Floor Statements

Mr. President, I commend my colleague from Oklahoma, a dear friend and somebody who has been passionate about health care for years. He and I came to Washington together in 1995. We served on the Energy and Commerce Committee, and we recognized then that changes needed to be made. Every year we have seen the same response in Washington. We have seen the end of a calendar year come, the need to find savings in health care. Administrations, Republican and Democratic, turn to Medicare and Medicaid and say we are going to extract $60 billion, $70 billion out of savings in these health care systems. We have laughed as they called it ``waste, fraud, and abuse'' because there is waste, fraud and abuse in it. We just didn't get any money out of it because we have been reluctant to fix the health care system in this country.

What are we doing? What is this plan? This plan is universal health care. Let me say it again. This plan is universal health care. This is providing affordable, accessible health care, provided by the private sector, for every American in this country.

This is change in the design of health care that has been historically, up to this point, employer negotiated, the majority employer paid for, and an employee has very little input into the makeup of the policies that cover them.

It doesn't reflect their age, it doesn't reflect their health conditions, it does not reflect their income.

What we are talking about is shifting it away from employers over time. We are talking about creating real incentives for individuals. We are talking about making sure 47 million uninsured Americans today and tomorrow have tax credits that can be used for real insurance coverage. What does that provide for them? For the first time, it creates a relationship between a patient and a health care professional.

We have talked in this institution, we have talked in this town, and we have talked in this country about the need to project wellness and prevention in health care. Well, this does it. This, for once, accomplishes that because we as individuals can negotiate our plans, not through the group plan but as 250 million-plus Americans. We can negotiate what makes sense for us from the standpoint of the scope of coverage that reflects what we are willing to pay as it relates to premium--and, by the way, provides States the capability to do the same thing with their Medicaid beneficiaries, their Medicaid patients, if, in fact, they want to begin to change the way their care is delivered, by creating the same relationship between a health care professional and them, because they now have the same insurance we do.

Medicaid beneficiaries have this big ``M'' on their foreheads. They do not want to be on Medicaid, but they are there because it is the last resort. What we want to do is integrate them into what all of the rest of us have; that is, individual insurance.

Dr. Coburn hit on a real key; that is, an attempt to bring everyone's health care costs down. It is not to pick out a group and to say, We are going to reduce yours, and pick out a group over here and say, We are going to reduce yours. This is an attempt--it is the first real attempt--to bring every-body's health care costs down.

What we learned when we created Part D Medicare, the drug benefit for 35 million-plus seniors in this country, was that when we created real competition between insurers and we brought transparency to price, two very real things happened: In the first year, premiums dropped 28 percent over what we had projected, and drug pricing dropped 33 percent.

We have a model we have already tried that seniors across this country say: Do not mess with this plan. That, in fact, exemplifies what we are trying to do. We are trying to create real competition between insurance for our insurance business; we are not letting one employer negotiate the plan and then dump it on the employees. But the question is, Can we have the same results as Part D by seeing the cost of health care reduced for all Americans? Well, you start that process when you eliminate cost-shifting. You accelerate that process when you inject what this bill does; that is, transparency in the price of health care that is delivered to you.

Imagine the day that you can go online and you can actually see what your doctor's visit is going to cost, what the lab workup is going to cost, what a visit to the emergency room at your local hospital is going to cost. In markets in North Carolina today, some choose not to go to the hospital for the nonemergency care, even though that may be their primary provider; they choose to go to the community health center because the community health center actually delivers the same if not a better level of care. But one thing is for certain: They know exactly what it is going to cost them. And these are individuals who are insured.

For the first time, all Americans have an opportunity at prevention and wellness. What does that mean? It means we can make decisions about our health care that have an impact on the cost of our health care to us and consequently have a ripple effect across the marketplace, that as more and more Americans make healthy decisions, the cost of health care overall comes down.

It means we have freed up those valuable health care dollars to make sure they are there for the individuals who are going to be susceptible to disease--chronic or terminal illness.

It means the relationship we have now established between patient and health care professionals means we have recognized we can accumulate the data we need so that Medicare reimbursements are no longer a shot in the dark where we pull a number down that may not be reflective of the cost of delivering the service, may not be reflective of the value of the service.

The reality is that when we create that relationship, we are able to accomplish the accumulation of data that tells us what things really should cost.

In health care, those healthy decisions allow individuals to make decisions about disease management. The most costly part of the U.S. health care system is the chronic diseases that exist and our inability to manage those diseases. The most expensive is diabetes.

Today, we have electronic capabilities for diabetics and for coronary heart patients where, at different periods during the day, their vital signs can be transmitted over a telephone line to their doctor. The doctor can instantly know whether, if it is a diabetic, they are managing their insulin. If it is a coronary heart patient, they can determine whether the fluid buildup means they need to adjust their medication. What does that give us the ability to do? It means we can take a patient who up to that point got too much fluid on the heart, made an emergency room visit, and in all likelihood was admitted for 3 days as they get the medicine back in balance. Now, a doctor, 24 hours a day, as these reports come in, can change their diuretic, can work with a diabetic on checking their blood sugar and what their insulin intake is, can detect whether they took the right medication. We can extrapolate that across every disease because technology now lets us do it in a real way. If we are not able to do this, then we are not able to recognize the value of new technology.

So much technology today that would benefit us in the Medicare marketplace is not reimbursable by Medicare. It is a decision they make because it is not tested in the marketplace; therefore, it has no value because they do not know how to reimburse for it. Well, the reality is, when you have a health care system that responds to the benefits to individuals, all of a sudden you have the market that creates a value for the technologies and for the innovations.

So I am delighted to be here. There is so much to this bill. This bill is the most comprehensive transformation of the health care system in my lifetime.

One might say it is difficult to do so big a bite at one time. I made that mistake. The reality is that when you look at the timeline we are up against every year we do not adopt this type of transformation of our health care system, more Americans become uninsured, more individuals with preexisting conditions no longer can afford health care, and the cost of everybody's health care in America goes up because we have not eliminated cost-shifting.

With disease management we could do today if, in fact, people had incentives in their system to take the time to monitor their health, to take their medication, to counsel with health care professionals about changes they could make, the more money we can save not only for each one of us but for the total system.

I am convinced that if you could only pick one thing out of this plan that you highlighted for the American people, it would be this: For the first time, we are presenting a very real way to insure 47 million Americans, the people who are most at risk in this country. If all of us were the beneficiaries in some way of reduced prices, more access, the ability to have transparency in pricing, the accumulation of data, electronic medical records that enable us to find savings, if that is the byproduct of us finding a way to use savings in the system to insure 47 million Americans, I believe that is the right thing to do.

The President came out in the State of the Union and he presented a very similar plan. Our plan expands on what the President said. Our plan goes to the heart of the health care system and says: If we are going to change it, then we have to go through total transformation. This is that total transformation that at the end of the day empowers every individual in this country to have custom health care coverage for themselves, for everyone in their family, for their health conditions, for their income and, more importantly, for their security.

So I commend the Senator for his work. I now look forward to working with him as we go through what I think will be a very intellectual debate about the future of health care in this country. As some look at Europe and look at other countries and say, Maybe we ought to do that in the future, I believe if we adopt this method we are going to have every country in the world looking at this model and saying, How do we do this? How fast can we do that?

I would only use that time to thank the Senator from Oklahoma. This is a crucial debate that this country needs to have, this institution needs to have. More importantly, we are at a point where we have to stop talking about what we are going to do and actually start doing something. The Senator from Oklahoma has stated it very well. What we can do is bring a higher level of care to all Americans--not just some Americans, to all Americans. Through that effort, all Americans receive a financial benefit. Our system prospers because we are able to take care of more, and we are able to provide an unlimited opportunity in the future because we unleash innovation and technology in health care.

I have wondered what it would be like if we had innovation at the same level in health care as, say, in cell phones; that we would have a new platform every 6 years, and that platform would provide an array of opportunities to us that we are not forced to take, but they are available to us if, in fact, we want them. Health care has been starved of innovation, in large measure because it treats every American differently. This is the first real opportunity for universal coverage, universal access, where every American has an opportunity at the best coverage available.

I thank the Senator from Oklahoma.

Mr. President, I rise today to honor the life of Jason Ray, a young man whose life was tragically cut short this past weekend while with the University of North Carolina basketball team during their trip to the NCAA Tournament games in New Jersey.

Jason, a 21-year-old native of Concord, NC, was set to graduate from UNC-Chapel Hill this May majoring in business administration with a minor in religion.

Jason was best known for regularly performing at sporting events as the university's mascot, ``Rameses.'' He was a member of UNC's cheerleading squad.

I have seen Jason perform at the school's sporting events. I admired his unmatched school spirit and his animated, energetic interaction with the Tar Heel fans.

The University of North Carolina community lost a dear friend in Jason on Monday. However, he left a legacy that will certainly last for the many generations of fans that watched him perform. College basketball holds a special place in North Carolinians' hearts. Jason's team spirit and dedication helped make rooting for UNC basketball a community tradition.

I send my thoughts and prayers to his family, teammates, classmates, fans, and friends.

Mr. President, I rise today to congratulate a college basketball team that this past weekend won a national title.

I am speaking of Barton College in Wilson, NC, which beat the defending champion Winona State to win the Division II Basketball Championship.

Through their win, Barton College also ended Winona State's Division II record 57-game winning streak.

Now I have seen a lot of college basketball games over the course of my life, especially representing the State of North Carolina, where basketball is not just a game but a way of life, but this one ranks close to the top when it comes to exciting endings.

With only 45 seconds left to play in the game, Barton down by 7 points--a deficit that would be extremely difficult to overcome by any team--and assisted by the stellar performance of his teammates, Barton's Anthony Atkinson scored an unbelievable 10 points in the remaining 39 seconds, included a buzzer-beating lay-up, to win the Division II national title by a score of 77 to 75.

If you didn't see the game live, I would suggest you go on the Internet and watch the ending to this fantastic game.

It is simply unbelievable and is reminiscent of Christian Laettner's game-winning last-second jump shot in Duke's dramatic 104 to 103 victory over Kentucky in the East regional final of the 1992 NCAA Tournament.

For Barton College, a small private school with a student body of only 960 students, this win over Winona State, a relatively large school with an enrollment of over 8,000 students, represents a ``David and Goliath'' story for a smalltown North Carolina basketball team.

Again, I congratulate the NCAA Division II National Champion Barton Bulldogs and head coach Ron Lievense on an extremely exciting end to an extraordinary season.

Mr. President, I rise today to express my support for S. 976, the Genomics and Personalized Medicine Act of 2007, which my distinguished colleague from Illinois, Senator Obama, and I introduced on March 23, 2007. Senator Obama introduced this legislation last year. We have worked together on some revisions, and I am proud to join him in cosponsoring the legislation this year.

I believe this legislation will help improve the quality and safety of health care by providing a better understanding of what causes certain diseases. Through a coordinated research initiative and safer genetic tests, patients and doctors will be empowered to make more informed decisions about medical treatments.

This bill will advance the study of human genes and their functions to better predict patients' susceptibility to certain diseases or conditions and better customize drugs and medical treatments to meet patients' unique needs. By facilitating genomics research, fostering a capable genomics workforce, and encouraging the development of high quality genetic tests, patients will be better informed about the medical care they need.

I am proud that North Carolina is a leader in genomics and personalized medicine research. Duke University's Institute for Genome Sciences and Policy and the University of North Carolina at Chapel Hill's Institute for Pharmacogenomics and Individualized Therapy are both conducting significant research efforts in this area and support a stronger Federal focus on genomics. This legislation will increase Federal support for initiatives at Duke and Chapel Hill--a win-win for North Carolina and patients.

Specifically, this bill establishes an Interagency Working Group at the U.S. Department of Health and Human Services to pull together and accelerate genomics research by developing standardized terminology and establishing quality standards and guidelines for the collection, processing, and storage of genomic samples and data. It advances genomics research by establishing a national biobanking distributed database that collects and integrates genomic data to simplify pooled data analysis. The bill also develops biobanking initiatives at academic medical centers across the country, including biobanks containing biological specimens. It will improve genetics and genomics training by developing model training programs, residency curricula and teaching materials, and by integrating genetics and genomics into clinical and public health practice by developing health professional guidelines.

The bill will also encourage drug sponsors and device companies to develop companion diagnostic tests, and it will improve Federal oversight and regulation of genetic tests by identifying which tests require review and which agency--the Centers for Medicare and Medicaid Services or the Food and Drug Administration--should have oversight over specific categories of tests. It requires the Centers for Disease Control and Prevention to evaluate direct-to-consumer marketing of genetic tests to which consumers have direct access and to educate the public about genomics and its applications. It also asks the Agency for Healthcare Research and Quality to assess the clinical utility and cost-effectiveness of companion diagnostic tests that guide prescribing decisions.

Mr. President, I take the floor today to speak on two subjects and very briefly to address my colleague from Ohio. Mr. President, I wish to make an important point about why these collective bargaining provisions are, in fact, harmful to the United States of America and to the American people. It is a pretty simple point.

Terrorists don't have collective bargaining agreements. I will say that again. Terrorists don't have collective bargaining agreements. Terrorists don't go on strike. Terrorists don't call their unions to negotiate before they attack. They are always plotting and, because of this, we must be always working vigilantly to protect our homeland.

Today we are debating how quickly we are going to respond to threats from terrorists who are eager to strike us, and some in this body are suggesting that we should give the ability of the people who are on the front lines to collectively bargain. It is absurd. It is absolutely absurd. But I assure my colleagues, if this collective bargaining language stays in, we risk doing exactly that--accepting something absurd.

(The remarks of Mr. Burr pertaining to the introduction of S. 765 are printed in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

Mr. President, I yield the floor.

Mr. President, I wish to talk about education, something many in this body take very seriously. I rise today to address the Nation's dropout crisis. Each day that our schools are open, approximately 7,000 students drop out of high school. That is 1.2 million students annually who do not complete their high school education. Almost a third of American students who enter high school in the ninth grade drop out of school and never receive their high school diploma.

I know our students, our schools, our communities can do better. To ensure that these young people have a better future and that America maintains its competitiveness in a global economy, I suggest to all my colleagues that we must do better.

According to a Manhattan Institute study, the high school graduation rate for the class of 2003 nationwide was only 70 percent. Thirty percent of our students in this country do not cross the goal line of graduation. Even more alarming, however, is that high school graduation rates for subgroups of students in 2003 were for White students, 78 percent; African Americans, 55 percent; Hispanics, 53 percent.

Graduating from high school is a 50-50 proposition in 930 of our high schools in our country. Fifty percent of the students in 930 schools do not get their high school diplomas. In 2,000 high schools, it is a 60- 40 proposition. Sixty percent are going to get their diploma, 40 percent will not get their diploma.

Just last week, my home State of North Carolina released its most current data on our State's dropout crisis. Our statistics, likewise, point to an urgent need to pay attention to our public high schools and these students.

North Carolina's statewide graduation rate was 68 percent. Yet for Black students, that rate falls to 60 percent; for low-income students, 55 percent; and for Hispanic students, 52 percent. Nearly 80 percent of the Nation's high schools that produce the highest number of dropouts are in 15 States, and I am embarrassed at the fact that North Carolina is one of them.

To retain our competitive edge in the world economy, America's youths must be prepared for the jobs of today and the jobs of the future, jobs which increasingly require a postsecondary education. Unfortunately, in 2003, 3.5 million Americans ages 16 to 25 did not have a high school diploma and were not enrolled in school.

Individuals without a high school diploma experience higher rates of unemployment, incarceration, and are more likely to live in poverty and receive public assistance than individuals with at least a high school diploma.

We know the statistics, but they are worth repeating. Mr. President, 4 out of every 10 people ages 16 to 24 without a high school diploma receive some type of government assistance. A high school dropout is eight times more likely to be incarcerated than a person with a high school diploma.

I am fortunate to represent a State with a rich history in its commitment to higher education. The State of North Carolina is the home of the Nation's first State university, the University of North Carolina at Chapel Hill, which welcomed students for the first time to its campus on January 15, 1795. All total, North Carolina has 127 degree-granting institutions of higher education--75 public and 52 private. However, North Carolina and the rest of the country cannot rest on their laurels with their higher education systems. We should be and are proud of our high college-going rate in North Carolina. Yet while 64 percent of recent North Carolina high school graduates go on to college, that number is far too low.

There is no silver bullet that will fix our educational system, including high school reform which many have talked about. I hope more and better research will give us a better direction and maybe better answers, but until then, there are a number of things that we can and we should be doing to improve what is a problem that must be addressed.

In particular, we know the three Rs to making our public high schools work better for today's students are rigor, relevance, and relationships. Today, Senator Jeff Bingaman from New Mexico and I are introducing bipartisan legislation, the Graduate for a Better Future Act. This is to help turn the tide of our Nation's dropout crisis.

Senator Bingaman has been a stalwart leader in the Senate on issues relating to dropout prevention. I am proud to join him in an effort to lower high school dropout rates and to raise high school graduation and college-going rates.

This legislation will create a competitive grant program targeted at school districts and high schools with the lowest graduation rates, focused on those three Rs of high school reform: rigor, relevance, and relationships.

Funds under this act would be used for models of excellence for academically challenging high schools to prepare all students for college and for work; to offer academic catchup programs for those students who enter high school and do not meet proficient levels in mathematics, reading, language arts, or science that enable such students to meet proficient levels and remain on track to graduate from high school with a regular high school degree; to implement early warning systems to quickly identify students at risk of dropping out, especially systems that track student absenteeism, one of the greatest predictors that a student may drop out of high school; to implement comprehensive college guidance programs that ensure all students and their parents are regularly notified of high school graduation requirements, college requirements for entry, and provide guidance and assistance to students in applying for postsecondary education and in applying for Federal financial assistance and other State, local, and private financial aid and scholarships; to implement a program that offers all students opportunities for work-based and experiential learning experiences, such as job shadowing, internships, and community service so that students make the connection between what they are learning in school and how that applies to the workplace that we want them to be in; and to implement a student advisement program

in which all students are assigned to and have regular meetings with an academic teacher adviser.

A recent survey of high school dropouts by Civic Enterprises presents a picture of the American high school dropout that is surprising to many. I know it surprised me. Eighty-eight percent of those students who dropped out of high school had passing grades when they dropped out. Let me say that again. Eighty-eight percent of the students who dropped out of high school had passing grades which would have enabled them to complete their high school diploma. But they dropped out. Fifty-eight percent dropped out with 2 or fewer years to complete high school; 66 percent said they would have worked harder if expectations had been higher; 81 percent recognized that a high school diploma was absolutely vital to their success in life; and 74 percent said they would have stayed in school if they had it to do all over again.

Mr. President, this is the point where we get a redo. We get an opportunity to make sure students get an opportunity in the next generation so they don't make the same mistakes the last ones did.

Over the past 25 years, the difference in earnings between workers with lower and higher levels of education has grown. As my home State of North Carolina has experienced, gone are the days when an individual with only a high school diploma or GED can find a high-paying job in industries such as manufacturing, textiles, or furniture.

The global economy has changed the marketplace, and the competition is no longer the person who sits next to us. It is the person who graduates from the school we will never hear about or have an opportunity to visit.

We know more education pays off. Over his or her lifetime, an individual without a high school diploma will earn approximately $1.1 million less than an individual with a bachelor's degree, $1.5 million less than an individual with a master's degree, and $2.4 million less than an individual with a doctoral degree.

What is the message to our children and our grandchildren? Is it that the future is more competitive than the past, that to be competitive in the job market means we have to raise our educational skills, and as parents and grandparents, we have to make it happen? The answer is yes.

The Senate can no longer sit by and accept rates of 30 percent of our students who don't cross the goal line of high school and accept that without a fight. We can do better, and we should do better.

I look forward to working with my colleagues on the Health, Education, Labor, and Pensions Committee, and with my cosponsor, Senator Bingaman, to face our Nation's dropout crisis head on. This is a first start. This is the ability to educate parents and students about not only how we engage them in the proficiencies they need to be competitive but, more importantly, how we teach them that our expectations are greater than what they felt in the past.

It is time that the Senate lead by example to begin to pass legislation that has a real impact on the high school graduation rates in this country; that we can look back and say it was this legislation that started the process, and it was quickly followed up with additional legislation that helps our youth compete, regardless of where that job is and regardless of who their competition is.

As this legislation comes before the committee and comes to this floor, I urge my colleagues to pay particular attention to the impact it has on our children and our grandchildren but, more importantly, on our competitiveness in the future.

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

Mr. President, I wish to talk about education, something many in this body take very seriously. I rise today to address the Nation's dropout crisis. Each day that our schools are open, approximately 7,000 students drop out of high school. That is 1.2 million students annually who do not complete their high school education. Almost a third of American students who enter high school in the ninth grade drop out of school and never receive their high school diploma.

I know our students, our schools, our communities can do better. To ensure that these young people have a better future and that America maintains its competitiveness in a global economy, I suggest to all my colleagues that we must do better.

According to a Manhattan Institute study, the high school graduation rate for the class of 2003 nationwide was only 70 percent. Thirty percent of our students in this country do not cross the goal line of graduation. Even more alarming, however, is that high school graduation rates for subgroups of students in 2003 were for White students, 78 percent; African Americans, 55 percent; Hispanics, 53 percent.

Graduating from high school is a 50-50 proposition in 930 of our high schools in our country. Fifty percent of the students in 930 schools do not get their high school diplomas. In 2,000 high schools, it is a 60- 40 proposition. Sixty percent are going to get their diploma, 40 percent will not get their diploma.

Just last week, my home State of North Carolina released its most current data on our State's dropout crisis. Our statistics, likewise, point to an urgent need to pay attention to our public high schools and these students.

North Carolina's statewide graduation rate was 68 percent. Yet for Black students, that rate falls to 60 percent; for low-income students, 55 percent; and for Hispanic students, 52 percent. Nearly 80 percent of the Nation's high schools that produce the highest number of dropouts are in 15 States, and I am embarrassed at the fact that North Carolina is one of them.

To retain our competitive edge in the world economy, America's youths must be prepared for the jobs of today and the jobs of the future, jobs which increasingly require a postsecondary education. Unfortunately, in 2003, 3.5 million Americans ages 16 to 25 did not have a high school diploma and were not enrolled in school.

Individuals without a high school diploma experience higher rates of unemployment, incarceration, and are more likely to live in poverty and receive public assistance than individuals with at least a high school diploma.

We know the statistics, but they are worth repeating. Mr. President, 4 out of every 10 people ages 16 to 24 without a high school diploma receive some type of government assistance. A high school dropout is eight times more likely to be incarcerated than a person with a high school diploma.

I am fortunate to represent a State with a rich history in its commitment to higher education. The State of North Carolina is the home of the Nation's first State university, the University of North Carolina at Chapel Hill, which welcomed students for the first time to its campus on January 15, 1795. All total, North Carolina has 127 degree-granting institutions of higher education--75 public and 52 private. However, North Carolina and the rest of the country cannot rest on their laurels with their higher education systems. We should be and are proud of our high college-going rate in North Carolina. Yet while 64 percent of recent North Carolina high school graduates go on to college, that number is far too low.

There is no silver bullet that will fix our educational system, including high school reform which many have talked about. I hope more and better research will give us a better direction and maybe better answers, but until then, there are a number of things that we can and we should be doing to improve what is a problem that must be addressed.

In particular, we know the three Rs to making our public high schools work better for today's students are rigor, relevance, and relationships. Today, Senator Jeff Bingaman from New Mexico and I are introducing bipartisan legislation, the Graduate for a Better Future Act. This is to help turn the tide of our Nation's dropout crisis.

Senator Bingaman has been a stalwart leader in the Senate on issues relating to dropout prevention. I am proud to join him in an effort to lower high school dropout rates and to raise high school graduation and college-going rates.

This legislation will create a competitive grant program targeted at school districts and high schools with the lowest graduation rates, focused on those three Rs of high school reform: rigor, relevance, and relationships.

Funds under this act would be used for models of excellence for academically challenging high schools to prepare all students for college and for work; to offer academic catchup programs for those students who enter high school and do not meet proficient levels in mathematics, reading, language arts, or science that enable such students to meet proficient levels and remain on track to graduate from high school with a regular high school degree; to implement early warning systems to quickly identify students at risk of dropping out, especially systems that track student absenteeism, one of the greatest predictors that a student may drop out of high school; to implement comprehensive college guidance programs that ensure all students and their parents are regularly notified of high school graduation requirements, college requirements for entry, and provide guidance and assistance to students in applying for postsecondary education and in applying for Federal financial assistance and other State, local, and private financial aid and scholarships; to implement a program that offers all students opportunities for work-based and experiential learning experiences, such as job shadowing, internships, and community service so that students make the connection between what they are learning in school and how that applies to the workplace that we want them to be in; and to implement a student advisement program

in which all students are assigned to and have regular meetings with an academic teacher adviser.

A recent survey of high school dropouts by Civic Enterprises presents a picture of the American high school dropout that is surprising to many. I know it surprised me. Eighty-eight percent of those students who dropped out of high school had passing grades when they dropped out. Let me say that again. Eighty-eight percent of the students who dropped out of high school had passing grades which would have enabled them to complete their high school diploma. But they dropped out. Fifty-eight percent dropped out with 2 or fewer years to complete high school; 66 percent said they would have worked harder if expectations had been higher; 81 percent recognized that a high school diploma was absolutely vital to their success in life; and 74 percent said they would have stayed in school if they had it to do all over again.

Mr. President, this is the point where we get a redo. We get an opportunity to make sure students get an opportunity in the next generation so they don't make the same mistakes the last ones did.

Over the past 25 years, the difference in earnings between workers with lower and higher levels of education has grown. As my home State of North Carolina has experienced, gone are the days when an individual with only a high school diploma or GED can find a high-paying job in industries such as manufacturing, textiles, or furniture.

The global economy has changed the marketplace, and the competition is no longer the person who sits next to us. It is the person who graduates from the school we will never hear about or have an opportunity to visit.

We know more education pays off. Over his or her lifetime, an individual without a high school diploma will earn approximately $1.1 million less than an individual with a bachelor's degree, $1.5 million less than an individual with a master's degree, and $2.4 million less than an individual with a doctoral degree.

What is the message to our children and our grandchildren? Is it that the future is more competitive than the past, that to be competitive in the job market means we have to raise our educational skills, and as parents and grandparents, we have to make it happen? The answer is yes.

The Senate can no longer sit by and accept rates of 30 percent of our students who don't cross the goal line of high school and accept that without a fight. We can do better, and we should do better.

I look forward to working with my colleagues on the Health, Education, Labor, and Pensions Committee, and with my cosponsor, Senator Bingaman, to face our Nation's dropout crisis head on. This is a first start. This is the ability to educate parents and students about not only how we engage them in the proficiencies they need to be competitive but, more importantly, how we teach them that our expectations are greater than what they felt in the past.

It is time that the Senate lead by example to begin to pass legislation that has a real impact on the high school graduation rates in this country; that we can look back and say it was this legislation that started the process, and it was quickly followed up with additional legislation that helps our youth compete, regardless of where that job is and regardless of who their competition is.

As this legislation comes before the committee and comes to this floor, I urge my colleagues to pay particular attention to the impact it has on our children and our grandchildren but, more importantly, on our competitiveness in the future.

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

Mr. President, I wish to take this opportunity to honor the life of Caldwell County Sheriff Gary M. Clark, who died from cancer on February 2 at the age of 47. Sheriff Clark was an outstanding and dedicated public servant whose influence, knowledge, and achievements were widely known and highly regarded.

Sheriff Clark served the citizens of Caldwell County with honor and distinction for 27 years. He began his law enforcement career with the Lenoir Police Department, where he served for 22 years. He was first elected sheriff of Caldwell County in 2002 and reelected to a second term in November 2007.

Sheriff Clark loved serving the citizens of Caldwell County and dedicated his life to law enforcement. Additionally, he loved his family and was a dedicated husband and father. He was also a man of great faith.

Sheriff Clark is survived by his wife Kim Clark; two daughters, Megan Elaine Clark, 14, and Staci Michelle Clark, 11; his parents Stanley and Norma Clark; and a brother, Alan Clark.

I know my colleagues in the Senate join me in honoring the life of Sheriff Gary M. Clark and in offering condolences to his family, friends, and colleagues.

Madam President, I applaud the Senator from Rhode Island, my colleague, someone committed to standing up for what our veterans need. My hope is that we are not only fixing roofs in the future but we are actually updating facilities that need to be updated to be able to handle the increasing veterans population. Many of those facilities are in my State of North Carolina.

I take somewhat of an objection to something he stated--that we are here today because of our lack of moving these bills in the last Congress. This Senate requires tremendous bipartisan support. Without that bipartisan support, things come to a screeching halt. That is what happened last year. It was described as an election. There were some who did not want to see an appropriations process happen.

As a matter of fact, it happened some time ago in this Senate, when the majority and the minority were in different positions, when the majority came in and was handed the appropriations bills. We were in the majority. I wasn't here, but my understanding is that they went through days, if not weeks, of amendments. They came up with an omnibus bill. That is not what we did here.

We are headed into 2007, the 110th Congress, but what was the action? The action today was that the majority leader came to the Senate and offered the resolution, filled the amendment tree, filed cloture, and went off the bill. We are debating this in morning business. We are not debating it as part of the resolution.

Now, I correct my dear friend, Senator Specter, from Pennsylvania. He said no amendments would be offered. In fact, there were two amendments offered. They were offered by the majority leader. The first one was at the end of the resolution, this multipage document, add the following:

This division shall take effect two days after the

enactment.

And then he filed a second-degree amendment that said: In the amendment strike 2 and insert 1.

Not a lot of substance to that amendment. Not much at all. As a matter of fact, it is hard to find someone here who can actually state what it means. And grammatically, what he has done is he has now changed the amendment to say: This division will take effect ``one days'' after date of enactment. That is how much attention the majority leader spent on his own amendments.

Now, the fact that he did this, what does it do to the rest of us? It means we cannot offer amendments. It means that for those who are concerned with the BRAC process--which is a transformation of our military in the United States; it is a consolidation of our base structure; it is putting the right people at the right place, training for the right thing, so that America can be safer based upon new threats--what does it do? It doesn't fund any of it.

Here is a process that is supposed to be complete by 2011, and in 2007 we are going to fund none of what BRAC called for in the legislation passed by this body. In North Carolina, that is $300 million to Fort Bragg alone. That money was to build barracks, a vehicle maintenance shop for the 4th Brigade Combat Team, and a multipurpose training range. Without these funds, none of that will be completed.

As a matter of fact, I can say, just like my colleagues who came to the Senate floor, that our military bases are everyone's; they do not belong just to the States in which they are located. Our military leadership, our soldiers, our military families have begun this multiyear process to meet the requirements that Congress has given to them in the legislation we passed, and now we have done it without the funding. We risk not only placing communities and bases in disarray, but we will delay vitally needed transformation in our military.

I don't understand how my colleagues on the other side of the aisle can look the American people in the eye, tell them they support our sons and daughters, husbands and wives, brothers and sisters overseas, and simultaneously refuse to add the critical funds needed to take care of those very same troops--their families, their children, their husbands, their wives, their children--here at home. But the actions of the majority leader have, in fact, accomplished just that because there is not an opportunity for me, or for Senator Hutchison, who is the ranking member on the Committee on Appropriations Subcommittee on Military Construction, to offer an amendment--one that would be overwhelmingly accepted. But if you allow one, potentially you have to allow another.

Fort Bliss, TX, which is scheduled to absorb 17,000 soldiers and 10,000 family members under BRAC, is losing $463 million because Congress did not fund it in this continuing resolution. Fort Benning, GA--$300 million that was going for barracks for the troops and a brigade training complex.

What does this mean? It means that as we try to bring troops back in from Germany and other bases around the world--we have made a determination we do not need to forward-deploy like that--we can bring them back on our soil. They can be with their families in neighborhoods where they can feel like a part of the community instead of on foreign land where only the base is considered United States territory. It means we are going to have to keep them there, or we will have to bring them back here but not have the housing for them. I have gone through that in Fort Bragg. I have had 18- and 19-year-old soldiers living in 1950s era barracks, and the Congress, in their infinite wisdom, was able to fund the type of housing that was needed at Fort Bragg and many other installations.

Now, at a time when we have already planned for these families and these troops to come back, what does Congress say? I am sorry, we will not fund it in this bill? We are going to wait until 2008, and then it may or may not be funded? Maybe that is an objective on someone's part to try to knock BRAC off and to not have this consolidation. If it is, they have to question the decisions made by our military leaders and agreed to by Congress that said this is in our long-term best interest. It doesn't end with the discussion on BRAC, as sorry as I am to see a process that excludes our ability to effect the funding that is needed for military construction and for the base realignment and closure process.

Late last year, in the last week this Congress was in session in the 109th Congress, we passed what I thought was one of the most important pieces of legislation the 109th Congress dealt

with. It dealt with the threat we are faced with from chemical, biological, radiological and nuclear threats, naturally produced, intentional, or accidental. It dealt with things such as anthrax and smallpox, Ebola and Marburg. We were challenged to try to revamp our entire structure of countermeasure research and development in this country, and I daresay by unanimous consent in the Senate and in the House of Representatives we passed that important bill, one that identified the problems we had in America but, more importantly, the problems we had with our ability to take basic research, in many cases funded by companies or by the National Institutes of Health, and to convert that basic research into a countermeasure, a vaccine, an antiviral that would give us the security of being able to look at the American people and say: If terrorists get ahold of anthrax, don't worry, we have something to protect you. We have a vaccine we can give you. If, by chance, Marburg, a disease, gets out of Africa, we have a countermeasure we can give to you if, in fact, you are infected.

We were able to create this new entity which actually put the Federal Government in a position where we have facilitated the commercialization of that basic research, where we did not rely on only 1 company out of 100 to succeed because somehow they were able to go into the private marketplace and find enough money to make it through this challenging drug and vaccine development and approval process designed in America. We created the Biomedical Advanced Research and Development Authority, referred to as BARDA. BARDA was the structure at the Department of Health and Human Services. It was a structure that was under development for 2 years in Congress--enough time that sunlight was brought to every piece of it. I daresay it was one of the most open processes this Senate has seen in some time. Members had the opportunity to address every word of every sentence of every paragraph of the bill. At the end of the day, they were convinced it was the right piece of legislation, and it was passed into law.

There is only one problem. We have it in place now, and the continuing resolution doesn't fund it. Yes, $160 million was intended to be in the appropriations bills to kick start BARDA, to allow this structure to be set up under a new Assistant Secretary for Preparedness and Response and to begin to sort through the research being done at academic institutions across the country, small pharmaceutical companies, biotechnology companies, big PhRMA and to get them all to participate because for the first time they knew what the rules were.

We added a number of biological agents to our threat list. That is a function the Secretary of Homeland Security does on a regular basis as we see new threats arise. When we increase the size of that threat list, that means somebody has the responsibility in the Federal Government to begin an intense research and development process to try to create a countermeasure for it. One would think at a time when we just doubled the size of that potential list of threats that it would be high on the priority list of the Congress of the United States to fund the only mechanism we have to actually create the countermeasures. But, no, in this particular continuing resolution, it is minus the $160 million to fund BARDA.

Even worse than that, there is no opportunity in this process to offer an amendment to a bill that 100 percent of the Senators present that day voted for, that the House voted unanimously for and the President signed into law just last December.

On one side, we put our soldiers and their families on hold. To some degree, we put on hold the plans of our military leaders. On the other side, we recognize the threats we face from people who want to do bad things and from Mother Nature. We understand the responsibilities we have to prepare these countermeasures, these vaccines, these antivirals for the entire population, and we still cannot fund it. I guess we are not having the debate because we know it would become law, it would be funded. And if it was funded, then we would break the caps, so we would have to find somewhere else to get the money.

I was willing to come to the floor and propose some ways to get the money or to propose to my colleagues that I thought it was important enough that we break the cap by $160 million, which I seldom do on this floor. This is in the face of not only the threats we know about, but it is also the threat of pandemic flu. It is those natural things such as pandemic flu that we cannot look down the road and know what is around the corner. But if we have the right mechanism in place and if it works and if it is tested, we can respond in an expeditious way and begin to have those things we think are so important for the American people.

BRAC will not be settled in this continuing resolution. We will put our military on hold. We will put the changes on hold. If that has an effect on our tempo--even at a time we are at war--I guess some have made a decision that is the way it is. As it relates to bioterrorism, chemical, biologic, radiological, even pandemic flu, we put that on hold, too, because we are not going to fund the creation of the project.

We did all that because of two amendments--two amendments--that were offered by the majority leader: ``At the end of the resolution add the following; this division shall take effect 2 days after date of enactment,'' and followed up by a secondary amendment that says, ``In the amendment strike 2 and insert 1.'' Now we have an amendment that says--or a law that says--this division shall take effect ``1 days'' after enactment--clearly, no thought. It is a nice way of shutting us out from offering amendments.

I do not think the plan for this bill was to set a host of unlimited amendments. As a matter of fact, I hope and I believe we will finish the continuing resolution before the 15th, which is the date the Federal Government's money runs out. There is no scare or threat the Federal Government is going to run out of money and shut down. I think every Member is committed to do that. I am, too.

But I think it is important that we come down and talk about the things we left out but, more importantly, that we point out to everybody the fact that we were not even given the opportunity to put them back in, that when we denied the ability of Members of the Senate to consider changes to a bill--much less not have a vote--we have cut the American people out of the process, we have cut out the people who send us here to represent them. Sometimes they like it, sometimes they do not, but they expect us to take a position.

Well, that is what could have happened with two very valuable amendments, two that I believe would have overwhelmingly been accepted. Would it cause a little difficulty on our part trying to figure out where to take the money from? Probably so. But right now, in the scope of everything we are faced with, I cannot think of two more important things for us to have in this continuing resolution than to fund the troops, their families, their housing, their daycare, their schools, and to allow this transition in our military to take place as it relates to the consolidation of our bases around the world.

I certainly cannot think of anything that gets very much higher on the priority list than to make sure we have the vaccines, the countermeasures, the antivirals one might need if, Heaven forbid, we were ever attacked using chemical, biological, radiological or nuclear weapons or, in fact, Mother Nature is just so mean to us. In fact, the threat is so extensive to our country, we need to be prepared.

We could be there. We will not be there, but we could. And it is all because of the choices that were used to move this bill.

I thank the Presiding Officer for her indulgence, and I yield the floor.

Mr. President, on this brisk day in Washington, weatherwise, we have had a refreshing debate about minimum wage. I have listened to the majority leader say that those who have minimum wage amendments and would like to have votes are, in fact, against raising the minimum wage. I introduced my amendment yesterday. I highlighted the wonderful work of Senator Kennedy and Senator Enzi, the managers of the bill, the fact that we were long overdue for a minimum wage increase, and that, as a Member of the Senate, I thought it was important we explore, as we do this, if we can make some changes that allow us to address other areas.

Now, I happen to be the Senator who offered the amendment--and I thank my colleagues Senator Coburn and Senator DeMint who are cosponsors--who suggested this--that with the $2.10 increase we make in minimum wage, we allow an employer to determine if they want to provide that increase in wages or in health care benefits.

We have had a debate in this country for years, over the 13 years I have been here, about the uninsured population and what we need to do. Here is an opportunity to do something. Here is a real opportunity to give employers the incentive to provide to the most at-risk minimum wage workers a health care benefit that can be covered under the umbrella of health coverage that we, as Members of the Senate and those of us who work for the Federal Government, actually have that protects us.

All Americans should have access to quality and affordable health care. Under our current system, many get health care from their employer. Let's increase the number of Americans under that umbrella of coverage and take the opportunity, as we increase the minimum wage rate, to allow employers to be the ones to do it.

The majority leader has filed a cloture motion on S. 2. Let me explain exactly what that means. We are going to cut off the ability to offer amendments on anything non-germane. Anyone listening to the description of my amendment would have to say, clearly, that is germane. You will use the $2.10 increase in the minimum wage to allow employers to offer health care with that $2.10. Now, this is not a shot at the Parliamentarian of the Senate, but this amendment is not germane. In filing cloture without an agreement, we

won't be allowed in the Senate to have a vote on my amendment. I can come here and sell the merits of my amendment to those across the country who listen to this and they will say--that makes a tremendous amount of sense. We want to extend health care to the uninsured. An excellent way to do that is to use the power of the employer. As an employer negotiated for the rest of his employees who may not be at the lower end of his pay scale, he can use the minimum wage workers in the group rate and access health insurance cheaper than they could as individuals.

But no, filing cloture means without an agreement the Senate is never going to have a vote on this. We will be denied the vote because this is non-germane.

I am not sure where this fits in that open process I heard described. As a matter of fact, we have actually filed cloture for a bill we have not even called up, a resolution on Iraq. I guess that means we will limit our debate on the war, too. Gee, that is a strange one to limit debate on.

Let me take the time I have today to talk about my amendment. Mr. President, $2.10; what is that on an annual basis for an individual at the lowest end of the income scale in America? It is $4,368. Some people will be opposed to the amendment even though they will not get an opportunity to vote on it because they will say that is not enough money. Let me show what it can buy.

Mr. President, $4,300 a year can buy health insurance, 100 percent for an individual. It can buy almost 50 percent of family coverage. This is the average as followed by the Kaiser Family Foundation of fee- for-service insurance: $3,782. I might say that regionally, where you live in the United States dictates the cost of health insurance, but this is an average for the United States, fee-for-service, traditional health care coverage, $3,782; a preferred provider plan, $4,150; a POS plan, $3,914; and a health maintenance organization, $3,767.

The argument that you cannot provide health care with the $4,368 increase we are giving to a minimum wage worker clearly has been demonstrated by the Kaiser Foundation to be wrong. You cannot only provide it as an employer, you can pay 100 percent of it. A minimum wage worker would not have to put a dime out of their pocket to have health care coverage that is equal to what a Member of the Senate has. But when you file cloture, when you limit debate, when you deny a vote, you have now denied every minimum wage worker in the country of having an opportunity for their employer to work on behalf of their group to extend the health care benefit to minimum wage workers: a 100-percent benefit.

The President and myself--I think we pay 25 percent of our insurance premium for health care, and that percentage certainly changes, depending on who you work for. But an employer assumes some percentage. Some employers pay 100 percent, but it is rare today. Here is an opportunity to give employers an incentive to provide 100 percent of the premium cost and still have money left over to provide to their employees.

I am sure there are people listening to this debate who are saying this is crazy. If we have 47 million uninsured in this country, how many of those might fall into this category? The reality is, it is almost 15 million Americans whose income is $25,000 or less.

The average minimum wage worker today makes a little over $10,000. The actual national poverty level is a little over $9,000. They are very close to it for a full 40 hours worth of work.

When we look at 47 million Americans, I am beginning to think we like that number more for the purposes of debate than as a target or a goal to solve.

I said at the beginning, I believe all Americans should have access to quality, affordable health care. My opposition only wants that access if the Government provides it instead of the private sector. That was the debate in Part D Medicare when we created the first ever drug benefit for seniors in this country. And there were two sides, those who said only the Federal Government can provide this and those who believed that the private sector could, in fact, negotiate prices-- not just for the price of the drugs but through that, the premiums-- where seniors could be afforded choices.

Today, the majority of Medicare-eligible individuals are signed up with the Part D prescription drug plan. Much to my amazement, for those who are incredibly pleased with their plan, the percentage is close to 100 percent because of their choices and those who want to assume more financial risk out of their pocket and pay a smaller premium can do it. Those who do not want to pay out of their pocket but want to pay a higher premium can do that. For every milestone we have seen in Part D, drug prices have reduced because we have injected competition, premium prices have reduced because we are now providing drugs to seniors who are actually taking them.

What does that do to our overall health care system? It means the more they are taking their medications, the less likely they are to visit the hospitals. Gee, I wonder if that is applicable to what we are talking about here? Why are health care costs going so high? Yes, we have a lot of new technology. That technology allows us to do things in a noninvasive way. Instead of cracking a chest open and doing a bypass on somebody's heart because maybe they ate the wrong things for 60 years, now we can go in through their leg, we can go up through their vein structure, we can put in a stent and we can open and eliminate the risk of a heart attack. The quality of life is better for them because the recovery is shorter. In some cases it can be done as an outpatient procedure. That $70,000 average cost of a heart bypass is reduced significantly and, consequently, with that, the overall health care system sees savings.

Imagine if we had not been doing that what the rise in health care costs would be. Part of health care inflation today--and I suggest it is a large part--is the cost shift that goes on. What is cost shift? The Presiding Officer and I have health insurance.

When we go in and access health care, the hospital, the doctor, the lab, and the pharmacist know they are going to get paid because we give them an insurance card. There is no question in their mind. They know exactly what their reimbursement is going to be. If a Medicare beneficiary at any point accesses health care, that doctor, that hospital, that lab knows exactly what the reimbursement is they are going to get from Medicare for the procedure they offer.

But when somebody goes into an emergency room who is uninsured and they do not pay: What happens to the cost of the procedure they got? It is real simple. It gets shifted to us. It gets shifted to everybody who has insurance. And to recover that, everybody's premium in the country goes up.

So as I stand here and talk about a very specific group, minimum wage workers in America, what everybody has to understand is what we do on this issue affects everybody's health care in America. It affects everybody's premium amount in America. It affects 25 percent of all Federal employees costs. If you want to drive some costs down in the Federal Government, it is easy: Let's do this because we will eliminate a significant part of the cost shifting that is going on in our health care system in this country.

Studies have shown in order to get individuals to purchase their own health insurance, tax incentives to individuals need to cover half or more of their health insurance premium. We are covering 100 percent of it. Many tax-based health care proposals to help the uninsured are criticized because they do not meet the threshold of covering half or more of an individual's health insurance premium. This is the first time I have ever been criticized because we offered 100 percent of the premium.

Now, why might other people object to this? Well, quite honestly, they might say the employees should get wages, not health care. Well, let me restate what I said at the beginning, so it is clear.

All Americans should have health coverage. Mr. President, 14.6 million Americans make less than $25,000 a year and are uninsured. So if we are wondering in that pot of 47 million what makes up some of them, here is 14.6 million of them right here. They make less than $25,000 a year, and we know for a fact they are uninsured.

Mr. President, $2.10 a day can buy basic health insurance for a minimum wage worker. On this chart is a breakdown of millions of uninsured by household income. You notice that close to the largest group is shown right here: $25,000 and below.

This amendment is like a laser beam on exactly where we can make a difference. You see, we are at a real crossroads in America. We have gotten used to the best health care delivery the world has ever seen. As a matter of fact, if we tried to import from another country--and I will not name one because I do not want to offend them--their health care system into our country, the American people would rebel. They would not wait. They would not accept half a loaf when they thought they deserved a whole loaf. That is how our system is.

So if we want to get a handle on this incredible cost of health care, we have to do two things. We have to provide coverage and we have to promote prevention and wellness.

You see, if we can teach people how to control disease, then the number of times they access health care is going to be less. That is pretty much common sense. The problem is if we cannot create a relationship between an individual and a health care professional, how in the world are we ever going to complete the educational process of what disease management is? How can we teach a diabetic that it is just as important to get exercise and to have a diet as it is to take their medication and check their blood sugar?

As a matter of fact, in Asheville, NC, we are in the 10th year of a project called the Asheville Project, where it has focused specifically on diabetes. This idea was clearly out of the box because the community decided, with a grant, they were going to reimburse pharmacists to counsel diabetes patients.

Think about that: A diabetes patient goes in. They are getting their medications filled. Now in Asheville, NC, and 10 other locations in the United States, that diabetes patient will sit down with the pharmacist, and the pharmacist will look through their drug regimen and make sure it is correct. They will make sure there is no interaction of different medications that they are currently taking. They will talk to them about exercise. They will give them suggestions if they are not getting exercise. They will check their progress if they are. They will talk to them about diet. They will actually weigh them. Maybe that is what we are scared of: If we do this, they will start weighing all of us.

The reality is in Asheville, NC, and these 10 other cities across the country, there is now data. It is not me. It is the data that proves they save $2,000 a year per diabetic because we now provide for every diabetic this intense relationship with a health care professional.

Now, what you have to understand is that in Asheville's case, and these other areas around the country, this is not the traditional entry point where we would choose to educate. This is quite creative. As a matter of fact, we have talked about it, and it has been rejected in this institution before, that we actually pay pharmacists to do part of the health care education. I hope it is something we will reexamine because I think there is tremendous merit to it. It has proven to be successful.

But what does it prove? It proves that if prevention and wellness are promoted, there are savings that are derived across the system, and those savings will drive down premium costs for every American.

Well, how do you get there? You get there by making sure every American is covered. Mr. President, 14.6 million--that is a real chunk of people whom we have an opportunity to affect whether they actually have health care coverage, whether they will actually have the education they need with a health care professional on disease management. It could be diabetes; it could be HIV/AIDS. There are a number of things that fall into the category.

But the reality is, if we miss this opportunity, we will continue to have 14 million people who will access health care in the emergency room on an as-needed basis, and the likelihood is, there will be an in- hospital patient with an average stay of over 3 days. And at the end of that stay, they probably will not have the money to pay for it, and, in fact, that will get cost shifted to everybody's insurance across the country. They do not want to do that; they just do not have the money to pay for it.

Well, here is an opportunity for them not to be put in a difficult situation. Here is an opportunity for an individual to have 100 percent of their insurance--let me go back to that. For an individual, $4,386, under a traditional PPO, POS, or HMO, pays 100 percent of their premium costs--better than we get as Senators--and for a family, $9,900, $11,000, $10,000--$10,000 is the average across the country, based upon the type of plan you choose. We could pay 50 percent of a family's health care premium if we allowed employers to use the $2.10 and to apply it to health care benefits versus wages.

One in five adults age 18 to 64 were uninsured in 2004--one in five adults. More than 54 percent of the uninsured are in families making 200 percent or less of the Federal poverty guideline. Again, that is $9,800 a year. Americans living in households with annual incomes below $25,000 have a higher incidence of no insurance. Mr. President, 24 percent were uninsured in 2004, compared to 15.7 percent of the total population. You see, this is not just the norm percentage who do not have insurance; this is almost double the national norm.

Now, why this bill? Why the way we chose to do it? Well, employers are the centerpiece of health care delivery in the United States today. They may not be in the future. I am anxious to have that debate. Personally, I believe a health policy should be like a 401(k) plan. You should be able to take that health policy with you regardless of where you go, that when you change employers, you should not have to lose insurance coverage with a given company and the structure of your plan. You should have the option to take that with you. So I am sure at some point this year we will have that debate.

Mr. President, 174 million workers and their dependents received health coverage through the workplace in 2004. So if you ask yourself, why am I offering this on the minimum wage bill? it is because 174 million Americans receive their health care coverage via their employer. We have this excellent opportunity right now, as we talk about increasing minimum wage, where we can provide the incentive.

I might add, I said the ``option,'' that an employer have the option. I am not mandating that an employer has to offer health care. There is a lot of work that goes into a company providing health care for their employees. They have to meet with plans. They have to negotiate rates. They have to keep records. There are going to be some employers who do not provide health care as a benefit, and they may not provide it for their employees afterwards. But you also have a segment of America that is minimum wage workers where companies would like to find a way for those folks to stay with them versus to leave for a nickel-an-hour or a dime-an-hour increase by somebody else.

I can tell you, if you offer them 100 percent of their health care, then somebody is going to have to bid very high if, in fact, they are not providing health care, too.

Workers, and especially low-income workers, feel more comfortable with their employers negotiating health care benefits than going into the individual market and purchasing it themselves. Why? It is real simple. It is because an employer negotiates volume. When I walk in, they see one individual, and they know I must be uninsured, if I am in there to buy health care, and the likelihood is they are never going to pull that sheet out of the middle drawer that says ``discounts.'' I will never receive a discount as an individual.

And oddly enough, in this country, I have to say--and this is wrong-- the lower your income, the more the actuaries look at you and determine you are going to cost more. It is 100-percent wrong. And part of it is the structure of our model in this country: that we seldom promote wellness and prevention. I do not care where your income level is, if you provide those individuals with the tools they need, they are as healthy as the person next to them. What these folks do not have, because they do not have coverage, is they have

no relationship with a health care professional. And that health care professional could be a primary care doctor; it could be a nurse; it could be a hospital; it could be a community health center; it could be a rural health clinic. And in the case of Asheville, NC, it could be a pharmacist in a very targeted program.

More than 8 out of 10 of the uninsured are in working families. I am not talking about isolated individuals. I am picking these folks and not suggesting that we are doing something that just affects individuals. These are families. That is why when I talk about the family piece, think about a family that has never had health insurance for their children. Think about when they go in and their employer says: You know, we have this new requirement that we have to raise the minimum wage $2.10. But I will offer you 50 percent of your health care premium for your entire family, your wife and your children. It is going to be in place until your children get out of college. Maybe that will give them an incentive to encourage those kids to graduate from high school and to consider higher education as part of their future.

Six out of ten uninsured individuals have at least one family member working full time year-round. This is a huge population we are talking about affecting with this amendment. In 2002, 42 percent of wage and salary workers, age 18 to 64, were not offered health coverage through their employers. Here is a tremendous opportunity, as we do something that I have said I will support, and I doubt it will receive very many votes in opposition--here is an opportunity for the Congress to significantly affect the uninsured. But I remind everybody, we are not going to have an opportunity to vote on this amendment. It is so timely that I would come to the floor, I would wait my turn to talk about an amendment that I couldn't talk about the other day because the leadership was in a hurry. So I called up my amendment so it would be pending--pending means that it should get a vote before cloture would be filed--only to find out from the majority leader when he stood, I think he referred to my amendment as ``silly.''

I don't think it is silly. It may be non-germane, but the health insurance of minimum wage workers is not silly. As a matter of fact, it is crucial to the health care change that we have to accomplish in this country if, in fact, we are going to keep health care affordable for all Americans, not just some Americans.

Let me talk about employers and employees. I believe my amendment is a win-win. I challenge any Member of the Senate to tell me who loses. Think about it. An employer is able to negotiate for minimum wage workers at the group rate which means he might be able to negotiate, because he is putting more people in the pool, an even lower cost for his overall workforce than he had before. He is able to offer his employees health care which his competitor might not. His employees have a tendency, then, to stay with him longer because we all know that there is a cost that is incurred by an employer, an investment to train them, an investment to have them in the business. And the last thing they want to do is see minimum wage workers that work a month or 2 or 6 months and keep moving from employer to employer. And by the way, the one thing they don't have control over as an employer is the days that employees call in because they are sick. Those are days that the employer is planning on getting something done. That minimum wage worker, because they are now sick, picks up the phone and says: I can't be there.

Maybe if we get them covered by insurance, maybe if they actually go for prevention and wellness education, maybe if they learn through that health relationship the things they should do and should not do, maybe they are not going to be picking up the phone and calling in and saying: I will not be there.

The employers lose on those days, but the employees lose on those days, too, because this is a minimum wage worker. They are paid by the hour. They are only paid when they are there. Provide them health care, enable them not to make that phone call, the employer doesn't have a disruption in his business, and the employee doesn't have a subtraction in his paycheck. This is truly a win-win for employees and employers.

Employers will spend less time and less money overall by providing the $2.10 increase in health benefits. Let me restate that. Employers will spend less money overall by providing it in health benefits. Why? Because they buy in bulk. What does that mean? It is more bang for the buck. They are able to get more benefit for a smaller amount of dollars. That means that when they go and negotiate the structure of a plan, they could negotiate something that had an even richer benefit, maybe no out-of-pocket cost, maybe no copayment for drugs because they have another $500 there with which they can negotiate. Employers get the same deduction in calculating taxable income, if they provide compensation in the form of health benefits or compensation in the form of wages and salaries.

We all know because we have gone through part of the debate that when employers and employees are covered by health insurance, that is done with pretax wages.

My point is, the tax implication on the minimum wage worker does not go up. They get the same advantage that we have, that their health benefits are not only deductible for the employer, but they can access some pretax dollars to do it.

To deny a vote on this amendment is to not give minimum wage workers the same thing we have. Sure, there is a discrepancy in the difference that you make and I make and they make, but now we are talking about fairness from the standpoint of benefits. We have an opportunity to change that. And because we are in such a hurry in the Senate and because the majority leader is tired of people offering amendments--I think all of them have merit. I haven't seen any that I thought were for the purposes of delay. As a matter of fact, I would be for moving to wrap up this bill tomorrow if the majority leader would say I could have a vote on this amendment. He is not going to give me a vote. You can use the Senate rules to make sure that votes don't happen. And maybe I could have designed this in a way that it was germane. But sometimes the best things are simple. Sometimes when you lay it out in a way that people across the country, especially minimum wage workers, understand, it is better for them. We could hide it and make it confusing and make it to where employers possibly couldn't provide everything that they could. But we decided to leave it simple.

What might be another objection to this bill? Well, can employers truly implement this process. Let me go to another chart. I think you have heard me say most of this except for the last one: Some coverage is better than no coverage. Will every employer get it right? Probably not. Will every employer get as much bang for the buck as they possibly can? Maybe not. Some coverage is better than no coverage. You have heard the percentages about the population that are at the income levels that minimum wage workers are. If you only believed that this amendment would provide some coverage, then you have to agree with me that is better than no coverage.

Under our current health care system, employees will be better off with health care coverage through their employers because employers get better pricing. If they don't or they can't, then I know what is going to happen. They are going to offer it in wages. But should we deny them the opportunity to try to help us solve part of the health care problem that we have in America, and that is the uninsured that are here?

I said earlier that I thought all Americans had a stake in this amendment because it is their health care premium that is affected by every health care policy we take up. When we add additional mandates for coverage, we drive up premium costs. When the American people exercise, watch what they eat, they help us to moderate health care costs and premium costs. Health insurance, even the most basic health insurance, gives people access to a system of health care, that relationship with a health care professional, that primary care doctor, the prevention and wellness programs, routine testing for chronic diseases that keep them out of a hospital.

I want to relate a story. I won't mention the company. Well, I will mention the company: Dell computers. I think it is important that you understand that they are in one of the most competitive industries in the world. I daresay I don't think anybody is going to wake up tomorrow and say: I think I will get into computer manufacturing because there is so much money to be made. Everybody globally is in computer assembly and manufacturing. Dell does it the best. I don't say that just because they have a plant in North Carolina. I say it because the experts say that.

I might also say, since Lenovo has a plant in North Carolina, they do a pretty good job, too. But Dell recognized one day that if they wanted to be competitive in this highly competitive industry of computers, they had to do something about health care. They were self-insured. They had already taken the first step. They assumed a lot of the risk as a company to drive down the cost of their health care for employees and, consequently, for the company. What did Dell find out?

Dell tried to make available prevention tools for their employees. If they were overweight, they would give them a dietician to work with them. If they had diabetes, they would give them somebody who could counsel them about diabetes. If they smoked, they paid for a cessation program. What happened? Less than 10 percent of the Dell employees who were affected by these things took advantage of the program. Less than 10 percent of them signed up to receive the help.

Any other corporation in America might have said: I will just accept the fact that we are going to have this high health insurance. But Dell realized: We are still making computers. And if we can't fix this, we are not going to be competitive.

What did they do? Dell offered employees up to $250 cash if they would sign up for the program. I will tell my colleagues, the American people respond to money. They do respond to money. All of a sudden, the enrollment in these plans went sky high. Today, some 5 or 6 years later Dell computers can prove that they save about $1,700 for every employee who goes into that program. Those numbers may have changed since the last time I met with them.

My point is this: Everywhere we looked--private sector, public, individual, group--where we have been brave enough to go out and do it differently, where we have been brave enough to force prevention and wellness into the system, it works. It works for the employee and for the employer. It is job security because they are more competitive. And every American receives the benefit of it because there is less cost shift in the system.

Let me bring it back to where we are. All Americans should have health coverage. We have this unique opportunity, as we debate the opportunity for minimum wage workers to receive a $2.10 raise over a period of time, to give the option to every employer to provide that $2.10 increase in health care benefits versus in wages. And the Kaiser Foundation's health research proves that, for an individual, regardless of whether it is traditional fee-for-service insurance, point-of- service, or health maintenance organization, that $4,368 a year pays 100 percent of the premium cost for that minimum wage worker, which is a higher percentage than a Member of the Senate is paid for by the Federal Government. That means a minimum wage worker is not required, such as I am, to pay 25 percent of their health care cost, but they would get 100 percent. If, in fact, their family is uninsured, which the majority of them are, the Kaiser Family Foundation says the average for family coverage--wife, kids, unlimited--that an employer for a minimum wage worker can provide is almost 50 percent of the premium cost.

This is a tremendous opportunity, from a standpoint of health care policy, that I so hope we are not going to miss the opportunity to do. But if my colleagues on both sides of the aisle allow debate to be shut down without an agreement from the majority leader that he is going to allow a vote--the only reason I can see not to have a vote is because nobody has figured out how to put a second-degree amendment on it. It is too simple. Procedurally, if they can kill it, they would.

In North Carolina, Mr. President, there are 1.3 million uninsured individuals; 17 percent of my State's population is uninsured, compared to the national average of 16 percent. So, listen, I feel bad. I wish to see North Carolina do better. As a matter of fact, we have probably more waivers in health care than any State in the country right now, from Medicaid to the soon-to-be dual eligibles under Medicare because we are trying to lower the costs for everybody by being creative as to how we do it. I will tell you this: In North Carolina, the centerpiece of our success is two words: Prevention and wellness. When we are able to establish a relationship with a health care professional, we now have an opportunity to bring prevention and wellness into every person's health care regimen. I am convinced this is absolutely crucial to the future of health care in this country and to the affordability of health care for the future.

Eight hundred and ninety eight thousand uninsured individuals and families are on their own with one full-time worker in North Carolina. So when I said 1.3 million uninsured, understand that almost 900,000 of them are in families--families who could get 50 percent of their premium paid for by their employer, if we gave the employer the option of providing health care versus being forced only to provide wages.

In North Carolina, we have 204,360 uninsured part-time workers. That means they are not going to work 40 hours. So maybe they are only going to work 20 hours, and instead of getting $4,368, they are going to get a little over $2,000. Well, even those part-time workers--uninsured part-time workers--if they are earning minimum wage under this program, as much as 50 or 60 percent of the premium of their health care could be paid for. So it is not limited to full-time workers.

It is too simple. It is way too simple. Everybody in the country gets it. Why doesn't the Senate get it? How can anybody look at this and say we should not do it? It is easy. The Senate rules allow you to not have a vote. I am not trying to delay; I am trying to make the bill better. I am trying to learn from what we are learning all across the country-- that there are smart people outside Washington who are in companies, in States, who are involved in the health care system, and we have a real opportunity to take what they have been telling us and apply it to the most at-risk group of Americans, which are the minimum wage workers.

I have always shrugged it off when somebody came up to me and said: Gee, do you guys ever listen in Washington? Do you pay attention to what is going on? Because I thought we did. I do. But, you know, what I am learning today is that ``we'' don't. You cannot come on the floor of the Senate day after day and talk about the uninsured population and how we have an obligation to take care of it, and here is a real opportunity to do it--and what is the majority's answer? We are not going to let you vote because we think you are trying to delay.

I am not trying to delay, I say to the majority leader; I am trying to provide health care for minimum wage workers--for maybe 14.6 million people in this country. You know, the sad part is, even if I get this done, there are still 30 million Americans who are uninsured. Maybe the fear is that it will work. Maybe they will find out that when these guys get insurance, they are no longer going to be sick. Maybe they are worried we are going to find out that if they are not sick, our insurance will go down and every American's insurance will go down.

Health care continuously ranks as one of the top issues in this country. I have devoted 13 years now to understanding health care to the degree that I feel like I can walk into an operating room and do a procedure, even without staying at a Holiday Inn Express. But, you know, we are not listening to them. We are not listening to doctors, nurses, community health centers or rural health clinics. And I can tell you this: We are not listening to the American people. We are not doing what we can to provide the opportunity for health care coverage to be extended to them. Do you know what? People with high health care costs, in the absence of having to spend that on health care, are not going to spend it in other areas. It is those other areas that create jobs. It is the groceries, it is the

gas, those things they pick up on the way home to eat that fuels our restaurants.

If you want to have good balance and growth in the economy, if you want Americans to be at work, if you want this country to prosper, this is a piece of it. This is a piece to make sure Americans have health care coverage. I am confident this is not the last time we are going to have this debate this year. We will have a debate, and it will actually be considered germane. I have wondered for the time I sat and listened to the majority leader, what will be the excuse then? Maybe it is because it wasn't their idea. Maybe it is because they would like to wrap it into something bigger.

Well, as I said, 13 years after I have worked on health care--and I see my colleague from Iowa and I know he wants to speak, and I will wrap up, and I don't know anybody who has devoted much more to health care than he has. This is a real opportunity, Mr. President. It is an opportunity for the Senate to actually do something on health care versus sitting on the floor and talking about it. As it stands right now, this opportunity for minimum wage workers in America will not happen because the Senate will be denied the opportunity to vote as to whether they would like this to be part of the plan. Again, I am sure it is difficult for America to believe that this is not germane to the minimum wage bill, as it was to me. But I am not here to battle the interpretation of the Parliamentarian; I am here to suggest to you that one of the reasons we are here is we are supposed to do what is right. We are supposed to pay attention to what is going on across the country, and we are supposed to do what is right to fix it.

I ask you to think that I am doing something right today. I could walk away having a vote where I didn't win. But not getting the opportunity to have a vote cheats America out of the opportunity to begin to turn around our health care system. I hope that between now and Tuesday with the cloture vote, Members on both sides of the aisle will have an opportunity to look at this vote and to encourage the majority leader to allow us to have a vote and, if not, to encourage him to vitiate the cloture vote and allow us to talk some more.

This is important. We ought to spend time talking about major policy shifts. For the 10 years I spent in the House of Representatives, I dreamed of the fact that I could come to this floor, with the tremendous thought and debate that goes into the work here--I am not going to tell you I am disillusioned, but I can tell you this: To take something of this importance and to suggest we are not going to vote on it, or to suggest that when we are talking about ways we can improve a bill, we haven't got time to sit and debate this, that is not the Senate I envisioned before I got here.

That is not the deliberative process, the open and balanced and thoughtful Senate I used to see from the other end of the Capitol. It is my hope that, as we move forward, we will be allowed the opportunity to debate this more. Hopefully, we will be allowed to vote up or down on it. As I said, if I lose, I will save the debate for another day and another bill. We are going to have an opportunity to debate health care, I know. We are going to find more things to agree on than we disagree on. I never envisioned the Senate saying that because this is a tough vote we are not going to take it.

This vote is not near as tough as the fact that 14 million Americans, who are, in all likelihood, minimum wage workers, could have the option of health care if we did this and are not going to have health care if we don't vote. That is not silly, and it is not a delaying tactic; it is policy.

I yield the floor.

Mr. President, I ask unanimous consent to set the pending amendment aside.

Mr. President, I call up amendment No. 195.

Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. President, let me take this opportunity to commend my colleagues, Senator Kennedy and Senator Enzi. There is no question that we need to do something on minimum wage. What I am trying to do is realize that, as we do this, we do it in the wisest way we possibly can.

My simple amendment is very brief. It allows employers, with the increase we are making in minimum wage, to supply that equal dollar amount in health care benefits. Think about that. It would be the option of the employer to invest the $2.10 in the health care benefits of his or her employee. Some will probably suggest that is not enough.

If you look at the national average today for 100 percent of an individual's premium, the national average, based on the Kaiser Foundation, is $4,248. Well, based upon the amount we are proposing to raise the minimum wage, that leaves $120 to spare after we have paid 100 percent of that individual's health care. Stretch it a little bit further and apply it to a family, and that $4,368 that we are going to increase their wages by would provide almost 50 percent of the premium of a family plan.

You know, we talk about extending health care to all Americans, about the need to provide the resources for people to have affordable and accessible health care. Well, here is a way to do it. Let's allow those employers to have a benefit package that they extend to minimum wage workers for the first time so those who are most at risk might have the opportunity to be supplied health care by their employer, negotiated at the group rate.

Some might think that all Americans don't have a dog in this fight. I say they do. For every American we can put under the umbrella of coverage, we have reduced the cost shift in health care to where insurance premiums for the average person today will not continue to go up at the rate it is today. My hope is that even if it is incremental, we can bring more Americans under the umbrella of coverage.

It is my hope that my colleagues will see the great benefit we are talking about now, money designated to increase the wages of individuals, and we will at least allow employers the option to give them that benefit in health care. I think it is a very reasonable amendment. I urge my colleagues to support it.

I yield the floor.

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

Mr. President, I yield back the remaining time, and I ask for the yeas and nays.

Mr. President, I ask unanimous consent that the Committee on Armed Services be authorized to meet during the session of the Senate on December 5, 2006, at 9:30 a.m., to consider the nomination of Robert M. Gates to be Secretary of Defense.

Mr. President. I ask unanimous consent that the Committee on Commerce, Science, and Transportation be authorized to hold a Full Committee hearing on Nominations on Tuesday, December 5, 2006 at 10 a.m. in room 253 of the Russell Senate Office Building. Nominees to be considered are Steven Chealander to be a Member of the NTSB and Charles Dorkey to be a Member of the Advisory Board of the Saint Lawrence Seaway Development Corporation.

Mr. President, I ask unanimous consent that the Committee on Finance be authorized to meet during the session on Tuesday, December 5, 2006, at 10 a.m., in 215 Dirksen Senate Office Building, to hear testimony on ``Report Card on Tax Exemptions and Incentives for Higher Education: Pass, Fail, or Need Improvement?''

Mr. President, I ask unanimous consent that the Committee on Finance be authorized to meet during the session on Finance on Tuesday, December 5, 2006, at 12 noon, in 215 Dirksen Senate Office Building, to hear testimony on the nominations of Mr. Anthony Ryan to be Assistant Secretary for Financial Markets, U.S. Department of the Treasury, Washington, DC; Dr. Phillip Swagel to be Assistant Secretary for Economic Policy, U.S. Department of the Treasury, Washington, DC; Mr. Dean Pinkert to be Member of the U.S. International Trade Commission, Washington, DC; Mr. Irving Williamson to be Member of the U.S. International Trade Commission, Washington, DC; Ms. Dana Bilyeu to be Member of the Social Security Advisory Board, Social Security Administration, Baltimore, MD; and, The Honorable Mark Warshawsky to be Member of the Social Security Advisory Board, Social Security Administration, Baltimore, MD.

Mr. President, I ask unanimous consent that the Committee on Health, Education, Labor, and Pensions meet in executive session during the session of the Senate on Tuesday, December 5, 2006 at 5 p.m. in SD-430.

Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet to conduct a hearing on ``Examining Enforcement of Criminal Insider Trading and Hedge Fund Activity'' on Tuesday, December 5, 2006 at 9:30 a.m. in Dirksen Senate Office Building Room 226.

Witness List

Panel I: Mr. Ronald J. Tenpas, Associate Deputy Attorney General, United States Department of Justice, Washington, DC; The Honorable Richard Blumenthal, Attorney General, State of Connecticut, Hartford, CT; Ms. Linda C. Thomsen, Director of Enforcement, U.S. Securities and Exchange Commission, Washington, DC;

Panel II: Mr. Gary J. Aguirre, Former Investigator, U.S. Securities and Exchange Commission, Washington, DC; Mr. Walter J. Stachnik, Inspector General, U.S. Securities and Exchange Commission, Washington, DC; Mr. Robert B. Hanson, Branch Chief, Division of Enforcement, U.S. Securities and Exchange Commission, Washington, DC; Mr. Mark Kreitman, Assistant Director, Division of Enforcement, U.S. Securities and Exchange Commission, Washington, DC; Mr. Paul R. Berger, Former Associate Director, Division of Enforcement, U.S. Securities and Exchange Commission, Washington, DC; Mr. Eric Ribelin, Branch Chief, Office of Market Surveillance, U.S. Securities and Exchange Commission, Washington, DC.

Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet to conduct a hearing on ``Judicial Nominations'' on Tuesday, December 5, 2006 at 2:30 p.m. in Dirksen Senate Office Building Room 226.

Mr. President, I ask unanimous consent that the Subcommittee on Federal Financial Management, Government Information, and International Security be authorized to meet on Tuesday, December 5, 2006, at 10:30 a.m. for a hearing regarding ``An Assessment of Improper Payments Information Act of 2002''.

Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 583, S.3678.

Mr. President, I rise today in support of S. 3678, the Pandemic and All-Hazards Preparedness Act. This bipartisan bill, which was drafted closely with Senator Kennedy, will improve our public health and medical preparedness and responses during emergencies and disasters. I thank the Senator from Massachusetts for his partnership on this important legislation. I also thank Chairman Enzi for his leadership, Majority Leader Frist, Senator Gregg and all 14 bipartisan cosponsors of this legislation for their hard work and support.

S. 3678 achieves two overarching goals. It reauthorizes the Bioterrorism Act of 2002, which was signed into law

following the terrorist attacks of September 11 and expired at the end of September, and it builds on the Project Bioshield Act of 2004, to speed up the development of drug and vaccine countermeasures against bioterrorist and other public health threats.

In June 2002, President Bush signed the Bioterrorism Act into law and stated the legislation was proof that ``When people of both parties work together, they can work on behalf of our country.'' Over the last 2 years, S. 3678 has been developed through the same bipartisan process. We all understand that the threats of bioterrorism and other public health emergencies, such as pandemic flu, are very real and we are committed to act now to protect the American people.

We know we must act now, before avian flu reaches our shores, before the next hurricane devastates a great city, before a bioterrorist attack kills an innocent American.

The threat of bioterrorism remains. Around the world, radical religious groups are being urged to establish new terror cells that specialize in biological warfare. It is increasingly easy to access Internet guides to bioterrorism, including methods for contaminating food and water supplies and spreading deadly microbes using do-it- yourself sprayers.

We often think of smallpox and anthrax as the gravest bioterrorism threats; however, as science and technology advance, the number of worrisome agents is expanding. In fact, the Department of Homeland Security recently determined that an additional nine biological agents present material threats against the United States sufficient to affect national security.

It is clear we will not keep up with new and emerging threats if we continue to be constrained by practices and procedures which require, for example, a decade to develop a new drug or vaccine countermeasure. Instead, we must take a faster, more creative approach to developing flexible, dynamic defenses against these threats.

Hurricanes Katrina and Rita proved once again that Mother Nature can be extremely destructive. And now, the United States is preparing for a potential flu pandemic that may be carried by birds. The biodefense plan laid out in this bill will enable us to be more flexible and will allow us to rapidly respond to all-hazards emergencies--be they natural, deliberate, or accidental.

We take five key actions in S. 3678, which will better prepare the Nation for the all-hazards public health emergencies of the future.

First, the bill puts someone in charge. After Hurricane Katrina, it was unclear who was in charge of our public health and medical response to this devastating storm. I believe unity of command and control is the key to rapid emergency response. This legislation identifies the Secretary of Health and Human Services as the lead Federal official for public health and medical response to emergencies, thereby eliminating confusion and chaos and increasing accountability and predictability. S. 3678 also unifies HHS preparedness and response programs under a renamed Assistant Secretary for Preparedness and Response, ensuring someone in the Federal Government is constantly improving our preparedness.

Second, S. 3678 funds State and local preparedness. We know the best emergency response begins at the local level. My bill reauthorizes over $1 billion per year in grants from HHS for State and local public health and medical preparedness. Authorization for these important grant programs expired in September 2006. The legislation also stresses accountability and fiscal responsibility in order to measure the progress made through these funds, and it requires States to match Federal investments in preparedness, beginning in 2009.

Third, the bill improves public health security. Public health departments across the country have varying abilities to identify a case of bird flu and contain its spread. S. 3678 establishes a set of key capabilities that all health departments must strive for. It also modernizes how public health departments detect, respond to, and manage public health threats, by collecting instant electronic information which will enable public health officials to make informed decisions before, during, and after a public health emergency.

Fourth, S. 3678 will speed up emergency medical response. During the response to Hurricane Katrina, it was too difficult for willing health care providers to volunteer their time and provide much-needed medical expertise to the gulf coast region. My bill makes it easier for health care providers to volunteer in emergency situations, and it enables the Secretary of Health and Human Services to provide liability protections for approved volunteers. This legislation also promotes the use of mobile hospitals and alternative Federal facilities which can help handle an increased number of patients during an emergency. Additionally, the bill improves planning and logistics for health care providers and volunteers to ensure emergency medical care can be delivered faster during a disaster.

Finally, the bill ensures the development of more drug and vaccine countermeasures to combat public health emergencies. The process for developing a new medical countermeasure still takes up to a decade and costs hundreds of millions of dollars. S. 3678 will improve our ability to quickly develop drugs and vaccines to protect against threats such as bird flu and bioterrorism. It reorganizes and enhances HHS medical countermeasure research, development, and procurement activities, through the Biomedical Advanced Research and Development Authority, or BARDA. Modeled after the Defense Advanced Research Projects Agency's successes in defense research, BARDA will bring innovation to a process that is simply too slow to combat terrorist activities or Mother Nature.

Making the Government more dynamic, nimble, and accountable will bring more and better medical countermeasures to the public faster case of emergency.

In closing, I applaud my Senate colleagues for taking a decisive step forward today in improving the Nation's preparedness for all-hazards public health emergencies--including acts of terrorism and those brought to us by Mother Nature, by passing S. 3678, the Pandemic and All-Hazards Preparedness Act.

I would like to thank the staff of my Subcommittee on Bioterrorism and Public Health Preparedness for their hard work, Jennifer Bryning, Kendall Byrum, Jenny Ware, Heidi Swygard, former staff director, Dr. Bob Kadlec, and former Senate fellow, David Marcozzi. Also, thank you to the majority leader's staff, especially Elizabeth Hall. Thank you to Chairman Enzi's staff, Katherine McGuire, Ilyse Schuman, Steve Northrup, and David Schmickel. Thank you to Senator Kennedy's staff for their hard work, David Bowen, and Caya Lewis. And thank you to Senator Gregg's staff for their support, David Fisher, and Richard Weiblinger.

Earlier this year, I had the opportunity to travel to the Gulf Coast to learn from the disaster of Hurricane Katrina. It is our solemn responsibility to do all we can to make sure our Federal response is better. I want to also thank the many State and local public health officials from across the country, the hospitals, health care providers, elected officials, patients, EMT personnel and citizens who gave us their ideas and shared their experiences in this process. Together, we have laid out a plan to improve our Nation's public health and to better respond to disasters in the future.

Mr. President, I ask unanimous consent that the amendment at the desk be agreed to, the committee-reported amendment, as amended, be agreed to, the bill, as amended, be read a third time and passed, the motion to reconsider be laid upon the table, and that any statements relating to the bill be printed in the Record.

Mr. President, I thank the chairman of the committee, and I also thank the ranking member, Senator Kennedy, who has been extremely helpful throughout this whole process. If it were left up to the three of us, this bill would have become law and would have been signed by the President months ago, because in fact 50 percent of this bill was passed unanimously in the House of Representatives. But as you begin to see now the interest of my colleagues who think this is a vehicle leaving the Senate, some of the amendments that have popped up are not even germane to the issue of what we are here to talk about.

More importantly, I think we need to focus on why we are here-- because of the threat of terrorism, the power of Mother Nature, what we have learned from the destruction of Katrina, what we continue to hear from the voices of individuals whose intent is every day to kill Americans.

This morning, the World Health Organization confirmed that the H5N1 bird flu strain has mutated. As you know, we don't have a vaccine today, but we are desperately trying to get there.

This Congress has made some exceptions as it relates to our development of a vaccine for pandemic flu because of the urgency. Yet, they do not see the same urgency as it relates to e. coli, or smallpox, or anthrax, or the ability to genetically modify any of them to overcome anything that we might have in our arsenal to defeat them today. Yet this morning the World Health Organization announced that in areas of China they have established that bird flu has mutated. That mutation means we do not have a vaccine; it means that the antivirals Tamiflu and Relenza that we have don't protect against this strain. It means we are completely unprotected.

In addition to that, reported today by the head of al-Qaida in Iraq, he put out an audio message that said this: ``We are in urgent need for you as American bases are the perfect place for nonconventional experiments of biologic and dirty warfare.''

But some argue that is not a real threat, that al-Qaida never participated in that. However, this quote is from the head of al-Qaida calling on his brothers, his scientists, to bring their research and development and see how well it works. If it can be used there, it can be used here.

In this bill, our attempt was to make sure that we have in place a robust research and development process that is focused on threats that might be intentional, threats that might be accidental, or threats that are natural. We certainly saw the power of the natural threats 1 year ago with Hurricane Katrina. As we sit here almost on the fifth anniversary of the anthrax attacks on the Congress, I think it is worth reminding our colleagues that this threat hasn't gone away. This threat continues yet today, and 5 years later we do not have the vaccines and drugs to defeat these threats. And if in fact terrorists have spent any time to genetically modify it, we have to question whether we have an antiviral capability to treat individuals who are infected and reverse that course and make sure there is no loss of life.

We are headed into a new season of pandemic flu. As that season starts and we detect those infected birds, how long will it be before one bird finds the shore of the United States, be it through Canada or Alaska?

We need to continue. We need to pass this legislation, We need to catch up with what the House did this week.

Members will come to the floor and say, ``We didn't debate it enough; we didn't have enough hearings; my voice wasn't heard.'' Let me assure you I have reached out to every Member of this body. I have continuously solicited their input, and most of that is incorporated into this bill. I will assure you there has been some input that I could not accept in the bill because it wouldn't maintain what we tried to accomplish; that is, to assure the American people we are doing everything within our power to make sure they are safe.

The legislation we have developed focuses on strategies to address public health and medical needs of at-risk individuals. Every person in this body learned after Hurricane Katrina that we have to better prepare to meet the needs of at-risk individuals, children and older Americans, in a totally different way than our current response plans. In our bill, we require that to be part of our national preparedness goals. We set up an at-risk individuals advisory committee to continually remind those responsible for responding to disasters of what in fact they need to do for at-risk populations.

In addition, we require of every State emergency response plan to incorporate at-risk individuals into their plans. We have not left them behind. We have made them a centerpiece of our focus in this legislation.

We also strengthen the State and local public health infrastructure in this bill by reauthorizing over $1 billion a year in Federal funding for grants from Health and Human Services for public health and medical preparedness.

The last thing we do, which I will focus on, is the single most important thing in this bill. We put somebody in charge. We made one individual responsible for the health care response of the Federal Government. And where we had those responsibilities fragmented before, with the help of the chairman of the Department of Homeland Security Appropriations Committee, we began to move those things. And where there needed to be greater consultation with agencies such as the Centers for Disease Control and Prevention in Atlanta, we built in that concentration.

I am convinced that with one person in charge when there is another disaster in America, we will not have fingerpointing. We will know exactly who to go to and who to hold responsible for execution of the plan, for creation of the plan, but, more importantly for how that plan dovetails with 50 State plans, thousands of communities, regardless of what the threat is, whether it be natural, intentional, or accidental.

We truly have lived up to what the chairman of the committee asked us to do--that was create the ability for an all-hazards response. Don't put us in a situation where we create something for a known threat only to have to go back and recreate the wheel when all of a sudden a threat appears that we didn't anticipate. This sets up a framework that allows us to do that.

It is my hope that later today the chairman will offer a unanimous consent request. I believe it will be objected to, but we will continue to try to improve our security level and put in place these changes so that the American people have that comfort of knowing we are doing our job.

I yield the floor.

Mr. President, I don't see additional Members in the Senate, so I will take the opportunity to ask unanimous consent to address the Senate for 5 minutes. If I do see additional Members seeking recognition, I will certainly accommodate them.

Mr. President, I was reminded, as Dr. Coburn spoke, that we do have a blueprint that guides us as it relates to pandemic flu. It is ``The Great Influenza.'' Most of us in the Senate were not here in 1918. I daresay we have few Members who were here at that time. This book is the greatest recap of what happened at that time and the significant impact on the lives of the American people and how many individuals died. Unlike what we might expect in a flu season, those affected were not the old and at risk. They were the young and healthy. They were the ones who were attacked with this case of pneumonia which was a strain which could not be overcome with any medicine they had available.

One walks away from this historical lesson realizing, if we think it could happen--which nobody questions--then we should do everything within our means to make sure we are not left in the same position we were in 1918 with no stable of products to defeat this virus.

What do we do in this bill? We develop a partnership between the Federal Government and private companies, between the Federal Government and academic institutions, between the Federal Government and any researcher who might have research that leads us to believe they might hold the key to a cure. We enter into that partnership with the belief that as long as the research and development shows promise in the right direction, we will continue to be a good partner, but if at any point, in real time, we see it is not headed where we want, we stop our funding. We are fiscally responsible.

We make sure one person is in charge of the health response in the United States versus a multitude of individuals at multiple agencies. For the first time, this country would have an approach to our health response and to our development of antivirals and vaccines to defeat these agents that is not limited to one area but covers all hazards.

We build on the State preparedness plans. We do not trump the State plan. We do not create two separate plans. We integrate into that State plan to make sure we are there to support the replenishment of supplies, with the logistic needs. We have to make sure, in fact, that in the first 72 hours after a disaster, individuals feel the full effects of local, State, and Federal resources.

We rebuild the public health infrastructure in America. I challenge anyone to look at the community they live in and compare the public health infrastructure they grew up with to the one they have today. It is impossible to believe we can have a nationwide plan of response if, in fact, our public health infrastructure varies as greatly as it does today from the inoculation point for low-income children to the only place, in some cases, where health care can be delivered.

We strengthen our surveillance, which, as we look at the bird flu, is absolutely crucial, our ability to identify at the earliest possible point whether, in fact, an infection and a threat is alive and well.

We allow for the surge capacity of health care professionals. I see my colleague from Louisiana is in the Senate. She would be the first to know that one of the challenges when Katrina dramatically affected this country was that health care professionals around the country who intended to go to Louisiana and supply that very important medical surge capacity had a licensing problem in Louisiana. I forget the exact reason. But the question is, How can we overcome this challenge in the future? We create in this bill a voluntary network that health care professionals can sign in to get their credentials verified ahead of time, where the United States can then deploy these approved health care professionals on a moment's notice without any additional hurdles.

I see my colleagues. Since we do have individuals who could execute their objection, it would probably be an appropriate time to offer the unanimous-consent request.

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

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

Mr. President, I ask unanimous-consent that the HELP Committee be discharged from further consideration of S. 3678 and the Senate proceed to its immediate consideration. I also ask unanimous- consent that the substitute at the desk be agreed to; the bill, as amended, be read the third time and passed, and the motion to reconsider be laid upon the table.

Mr. President, reserving the right to object, as Members may have missed the over 30 minutes many of us have been in the Senate Chamber, a significant amount of time and effort has gone into this bill. A very general solicitation and at times a very specific solicitation for input has been sought from my colleagues, without a response.

Yesterday, a list of possible amendments was supplied. Most of those amendments were not even applicable to what is in the bill. We are not in a position right now to know what the specific modifications are that are being suggested, since we have not seen the actual amendments. Therefore, I object to the unanimous-consent request.