Floor Statements

Mr. President, first of all, let me compliment the work of my senior Senator, Jack Reed, on this issue. When I first came to the Senate 3 years ago, Senator Reed had already established his reputation as somebody who fought passionately for unemployment insurance for people who were out of work. He understood that a family who is out of work, through no fault of their own, very often has the unemployment insurance they and their employers have contributed to as their only lifeline; that as our vibrant economy goes through ups and downs, there are times when individual families pay a terrible price when the economy contracts, when jobs are lost, and when individual families have to make what Vice President Biden called that ``longest walk'' up the stairs to tell their kids, their families, they have lost their job.

At that time, that lifeline for a hard-working family who, through no fault of their own, is out of work is all important. Senator Reed knows that well. He has been a champion on this issue, not just when it has been at the forefront of national attention as it is right now, but day in and day out, constantly fighting for the people in Rhode Island and folks across this country who need this lifeline.

I wanted to say a few words to echo Senator Reed's comments. Rhode Island still has 12 percent unemployment. We have the fourth worst unemployment of any State in the country. It has been that way month after month after month after month, with individual families paying the terrible price of the economic consequences of something that took place well outside of Rhode Island. It was Wall Street that collapsed. It was the big Wall Street banks. It was the bets by the Wall Street banks in a wild derivatives market, a wild mortgage security market, that tanked this economy, that required emergency action by Congress to try to put it right before a real depression ensued, and that kicked off the great recession that we have been suffering since then. That great recession washed like a tsunami across our country, and it hit particularly hard in my home State of Rhode Island.

In Rhode Island, we have 70,000 families who have somebody out of work. It is actually probably more than that because the unemployment numbers tend to undercount the actual harm. But the official count is over 70,000 families. I can promise you this: There aren't 70,000 jobs waiting around for those people in Rhode Island. They are just not there.

The notion that the Republican side has often developed, which is that unemployment insurance contributes to unemployment; that people who are looking for work need a little bit more motivation to go out there and take a job, and if you could just threaten their families' survival, threaten their ability to have food on the table, threaten their ability to stay in their homes, and threaten their ability to afford health care, they will then be motivated enough and will go out and get those jobs--I don't know where they get that from, but it is not from Rhode Island. We are a hard-working State. We don't have the jobs to take 70,000 people and put them back to work as this economy just haltingly now begins to recover.

Six-thousand Rhode Islanders have lost their emergency unemployment insurance benefits because of the stall tactics of the other side of the aisle; 2.5 million Americans across the country have lost their benefits. Those sound like big numbers. Behind every one of those 6,000 Rhode Islanders is a family story, a story about an individual who has to face some hard choices about whether they are able to pay the mortgage, whether they are able to buy new clothes for kids when the kids go back to school, whether they are able to pay for their medications, whether they are able to simply keep food on the table and a roof over their heads.

It certainly played a crucial part in preventing economic disaster for Sandy in Warwick, RI, who is 60 years old. She has a background in accounting. She has been unemployed now for 13 months and is trying to find a job in that tough, tough, tough, Rhode Island economic climate. She has applied for about 100 jobs. She is out there working. She is out there trying to find a place where she can put her skills back to work the way she always did, but no luck so far.

Her lifeline was unemployment insurance. If the Senate Republicans had been successful in their filibuster of this unemployment insurance, Sandy would have lost what is now her only remaining source of income. The consequences of that, obviously, are catastrophic for Sandy, for the other 6,000 Rhode Islanders in that position, and for 2\1/2\ million Americans around the country.

The great argument we hear our friends on the other side make is: We understand how painful this is going to be. We understand that people are going to have to come home and tell their kids we are going to have to move. We can't keep our home any longer. You are going to have to pack up your bedroom, put the stuffed animals in a box, and we are all going to have to clear out because I simply don't have the income.

Crossroads, our biggest shelter in Rhode Island, is packed. We have people sleeping in conference rooms. But the Republicans say: You know, we understand that is tough. We understand if you can't pay for medication for your spouse, that is tough. As people start to think about heading back to school in September, and you can't pay for clothes for the kids, you can't pay for pens, pencils, and schoolbooks, that is tough. But something more important is at stake here, they tell us, and

that is our national debt. We have to worry about that more than the care of American families who are out of work, through no fault of their own, because of the wild spree that Wall Street took under the Bush administration.

I would think more of that argument if it were at least consistent, but it is not consistent. It is an argument that they apply when regular working families are out of work through no fault of their own because of the Wall Street meltdown from the Bush policies. That is when they get all excited about how important the deficit is. But when it comes to, say, oh, tax cuts for billionaires, tax cuts for corporate CEOs, well, then a different rule prevails. Then the debt isn't so important. Then the deficit isn't so important. What is more important are the folks with the big salaries--the CEOs earning on average these days 400 times what a regular average salaried worker gets paid--400 times more every day than the average worker. That is the kind of tax cut that is more important than the deficit.

I saw this cartoon the other day, and I wanted to share it on the Senate floor. I thought it was a pretty good description of where we are on this. Here are our friends on the other side. It says ``Senate GOP'' on this cranky fellow's hat, and a little cat on the front of the boat says ``jobless benefits,'' if you can't read it. The fellow is saying to the little cat on the front of the boat: Too much weight. You get off the boat into the water. You are on your own. We don't care. Actually, it ends at get off the boat. I added the rest. On the back of the boat we see tax cuts for the wealthy.

But the Republicans do not see that. They do not worry about that. They are not concerned about that. Since the estate tax went to zero, four estates have been reported in the media of more than $1 billion-- more than $1 billion. Each estate has gone through tax free, at a cost to the Treasury, at a cost to the deficit and the debt of hundreds of millions of dollars, and not a peep--not a peep--from the other side from those who are concerned about the deficit, when that is the issue. But you get a poor family out of work, one lifeline left keeping them in their home, one lifeline left keeping food on the table, and giving that lifeline the chop is something they are all for. That is something they are all for.

Well, fortunately, what happened here in the Senate yesterday is they lost. They didn't lose on a fair-and-square up-and-down-majority-rules vote. They lost on a 60-40 filibuster vote. They made us win by 20 points. Not just majority rules, the way it is in most places, but they forced us to 60-40 and we still won. So the unemployment insurance benefits should begin to flow to those families who are in such distress right now, and wondering how they are going to make it through the next day, through the next moment.

But it is not enough for them, once losing the debate, to simply pick themselves up, dust themselves off and, like good sports, go on to the next disagreement. We have other things we will disagree about. Nope. That is asking too much of our friends, unfortunately, to have that kind of good sportsmanship--to stand up, get back on the field and go back to the battle. We have to burn 30 hours of Senate floor time to no purpose. We can't do other work during this period. We can't do amendments during this period.

We know how the vote is going to come out. Literally, no possible purpose is accomplished by requiring us to burn the 30 hours, except two things for sure will happen. One thing for sure that happens is that all those families out there--those 6,000 Rhode Island families, those 2\1/2\ million families across the country--will have to wait a little longer. They have been stretched to the very end of their budgets and they are hanging on by their fingernails. But instead of saying: Fair and square, okay, we tried. We threw up every obstacle we could, but we lost 60-40, so let's go on to the next thing--nope, they are going to make them hang on for another 30 hours.

The other thing they accomplish through this is that they burn Senate floor time. The Good Lord only gives us so much time. You can't get minutes back when they are gone. You can't get hours back when they are gone. You can't get days back when they are gone. We have a lot of work to do in this Chamber, and our friends on the other side would like to have us do as much work as possible in as little time as possible, because, frankly, they want as little done as possible. So it actually suits their goal to burn floor time to no effect here on the Senate floor.

So that is what we are doing. I am here alone right now. Senator Reed was here alone a minute ago. I suspect that when I leave, we will go back into a quorum call and time will tick, tick, tick, tick past with nothing being accomplished here. We could be working on jobs legislation. We sure need that. We could be working on energy legislation. We sure need that. There are a host of things Americans want us to be working on. But the Republican side of this Chamber has a strategy to prevent anything from getting done. Their policy is saying no, no matter what the question is--that is their answer, no matter the proposal--as long it comes from the Obama administration. That is their purpose, and they achieve that purpose when they burn this time.

So here we are on the Senate floor with time ticking away, second by second, minute by minute, accomplishing nothing other than burning 30 hours that, frankly, belongs to the American public. These are 30 hours we should be accomplishing the public's business, moving on to the next issues and going forward.

I would hope that, if nothing else, out of the spirit of good sportsmanship, our friends on the other side would call this off and say: All right, enough. We wish we had won. We want a world in which the deficit only applies to unemployment benefits for working families and we get to dig big holes in the debt and the deficit when it is our tax cuts for the wealthy, but we lost on that one. Let us move on. We will take the hand up off the field, we will dust ourselves off and move on to the next one. If for no other reason than good sportsmanship, I would hope they would do that and call off this period of delay.

That would also allow us to get to other business. We may disagree, but we might as well get to the business. We might as well have these arguments out. We might as well have our fight. Let's not just kill time here. So I hope my colleagues will reconsider. Time ticks away, awasting here. Everybody has work to be done. The American people await us, particularly on jobs legislation. There is an enormous amount we could do to help them if we could simply get to it.

We have a small business bill we are trying to tee up that would provide enormous value to the economy, including in particular Rhode Island, where small business is so important. Small business is the heartbeat of Rhode Island's economy. To the extent we can provide additional capital and support for small business, we could get to that. We could be working on that right this minute instead of being stuck in this long delay, in this empty Chamber while 30 hours ticks uselessly away because our friends simply can't dust themselves off after their defeat, stand up and go on to the next issue. They have to force this long 30-hour stall.

I thank the Presiding Officer again for the time, I yield the floor, and I suggest the absence of a quorum.

Mr. President, I thank Senator Landrieu and also Senators Merkley and Cantwell, who spoke before me, for the extraordinarily hard work they have put in to bring us to this moment. This is the culmination of a lot of hard work against what was for a long time unanimous Republican opposition. We couldn't get this done because we couldn't get one vote from a single Republican to help small business through our community banks. Thankfully, Senator LeMieux has broken the ice. Now we are in a position to go forward. There may well still be significant parliamentary maneuvers by the other side to slow it down and delay it rather than have it go smoothly, as it should.

The situation in Rhode Island is pretty dire. We are a small business State, and we have more than 12 percent unemployment. The situation in which that takes place is the one my colleagues have described.

The big banks are hoarding cash. They have been given access to the Treasury, and they are borrowing money at extremely favorable rates, but it is not filtering out. It is being invested for their own account, building up their balance sheets, not getting through to businesses, particularly not to small businesses. The big corporations are hoarding cash. That is putting pressure on employment and on small business. So for a small business, even if you are profitable, even if your loans to your bank have consistently been performing, the tightening up of credit on the community banks has restricted the funds that are available to even solidly performing small businesses that wish to invest and hire.

The solution for this is a wonderful one that Senator Landrieu, Senator Merkley, and Senator Cantwell recommended, and that is to turn to our local community banks that were not a part of the Wall Street problem and know where the good businesses are. They have existing relationships with them. They would love in many cases to loan to them. They just don't have the capital. So this provision would bring together the capital available from the Federal Government and the expertise of the local community banks to meet the urgent need of America's small businesses. The market for capital has tightened so much that this kind of a mechanism makes a lot of sense. The government loans capital, and there is a fee. It is not giving it away; it is earning a fee, and it frees up additional capital for the banks in turn to loan, the local community banks, to bring their expertise to bear on those businesses. So the bank then loans the capital and it gets out the funds and the small businesses gather funds and from that capital they are able to go out and hire and invest and help to begin to further improve the economic climate.

This is a good idea. It is timely. I hope as we go forward. The good sense that Senator LeMieux has shown and the priority he has put on small business and local community banks is able to sink in a little bit further. Frankly, I wish we had been able to do this some time ago, but the absolutely unanimous blockade from the Republican Party has prevented this.

I will close by saying that having been a party to many of these discussions as the Senator from Louisiana has been keeping us abreast of her negotiations, I know what a long ordeal this has been for her. I know how tenacious the Senator from Louisiana has been on this. She has finally been successful in terms of delivering what is now a bipartisan amendment, and it is a great moment. I congratulate her and I look forward to working with her toward success.

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

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

Mr. President, may I speak for up to 15 minutes as in morning business?

Mr. President, I heard that some of my colleagues on the other side were here earlier engaged in a colloquy of condemnation of the appointment of Dr. Berwick to run CMS. I wanted to come back and respond because I think this body is making a mistake and is taking a very wrong path by attacking and criticizing this particular nominee.

To provide just a moment of context to his appointment, when I was here yesterday I had a graph that showed that in 1955, the year that I was born, we spent about $12 billion on health care as a nation. Last year we spent $2.5 trillion, 200 times as much. The graph showed not only the steep curve that took us from $12 billion to $2.5 trillion a year, but also the fact that curve was accelerating. It was getting steeper. In the last year the year-to-year increase was $134 billion in health care expenditures.

That is the biggest year-to-year increase in the history of the Republic. If we kept at it, by 2016 a family of four in Rhode Island would be paying $26,000 in premiums for a basic health care policy. Medicare Advantage plans jumped 14 percent last year nationally, on average. We are in both an unsustainable and an accelerating health care cost increase environment. Something absolutely has to be done about it. I suspect almost everybody in this Chamber would agree with that.

That is the backdrop--unsustainable, accelerating health care costs that now gobble up more than 17 percent of our gross domestic product. There is a huge discrepancy between us and every other nation in terms of the amount of our economy that we burn on health care. I believe the closest to us is now at 12 percent of GDP, and we are at 17 percent, and it climbs every year along with that accelerated, unsustainable rate of health care cost increase.

The question is, What are we going to do about it? This is a terrific burden on our economy. It is uncompetitive against other nations, it hugely depresses our manufacturing sector, and it clobbers families who have to pay for health care that is so expensive. It simply has to be addressed.

There are two ways we can do it. We could preserve the status quo and simply cut benefits that people receive. We could make Social Security health care benefits knocked down. We could make Medicare benefits knocked down--disability health care benefits for Social Security. We could make Medicaid benefits knocked down. We could spend less, I suppose, on TRICARE in the Veterans' Administration and provide fewer services, pay for less, or require more copays. That is one way to go about doing it, but it is not a very smart way and it is not a very humane way.

A lot of the costs in our health care system is waste; it is waste and inefficiency. If we look at the report of the President's Council of Economic Advisers, they come at it in two ways, and both ways come to the same number, about $700 billion a year--a year--in waste and excess costs.

The New England Healthcare Institute did a study--$850 billion a year in waste and excess cost.

The Lewin Group and former Bush Treasury Secretary O'Neill have both arrived at a different number, but they agree the number is $1 trillion a year in waste and excess cost.

So if we have a huge cost problem, and if we have waste and excess costs as high as $1 trillion a year--to give us an idea of the scale, remember it was about $2.5 trillion last year. It is supposed to be $2.7 trillion this year. If the Lewin Group and Secretary O'Neill's number is right, that means one-third of the cost, more than one-third of the cost is waste in excess care, unnecessary cost. So going after that waste and excess cost should be a priority to deal with the cost burden that our health care system puts on the country.

How would we go about doing that? Well, we are actually fortunate in one respect. In all of the mess of our health care system we are fortunate in one respect; that is, there is a proven correlation in many areas between improving the quality of care and lowering the cost of care.

Probably the most famous example is dealing with hospital-acquired infections. A hospital-acquired infection costs maybe $60,000 on average to treat, and it is avoidable. It is completely preventable. So if we crack down on hospital-acquired infections, if we fix the process failures that permit hospital-acquired infections to occur, we improve the quality of care, we save people's lives, we get them out of the hospital sooner and healthier, and we save money, all together. But because of the bizarre economics of our health care system, it is not in anybody's financial interest to do that who is also in a position to do that. So over and over, we have these failures where we could have huge win-win situations in which we improve the quality of care for the American people while reducing the cost of the health care system.

It happens with hospital-acquired infections. It happens with administrative overhead. Medicare runs about 3 to 5 percent of overhead. The private insurance market runs at about 20 to 27 percent overhead. It has more than doubled in the last 6 years, from 2000 to 2006. In 6 years it has more than doubled, just the administrative overhead, not health care itself, the administrative overhead of the private insurance industry. That is part of the waste and excess costs.

We can tackle those things. We can drive them down. We can improve, for instance, maternal mortality rates in this country. Believe it or not, America is 39th in maternal mortality. Maternal mortality is a cold, statistical way of describing a mother dying in childbirth, giving birth to her baby, and we are 39th in the world; 38 countries do better at protecting moms while they are giving birth to their children than we do.

If we can improve that rate, we can save money because the same process failures that lead to those deaths lead to expensive complications, additional days in the hospital, sometimes lead to lifelong injuries to the baby as it is being delivered, which create huge cost. So, again, it is a win-win when we improve the quality of care to lower the cost of medicine.

Now, why do I say all of that? Why do I talk about the importance-- first of all, the urgency of the cost problem and the importance of pursuing this win-win strategy to reduce the cost of care by improving the quality of care for Americans? I mention that because Don Berwick is probably the leading pioneer in this area.

The bible of the quality of improvement movement was a book called ``To Err is Human,'' written, I believe, by the National Institutes of Health. Dr. Berwick was one of the lead authors of that report. It was followed by another report called ``Crossing the Quality Chasm.'' Those two reports have been the foundation for the quality reform movement.

I am very familiar with the quality reform movement because I founded something in Rhode Island called the Rhode Island Quality Institute which has led in this area. The legislation we passed, the health care legislation, contains an immense number of reforms of the delivery system that are designed to capture this win-win, that are designed to improve the quality of care in ways that lower the cost of care.

One economist has called it the most significant action on medical spending ever proposed in the United States. A Noble Prize-winning economist has noted that official estimates don't give the plan much credit for the cost-saving efforts in the proposed reform, but realistically the reform is likely to do much better at controlling costs than any of the official projections suggest.

An MIT professor, who is a leading health economist, said: I cannot think of a thing to try that they did not try. They make the best effort anyone has ever made. Everything is in here. You could not have done better than they are doing.

So the bill created an array, a portfolio of tools for beginning to change our broken, dysfunctional health care delivery system and move it more in the direction of better patient care that costs less money.

The lead practitioner of that, the lead advocate of that, the person who has thought about this the most and done the most work on it is Dr. Don Berwick. So it makes perfect sense he would be the person brought over by President Obama to lead CMS and to apply these principles of improving the quality of care, to reduce the cost for America. He is an expert at it. I think

we wrote good legislation on the delivery system reform. I think it was actually very good legislation. But it does not matter how good the legislation is that we write if the executive branch does not get out there and implement it in a dynamic, thoughtful, iterative way. We learn something, we move on.

We have to be creative and continue the pressure on this. We have to take what we learn in different projects and bring them together and try something now and constantly be in a process of innovation and improvement in order to be effective. Nobody will do that better than Professor Berwick. That is why both President Bush, H.W. Bush, and President Bush, W. Bush, their CMS directors have applauded this nomination.

Gail Wilensky, the Administrator of CMS under President George H.W. Bush, said: Berwick has longstanding recognition for expertise and for not being a partisan individual.

George W. Bush's CMS director, Tom Scully, said: You are not going to do any better than Don Berwick.

So from the other side of the aisle, from the partisan side of executive management of this, the previous CMS directors know how qualified this man is. I know my Republican colleagues want to talk about rationing. They would love to paint rationing and socialized medicine and death panels all over the health care bill. Obviously they cannot resist the opportunity to do that using Dr. Berwick.

But, frankly, it is not fair, and I think it puts them on the wrong side of history. It puts them on the wrong side of reform. It raises the question, Whose side are they on? When we have somewhere between $700 billion and $1 trillion of waste every year and the person who George Bush's CMS director says we are not going to find any better to come in and fix that program than the nominee, and they are against the solution to that, whose side are they on?

Well, it is pretty clear they are on the side of the $700 billion to $1 trillion a year in waste. That is a choice they can make. But I do not think it is a wise choice. When we are dealing with doing things such as eliminating hospital-acquired infections in order to save money, and they are against the person who is the leading proponent of this and who is going to lead us in that direction, who are they for? Are they for the families who lose a loved one to a hospital-acquired infection? It does not seem that way. It seems like a vote in favor of the status quo. It seems like a vote in favor of the status quo and the continuing unbelievable number of deaths and casualties from hospital- acquired infections.

One of the findings of the ``To Err is Human'' report is that 100,000 Americans die every year, 100,000 Americans die every year because of avoidable medical errors. When we clean up the medical errors, when we clean up the process failures that lead to those medical errors, we save money. That is Don Berwick's expertise. When they oppose him, whose side are they on? Are they on the side of 100,000 Americans who lose their lives every year because of avoidable medical errors? I do not think so. It sounds as if they are on the side of the 100,000 medical errors.

Let this guy have a chance. He has bipartisan support. He is an expert in this area. The area he is expert in is the best path to lead us to cost savings in health care because it is a win-win path. We do not have to take something away from somebody to create the savings; we can earn the savings by reforming the delivery system so it provides better health care.

He has founded the Institute for Healthcare Improvement. He has worked as a board member on the American Hospital Association on Quality Initiatives. He chaired the Advisory Council for the Agency for Health Research and Quality. He goes back to the Clinton era, where he was on President Clinton's Advisory Commission on Consumer Protection and Quality. He is the real deal.

So I urge my colleagues, as I did yesterday, to step back from the partisanship, to step back from the posturing. We have heard enough about rationing. There is not rationing in this; this is quality reform. We have heard enough about death panels and socialized medicine and all of that nonsense.

We have a serious problem in our health care system. We need to address it seriously. There is a path to address it that is a win-win for our country, for our people, for our society that reduces costs and provides Americans better care. To me, it is embarrassing that we should be 39th in maternal mortality. There are 38 countries that keep mothers alive through childbirth better than we do. That is the kind of thing we should be fixing. That is the kind of quality reform we need. That is the kind of quality reform Don Berwick gets behind.

This should be an area where we can all get behind this. Some of the work he has done has been in Republican States, in States with Republican Senators. I just know, off the top of my head, that Utah is a leading State in the quality reform area. The North Carolina Medicaid effort on Medical Home is one of the leading early studies on this issue. These people have Republican Senators who can report on how successful those have been. Yet they have made the choice not to look at Berwick for the person he is, for the expert he is, for the purpose he brings to this job, but just as an excuse to try to go back to the slogans and try to sloganeer their way through what is a real and significant problem for our country.

So unless you want to wish failure on America in this task, unless you want to wish failure on America in reducing the 100,000 deaths every year from avoidable medical errors, unless you want to wish failure on America in improving our status so we are the best in the world on maternal mortality rather than 39th, unless you want to wish failure on America in the only win-win path to reducing the terrible burden of health care costs, the accelerating burden, unsustainable burden of health care costs on our country, unless you want to wish America failure in that, you ought to support Don Berwick because he knows how to follow this path, this win-win path, toward health care savings that come from improving quality. That is a path we should be on.

There is no one better suited to lead CMS down that path than Dr. Berwick. So I hope we can find a way in this body to be better than that. I think Dr. Berwick gives us the occasion to be better than that. At long last, I hope that soon we become better than that.

I yield the floor, and 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 came to the Senate floor earlier today to speak about the nomination of Don Berwick to run the CMS and talked a little bit this morning about the area in which he specializes, which is how to lower the cost of the American health care system by improving the quality of care; that it is a win-win and to call it rationing is incredibly misleading and raises a legitimate question about whose side somebody is on who wants to attack this kind of reform of the health care system.

I went back to my office and found an article in the Washington Post today, which is entitled ``Hospital infection deaths caused by ignorance and neglect, survey finds.'' So if I could just read a few pieces from it, then I will ask unanimous consent to have this article printed in the Record.

An estimated 80,000 patients per year develop catheter-

related bloodstream infections, or CRBSIs. . . . About 30,000

patients die as a result, according to the Centers for

Disease Control and Prevention, accounting for nearly a third

of annual deaths from hospital-acquired infections in the

United States.

So 80,000 people get hospital-acquired infections in their blood from the catheters that go into them when they are

in a hospital. Of those 80,000, 30,000 die, and that is about one-third of the annual deaths from all hospital-acquired infections, which means about 90,000 Americans die every year from hospital-acquired infections.

This article goes on to say those deaths are preventable. We have known this for a long time. This article is confirming something that has been studied for a long time.

. . . evidence suggests hospital workers could all but

eliminate [catheter-related bloodstream infections] by

following a five-step checklist that is stunningly basic: (1)

Wash hands with soap; (2) clean patient's skin with an

effective antiseptic; (3) put sterile drapes over the entire

patient; (4) wear a sterile mask, hat, gown and gloves; (5)

put a sterile dressing over the catheter site.

A lot of this came out of original work that was done in Michigan, the so-called Keystone Project. We have taken that in Rhode Island and adapted it to try to reduce these hospital-acquired intensive care unit infections. But this is preventable. The point is, when we prevent it, we save money because those 80,000 patients per year developing catheter-related bloodstream infections--as to the last information I saw, I believe it costs about $60,000 to treat hospital-acquired infections. So I cannot do the math in my head, but multiply $60,000 times 80,000 patients per year getting these catheter-related bloodstream infections and we get into very big money very quickly.

Don Berwick is the leader of the health care reform effort that tries to take exactly that kind of problem and solve it so this process, this stunningly basic process that can prevent these infections, actually gets implemented over and over and over, every time, so we can eliminate these infections. When we eliminate them, we eliminate the cost of treating it; we eliminate the excess days that had to be spent in the hospital while the patient was treated for the infection; and, of course, most importantly, we eliminate 30,000 people dying from a hospital-acquired, catheter-related bloodstream infection every year.

What is not to like about that? That is the theory of health care reform that Don Berwick is the lead proponent of. So I came back to the floor because this story is so clearly on point as to exactly the kind of reform he has been a proponent of--from his years on the Clinton Consumer Quality and Protection Commission--I do not have its exact name right now, but it was a Clinton-era quality reform initiative-- from his leadership writing ``To Err Is Human,'' the initial report that kicked off the health care quality reform movement, and the follow-on report, ``Crossing the Quality Chasm.''

This is what this guy specializes in and this ability to go into the American health care system and find these ways where, by improving the quality of care, we lower the cost. Again, whatever 80,000 patients is times--I may have the number wrong, but my recollection is about $60,000 per infection--we get into pretty big money in a pretty big hurry. It is preventible, and it is that kind of savings that is going to help turn the corner for American health care.

So I ask unanimous consent that this Washington Post article entitled ``Hospital infection deaths caused by ignorance and neglect, survey finds'' by N.C. Aizenman, dated Tuesday, July 13, 2010, be printed in the Record.

Mr. President, I yield the floor.

I suggest the absence of a quorum.

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

Mr. President, the majority leader indicated today that he would be preparing legislation on energy to deal with a number of different issues, among them the response we should make to the terrible spill, geyser of oil gushing into the Gulf of Mexico and all the damage that has ensued in the gulf States as a result.

I come to the floor this evening to say a few words about a problem I believe we need to address in the context of this catastrophe. That problem is the problem of regulatory capture of the captive regulator. Although it comes up in the context of the failure of the Minerals Management Service to do its job to see that the private sector deepwater drilling in the gulf was done properly, it is a problem that is not limited just to the geyser of oil gushing into the Gulf of Mexico and the failure of MMS to have taken adequate steps to prevent it. It occurs in other areas as well.

One that leaps to mind is the Securities and Exchange Commission, the so-called securities watchdog which was sound asleep at the switch as the economy careened towards the huge financial meltdown with repercussions we are still seeing today.

The Senator from Michigan, Ms. Stabenow, was just talking about the catastrophes in her State and the pain that the lack of unemployment insurance is creating. That goes back to the original Wall Street meltdown, and that launched a tsunami of misery across the country that we are still dealing with today.

So if you take a look at those two catastrophes--the giant financial meltdown catastrophe, the consequences of which we are still living, that families in Rhode Island, families in Illinois, families in Michigan are still dealing with; and the disaster in the gulf that has created a catastrophe throughout Louisiana, Alabama, Florida--they have a common theme. The common theme is this issue of regulatory capture.

My hometown paper editorialized pretty trenchantly about the gulf problem. They said:

The Deepwater Horizon accident has made it painfully clear

that, in its current form, MMS is a pathetic public guardian.

Neither it nor BP was prepared for a disaster of this

magnitude, and MMS' cozy relationship with industry is a big

reason why.

The issue of regulatory capture has been written about for a long time. In 1913, Woodrow Wilson wrote:

If the government is to tell big business men how to run

their business, then don't you see that big business men have

to get closer to the government even than they are now? Don't

you see that they must capture the government, in order not

to be restrained too much by it?

`` . . . they must capture the government, in order not to be restrained too much by it.''

The first dean of the Woodrow Wilson School, Marver Bernstein, wrote, 55 years ago, that regulators tend over time to ``become more concerned with the general health of the industry'' and that they try ``to prevent changes which will adversely affect'' the industry. He said, it ``is a problem of ethics and morality as well as administrative method.'' He called it ``a blow to democratic government and responsible political institutions.'' And ultimately he said it leads to what he called ``surrender.'' He said, ``The commission finally becomes a captive of the regulated groups.''

Even recently, the Wall Street Journal editorial page contained an article by a senior fellow at the Cato Institute, saying:

By all accounts, MMS operated as a rubber stamp for BP. It

is a striking example of regulatory capture: Agencies tasked

with protecting the public interest come to identify with the

regulated industry and protect its interests against that of

the public. The result: Government fails to protect the

public.

So from Woodrow Wilson, in 1913, through Marver Bernstein, 55 years ago, to the Wall Street Journal editorial page just this month, the identification of the problem at MMS with the doctrine of regulatory capture I think is clear.

So the question is, What are we going to do about that? It has been a recurring problem, and the difficulty is that for the regulatory agency, they are constantly engaged with the regulated industry. The industry is there all the time. The industry is pushing on them all the time. The industry is on the other side of the revolving door of jobs, often. The industry has lawyers and lobbyists working the agency. The industry threatens lawsuits if it gets regulations it does not like, and is accommodating and friendly when it gets regulations it does like. In some cases, such as MMS, the relationship gets completely toxic and you get social events with industry representatives, including illegal drug use and sex. You get staff failing to collect millions of dollars in royalties owed to the American people. You get senior executives steering contracts to an outside company created by those executives. You get district managers telling investigators: Hey, obviously we are all oil industry. You get employees accepting gifts from the companies regulated by MMS, trips to the Peach Bowl on a private airplane, skeet shooting contests, hunting and fishing trips, golf tournaments.

You get an MMS inspector inspecting the oil drilling platforms of a company that he has a job application in with. While they are considering whether to hire him, he is inspecting their oil drilling rigs. I guess it comes as no surprise that in those oil rig inspections he found no violations. But that is an environment in which the regulatory agency has yielded to this long recognized problem of regulatory capture. So I think it is time we did something about it.

It is a doctrine that has been known for many years, and clearly both at the Securities and Exchange Commission and at MMS it has been realized, and it has been realized in ways that are extraordinarily painful and damaging for America. It has been realized in ways that are truly catastrophic--in one case, for our economy, in another case, for the environment of the gulf area.

What I have proposed is that we authorize the Attorney General of the United States, at the direction of the President or upon the invitation of a Cabinet official who senses a concern about that agency, to make a determination whether that agency is still truly independent of the industry it is supposed to regulate. If the President or the Cabinet official deemed that component no longer credibly independent of the corporation or the industry it is supposed to regulate, then the Attorney General is allowed to step in and clean up.

It is as simple as that. They would be charged to hire and fire and take personnel actions; to ensure the integrity of the personnel within the component; to establish interim regulations and procedures; to ensure the integrity of a process in the component of government. They would be charged to audit the permits and the contracts and ensure that the component of government has signed off on them legitimately, and if it appears that the permits or contracts have been affected by improper corporate influence, to recall them and renegotiate them so that they are done fairly and squarely and not a friendly negotiation in which both sides of the negotiation are, in effect, working for the industry and no one is representing the public interest. They would be charged to establish an integrity plan for that component and then to clear out once his or her job is done.

We have known about regulatory capture now for a century. We have seen it in action throughout that period. We have had two of the most catastrophic examples of regulatory capture happen just now on our watch, and in all this time we have never really come up with a mechanism for addressing it, because the pressure on these regulatory agencies is systemic, because it is constant and persistent, because it is done quietly. The industry doesn't come in and say: We are taking over. News flash to the world: This isn't going to be an independent agency any longer.

No. Quietly, as quietly as they can, they slip their tentacles deeper and deeper and deeper into the agency until they quietly control it-- surreptitiously, stealthily, but they own it--and the interest that agency wants to serve is now the corporate interest and not the public interest.

So if we are going to face up to a problem that is that persistent, that constant, which has been recognized for a century and has recently yielded the two biggest disasters, economic and environmental, this country has recently seen, we have to create a persistent counterpressure. I think the threat of the Attorney General of the United States, our top law enforcement officer, coming in and cleaning house is that kind of persistent counterpressure we need.

So I urge my colleagues, as we discuss the different provisions we are going to bring to bear that are going to be our lessons learned from the gulf catastrophe, that we not overlook what is probably the biggest lesson of all: the lesson we have known for a long time about the problem of regulatory capture and the incidence of regulatory capture in these particular cases bearing such painful, damaging fruit, such bitter harvest for the American people.

I will continue to push. If colleagues have ideas they think would improve it, I would be delighted to discuss those ideas. I think we will have failed in our duty to the public if we do not take away from the financial disaster caused by the deliberately blind eye of the Securities and Exchange Commission and the catastrophe caused by the complete co-opt of MMS--if we don't take away from those the lesson that this can't be tolerated anymore.

Regulatory capture is no longer a theory; it has been proven to be a disastrous practice in at least those two agencies, and we don't know how many more agencies are in a similar position. The disaster may not yet have happened, but they may be just as captive. When you think of the billions and billions of dollars of taxpayer value in Federal land, in timber leases, in mining leases within the continental United States, in contrast with giant corporations; when you think of that huge pile of public wealth from which the giant corporations feed, it is hard to imagine they are not working just as hard to co-opt the regulators who protect that wealth as they work to successfully co-opt the regulators who are supposed to be watching the Wall Street financiers and who are supposed to be watching big oil as it drilled in the gulf.

So let's not overlook this lesson. I am willing to consider a lot of ideas that will help get us there. I put this out because it is the best one I have come up with yet, and I look forward to working with folks. It is too important that we don't go away from this having failed in our duty to protect the American public from the next disaster.

I thank the Presiding Officer.

I yield the floor, and I note 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 Senate proceed to a period of morning business, with Senators permitted to speak for up to 10 minutes each.

Mr. President, I ask unanimous consent that the Banking Committee be discharged from further consideration of H.R. 5502 and the Senate proceed to its immediate consideration.

Mr. President, I ask unanimous consent that the bill be read a third time and passed, the motion to reconsider be laid upon the table with no intervening action or debate, and any statements related to the bill be printed in the Record.

Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of S. Res. 580, submitted earlier today.

Mr. President, I ask unanimous consent that the resolution be agreed to, the preamble be agreed to, the motions to reconsider be laid upon the table, with no intervening action or debate, and that any statements related to the resolution be printed in the Record.

Mr. President, I understand that H.R. 5618 has been received from the House and is at the desk.

Mr. President, I ask for its second reading and object to my own request.

Mr. President, I ask unanimous consent that when the Senate completes its business today, it adjourn until 10 o'clock a.m. on Wednesday, July 14; that following the prayer and the pledge, the Journal of proceedings be approved to date, the morning hour be deemed to have expired, the time for the two leaders be reserved for their use later in the day; that following any leader remarks, the Senate proceed to a period of morning business until 12 noon, with Senators permitted to speak therein for up to 10 minutes each, with the time equally divided and controlled between the leaders or their designees, with the majority controlling the first 30 minutes and the Republicans controlling the next 30 minutes.

Mr. President, I understand that we hope to reach an agreement on the initial amendments in order to the small business jobs bill, H.R. 5297, and that we will be able to resume its consideration tomorrow.

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