Floor Statements

Mr. President, I rise today to support action on health care this week. There is a bill that will be voted on tomorrow morning that I think is extremely critical to the health of the Nation.

As chairman of the Committee on Health, Education, Labor, and Pensions, I can attest that access to affordable health care is the No. 1 issue for working families who contact my committee. I do need to explain where we are in this process.

We have a bill that made it out of committee to provide for small business health plans. There has been unanimous consent requested to proceed to the debate. That was denied. That is just the right to debate the bill, but it was denied. So a cloture motion was put in, and we will vote on that cloture motion tomorrow. That will be the 3 days after the cloture motion was filed. So that is a 3-day delay that we already have in solving small business health plan problems.

Tomorrow morning we will vote at 10. I can't imagine anybody voting against better health for people who work in small businesses. I am anticipating that we will get 60 votes. When we get 60 votes, we still will not get to debate the bill. We will have 30 hours of debate on that cloture vote before we will get to offer any amendments. Thirty hours. That could easily be 3 days. It could easily be Thursday before we get to offer the first amendment. I hope the other side will help to get cloture so that we can proceed to the debate. Then I hope that they would agree to shorten that time significantly so we could actually get to amendments and debate the bill.

We need to have a debate over the rising cost of health care. More importantly, we need to take action. Americans are tired of the status quo. They are tired of more of the same from the Senate. They are tired of excuses. They do want to see change for the better.

The majority leader announced his intention to bring a bill before the Senate that would allow small businesses to band together across the country and negotiate for better health care benefits at better prices. This bill sets up a system where we get a little bit of uniformity out there for the small businesses to band together across State lines and form a big enough pool that they have some power to negotiate against the insurance companies.

It is probably important to do that vote. I have some actuarial studies that show how many more people will be brought into the system, and CBO has done some evaluations of how many more people will be able to be insured and what kind of savings there will be. But I don't think they have the numbers right. The numbers are far greater than what they list.

Here is the reason I believe that. I had a lot of people call me Friday and Saturday and Sunday and let me know about the ads being run across the country. They are not referring to it as the small business health plans or even the Health Insurance Marketplace Modernization and Affordability Act. They are not even referring to it as S. 1955. They are referring to it as the Enzi bill. It is not the Enzi bill. It is the small business health plan bill. There are even Web sites set up. Thousands, if not millions, of dollars are being spent on advertising against it, which tells me that perhaps the ability for small companies to get together and negotiate against the insurance companies might be worth a lot more than anybody anticipated. That is where the ads are coming from.

Tomorrow morning we will be voting on the motion to proceed to the consideration of S. 1955. The bill will reduce the cost of health care, especially for America's small business owners and working families. Today, of the 45 million people without health insurance, 22 million own or work for small business, according to the Small Business Committee definition of a small business, or they live in families that depend on that small business for wages. Besides the 22 million out of the 45 million, there is another 5 million who are self-employed who could take advantage of this bill. That makes 27 million people who can't afford decent health insurance right now.

It is long past time for Congress to take action. The American people aren't going to accept excuses any longer. It is time for the Senate to take the first major step in nearly 15 years toward more affordable health insurance options for small businesses and working families.

There has been a bill on the House side that has passed 8 times in the last 12 years for association health plans. The Senate has never gotten any kind of a bill like that out of committee until now. This bill is not quite like that bill. This bill was derived by talking to the insurance companies, talking to the insurance commissioners, having them sit down with the associations and try to find a workable way that would not unlevel the playing field so that some people would be paying more for their health insurance while others were paying less. They worked for almost a year with me. All of them were convinced that something needed to be done. All of them were willing to work in a positive manner to come up with a bill that would work. That is what we have before us now.

That is not to say that the bill won't be changed through the debate, if we can get to the debate. There probably will be changes. There can be amendments to the bill. One of the things I have learned being in the State legislature as well as in Congress is that quite often amendments do help make a bill better. I do know that the American people support giving small businesses the same power that big businesses have had to negotiate for better benefits and better prices.

The fact that it has taken us so long to get to this point has to be frustrating for our constituents and the small businessmen. That is most of the people in the United States. They are either small business or they work in small businesses. When they work in a small business, they understand the plight of the business much better than in a big business. We already gave big business a lot more opportunity to negotiate than what we have in this bill for small business. This is a great start for small businesses to bring those costs down.

Small business owners and working families do want an up-or-down vote on small business health plans. They think they deserve it, and I believe they deserve it. I believe almost everybody here thinks they deserve a vote on whether they ought to be able to have a fraction of what the big companies have as an advantage in working with the insurance companies.

For years the small business owners have been asking the Senate to grant them the power that the big businesses have so they can secure affordable health care for their employees and their families. For the first time in over a decade, the Senate committee has reported a bill that gives small business owners the power they are seeking. Americans have sent hundreds of thousands of letters, petitions, phone calls, e- mails, faxes to the Senate over the past few weeks in support of small business health plans. The National Federation of Independent Businesses, one of the associations interested in this, delivered 500,000 petitions from across the United States asking us to do something. The people have taken time out of their busy days to demand action, and they deserve that up-or-down vote.

I remember getting permission, shortly after I got to the Senate, to hold a small business hearing in Casper, WY. That is the big city in the center of Wyoming. I held that hearing. I was pleased. I had about 100 small businessmen show up to lend their support and express their needs.

Afterward, one of the reporters asked: Aren't you disappointed you only had 100 people show up?

I said: Actually, this is small business. I am kind of surprised that 100 showed up because in small business, if you have an extra person who can spend a day at a hearing, you would probably fire them because you would have one more person than you needed.

In small business, they don't have nearly the diversity or the specialization, but they have a lot of personal ability and flexibility to take their product to market and to make a difference against the big companies that way. But they need some extra help. I know the minority leader will want an up-or-down vote on a bill sponsored by Senators Durbin and Lincoln. I believe the minority leader should get that up-or-down vote, even though I don't believe the bill he supports would provide the kind of change small business owners want and need. I know what the support is for that bill. I would love to do the comparisons between what we are trying to do in small business health plans and that. Let's see what the will of the Senate is, and let's not resort to blocking consideration through procedural motions.

I am sure some of my Democratic colleagues will want to use their share of the 30 hours of debate after this vote to discuss a variety of health care issues. Some Members of the minority will want to discuss the Medicare drug benefit. I have heard that on the floor in this preliminary time. Some will want to talk about drug importation. Some will want to talk about stem cell research. I know that from the debate we have had on the floor today. It is their right under the Senate rules.

I am not sure how I would go about explaining that to the small business owners and the working families who work in those small businesses. I suppose that the vast majority of those small business owners are going to be too busy during the day and night to watch the Senate debate on C-SPAN2. But those who do will understand that the issues we are talking about are not the solution they are expecting, and that they are external to the bill we are debating at this time. Those are important issues. But if they are just being done to block a bill--and that will be the way it will be termed by small business--I suspect there will be a price to pay for that kind of action.

I hope, for all our sakes, that the TVs in hospital emergency rooms are not tuned to C-SPAN. Some of those Americans who depend on small business and are in the emergency room may have no health insurance. Maybe their company dropped the coverage last year or

maybe the company could not afford health insurance in the first place.

What would they say if they were watching us this week? After all, the caption on the screen will read that we are supposed to be debating health insurance for working families. But instead of debating two competing visions for providing more affordable health care options for small businesses, we will be talking about Democratic amendments on a number of issues, including the Medicare drug benefit, which has already been done, and people are signing up in numbers that had not been anticipated. There is also already enough competition out there that it has driven the prices down. That is what competition does. It is working for seniors and they are saving money.

But instead of talking about things that are working for Americans, we should be debating the challenges that still face us, such as the rising cost of health care for America's working families.

Every day, emergency rooms treat more than 30,000 uninsured Americans who work for or depend on small business. That is at least 30,000 reasons why we should move right away to the consideration of S. 1955 to create small business health plans.

For the first time in more than a decade, the Senate has been presented with a bill that would create a whole new set of affordable health care choices through small business health plans.

Is it the perfect bill? No. I have never seen one in my 9 years in the Senate. We won't get to see anything even near perfect if we don't get to debate it. I believe most of my colleagues like the concept of getting as much perfection through amendments as possible and do want to work with me on it. Procedural votes won't get that done.

If we are waiting for the perfect bill, the one true and comprehensive solution to fix our health care system, then someone needs to bring us a tent, flashlights, and field rations, because we are going to be a very long time waiting for that. I am hoping it is not a series of 30-hour waits to debate things that won't have anything to do with getting small business health plans for small businesses. Americans are never waiting for perfection from Congress. They have given up on that long ago. But they do want action.

We have a good bill before us. We have a bipartisan bill before us. I am a former small business owner and I know something about the struggle to provide affordable health care to my family and to my work families.

Senator Ben Nelson, who coauthored this bill, is a former State insurance commissioner, so he knows something about the importance of protecting consumers. Senator Nelson and I have spoken about this bill with just about every Member of the Senate. We think it is a very good bill, and we have reached out to our colleagues over the last several months to take their concerns into account as we put the bill together.

Some of our colleagues will have amendments they believe will make it even better, and they should have the opportunity to offer those amendments. Neither Senator Nelson nor I are afraid of that, nor are we afraid of any alternative bills that Members might want to propose.

I urge my colleagues to set aside tomorrow's motion to proceed to the consideration of the bill. Let's get on with it, debate it, and have some amendments. We can have constructive votes on the floor on a number of issues that will improve this bill. But if we have to go through the procedural motions, let's keep in mind those 27 million uninsured Americans who work for or depend on small businesses. Those are 27 million Americans who are counting on the Senate to act now--not next month, not next year, but now.

Let's take the step toward more affordable health care for all Americans by giving small business owners the power to create small business health plans for themselves, their families, and their workers. Give them the chance they are seeking, instead of more of the same excuses for not acting. I don't think they will buy that.

I am hoping some of the media that is doing coverage will do a little bit better job than I happened to see last weekend. PBS did a special. They forgot to talk to anybody who worked on the bill. They talked about some problems with California's health care and attributed it to this bill. This bill cannot be the cause of that yet because it is not in California.

There have been concerns by a number of other groups. One was the attorneys general for a number of States. Again, it would have been nice if they would have talked to us to be sure they had the right bill and had read it before they took their action. So we will be covering that in the next few days.

If we have to talk for 30 hours, we will be plenty willing to do that. There are a lot of people in small businesses who see this as a primary concern and need, and they wish to see it done as soon as possible. They will not be very forgiving if people are holding things up to try to defeat the bill instead of making constructive progress.

I appreciate all those who have worked with me and all of those who are still working on amendments. Particularly, I would appreciate it if they would talk to me. There are some good ideas out there, things that would work. Many are for clarification. It will make a difference to small business. I hope everybody will get past this motion to proceed and the 30 hours of debate will get finished.

Mr. President, I ask unanimous consent that the Committee on Energy and Natural Resources be authorized to meet during the session of the Senate on Monday, May 8, at 3 p.m. The purpose of this hearing is to receive testimony regarding issues associated with the implementation of the provisions of the Energy Policy Act of 2005 addressing licensing of hydroelectric facilities.

Mr. President, I ask unanimous consent that the Committee on Homeland Security and Governmental Affairs be authorized to meet on Monday, May 8, 2006, at 3:30 p.m. to consider the nomination of David L. Norquist to be Chief Financial Officer at the U.S. Department of Homeland Security.

Mr. President, I ask unanimous consent that the Judiciary Committee be discharged from further consideration and the Senate now proceed to S. Res. 458.

Mr. President, I ask unanimous consent that the resolution be agreed to, the preamble be agreed to, and the motion to reconsider be laid upon the table.

Mr. President, I ask unanimous consent that the Secretary of the Senate be authorized to correct the engrossment of the Senate amendment to H.R. 4939, to reconcile the text of amendments 3728 and 3789.

Mr. President, I ask unanimous consent that when the Senate completes its business today, it stand in adjournment until 9:45 a.m. on Tuesday, May 9. I further ask that following the prayer and the pledge, the morning hour be deemed expired, the Journal of proceedings be approved to date, the time for the two leaders be reserved, and the Senate resume consideration of the motion to proceed to S. 1955, the small business health plans bill, with a vote on the motion to invoke cloture on the motion to proceed to S. 1955 to occur at 10 a.m.; further, that the time before the vote be equally divided between the chairman and ranking member of the HELP Committee or their designees.

Mr. President, tomorrow morning at 10 o'clock, we will have a cloture vote on the motion to proceed to S. 1955, the small business health plans bill. I do expect we will be able to proceed to this bill, and I hope we can expedite the 30 hours of debate postcloture and get on with the bill tomorrow.

Mr. President, if there is no further business to come before the Senate, I ask unanimous consent that the Senate stand in adjournment under the previous order.

Mr. President, this is under the jurisdiction of the Education Committee. We have taken a look at it. FEMA just has a different definition that needs to be changed from what other schools have. It clears up some language. It is not any problem.

Mr. President, I rise to introduce the Pharmacist Access and Recognition in Medicare Act. I have enjoyed working closely with Chairman Cochran and Senator Talent on

this bill that will help protect the valuable role that pharmacists play in our communities.

I have spent a lot of time over the past few months traveling around my home State of Wyoming talking to seniors about the new Medicare prescription drug benefit. This new voluntary benefit represents the most significant improvement to Medicare since its inception in 1965. Because of this new benefit, more seniors have prescription drug coverage and are able to purchase the medicines they need. Since the benefit took effect on January 1, 2006, 17,700 beneficiaries in Wyoming have signed up for prescription drug coverage and 27 million beneficiaries nationwide have drug coverage. I encourage all beneficiaries to enroll in a prescription drug plan before May 15, 2006.

I strongly support our community pharmacists. The changeover to Medicare Part D hasn't been easy and has produced several obstacles they have had to deal with as they have worked to serve Medicare beneficiaries. In traveling around my State over the past few months, I have talked to a few pharmacists who mentioned a few key problems they are facing with this new Medicare program that I believe we should address.

The first is an issue of cash flow management. As the only accountant in the United States Senate, I understand this problem. Most pharmacists have to pay their wholesalers like clockwork two times a month, but they are not receiving their reimbursement from the prescription drug plans in a similar timely fashion. This bill changes that. The bill states that plans have to reimburse all ``clean claims'' every 14 days. The bill also facilitates a quicker reimbursement by specifying that claims submitted electronically shall be paid by electronic transfer of funds. This is a small change in the law that I believe will play a large role in helping ease the transition to the new program for our local and community pharmacists.

The second issue I have heard about is called co-branding. Some of the prescription drug plans have partnered with some of the larger pharmacies and the plans are putting pharmacy logos on the benefit cards the beneficiaries use to get their prescriptions filled. Some people have told me that this is very confusing, because beneficiaries think that they must go to the pharmacy listed on the card. My bill says that co-branding is no longer allowed and all newly issued cards will not have pharmacy logos on them.

The final thing this bill does is expand upon what was in the Medicare bill that passed in 2003 regarding medication therapy management programs. I am pleased to say that Wyoming is ahead of the curve in this area. A few years ago, the Wyoming Department of Health partnered with the University of Wyoming to provide a service called Wyoming PharmAssist, which directly connects patients with registered pharmacists to review their medications for possible drug interactions and duplications. I was pleased to learn that this service is more advanced than systems in other States, providing patients with ways to reduce their monthly medication costs while improving safety. The Wyoming PharmAssist program can save clients $152 per month and $1,844 a year. Wyoming Pharm-Assist pays registered pharmacists for these unique services and is a model for the Nation. My bill tries to make the Federal program more like the very successful program in Wyoming.

I commend all the pharmacists across the country who are working so hard to make this new Medicare program work. They are getting life saving drugs to seniors who may not have been able to afford them before. I am proud to say I voted for this program back in 2003 and I am pleased with all the progress we are making.

I believe the Senate operates under what I call the 80/20 rule. 80 percent of the things that get done around here are non-contentious issues with support from both parties. The other 20 percent are the contentious issues that we seem to spend all our time talking about. I think this bill falls into the 80 percent category. This is a small bill that will do a lot of good for our pharmacists. It has wide support and I look forward to working with Chairman Grassley to help move this bill through his Committee.

I invite my colleagues to join me and Senators Cochran and Talent as sponsors of this bill to allow pharmacists to continue to provide the best quality care for seniors and the disabled who rely on them for their medications.

I ask that the text of the bill following my statement be placed in the Record.

Mr. President, I rise to introduce the Pharmacist Access and Recognition in Medicare Act. I have enjoyed working closely with Chairman Cochran and Senator Talent on

this bill that will help protect the valuable role that pharmacists play in our communities.

I have spent a lot of time over the past few months traveling around my home State of Wyoming talking to seniors about the new Medicare prescription drug benefit. This new voluntary benefit represents the most significant improvement to Medicare since its inception in 1965. Because of this new benefit, more seniors have prescription drug coverage and are able to purchase the medicines they need. Since the benefit took effect on January 1, 2006, 17,700 beneficiaries in Wyoming have signed up for prescription drug coverage and 27 million beneficiaries nationwide have drug coverage. I encourage all beneficiaries to enroll in a prescription drug plan before May 15, 2006.

I strongly support our community pharmacists. The changeover to Medicare Part D hasn't been easy and has produced several obstacles they have had to deal with as they have worked to serve Medicare beneficiaries. In traveling around my State over the past few months, I have talked to a few pharmacists who mentioned a few key problems they are facing with this new Medicare program that I believe we should address.

The first is an issue of cash flow management. As the only accountant in the United States Senate, I understand this problem. Most pharmacists have to pay their wholesalers like clockwork two times a month, but they are not receiving their reimbursement from the prescription drug plans in a similar timely fashion. This bill changes that. The bill states that plans have to reimburse all ``clean claims'' every 14 days. The bill also facilitates a quicker reimbursement by specifying that claims submitted electronically shall be paid by electronic transfer of funds. This is a small change in the law that I believe will play a large role in helping ease the transition to the new program for our local and community pharmacists.

The second issue I have heard about is called co-branding. Some of the prescription drug plans have partnered with some of the larger pharmacies and the plans are putting pharmacy logos on the benefit cards the beneficiaries use to get their prescriptions filled. Some people have told me that this is very confusing, because beneficiaries think that they must go to the pharmacy listed on the card. My bill says that co-branding is no longer allowed and all newly issued cards will not have pharmacy logos on them.

The final thing this bill does is expand upon what was in the Medicare bill that passed in 2003 regarding medication therapy management programs. I am pleased to say that Wyoming is ahead of the curve in this area. A few years ago, the Wyoming Department of Health partnered with the University of Wyoming to provide a service called Wyoming PharmAssist, which directly connects patients with registered pharmacists to review their medications for possible drug interactions and duplications. I was pleased to learn that this service is more advanced than systems in other States, providing patients with ways to reduce their monthly medication costs while improving safety. The Wyoming PharmAssist program can save clients $152 per month and $1,844 a year. Wyoming Pharm-Assist pays registered pharmacists for these unique services and is a model for the Nation. My bill tries to make the Federal program more like the very successful program in Wyoming.

I commend all the pharmacists across the country who are working so hard to make this new Medicare program work. They are getting life saving drugs to seniors who may not have been able to afford them before. I am proud to say I voted for this program back in 2003 and I am pleased with all the progress we are making.

I believe the Senate operates under what I call the 80/20 rule. 80 percent of the things that get done around here are non-contentious issues with support from both parties. The other 20 percent are the contentious issues that we seem to spend all our time talking about. I think this bill falls into the 80 percent category. This is a small bill that will do a lot of good for our pharmacists. It has wide support and I look forward to working with Chairman Grassley to help move this bill through his Committee.

I invite my colleagues to join me and Senators Cochran and Talent as sponsors of this bill to allow pharmacists to continue to provide the best quality care for seniors and the disabled who rely on them for their medications.

I ask that the text of the bill following my statement be placed in the Record.

Mr. President, I rise to support a resolution supporting the goals and ideals of the Year of the Museum. I am pleased to be joined by Senator Kennedy and other members of the Cultural Caucus in sponsoring this resolution recognizing the vital role museums play in the fabric of our American culture.

On the occasion of the 100th anniversary of the American Association of Museums, we treasure the more than 16,000 museums in the United States that house many of our greatest treasures. Museums inspire curiosity in students of all ages and foster a greater understanding of the world around us. Museums help us connect to the past and envision the future. Today, we celebrate their contribution to the vitality of our communities and our culture over the past 100 years.

I urge my colleagues to support this resolution.

Mr. President, this amendment increases funding by $3 billion and will be offset by closing tax loopholes, which means raising taxes, which would require a separate effort, anyway. The resolution we have before us already provides $12.7 billion in 2007 for grants to local education agencies, the largest component of No Child Left Behind. That represents a 45-percent increase from 2001.

The Federal investment in education will have grown by $12.2 billion, or 29 percent, since fiscal year 2001. In addition, the resolution provides an additional $1.5 billion for funding for function 500, which includes No Child Left Behind, and those funds can be used for that. Education is and should be one of our highest priorities, but this amendment is paid for by increasing taxes and busts the discretionary spending cap. I ask that you vote no.

Mr. President, for the Committee on Health, Education, Labor, and Pensions I report favorably the following nomination lists which were printed in the Record on the dates indicated, and ask unanimous consent, to save the expense of reprinting on the Executive Calendar, that these nominations lie at the Secretary's desk for the information of Senators.

Mr. President, I ask unanimous consent that the Subcommittee on Education and Early Childhood Development be authorized to meet during the session of the Senate on Wednesday, March 1, 2006, at 10 a.m., for a hearing on ``Protecting America's Competitive Edge Act (S. 2198): Helping K-12 Students Learn Math and Science Better.''

Mr. President, I rise to introduce the Consumer Assurance of Radiologic Excellence Act of 2006. This bill would improve the quality and value of diagnostic medicine. If the RadCARE Act is enacted, patients and providers alike will benefit from more efficient and accurate diagnoses and safer, more appropriate therapies, all afforded at a substantially decreased cost to the taxpayer.

Most of us feel anxious when we see the doctor, regardless of whether the evaluation reveals a problem. That is particularly true when we are concerned about cancer. How reassuring it is for us to believe that our physicians have available to them the full range of diagnostic tests and therapeutic procedures necessary to manage our care in the best way possible. We expect, too, that everyone who participates in our care is highly qualified to perform the services they provide. It is an expectation that each of us deserves to have but, all too often, is unrealistic.

Effective treatments are predicated on accurate diagnoses, and every treatment has the potential to cause harm. Missed, inaccurate, or delayed diagnoses can lead to unnecessary or dangerous therapies, with avoidable medical costs the least of the consequences. Physicians and patients should be able to trust that the technical providers such as the radiologic technologists, ultrasonography technologists, and medical radiation technologists who actually perform these tests are well qualified to do their jobs and have the appropriate credentials help to provide this assurance.

Cancer of many different types has become much more common; indeed, cancer is the second leading cause of death in America, behind only heart disease. Medical imaging tests play an increasingly important role in diagnosing a wide variety of malignant diseases and in determining the results of treatment. Radiation therapy is a common form of cancer therapy and used in more than half of all cancer cases. As our population ages, we should anticipate that such procedures and therapies will be performed with greater frequency on older Americans, with the cost borne more and more often by federally financed health care programs. For example, in 2004, Medicare paid over $1 billion for radiation therapy.

Improvements in health care often occur through technological innovations. For example, today's providers depend much more on diagnostic medical imaging than they did in the past, which has led to a rapid increase in the number of procedures performed, procedures that are not limited just to patients with cancer. Over 300 million radiologic procedures are performed annually in the United States, with 70 percent of Americans undergoing some type of medical imaging exam or radiation therapy treatment annually.

These innovations, while of undeniable potential benefit, come with substantial costs. Radiology costs are reaching over $100 billion annually; diagnostic imaging is one of the fastest growing cost areas in American health care. These costs are not limited to charges alone. Sedation, administered to facilitate a diagnostic imaging study, may compromise breathing or heart function. Therapeutic interventions based, in part, on these studies are fraught with potential complications, and the risk increases if the diagnostic information is incomplete or inaccurate. Similarly, a decision not to intervene carries its own risks, especially if the facts on which the decision is made are in error.

Congress has already taken some steps to assure the public that those who provide these services meet sufficient standards of technical proficiency. The Mammography Quality Standards Act of 1992 established standards for technologists performing one crucial diagnostic test; substantial quality improvement has been the result. The Consumer- Patient Radiation Health and Safety Act of 1981 encouraged the States to set standards for the technical competence of those who provide diagnostic imaging or radiation therapy services to patients but left compliance with those standards optional. Unfortunately, to date, nine States and the District of Columbia have enacted no regulatory statutes at all while, in a further six States, those regulations remain incomplete. Some provider disciplines have no specified standards of education, training, and experience at all. In fact, a provider with only a few hours of course work or a couple of weeks of on-the-job training may be responsible for obtaining the image a physician uses to diagnose your cancer or to deliver the radiation that is crucial to the treatment of your tumor. One doesn't have to be a doctor to recognize that this is not good medicine to rely solely on the good intentions of those who employ these providers.

In its report to Congress this March, MedPAC--the Medicare Payment and Advisory Commission--recognized that, while the issue is complex, technical excellence in diagnostic imaging and radiation therapy plays a central role in improving the public health and lowering costs of care. The RadCARE Act seeks to implement those recommendations that speak to credentialing of technical providers and brings to completion work begun with the Consumer-Patient Radiation Health and Safety Act.

Many will benefit if we pass the RadCARE Act. Better diagnostic images will help physicians to make faster, more accurate diagnoses or, alternatively, to exclude problems from further consideration. Risks such as sedation-related complications and radiation exposure will decrease. Patients will receive therapies that are more considered, precise, and safe. Provider and consumer confidence in the health care process will rise. Qualified technologists will be recognized for their professional achievements and motivated to improve their practice. Taxpayers, even if they are fortunate enough not to require diagnostic or therapeutic radiologic services, will appreciate that their tax dollars are not being wasted on poor quality, repetitive diagnostic examinations or unsafe therapies.

Could the RadCARE Act have unintended, adverse consequences? Some argue that meaningful credentialing of these technical providers will decrease access to care--that it is better to have non-credentialed providers than none at all. Certainly, establishing and maintaining a health care workforce that is adequate in size is an important goal for us to achieve. I would make the case, though, for quality--that bad information is worse than no information at all. It is reassuring to note that, in those States that do regulate this type of technical practice, the number of practitioners has remained stable. To further address this concern, the RadCARE Act gives the Secretary of Health and Human Services the flexibility necessary to modify regulations promulgated under this legislation, so that access to services is not compromised but standards are preserved.

Some fear that credentialing technical providers will increase health care expenses by inflating personnel costs. Again, in those jurisdictions that regulate this type of technical practice, wage inflation has not occurred. Regardless, while I believe that workers should be compensated, fairly and proportionately, for the work that they do, the cost savings from delivering care correctly far outweigh any potential cost increase that might result from higher salaries.

Others are concerned that the RadCARE Act could infringe on the States' right to regulate health care practice or that Congress lacks the capacity to define the standards of practice that should apply. The Act does not codify any particular State action; rather, it provides a substantial economic incentive to the States to establish, at least, minimum standards, an action for which there is precedent in the Mammography Quality Standards Act and one that is consistent with current public and private sector initiatives, such as ``pay for performance,'' that tie reimbursement to recognized best practices. Similarly, the RadCARE Act does not specify what standards should be followed but gives the Secretary the opportunity to derive those standards from those most qualified to provide them: the professional community. Indeed, the Act is supported by the Alliance for Quality Medical Imaging and Radiation Therapy, a consortium of over 275,000 technical professionals.

I invite my colleagues to join me and Senator Kennedy as sponsors of this bill to increase the quality and value of these important diagnostic procedures and lessen the possibility of life-threatening medical mistakes.

I ask that the text of the bill be printed in the Record.