Floor Statements

Mr. President, I join the majority leader and the chairman of the Armed Services Committee to express my appreciation to colleagues who will support the provisions for Federal assistance for high-need States. Rhode Island is one of those high-need States.

One of the key targets to being a high-need State is a high unemployment rate. Right now, ours in Rhode Island is about 12.8 percent--nearly 13 percent. Since the beginning of this crisis, we have either been the second or third highest unemployment State in the Nation, only behind Senator Levin's State of Michigan. It is the highest level of unemployment Rhode Island has seen since World War II, in a generation. It amounts to, in our very small State with a population of fewer than 1 million people, 73,000 people who are unemployed. That is only counting the ones who qualify as unemployed under the labor standards; for people out too long, they are even more. After a while, they don't count them any longer in the statistics. It is actually more than 73,000 people unemployed in a State of less than 1 million; 73,000 families are facing unemployment and are worrying about how to care for their loved ones.

We know this is a national problem, and we know many States are suffering. To be in this category of these four States that are high- need States and that are getting a little extra attention in the Finance bill is not something we want. I would love for Rhode Island to have a 7- or 8-percent unemployment rate. I would be delighted. This is a real trial for the people of Rhode Island, and I appreciate that there are people, including our distinguished majority leader, who are reaching out to try to help Rhode Island while we are in this period of intense economic suffering.

From my perspective, I have supported others when we went to help the States that depended on the auto industry. I have watched billions of dollars flow across this floor to support those big auto States. I have watched and supported billions of dollars flowing across this floor to support the big finance industry States--Wall Street--and to protect our banking industry. I have supported it when billions of dollars flowed across this floor to support coastal States that were hit hard by storms and hurricanes. I watched billions of dollars flow through here for the States hit by flooding recently with the terrible floods in the South and a little while ago when the terrible floods hit the upper Northwest. I have watched enormous support go to States when they experienced wildfires, and when our distinguished leader on the Budget Committee, Senator Conrad, argued so effectively for the States affected by drought.

I am on the Environment and Public Works Committee. The coal States are getting taken care of in amazing ways. Over and over again, when we have seen our fellow States in trouble, we have been willing to help them out. All I am asking is, from Rhode Island's perspective, we have watched all of these things go by, and there is yet to be anything for Rhode Island.

I hope very much that my colleagues will not take this opportunity to turn what has been a very collegial atmosphere about helping each other's States when they are in trouble and, for purposes of politics, pile onto little Rhode Island. This is something that we need. This is something that is important to us.

Do we depend on coal? No. Do we depend on the auto insurance industry? No. Do we depend on Wall Street? No. Have we had a big hurricane? No. Nor have we had flooding, wildfires, or drought. But the condition of our people, economically, is just as bad as if those things had occurred.

Rhode Island is at nearly 13 percent unemployment. I urge my colleagues to stand with the leader and with the tradition of kindness and collegiality that has always characterized this body when a State is experiencing particular distress and difficulty.

I yield the floor.

Mr. President, first, let me thank my distinguished Environment and Public Works Committee chairman, Senator Boxer, for her passionate defense of this statute, which has improved the quality of life and the quality of our air for a generation now of Americans against this assault. I appreciate that she has given me a few moments to discuss the amendment the Senator from Alaska wanted to offer. I know it was not offered, but, nevertheless, I feel we need to respond, given the message that amendment sends to this body, to the Nation, and to the world regarding America's position on the need to curb global warming and our move toward a clean energy economy.

This amendment would have tied the hands of the Environmental Protection Agency at the very time we need its help to protect the American public from the dangers of climate change--dangers to America's public health, to our national security, and to our economy.

A little history is in order here.

In 2007, the U.S. Supreme Court overrode the Bush administration and ruled, in a case called Massachusetts v. EPA, that the Clean Air Act requires the Environmental Protection Agency to regulate greenhouse gas emissions as pollutants, if the Agency determined that greenhouse gases posed a danger to public health, and the Court further obliged the EPA to go ahead and make that determination, yes or no.

The Bush administration, of course, did everything in its power to avoid the duty ordered by the Supreme Court, and it was only this April that the EPA, under Administrator Jackson, finally issued its proposed endangerment finding. The finding, unsurprisingly, acknowledged what every reasonable scientist--in fact, every reasonable person--has known for years: That carbon dioxide and other so-called greenhouse gas emissions cause our planet's atmosphere to warm and pose a threat to the public health.

The conclusion that these gases should be regulated under the Clean Air Act logically and inevitably followed, as required by law, from the determination that these pollutants threaten public health. Thankfully, this administration has already begun this important work. Senator Murkowski's amendment would have required EPA to take what is called a timeout while Congress crafted a legislative solution to global warming. Unfortunately, time is not on our side as we race to protect our planet from the effects of carbon pollution.

Just yesterday, our President spoke before the United Nations about the challenges to all nations from unchecked global climate change and the opportunities we have to revive the world economy through the advancement of clean energy and clean energy jobs. The world community needs the United States to be a leader in this effort, and the world is watching our actions closely.

President Obama pledged that our steps so far--investments in alternative energy, efficiency measures, tougher fuel standards--and our steps to come ``represent an historic recognition on behalf of the American people and their government.'' He said:

We understand the gravity of the climate threat. We are

determined to act. And we will meet our responsibility to

future generations.

Forcing the EPA to take a timeout now would have sent exactly the opposite message; would tell the world we do not truly care about climate change; that we are not ready to step up, let alone lead; would say we would prefer to leave a polluted world to our

children and grandchildren, a world far worse off than the world our parents and grandparents left to us. Any timeout now would have damaged our international progress and our leadership.

Moreover, a timeout of the sort proposed in the Murkowski amendment would have hurt our legislative efforts. Supporters of the timeout idea profess to want a legislative solution to address climate change. Well, maybe. But doing so would have set back that very goal.

To the extent some of the big polluters are working with us in this legislative process, it is because they feel the hot breath of the future on their necks, and they know they had better participate or be left to their fate. Give them an artificial reprieve from those consequences--real consequences of science, of fact, of law, and of nature--and their motivations would change. Delay would become their friend, indeed their purpose, because of the artificial, false status quo that a timeout would create for them.

Let me tell you how these polluters affect Rhode Island, my home.

Let's start back in 1972, when EPA authorized the use of tall smokestacks instead of emissions limits. By the mid-1970s, four different circuit courts of appeal had ruled that the Clean Air Act required real emissions controls and not just increased stack heights. A tall smokestack only curbs local emissions, but it spreads the poisons widely.

In 1977, Congress enacted section 123 of the Clean Air Act, which barred the construction of smokestacks taller than called for by good engineering practice. Notwithstanding, Midwestern powerplants continued to increase the height of their stacks. The average smokestack height increased from 200 feet tall in 1956 to over 500 feet tall in 1978. In 1970, there were two smokestacks in the United States taller than 500 feet. By 1985, 180 smokestacks stood taller than 500 feet. Twenty-three of these were over 1,000 feet. Once you get over 1,000 feet tall, you actually have to put that smokestack on the aviation safety maps because it becomes a hazard to aviation. Local interests, of course, were happy because less of the smokestack-emitted poisons fell locally and more were spread abroad.

What did this mean for downwind States, such as my State of Rhode Island? Well, all other things being equal, the taller the stack, the farther the poisons travel. According to a 2001 report by the Clean Air Act Task Force entitled ``Power to Kill: Death and Disease from Power Plants Charged with Violating the Clean Air Act,'' pollution spewed from just 51 plants has shortened the lives of as many as 9,000 people nationwide annually, including about 1,500 to 2,100 people in our downwind States such as Rhode Island.

These plants have also caused tens of thousands of asthma attacks each year and hundreds just in Rhode Island. This is just from 51 plants. Physicians for Social Responsibility has estimated that all coal plants in the United States together cause about 23,600 premature deaths and 554,000 asthma attacks each year.

The Centers for Disease Control tells us that between 1980 and 1995 the incidence of childhood asthma increased over 100 percent--the increase of childhood asthma more than doubled--from 3.6 percent to 7.5 percent of all children.

By 2005, nearly 9 percent of all children were reported to have asthma. In African-American children, the rate soared to 19.2 percent-- nearly one in five African-American children.

Massachusetts, Maryland, and my State of Rhode Island--all downwind States--were among the five States with the highest incidence of asthma. The Rhode Island Lung Association estimates that 15,000 children--15,000 children in my State of less than 1 million population--have asthma. Nationally, every year more than 40 kids 4 years old and under will die from asthma. Another 115 kids 5 to 15 years old will die, and nearly 400 more age 15 to 34 will die every year. This is what upwind polluters have helped cause.

When I was attorney general for the State of Rhode Island, I joined EPA's lawsuit against American Electric Power for its illegal modification of 16 plants. In 2008, the utility company settled the lawsuit by installing billions of dollars of pollution-control equipment which slashed NOX and SO2 emissions by 813,000 tons each year--813,000 tons of pollution each year. American Electric Power also paid a $15 million penalty, nearly five times what ExxonMobil has paid so far for the Exxon Valdez oil spill in 1990, and it invested another $60 million in environmental mitigation projects. So don't tell me things can't be done.

But in Rhode Island, the danger continues, and still every summer in Rhode Island the morning radio announces several days that are unsafe air days, when infants and seniors and people with breathing difficulties are told they should stay home, that they should stay indoors because the summer air in Rhode Island is not safe, and one of the prime reasons it isn't safe is because we are downwind. So don't expect a lot of sympathy from me for these polluters, with their belching smokestacks, that want a free pass to endanger the public, timeout or not.

Here is a little description of how tall some of these stacks go. The tallest building is Willis Tower in Chicago. A lot of its radio towers are on the top, but it is still a heck of a big building. The Empire State Building is 1,250 feet. The Washington Monument is 555 feet. The Statue of Liberty is 305 feet. In Marshall, WV, there is a smokestack 1,204 feet tall. In Rockport, IN, there is a smokestack 1,038 feet tall. In Jefferson, OH, there is a smokestack exactly 1,000 feet tall. I don't know whether that has to go on the aviation safety maps. That is just at the boundary. What these things do is they solve the local problem of pollution by pushing the poisons so far up into the atmosphere that they don't fall in West Virginia, in Indiana, and in Ohio, but they move elsewhere and they land often in Rhode Island, and we face the health consequences every day. So if anybody is looking for a sympathetic ear for these powerplants, they have come to the wrong place if they have come to Rhode Island.

Today, we are facing perhaps the greatest environmental threat of our time: Global climate change triggered by increased concentrations of carbon dioxide in our atmosphere. We have supersaturated the atmosphere with carbon dioxide, and it is having an effect. Coal-fired powerplants share much of the blame. Forty percent of all carbon dioxide emissions come from coal powerplants. And the polluters will fight--they are fighting--any effort to control their carbon dioxide emissions. The polluter opponents of climate change who are resisting our change to a clean energy economy are strong and wealthy, and they will stop at nothing. We have even recently seen forged letters to Congress opposing climate change legislation in the names of groups that never authorized the letters.

Just like the polluters fought the Clean Air Act in the past, just like the polluters built taller stacks rather than making what comes out of the stacks cleaner, just like the polluters manipulated their flunkies in the Bush administration, today the polluters wanted a timeout. They may say they support a legislative solution to climate change, but if they could fool us so that we defunded and stopped and weakened all of the other available tools for pollution control, that would not help in passing a climate bill. That would give those polluters every incentive in the world to defect, to delay, and ultimately to defeat our efforts to move this country toward a clean energy economy, to stop subsidizing their pollution of our air, and our efforts to start solving this great problem of our day. To protect ourselves, we have to keep all of our tools available, all options for curbing greenhouse gas emissions working to protect us.

I thank the chairman very much for yielding me this time, and I look forward to working with her as we continue to find ways to support this legislation.

I yield the floor.

Mr. President, on World Alzheimer's Day, it is important that we pause to consider the devastating impact of this debilitating disease and the importance of scientific research into its causes, effects, and treatment.

More than 5 million Americans are affected by Alzheimer's, and it is estimated that this number will increase to between 11.3 and 16 million by the year 2050. One in 10 individuals has a family member with the disease.

I am a proud cosponsor of S. 1492, which would increase National Institutes of Health funding for Alzheimer's research to $2 billion for fiscal year 2010 and provide grants for research designed specifically to help caregivers. This bill would establish a National Summit on Alzheimer's to examine promising research programs and raise awareness.

We must find ways to prevent this disease before it starts. The vital investments made by this bill will put us ahead of the curve, both in terms of research and increasing public understanding of the disease. On this day, when we remember those suffering from Alzheimer's disease and those who have succumbed to it, let us recommit ourselves to meet the challenge posed by this disease and do everything we can to alleviate the suffering it causes.

Mr. President, this would be a particularly opportune important time for me to say a word about our friend, Senator Kennedy. I had not planned on doing so at this particular juncture, but someone very important to him, and in a very different way to me, is now in the gallery. So I will speak very briefly, but I do want to, as I have said before, thank Senator Kennedy for his kindness to me.

As a very senior and distinguished Senator, a person with a national and, indeed, international reputation, a person whose standing in this body was unmatched, a person whose legislative prowess and capability was unmatched, he did not need to pay any attention to a new Senator of no particular seniority, clout, or renown from Rhode Island. Yet he did, I think in large part due to the friendship the new Senator from Rhode Island had with his son, a very talented and able Member of the House of Representatives, who is senior to me in our Rhode Island delegation and who represents Rhode Island with exceptional distinction over in the House of Representatives. For that reason, and for the reason of a number of other family friendships, he was particularly kind to me. I appreciate that more than he could have imagined.

It is a bit daunting to come here as a new Senator not knowing whether you will find your way, not knowing whether you will evince any ability, not knowing whether you will have any effect, not knowing whether, indeed, you will be very welcome. You have to fight yourself through that stuff as a new Senator.

I can remember when I was presiding, where the distinguished junior Senator from Alaska is now sitting, and a colleague of ours who shall remain nameless was giving a speech of some length. Senator Kennedy was waiting to speak, and he sent a note up to me inquiring whether I felt that the standards of the speech we were then being treated to met the high standards of our common alma mater, the University of Virginia School of Law. I could not help but smile back and return the note, saying: No, I do not think so, but that is okay because I am waiting for a great speech from you.

There is one particular kindness I wanted to mention. Senator Kennedy was very important to Rhode Island. He was important to Rhode Island not just because of his son Patrick but because Rhode Island pays a lot of attention to Massachusetts, there is a lot of overlap in the constituencies of Massachusetts and Rhode Island, and Rhode Islanders have long admired Senator Kennedy. When he came on behalf of candidates, on behalf of his son, on behalf of me, on behalf of others, there was always an atmosphere of celebration around him and around the events he attended. Other speakers have spoken of his ability to rev up a crowd and get people fired up and enthusiastic, and he was really remarkable in that respect. We never tired of his visits, and Rhode Island always welcomed him with open arms.

He had a special place for Rhode Island, and in particular he had a special place for somebody who was very dear to both Congressman Kennedy and to myself; that is, a predecessor of mine here in the Senate from Rhode Island, Senator Claiborne Pell. Senator Pell was a political legend in Rhode Island, in many ways an improbable candidate.

Senator Kennedy's brother, President Kennedy, at one point said, publicly enough that it became a matter of sort of common discussion in Rhode Island, that Claiborne Pell was the least electable candidate he had ever seen. So when Claiborne Pell ran ahead of President Kennedy in Rhode Island in the election, it was a matter of great pride to Claiborne Pell and one that he was fond of reminding all Kennedys about.

It was, I guess as they would say in ``Casablanca,'' the beginning of a beautiful friendship. The friendship began back then. It continued long after Senator Pell had left the Senate. It continued long after Senator Pell had lost his ability to walk around and became confined to a wheelchair. It continued even long after Senator Pell had lost his ability to speak and could barely speak because of the consequences of his illness.

One of the ways it manifested itself is that every year Senator Kennedy would take the trouble to sail his sailboat, the Maya, from wherever it was in New England to Newport, RI, and there take Claiborne Pell out sailing. I had the pleasure to be on that last sail, and you could just imagine the scene, with the heaving dock and the heaving boat and Senator Pell in his wheelchair and a rather hazardous and impromptu loading of Senator Pell into the sailboat. And then, of course, it got underway. Because Senator Pell was having such trouble speaking, he really could not contribute much to a conversation. But Senator Kennedy had the gift of being able to handle both sides of a conversation and have everybody feel that a wonderful time was being had. So he carried on in a full, roaring dialog with Senator Pell, essentially providing both sides of that dialogue, and Senator Pell was smiling from ear to ear.

It said a lot about what I appreciate so much about Senator Kennedy. First of all, Rhode Island mattered to him, as it matters to Patrick Kennedy, as it matters to me. Second of all, as powerful as he was and as important as he was, friendship mattered more than authority or clout or power. There was nothing any longer that Senator Pell could do for Senator Kennedy. There was nothing that could be done to advance his legislative interests or his political interests or his fundraising interests or any other aspirations he may have had. But it mattered to him to do this because he was loyal and because friendship counted.

In a body in which opportunism and self-promotion and self- advancement are not unknown, it was remarkable of Senator Kennedy to give so much of his

time to this particular pursuit, to this particular visit, taking his old, now disabled friend, out for a sail and giving him so much pleasure, with no hope or hint of reward or return to Senator Kennedy himself.

So I will conclude with that. I guess I will conclude with one other thing. He loved Robert Frost. On his desk here right now is a poem from Robert Frost, ``The Road Not Taken.''

I know he was fond of Frost's work in particular. I keep a little book of poems and things that matter to me, quotations, and one of them is a poem by Robert Frost. It is not ``The Road Not Taken,'' which is the poem on Senator Kennedy's desk. It is a different one. But I will close by reading it. It is called ``Acquainted with the Night.''

I have been one acquainted with the night.

I have walked out in rain--and back in rain.

I have outwalked the furthest city light.

I have looked down the saddest city lane.

I have passed by the watchman on his beat.

And dropped my eyes, unwilling to explain.

I have stood still and stopped the sound of feet

When far away an interrupted cry

Came over houses from another street,

But not to call me back or say good-bye;

And further still at an unearthly height,

O luminary clock against the sky

Proclaimed the time was neither wrong nor right.

I have been one acquainted with the night.

Mr. President, I ask unanimous consent that the Judiciary Committee be discharged from further consideration of S. Res. 245 and the Senate proceed to its immediate consideration.

I ask unanimous consent that an amendment to the resolution, which is at the desk, be agreed to; the resolution, as amended, be agreed to; the preamble be agreed to;

that an amendment to the title, which is at the desk, be agreed to; the motions to reconsider be laid upon the table, with no intervening action or debate, and any statements related to the resolution be printed in the Record.

Mr. President, I ask unanimous consent that the Judiciary Committee be discharged from further consideration of S. Res. 247 and the Senate proceed to its immediate consideration.

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 ask unanimous consent that the Senate now proceed to the consideration of S. Res. 259, which was submitted earlier today.

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

Mr. President, I ask unanimous consent the Senate proceed to the consideration of S. Res. 260, which was submitted earlier today.

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

Mr. President, I ask unanimous consent the Senate proceed to the immediate consideration of S. Res. 261, submitted earlier today.

Mr. President, I ask unanimous consent the resolution be agreed to, the preamble be agreed to, the motions to reconsider be laid upon the table, and any statements be printed in the Record.

Mr. President, I ask unanimous consent that the tributes to Senators Kennedy and Martinez in the Congressional Record be printed as separate Senate documents and that Senators be permitted to submit statements for inclusion until Friday, October 9, 2009.

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 Senate proceed to executive session to consider Calendar Nos. 405, 419, and 420; that the nominations be confirmed en bloc and the motions to reconsider be laid upon the table en bloc; that no further motions be in order; that any statements relating to the nominations be printed in the Record; that the President be immediately notified of the Senate's action; and that the Senate then resume legislative session.

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 to speak for up to 15 minutes.

Mr. President, why are we working so hard on health care reform right now? Well, one reason is because the present system is out of control and unsustainable. This is the cost curve of our national health expenditures. In 2009, it hit $2.5 trillion, and it is going to continue to go up to the point where right now it is estimated that in the year 2016--which is not too far from where we are right now--in the year 2016, a standard family policy on average in Rhode Island will cost that family $26,000 a year. A middle-class family in Rhode Island cannot afford $26,000 a year just for health insurance. Something urgent has to be done.

During the 8 years of the Bush administration, it probably increased by nearly $1 trillion, and nothing got done. Our friends on the other side of the aisle were happy as clams with that state of affairs. Now, in the first year of the Obama administration, with more progress made on health care than at any time since back when the Clintons tried it, we hear once again the catcalls and the criticisms from our colleagues--anything to stand in the way of progress. But that is why it is so important. We simply can't afford not to do so when we look at the risks our country faces economically.

There has been some criticism of the stimulus bill, the Economic Recovery and Reinvestment Act. This is it right here: $0.8 trillion. From all the noise on the other side of this Chamber, one would think this dwarfed, shadowed the fiscal health of the Republic, but, in fact, it is a tiny little sliver compared to the debt that was run up during the Bush administration. We see that $8.9 trillion is the difference between what the nonpartisan CBO projected when President Bush took office from President Clinton and when President Bush left us when he was done--$8.9 trillion. This doesn't even count the Bush hangover of all the spending President Obama has had to do to help save the banks, to help save the financial system, and to help save the American auto industry.

He campaigned on none of that. None of us wanted to do that. When catastrophe asserted itself, we had to respond. The catastrophe took place not on President Obama's watch but beforehand. He has led this effort to put out the fires. The big risk is the $38 trillion in unfunded liability for Medicare alone. That is part of that climbing cost picture that is driving us out of control.

Of that, the Lewin Group--a pretty respected group around these parts for their opinions on health care--says the

excess costs in the health care system add about $1 trillion a year: $151 billion for excess costs for incentives to overuse services; $519 billion for excess costs from poor care management and lifestyle factors; $135 billion a year for excess costs due to competition and regulatory factors; $203 billion a year from excess costs due to transactional inefficiencies.

We can reform this health care system in a way that improves the quality of care, while addressing this $1 trillion in excess costs, which, according to George Bush's former Treasury Secretary, Paul O'Neil, who ran the Pittsburgh Regional Health Initiative and knows something about health care, is associated with ``process failures.''

Process failures can be corrected. One of the ways you can correct them is with a competitive public option. We have had a lock in the main middle market of health care by the private insurance market for all these years. This is what we are left with--$1 trillion in waste from process failures. Obviously, they failed at the job. They have catastrophically, indisputably failed.

All we ask is to put a public option in side by side to compete with them--in the same way a public option in workers' compensation insurance competes in Senator McCain's home State of Arizona with the private insurance providers in workers' compensation. I don't hear complaints from him about the business community and the workers' compensation.

In the home State of Senator Ensign, Nevada, there is actually a single-payer public option for workers' compensation health insurance, and his employers seem absolutely fine with it. So it is not as if it is some strange, bizarre idea out on the fringes; it is a way of doing business in some of the home States of the opponents of this.

Our colleagues and their predecessors in this Chamber opposed Medicare when it was first proposed. Now it is probably the most popular program in the country. We have seen them in this Chamber fighting against children's health insurance. It was only thanks to our beloved colleague, Senator Kennedy, coming back from his sick bed to cast the tie-breaking vote, that we actually were able to win that against Republican opposition.

The ideas they have seem, to me, to be abject failures. One is to continue the lock for private health insurance companies so they are the only place you can get coverage, unless you are old enough for Medicare or you qualify for Medicaid or you are in the military. That is clearly not a sign of success.

As Senator McCain indicated, it would be good to be able to cross State lines and buy insurance from out-of-State insurance companies. Yes, look how well that turned out for us with the credit card industry. We just had to pass legislation, thanks to Chairman Dodd, to rein in the abuse and practices of the credit card industry because you can go to practically unregulated States and get credit cards that don't have basic consumer protections.

We don't want to see that in health insurance. We want careful, thoughtful local regulation of health insurance. We have 100,000 people who are killed every year by medical errors--and who knows how many injured--and the solution our friends across the aisle see is to take away the damages that the worst injured Americans are entitled to. That is how the reform they proposed in the HELP Committee works. It cuts damages, caps them, meaning it only would affect the people for whom the damages are the highest, who are harmed the worst, who would disproportionately be women because of the way it was organized, focusing on economic damages. So if you take a system where you kill 100,000 Americans every year because of medical errors--and injure who knows how many more--and your solution to the problem is to put the cost of it entirely on the backs of the worst victims of that error and injury, I think that is a mistake.

We would prefer, as Democrats--and I think as rational people--to reduce the incidence of malpractice and error, reduce the errors of malpractice claims by reducing the incidence of malpractice and error. We put enormous effort in this bill into putting structures into place to allow that to happen.

In terms of the real fear people heard when they went back home, it was a little disingenuous when that fear was whipped up by our colleagues with false statements about death panels in the legislation, how this was socialized medicine, and how a bureaucrat would jump in between you and your doctor if the bill passed. That is patently false. It spread like wildfire. Who wouldn't be afraid of those things? Now they observe there is real fear out there. I also had the opportunity to travel around my State during this break, similar to many colleagues, and I sat down with my constituents and heard what they had to say about health care reform. I sat down with hospital executives; pediatricians; OB/GYNs; family physicians; critical care doctors; the State medical society; health insurers; CVS, the pharmaceutical chain that makes its home in Rhode Island; the Rhode Island MS chapter; business community leaders; members of our Rhode Island quality institute, which is reforming health care at the State level and it gives great leadership to our country right now; and with members of all walks of life who have come together and are working tirelessly to help build our State's information technology infrastructure.

I learned a great deal from those individuals and institutions. I learned a great deal also at two community dinners I held in West Warwick and in Johnston, RI, where hundreds of Rhode Islanders came out to join me and our senior Senator Jack Reed, not only for spaghetti and meatballs--and they were good. I think I might be the only Senator to introduce meatballs into the townhall formula, and it worked fine. They were for a serious, civil, and constructive debate on the state of our current health care system. It brought out some stories I wish to share quickly this afternoon.

The first story is about Christine, who is a wife and mother, from Coventry, RI. Her family's struggle to maintain health insurance has left her and her husband with very difficult choices and few options. In 2007, Christine was diagnosed with multiple sclerosis. Shortly thereafter, she lost her job. She was shifting the family's coverage to her husband's employer, when her husband was laid off as well. That left Christine and her husband and their 6-year-old son with no health insurance. Still reeling from those bits of bad news, Christine and her husband were faced with decisions no one should be forced to make. Without medical insurance, with no affordable options for health coverage because of Christine's preexisting condition, they faced a choice now of leaving their home--think about that. You have a 6-year- old son who might lose his home--or paying for health insurance. At the moment, they cannot see a way to manage both.

As Christine told me:

I don't want any handouts. Unfortunately, life has handed

me and my family a difficult path, and right now my family

needs a little help. We should not have to make a decision

between our health and our financial stability.

Until her husband finds a job, Christine says that every day they hold their breath and pray nothing will happen because that is all our broken health care system now has to offer them.

I also met Anna from Johnston, RI, who shared the story of her sister Tina. As is the story of so many today, Tina's husband lost his job. Their only option for health insurance was through COBRA. At $1,500 a month, on top of mortgage and car payments and groceries, Tina knew, financially, this coverage was unsustainable. Finally, she had to give it up.

Shortly after dropping coverage, Tina began to lose weight. Anna explained that, at first, she thought her sister's weight loss was a reaction to the stress of the family's financial situation. But then the weight loss continued, and they realized something was seriously wrong. Despite urging from her family, Tina resisted going to the doctor because she was afraid the medical bills would make a very difficult financial situation unbearable.

Eventually, Tina felt so sick they called the ambulance, and she was taken to the hospital. Tina died 3 days later of a heart attack, complicated by bone cancer and diabetes. When Anna talked to the doctor who treated Tina, they asked the family why Tina had avoided coming to the hospital for so

long because, with proper early intervention, her sister's conditions would have been treatable.

Anna told me she understands people get sick and die, but the manner in which her sister passed away was tragic because it didn't have to happen.

Over the August recess, I also heard from Rhode Islanders through the health care storyboard I ran on my Web site. Two of the stories are remarkable.

The first is from Ken, a recent Rhode Island College graduate from Greenville. He worked hard, dreaming he would be the first in his family to achieve a college degree. A year after graduation, Ken has that college degree, but he cannot find a full-time job with health insurance benefits. In this difficult economy, he works two part-time jobs at minimum wage, and he has no health benefits.

Ken wasn't looking to make a six-figure salary after graduation, but he was looking to be able to get by. On his current income, he has difficulty making ends meet with his day-to-day expenses, and he says it will take years to pay off his student loans at this rate.

I ask unanimous consent for 5 more minutes.

Ken is having a hard time making ends meet with his day-to-day expenses, and it will take years to pay off his student loans. On such a limited income and in this situation, health insurance is simply not an option for Ken.

Ken is discouraged and frustrated. Despite his hard work and achievement, he knows that at any moment he is one sickness or injury away from thousands of dollars in debt or ruined credit that would affect his chances for a prosperous future. He has worked for everything he has earned, but health care costs are so high he is scared about his future, if nothing is done to fix our health care system.

Last is Beth, a small business owner in Providence. She and her husband have two full-time and two part-time employees. They find themselves at the whim of insurance companies. Because they don't have the bargaining power to negotiate the terms of their health insurance package, they have seen 41 percent increases in their insurance rates for 2 years in a row.

Beth told me the cost of health insurance is breaking the backs of small entrepreneurs, those critical drivers of innovation and building blocks of our Nation's economy. She doesn't understand how or why anyone would start their own business under the deep financial burdens imposed on small business by our current health insurance system.

Beth also cannot afford health insurance coverage for her twin 3- year-old girls. Beth admits she is terrified about what might happen to them without the safety net that health coverage offers. She urges us to work quickly toward reform so others do not have to struggle with the same fear and frustration as her family.

The Senate has been working hard on health reform legislation since the very beginning of this year. The process is trying and tiring and extremely complex. As we turn up the heat even more the next few weeks and become mired in the intense process of drafting a final bill and getting it to the floor, I urge my colleagues to remember health care reform is not about the interest groups, it is not about parliamentary procedures, it is not about secret meetings, and it is not about CBO scores. Reforming our health care system in America is about Christine and Tina and Beth and Ken and thousands like them in every one of our States across the country. And it means injecting some fairness and some reason into a system that has punished the sick, rewarded the greedy, and discouraged those who try to do the right thing.

For me, these stories reinforce the urgency of what we need to get done in the Senate. I am fully committed to completing this task, as I know the Presiding Officer is, and I look forward to getting it done over the next few weeks.

In closing, let me just say this is the first time I have spoken on the Senate floor since our colleague, Senator Kennedy, has left us. His desk is three down from me. I don't know if the camera shows it now, but there is a black drape over it and some flowers and a copy of Robert Frost's ``The Road Less Traveled.'' I know this poem meant a lot to him, and he certainly meant a lot to me as a very gracious mentor with vast experience who could easily have ignored a new colleague. But he took an interest, and I will never forget his kindness to me.

We all will miss his booming voice. He could fill this Chamber with his voice. We will miss his rollicking good humor. No one enjoyed life and enjoyed his colleagues more than the senior Senator from Massachusetts. We will miss his masterful legislative skills as we try to work our way through the obstructions the other side will be throwing up against progress on health care reform. His wise voice and counsel will be missed.

Finally, we will miss his lion's heart. He knew when the fight was right, he knew when it was worth fighting for, and he was in it to win it.

Ted, God bless you. We miss you.

I yield the floor.

Let me thank Chairman Dodd for his leadership and for his remarks. He said he would give us a discussion of where we are, and he has done a wonderful job of showing how this bill will improve the lives of regular Americans in a very concrete way, including particularly Americans who have insurance.

To supplement his discussion of where we are, I wanted to give a quick discussion of where we have been because the trajectory of where we have been to where we are tells us something about where we are going. And everybody in this country, insured or uninsured, should have some real concern about where we are going in health care in this country if we do not act.

The year I was born was 1955, and this was the headline from the New York Times in 1955. It is hard to read the little part here; I will read it to you. It says:

The Problem of Cost. Millions of Americans cannot afford to

pay the costs of medical care, and they are not protected by

adequate health insurance.

That was 1955. This section says:

In human terms, this meant that the American had to scrap

his budget, dig into savings or go into debt, to pay some

$7.5 billion for doctors, hospitals, dentists, nurses, and

the myriad physical accessories of medical care.

That was 1955, when the Nation's medical bill ran over $10 billion. They were horrified to say over $10 billion. It is now over $2.5 trillion.

So that is the year I was born. We were already bemoaning the state of America's health care system.

This is 1979. I had just gotten out of college. And the HEW Secretary said: Health cost called unjustified. HEW Secretary Patricia Roberts said: The quality of American health care does not justify its price tag of more than $200 billion a year. Still bemoaning the health care problems, still not getting anything done about it.

Now, 1988. This was the year my wife became pregnant with our first child. And here it is. Prospects: Soaring health care costs. Joseph Califano said--he was the former Secretary of Health and Welfare--``The average jump in premiums could hit 30 percent in 1989.'' But at the same time, we are getting less for it.

Chairman Dodd just talked about a 20-percent jump in his State recently. You think this was happening today? It is from 1988, 20 years ago. The more

things change in health care, the more they stay the same.

Here is 1992. Health care costs increasing at more than twice the rate of wages have made benefits so expensive it would be surprising if companies were not responding. ``Health care costs dampening hiring.'' And they dampen wages, as we have seen, and increasingly businesses are having to avoid health care because they cannot keep up with that cost. That from 1992.

So we took those stories and we put them together on this chart. This shows the increases in America's spending on health care in each of those years, starting back the year I was born, that first story, 1955, then 1979, then 1987, then 1992, then 2009. It increased from $12 billion, which seemed like a big number then, to $200 billion, to over half a trillion dollars, to $850 billion, nearly a trillion, and now $2.5 trillion.

Look how much it has bumped from 1992 to 2009. This, my friends and colleagues, is what is called a trajectory. It is going to keep going if we do not do anything about it.

The latest estimates for my home State of Rhode Island are that in 2016, which is not too far from now, in 2016, probably about this far up on the graph, $26,000 a year is what a family will have to pay for family coverage--more than $26,000 a year. That means if you are a comfortably earning hard-working individual pulling down a salary of $52,000, half of your income, pretax income, goes out the door for health care before you start anything else. That is not sustainable. That is why we talk about Thelma and Louise instead of Harry and Louise. That is why we need to change the direction of our health care system, not just for the uninsured but for everyone so that all Americans can have a secure health care future. No American will have a secure health care future if this trajectory is allowed to continue.

So if you are out there asking, How would a change in the direction of our health care system help me, think of Thelma and Louise headed off the cliff because that is what the American health care system is like right now. The cliff is coming, and we are all in the car together, and together we have to solve this problem. Because we have to solve it together, it is very disappointing that so many of our friends on the other side have refused to participate in this conversation and have reverted to labels and name calling: socialized medicine, government mandates--things that have nothing to do with our legislation but are designed to scare people and to provoke those who have not sat down and read the bill and do not know better. It is unfortunate.

What does it measure up against? Let me show you a couple of other things. We have had a lot of talk in recent days about the stimulus plan and how effective that has been--a $787 billion stimulus. There it is, that $0.88 trillion is the stimulus for all of the barking and moaning we have had about how much that cost this country. That is what it is. The $8.9 trillion is what George Bush ran up in debt for this country during his Presidency.

Three-quarters of the debt this country bears, George Bush ran up during his Presidency. It was an orgy of fair-weather borrowing. When we didn't need to go into debt to protect our economy, when things were humming along, that is what he did, $9 trillion. Here is our unfunded Medicare liability, $38 trillion. We don't have $38 trillion now. Unless we do something about this cost, we are truly going off the cliff in that car with Thelma and Louise, following that trajectory of cost I showed.

It is not all going for health care that makes everybody better. It is going to a lot of other things. Here is one thing it is going to. Insurance industry profits. Have you noticed your wages going up a lot in the last couple years? For a decade, from 1999 to 2009, wage growth has been 29 percent. That is less than 3 percent a year and way less than 3 percent a year compounded. That is what wage growth has been like. If you don't feel like your wages have gone up much in the last decade, you are right. They haven't. For many Americans, wages flat- lined for a decade. How about your insurance premiums? Did they flat- line? No, sir. The insurance premiums went through the roof, increased 120 percent, more than doubled in one decade. That is the steep curve I showed you, 120 percent. How about insurance industry profits? Up 428 percent in the same period that wages were up 29 percent. So there is something we can do something about.

On insurance, so many Americans are uninsured, it is worth taking a look at this. We have all used and heard the figure about 46, 47 million Americans who are uninsured. That is the people who are uninsured at any given minute. As I stand here at this desk right now, out there in America there are about 47 million people who are uninsured. But some people gain insurance and some people lose insurance. Over the course of a year, the number of people who lose their insurance, whose families lose their insurance, is nearly 87 million. If you started on the east coast and moved your way west, and when you got to the Mississippi and you started into Minnesota, Iowa, Missouri, Arkansas, and Louisiana and you took the population of every single State west of that all the way to California, the population of all these States is about 87 million, to give you an idea of how many Americans lose their health insurance and have to go without it at a point during the year.

Then there are catastrophic levels of waste in our health care system. Our former Treasury Secretary, a Republican, knowledgeable about this, ran the Pittsburgh Regional Health Initiative for years. He said $1 trillion of annual waste is associated with process failures. He has calculated $1 trillion a year of waste in our health care system.

The Lewin Group is a group many people talk about here. They are described on the Senate floor as the gold standard in health care information. Sources of potential excess costs: Excess costs from incentives to overuse services, from poor care management and lifestyle factors, excess costs due to competition and regulatory problems, excess costs due to transactional inefficiencies; $151 billion here, $519 billion here, $135 billion here, $203 billion here. As we say in Washington, a billion here and a billion there, and pretty soon it starts to add up. This adds up to over $1 trillion in waste in congruence with what the former Treasury Secretary said.

It is not just newspapers that are saying it. It is also President Obama's own Council of Economic Advisers. Their report on July 9 said that:

Efficiency improvements in the U.S. health care system

potentially could free up resources equal to 5 percent of

U.S. GDP which is above $700 billion a year.

They also noted:

[It] should be possible to cut total health expenditures by

about 30 percent without worsening outcomes . . . [which]

would again suggest that savings on the order of 5 percent of

GDP could be feasible.

Again, two calculations coming to the same point, savings of over $700 billion a year.

That is one of the things we are trying to do. In addition to family- by-family improvements, small business-by-small business improvements, individual-by-individual improvements that Chairman Dodd has wrought through this bill, we are also trying to turn around a health care system that has been out of control, that has not been reformed for my entire lifetime. So that now is our moment, and it is on a trajectory that will break this country if we don't do something about it. We simply cannot continue a cost curve such as this that is already at $2.5 trillion and is accelerating northward. We can't be competitive with our international competitors in trade if we do this. We can't sustain our families if we do this. We simply cannot keep this government fiscally solvent if we do it. We have to turn the car before it gets to the cliff. If we can't do that, then shame on us.

I think we need to be in this together. One of the ways we will do this is through a public plan. A public plan is important because there are a number of ways in which you change those cost curves. You don't have to take services away from people because of all that waste. What you have to do is deal with the waste. You build in electronic health records for every American so the efficiencies that other industries have enjoyed from the computer revolution finally hit health care which, according to the Economist, has the worst information infrastructure of any American industry except mining--the mining industry and then

health care. Huge improvements and huge savings from that.

Quality improvements can save money. It has been demonstrated over and over again, as in Senator Stabenow and Senator Levin's home State of Michigan. They did quality improvements in intensive care units. In 15 months, they saved $150 million and 1,500 lives, and it wasn't even in all the intensive care units. It was just in one State. It was that one kind of quality improvement program, just in intensive care units. So huge gains to be made from quality improvements.

Prevention. Senator Harkin spoke the other day about what can be gained from preventing particularly conditions that arise from diabetes. Enormous savings, if we can focus on all that.

Transparency and improved administrative efficiency so doctors and insurers aren't fighting all the time. We can do all those things, but somebody has to lead. The question for us is, can we trust the private insurance companies to lead in all those areas. If you look back, you see they never have. We are way behind where we should be. They are not leading. It will take a competitive public option to pick up those issues and run with them and show what we can do.

I will close with this. One of the things we are hearing is you can't possibly have a public option. It is a line in the sand. The very distinguished ranking member of the HELP Committee has said it is intolerable to have a public option. It simply would not work. It can't happen. There are two ways we get health insurance in this country. One is through a private health insurance provider. The other is through workers' compensation, which the business community runs in order to protect itself against the injuries and illnesses and diseases and catastrophic harms that can happen to people at work and that they have to protect themselves against. All across America, there are State funds, public options that deliver health care insurance, State by State, over and over again. So when the ranking member goes home to his State of Wyoming, not only is a public option for delivering health insurance not anathema, it is what he goes home to.

He goes home to a single-payer public option for health care, one his business community appears perfectly satisfied with and he appears perfectly satisfied with.

Their Presidential candidate, John McCain, goes home to Arizona to a public plan with 56 percent market share. It competes in a lively workers' compensation health insurance market. The distinguished minority leader goes home to Kentucky, and in Kentucky his business community enjoys a public option for workers' compensation health insurance. So we should be able, in the spirit of coming together in the face of this national emergency, to put aside the old notion that a public option simply can't exist, can't happen. It happens in nearly half our States. It is supported by the business communities in those States. It delivers care efficiently, and none of the Republican Senators from those States have, to my knowledge, ever complained about it in that context.

I will conclude with that. I think we are at a turning point, and it is important, as we go, that we remember this is a long struggle we have been on. My entire lifetime, since 1955, it has gotten dramatically worse, and the rate at which it has been getting worse is increasing. It is worsening. We have to do something about it now--for everybody in this country, for businesses large and small, and for people and families, insured and uninsured, and we are pledged to do that.

I thank the very distinguished chairman and yield the floor.

Mr. President, will the Senator yield for a moment?

Mr. President, I want to respond to what the Senator was saying, that this trajectory is very likely to continue. Every signal and every prediction is it is going to continue and we will hit that 35 percent, spending a third of our entire economy just on health care, and that really does break our country. It is a terrible indictment of our generation if we allow it to happen.

But we also have a great opportunity here, which the chairman has also pointed out. As you know, over and over again, as the distinguished Presiding Officer knows, over and over again, in legislation, we are asked to make hard choices between two things, and if you go one way, you cannot go the other. Economists would call it a zero sum game. You cannot have both. There is no win-win.

This is a situation where there is a win-win. As the distinguished chairman pointed out, we are spending 17 percent of our gross domestic product on health care in this country. It is the worst record, the highest expenditure, of any country in the world. Most other developed nations spend 8 or 9 percent. That is the average of the European Union of their gross domestic product on their health care.

For that exaggerated expenditure, what do we get? Lousy health outcomes. We are way behind our developed competitor nations in obesity. We have far higher rates of obesity in our country. We are way behind in child mortality. We have far greater rates of child mortality in the United States than there are in our developed nations with which we compete. There is far greater longevity in those countries than ours. Americans do not live as long as people in our competitor nations, the developed ones, and a lot of it has to do with our health care system.

So by bending that curve, by investing in prevention, by improving the quality by investing in electronic health records, by eliminating those medical errors, we accomplish two things at once. We improve the health statistics of our Nation, we have people who live long, we have less babies who die in childbirth, we have a thinner and less obese and less ill nation, and we lower the costs, and we do it together.

So it should be something we could agree on, on both sides of the aisle, but, unfortunately, these old canards about socialized medicine and how we

could not possibly have a public option--except for the fact we already have it in half our States, including our own; but we are not going to talk about that right now, we are just going to say we could never have it--that is the quality of the debate, when we have this huge win-win in front of us.

I hope everybody has a chance to sort of think about this over the break when we are gone and that we can come back with a new spirit of bipartisanship to really address this problem, seize that win-win, change the cost curve down, and solve this problem for the American people.

I will make one last point.

We have misled the public a little bit in our discussion, and we have done so because of the Congressional Budget Office and its professional capabilities. The Congressional Budget Office is very good at predicting what costs are going to be. So everybody has heard that our bill might be $600 billion, that the Finance bill might be $900 billion. They see the costs and they say: Well, how could you possibly be talking about savings when all we hear about are costs? All CBO can say about savings is that--and this is a quote--large reductions in health care costs are possible--large reductions. But they cannot quantify it. They cannot give us a number. And they have told us why they cannot give us that number.

They cannot give us that number because we can give the Obama administration, here in Congress, the tools to solve this problem. We already passed the electronic health records legislation. If, God willing, we pass the chairman's legislation from the HELP Committee, they will have the tools to improve the quality and turn the curve. They will have the tools to improve prevention and turn the curve. They will have the tools to reduce the unnecessary, wasteful administrative fighting between doctors and hospitals and insurance companies, that try not to pay them. That whole fight can disappear or at least shrink a lot, and that will help turn the curve.

But CBO cannot predict how effectively the Obama administration will do that. Like any CEO, the President of the United States and his staff are going to have to manage this problem, and that is where the savings will come. So people should not be misled that there are not real savings possible. Not only are they possible, they are mandatory. We have to turn this curve, and we have to do it dramatically. We can do it because we could drop our GDP expenditure of this by 50 percent and still have health care as good, if not better, than all of our competitor nations: France, New Zealand, Canada, England, Holland--all these countries--Japan. We can do it.

The promise is out there. We should not let the CBO scoring fool the public. That is my last point.

Mr. President, I yield the floor, and I will relieve the distinguished Presiding Officer so he can speak as the Senator from Colorado.

I rise to speak in support of the Foreign Manufacturers Legal Accountability Act of 2009, which I am introducing today with the ranking member of the Judiciary Committee, Senator Sessions, and Senator Durbin. This bipartisan bill is an important step in protecting American consumers and businesses from injuries caused by defective products manufactured outside the United States. Those products hurt American consumers--they lead to serious injuries, and even death--and they hurt the American businesses that must deal with angry customers, product recalls, and unusable inventory.

The list of recent examples of Americans injured by defective foreign products is shocking. Last year, a contaminated blood thinner from a foreign manufacturer caused severe medical reactions and contributed to numerous deaths. In 2006, a foreign-made, lead-tainted charm bracelet claimed the life of a 4-year-old. The autopsy demonstrated that the charm was 99 percent lead, 1,650 times more than the 0.06 percent lead limit specified in enforcement guidelines for children's jewelry. Imported food products from seafood to honey have been contaminated with unthinkable chemicals, including veterinary drugs banned in domestic production, potentially harmful antibiotics, and unapproved food additives. Sixty million packages of pet food contaminated with tainted wheat gluten have been recalled in the last two years. Substandard tires have failed, leading to fatalities. Most recently, defective drywall imported from China has been found to contain excessively high levels of sulfur, causing houses to smell like rotten eggs, corroding copper wiring, and making expensive appliances fail. Thousands of homes may be affected.

At a hearing that I chaired in May, the Subcommittee on Administrative Oversight and the Courts explored the legal hurdles facing consumers who are injured by defective foreign products and by businesses that find that their foreign partners refuse to honor their contracts. These hurdles allow foreign manufacturers to continue to injure American businesses and consumers, and also put American manufacturers at a competitive disadvantage since they allow foreign manufacturers to offer cheaper products that do not comply with American safety requirements. Two major hurdles to proper accountability are the inability to serve

process on the foreign manufacturer and the ability of that foreign manufacturer, even if served, to evade the jurisdiction of American courts. As the witnesses testified at the hearing, legislation that addresses these issues is necessary and appropriate. The Foreign Manufacturers Legal Accountability Act addresses both concerns.

The first problem, the inability to serve process on a manufacturer, essentially means that it is difficult for an American to give a foreign manufacturer the documents necessary to give it the legally required notice that it is the subject of a lawsuit. This sounds like a simple step, and it should be. Unfortunately, however, it is very hard to serve process on foreign companies abroad. As witnesses explained at the hearing in May, service abroad is complicated by the Hague Convention on the Service Abroad of Judicial and Extra Judicial Documents in Civil and Commercial Matters, to which the United States is a signatory. Under that convention, a complaint must be translated into the foreign language, transmitted to the Central Authority in the foreign country, and then delivered according to the rules of service in the home country of the defendant. This can cause months and even years of delay, not to mention great expense for Americans.

The Foreign Manufacturers Legal Accountability Act will allow Americans to overcome that procedural hurdle by serving legal papers inside the United States on registered agents of foreign manufacturers. The bill requires the heads of federal government agencies such as the Food and Drug Administration to pass regulations requiring that foreign manufacturers of products regulated by their agencies register an agent who will accept service of process. It allows regulators to exclude manufacturers who only import a minimal amount of products into the United States. It imposes a minimal burden on foreign manufacturers, since they would only have to appoint one agent to accept service of process for all state and federal regulatory and civil actions anywhere in the United States. The bill allows the manufacturer to choose any location for that agent with a ``substantial connection to the importation, distribution, or sale of the products of such foreign manufacturer or producer.'' This clear and straightforward system will allow Americans to commence their lawsuits fairly and promptly, and ensure that foreign manufacturers have proper and fair notice of the proceedings brought against them. It will not conflict with American obligations under the Hague convention, since that convention applies to service of process on foreign manufacturers in their home countries, not in the United States.

The second hurdle, the inability to establish personal jurisdiction over foreign manufacturers, can end a lawsuit against a foreign manufacturer before it even begins. Think about how unfair this is. A foreign manufacturer sells its defective products in the United States, injures American consumers and businesses, and then argues that it is not subject to the courts in the state where the American was injured-- in legal parlance, that the courts do not have personal jurisdiction over it. As witnesses explained at the hearing, foreign manufacturers raise this technical legal defense to avoid liability even when serious injuries or even death have been caused by their products--their defective tires, fireworks, exercise equipment, bikes, and toys.

The Foreign Manufacturers Legal Accountability Act will enable injured Americans to surmount this hurdle. It will make clear to foreign manufacturers that by importing their products into the United States and by registering an agent in the United States, they are consenting to the jurisdiction of the courts in the state where their agent is located. By consenting to jurisdiction, the manufacturers will avert unnecessary and expensive legislation about technical legal issues and allow courts to settle the merits of disputes. This approach is fair to foreign manufacturers since all American manufacturers are subject to the jurisdiction of the courts of at least one state. This bill therefore complies with the trade principle that we should not subject foreign manufacturers to burdens not already imposed on domestic manufacturers.

Indeed, the Foreign Manufacturers Legal Accountability Act is ultimately about fairness. We all know American manufacturers comply with regulations that ensure the safety of American consumers and businesses. When they fail to do so, they must answer to regulators and are held accountable through the American tort system. Unfortunately, however, foreign manufacturers are not being held to the same standards--injuring American consumers and businesses, and putting American manufacturers at a competitive disadvantage. We must level the playing field for all manufacturers and provide justice for American consumers and businesses. The Foreign Manufacturers Legal Accountability Act will allow us to make a major step in that direction. It covers major product categories including consumer goods, drugs, cosmetics, and chemicals, and it requires relevant agencies to study workable approaches to ensure that foreign food producers also are brought within the ambit of the American legal system.

Protecting Americans and holding foreign manufacturers accountable when their products harm American consumers and businesses is a bipartisan issue. Everyone agrees that we should do what we can to keep Americans safe from defective products. So too, I think, do we all agree that American companies should not be at a competitive disadvantage to their foreign counterparts. The Foreign Manufacturers Legal Accountability Act builds on those fundamental agreements. I am grateful to my colleagues Senator Sessions and Senator Durbin for their hard work on this bill and look forward to working with my colleagues on both sides of the aisle to see it passed into law.

Mr. President, I rise today to introduce legislation that would help families struggling with medical debts overcome hurdles that under current law make it difficult for them to find relief in the bankruptcy system. With medical costs at an all-time high and the unemployment rate hovering near 10 percent nationwide--and 12.4 percent in my home State of Rhode Island--too many individuals and families struck with injury and illness have no other option but to file for bankruptcy. According to a recent Harvard University study, health care-related costs have been a primary driver of personal bankruptcy filings, contributing to over 62 percent of filings in 2007.

The statistics are as shocking as the personal stories are heartbreaking. Countless Rhode Islanders have written to me during my time in office asking for help with crippling medical costs, and I want to share just two of their stories with you today.

Adam, a 23-year-old from Bristol, recently underwent surgery for cancer. Adam's treatment plan requires him to undergo a CT scan every 2 months. While his insurance initially paid for his health costs, he received word not long after his surgery that his policy was ``maxed out'' and that he would have to pay $6,700 out of pocket for an upcoming CT scan. As of today, Adam, a young man just starting his adult life, has $20,000 in medical debt and reports that he ``cannot see any light at the end of the tunnel.''

Robert, a veteran and retiree also from Warwick, suffered a major heart attack in November of 2004. Although he had health insurance, Robert was responsible for paying a $2,000 deductible plus 20 percent of the cost of his care. After 40 years of working and saving, these medical costs wiped him out, and he had to sell his home.

Adam and Robert have both suffered unexpected medical costs that have turned their lives upside down. These Rhode Islanders, like millions of others nationwide, may be forced to file for bankruptcy to get a clean start--but when they do, they will learn that the bankruptcy process can be time consuming and costly and ultimately may not allow them to stay in their homes.

The legislation that I am introducing today, the Medical Bankruptcy Fairness Act of 2009, would help people who because of medical costs have no other choice but to file for bankruptcy. The bill would waive procedural hurdles so that Adam and Robert would have the option of a speedier, less expensive, and more efficient bankruptcy. To begin with, it would waive credit counseling requirements for these debtors. Such requirements have little relevance to people whose debt stems not from poor budgeting but, rather, from uncontrollable medical expenses. The bill would also waive the so-called ``means test,'' making the filing process quicker and less costly and making sure that people have the ability to file to have their debts discharged in chapter 7, as opposed to a chapter 13 plan under which they would have made debt payments for 3 to 5 years.

In addition to removing these procedural hurdles, the Medical Bankruptcy Fairness Act would give people with high levels of medical debt the ability to retain at least $250,000 in home value through the bankruptcy process. The ``homestead exemption'' is one of many aspects of bankruptcy law that looks to the laws of the individual States. While filers in some States already have the ability to preserve home equity at this level, a number of States offer homestead exemptions of $5,000 or less. With the average home price nationwide around $200,000, the $250,000 exemption included in this bill will allow the majority of individuals and families crushed by medical debt to keep their homes.

Finally, the bill would eliminate an obstacle that prevents many bankruptcy filers from accessing the chapter 7 bankruptcy system, which as I mentioned earlier is the simplest and most efficient form of bankruptcy. Because attorneys' fees are ``discharged'' at the end of a chapter 7 bankruptcy, attorneys generally require the upfront payment of fees in chapter 7 proceedings. Many debtors who would be better off filing for a quicker and less costly bankruptcy in chapter 7 are forced to file in chapter 13 because they don't have enough cash to pay the attorney. The Medical Bankruptcy Fairness Act would make attorneys' fees nondischargeable in chapter 7 bankruptcies, as in chapter 13 bankruptcies, making it easier for debtors to elect the more efficient chapter 7 proceeding.

Before I conclude, I want to acknowledge the hard work of my colleague from Massachusetts, Senator Kennedy, on the issue of medical debt. Senator Kennedy offered amendments during the consideration of the 2005 bankruptcy reforms that would have given people struggling with medical debts treatment similar to that which they would get under the Medical Bankruptcy Fairness Act. Unfortunately, those amendments were voted down. I look forward to working with Senator Kennedy to make sure that we don't miss another opportunity to help Americans struggling with medical debt.

There are people in every State suffering from medical hardship and related debts who would benefit from this legislation. I urge my colleagues to work with me to pass it to Adam and Robert and the millions like them nationwide a clean start in bankruptcy.