the influential people around here from Nevada and New York said this economy is in a real downturn, and we are being hit harder than anybody else. I said: Well, that is a nice gesture, but this part of the bill isn't going into effect for 4 years. How do we know that in 4 years Nevada and New York are the ones that are going to be hard hit? We ought to have provisions for whoever is hard hit.

Those are the kinds of things we were trying to take care of in committee with inadequate numbers. As we worked through--well, the President wanted to do a speech to the Nation, a joint session speech. They do those over on the House side, and the House and Senate show up for it. It was on health care. Following that health care speech, the next morning we went to the Gang of 6 meeting. I kept notes on what the President said. I had about 12 areas we had tried to draft legislation on that he had pretty specific suggestions on. I had to say: This is something we didn't do. We didn't do this yet. We talked about that for a whole day. Immigration was one of the big ones. Medical malpractice was another. That has been a huge concern to the medical community.

I have several things I need to say on this health care bill. I know we are talking in the 30 hours following the appropriations bill. I have things to say about the appropriations bill too. I usually don't talk for very long down here, but I have some of that pent-up passion from all the calls and things I have gotten. So I will talk about both spending and health care.

I will start with the spending because we just voted for a bill that costs $446.8 billion, and Senators didn't have any opportunity to debate the critical issues within that bill. Of the six bills, three-- Financial Services, Labor-HHS, and State and Foreign Ops--were airdropped into conference with no opportunity for debate on this floor. So we had no opportunity for consideration. The Transportation bill, the HUD bill, received a 23-percent increase over last year. The State and Foreign Ops bill received a 33-percent increase over last year. Collectively, the six appropriations bills account for a 12- percent increase in Federal spending over last year.

Our national deficit for the past fiscal year stands at $1.4 trillion. I don't see that going down at all. Our current unemployment level is at 10 percent, despite the administration's insistence earlier in the year that Congress pass a $1 trillion-plus stimulus package. The Senate is currently in the middle of a debate on a health care reform bill that has a 10-year implementation cost of $2.5 trillion. Sometime in the next month, we will be forced to raise the Nation's debt ceiling for the second time this year to a level that exceeds the current ceiling of $12.1 trillion.

The bill makes a number of significant policy changes with respect to the fairness doctrine. This omnibus does not include the fiscal year 2008 ban on Federal funds being used to enforce or implement the so- called fairness doctrine. The bill makes changes to several longstanding policy provisions contained in the Financial Services bill and specifically the District of Columbia section dealing with abortion, medical marijuana, needle exchanges, domestic partners, and the DC Opportunity Scholarships.

The bill also contains 5,224 earmarks that total $3.8 billion.

Well, let me go into the definition of an earmark. According to the champion of it for many years, Senator McCain, it is not an earmark if you take a specific project to the committee of jurisdiction, where they can debate it and decide whether it is a valid project and how it might fit in with other formulas and things they are already working on. If the committee that actually works that issue approves it, it is not an earmark. But, of course, it has to be put in, in the authorization process, not dropped in by airmail when the conference committee is meeting at the end of the bill. It is considered an earmark when it is just sent to conference, nobody got to debate it and vote on it, and it was shoved into the bill. There are ways special projects can be done and approved by several votes. Normally, it would be the committee of authorization and then the Appropriations Committee and then the floor of the Senate; and that same process would have already been done on the House side because they start all funding bills. So that is probably six or seven votes on an item before it can actually get passed, if it goes through the regular procedure.

Of course, it is easier to have somebody to champion it and quietly slip it in without any votes, except a final vote. The final vote is what we are doing right now. It is on the whole package. You cannot pick out a section or an earmark and have a vote on that. Besides that, with 5,224 earmarks, that would take a long time. But it totals $3.8 billion. That is still a lot of money. It has been denigrated since we went into the trillion-dollar category, but $3.8 billion is still a lot of money.

How is this playing out around the country? I found a blog I hadn't seen before. It kind of speaks to what we are doing in appropriations right now. This is uglytruthstudios.com. It begins:

Don't tell me where your priorities are. Show me where you

spend your money and I will tell you what they are.

That is James W. Frick, who is not the author of this. The author then goes on to say:

I was mad when I decided to start this blog and podcast. I

was mad about the current state of our congressional

spending. I know, I know, a lot of folks are upset about the

government and what they spend. My anger starts with the

simple fact that they cannot complete the spending process.

They haven't been able to complete the process, not even one

time, since 1999.

You can see that this is directed against both sides of the aisle.

Folks, you are right to be mad about the out of control

spending of the Federal Government, but we all must start

with a hard look at how the money is being spent before we

can take an honest look at what it's being spent on.

Take for instance the topic of Healthcare. You will be hard

pressed to find a single soul in this country that doesn't

think the system needs to be re-evaluated.

For the last eight plus months we have heard on the morning

news, the Sunday talk shows, from congressional leaders, the

President of the United States, and even concerned citizens

about the impending healthcare crisis.

Primetime television has been interrupted for Presidential

addresses. The President addressed a joint session of

Congress, he held town meetings, he held focus group

meetings, he met with members of industry.

Congress itself has begged and pleaded for people to not

get too excited about their plans, to work with them on

putting reform in place. This was a crisis. A crisis that

needed to be addressed immediately, the citizens of the

United States of America needed to get behind the effort they

were putting forth.

The media was dominated with the urgency to get something

done. Television showed outraged Americans at town hall

meetings. Congress exchanged ideas and both sides pointed the

finger at the other side trying to show that their side was

most in tune with what our country needed. They were on top

of this situation.

Well they have ``sort of'' been tending to the business of

our nation's healthcare. The ugly truth though is this: in

their rush to be in the media on the Healthcare crisis,

Congress has not yet completed the Labor, HHS and Education

Appropriation for the 2010 Federal Fiscal year. The House

completed their version of the bill on July 27. The Senate

has not yet passed a version of the bill.

The Senate in all their talk about getting Healthcare done

has yet to even take the bill up on the floor for a vote.

Well, that part isn't true anymore. It has been finally taken up. It was supposed to be October 1, but we are tardy in that.

Now, mind you, tomorrow night you will probably have your

football game, family dinner or general quiet evening

interrupted by the Senate working through the weekend.

That is where we are now.

A vote of monumental importance during prime time

television, but not on the job that they should have been

doing; no, no, this is a vote on what they want to do.

For simple reference sake this is the equivalent of taking

out a trillion plus dollar loan, making commitments

associated to the loan, and never spending a second asking

yourself the following questions: Is this in the budget? Can

we afford it? Hell have we even thought about what we are

willing to spend on it? Have we decided yet what we are

spending on healthcare this year?

Healthcare was not a big enough problem this year for the

United States Senate to complete the normal course of

business by appropriating the spending for Fiscal Year 2010.

However, it apparently is a big enough to deal to forward

spend a conservative average of over $85 billion a year. It

is not a big enough deal to spend the $160 Plus Billion this

year that includes Labor and Education as well.

The House of Representatives despite passing their

appropriation in July has not accounted for the spending in

their passage of a conservatively estimated $1.2 trillion

Healthcare Plan. I am sure they would argue that they have,

their actual spending doesn't start for a few years. I would

argue that you had better start thinking about doubling

spending in 5 years now.

That is a slap in the face to hard working Americans. In my

book we all have roles to play. If you got elected to

Congress or in this specific case, the Senate, you were

placed in a position of public trusteeship. You were elected

to spend the people's money and make sure we are a solvent

nation. I bet that they just got so caught up in solving the

problem that they forgot to handle the process of budgeting

and spending. But wait, they continue to spend, and they make

forward commitments with our money that never come in on

budget.

You will find that I am not a big call to action guy. I am

actually kicking myself for not stopping my normal job and

getting started railing on this problem before now. I have

watched in great horror over the last 10 years as both

parties have ignored the process of spending, and funded our

government with our tax dollars through one size fits all

process. A one size fits all process that generally is traded

on our hard earned tax dollars, votes exchanged for passage.

It is time for the nonsense to stop. Keep watching them. I

have heard and firmly believe that you can track someone's

intentions by how they plan and spend their money. No matter

what the claimed intentions may be, people normally put their

money where their mouth is. Congress is putting our money

where their mouth is. If Healthcare isn't important enough to

finish the appropriations process on, then don't take the

time to spend more money on it.

Remember--It's all about the money stupid.

Mr. President, we are finally getting to the spending. We have been spending all year, but we are finally getting to some of these pieces. It still leaves the defense piece undone. We are continuing last year's appropriations up to the current time.

I have some things I have gleaned from different places. I particularly thank the Wall Street Journal for their articles and editorials that inform America. I think if I were picking one source of information, that is the one I would pick. I read the Washington Post, the Washington Times, the Wall Street Journal, and I get clips from every newspaper in Wyoming. I get a couple of those newspapers complete. I read a lot of news, but from a national perspective and one that is actually paying attention to what we are doing here, my favorite is the Wall Street Journal.

Earlier in the week, I quoted from a cost article I had found in the Wall Street Journal. I was chastised for using them as a source and then was countered by a Senator using Wikipedia. You can go into Wikipedia and do your own editing. I am not sure if that is a good source. I would prefer to rely on the Wall Street Journal.

There is not any article or opinion that cannot be quibbled with, and that is just like the amendments we have here. What I prefer to think is when an amendment or an article or a speech is given, we ought to be looking for the idea, the grain of truth, the juice of it that should be used, and we are not doing that right now. We are just doing amendments there and amendments here. We are defeating the amendments here. And it kind of bothers me that we have all these amendments from this side because, first of all, our amendments were voted down, all except two, when we went through the Health, Education, Labor, and Pensions Committee process to get the bill out of committee and when we went to the Finance Committee, the same thing happened. I think we had two amendments that were taken as well over a whole week of amendments. The two bills were taken to a closed door back here and were massaged into a new bill. Some pieces of those two bills can be found there, but not all of it and not in the same form. We had no input to that at all. No input at all. Now it is on the Senate floor, and we have the chance to do amendments.

I contend the Democrats are filibustering their own bill because every time we put up an amendment, they put up an amendment. If you wrote the bill, that bill ought to be good enough that you do not have to keep countering your own bill. We did not get to write the bill so we ought to be able to make at least some points about what ought to be changed by using our amendments.

Last week--one of the most fascinating things around here that I have seen--there was a Democratic amendment and then a Democratic side-by- side to it. Normally we get to present the side-by-sides. They are arguing within themselves. It is on a very important issue.

Getting back to the spending, I will mention that since taking office, Mr. Obama pushed through a $787 billion stimulus bill. Hardly any of that money has actually gone out. I would guess about 25 percent of it is all because there is health IT in there. It is $47 billion, and that is not going to go out for 4 years. I don't know how you put something in a stimulus bill where you are trying to get something done immediately and not release the money for 4 years. Granted, there is some work that needs to be done in that 4 years in order to make that money worth anything at all. It just fascinates me.

We had a $787 billion stimulus bill that was not anticipated to go into effect right away; $33 billion expansion of SCHIP; a $410 billion Omnibus appropriations spending bill; and an $80 billion car company bailout. The President also pushed an $821 billion cap-and-trade bill through the House and is now urging Congress to pass a nearly $1 trillion health care bill.

The administration says it is now instructing agencies to either freeze spending or propose 5-percent cuts in their budget for next year. This will not add up to much unless agencies use the budget they had before the stimulus inflated their spending on their baseline in calculating their cuts. That is why we are talking about this bill right now, the minibus or omnibus that is pretty ominous, with all the spending in it, with every one of those bills having a huge increase over a year ago. That will get built into the baseline so next year there can be another huge increase. They compound dramatically.

If the Education Department uses its current stimulus-inflated budget of $141 billion instead of the $60 billion budget it had before the President moved into the White House, freezing its budget will do nothing to fix the fiscal mess that has been created. As I mentioned, there is this little thing of second-degreeing their own amendment.

The Democrats are having a little problem deciding on their message. On the one hand, the President said just this week that we have to ``spend our way out of this recession. On the other they keep telling us the deficit is too large and isn't 'sustainable.' In this tug of political spin, watch what they spend, not what they say. And that means watching this weekend's expected Senate vote,'' which we have had, ``on the 1,088-page $445 billion''--ominous--`` `omnibus' package of spending bills to fund the government for fiscal 2010. The House passed a similar elephant earlier this week''--I don't know why they are referring to it that way; it is similar to a donkey--``allowing spending federal agency budgets to increase spending by some $48 billion, or about 12 percent from 2009. That increase--when inflation is negligible--is in addition to the $311 billion in stimulus already authorized or out the door for these programs. Adding this new stash means that federal agencies will have received nearly a 70 percent increase in the last 2 years.''

Has anybody gotten that kind of increase? ``Oh, and that's not all. The President and Congress also want to spend as much as $200 billion more

from the Troubled Asset Relief Program''--which is another stimulus, but it was done as a series of loans, so we are supposed to get the money back from that. What they are talking about doing is taking the money from that program and using it for some other programs. Anything that comes back is supposed to go to reduce the deficit. Lord knows that is big enough.

As I mentioned, there are 5,324 earmarks in this bill. That brings the total for the year to about 10,000 or about 23 for every congressional district. That is after a promise that the President would not sign any bill that had earmarks, but he has already done that once. Hopefully, he will not do it twice.

We have been talking about jobs this week. I even got invited to the White House to talk to the President about jobs. Of course, the message the Senator from Washington, Mrs. Murray, and I delivered to the President is, we ought to get the Workforce Investment Act done. That is a job training program that would train 900,000 people a year to higher skill levels to meet some of the skill levels we are missing in this country that we are having to export.

What has been the status on this bill? We have been working on this for 4 years--4 years. This country did not need jobs before. Now we need jobs, so maybe we are going to get something done on that.

She, I, and Senator Kennedy passed this bill through the Senate twice unanimously, but the House has never taken it up. I don't know how we are going to get jobs done if something that is that bipartisan--it passed the Senate both times with everybody voting for it. We cannot get more bipartisan than everybody voting for it. We are talking about bipartisan bills. That is really important.

Talking about jobs, one of the things I mentioned at the White House was that 2 days before this meeting, the EPA had put out the notice of the new regulation where they are going to take care of greenhouse gas emissions, CO2 and seven other chemicals.

According to Kimberly A. Strassel:

In the high stakes game of chicken the Obama White House

has been playing with Congress over who will regulate the

Earth's climate.

Right now the Copenhagen meeting is going on--

The president's team just motored into a ditch. So much for

threats.

The threat the White House has been leveling at Congress is

the Environmental Protection Agency's ``endangerment

finding,'' which EPA Administrator Lisa Jackson finally

issued this week. The finding lays the groundwork for the

EPA to regulate greenhouse gas emissions across the entire

economy, on the grounds that global warming is hazardous

to human health.

From the start, the Obama team has wielded the EPA action

as a club, warning Congress that if it did not come up with

cap-and-trade legislation the EPA would act on its own--and

in a far more blunt fashion than Congress preferred. As one

anonymous administration official menaced again this week:

``If [Congress doesn't] pass this legislation,'' the EPA is

going to have to ``regulate in a command-and-control way,

which will probably generate even more uncertainty.''

The thing about threats, though, is that at some point you

have to act on them. The EPA has been sitting on its finding

for months, much to the agitation of the environmental groups

that have been upping the pressure for action.

President Obama, having failed to get climate legislation,

didn't want to show up to the Copenhagen climate talks with

big, fat nothing. So the EPA pulled the pin. In doing so, it

exploded its own threat.

Far from alarm, the feeling sweeping through many quarters

of the Democratic Congress is relief. Voters know cap-and-

trade is Washington code for painful new energy taxes. With a

recession on, the subject has become poisonous in

congressional districts. Blue Dogs and swing-state senators

watched in alarm as local Democrats in the recent Virginia

and New Jersey elections were pounded on the issue, and lost

their seats.

But now? Hurrah! It's the administration's problem! No one

can say Washington isn't doing something; the EPA has it

under control. The agency's move gives Congress a further

excuse not to act.

``The Obama administration now owns this political hot

potato,'' says one industry source. ``If I'm [Nebraska

Senator] Ben Nelson or [North Dakota Senator] Kent Conrad,

why would I ever want to take it back?''

All the more so, in Congress's view, because the EPA

``command and control'' threat may yet prove hollow. Now that

the endangerment finding has become reality, the litigation

is also about to become real. Green groups pioneered the art

of environmental lawsuits. It turns out the business

community took careful notes.

Industry groups are gearing up for a legal onslaught; and

don't underestimate their prospects. The leaked emails from

the Climatic Research Unit in England alone are a gold mine

for those who want to challenge the science underlying the

theory of manmade global warming.

But the EPA's legal vulnerabilities go beyond that. The

agency derives its authority to regulate pollutants from the

Clean Air Act. To use that law to regulate greenhouse gases,

the EPA has to prove those gases are harmful to human health.

That is the endangerment finding. One is CO2, and I am breathing that out right know.

Put another way, it must provide ``science'' showing that a

slightly warmer earth will cause Americans injury or death.

Given that most climate scientists admit that a warmer earth

could provide ``net benefits'' to the West, this is a tall

order.

Then there are the rules stemming from the finding. Not

wanting to take on the political nightmare of regulating

every American lawn mower, the EPA has produced a ``tailoring

rule'' that it says allows it to focus solely on large

greenhouse gas emitters. Yet the Clean Air Act--authored by

Congress--clearly directs EPA to also regulate small

emitters.

This is where the green groups come in. The Tailoring rule

``invites suits,'' says Sen. John Barrasso--

Who is the other Senator from Wyoming--

who has merged as a top Senate watchdog of EPA actions. Talk

of business litigation aside, Mr. Barrasso sees ``most of the

lawsuits coming from the environmental groups'' who want to

force the EPA to regulate everything.

[The President] may emerge from Copenhagen with some sort

of ``deal.'' But his real problem is getting Congress to act,

and his EPA move may have just made that job harder.

I thank Kimberly Strassel for those words.

Staying on the topic of jobs:

House Democrats keep stepping on President Obama's applause

lines about innovation and job creation. On Tuesday, Mr.

Obama announced that ``we're proposing a complete

elimination of capital gains taxes on small business

investment'' for 1 year. Responding with rare dispatch,

the House voted yesterday--

Actually, that would be the day before yesterday now. Some of these things I wrote and hoped I would give before now.

--the House voted yesterday to change the capital gains rate

for venture capitalists who invest in technology start-ups.

But rather than eliminating the tax, the House more than

doubled it, moving the tax rate to 35 percent from 15 percent

by reclassifying such gains as ordinary income.

Private equity fund managers and managers of real-estate

and oil-and-gas partnerships would also get socked with a 133

percent tax-rate increase. Now, there's a way to encourage

economic growth and new jobs. Knowing how popular tax

increases are with unemployment at 10 percent, the House

majority rushed the bill to the floor without a hearing or

even a committee vote. Then they buried it in a package

advertised as an extension of tax cuts for research and

development.

And that is how it will come over here.

And, of course, there are some other problems in the United States with jobs. There are projections that show unemployment in construction will rise by about 1.3 million and that will be outweighed by the continued drop in manufacturing and mining jobs. Goods-producing employment as a whole is expected to show virtually no growth in total jobs, according to the report. By 2018, that sector will account for 12.9 percent of the jobs, down from 14.2 percent of the jobs. You know, in order to grow the economy, you either have to produce something or you have to sell something. So separately, the number of workers filing new jobless claims rose 17,000 to 474,000 last week, the Labor Department said, which is an unwelcome change after 5 weeks of declines.

Of course, accounting is one of my favorite things. I am the accountant in the Senate, and we have been doing some accounting on jobs that are saved. Clear back at the very beginning of the administration, when Secretary Geithner was appearing before the Finance Committee and the President was saying he will create or save 3 million jobs, I asked what is the definition of saving a job? After he explained a little bit on that, I said: Well, I think probably anybody who is employed, still employed would meet that criteria, so why don't you save or create 180 million jobs? But now we have had some measurements done on jobs that were saved, and this one particularly

stuck with me. There is a report on the stimulus for a shoe store in Kentucky, and since I used to be in the shoe business as well, that kind of stuck out. This is from the Washington Examiner--a ticker on stimulus jobs created--and what they said is a shoe store owner claimed to create nine jobs on an $889 contract, when in fact he supplied nine pairs of shoes to the Army Corps of Engineers. A lot of accounting problems around here, and talking about saving jobs without a good definition is only one of them.

Let's see. The government has taken over the banking industry, the car industry, trying to take over the health care industry, trying to take over the energy industry, none of which Washington knows much about, but one that hasn't had much said about it yet is student loans, and I am not sure exactly when that is coming to this body, but I did want to mention that the Department of Education right now is pressuring schools to move to a government-run student loan program in lieu of utilizing private lenders, who are more efficient and have traditionally offered better customer service. That is why people stay with them, is the better customer service, if the price is the same. However, it is also important to note that the proposed student loan takeover, which is H.R. 3221, would cause private lenders to cut an estimated 35,000 jobs across the country. That is according to a survey by the Federal Family Education Loan Program Industry Groups. With the unemployment rate lingering around 10 percent, it is nothing short of amazing that presumably vulnerable politicians continue to advocate big government programs that will result in private-sector job loss.

We will be saying more about that as it comes up. I am not sure when it is going to come up, but I did hear the Secretary of Education--and again, this is good government accounting--said it would provide another $80 billion for them to work with. Under the best of government accounting, it would be $40 billion, I believe. And even that is only because of the way it is accounted for.

Another problem we have now is with taxes, with the estate tax, and that is one that won't die because the Democrats are afraid to let the tax rate hit zero. For years, we have had people saying that the estate tax is not fair; that in this country you get taxed when you earn money, you get taxed when you buy something, you get taxed when you use something, you get taxed when you sell something, but the tax people are upset about is the tax you get after you are dead. We had a bill that already passed. The hated death tax is scheduled to expire, with the rate falling from 45 percent to zero for 2010. Then it will be restructured in 2011 at a rate of 55 percent.

This bizarre policy goes back to 2001, when the Democrats wouldn't let President Bush permanently kill the death tax. So the Republicans bet if the tax were eliminated for 1 year, it would never come back. Well, the moment of truth has arrived and the House Democrats recently voted to cancel that repeal and hold the rate permanently at 45 percent with a $3\1/2\ million exemption. So now the majority leader wants to do the same, and would suspend the health care debate and turn to that estate tax, but he would need 60 votes to do that, and I think that is because all the Republicans and many of the Democrats are saying no to that. Blanche Lincoln and Jon Kyl, Arkansas and Arizona, have placed some proposals out there.

The correct way to tax a gain in the value of assets bequeathed to an heir with capital gains of 15 percent is when the assets are sold. There ought to be some actual action that derives some revenue for it; otherwise, people out our way are having to sell off ranches prematurely in order to have the money to pay off death taxes when the founder of the family passes away. A recent problem we have had with that is that the land values are going up. I suppose they have stagnated at the moment, but it is hard to tell. These ranchers were putting money in, trying to do estate planning so they could pay this with not having to sell off part of the farm, and were doing a pretty good job of that. Of course, they made some adjustments when we made adjustments and started giving them a decline. And there is going to be a lot more said on that yet.

We have this massive spending bill, this huge increase in spending, and I want to share with you some of the words of Douglas Holtz-Eakin, the former Director of the Congressional Budget Office, which we talk about here regularly and point out as being a nonpartisan office. He spoke recently at the Senate Committee on the Budget, or relatively recently--November 10. This is kind of what he said:

President Barack Obama took office promising to lead from

the center and solve big problems. He has exerted enormous

political energy attempting to reform the Nation's health-

care system. But the biggest economic problem facing the

Nation is not health care. It's the deficit. Recently, the

White House signaled that it will get serious about reducing

the deficit next year--after it locks into place the massive

new health-care entitlements. This is a recipe for disaster,

as it will create a new appetite for increased spending and

yet another powerful interest group to oppose deficit-

reduction measures.

Our fiscal situation has deteriorated rapidly in just the

past few years. The Federal Government ran a 2009 deficit of

$1.4 trillion--the highest since World War II--as spending

reached nearly 25 percent of GDP and total revenues fell

below 15 percent of GDP. Shortfalls like these have not been

seen in more than 50 years.

Going forward, there is no relief in sight, as spending far

outpaces revenues and the Federal budget is projected to be

in enormous deficit every year. Our national debt is

projected to stand at $17.1 trillion 10 years from now, or

over $50,000 per American. And per American means every

man, woman and child.

Continuing to quote:

By 2019, according to the Congressional Budget Office's

analysis of the President's budget, the budget deficit will

still be roughly $1 trillion, even though the economic

situation will have improved and revenues will be above

historical norms.

The planned deficits will have destructive consequences for

both fairness and economic growth. They will force upon our

children and grandchildren the bill for our overconsumption.

Federal deficits will crowd out domestic investment and

physical capital, human capital, and technologies that

increase potential GDP and the standard of living. Financing

deficits could crowd out exports and harm our international

competitiveness, as we can already see happening with the

large borrowing we are doing from competitors like China.

Yes, the President went to China recently; Secretary Geithner has been to China. They weren't over there trying to visit the Great Wall. They were over there trying to explain to China how we would be able to pay off our bonds. And last week, it was said that Standard & Poor's and Moody's were taking a look at the United Kingdom and the United States to see if there shouldn't be a downgrade in their rating. And so Mr. Holtz-Eakin says:

At what point, financial analysts ask, do rating agencies

downgrade the United States? When do lenders price additional

risk to Federal borrowing, leading to a damaging spike in

interest rates? How quickly will international investors flee

the dollar for a new reserve currency? And how will the

resulting higher interest rates, diminished dollar, higher

inflation, and economic distress manifest itself? Given the

President's recent reception in China--friendly but

fruitless--these answers may come sooner than any of us would

like.

Mr. Obama and his advisers say they understand these

concerns, but the administration's policy changes are the

equivalent of steering the economy toward an iceberg. Perhaps

the most vivid example of sending the wrong message to

international capital markets are the health-care reform

bills--one that passed the House earlier this month and

another under consideration in the Senate. Whatever their

good intentions, they have too many flaws to be defensible.

First and foremost, neither bends the health-cost curve

downward. The CBO found the House bill fails to reduce the

pace of health-care spending growth. An audit of the bill by

Richard Foster, the chief actuary for the Centers for

Medicare and Medicaid Services--

And that is the CMS, which is a division of Health and Human Services. So this is the chief actuary issuing this report.

--found that the pace of national health-care spending will

increase by 2.1 percent over 10 years, or by about $750

billion. Senate Majority Leader Harry Reid's bill grows just

as fast as the House version.

Yesterday, or the day before yesterday, we got a new actuarial report that addressed the Reid bill as opposed to the House bill, and we talked about that fairly extensively. I haven't seen any articles about it yet. But one summary comment on it is that, according to this Actuary of CMS--which is a part of the administration--the cost of health care under the Reid bill will increase by seven-tenths of 1 percent.

That doesn't sound like much, but it is seven-tenths of 1 percent more--more--than if we did nothing. That is not bending the cost curve down.

Mr. Holtz-Eakin goes on to say:

Second, each bill sets up a new entitlement program that

grows at 8 percent annually as far the eye can see--faster

than the economy will grow, faster than tax revenues will

grow, and just as fast as the already-broken Medicare and

Medicaid programs. They also create a second new entitlement

program, a federally run, long-term-care insurance plan.

Finally, the bills are fiscally dishonest, using every

budget gimmick and trick in the book: Leave out inconvenient

spending, back-load spending to disguise the true scale,

front-load tax revenues, let inflation push up tax revenues,

promise spending cuts to doctors and hospitals that have no

record of materializing, and so on.

If there really are savings to be found in Medicare, those

savings should be directed toward deficit reduction and

preserving Medicare, not to financing huge new entitlement

programs. Getting long-term budgets under control is hard

enough today. The job will be nearly impossible with a slew

of new entitlements in place.

In short, any combination of what is moving through

Congress is economically dangerous and invites the rapid

acceleration of a debt crisis.

It is a dramatic statement to finance markets that the

federal government does not understand that it must get its

fiscal house in order. . . .

The time to worry about the deficit is not next year, but

now. There is no time to waste.

Again, Mr. Holtz-Eakin is the former Director of the Congressional Budget Office and a fellow at the Manhattan Institute. This is adapted from testimony he gave to the Senate Committee on the Budget on November 10.

Since that time I have been talking about how we have maxed out our credit cards, but this is something known across the Nation.

I have to share something. I mentioned I get things from all the papers in Wyoming. This comes from the Lovell Chronicle. That is a place that is probably about 120 miles from Yellowstone Park. That is always how I describe our State, in terms of Yellowstone Park, because a lot of people know where that is.

Her name is Diane Badget and she writes a column regularly.

My dad used to play this silly game with us. We'd hear

``THUMP, THUMP'' coming from the kitchen. One of us would

ask, ``Dad, what are you doing?'' He'd reply, ``Beating my

head against the wall.'' At that point another of us would

dutifully respond, ``Why?'' Then we'd wait a second for the

expected reply: ``Cause it feels so good when I quit!''

Has the bickering in Washington sickened you to the point

where you almost don't care what they do as long as they shut

up? Be careful! That's what some are hoping for. They are

disdainful of our feeble attempts to get them to listen to

us. They hope that if we beat our heads against the wall long

enough we'll realize how much better we'd feel if we'd just

quit.

She goes on to talk a little about Copenhagen.

The plans for building safe, clean nuclear power plants to

provide electricity evaporated when the promise of a secure

place to store spent nuclear fuel suddenly ended. Yet this

same administration has decried coal fired plants as

``ecological disasters'' and large-scale wind and solar

energy as too expensive to build yet. Nothing has been done

to utilize the vast reserves of resources in Alaska.

Okay, if we can't use coal plants, can't afford wind or

sun, Alaska doesn't exist, and nuclear options just got

flushed, what should we do? Oh, I know! Let's gather up half

of the over-zealous geniuses who supported Obama's decision

and put them on giant hamster wheels hooked to generators!

Then we'll take the other half and utilize their hot air to

turn turbines! It makes as much sense as anything in the Cap

and Trade bill.

My grandkids can't pray in school, but other kids are

provided with prayer mats. No wonder so many terrorists are

found right here in the very country they have sworn to

destroy. How many more radicals are walking among us,

undetected?

She talks about:

The decision to try the 9/11 conspirators in our court

system is a travesty. These murderers have already pleaded

guilty in a military tribunal. They are not entitled by our

Constitution to a trial. U.S. citizens are entitled to a

trial before a jury of their peers.

But she does move on to healthcare as well.

Are you confused yet? Apparently Congress is. The health

care plan that the Senate voted to send to the floor for

debate is a perfect example. One side says that it will be

deficit neutral, will ensure competition, will not affect

Medicare and won't result in more taxes. The other side says

it will cost too much, eliminate competition, slash Medicare

and tax us out of our underwear.

Barbara Boxer (D. Ca) touted Medicare as a great example of

how seniors are able to chose a ``public option''. Excuse me?

When we turn 65 we are required to sign up for Medicare. How

is that optional? I think at this point both sides of the

aisle are trying to sell us snake oil, and somewhere in the

middle is the truth.

Are you worried yet? Are your children and grandchildren

going to enjoy the same freedoms and opportunities that we

enjoyed? The future of my grandchildren should have been

better than the life I had, and my life has been pretty

doggone good. Instead, future generations are going to be

paying, financially and personally, for the mistakes made

right now by a president who presumes too much power and a

system of checks and balances that no longer works.

We have been talking about having a bipartisan bill here. Maybe that would end the contradiction and furor that we are talking about here. I think a lot of people must have missed the speech Olympia Snowe made about durable social reform always being bipartisan. I want to share some comments on that. I know her speech wasn't noticed by the press corps.

With Majority Leader Harry Reid's announcement this week of

a double-secret bargain that Democrats hope will squeeze

ObamaCare through the Senate after nine whole days of debate

so far in the world's greatest deliberative body--the Maine

Republican's words seem more pertinent than ever.

Mrs. Snowe began by noting that this year's health debate

is ``one of the most complex and intricate undertakings the

Congress has ever confronted,'' and that she, too, has

devoted much of her three-decade political career to

promoting cheaper, better quality insurance. ``But it must be

done in an effective, common-sense and bipartisan way,'' she

cautioned.

Far from ``systematically working through the concerns, the

issues and the alternatives,'' Mrs. Snowe added, Democrats

have instead favored ``artificially generated haste'' and

settled on a strategy ``to ram it, to jam it'' through

Congress. The Senator detailed her good-faith participation

in the ``group of six'' on the Senate Finance Committee,

which met some 31 times over the spring and summer and

reflected ``the kind of extensive, meticulous process that an

issue of this magnitude requires.''

The negotiators tried to build a consensus, blending the

best ideas from both parties. Or at least they did before the

group of six, and Mrs. Snowe in particular, became a liberal

political target for supposed obstructionism. Chairman Max

Baucus then pushed their unfinished work to the Senate floor,

where Mr. Reid is now rushing to pass a bill in a race

against its rising unpopularity and President Obama's falling

approval ratings.

Mr. Reid made his case with his usual intellectual nuance

this week: ``Instead of joining us on the right side of

history, all the Republicans can come up with is, `Slow down,

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

these same excuses before, you're right. When this country

belatedly recognized the wrongs of slavery, there were those

who dug in their heels and said, 'Slow down, it's too early,

things aren't bad enough.' ''

Then, after equating opposition to Medicare cuts and tax

increases with support for human bondage that it took a

bloody civil war to end, Mr. Reid went on to draw analogies

to women's suffrage, Social Security, civil rights and

Medicare.

Mr. Reid would have done better listening to Mrs. Snowe

about the ``history'' of major social legislation, which she

also discussed in her November speech. Her main and telling

point was that durable social reform in America has always

been bipartisan, and not merely with one or two opposition

party votes.

While Social Security passed when Democrats controlled both

Congress and the White House, she said, 64 percent of Senate

Republicans and 79 percent of the House GOP supported it.

Civil rights passed with 82 percent of Republicans in the

Senate and 80 percent in the House, while 41 percent and 51

percent, respectively, voted for Medicare. Mrs. Snowe could

have added the 1996 welfare reform that President Clinton

signed with the support of nearly all Republicans in

Congress, 98 Democratic Representatives and 25 Democratic

Senators.

``Policies that will affect more than 300 million people

simply should not be decided by partisan, one-vote-margin

strategies,'' Senator Snowe explained, and Congress should

not be ``railroading solutions along partisan lines.''

On the debate that we have had, one of the points of contention, of course, has been Medicare. They talked on that side of the aisle about how good Medicare is. We talked on this side of the aisle about how Medicare is being harmed. I think what we are really giving people the impression of it is when we pass the bill, all of it will be free. That will not happen. But there was some contention that private insurance was less fair to people, Medicare was always fair. So I dug up some information on it. Investors Business Daily has done a little bit of research in that area. They found that:

Throughout the health care debate insurance companies have

been cast as greedy villains that gleefully deny medical

claims. But

when it comes to rejecting claims, they can't hold a candle

to government.

They found the most claims are the ones denied by Medicare, not the private sector.

What has happened in the last couple of days, Medicare has been so popular that the leader has said he is going to include, now, a piece that will bring the age group to 55. We have been talking about how, under the present circumstances, with the money that is being stolen from Medicare, that it is going to go broke. The majority leader--and evidently it is just the majority leader because when we asked to see a copy of it yesterday in a little colloquy we had with the Senator from Illinois, Senator Durbin, he said he had not seen it. So I think--I know they had been briefed on it probably in a general way the night before. But it was explained to us that if anybody knew what was actually in that, that then the CBO score that comes out of that, how much it will cost, would have to be shared with everybody.

I thought we were in the new era of transparency. That doesn't sound very transparent to me. Even Democrats didn't get to see it because, if they did, then all of us could see how much it is going to cost as soon as the Congressional Budget Office has declared that.

That bothers me. I think it kind of bothers America. What we are worried about is it is going to come to the floor all of a sudden and we are going to have to make decisions on it. Evidently it is being talked about a little bit on the other end of the building, because I saw that Speaker Pelosi stopped short of endorsing the full Senate compromise, saying she needed to see ``something in writing.'' But she said, ``There is certainly a great deal of appeal'' in expanding Medicare. But the Washington Post did a little editorial. This would have been on December 10. They called it ``Medicare Sausage? The emerging buy-in proposal could have costly unintended consequences.''

Incidentally our side has only seen this based on what the media has heard, and I don't know what kind of briefings the media has had on what this particular proposal has.

The Washington Post says: ``The emerging buy-in proposal could have costly unintended consequences,'' and begins by saying:

The only thing more unsettling than watching legislative

sausage being made is watching it being made on the fly. The

11th-hour compromise on health care reform and the public

option supposedly includes an expansion of Medicare to let

people ages 55 to 64 buy into the program. This is an idea

dating to at least the Clinton administration, and Senate

Finance Committee Chairman Max Baucus originally proposed

allowing the buy-in as a temporary measure before the new

insurance exchanges get underway. However, the last minute

introduction of this idea within the broader context of

health reform raises numerous questions--not the least of

which is whether this proposal is a far more dramatic step

toward a single-payer system than the lawmakers on either

side realize.

The details of how the buy-in would work are still sketchy

and still being fleshed out, but the basic notion is

uninsured individuals 55 to 64 who would be eligible to

participate in the newly created insurance exchanges could

choose instead the emergency coverage through Medicare. In

theory, this would not add to Medicare costs because the

coverage would have to be paid for--either out of pocket or

with the subsidies that would be provided to those at lower

income levels to purchase insurance on the exchanges. The

notion is that, because Medicare pays lower rates to health-

care providers than do private insurers, the coverage would

tend to cost less than a private plan. The complication is

understanding what effect the buy-in option would have on the

new insurance exchanges and, more important, on the larger

health-care system.

Currently, Medicare benefits are less generous in

significant ways than the plans to be offered on the

exchanges. For instance, there is no cap on out-of-pocket

expenses.

Wasn't one of the promises that we were going to be sure that catastrophic was covered for everybody? One of the things I discovered early on in this process is that catastrophic is not covered in Medicare, not in the regular plan. You have to get the Medicare Advantage to get catastrophic or the more expensive Medigap policy. Of course, we are talking about taking a whole bunch of money out of the Medicare Advantage, which the companies say will either reduce benefits or eliminate it altogether.

I think this book was delivered to every office. I got one in my office. It is called ``Voodoo Anyone?'' It is ``How to understand economics without really trying.'' I do hope every Senator finds their copy of this book and takes a look at it because it talks about prices, how prices are set, what affects prices, what happens when you fix prices. Then it talks about health care and energy and education and crime and social and agriculture and labor and monopolies, and financial markets and government action.

I have never found a book that put it quite as succinctly or quite as understandably as this book does. We need to be paying some attention to the fixing prices part of it, for sure. He gives a nice example on this.

You're in a college town, and you realize that there is no

good place to buy a decent bicycle. So you get some money

together (loans, the parents, investors, whatever) and you

open up Deals on Wheels. But business at first is slow. So

you figure you'll bring in customers for a sale. You look

at your books and you make some tough decisions. You paid

$100 for a bike from the manufacturer, and you sell it for

$110. But without customers, you realize you need to do

something.

So you decide to sell the bicycles for $80 as a way to draw

customers to Deals on Wheels. You know that you can't

continue to sell your bikes at a loss, so you say it's a one-

day sale only. And sure enough, the word gets out, and you've

got more customers than you can handle. They can't fit in the

store and spill out on the street.

Little did you know that a lawmaker passed by, saw the

crowd and realized something good was going on. The

politician goes back to Washington, D.C., and convinces his

colleagues that an $80 bicycle is a great thing. ``Bicycles

have so many benefits,'' intones the lawmaker. ``They can

help you get healthy. And the more people who ride bikes, the

less pollution there is. And, of course, more people riding

bicycles will help the United States become less dependent on

foreign oil.

To thunderous applause, the politician sits down and

watches his bill that will cap the price of bicycles at $80

pass in a near unanimous vote. (The politician and all his

colleagues have calculated a lot of votes will come their way

in the next election as a result of this bill).

But for you, the bicycle dealer, the one-day sale has

become a permanent condition. You can't find bicycles for

less than $90, so you're going to be selling all bicycles at

a loss.

Do you stay in business? You instead sell off the rest of

your inventory and explore other employment opportunities.

I read that to lead up to what he has on Medicare. He says:

Remember the bicycle example? A price control on bicycles

below the cost of production signaled to consumers to buy

cheap bikes. But it also told producers that they couldn't

make any money. When you have high demand and low supply, you

get a shortage. And that's where the Medicare program stands

today--waiting lists, fewer doctors who see Medicare patients

and shorter hospital stays are all evidence of a shortage in

the medical care for senior citizens.

There are several more pages on Medicare I won't cover. I encourage my colleagues to read it. It is a very small book, a very short book, but it makes a lot of excellent points.

Of course, the day before yesterday we got this report from the Actuary of CMS, which is part of Health and Human Services, which is a part of the administration. He said that Medicare would not be sustainable under the Reid bill.

Is there a way to fix Medicare? I think so. We have promoted over here several times that instead of taking these cuts to Medicare and expanding them into brandnew entitlements--an entitlement is something that goes on forever without congressional approval--we ought to lop off the Medicare piece and make sure we get it right.

Yes, there are things that have been noted that would save money. But that money that is saved ought to go right back into Medicare so that those seniors who are so nervous across the country would understand we weren't cutting their programs.

They say: No, we are not cutting the program. We haven't cut a single guaranteed benefit.

We also haven't fooled a single senior out there. The only ones we have fooled have been the AARP. Of course, the AARP is going to make more money off of Medigap than they ever made off Medicare Advantage. They have to look at where the bread is buttered here.

Senator Dodd said that he would like to know exactly which pages had cuts to Medicare on it. I have a sheet here that shows the exact page numbers in the bill and the CBO report.

I ask unanimous consent that the following be printed in the Record in this regard.

Of course, the Democrats do recognize that there is a problem with Medicare going broke; otherwise, they wouldn't have to put a special commission in there. There is a special MedPAC commission. There already is a MedPAC, so there is going to be a MedPAC on steroids in there. That means it will have to report to us and we will have to take action on it or else they will be able to take action anyway. If we are not breaking the system, what do we need that for?

Actually, if we use the money that comes from Medicare only for Medicare, the commission would have a much easier job.

For one thing, we would be able to do the doc fix. The other side keeps referring to how the deficit will be reduced by this bill--$157 billion in the first 10 years and another number for the second 10 years. But that is only if you believe we will not fix any of these things that are major problems, such as the doctors.

We are not paying the doctors enough. Right now, 25 percent of the doctors won't take a new Medicare patient. The number varies between 45 percent and 50 percent who won't take a new Medicaid patient because we pay too little. We did the price fixing such as I described in that book. If you do price fixing, you can't afford to pay the doctors enough. The doctors know that. They are not going to work for nothing or less than nothing. Consequently, if you can't see a doctor, you don't have any kind of insurance. That is a basic guarantee of insurance, that you will get to see some medical person and they will do some kind of treatment if you need it. We are also hoping the doctor gets to make the decision on the treatment you have.

There is also a little medical commission in the bill, preventative commission, a task force that put out a report on mammograms and upset the whole country, with some justification. As those things are adopted for everybody, it takes away the right for the doctor to say: My patient is a little bit different. We are all a little bit different. Some of these commissions and task forces need to be looked at. Is America listening?

Last week, there was a vote in Kentucky. There were two people running for the legislature there. It was a highly Democratic district. The Republican talked about health care. That was his whole pitch. He did a warning on health care. He won in a heavily Democratic district.

This is being reported repeatedly across the country. I have some things where I could go into some of the poll numbers that are out there now. I know individuals are looking at those poll numbers and realizing the American people have figured it out. They really have. Congress hasn't figured it out, but the American people have figured it out.

I have to talk about one specific part of the bill. Senator Harkin and I worked together on this bipartisan amendment. It wasn't one we invented; it is one we found from Safeway. Safeway has some programs they put into effect for their employees on a voluntary basis that cut the cost of health care for Safeways while increasing the benefits for the employees. That is not happening anywhere in America. You have seen the charts on how fast health care is expanding. Safeway was able to get about an 8-percent reduction the first year and has been able to hold it level since then.

Senator Harkin and I asked: How did you do that? One of the ways was to give people incentives to do the right thing. Again, it was on a voluntary basis. We got the flexibility for these incentives put into the HELP Committee markup. It was approved. It was put in. It was bipartisan. It should have been approved and put in. It was also a good idea. There was this clinic that we call Safeway that had been the lab for it, that had tried it and it worked. It was to raise the limit people could have for doing these incentives from 20 percent to 30 percent and even up to 50 percent, if it worked. Without my approval, that was jerked out of the bill before it was actually printed.

I hope people take a look at the November 29 issue of Roll Call, where there is an editorial by Morton Kondracke, who explains how this all works and what a difference it could make and how terrible it is that it got pulled out.

It is interesting that some of the groups that were against it were ones such as the American Cancer Society, the American Heart Association, and the American Diabetes Association. They did it on the basis that it discriminates against people who want to stay fat and won't quit smoking. Incidentally, a smoker costs $1,200 a year to somebody else because it isn't included in their insurance that way.

Ways of improving the system--I will talk about that at another time. I can see everybody is fascinated by all of this. We will talk about lawsuits and health savings accounts.

The other side would like to eliminate health savings accounts. Actually, what they want to do is tell you what insurance you have to have. They want the government to tell you what the minimum acceptable insurance is. That is not bad enough. If you don't buy at least the minimum acceptable insurance, then you get fined. Under the House bill, you can go to jail. That is only if you don't pay your taxes as a result of the fine. That is done through the IRS. It is a huge expansion of the IRS at the same time.

Health savings accounts have been working in this country. In fact, they work for our employees in the Senate. The health savings account is where you buy a high-deductible policy and you have the right to put money tax free into a savings account that can only be used for health, with the theory that if you do have something happen to you, you can draw out of your health savings account to pay this deductible.

If you are young and healthy, it is a tremendous thing. One of the young ladies in my office said: Let's see, the amount I have to pay for regular insurance and the amount I have to pay for a health savings account are considerably different. If I took that difference and put that into a health savings account, it would still belong to me. It would roll over from year to year, and I would have that available tax free whenever I need it. She did that. Within 3 years, she had the entire deductible covered in there. She was smart enough to continue to put money in there, tax free money that will take care of her health care expenditures. Do you think she will be upset if we eliminate health savings accounts? Yes, I think so.

There is another thing Senate employees use; that is, flexible spending accounts. Even if you pick the ones without the high deductible, you have the right to figure out how much your medical expenses are going to be the next year and put those into a special account, a flexible savings account. Over the next year, you can use that money from the flexible savings account, which comes out of your paycheck, tax free for the medical needs you have.

People who know they are going to have medical needs find this to be useful. They find that they can tell--you have to do it by Monday--how much you think you are going to spend the next year. The downside of it is, if you don't spend it all, the extra goes back to the Federal Government. Even though it came out of your paycheck, it goes back to the Federal Government.

A lot of people would say this would be a good deal if we could roll that over. There are a lot of eyeglasses and dentists appointments that are done in December for people to be able to use

that flexible spending account. If it rolled over, they could continue to use it for what was really necessary.

That is being limited in the bill. That will be a detriment to people who have some catastrophic things happening to them. Cancer would be one of those things. If they know how much they are going to have to spend on MRIs and CAT scans and other kinds of tests over the coming year, in December they put that amount of money in there, and then they can have this little bit of a tax advantage for taking care of their health care costs.

That is much like big business provides in the much better plans than we have in the Senate.

To conclude, I would like to have a document printed in the Record by unanimous consent, which is titled: ``A Specific Plan of Action: Lowering Health Care Costs.''

I am inserting this on behalf of Senator McCain because people keep claiming that when he ran for President, he said things differently than what is being said now, and with this as part of the Record, maybe we can get them to quit saying that. Because he did talk about waste, fraud, and abuse in Medicare and the need to contain it and physician payments and coordinated care and preventable medical errors. So I ask unanimous consent that document be printed in the Record.

I hope, on future appropriations--I hope when the President gets this bill, if it makes it through the process--and it appears as though it should easily do that--he will veto the bill and send it back because the 5,224 earmarks, amounting to $3.8 billion--instead of talking about 5 percent of what the Cabinet members expend, it might be more valuable to talk about $3.8 billion.

There are other things that need to be done. We do need to start being fiscally responsible. Of course, one of the questions is: Why haven't we been, in the past, fiscally responsible? That answer to that is, we did not have our credit cards maxed out before. We were able to print the money and nobody noticed. But now when we print the money, people do notice. So we have both the end of the year appropriations-- the end of the year, incidentally, was the last day of September, and we are doing them now--and we have this health care crisis to solve. There is not anybody who does not want to come up with a solution to it. But we want to do it step by step and get the confidence of the American people.

The American people do not have confidence in what we are doing. I have several documents that would show what percentage of the people do not agree we are doing the right thing. That ought to get the attention in virtually every State because it is not just as a national whole, it is in every State. People have figured out what we are trying to do, and they do not think we are doing it right. We better get it right or people will be even more upset.

I yield floor.

Mr. President, reserving the right to object, we are going to have three Democratic amendments and one Republican amendment voted on, and the Democrats wrote the bill. The Democrats are doing a side by side to their own amendment.

It looks to me like they ought to get together and get some things figured out. There ought to be a little bit more fairness on the number of amendments. So I object.

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

Mr. President, for several weeks I have been saying, where are the appropriations bills? Under Federal law, we are supposed to have those done by October 1--October 1. Let's see. This is December 10. We must be past that deadline.

Well, here come the bills. They are all packed into one. There won't be the debate we would get if we handled them one by one. It is fascinating to me that one of them is Health and Human Services. All year we have heard that health is what is breaking the people of this Nation, how important health care is; why we have to do health care reforms under strict deadlines--strict deadlines that have shifted a number of times and are irrelevant to getting a good bill. But health care is that important, and it is one-sixth of the Nation's economy. So why haven't we had the health care appropriations debate before October 1? Why did it get put off until now? I guess it is because all of the earmarks weren't ready yet or maybe it is because they thought this bill ought to pass and solve all of the problems.

I think the bill could have passed much faster. I think it could have solved a lot more problems. If it would have had the kind of bipartisanship Senator Durbin keeps describing as having happened, we would already have the bill done. Much of what he keeps repeating--and the more times you repeat it doesn't make it more true--in every speech he gives, he makes the same comments about how long the HELP Committee worked on this bill and how many amendments from the Republican side were automatically accepted into the HELP bill. We always have to come out and correct that. Yes, there were a number of amendments. That bill was put together over a period of 2 weeks with a new committee chairman, without a single input from Republicans. It was brought to the committee for markup. We did have about 3 days to do amendments, and we did a lot of amendments. They did accept some of the amendments. Of course, we helped correct punctuation, we helped correct spelling, and we did have a few amendments that were accepted that actually made a difference.

After the vote, they didn't publish the bill for the public to look at--the amended version of the bill for the public to look at. I think that was so they could rip out the Republican amendments they had accepted. That has never been done in committees. When amendments are accepted, they are left in the bill, or at least the Senator who proposed the amendment gets to talk about why maybe it should or shouldn't be in there, or at least he is informed that they are going to rip it out. Not in this case. The bill is published, we are looking for some of these things and find they are gone. Then they wonder why there is opposition to the bill.

Then he talks about the hours we spent together working as the Group of 6. I appreciate him mentioning the hours, but hours don't make any difference if ideas aren't taken. The purpose of the hours is to be able to express ideas that can be included in a bill. Just getting to express them isn't enough. To make them bipartisan, they have to be included. Anybody who looks at the things we have on our Web sites would understand that we did have some good ideas, some things that would make a change in the way we do health care in America. Are those in this bill? No.

This is the Reid bill. This wasn't put together by the HELP Committee or the Finance Committee, although significant parts of both of those bills, which we didn't have input into, are a part of it. How was that designed? That was designed behind closed doors right over there, with no Republican input whatsoever. How does that make it bipartisan? How does that even give us a chance to make it bipartisan? Then they wonder why we have amendments.

Here is a fascinating thing on amendments: In the HELP Committee, the Democrats presented more amendments than the Republicans did. The Republicans did get two that we voted on and passed. The Democrats had over 30 that they presented to get passed. How come they even had to put in amendments? It was their bill. We are facing the same thing with the bill that is on the floor here. They are putting in more amendments than we are. Every time we put in an amendment they have a side-by-side on it to give them some cover to say, well, what they said wasn't that important. It wouldn't make a difference. Besides that, we don't want to do it, so we will have something that says we voted for that concept.

If you put the bill together, you shouldn't be the ones filibustering and doing the amendments. They have a unique position here now. We have a Democratic amendment and a Democratic side-by-side. I don't remember ever seeing that before. But we had a request this morning for three Democratic votes and one Republican vote. That is real bipartisanship? Yet they want the cooperation.

The thing that upsets me the most is they keep saying this will save money, this bill is going to save the country money, and we are in this appropriations process and we ought to be interested in saving the country money. But CBO didn't say that. CBO did not say that this bill will save money, unless you use a whole bunch of phony accounting, and there is phony accounting in this bill. That is how they are able to say, Oh, yes, we save money. We save money. This is going to save the American people a lot of money. No, it does not. Do not buy that story. Look at the accounting. I am the accountant. I have taken a look at it, but I am not that good of an authority.

We just got the report from the CMS chief actuary. Yes, that is the actuary who is actually in charge of Medicare and Medicaid and he did an analysis on it. I am going to go into some more detail on that analysis, because he says this bill does not save money. This bill will cost seven-tenths of 1 percent more than if we did nothing. Is that health care reform?

And where is the transparency we were promised would happen under this administration? Transparency? They built the bill behind the closed doors over on that side of the Senate Chamber and now a significant part of the bill--which is called the public option, government option, government-run program, whatever you want to call it--has been drastically changed. The newspapers have written about it. People have seen it. But the newspapers haven't seen what is in there. The Democrats, according to Senator Durbin, the majority whip, have not seen that bill. The only one who has seen it is Senator Reid and the Congressional Budget Office. He is not going to disclose any of that-- any of that--until after he sees what the score is going to be. That is the ultimate in transparency, in my opinion. If you think

you have a good idea, maybe you ought to let people see what the score is and see what the bill is, and you ought to if you expect us to debate it in a hurry. That is what we are under, this hurry-up situation. Hurry up so a bill that isn't going to do anything until 2014 can be passed by Christmas.

This side is ready to reform health care. This side is ready to stay in through the weekend. We already stayed in through last weekend. We will stay in until Christmas. We will stay in the days after Christmas. We will stay in next year. But it has to be right. The American public expects this to be right.

There has never been a major piece of legislation passed by this body in the history of the United States that was passed by one party. Not yet, there hasn't been. There is a good reason for that. It is full of flaws if just one side's ideas are incorporated in the bill, and this is no exception. This has a lot of flaws. This is a real move to the left to incorporate most of the people over there, but they weren't able to incorporate all of them, so now they are doing a secret public option to expand Medicare to distract people without telling them what is in it and expecting us in a few days to vote on this thing.

Well, I am going to share some of these numbers from the CMS chief actuary a little later, but I see my colleague is here and is actually going to talk mostly on the appropriations bill. I will say that what I have had to say ties in directly to appropriations. It is spending money. We are going to spend $464 billion of Medicare money from a system that is going broke and we are going to raise taxes--that is kind of an appropriation too--to cover the other $\1/2\ trillion in new programs that are not going to lower premiums or save the United States money, according to the CMS Chief Actuary Rick Foster.

I yield the floor.

Mr. President, what is the time situation?

Mr. President, I rise to discuss a new report on Senator Reid's health care reform bill. This kind of fits in with the appropriations that deal with Health and Human Services that is over 2 months past due.

Last night, we received a new analysis of the Reid bill we have been discussing about 11 days straight, performed by the Center for Medicare and Medicaid Services--that is CMS--which is under the Department of Health and Human Services. The chief actuary, Rick Foster--this is the guy in charge of all this. He is the chief actuary. This is not somebody outside the system. This is the guy who has to answer for all this. He serves as the independent technical adviser to the administration and Congress on estimating the true costs of health care reform. Some of the findings in this report directly contradict some of the claims we heard this week about the Reid bill.

For a week now, we have heard how the Reid bill will help slow spending growth and reduce how much we as a nation spend on health care. Mr. Foster's analysis shows that statement is false.

According to this report, national health expenditures will actually increase by seven-tenths of 1 percent over the next 10 years. That is seven-tenths of 1 percent if we did nothing different. Despite promises that the bill would reduce health care spending growth, this report shows the Reid bill actually bends the health care cost curve upward.

We have also heard, over the past week, how this bill will reduce health insurance premiums. Again, the administration's own chief actuary says this is false. The new report describes how the fees for drugs, devices, and insurance plans in the Reid bill will increase health insurance premiums, increasing national health expenditures by approximately $11 billion per year.

We have also heard how the Reid bill will reduce the deficit, extend the solvency of the Medicare trust fund, and reduce beneficiary premiums. According to the Foster report, these claims are all conditioned on the continued application of the productivity payment cuts in the bill which the actuary found were unlikely to be sustainable

on a permanent annual basis. If these cuts cannot be sustained, one of two things will happen. Either this bill will dramatically increase the deficit or beneficiaries will not be able to continue to see their current doctors and other health care providers.

In reviewing the $464 billion in Medicare cuts in the Reid bill, the Foster report found these cuts would result in providers finding it difficult to remain profitable.

The report went on to note that absent legislative intervention, these providers might end their participation in the Medicare Program. In addition, if enacted, the report found that the cuts would result in roughly 20 percent of all Part A providers--that is hospitals, nursing homes, et cetera--becoming unprofitable within the next 10 years as a result of these cuts.

As a former small business owner myself, I understand the impact this will have on doctors, hospitals, and other health care providers. In rural areas, such as my State, these providers will go out of business or have to refuse to take any more Medicare patients.

The CMS actuary noted that the Medicare cuts in the bill could jeopardize Medicare beneficiaries' access to care. He said the Reid bill is especially likely to result in providers being unwilling to treat Medicare and Medicaid patients. That is what we have been saying for about 11 days.

The Reid bill also forces 18 million people into the Medicaid Program. The Foster report concluded this will mean a significant portion of the increased demand for Medicaid services will be difficult to meet. These are not the claims made by insurance companies or anyone who might have a vested interest in the outcome of the debate. These come directly from the administration's own independent actuary.

In light of this report, why are the sponsors of this bill continuing to argue for a $2.5 trillion bill of new programs which will increase health care spending, drive up premiums, and threaten the health care of Medicare beneficiaries?

We can do better. We need to start over and develop a bipartisan bill that will address the real concerns of American people--develop a bipartisan bill. They cannot just exclude one side because there is a majority that won the election and gets to write the bills. We get tired of hearing that told to us. Where is your comparable bill? We are not trying to have a comparable bill, we are trying to have input into the current bill or the current bills: Sit down, talk about the principles, find the actual things that fit into those principles, develop the details, and have a bill that goes step by step so we get the confidence of the American people. The step we ought to start with is Medicare. That is why I present this report from the actuary of CMS, which is part of the Department of Health and Human Services, which is assigned most of the job of coming up with the details of the bill we have before us. That means actual elected officials would not be doing it. But this CMS actuary says everything that has been said by that side of the aisle is false unless there is some phony accounting that goes into it.

I yield the floor and reserve the remainder of our time.

Mr. President, I suggest the absence of a quorum and ask unanimous consent that we divide the time.

Mr. President, I appreciate the statistics the Senator from Montana cited about how long we have been debating this and how many amendments we have done. That is how few amendments we have done, actually. The majority is now filibustering their own bill. I have no idea why that is happening. We have been calling for votes on both of these amendments that have been proposed so far and haven't been able to get the votes. I don't understand how they can talk about how many amendments are being done.

I also have to voice some other frustration. I don't know how many times I have heard the exact same speech by the Senator from Illinois, Mr. Durbin, on this floor talking about the amount of hours that have been spent together working on these bills in the HELP Committee and the Gang of 6 in the Finance Committee. It isn't about how many hours we spend together. It isn't about how many hours we spend on the floor. It is whether we are accepting ideas. I understand the other party won the last election, but somehow they will have to get over this attitude that they won the election, they get to write the bill, they don't have to take any ideas from anybody else.

In the HELP Committee, I keep pointing out that most of the things we turned in were kind of punctuation corrections and spelling corrections. Any ideas we actually had that appeared to be accepted to be in the bill were ripped out of the bill before it was actually formally printed, without talking to us. What kind of bipartisan deal is that?

Another thing with the HELP Committee, we have only had 10 days of debate on this. We did more than that in the HELP Committee when we were marking up the bill.

But we are having, in the words of Yogi Berra, deja vu all over again. When we were having that markup, the majority withheld a significant part of the bill, a big part of the bill. It was the government-run option part of the bill. They wouldn't give us the wording on that. I think they were still writing it. Maybe that is what is happening right now too. But we couldn't get the text we were going to write amendments on so that we could deal with the bill. I think America noticed that in August. People said: How come everybody isn't reading the bill? You can't read what you don't have.

The point I am making is, right now the newspapers are full of information--well, speculation; it has to be speculation--about what this new Medicare expansion does. I haven't run into anybody who has seen the text of that. I have asked some of the media, and they didn't see the text. They got a briefing. We haven't even had a briefing. The majority side has had a briefing, but our folks who have talked to those folks said: Wow, that was pretty general. How could you make up your mind on whether you are going to support it based on the little bit of information you received? That is not the way to run any kind of an organization, especially if you want bipartisan votes.

You can't write the bill in secret, which is what was done with this bill. There wasn't a Republican involved in the behind-the-door stuff Leader Reid did to put together the bill we have now. That is not bipartisan. There

hasn't been a single person from the Republican side briefed on this new proposal that is going to save the world.

Actually, I noticed that the American Medical Association suddenly left the bill and said: This will be the worst thing that could happen to us. The hospital associations, which have been strong supporters of the bill, have also said this won't work, particularly the Mayo Clinic, which we have been holding up as one of the prime examples of the way to do health care, saying: If this Medicare expansion happens, it will cost us millions. We won't be able to provide the kind of care we have been providing.

What is the deal around here? When are we going to actually get to see something? When is the majority actually going to share with us this marvelous idea they have had? What kind of a way to run a business is that?

Are we going to recess for the weekend? I don't want to recess for the weekend. I am conscious of the 11 days we have been debating, and we have only covered 14 amendments. We have a lot of important amendments that either will be a part of the bill or will help the people in this country to understand what is being thrust on them. There has never been a bill of such importance as this one from the standpoint of how many people it affects. We are talking about reforming health care in America. That is everybody. That is every single individual, every single provider. Every single business will be affected by this bill.

We talk about 2,074 pages, which seems like a lot. It would be for a normal bill that you could debate in a limited period, which is what we are being asked to do. But 2,074 pages isn't nearly enough to cover health care for America.

So why is it only 2,074 pages? There are hundreds of references in there to how the Secretary of Health and Human Services is going to solve all the problems. The things we aren't able to put into detail in there we just assign to her, and she will magically be able to solve the problems for American health care. After all, it is her Department. But that is not going to happen. You can't give that many assignments to any agency, any department, any group of people and expect them, in a reasonable amount of time, to come up with solutions, solutions that ought to be decided on by this body, the elected officials--not appointed officials but elected officials. That is not going to happen with this bill.

The only way that could happen is if we took significant parts of it and put it up one piece at a time and solved it. That is what seniors are asking for. They are asking for us to take the Medicare part and give them some assurance that when we are through, it will work. We are not even getting to see a significant part of it. We have been pointing out how taking $464 billion out of Medicare will break it, will ruin it. You just can't steal $464 billion out of Medicare and have it come out good. The majority recognizes that. That is why they put in the special commission that is going to come to us each and every year and suggest the kinds of cuts we ought to make to keep that solvent.

The biggest thing we ought to do is take these cuts that are provided and make them actually apply only to Medicare. But how are you going to fund the expansion of Medicare now down to age 55? How do you do that? I guess you charge a premium to those people. That is kind of the rumor that is out there. How big of a premium? How big of a premium are you going to thrust on those people? I suspect it is going to be the older and the sicker people in that 55- to 64-age category who are going to want to shift over to Medicare.

If it is a higher premium so the system stays solvent--having nothing to do, of course, with age, because we cannot do that under the bill, or sickness, because we cannot do that under the bill--and those are good ideas--but those better be up in that range of the high-risk pools that the States already have.

People come to me and say: You have to do something about health care because we cannot afford that high-risk pool; it is too expensive. Well, how much more are we going to expect the young people to pitch in in their paycheck? That is where the Medicare money comes from right now. They deduct a portion of the paycheck from every single working American, and that goes into Medicare, and gets paid out right away to Medicare recipients, none of whom or hardly any of whom are the ones paying into the system. They are hoping that system is going to be there when they get older.

What I am asking for is for the majority to show us the paper and give us a reasonable time to look at it and give America a reasonable time to look at it. I do not think it is unreasonable for that to be on the Internet. That is a significant part of the bill. That would be a significant bill all by itself. It was held from our view when the HELP Committee did it. Incidentally, that HELP Committee bill--that was put together in 2 weeks without our help and put on us--parts of it were withheld, as this has been withheld, until the last minute and then thrust in.

That is what created this enormous outrage across America of: Did you read the bill? How can you read the bill if you have not seen anything in it, if it has not been given to you? I do not think it is intended to be given to us until we have to shuffle this thing through at the end.

The anticipation was to get this done by Christmastime, and the majority side keeps talking about getting this done by Christmastime. Will we have time to read it before Christmastime? Will we have a chance to do any amendments on it before Christmastime? I am willing to stay around and work through the weekend and keep doing amendments, but I would like to see this marvelous idea that is going to solve the whole problem. If it was that marvelous and that good of an idea, I think it would be shared already.

Mr. President, I yield the floor and reserve the remainder of our time.

Mr. President, I am fascinated by the speech we heard. There has been a bipartisan proposal. The chairman of the Budget Committee and the ranking member of the Budget Committee have proposed a commission, and that bipartisan deal is being chastised here. So we are on the bill, where 64 percent of the amendments that have been filed so far were filed by the Democrats, and I keep wondering why they are filibustering their own bill.

Then when something bipartisan does come up, they are opposed to that too. I know they think the only good ideas come from the other side of the aisle, and I do get frustrated with that.

Certainly.

I cannot fault the Senator from Montana for his efforts to get a bipartisan solution. As I have said many times, I am sorry he had to be cut off by phony time deadlines that kept us from reaching that kind of a solution, and then winding up with things that are in this bill we are talking about that were not a part of our discussions-- again, the things that were proposed by people on this side of the aisle that are not in that bill.

There were some possibilities for solutions. But we wound up with that same situation of: We won the election, we get to write the bill, and it has to be done quickly. So I am disappointed in the whole process.

I will.

The Senator is absolutely right. We have not even seen this new piece. Nobody wants to show us the new piece. They keep talking about it. They have leaked it to the newspapers, but they will not show it to us, and then they keep talking about how this bill is going to solve the deficits for this country; that there is $157 billion or something saved in the first 10 years. That is only--only--if you use the phoney accounting they are using. It is only if you don't do the doc fix. It is only if you don't solve the myriad of other things we have brought out.

We have a bill they keep talking about as being the solution. America has figured it out, but the Democrats haven't figured it out.

I see the leader is on the Senate floor. I yield the floor.

Recognition of the Minority Leader

Mr. President, it is my understanding the leader spoke under leader time.

So we should have an adequate 10 minutes to allocate to the Senator.

Mr. President, I yield myself 10 minutes.

Mr. President, Americans across this country are facing the reality of an economy that is in trouble. The unemployment rate is now 10 percent. According to the Department of Labor's broadest measure, some 17.5 percent of Americans are without a job entirely or are underemployed.

We have shed 3\1/2\ million jobs since January of this year and the average work week is now down to 33 hours for the American worker. Americans are struggling to find good jobs and, because of that, they are having trouble making their mortgage payments. Fourteen percent of all mortgage loans, meaning 7.4 million households, were delinquent or in foreclosure in the last quarter. That is the highest number since the mortgage bankers industry began this survey in 1972.

Many economic indicators point toward a slow, unsteady and jobless recovery, and the American people know it. In a recent survey, 82 percent of Americans said our Nation's economic conditions are poor. In recent weeks, President Obama has convened a summit at the White House to discuss jobs and economic issues. He has given speeches to discuss proposals for job creation and economic recovery. There has even been discussion about spending additional billions of dollars on another economic stimulus bill.

Unfortunately, the President has not advocated for the single quickest and simplest way to promote economic growth. If the President wants to save jobs and grow the economy, all he needs to do is tell the majority leader and the Senate Democrats to scrap this $2.5 trillion Reid health care reform bill and work it over, step by step, to get it right and to save costs.

Senator Reid's prescription for our economic troubles is a $2.5 trillion bill full of tax increases, higher health care costs, and $500 billion in Medicare cuts. The Reid bill contains $500 billion in new taxes. Primarily that is how it is being paid for--steal money from Medicare and tax people additionally. There are new taxes on individuals, new taxes on small businesses, and new taxes on health care providers.

These new taxes will raise health care costs. They will be passed on to the individuals in the form of higher premiums. According to the Congressional Budget Office, the Reid bill will drive premiums up by 10 percent to 13 percent.

I know the other side likes to relate to those pieces of the bill that talk about--one section that brings it down by 7 percent and another one that brings it down by 7 percent, but they fail to notice that the bill actually raises it to 27 percent to begin with. When you subtract that out, it still winds up with a 10-percent to 13-percent increase.

Who gets taxed under the Reid bill? If you don't have a government- approved health insurance, you get taxed. Incidentally, we are going to tell you--Washington is going to tell you what the minimum requirement is. That will be higher than most people have for insurance at the present time. The government will tell you what you need and they will fine you if you do not agree.

The total amount of new taxes on uninsured Americans is $8 billion. According to the Congressional Budget Office, half of the new taxes on the uninsured will be paid by families earning less than $68,000 a year.

If you do not have insurance, you will get taxed. If you have insurance, you can get hit twice by new taxes in

the Reid bill. First, new taxes on health care providers will be passed on to consumers in the form of higher premiums. Second, if the government bureaucrats decide your employer-sponsored insurance is too generous, you will get taxed for that too.

The Reid bill contains $150 billion in new taxes on employer- sponsored health benefits. These new taxes on benefits fall disproportionately on middle-income Americans. According to the Joint Committee on Taxation, 73 percent of those hit with new taxes on benefits earn less than $200,000--73 percent. That is a whole bunch of people down there in that category.

The Reid bill also contains new taxes on businesses that cannot afford to provide health insurance. Most employers do provide health insurance to their employees, but there are some who simply cannot afford to and stay in business. Senator Reid's health care plan will mean they will have to pay $28 billion in new taxes. These are the same businesses that are barely making it. These are the same businesses that are having to lay off workers to keep the company afloat, the same businesses that are cutting shifts to prevent further layoffs, and they are cutting wages to keep their employees on the payroll.

With our Nation's unemployment in double digits and millions more Americans worried about keeping their jobs and paying their bills, it is unthinkable to me that any Member of this body would support new taxes on businesses that are already struggling. These are the small businesses that absorb the extra employees that get laid off from the big businesses--and hopefully it is the small businesses that become the future big businesses.

In addition to the job-killing taxes, the Reid bill raises Medicare payroll taxes by $50 billion. These will fall disproportionately on small businesses. Approximately one-third of America's small businesses will be hit with this tax increase. These are the same small businesses that employ 30 million Americans.

I have to say, when you talk about taxing the rich, we are also talking about taxing the owners of small business corporations, because the money flows right through to them, even though they have to put most of it back into the business in order to keep the business going.

Not only will small businesses see their taxes go up under the Reid bill, they will see their health insurance premiums go up as a result of new taxes on health care providers. Beginning in 2010--that is 3\1/ 2\ years before many of the health reforms go into effect--new fees will be imposed on health insurance companies. That is right now, 3\1/ 2\ years before the reforms go into effect. The Congressional Budget Office and the Joint Committee on Taxation have characterized these as excise taxes. They have also testified that these fees will be passed through to consumers in the form of higher premiums.

If you need prescription drugs, you get taxed. Beginning in 2010, new fees will be imposed on prescription drug manufacturers. Similar to the health insurer fee, CBO and Joint Tax say it will be more expensive to buy prescription drugs.

If you need a medical device, you get taxed. Medical device manufacturers will be subject to a 2\1/2\-percent excise tax on sales. Again, the Congressional Budget Office and Joint Tax have testified that this tax will increase the cost of medical devices. Just like prescription drug costs and health insurance, this new tax on devices will drive premiums up. If you have high out-of-pocket drug expenses, you will get taxed. A family will no longer be able to deduct medical expenses that exceed 7\1/2\ percent of their gross income as they can now. Instead, they can only deduct expenses that exceed 10 percent. In plain English, this proposal limits the tax deductions a family can take for medical expenses. For example, a family of four earning $57,000 in 2013 would lose a tax deduction of $1,425. A family of four earning $92,000 in 2013 would lose a tax deduction of $2,300.

Instead of working toward a bipartisan solution to our economic problems, Senator Reid has brought a bill before us that spends $2.5 trillion over 10 years, raises taxes on middle-class families and small businesses. I support health care form, and I will continue to work to enact real reforms that lower the cost of health care. I cannot, however, support higher taxes that further jeopardize our economic recovery by punishing small businesses and raising health care costs for working families.

I yield the floor.

Mr. President, I voted to support Senator McCain's motion to commit the bill back to the Finance Committee to protect all seniors from the Medicare cuts in this bill.

Section 3201(g) of the Reid bill shields Florida from the sweeping payment reductions to Medicare Advantage plans. Democratic Senators from Florida, New York, Oregon and Pennsylvania have also reportedly sought carve outs to protect seniors in their States from these cuts.

It is unfair to protect only seniors in Florida from these cuts. President Obama said if you like what you have, you can keep it. I believe that principle should apply to all Medicare beneficiaries.

At least some of my Democratic colleagues are honest about what they are doing. The New York Times yesterday quoted the Senator from Florida as saying, ``It would be intolerable to ask senior citizens to give up substantial health benefits they are enjoying under Medicare . . . I am offering an amendment to shield seniors from those benefit cuts.''

Bloomberg News also quoted that same Senator as saying, ``We're trying to grandfather in seniors so that they don't lose the benefits they have.''

Now, I disagree with these sweetheart deals. But I understand the motivation behind them. We should not be

taking benefits away from Medicare beneficiaries.

What I don't understand is how other Democrats can deny that the Reid bill cuts Medicare benefits. I have heard my Democratic colleagues repeatedly argue that there no cuts of any ``guaranteed benefits'' in the Reid bill.

I was not familiar with the term ``guaranteed benefits,'' so I asked my staff to review the Medicare statute. They searched through the entire Social Security Act, which governs Medicare, and could not find that term anywhere. That is because the term doesn't exist. The other side just made it up.

Medicare Advantage plans provide extra benefits to beneficiaries who enroll in these plans. These are the benefits that will be cut under the Reid bill. Clearly the Senator from Florida understands the value of these benefits. That is why he and other Democrats are fighting tooth and nail to undo the cuts in their States.

At the same time, other Democratic Senators continue to argue that Medicare Advantage is neither Medicare nor an advantage.

That is false. Medicare Advantage is Part C of Medicare. If you go to the Web site of the Department of Health and Human Services, it says Medicare Advantage is part of Medicare.

As to the ``advantage'' part, Medicare Advantage does provide extra benefits, and seniors place great value on them. It's that simple. That is why the Senator from Florida and others are trying to get carve outs for seniors in their States.

Under the Reid bill, seniors will lose vision benefits. Apparently, the other side does not think vision care is an advantage.

The Reid bill will cut dental benefits for seniors. These are also apparently not an advantage for seniors.

The Reid bill will cut hearing benefits for seniors. These are apparently not an advantage for seniors.

The Reid bill will cut home care for seniors with chronic illnesses. The other side thinks these benefits are not an advantage.

The Reid bill will cut disease management programs for seniors. These benefits are also apparently not an advantage.

The Reid bill will cut nurse help hotlines for seniors. The majority apparently does not believe this is an advantage.

The Reid bill will end reduced cost sharing for primary care physician visits. This is apparently not an advantage for seniors.

The Reid bill will eliminate reduced premiums for Part B. This is apparently not an advantage for seniors.

The Reid bill will eliminate reduced cost sharing for breast cancer screening. This is apparently not an advantage for seniors.

The Reid bill will eliminate reduced cost sharing for prostate cancer screening. This is apparently not an advantage for seniors.

Most disturbing of all, the Reid bill will cut seniors' protections against catastrophic costs under Medicare Advantage. The other side says they want to keep medical bills from driving folks into bankruptcy. At the same time, they are eliminating Medicare Advantage benefits that actually protect Medicare beneficiaries from catastrophic medical costs.

How is catastrophic coverage not an advantage to seniors? It seems to me few things could be more advantageous than not losing your life savings because of medical bills.

It is obvious to anyone who listened to the list I just read that these are real benefits. Furthermore, it should be equally clear that the Reid bill will take these benefits away from millions of Medicare beneficiaries.

Anyone who doubts what affect the Reid bill will have on Medicare beneficiaries should look at the last time that Congress made cuts like this. The impact was severe.

Congress enacted the Balanced Budget Act of 1997, which included similar types of cuts. Once it took effect, nearly one out of every four of the plans, then known as Medicare+Choice, pulled out of the program.

According to an article in the Fort Lauderdale Sun Sentinel, when the Prudential Medicare+Choice plan withdrew from Florida, nearly 12,000 seniors in Broward, Palm Beach and Miami-Dade lost their coverage of prescription drugs, eyeglasses, hearing aids or other benefits.

You can bet seniors in Broward, Palm Beach and Broward counties haven't forgotten these cuts, losing their plans, sometimes their doctors, and certainly those benefits.

According to the Baton Rouge Advocate, over 50,000 Louisiana seniors lost the extra benefits that had been provided by Medicare+Choice plans. The cuts were so disruptive and confusing that State Insurance Commissioner Jim Brown had to air public service announcements. You can bet Louisiana seniors remember those cuts.

After these cuts went into effect, the Chicago Daily Herald reported that the Senior Health Insurance Program run by the Illinois Department of Insurance was ``deluged with phone calls from senior citizens affected by the move of some health maintenance organizations to drop Medicare.''

By that time, United Healthcare had decided to no longer offer Medicare+Choice plans in DuPage, Kane, Lake and Will counties. This affected 12,000 seniors in these Chicago suburbs.

By 2000, the Daily Herald reported that Aetna and Humana were also pulling out, dropping coverage for 2,794 beneficiaries in Lake County and 6,180 Aetna enrollees in Cook, Lake, Kane and DuPage counties. All of these beneficiaries lost the extra benefits they had previously received from their plans.

Brian Carey, director of Senior Services for Schaumburg Township, was quoted as saying, ``It's just thrown so many people into, in some cases, a complete state of panic.''

By 2002, the Chicago Tribune quoted CMS administrator Tom Scully as saying there were no--that's zero--Medicare plans serving Chicago and its suburbs.

If the Reid bill is passed, we will again see millions of Medicare beneficiaries lose the benefits they currently receive from Medicare Advantage.

Medicare beneficiaries understand this program provides real advantages to those who enroll in the program. They do not want to lose these benefits.

I hope that all of my colleagues support the McCain amendment and ensure that these seniors continue to receive these benefits.

Mr. President, I yield up to 10 minutes to the Senator from Arizona.

Mr. President, I yield up to 10 minutes to the Senator from Ohio, Mr. Voinovich.

Mr. President, I yield up to 10 minutes to the Senator from Idaho, Mr. Crapo.

I yield myself the balance of the time.

Amendment No. 2962 to Amendment No. 2786

Mr. President, I rise to speak in support of the Nelson amendment. We have been talking about the McCain amendment, which provides fairness for seniors who have Medicare Advantage so everybody across the country can have the same thing Florida is getting. But the critical amendment I wish to talk about is the Nelson amendment.

This amendment needs to be adopted if we truly want to prevent Federal dollars from being used to pay for abortions. I am asking my colleagues to support a Democratic amendment. This isn't a partisan issue; it is a human issue. Even if you are on the other side, I hope you can agree it is not right to force people to pay for a procedure they may find offensive to the core of their morality. This issue is very personal for many of us. It is for me.

When my wife Diana gave birth to our first child, Amy was 3 months premature. She weighed just 2 pounds and the doctor's advice was: Wait until morning and see if she lives. The doctors couldn't do anything to help this newborn baby. She survived the night.

The next day I took Amy to a hospital in Casper. An ambulance wasn't available so we went in a Thunderbird. It was in a huge blizzard, the same blizzard that prevented us to fly Amy to a hospital in Denver that specialized in that. But we took this car and went to the center of the State to the biggest hospital to get the best care we could find. We ran out of oxygen on the way because the snow slowed us. The highway patrol was looking for us, and they were looking for an ambulance. All along the way, we were watching every breath of that child.

We arrived at the hospital in Casper and put her in the care of doctors. There were several times when Diana and I went to the hospital and found her isolette with a shroud around it. We would knock on the window and the nurses would come and say: It is not looking good. We had to help her to breathe again or: Have you had your baby baptized? We did have Amy baptized a few minutes after birth, as she worked and struggled to live. Watching an infant fight with every fiber of her being, unquestionably showing the desire to live, even though they are only 6 months developed, is something that will show you the value of life. Amy survived and is now a teacher so gifted she teaches other teachers.

Amy's birth changed my whole outlook on life. It reminded me of the miracle of life and the respect we owe that miracle. The Reid bill, as it is currently, does not respect life. But the amendment before us will allow that respect to be given to every American who benefits from that bill.

On September 9, President Obama told a joint session of Congress: ``No Federal dollars will be used to fund abortions.'' I agree. No Federal dollars should ever be used to pay for abortions. To do otherwise would compel millions of taxpayers to pay for abortion procedures they oppose on moral or ethical grounds. Unfortunately, the Reid bill fails to meet that standard set by the President. Section 1303 of the bill provides the Secretary the authority to mandate and fund abortions.

Some have questioned exactly how this bill funds abortions. It is quite simple. The bill funds abortions through the government-run insurance option and through subsidies to individuals to help pay for the cost of private insurance. Both of these options are funded with Federal dollars. Under the community health insurance option, also known as the government-run plan, the Secretary of Health and Human Services could allow the plan to cover abortions. In addition, the new tax subsidies in the bill could also go to private plans that cover abortions. In both these cases, Federal subsidies would be paid to plans that cover abortion.

The Reid bill attempts to use budget gimmicks so its sponsors can argue that Federal funds will not pay for abortions. As the accountant in the Senate, I am not fooled by these gimmicks and neither should anyone else be. If the Reid bill is passed, Federal dollars will be used to pay for abortions.

Money is fungible. That is an interesting word. It means Federal dollars paid into a health plan could be shifted across accounts. We don't have a good accounting system for that. It can replace other spending and those dollars could then go to pay for abortions. There is no way to absolutely prevent Federal dollars from paying for abortions once they are paid to plans that cover abortions.

That is why Federal laws for the last 30 years have explicitly prohibited Federal funding going to such plans. That is right. It is already Federal law, although it comes in, in the appropriations bill, on an annual basis. Federal law currently prohibits funds going to pay for abortions under the Medicaid Program, under FEHBP--that is the program where we get our health insurance; it is the one that provides all the

health insurance for all Federal employees, the same choices of plans-- and the TRICARE Program, which is for all our Active military and their families.

Current law recognizes the only way to actually prevent Federal funds from being used to pay for abortion is to offer the coverage of abortion in separate insurance plans and collect separate premiums to pay for that plan. This is what States who want to cover abortion for their Medicaid populations already do. As I said earlier, Medicaid is prohibited from using Federal dollars to pay for abortions. As a result, States set up separate plans and collect non-Federal dollars in separate accounts to pay for those services.

If anyone has any doubts about the impact of the Reid bill, I would point them to the comments made by the senior staff at the U.S. Conference of Catholic Bishops. The associate director, Richard Doerflinger, recently described the Reid bill as ``completely unacceptable'' and said it was the worst health reform bill they had seen so far on life issues.

It is probably worth it to note that the bishops have been longtime supporters of health care reform and covering the uninsured. Similarly, National Right to Life said the Reid bill ``seeks to cover elective abortions in two big new Federal health programs, but tries to conceal that unpopular reality with layers of contrived definitions and hollow bookkeeping requirements.''

There has also been some misinformation out there regarding this amendment, and I wish to take a minute to clear up a couple arguments used against the Nelson amendment. First, it does not prohibit individuals from purchasing abortion coverage with their own private dollars. When similar arguments were made during the House debate on the Stupak language, PolitiFact, a Pulitzer Prize-winning, fact- checking organization, concluded that such statements were false. The Nelson amendment only prohibits Federal funds from subsidizing those plans.

Some have argued the Nelson amendment could cause individuals to lose the abortion coverage they currently receive from their current health insurance plans. That also isn't accurate. I would urge everyone to read section 1251 of the bill. Section 1251 says, clearly and unequivocally, that:

Nothing in this act or an amendment made to this act shall

be construed to require that an individual terminate coverage

under a group health plan or health insurance coverage in

which such individual was enrolled at the date of the

enactment of this act.

According to the sponsors of this bill, this section protects the ability of persons with existing insurance coverage to keep that same coverage. If section 1251 works as its authors describe it, this bill should make no changes to existing insurance plans that cover abortion and should allow individuals to keep the plans they have.

Some have also said this amendment would ban abortion procedures. That, too, is false. The amendment does not ban abortions; it simply prohibits Federal dollars from paying for abortions, which is consistent with the current law.

Many of my Democratic colleagues have argued during the debate that the health care we provide under this bill should be as good as the coverage given to Senators. If they believe that, they should all support applying the same rules regarding abortion coverage that apply to our own health plans. Federal employees' plans are prohibited from covering abortion--all Federal employees, not just Senators.

I will work hard to see that taxpayers are not compelled to fund abortion services. I believe those of us in elected office have a duty to work to safeguard the sanctity of human life, since the right to life was specifically named in the Declaration of Independence. By safeguarding our right to life, our government fulfills the most fundamental duty to the American people. When that right is violated, we violate our sacred trust with our Nation's citizens and the legacy we leave to future generations.

Regardless of what some people think, God doesn't make junk. He makes people in a variety of sizes, shapes, and abilities, and disabilities. There is a purpose even if we cannot understand it. I like the sign just outside Gillette. It says: ``If it's not a baby, you're not pregnant.''

I don't believe Federal funding should be used to pay for abortions, and I will work to ensure that it doesn't happen under this bill. I will vote in support of the Nelson amendment and encourage my colleagues to do the same to protect life and respect the miracle of life that I witnessed with the birth of my daughter Amy.

I thank the Chair and yield the floor.

Mr. President, I assume that added a few additional minutes to our time as well.

I yield 10 minutes to the Senator from Nebraska.

Mr. President, I yield myself as much time as I might need out of the remaining time we have.

I, too, thank the Senator from Vermont for his passionate comments on community health centers. In Wyoming we have community health centers and they serve a great role. For underserved areas across the Nation, they are absolutely critical. I wish there were more that we were doing in the area of community health centers. I think it provides some better solutions than some of the other things we are doing in this bill.

Wyoming is considered to be underserved. The whole State is underserved. Even our biggest cities are considered underserved. We are missing every single kind of medical provider, including veterinarians.

Usually when I make that comment, people say: People don't use veterinarians. But as far as our distances are, some people are happy to get to a veterinarian in an emergency situation.

We do have situations across the country that need to be taken care of. One of my concerns is that we are doing this huge Medicaid expansion. And when we do the Medicaid expansion, we already have it priced for doctors so that 60 percent of the doctors won't take a Medicaid patient. If you can't see a doctor, you don't have insurance, period. I don't think we are doing enough to take care of that difficulty prior to expanding this population. So we are going to shove more and more people out of getting any health care.

Amendment No. 2942

But the main thing I wanted to do today is rise in support of the Gregg amendment which would prevent Medicare cuts in the Reid bill from being used to create new entitlement programs to cover the uninsured. Yes, I want to have the uninsured covered. I don't oppose covering the uninsured, nor do I oppose reforming the Medicare Program. We need to do those things. We absolutely need to do those. But we shouldn't do it on a system that is going broke. We should not take the money from a system that is going broke to do new entitlement programs.

I know the Senator from Montana admitted that if the Gregg amendment were to pass, it would limit some of these entitlements, that they wouldn't be able to do them. Again, we are not opposed to doing those new entitlements. We are opposed to paying for them with Medicare money because Medicare is going broke.

They do say that if we put these extra burdens on Medicare, we will extend the life of it. And you can believe that or not. But we could expand it even more and we could solve some problems in Medicare if we took the money and we used it for Medicare. Medicare needs changes. Medicare needs to have money that we are now going to move away and put into other programs. But don't worry about it because we are going to form a Medicare Commission. Every year, that Commission is going to tell us what we ought to do to make more cuts. Before we start doing more cuts, maybe we ought to make sure the cuts we are doing go to what we anticipated needed the most help.

I am not opposed to covering the uninsured. I don't oppose reforming the Medicare Program. We should do those things. What I oppose is the Reid bill. This is the wrong approach to solve the problems.

The Gregg amendment would go quite a ways to solving some of my discontent with the bill. The amendment offered by my friend from New Hampshire highlights the main problems of the Reid bill and suggests a better approach. His amendment would protect the savings from the Medicare Program and prevent them from being used to create a new entitlement. This would mean this new program would not have to rely on cuts to Medicare to fund its operation. It would also reserve all money taken from Medicare so that it could be used to fix the problems in the Medicare system.

Earlier, we had an amendment that said that the money for Medicare would go to Medicare. Every single program that we allocate money to, we have inspectors general who are supposed to make sure the money for that program goes to that program. But this is a different situation. What we are saying here is that we want the money from Medicare to go to Medicare, not the money for Medicare to go to Medicare. The money for Medicare has to go to Medicare. But we are going to take money from Medicare. I say, if we have that money we can take from Medicare, we ought to put it to Medicare and only to Medicare until we have the Medicare problem solved. Our seniors are relying on that. Don't be caught up by the little words in do-nothing amendments that say the money for Medicare is going to go to Medicare. What we want to say is that the money from Medicare goes only to Medicare.

I am on my time here.

It is my understanding that the Senator from Montana is willing to take his time for the question.

Absolutely.

Yes.

That is where the Senator runs into a dead end. If you take the money that would be from home health care and you put it into an entitlement that has nothing to do with home health care, nothing to do with Medicare, then you did not extend the life of Medicare.

Reclaiming my time, I am the accountant in the Senate. If you take money from a program and you give it to something else, you have less money in that program. We admit that Medicare does have problems in the long term. Seven or eight years out there, it is going broke, and maybe we can extend it a year or two. If we took that money, that fraud and abuse--and I will say some more things about fraud and abuse here in just a minute--if we took that money and put it into the Medicare Program to extend the life of the program, we could give some assurance to seniors that we are doing something for them. That is where a lot of the concern comes from.

On fraud and abuse, if there is all this fraud and abuse out there, how

come we haven't been getting at that in the past and putting it to some kind of good use? All of a sudden, we are saying there is all this fraud and abuse and we are going to take this extra fraud and abuse and we are going to put it in there. I notice we have increased the amount of fraud and abuse we are capturing, but we did that by changing the definition. We just claimed more fraud and abuse. We didn't capture more money. That is one of the problems with having a government bureaucracy do things they really have no value in doing. If the government agency finds the money, it doesn't come back to their program, so they are not very excited about doing it. We keep passing fraud and abuse things around here, and the fraud and abuse never gets found to any extent. And the money can't be used if it can't be found.

As an accountant, what I have always suggested is, we have a separate fund set up, and when we find this fraud and abuse, we put it in that fund. We would only be able to use the money from that fund in these areas where we say we are going to fund it with fraud and abuse money. Because we have no incentive in government to go out and collect the money. It is a huge problem around here.

Some Democrats have argued that we are not creating a new entitlement program. They are simply wrong with that too. Just like Social Security, Medicare, and Medicaid, this bill will commit the Federal Treasury to paying for these new subsidies for the uninsured forever.

When we start a program around here, we don't put an end date on it. As soon as we have passed it, the people say: Wow, thanks, that is really great. Now what are you going to do for us? We look around and we say: Maybe we can do like Medicare Part D. Then we pass that and they say: Yes, you gave us Medicare Part D, but you still have the doughnut hole. So we take care of that. Anytime we do an entitlement, we keep adding to the entitlement regardless of where the money is coming from. And that is how Medicare has gotten in trouble. Once subsidies are given, they are never taken back. They are only expanded. There is no appreciation for what has been done. Medicare Part D; now they want the doughnut hole closed.

We are going to do kind of a phony thing to close that doughnut hole. PhRMA said they would give $50 billion that can be used as a subsidy as people go through the doughnut hole, but they said: You can only use the subsidy if we can pay it directly to the customer. That way, they keep in contact with the customer. And you can only use it if they stay with our brand name. OK, so they get through the doughnut hole. Then the taxpayer picks up the money, and they are stuck with the brand name. That is why the pharmaceutical companies can make so much money. If they can get them to not switch to that generic and make good economic decisions as they go through the doughnut hole, they can make a lot more money, once it is on the taxpayer outside of the doughnut hole. I am really upset with the pharmaceutical industry for doing that. That is the reason they are putting all the money into promoting this.

That means that as Federal spending continues to grow, new programs continue to grow. It will crowd out other Federal spending priorities such as education or national defense. States will tell you it is already crowding out education. When we put these new Medicaid requirements in there and they have to pay for them, they have a limited budget too. What they have done is take money away from colleges, so colleges have had to increase tuition dramatically in order to cover the money they had to give to Medicaid. So when we do some of these things, we are affecting a whole lot of things, other spending priorities such as education and national defense.

Any future attempts to modify or restrain this growth will be met by cries of indignation, arguing that cuts would devastate access to health care. If anyone has any doubt, they should look at the transcripts from our debate on the Deficit Reduction Act.

In 2005, Congress tried to reduce Medicare spending by about $20 billion and enact modest reforms to the Medicare Program. These reforms would have strengthened the long-term solvency of these programs which we are talking about now and helped reduce the Federal deficit. In response, Senator Reid called that bill an ``immoral document,'' and the junior Senator from California said she strongly opposed the cuts in the bill because they would ``cut Medicare and Medicaid by $27 billion.''

There are thousands of media quotes. The media quotes the majority more often, and here in DC the volume of quotes is equated with being right. Yet today these same Members and the rest of my Democratic colleagues want to create a new entitlement program that will spend hundreds of billions of dollars, and they would pay for it by cutting $464 billion from the Medicare Program. That is enough money to run the State of Wyoming for 320 years.

We don't understand how much money we are talking about here. You can't take that kind of money from a program, give it to other programs, and expect the program to work. We recognize that. That is why we put this Medicare Commission in there that annually is supposed to suggest extra cuts.

Let's see. We made a deal with the hospitals that we weren't going to cut them. We made a deal with the pharmaceuticals that we wouldn't cut them any more. We made a deal with doctors that we wouldn't cut them any more, although we never followed through on the doctor stuff because their deal--and these were all hidden deals--was supposed to be that they would either get a 1-year fix on the doc fix and medical malpractice or they would get a 10-year fix on the doc fix. That isn't in either of the bills. I don't know if they are going to stick with the hidden deal they made. I don't know what other hidden deals there were in this.

I believe these facts highlight why we need to adopt the Gregg amendment.

We should be very careful creating a new entitlement program which will permanently obligate our children and grandchildren to pay its costs. In fact, with the way we have maxed out our credit cards, we are now talking about the seniors actually having to pay for these other new entitlements. So grandpa and grandma will be paying for that, too, not just our grandkids and children. If my colleagues insist on doing it, however, at a minimum we need to guarantee that any new program has a stable and reliable source of funding. The Medicare cuts in this bill are neither stable nor reliable.

My Democratic colleagues have spoken at length about how the Medicare provisions in this bill will bend the growth of health care spending. That, unfortunately, is far from accurate. If you don't believe me, listen to what the other nationally recognized experts have to say.

According to the New York Times, the CEO of the world-renowned Mayo Clinic, which we use around here all the time, dismissed the reforms in the bill. Dennis Cortese said the Reid bill only took baby steps toward revamping the current fee-for-service system. The dean of the Harvard Medical School, Jeffrey Flier, said the bills being considered in Congress would accelerate national health care spending.

I wish there were more actual reforms in this bill. I applaud some of the efforts Senator Baucus included that will create incentives for coordinated care and rewarding providers who provide higher quality. I believe those are exactly the types of things we should do to improve the Medicare Program. Unfortunately, the savings from these actual reforms are a few pennies compared to the dollars of the arbitrary payment cuts included in the bill.

According to the Congressional Budget Office, all of the savings from the various policies to link Medicare payments to quality and encourage better coordination of care in the Reid bill provide less than $20 billion in total savings.

In contrast, the Reid bill includes over $220 billion in arbitrary payment cuts to health care providers, including hospitals, nursing homes, home health agencies, and hospice providers. We have made a point of how much those are and what the effect is going to be, and it is going to take away service that people have come to expect.

The Reid bill also includes an additional $120 billion in cuts to Medicare Advantage plans. Medicare Advantage is--we talked about wanting to provide catastrophic care for everybody. That

was one of the goals. Well, Medicare people do not have catastrophic care. They can buy catastrophic care through Medicare Advantage. But we are talking about making some substantial cuts to that which are either going to decrease benefits or, in some cases, make the whole service go away.

Those are not reforms. Instead, they represent the best efforts of folks in Washington to guess how much it actually costs real doctors and nurses to provide health care services to Medicare beneficiaries. We are not experts in the health care field, but we are going to guess at how much extra revenue they are getting. I want to emphasize that word ``revenue'' because, again, as an accountant, there is a difference between profit and revenue. We are going to cut substantially into the revenues, which is going to eliminate profits, which is the point at which people say: Why am I doing this?

So doctors and nurses are going to--people who are looking at being doctors and nurses are going to say: Why would I want to do that? Well, there is going to be a huge demand because the baby boomers are coming up, and they are going to need services.

So cuts like the ones to doctors and nurses and home health, and all of those, are an excellent example of how government price controls do not work.

Medicare does not negotiate payment rates with providers like private insurers do. Medicare uses price controls to set payment rates.

When I first went into the shoe business, President Nixon suggested we should have price controls; that the cost of goods was going out of sight. At that time, one could buy a pair of men's dress shoes for $10. They put in price controls--like this--but they could not put the price controls in immediately because it takes a while to pass a bill. So what did everybody who was manufacturing shoes do? They raised their prices, which forced us at the retail end to have to raise our prices too. By the time that went into effect, that $10 pair of shoes was $20. So price controls do not work. I have experienced it. It was dramatic, and it was terrible for the customer. We are talking about customers again.

Medicare uses price controls to set payment rates. Experts in Washington then look at various reported costs, revenues, and profits of health care providers, and then decide how much we should pay health care providers.

I have often said everyone thinks they know everything about a business until they actually have to run it. Unfortunately, we have been taking over a lot of businesses, and our expertise is showing. I am kind of fascinated by the Cash for Clunkers. That was a little business we decided we would set up on behalf of the government, and we said it would last for 4 months. It went broke in 4 days.

So as to any of the numbers anybody around here is considering, you ought to take a look at it because as a former small business owner, I want to assure them, it is actually a lot harder to run a business than it looks. For the simplest business you can think of out there, if you scratch the surface just a little bit you will find out those people are making dramatic decisions on a daily basis just to keep in business, which means, hopefully, paying themselves, but definitely paying their employees because that is not an option. If it was as easy as we think around here to do a business, everybody would be going into business.

The Medicare cuts in this bill are based on the efforts of folks in Washington to decide how much it costs to run a nursing home in Cheyenne or a home health agency in Gillette or any of these businesses in much smaller communities than that. Based on the past track record of Washington, I do not have much confidence in their abilities, and I do not think America does. I think that is showing up in the polls. I think that is showing up in the town meetings.

In 1997, Congress passed the Balanced Budget Act. It contained Medicare payment cuts. Lots of smart folks in Washington made arguments similar to those we are hearing today about how those cuts would not harm the providers or beneficiaries. That was historic.

Well, let me show you the historic arrogance of that time. What happened after these cuts went into effect? Within 2 years, these cuts had driven four of the largest nursing home chains in the Nation into bankruptcy. Vencor, Sun Healthcare, Integrated Health Services, and Mariner Post-Acute Network all filed for bankruptcy. Between them, they operated 1,400 nursing homes that provided care for hundreds of thousands of Medicare beneficiaries.

Similarly, the bill also included cuts in payments to Medicare+Choice plans. After these cuts went into effect, one out of every four plans pulled out of the Medicare program. Millions of beneficiaries lost the extra benefits these plans had provided.

Given this track record, I have grave concerns about what the Medicare cuts in the Reid bill would do to Medicare beneficiaries and the doctors, hospitals, and other providers who treat them. I have even greater concerns about using any estimated savings from these cuts to fund this new entitlement program for the uninsured.

That is why we should pass the Gregg amendment. Rather than relying on cuts that could devastate the Medicare Program, let's find a stable and reliable funding source that we could use to pay for health care reform. The Gregg amendment says that savings from any Medicare cuts should be reserved for the Medicare Program. That way, if the Washington experts again got it wrong, we will not have already spent all the savings on another program.

Madam President, I yield the floor.

Madam President, I wasn't going to take any part of this 30 minutes, but I can't help it. I will allocate myself 5 minutes.

I keep running into this comment that the Republicans were willing to cut $481 billion from Medicare. Would somebody show me where we cut $481 billion from Medicare? We didn't do it, and this bill won't cut $464 billion. Seniors won't let you do that. We didn't even propose it; the President proposed that. We knew it wasn't going to happen. You cannot cut Medicare without

having the seniors all upset because they understand their program is going broke--going broke.

That is why we have had this series of amendments. We have tried to come up with one that would actually solve the problem. We have been emphasizing the problem. The Gregg amendment takes care of the problem. That is why we brought up the Gregg amendment and why we should pass it. Rather than relying on cuts that can devastate the Medicare Program, we can find a stable and reliable funding source to pay for health care reform.

The Gregg amendment says that savings from any Medicare cuts should be reserved for the Medicare Program. That is saying that if these things are all possible that we are talking about as being possible and as being cost savers, if they really work, put it into Medicare. If you really want to extend Medicare, don't just say you are going to extend Medicare and then overlook a few things.

I have a little chart I haven't had a chance to use yet.

It was reiterated here that this bill is ``deficit neutral.'' Yes, according to CBO, it is--if you assume that Medicare physician payments will be cut 20 percent in 2011 and that they will be cut 40 percent over the next 10 years. We hold the physicians hostage every year, 1 year at a time, to get something out of them, and then we keep the cuts from happening. These cuts aren't going to happen. If they did happen, it would not be deficit neutral.

The bill makes no provision for paying this 20 percent that will be cut in 2011 or for the 40 percent over the next 10 years. There is no provision. So that part is going to be false as to having a deficit- neutral bill.

A massive new tax will be imposed on employer health benefits, hitting 31 percent of American family plans by 2019, if that does not happen--and I think people will notice the tax in a whole bunch of different ways--then this assumption is wrong and it is not deficit neutral.

Also, it relies on us cutting $464 million from Medicare. The Actuary said this level of cuts would bankrupt hospitals and threaten patient care.

I have a typo on the chart. It is supposed to be $464 billion, not million. I am still having trouble with that.

That amount would fund the State of Wyoming for 320 years. It is a big number. We are talking about cutting it by that much. If we don't cut this and we use this to pay for the other entitlement, the bill is not deficit neutral. CBO says that.

Everybody is entitled to their own opinions, but the facts are there. The facts say that if, if, if. We are not going to do those ``ifs.'' I will not go into that point, even though I am a little upset.

Yes.

The Senator from New Hampshire is absolutely correct. I am glad he came here to make that point on the amendment we are going to vote on this afternoon. It is critical. If you want to save Medicare, this amendment will save Medicare. It doesn't prohibit their programs from happening. They can still do the entitlements, but they have to be sure they are paid for. That is one of the problems. To say they are going to take the $464 billion from Medicare and put it into these other entitlements, that is not fair.

Madam President, I yield 10 minutes to the Senator from Idaho.

Madam President, may I inquire as to the time arrangement?

Madam President, I usually don't say much at these debates, but today I am going to make that an exception. I allocate the rest of our time to me. There have been a lot of comments here and they need to be clarified.

I do want to pass a bill that decreases health insurance premiums. I have traveled thousands of miles across the State of Wyoming, and every time I talk with somebody about health care, they ask me to do something to lower their health care costs--to lower their health care costs. That is what most people in America want.

American families cannot afford to pay ever increasing health insurance premiums. Small businesses cannot afford premiums that increase twice as fast as inflation.

Earlier this week, CBO issued--actually, it was last week--its long awaited report on the impact the Reid bill would have on insurance premiums. CBO said the premiums for individuals and families purchasing their health insurance will increase by 10 to 13 percent.

That means if the Reid bill is enacted, these folks will pay 10 to 13 percent more--more--for their health insurance. The legislation that its sponsors say is intended to lower health care costs will actually increase insurance premiums.

We should not be surprised by this finding. Several well-known actuarial business consulting firms have already issued reports that said the exact same thing: The bill increases health insurance premiums.

What is surprising is that some of my Democratic colleagues have argued that this CBO report provides support for enacting health reform. The New York Times even described this as ``Good News on Premiums.''

These statements defy logic and common sense. The bill attempts to completely restructure the nonemployer insurance market and impose massive new government mandates. Is anybody surprised that as a result the costs will go up?

Yet some of my Democratic colleagues have attempted to cherry-pick data and use selective quotes to try to mask what CBO said. For instance, some of them have pointed out how CBO said the Reid bill would lower premiums by 7 to 10 percent because of changes in the rules governing the insurance market.

As the Senate's only accountant, I take offense to these kinds of misrepresentations. Giving my Democratic colleagues the benefit of the doubt, I will assume they do not understand the differences between gross and net numbers.

I am not going to try to do a lot of numbers here. I did that once in committee and my staff watching back at the office--I got to ask the accountants at the SEC important questions at the time Enron was failing. You could see this little wedge of people seated behind the people testifying, and they were all asleep. I want to use this chart instead.

CBO did say the premiums would go down 7 to 10 percent due to insurance market changes. They also said premiums would go down another 7 to 10 percent because healthier people would sign up for insurance. What my colleagues forgot to mention or do not want to mention is that CBO also said that premiums would go up by 27 to 30 percent because the bill has so many mandates and requires most Americans to purchase more expensive coverage.

Yes, the Federal Government is going to tell you what you need for insurance, and then they are going to fine you if you do not get it. Maybe this chart helps to explain it.

We can see the net impact. Here is the 27 percent in increases because of

the mandates and the requirement to purchase more expensive coverage. This is the decrease that I mentioned. But you cannot just talk about this decrease and you cannot just talk about this decrease. You can talk about the net, and the net is a 13-percent increase in premiums.

I urge anyone who questions what I am saying to read the CBO letter. It is on the CBO Web site. Page 4 of the letter clearly states premiums will increase by 10 to 13 percent. That amounts to $2,100 for families purchasing coverage on their own. That does not meet the requirement that people in Wyoming think they are going to get. And the younger they are, the more surprised they are going to be because we get rid of the ratings, and young people will be paying considerably more. They are already paying into Medicare for seniors without getting any promise that will last until the time they become seniors, unless we pass something like the Judd Gregg amendment.

We have to protect that Medicare money to make sure it goes to Medicare and only Medicare if we are going to make sure Medicare stays solvent. We have to make that as a promise to the kids paying into the system now. They and their employers, and the amount the employers pay in, is the amount they could have in their own pocket if the employer did not have to pay it. But they are paying that so seniors can have the Medicare benefits, and we want them to have those benefits. We should not at this point take money from Medicare and build new entitlements and expect those same young people to pay an increased amount on while they pay an increase in their insurance premiums. Their insurance increase is going to be a lot more than 27 percent. In Wyoming, it was estimated to be around 300 percent. I think they will notice. I think they will be upset. If this bill passes, there will be a revolution in this country when people realize what has been thrust on them in this bill.

I yield the floor and keep the remainder of my time.

Mr. President, I ask unanimous consent that following the comments of the Senator from Massachusetts, an article be printed in the Record called ``The Coming Deficit Disaster'' by Douglas Holtz- Eakin, the same Congressional Budget Office Director to whom he was referring. That goes into a number of these points I probably will do later, but I want it at this moment because I want to relinquish such time as the Senator from Oklahoma might want.

Senator Sessions?

Mr. President, I yield up to 20 minutes to the Senator from Alabama.

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

Mr. President, I allocate the balance of our time to the Senator from Tennessee.

I think we are in alternating modes, so I could yield some time to the Senator from Tennessee.

Mr. President, I reserve the remainder of our time for the Senator from New Hampshire, but I will allow the Senator to speak now.

Mr. President, I yield 5 minutes to the Senator from New Hampshire and 10 minutes to the Senator from Texas.

Mr. President, I yield such time as they need to several Senators for the purpose of a colloquy.

Mr. President, the time for the colloquy has, unfortunately, expired. The balance of the time goes to the Senator from Iowa. I thank everybody for their participation.

What is the status of the time?

I will reserve the remainder of my time.

Mr. President, I rise in support of Senator Judd Gregg's amendment, which would prevent the Medicare cuts in the Reid bill from being used to pay to create a new entitlement program to cover the uninsured.

I do not oppose covering the uninsured. Nor do I oppose reforming the Medicare Program. We should do those things.

What I oppose is the Reid bill. This is the wrong approach to solve these problems.

The amendment offered by my friend from New Hampshire highlights the main problems with the Reid bill and suggests a better approach.

His amendment would protect the savings from the Medicare Program, and prevent them from being used to create a new entitlement.

This would mean that this new program would not have to rely on cuts to Medicare to fund its operation. It would also reserve all of the money taken from Medicare so that it could be used to fix the problems in the Medicare Program.

Some Democrats have argued that we are not creating a new entitlement program. They are simply wrong. Just like Social Security, Medicare and Medicaid, this bill will commit the Federal Treasury to paying for these new subsidies for the uninsured forever.

That means that, as Federal spending continues to grow, this new program will continue to grow. It will crowd out other federal spending priorities, like education and national defense.

Any future attempts to modify or restrain its growth will be met by cries

of indignation, arguing that cuts would devastate access to health care. If anyone has any doubts, they should look at the transcripts from our debate on the Deficit Reduction Act.

In 2005, Congress tried to reduce Medicare spending by about $20 billion and enact modest reforms to the Medicaid Program. These programs would have strengthened the long-term solvency of these programs and helped reduce the Federal deficit.

In response, Senator Reid called that bill an ``immoral document.'' The junior Senator from California said she strongly opposed the cuts in the bill, because they would ``cut Medicare and Medicaid by $27 billion.''

Yet today, these same Members and the rest of my Democratic colleagues want to create a new entitlement program that will spend hundreds of billions of dollars. And they would pay for it by cutting $464 billion from the Medicare Program.

I believe these facts highlight why we need to adopt the Gregg amendment. I don't believe we should create a new entitlement program, which will permanently obligate our children and grandchildren to pay its costs. If my colleagues insist on doing it, however, at a minimum we need to guarantee that any new program has a stable and reliable source of funding.

The Medicare cuts in this bill are neither stable nor reliable.

My Democratic colleagues have spoken at length about how the Medicare provisions in this bill will bend the growth of heath care spending. That is unfortunately far from accurate.

If you don't believe me, listen to what other nationally recognized experts have to say.

According to the New York Times, the CEO of the world renowned Mayo Clinic dismissed the reforms in the bill. Dennis Cortese said the Reid bill only took baby steps towards revamping the current fee-for-service system.

The dean of the Harvard Medical School, Jeffery Flier, said that the bills being considered in Congress would accelerate national health care spending.

I wish there were more actual reforms in this bill. I applaud some of the efforts that Senator Baucus included that will create incentives for coordinated care and rewarding providers who provide higher quality. I believe those are exactly the types of things that we should be doing to improve the Medicare Program.

Unfortunately, the savings from these actual reforms are a few pennies compared to the dollars of arbitrary payment cuts included in this bill.

According to the Congressional Budget Office, all of the savings from the various policies to link Medicare payments to quality and encourage better coordination of care in the Reid bill provide less than $20 billion in total savings.

In contrast, the Reid bill includes over $220 billion in arbitrary payment cuts to health care providers, including hospitals, nursing homes, home health agencies and hospice providers. The Reid bill also includes an additional $120 billion in cuts to Medicare Advantage plans.

Those are not reforms. Instead they represent the best efforts of folks in Washington to guess how much it actually costs real doctors and nurses to provide health care services to Medicare beneficiaries.

These cuts are an excellent example of how government price controls work.

Medicare does not negotiate payment rates with providers, like private insurers. Medicare uses price controls to set payment rates. Experts in Washington then look at various reported costs, revenues and profits of health care providers and then decide how much we should pay health care providers.

I have often said that everyone thinks they know everything about a business, until they actually have to run it. As a former small business owner, I want to assure them, it is actually a lot harder than it looks.

The Medicare cuts in this bill are based on the efforts of folks in Washington to decide how much it costs to run a nursing home in Cheyenne or a home health agency in Gillette. Based on their past track record, I don't have much confidence in their abilities.

In 1997, Congress passed the Balanced Budget Act. It contained over $434 billion in Medicare payment cuts. Lots of really smart folks in Washington made arguments similar to those we are hearing today about how these cuts would not harm providers or beneficiaries.

What happened after these cuts went into effect? Within two years, these cuts had driven four of the largest nursing home chains in the Nation into bankruptcy.

Vencor, Sun Healthcare, Integrated Health Services and Mariner Post- Acute Network all filed for bankruptcy. Between them, they operated 1,400 nursing homes that provided care for hundreds of thousands of Medicare beneficiaries.

Similarly, the bill also included cuts in payments to Medicare + Choice plans. After these cuts went into effect, one out of every four plans pulled out of the Medicare Program. Millions of beneficiaries then lost the extra benefits that these plans had provided.

Given this track record, I have grave concerns about what the Medicare cuts in the Reid bill would do to Medicare beneficiaries and the doctors, hospitals and other providers who treat them.

I have even greater concerns about using any estimated savings from these cuts to fund this new entitlement program for the uninsured.

That is why we should pass the Gregg amendment. Rather than relying on cuts that could devastate the Medicare Program, let's find a stable and reliable funding source that we could use to pay for health care reform.

The Gregg amendment says that savings from any Medicare cuts should be reserved for the Medicare Program. That way, if the Washington experts again got it wrong, we will not have already spent all the savings on another program.