Floor Statements

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, we are going to be voting on an amendment very soon, amendment No. 2810. The whole point of this amendment is to reorder our priorities in terms of transportation. We have had significant debate on whether certain ongoing projects will be harmed.

We have seen a Department of Transportation inspector general's report that lists five problems with what is happening right now. Basically, the conclusion of the report is earmarks are not the most effective or efficient use of funds--noncompetitively awarded transportation earmarks.

Let me say that again. Noncompetitively awarded transportation earmarks reduce funding for each individual State's core transportation funding. They are not in unison with DOT strategic research goals. As a matter of fact, the research institute has oftentimes gone around with earmarks. They provide funds for projects that would otherwise be ineligible for transportation funds. They disrupt the agency's ability to fund programs as designated when authorized funding amounts are exceeded by what they call overearmarking. That is the technique where we put in an earmark, congressionally directed spending, but we do not put enough money in to pay for that congressional spending, so that excess money goes against the rest of the transportation priorities. Then, finally, many low priority earmarked projects are being funded over higher priority nonearmarked projects.

This is a simple amendment that says we are not going to spend money on earmarks unless they are for roads and bridges at this time. It does not stop earmarks; it just slows them down and says: Whoa. This is a lower priority than what we are doing.

In this bill are over 500 earmarks that come right now to $2.8 billion. Mr.

President, $2.8 billion would go a long way in terms of fixing the tremendous number of bridges that are structurally deficient in this country. That is just with the National Highway System. That does not have anything to do with State transportation highways.

The real question for this body--and there have been many claims made against this amendment. No. 1, this amendment will not lessen the amount of money that goes to State transportation departments. That money can be rerouted so certain things such as transit initiatives will not have to stop. But what it will say is, the Senate is on record for saying the highest priority ought to have the highest priority.

Minnesota is a tragic example of the misplaced priorities we have. Of the billions and billions of dollars, well over 10 percent of the last Transportation bill--authorization bill--and a significant amount of this bill will be spent on projects that are not a priority for a State, are not a priority for national transportation, but are our priorities. We can differ on what the low level priorities are, but nobody can deny we have a significant problem with structurally deficient bridges in this country.

We are going to spend $600,000 on horse-riding facilities, $5.9 million on a snowmobile trail, $8 million on a parking garage, $532,000 just on one particular earmark for a pedestrian trail, $1.25 million for a day center and park-and-ride facility, $3 million for dust control mitigation, and $2.75 million for the National Packard Museum when we have bridges falling down?

I think we have plenty of room to reorder our priorities. This amendment does not eliminate any earmark. What it does is delay it. There is no question about it. But the purpose is to put us in touch with the American people saying: First things first. This does not eliminate addressing the 13,000 people who die every year on unsafe roads. Those funds are still available.

We heard from the Senator from Missouri that 400 people succumbed to accidents related to bridges in the last year. The fact is, we have had almost 40,000 people die a year on our roads. A third of that is secondary to alcohol excess. But another third of that is associated with unsafe roads and bridges. That is according to the Department of Transportation.

Mr. President, I ask unanimous consent to have printed in the Record a letter from the Department of Transportation inspector general and an accompanying Executive Overview of Report AV-2007-066 of the Department of Transportation.

An investigation by the inspector general found the following: For 2006, there were 8,056 earmarks within the Department of Transportation program, with a total of more than $8.54 billion, or over 13 percent of DOT's appropriation. So for one in seven and a half dollars, we have directed the spending, and for most of them, it is against the highest priority things we should be funding. So thinking about the risks, thinking about the costs, thinking about our standing in terms of doing what we should be doing to make sure the highest ordered priorities are taken care of--that the bridges that are structurally deficient will be addressed, that the highways that do not meet or exceed a good or acceptable level of safety--we ought to be redirecting this money in that direction. That is what this amendment is about.

We get three choices. We can table the amendment, as I think the motion will be made so we do not have to deal with it, saying we should not change our priorities. We can say yes, and we can renew the faith in the American people that we understand we are here to do priority work. We are not necessarily here to do the next best thing for our political careers.

However you slice it, many of the earmarks are great things. They are great needs which have to be met at some point in time. But most of the earmarks that go for the bridges and roads will not be affected by this amendment at all. The ones that will be affected are those earmarks which are not a priority.

I know we are going to have a vote. I want to give the subcommittee chairman, as well as Ranking Member Bond, a chance to answer this debate. I will say I plan on offering this amendment in another form, if this amendment goes down, limiting it and more directing it, if in fact that is the case.

But we have a duty to do what is in the best interest of our transportation needs in this country. I realize there is a debate, and I realize there is disagreement with me on this issue. But it is going to be hard for us as a body to justify 500 separate earmarks that do not address the bridges in this country, will not help us assess that.

Earlier today, Senator Murray alluded to the $1 billion increase. Well, that is true, but we did not increase the money; we just made it toward the Transportation fund. The trust fund will run out of money a year earlier. So all we did was speed up spending that is allowed in the trust fund that we have today, and that will be consumed more quickly. I agree we probably should do that. But we will, in fact, have to address this issue, and it is about priorities.

With that, Mr. President, I yield back.

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

Mr. President, I ask unanimous consent to set aside the pending amendment and call up amendment No. 2811.

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

Mr. President, maybe this will not be as painful an amendment. Again, referencing what Senator Klobuchar said today about repairing the bridge that has collapsed and cost 13 people their lives and many others injuries, we decided not to order priorities with the last amendment but hopefully will give a little bit better consideration to this one.

About 2\1/2\ weeks ago, a friend of mine, who has been a friend for over 20 years, talked me into getting a bicycle. I have to say I have markedly enjoyed that exercise. This amendment says that for the $12 million to $18 million in this bill, which is not clear how much is actually for bicycle paths, we should not be spending money on bicycle paths for our own leisure, comfort, and exercise when we have bridges that are falling down. It is very straightforward. It prohibits funding bicycle paths until we have our bridges and highways in order. Through the years, we have spent hundreds of millions of dollars on bicycle paths. It is great, it

is fun, they are enjoyable, but it isn't as important for us to have fun and enjoyment as it is for us to be responsible in repairing the roads and bridges in this country. This is simply a prohibition that says for the funds that are in this appropriations bill for bicycle paths, we are saying, no we won't spend that money; we are going to spend the money on fixing roads and bridges.

I guess one could say we could do both. We can fix the roads and bridges and we can have bicycle paths. The problem is this body adopted an amendment creating another billion dollars for bridges just yesterday, and what that does is shorten the life of the trust fund. What it does is move the empty, the zero on that fund to 2009. We have addressed some of that, but we haven't addressed it near to the need I believe we should.

I ask my colleagues to give some thought about whether bicycle paths or the safety of our people in cars on bridges and roads in this country is more important.

I will give some examples. There is $3 million for three bike trails in Illinois. Illinois has 290 structurally deficient bridges.

There is $500,000 for the CEMAR Trail in Iowa. Iowa has 61 structurally deficient bridges.

There is $500,000 in Maryland. Maryland has 43 structurally deficient bridges on the National Highway System.

Mississippi has $2.2 million earmarked for bicycle trails and has 28 structurally deficient bridges.

Missouri has $750,000 for the Heart of America bicycle/pedestrian bridge and has 123 structurally deficient bridges on our National Highway System.

North Dakota has $800,000 for the Lewis and Clark Legacy Trail and has nine structurally deficient bridges.

The State of Washington, the chairman's State, has three bike earmarks, $3 million, and 76 structurally deficient bridges.

West Virginia has 98 structurally deficient bridges, but yet $1 million is going to the Paw Paw Bends Trail in Morgan County.

That is not the complete list. I can go on. I have five more pages of States around the country.

It is interesting that in Chesapeake, VA, the council voted in June to build a 2-mile bicycle path estimated to cost $16 million. That is to be paid for with federally earmarked funds and a match. The mayor of that city, in arguing against this expenditure, cast the lone vote, saying: It reminds me of a bridge somewhere to nowhere. You are talking about Government spending. To spend that kind of money on a bike path that would rarely be utilized is astounding to him. The traffic in that area, pedestrian and bike, is four people per day.

I don't deny that it is a wonderful experience that many millions of Americans are getting to enjoy the bike paths we build. The question is, Should we stop for a while and do what we should be doing with our other transportation needs?

A quote from Mary Peters, Secretary of Transportation, is the following:

Americans would be shocked to learn that only about 60

percent of the gas tax money they pay today actually goes

into highway and bridge construction. Much of it goes to

many, many other areas. Ten to 20 percent goes into areas

that are not directly transportation related.

Bike paths and trails happen to fit into that category.

The highway trust fund was set up to build highways and maintain bridges. When 40 percent of it is not used to maintain highways or build bridges, we have missed the priorities the American people have asked for.

The last time the gas tax was increased in 1993, it was 4.3 cents. We have had many people say we need a tax increase on transportation dollars to afford the Transportation bill. I don't believe that is true at all. I believe we ought to be spending the money on true transportation needs--roads and highways and transit--and we should have less of the other.

I ask unanimous consent to have printed in the Record an article from the Minnesota Star Tribune recently that noted the significant amounts of money that have been spent in that State on bicycle paths at the same time the chairman of the Transportation Committee did not allocate the funds, along with the State, to effectively solve the problems of the I-35 bridge.

I will limit my debate on this amendment and try to come back to the Chamber. I ask unanimous consent that the pending amendment be set aside and that we call up and consider amendments Nos. 2812, 2813, and 2814, as a block of three amendments, to be debated en bloc and then to be voted en bloc. I ask for their consideration to be available or time be made available to consider those amendments when I have time to come back to the floor.

Mr. President, I yield the floor and suggest the absence of a quorum.

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

Mr. President, I made an error in terms of calling up my

amendments. I ask unanimous consent that the pending amendment be set aside and that amendments Nos. 2812, 2813, and 2814 be called up.

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

Mr. President, I ask for the yeas and nays.

Mr. President, I asked for the yeas and nays.

The Chair asked whether there was a sufficient second. There was a sufficient second. And then a motion was made to table.

Thank you.

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

Madam President, I call up en bloc amendments Nos. 2704, 2705, 2706, and 2716.

Madam President, I ask unanimous consent that the reading of the amendments be dispensed with.

Madam President, I have three amendments that I will discuss in a group, and I believe one of them will be accepted by the majority and ranking member, and that is an amendment creating transparency at the World Bank on the malaria program. I will spend a very short time talking about that.

What we know is we have seen in the last 2\1/2\ years a tremendous change--much of it thanks to the chairman of this committee in terms of transparency and in working with us on the malaria program--but we have seen a change from using the wrong medicines, the wrong techniques, and the wrong prevention techniques. We have 2 million people a year in Africa die from a preventable, curable, treatable disease.

Not long after I came to the Senate, myself along with Norm Coleman and other people who have done great work--and Senator Brownback as well--on malaria, as well as the chairman, what we saw was an ineffective program. The President had a malaria initiative--PMI--and it was set out and peer-reviewed--scientific data to approach this disease from both prevention and treatment. What we saw at the World Bank was a failed $500 million program and an attempt at another program for which there is no transparency. But the reports from the scientific literature Lancet, the greatest medical periodical from the British, had a devastating article outlining the fact that the World Bank continues to use drugs that don't treat, drugs that have resistance, it does not do preventive indoor spraying, does not distribute on a free basis bed netting--the three significant, consistent ways in which we treat African malaria, as well as the way we treat it throughout the rest of the world.

So I want to thank them in advance for doing that. This simply says that the World Bank has to be transparent with what they are doing on malaria.

What we know is the World Health Organization has also changed significantly. We are going to see hundreds of millions of people's lives markedly changed through an appropriate drug treatment prevention strategy for malaria. Of those 2 million people who die every year, 500 million of them are 5 years of age and under--I mean 500,000. Five hundred thousand are pregnant women. There are another 500,000 children who are permanently brain damaged from malaria. If we are going to help in foreign aid, then it ought to be effective foreign aid. So I thank the chairman and ranking member for their consideration on that.

The next amendment I would like to bring up talks about having some transparency with the $5.3 billion we send to the United Nations every year. This body, as well as the House, unanimously passed transparency and accountability for our own Government and our own agencies. We are going to see this next January where everything in this country where the taxpayers' money is spent is going to be online and available for taxpayers, peer-reviewed looks, watchdog groups, as well as the press to see how we are spending money.

What this amendment does is it ensures that the U.S. contribution to the United Nations is not being wasted to fraud, which we have seen multiple times at the United Nations--waste, abuse, corruption, which we have seen and which has been documented--by maximizing the public transparency of all U.N. spending or our contribution thereof. This amendment says that the Secretary of State certify publicly that the United Nations is publicly transparent about its spending this year, before any of the money we are going to send to the United Nations next year is sent. The basic transparency required by this amendment would include a posting on a publicly available Web site of copies of all contracts, grants, program reviews, audits, budgets, and progress reports relating to fiscal year 2007.

There are a lot of reasons the U.N. should be accountable and transparent, the first of which--and I won't go into a lot of details-- is the Oil for Food Program where $10 billion was mismanaged, stolen, and fraudulently used in a way that was totally unaccountable, to the detriment of the people of Iraq. As of this time, there have been eight guilty pleas, two guilty verdicts, two agreements of forfeiture judgments, and nine pending cases. There are also fugitives from the corruption of that.

The U.N. to this day refuses to fully and publicly release the Oil for Food Program's contracts and financial documents. Some people will say: Well, you can't force this on the U.N.

(Mrs. BOXER assumed the Chair.)

There is not an accountability that we can require.

We are the largest contributor to the United Nations. We have a requirement and a responsibility to the people of this country to make sure that money is well spent. The easiest way to make sure money is well spent and properly spent is for it to be transparent and available to the people who are making these contributions.

The second reason we should be concerned about how the U.N. spends money is procurement fraud. Last year, former U.S. Ambassador to the U.N. John Bolton testified to the Federal Financial Management Subcommittee that of the $1 billion in U.N. peacekeeping contracts that were audited--they didn't audit all of them but just the first $1 billion that they audited--a third was found to be lost to waste and fraud and corruption. The U.N. refused to release this audit, even to Secretary Bolton, our representative at the U.N; however, he was able to secure a leaked copy of it. What that $1 billion represents in terms of waste, fraud, and abuse is our entire contribution to peacekeeping. For all the money we pay for worldwide peacekeeping through the U.N., what we can extrapolate from this audit is that our entire contribution was wasted.

There is an even more worrisome program at the U.N. called the United Nations Development Program. What we know over the last 10 years is that over $100 million has been funneled inappropriately, fraudulently, and without any oversight to North Korea for things which it should not have gone. Ten million dollars, at least, was transferred in cash directly to the leaders of the North Korean regime. We know some of that cash was used to purchase homes in Europe and Canada. The Chicago Tribune reported there was evidence that they deposited cash into the same account that North Korea used to buy ballistic missiles. The United Nations Development Program refuses to allow our own investigators from our own Government to audit and review its financial information. It refuses, despite the United States sitting on the UNDP Executive Board and being the largest contributor to the UNDP budget.

Basic transparency--the idea that we give money and they spend money to accomplish good in the world--can only be effective if we know where the money is spent and how it is spent. The idea to have the U.N. transparent will protect against future scandals.

One of the things that bothers me the most about this and our contribution is the fact that the U.N. refuses to be transparent with the money we give them. Every domestic agency, every government program in this country is required to provide this body detailed financial information, program reviews, audits, and budgets. According to OMB, we spend an excessive $5.3 billion of the taxpayers' money on the United Nations, but despite repeated

requests by Ambassador Bolton, by congressional committees, by oversight committees, by committees on investigation, the U.N. refuses to make available information as to how it spends its money, make its audits available, program reviews available, or any other financial data available to the Congress or the world at large or the public in this country.

The only way we have been able to find out what we have been able to find out is that documents have been leaked. This amendment matters. The reason it matters is that every dollar lost to U.N. corruption is one less dollar that can save the life of an African child, one more dollar that could efficiently prevent violence around the world. Just in what we know on UNDP waste and fraud last year, 20,000 lives could have been saved in Africa from HIV. Or take the country of Uganda, plagued by civil war, and epidemics, and other things; according to the World Bank, their whole GDP was less than what we have wasted.

Think about the impact we could have. Some will say the U.N. has a procurement Web site where information on all contracts that are granted is posted. They didn't have that until 2\1/2\ years ago when we started pushing. It only shows a very small percentage of moneys. It is not thorough or comprehensive. It is controlled by the U.N. Secretariat and not all the other agencies under the U.N. So we don't get a look at how our money is spent at the U.N.

This is an amendment that has real teeth. This says what is good for our country in terms of how we spend our money, making it publicly available and transparent to hold us accountable, ought to apply to the

Yes.

Mr. President, the next amendment I want to spend some time on has been in the news of late. The Global Fund initiative has been a very important tool in terms of fighting HIV, TB, and malaria, which are the three significant diseases around the world that are limiting progress, health, life, and sustainability for many people throughout the world.

What this amendment does is eliminate the secrecy of the operation of that group. I am not highly critical of discretionary spending to accomplish a goal, but I am highly critical of not having transparency on where money goes. We can do that in a way that protects whistleblowers and in a way that satisfies the American public that if we are going to send their money overseas, we know exactly what it is spent on and how it is spent.

This is a very simple amendment. It conditions 20 percent of our contributions to the Global Fund, which is significant, on certification by the Secretary of State that the Global Fund has made all the financial and programmatic documents available to the public on a Web site. That says if you are going to spend $100 million on a drug, put it on a Web site and say whether you competitively bid it, and here is what we paid for it. If you paid a consultant, say here is how much we paid them for it. It is the American taxpayers' money.

I think it is significant that the total amount of money contributed to date for the Global Fund, which I support, has been $2.9 billion. If we follow both what the committee or the Senate happened to do, we are going to have that above $6 billion at the end of next year; $6 billion is a significant amount of money. What the global fund says is they have an Inspector General and that we don't need this. The problem is that Inspector General reports are good only if the people who have decisionmaking capability on the funding get to see those reports. The board at the Global Fund doesn't even get to see the reports. As a matter of fact, the IG of the Global Fund recently retired over the controversy of his IG report that was very critical of the management of the Global Fund.

The answer to accountability is transparency in what we do. This is a straightforward amendment that conditions only 20 percent of the money--less than the increase of what we will be funding with the Global Fund--by saying you have to become transparent, you have to become accountable, and it has to be accessible. It is

simple. We will get better value for the dollars we contribute to the Global Fund if, in fact, we adopt this amendment.

The other thing that will happen is more people will have lifesaving treatments or preventive strategies applied to them if we have transparency and accountability.

All of the amendments we have talked about today are essentially about transparency. It is about if we are going to send American money into foreign places through independent agencies, separate from our own Government, we ought to know how that money is spent. It is straightforward. All of us would do the same thing as we give our money--we look at church budgets and we look at nonprofits' budgets when we contribute to them, and we find out how they are spending their money. We have independent reporting in this country on nonprofits on how they spend money and how much percentage on overhead and whether they waste money. So all these amendments are about accountability-- accountability through transparency. I admit they have some teeth. But we are not going to be accountable for the American taxpayers' dollars unless we apply enough pressure to get transparency so we know where the American taxpayers' dollars are going.

I also want to submit for the Record a copy of a whistleblower conversation at UNDP, associated with one of the other amendments. I ask unanimous consent that it be printed in the Record.

This outlines the fact that in the Global Fund, UNDP has true corruption in terms of directing how the money is spent to their friends, not the people who can actually do the work or not those who are best suited for the work, but rather at the whim of a friend of somebody working at UNDP. It is very revealing.

What is even more revealing is that UNDP refused to accept a U.N. ethics office and so, therefore, the whistleblower at UNDP doesn't even have the protections of other people at the United Nations. So we have an individual who was doing a great job, but because he reported and refused to send money to somebody not capable of doing a job, not capable of performing with a good portion of our taxpayers' money, he gets fired. That is the kind of transparency we need to have at the UNDP and at the Global Fund.

It is my hope the Members of this body will seriously consider that we ought to be applying the same standards to where we send money outside of our Government that we are now applying to our Government. It is my hope that I will have the consideration of the ranking member and the chairman in supporting these amendments.

Amendment No. 2705 Withdrawn

Amendment No. 2773

I ask unanimous consent to withdraw amendment No. 2705 and call up amendment No. 2773. Amendment No. 2705 is one of the en bloc amendments and it is the wrong number. I wish to replace it with amendment No. 2773.

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

I yield back my time.

I ask for the yeas and nays.

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

Mr. President, I yield back.

Mr. President, I yield back.

Mr. President, I ask for the yeas and nays.

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

Mr. President, I wanted to spend a few minutes noting some things in the press about H.R. 327 and my hold on that bill. This is a bill which is very well intended. It is to help prevent suicide among our veterans.

I have been in the medical field since 1978--1979, that is. Approximately 6 to 10 percent of my practice has been associated with depression, treating clinical depression, suicidal ideation, post- traumatic stress disorder, and other issues.

We need to offer our veterans whatever we can offer them in terms of helping them deal with what they have been through and also helping our veterans who have no connection with their war experience in terms of treatment of depression.

Our veterans have the right to expect the legislation we craft to deliver on good intentions. H.R. 327, frankly, does not do that. One of the serious flaws with H.R. 327 is that every veteran is preconditioned with a mental status exam. So if you are a World War II vet and you have a sore throat and you go to the VA clinic in Muskogee, under 327 you have to undergo a thorough mental status exam before you can have your sore throat treated. That is Congress hitting a gnat with a cinder block. It is wasteful of our dollars. It portends to have Congress practicing medicine, when, in fact, we do not know how to practice medicine, and you cannot.

What this bill sets up is that Congress is going to mandate the doctor-patient relationship or the patient-PA or the patient-nurse practitioner or the patient-social service or licensed medical social service masters. What we have decided is to interject, because of the tragedies that we have seen in the last couple of years, a mandated form of treating suicide, depression, and risk of harm.

I have reached out to Senator Harkin on this bill. I offered to make some simple changes. We were rebuffed. Then what we saw in the press is that I wanted to hold this only because of how somebody might not be able to have their second amendment rights guaranteed. That is hardly the situation at all. What I really am holding this bill for is because, first of all, it is bad medicine. No. 2, it duplicates and mandates things we should not be doing. It takes away from the professions within the VA who know what they are doing. It steps on and it interrupts what the VA is already implementing to a good extent and to a great degree.

There is another very serious concern with this, which is that it mandates the tracking of veterans who have mental health issues. The vast majority of our veterans do not have mental health issues, but the assumption under this bill is they all have to be screened for it. That would be like me, with every patient that I ever see in my practice, the first thing I have to do is make sure, because they were in the military, that they do not have some type of mental health disturbance coming back. It is insulting to our military men and women who have given their lives, given their blood, given their time, given their honor, and given their sacrifice to assume they cannot do that without having some disruption in their capability to function in this society. So it is highly insulting to the vast majority of our veterans.

Now, the question is, How do we solve the problem of depression and post-traumatic stress disorder that leads to suicidal thought, ideation, and behavior? That is what we ought to be doing. And what we are doing is creating a set of circumstances that may have an impact probably not any greater than what the VA is doing now but will, in fact, take away great resources from other mental health issues as well as other health issues within the VA.

Let me give you some statistics, if I may. The VA is 3 years into a mental health strategic plan that has been markedly successful in improving the quality of care and ensuring that high-risk factors such as suicidal ideation are considered when veterans are assessed or impact or enter the VA system. The VA has suicide prevention coordinators in every VA facility in this country. They have a hotline 24/7. They have hired over 3,000 mental health staffers just since the end of 2005. So they have recognized what was the problem. They are responding to it. They have two suicide prevention centers of excellence that are geared up and working on the very specific issues associated with our military and post-traumatic stress disorder from combat.

Between 2002 and 2007, the VA spent 2\1/2\ times the percentage of their budget as we spend in all other health care on mental health. So they are already addressing the issue.

The other thing that is disturbing is this tracking of what they will do. They are not going to be tracking the data, they are going to be tracking individual veterans under this bill. That violates their own civil liberties. If, in fact, you have encountered the VA and because you were screened, not of your choice and not because you had signs or symptoms, because of that, that becomes a part of your record. You automatically are limited in lots of things that you cannot do in this country because you served your country. Now you have a mental health screening, an indication on your VA chart that would forbid you from becoming a police officer, an airline pilot, or an EMS, many other professions within this country. The idea that we are going to track individual veterans and their mental health status rather than the data--this bill specifically states that we are going to track the veterans, not the data--is wrong.

Finally, this bill sets out a peer counseling provision that has already been proven in the literature to not be effective. Yet it is mandated in this bill. So what this bill is about is the Senate practicing medicine and mandating ways to do things that the VA itself has already started. It is 3 years into a program of which they are using experts in the field to guide them, and we are using emotion and response.

I am going to continue to hold this bill until we work on the issues to guarantee freedom of veterans in terms of tracking of their data and them individually, in terms of securing the data

about them--the VA has had two serious leaks on veterans health care data in the last 7 years--and also working to make sure we use a mental status exam when it is indicated and not create a system that is an affront to all the people who have served the country.

With that, I yield the floor.

Mr. President, I thank Senator McCain for highlighting some of the problems with the bill. The real problem is that we last year spent $434 billion of our grandkids' money that we could not come up with. We did not collect taxes; we lowered their standard of living in the future. How did we get there?

We got there because we use earmarks to buy votes on appropriations bills. So we never look at the appropriations bill, we only look to see if our little thing is in it. Not all earmarks are bad. What is bad is a lack of transparency in our Government.

I know, Mr. President, you have helped me in terms of the Transparency and Accountability Act, but that is all after the fact. What this bill does is create a lie. That is what it is. It is not anything less than that.

We are lying to the American people that we are fixing earmarks, when we are not. The reason is, the vast majority of people in this body do not want their earmarks disclosed because it limits their ability to play the power game with the well connected who get something ahead of everybody else.

The other problem with earmarks is it takes our eye off the priorities for our country. Earmarks cause us not to do what is best for the country as a whole in the long term. It makes us short-term thinkers. It makes us parochial in our interests. I challenge any Member of this body to look at the oath they took and see if it says anything about your State when you swore to uphold the Constitution and serve as a Senator. Your duty is to the country as a whole, not to the well-heeled special interests who are the beneficiaries, whether they are parochial or not, to your earmark.

So there is no question this bill will pass. But the question the Senators have to ask is: Was I intellectually honest when every one of them out there is saying: We will have to fix this later because we do not like it, but we do not have the courage to vote against it--because they know we have not fixed the problem. But they are afraid of the public outrage and the pressure that has been created, in the essence of creating the impression that we fixed the problem.

Now, why do I say we have not fixed the problem? You go through this. What the Senate passed was Dick Durbin-Nancy Pelosi's bill on transparency and earmarks, brought to the Senate by the Senator from South Carolina.

The first provision prohibits Senators from trading earmarks for votes. In other words, I will give you your earmark if you will vote for my bill. It is gone. It is not there anymore.

Prohibiting Senators and staff from promoting earmarks from which they or their families would receive a direct financial benefit, it is gone. We now say it has to be for that person, even though you may be connected. So we have gutted that. One of the greatest problems we have, we have gutted. So no longer is there a prohibition that your family member cannot benefit from an earmark from Congress. That is the greatest conflict of interest there is. Yet it goes on every day.

Third. Allows the Senate Parliamentarian, not the majority leader, not the chairman of the committee, to determine if a bill complies with earmark disclosure and transparency rules. The American people are never going to be able to hold us accountable until they can see what we are doing.

We have now said that, whoever is the leader, Republican or Democrat, this is not about who is in charge, it is about whether who is in charge will have the courage to go against the whole political power of their own party to certify.

The first appropriations bill we had so far in the Senate, the only one we passed, was certified that it was totally compliant. It missed it by $7 billion. They did not list all the earmarks, and they certainly were not transparent, but they certified they were.

The next provision prohibits consideration of bills, joint resolutions, or conference reports if earmarks are not disclosed. You can't bring it to the floor anymore if they are not disclosed. You still can bring it to the floor under the rules of this new ethics bills.

The next provision requires earmarks attached to a conference report to be publicly available on the Internet in a searchable format 48 hours before consideration. It still says it, but there is an out. The way this place works, we

bring conference reports up such as that all the time. So every time it is going to get waived, and we are not going to know. We are going to be voting on bills where the earmarks aren't disclosed.

Next provision: Requires 67 votes to suspend the earmark disclosure rule. That is what we passed 98 to nothing. Now if you want to fight that, you have to have 61 votes to say it doesn't. We have totally put on it the other side. We have totally made it so that you can in fact not disclose earmarks, and the majority will vote with you. We have made it hard for transparency rather than easy.

The next provision requires a full day's notice prior to attempting to suspend the earmark disclosure rule. Not anymore. No notice. So you could suspend it and don't have to notify anybody that you are suspending it.

Finally, it requires all earmark certifications from Senators to be posted on the Internet within 48 hours. Not anymore, not if the chairman of the Appropriations Committee doesn't think they can get it done. They just waive it.

So where are the problems? Why is it that the country has between 14 and 28 percent confidence in the Congress? It is because we continue to use sleight of hand to tell them we are doing something when we are not. I don't have any problems with the other things in the bill basically, but those are symptoms of the disease. The disease is right here. It is called earmarks. If we don't treat the disease rather than the symptoms, we are never going to fix the problem.

I am adamantly opposed to this bill and what it has done to gut earmark disclosure. I have been around here long enough to know what will happen under the time pressures and the constraints and the way we operate. This will all go away. It may not go away on the first bill or the second bill, but it will go away. So we find ourselves with the Senate getting ready to vote on an ethics and disclosure rule, and every Senator is saying: How do we fix the things we don't like? Well, we will do it later.

Nobody loves this bill, but we are going to vote for it, not because we are fixing the problem, but it looks as if we are fixing it. The confidence in Congress isn't going to go up; it is going to go down.

We started this debate 2\1/2\ years ago on an amendment on a bridge to 50 people in Alaska of which 15 Members of this body voted with me. But the American people came to realize that the bridge to nowhere stood for something more than the bridge to nowhere. It stood for the lack of character and integrity in this body in terms of making long- term decisions and putting the country first instead of political careers. We haven't solved anything with this ethics bills in terms of that problem and rebuilding confidence. There is a crisis of confidence in this country. There is a rumble that we don't deserve the positions we hold because we haven't earned them, because we are going to use sleight of hand. We are going to lessen confidence in this country. We talk about money. It is great, except what is going to happen is we are going to bundle $14,900 every 6 months and it is not going to be reported. Over a 6-year career, that is $180,000 that one lobbyist can bundle for you that does not have to be reported. So tell me how we fixed the problem? The bundling is a symptom of the earmarks. It is a symptom. Where is the connection between earmarks and campaign contributions? It is there almost every time. You just have to look for it.

With the President's help we passed the post-transparency bill, Senator Obama and I, to where we get a look at it after the fact. But now we don't want to have transparency before the fact. We have failed the American people with this bill. We are also failing the Senate and ultimately we fail ourselves.

I ask the American people to look at the pictures of their children and grandchildren. Do you want them to have the same opportunities, the same benefits, the same freedoms and liberties? This is the thing that is going to take it away--the lack of an honest and open debate about priorities, the continued spending of money we don't have, and most of it on the basis that we have a gateway drug to spending addiction called earmarks.

I yield the floor.

Mr. President, I just want to make two points on the Every American Insured Act, and that is that every American ought to have access to health care, and if we do that, the average American's health care policy right now would go down $1,000 a year. There is over $250 billion in cost shifting that is in the system today that will go away. We ought to be thinking about that. We ought to be looking at it.

What we do know from around the world is that a true competitive market will yield the best quality and the best results and the best outcomes for every American.

Mr. President, under the previous order, at 7:45, I had 5 minutes reserved. I wish to start on that amendment now, and that would give me a total of 10 minutes.

I withdraw my request.

Amendment No. 2570, As Modified, to Amendment No. 2530

Mr. President, I ask unanimous consent to call up amendment No. 2627, and I ask unanimous consent that Senator Vitter be added as a cosponsor.

Mr. President, this is a fairly straightforward amendment. I am not sure what the chairman thinks about it. One of the things we know--even from the chairman's words earlier--he rejected the CBO evaluation of the new enrollees in this system. What we do know is that a large number of children who now have insurance with their parents are going to be moved out of that insurance to somewhere else.

In the old SCHIP program, we had a concept of premium assistance. In the two States that have gotten through the very tough parameters of that assistance and have met it to meet the requirements of SCHIP, we found fewer kids go away from their parents' insurance and stay unified in the same clinic, with the same doctors, with continuity of care. And 77 percent of the children between 200 and 300 percent, which is what we are addressing with the new bill, are already covered. For the fully eligible kids up to 200 percent, CBO tells us for every one we add, we will take one off.

This amendment says let's not take them off. Let's use the money for premium assistance to help those parents keep the insurance with them. In Oregon--and the Senator from Oregon might know this--those families who chose the premium assistance option were more likely to receive care in a doctor's office or HMO, rather than a public health clinic or a hospital clinic. Families using the premium assistance option also reported fewer unmet primary and specialty care needs than those in traditional SCHIP. The premium assistance option works. We need to remove the difficulties and barriers so that more individuals eligible for SCHIP have the freedom to access it.

Ensuring that newly eligible populations under the Baucus-Grassley proposal are covered with a premium assistance model will ensure the preservation of market-based health care, rather than decline that system.

Many lower income families already participate in the private health insurance market. Seventy-seven percent, as I said, of those in the 200 to 300 percent of the Federal poverty level are already covered in a private insurance market. So if the purpose of SCHIP is to get kids covered and we are worried that some in this group--those at 200 to 300 percent--why not use premium assistance to help them stay in a contiguous family policy and help the parents maintain them within that policy?

We accomplish the same goal and we do a couple other things. No. 1, we let parents make a decision on who their doctor is going to be for their child, rather than a Government bureaucrat. In many SCHIP programs, there is a limited number of providers, and the child may not be seen now. What this does is use the funds to allow them to stay with their parents, still reaching the goal of covering more kids; but, also, CBO has scored this amendment as saving money because we will cover more children at a lower cost.

It is a fairly commonsense amendment. There are problems with the requirements on the premium assistance model in the old SCHIP program. As a matter of fact, four other States had gone to it and then left because of the complications of getting the waivers and meeting the requirements of the SCHIP, which forced children away from the primary care doctor they and their parents wanted to have.

There is one other thing that I think is important. Whether we like to admit it or not, 60 percent of the primary care doctors in this country don't take SCHIP or Medicaid. So we have limited it down to 40 percent. If we want to have equal access for these children under the SCHIP program, we need to take the Medicaid SCHIP stamp off their forehead. We need to give to them the market so they can go where they want to go. By doing premium assistance, you allow that freedom of choice by the parents of the children. When we don't allow premium assistance, we take choice away--here is what I had and now I don't have the choice. I submit to the body that this will discourage a large number of children from going into the SCHIP program. So if our goal is to increase it from 200 to 300 percent, and over 77 percent of those are already insured, why would we not want to keep those already insured and do a premium assistance model and help the other 23 percent with the SCHIP program?

It is a straightforward amendment. The Massachusetts Institute of Technology economist Amy Finkelstein recently released research about the unintended effect of what happens when the Government controls health care. The summary of that is we pay more, but we don't get better results.

I showed a chart here the other day, actually, of the fully absorbed cost of us buying insurance through the SCHIP program versus what you can buy in the private market. The difference is astounding. It is about $1,800 more to buy a $1,352 policy versus the other.

I ask unanimous consent for an additional 5 minutes, as I did when I requested it from the chairman.

I requested to start 5 minutes early so I could still have the 7:45 to 7:50 time slot. I will finish up faster than that. I need 2 or 3 minutes.

Mr. President, America spends 16 percent of its gross domestic product on health care, and that doesn't take into account any research and development. It is important to know that, through the private sector, M.D. Anderson, in Texas, spends more on research than the entire country of Canada. We don't want to disrupt that.

So keeping these children in a private program with their parents, with the continuity of care, I can tell you that as a practicing physician, when you have one child go one place and one child going somewhere else, and a parent going somewhere else, the ability to access health care declines. So I hope the chairman will consider accepting this and look on it favorably. We will actually make the Baucus-Grassley bill much more effective, much like we are seeing in Oregon, which has been effective with children staying on the same health care with their parents.

With that, I yield the floor.

I ask for the yeas and nays.

I just spoke.

Mr. President, I note a couple points. This does not force any kid, 200 percent or under, to go into the premium assistance program. A family making $62,000 a year--that is not a low-income kid. As a matter of fact, 21 States in this country have less income than that. It is working well where it is being utilized, and it does not force anyone into inferior care.

I understand the chairman's objection. I take that, but the record should show that of those who are on premium assistance today, they have adequate or greater care than the SCHIP program.

Mr. President, as a member of the Homeland Security Committee, we were advised that we would be given leniency on this vote through our chairman, through communication, I assumed, from leadership staff. We did not come on a timely basis. I would like to be recorded as aye. It will not make a difference in the vote.

Mr. President, I am going to spend a little bit of time first discussing health care in America. I have a little bit of experience, having practiced for 24 years. The children the majority whip talked about, I delivered 4,000 of them. I cared for well over a third of those through their infancy and into childhood.

Let's be clear about what this debate is. There is no difference. I agree with Senator Durbin. I want every person in this country to have health insurance. Actually, every problem that Senator Durbin mentioned could be solved by equalizing the tax treatment under the Tax Code so that everybody is treated the same under the Tax Code in this country.

Let's talk about where we are in health care in America today, then let's talk about what the possible solutions are.

What we have today is the best health care in the world. It is very expensive, there is no question about it. Eighty percent of all of the innovation in health care in the world comes out of our health care system. We have survival rates on prostate cancer, breast cancer, and colon cancer that far exceed anywhere else in the world. Our treatments for coronary artery disease are better than anywhere else in the world. If you have a heart attack in this country, you are more likely to live 5 years than anywhere else in the world. But we have a system that is designed to treat chronic disease instead of designed to prevent disease.

I know that the President this evening is supportive of prevention in terms of how do we change the focus in this country. You see, what we have coming to us is a storm. It is not going to be a storm that affects myself or the Senator from Ohio; it is going to affect our kids and our grandchildren. Here is what the storm is. If you are born today, born today, you are born owing $500,000 for the health care of everybody who was born before you under Medicare. Think of that. Listen to me--$500,000 is the cost we are laying on the next generation for the health care system we have under Medicare. That is not talking about Medicaid, that is not about SCHIP, that is about Medicare only. If you are born today, that is what you are going to bear over and above what our present tax rate is. That is called stealing opportunity from the next generation.

We also have a health care system under which 7 percent of the costs of health care comes about from tests that are ordered for you that you do not need. There is no reason you need them, but the tests get ordered because your doctor needs them or your hospital needs them. It is a full $170 billion a year we spend on tests that nobody needs except the doctors to protect themselves in the case of ``what if.'' And this body refuses to look at tort

changes that will make us order tests based on what you need rather than on the threat of a malpractice suit.

So we have liability costs, we have unfunded costs from Medicare, we do not have prevention. We spend tens of billions of dollars a year on disease prevention in this country, $7.1 billion at the NIH, $8.4 billion at the CDC, and then billions more that we can't quantify across many Federal agencies where you cannot measure that we did anything on prevention.

The average American does not know that at age 50, they should have a colonoscopy; they do not know that at age 35, they should have a mammogram; they do not know that if they have a family history of breast cancer, they should have that mammogram sooner; they do not know that every month, they should be doing a self breast exam; they do not know the symptoms of prostate disease in older men; they do not know what they need to know about prevention. We are totally inept in the programs we have today to communicate that to America.

So that is where we find ourselves today--the best health care system in the world, with the most innovation, but also 50 percent more expensive than anywhere else in the world.

Now, when you match up those two statistics I talked about, in terms of greater life expectancy, in terms of all of the cancers, in terms of heart disease, against the cost, what is the difference in all the countries that have universal, single-payor, government-run, bureaucratic-controlled health care? They let you die. That is the difference. If you need a knee replacement, like the Senator from North Dakota talked about, you do not get it because there is no money. Let's talk about some statistics. Average waiting time in Sweden: 25 months for heart surgery. How many people do you think live 25 months? How about an average of 10 months before the onset of chemotherapy for breast cancer in England. The reason their costs are down is because they are not caring for people at the end of life.

We can get all of that back if we emphasize prevention. Prevention. For every dollar we spend on prevention in this country, we are going to get 100 back. Yet we do not have effective prevention programs. So what is this debate really about?

There is not anybody in this Chamber who does not want to see kids have great access to health care, preventative or otherwise. There is not anybody in this Chamber who wants anybody not to have available health care. What is the real debate? Well, there are actually three.

The first debate is: Do we want the Government that cannot get you a passport, that cannot control the border, that cannot take care of the problems associated with a hurricane when we have a major emergency, do you want them running your health care? A government that is failing so many fronts because the bureaucracy is so big, the oversight is so poor from this body, the oversight is so poor, we do not do our jobs. We can find lots of ways to spend new money, but we cannot spend the effort to find out if money we are spending is working. The oversight is so poor that we have ineffective programs all over the place.

There is a columnist by the name of P.J. O'Rourke. He said, if you think health care is expensive now, wait until it is free. And there is a lot of truth to that. When it becomes free, it is going to be tremendously expensive.

So the debate is not about whether we should cover children and whether children ought to have great health care. They should. We have the resources to do it. What the debate is about is whether we are going to put into the hands of an incompetent government in many other areas your health care. And this is the first step in moving it all in that direction.

Now, the Senator from Illinois talked about the young child with acute lymphoblastic leukemia. We have moved to where we have about an 80-percent cure rate with that right now. We did not do that through the Government; we did that through the private sector. But he also noted that he did get this care. He did get chemotherapy. He did get it. So the other point that needs to be made about--the system we have now is shifting a quarter of a trillion dollars a year into a system because we are absorbing costs rather than giving individuals their care based on freedom.

The second point is, if we do this expansion of SCHIP, are we getting good value for what we are paying? There is a chart I want to put up that shows--these are CBO numbers. The reference to the private care comes from data about the individual health insurance market. The $1,532 comes from average of a $500 deductible added to the average premium for a private children's policy: $1,032. One in three will pay a $1,500 deductible, two will pay no deductible. So for $1,532, you can buy private coverage, but with this bill we are talking about spending $3,950 for government care for the same thing. That expense will be charged to your children and your grandchildren. I think it is probably not a great deal, not great value, for us to do it this way.

The other thing the Senator from Illinois recognized is that he wanted everybody to have insurance. All he has to do is cosponsor the Burr-Corker bill because that gives everybody in this country, if you are an individual, a $2,160 tax credit, refundable flat tax credit. If you are a family, it gives a $5,400 refundable tax credit.

Now, what does that mean? If you are earning $61,950, a bureaucrat is going to decide what your health care is and who your doctor is going to be and whether or not you have care versus you deciding. It is about freedom to choose.

So the Senator from Illinois can have every one of the desires he listed and meet every one of the goals by us equalizing the benefit under the Tax Code for all of us. That means it does not matter if you are rich or poor; you get the same treatment under the Tax Code. In other words, we are going to guarantee 100 percent universal access for everybody in this country, and it is not going to cost a penny.

The other thing this debate is about is, Do we really want to have a debate in this country on health care? If we do, let's have a total debate.

Mr. President, so this debate is about whether we get value, this debate is about whether we really are going to fix health care, and finally, this debate is about the dishonesty in this bill about how it is paid for. And what we are doing--you saw Senator Gregg with the chart out here. We are going to assume that in year 6, the cost of this is $3.5 billion, but the new program is 12. There has never been a program that is going to go down from that. So rather than violate their own rules, they cut it down and said it does not exist at the same level for the second 5 years of this authorization. That is exactly what America has come to expect of us--being intellectually dishonest with them about the true costs of programs.

So, as Senator Gregg said, the debate really is about the starting of the debate, about what we are going to do in health care. We have good health care. We have 43.6 million Americans who do not have it. This bill purports to put 3.3 million of them on SCHIP. The only problem with that is 1.1 million of them have insurance now, so there is a double cost. So we got back to the $3,900, which is what the American taxpayer, one way or the other, is going to pay for $1,532 worth of care. How does that make sense? It makes sense only if you are moving in a direction to have the Government run it all.

So if you want the personal freedom to be able to choose what your health care should be and you want the Government to equalize the tax basis under which we all receive care so that everybody gets the same benefit--not the wealthy, one, and the poor, a different one; the difference is $2,700 if you are well off and $102 if you are not--that is how the Tax Code discriminates against you now. What we do and what we suggest is everybody gets the same treatment. And what happens is, under this bill, CBO scores that it will add maybe 3.3 million kids. Under the Burr-Corker, we add 24 million people in coverage over the first 10 years of that program, according to JCT.

So if this is about covering all of the children and about covering those who do not have health care, we ought to be addressing it in a totally different way. We ought to be saying we want a universal flat tax credit that is refundable to everyone in this country so they can all have access.

Senator Wyden has proposed that on the other side with some minor differences in what we are suggesting through the Burr-Corker bill. But the fact is, you cannot have it both ways. Which way is better? Do you want the freedom to choose or do you want an organization that right now has proven to be terribly incompetent?

Some statistics about the incompetence: the doctor shortage in this country 15 years from now is going to be 200,000 doctors. Why is that? Why are the best and brightest not going into medicine today?

Why is that? It is the same reason that you see all the European single-payer systems moving toward what we have, as we try to move toward them. We are going in exactly the opposite direction. The reason is, by the time you finish 12 years of college and graduate and postgraduate and post-postgraduate education, you can't earn enough under Medicare or Medicaid to even repay your loans. So what is happening is, our best and brightest, instead of going into medicine, are going into other areas where they can be remunerated for their investment in education. This drives us further that away.

What is the statistic behind it? Fifty percent of the doctors don't see Medicare or Medicaid patients now. If you move to a new city and you are on Medicare, good luck on finding a new Medicare doctor. Why? Because the reimbursement is about 50 percent of what they can earn seeing somebody who is not on Medicare. So we will have a shrinking number of doctors, a government-run program that is going to control cost by saying, as the Senator from North Dakota said: Here is the amount of money. Guess what. We are not paying for it. It is going to get rationed. That is exactly what is going to happen to us. Consequently, we are going to take the best health care system in the world, with all its defects, and we are going to turn it on its ear. We are going to take the system that develops 80 percent of all new innovations in health care and run it away.

Example: M.D. Anderson Clinic spends more on research in health care than all of Canada. Think about that. One private outfit in this country spends more than the whole nation of Canada on health research. Why? Because we have a system that rewards innovation. We are going to kill that system. We are going to destroy it. The question is not whether children ought to be covered. Sure, they should. But so should their parents and everybody else but not in a way that destroys the system. The system will work if we create access for everyone. The system will work without raising a tax dollar to anybody. We will give everyone free choice to have what is best for them.

The numbers don't lie. If you doubt what I am saying about this being a step toward national health care, here is what they say. Question: Is this the first step toward a government-run, bureaucratic-controlled single-payer health care system? Senate Finance Committee: Absolutely not.

Now let's hear what the chairman said:

We're the only country in the industrialized world that

does not have universal coverage. I think the Children's

Health Insurance Program is another step to move toward

universal coverage.

AKA government-run health care in this country. So the system that gives us great innovation, that creates 80 percent of the new drugs, new techniques, new technologies, we are going to poke our finger in its eye because of what it has done.

We heard the Senator from Illinois say all the big businesses want to solve this. They have made commitments to health care. They now want to dump on the American public rather than on their shareholders. General Motors, Ford, Chrysler, they want us to pay for it. They had an obligation for it. They took plenty of bonuses when the profits were good. Now they want you as taxpayers to pay for it. That is why all the Governors want the SCHIP program, because it is going to expand their ability to solve their other budget problems. But what we are charged with is doing what is best for the country in the long run. I will promise you, a government-run, bureaucratic-controlled health care system is not the best thing for this country. And that is what we will get. What we to have do is go back and use a little common sense and look at what is happening.

In my State of Oklahoma, we have 117,000 kids on SCHIP. Oklahoma chose to make it a Medicaid expansion. The problem is, Medicaid doesn't pay enough so kids can't get access in Oklahoma under the rates which they pay. So have we given children access? We have a SCHIP program. Can they get care on a timely basis, can they get the same thing somebody through a private insurance firm can get? No. Is that the kind of care we want? I want everybody to have the same access. I don't want a Medicaid stamp on anybody's forehead. I want them to be treated equally under the Tax Code so they have exactly the same opportunity for access to care that the richest or the best union member or the best business offers. We can do that, but we can't do it by going in this direction.

We heard from the majority whip that we don't like kids. I don't care how much tobacco is taxed. The problem is their numbers are foolish, because we know as we raise the tax, the amount of volume goes down or it goes to the black market or it goes through Indian tribes who don't pay the Federal excise tax even though they owe it.

So what we know is the way we are going to fund this isn't going to work, but we are going to be on the hook anyhow. Except it is not us on the hook. It is your kids. The very kids we are going to insure, we are going to come back and say: By the way, you have to pay for your insurance through increased tax rates.

We should be very careful about what we are doing. I care dearly about children. I have four grandchildren, 10 and under. I look at them, and I see all the kids I have delivered through the last 20-some years. I see all the kids I have cared for, diagnosed major diseases on, treated broken bones, taken their appendix out. I look at all those, and not once were they ever turned down. The vast majority of physicians don't turn somebody down in need, but we are coming to a screeching halt. No longer can we continue to cut the incentive to have people going into the medical field. Take 200,000 doctors and see what would happen if, in fact, we had them there in the future.

The biggest problem facing hospitals today, they can't find a nurse. Why? Because the reimbursement rates are so low we can't incentivize enough people to go into nursing because they can't pay the costs to do it and the hours are terrible. You work four 12-hour shifts. You are off for 3 days, and you come back and work four 12-hour shifts. It is not a great life. So the people in medicine today, the vast majority, care deeply about kids, but they also care deeply about having some rest, having access to a normal life outside of that. My nurse added it up. During my 20 years, my average time in practicing medicine was over 80 hours a week. That is not uncommon in this country. It is not uncommon for doctors to spend 80 hours a week taking care of folks. But we are going to be short 200,000 because we are going to see less dedication because there is not the financial reward for people to invest that much time and their assets to get the education they need.

Let's talk about who is going to get on the system and who is not. Under the old system with this expansion, we are going to add 4.1 million kids. But we are going to take 2.1 million off private insurance. So in Oklahoma, I don't know what the exact numbers will be, but we are going to take kids off private insurance and then put them on a Medicaid system they can't get access to. We will feel good. We gave them insurance. We give them coverage, but they don't have access. Unless you are getting seen, it is not access.

Also under the new system, the newly eligible, they will add 600,000 kids, but there is a 1-for-1 trade. We will take 600,000 off private insurance. So tell me what we are doing? We are shrinking the pie so that the cost for everybody in private insurance is going to go up. That is what is going to happen. We are going to move it over to a government-run system that doesn't reimburse at a rate to give you access. Why would we do that? Why would we pay 2.5 times what it costs to get it in the private sector?

There are a lot of changes that need to happen in health care. We need to complete transparency as far as price

and quality so you as a consumer can make a decision. I am for that. We need true insurance market reform so that instead of big health insurance companies taking 40 percent of the premium dollars you pay and keeping it through administration of profits, we actually put it into health care.

We need a change in the insurance industry, where a bureaucrat sitting at a computer, either at Medicaid, Medicare or an insurance firm, isn't denying your care because they have never put their hands on you to say you need this or not.

What we are talking about is giving individuals the freedom to handle their own health care, the freedom to choose, the security to know that through this tax credit, everyone will have access in this country, no matter who you are, no matter what you make. You are equal footing with everybody else.

When the majority whip comes out and says that is what he wants, my challenge to him is, sign on to the Burr-Corker bill. That is exactly what it does. It gives equal access to everyone. Instead of an additional 130,000 kids in Illinois, he will have all the kids covered. Instead of the adults who are not covered in Illinois, he will have them all covered. He would not raise taxes on a soul. Will it shift some? Sure.

The question is, are our kids worth it? That is the question that has been raised by the Finance Committee and Senator Durbin and those who have spoken. I say they are. But if you go back to the numbers, which is $3,950, and you apply that and you take the 4.2 million children, we could cover all of the uninsured children if we did it at the cost of the private sector right now. If we said we will take the same amount of money we are going to spend under the SCHIP program and we will buy them all a private policy, we can cover every kid who is not covered today because we spend 2.5 times more doing a government program than the same thing you can do on your own in the private sector. Why wouldn't we do that?

We wouldn't do that because this is the first step in moving toward universal, government-run, bureaucratic-controlled health care.

One other point I wish to make. We have a Medicaid program today. We have a SCHIP program today. There are 680,000 kids right now who are not covered who are eligible for those programs. Tell me how effective we are at covering those 680,000 kids. They are eligible, but we don't have them? That is because of the failure of the Government bureaucracy to fully get a benefit out to those who are deserving of the benefit. So what do we do? We are going to go in the opposite direction.

The other important point is, what SCHIP does is separate you from your family. If you make $60,900 in this country--that is higher than the average family income in 21 of our States--your child is going to be eligible for SCHIP. So your child is going to go on SCHIP. They will have a different insurance plan than you. They will have different doctors. There is not going to be a family doctor who cares for the whole family. The child will have one, and the parents will have a different one. We will separate them and divide them. We are going to totally separate them. Then guess what is going to happen. Parents are saying: I could put my kid on SCHIP, and I will get a decline in my premium. But it would not decline because we would not have done any insurance market reform. We will not have created a competitive market where they have to bid for your care. We will not have done what we need to do to fix health care.

So I welcome this debate. This is a debate we ought to have in this country. Health care is important, and it is one of the things that is limiting our competition. But the reason it is limiting competition is because we aren't investing in prevention and nearly $1 out of every $3 spent in health care does not go toward helping anybody get well. The reason it is that way is because we have the Government in the middle of the market. We are about to make that worse.

What we do know in this country is markets work. Individuals in this country figure out how to buy a car that is good for them. They figure out how to buy auto insurance. They figure out how to buy homeowners insurance. But we assume if we give everybody a level playing field, they are not capable. How arrogant of us. Markets work.

What we will see is this $250 billion--this quarter of a trillion dollars in transfer payments, cost shifting--go completely out. The $250 billion will drop everybody's insurance cost in this country by $1,000 per person. So not only will we insure everybody who is not insured, we will lower their cost of insurance by $1,000, by eliminating the cost shifting, and we are paying for that already. So we will have great benefits if, in fact, we move to a true competitive market.

The last thing I will say is, if we do a tax credit--a flat tax credit, a refundable tax credit--it keeps families together. It keeps mama and papa and brothers and sisters going to the same clinic, with the same doctors, with constancy of care, knowledge of their history, knowledge that is important in terms of giving great care.

I look forward to this debate. I plan on being on the floor. I plan on asking questions. The fact is, this is the issue this country is dealing with both in terms of how hard it is to get health care in this country and how expensive it is. There are two ways of solving it. One says the Government is going to run it and the bureaucrats are going to control it and we are going to control the costs by rationing the care. The other way says we are going to let vibrant markets create transparent information and competition that lowers the cost and increases the quality for everybody. On the way, we are not going to be inefficient in the way we spend money, spending $3,950 for $1,500 worth of product. That is what we typically do up here. There is no reason we should do that again.

Mr. President, the majority leader asked unanimous consent to bring the ethics bill to the floor. He filled the tree, limiting amendments. I wish to spend a minute talking about that.

I honestly believe we are never going to have the problems fixed in Washington until we have absolute and complete transparency on earmarks. Senator DeMint and I have both, numerous times, asked for unanimous consent that what we voted on 96 to 0 in the Senate be the order of the day when it comes to transparency on earmarks. That was rejected. We had a Democratic conference, and what we actually did--and I am not saying this partisanly at all; this is not a partisan issue-- but what we did is gutted the transparency portion of the earmark reform. If you think the problems are going to stop with the ethics bill that is going to be coming up, we have another thought coming.

What the leadership has done, the majority leader along with those in the other body, they have cleaned the outside of the cup to what looks like is a good deal for the American public, but when you look over the edge of the cup, what you see is filth, what you see is a lack of integrity, what you see is a planned method to skirt transparency. The only thing Americans should believe is the only way they are going to know everything is on the up and up in this body is with 100 percent transparency. Anything less than that will not get you the accountability, will not solve the ethical problems that are out there. We need to be about that.

I am going to work hard to talk about that more. I think it is uncompromising what we are seeing done at this time to pull the wool over the eyes of the American people when it comes to earmarks. That is not a partisan issue. I am against earmarks, especially if they are not 100 percent transparent. But if you look at every ethical lapse that has happened in this body, it always goes back to earmarks. When they are transparent, and fully transparent to where the American people can see it, you are going to start getting good Government again. Until then, you are not.

I yield the floor.

Mr. President, I thank the chairman and appreciate her consideration in giving me an opportunity to call up an amendment even though we are not going to debate it. We will put it in the pending file. I understand that. I thank her for her courtesy.

I ask that the pending amendment be set aside and that amendment No. 2442 be brought up.

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

Mr. President, this is a fairly simple amendment. I plan on offering this on every appropriations bill. What it says to the American people is we know we are going to do certain things to send projects home. What this says is if you do that, then there ought to be a competitive bid on the project rather than a sweetheart deal to wherever it is going.

It is a very simple amendment. It says if we are going to send something home through an earmark, then the process of expending that money ought to be on a competitive bid basis so we get good value for the American taxpayer--no cost-plus, just competitively bid.

With that, I reserve my debate for a later time and yield the floor.

I object.

Mr. President, first of all, I thank Senator Lieberman and Senator Collins for their hard work on this bill. I think we shouldn't be so quick to pat ourselves on the back as far as the 9/11 Commission. The No. 1 thing the 9/11 Commission said is, the money that is spent on protecting this country ought to be based on risk. Fifty percent of the money in this bill is not based on risk. It is based on political calculations, on each one of us getting so much money for our State. That is absolutely wrong.

There are a lot of good provisions in this bill, I don't disagree with that point. But when we take $14 billion over the next 5 years for grants and say $7 billion of it isn't going to go based on the highest risk in this country, it is going to solve the political problems that Members of both the House and Senate have in terms of bringing home the bacon rather than putting that money where it should be put. What if something happens between now and the next 4 years and we could have spent the money in the high-risk areas, but we chose not to because we ignored it and we spent the money elsewhere taking care of our own political needs rather than the needs of our country?

The second point that ought to be made, and Senator Collins made this point, is, it is absolutely impossible for us, over the next 3 years, to screen 100 percent of the cargo. Yet that is what we have mandated. In fact, we are going to take a very effective high-risk program right now, and we are going to stop it and we are going to go to 100 percent screening. In the meantime, we are going to screen 50 percent of it, and we are not going to look at the high-

risk cargo. What we are doing with this bill on cargo is making our country less safe. It doesn't fit with any common sense, but yet that is what we have done because a majority of us want to answer the emotional call for 100 percent screening when, in fact, the scientists and people trained to protect us tell us that is not the way to go. We reversed, and we walked away from what we were told by the experts to do.

What do we know about grants? What we know is that of the $10 billion we have already given in grants, 30 percent of it was wasted, and we don't know about the other 70 percent because there are only eight people in the whole Department of Homeland Security who look at the $10 billion we have spent. And we are going to spend $14 billion.

We did get in some post-grant review, but there is no rigorous assessment and transparency of how the money is going to be spent. So it is going to go out there, and we are never going to know if it did the right thing.

On our track record for the $10 billion we have already spent, 30 percent of it we know failed, and 30 percent we know didn't go for legitimate homeland security items. And we don't have and didn't put the resources in this bill, if we are going to spend $14 billion over the next 5 years on grants, to make sure that money goes to do what it is supposed to do. So we are creating problems and taking money and not spending it in the way that is most appropriate, and that is what the Homeland Security said.

The other point the 9/11 Commission said is we ought to reorganize how we oversight intelligence. We didn't do any of that recommendation. We didn't do any of it. They also commented that we have to have the oversight and priorities, that you don't fight turf battles but what you do is fight the terrorists. This bill is loaded with turf battles where money is spent, ordered, and managed by one department, but the checks are cut somewhere else; not because that is the way to do it, but because we are protecting some politicians' turf in terms of controlling the money. I think that does not reflect well.

There is another interesting item we have created. We created a weapons of mass destruction czar and commission in this bill. That may be a good idea. I am not sure I disagree with that. But we also said to that czar--this is going to be a White House position--anything you tell the President, you cannot tell him in confidence. We gutted executive privilege to have an adviser to the President on weapons of mass destruction to have the confidence that what he says to the President in private, in confidence for the best part of this country, will become available to all of us.

First of all, no President is ever going to fill this position because they are not about to have an adviser behind them advising them who cannot give a clear, concrete recommendation without it being second-guessed by somebody on the outside knowing what they are saying. It goes against all common sense.

Finally, what we have done is we have taken our black box intelligence numbers, and we are going to tell the world what they are, which is crazy. We are going to tell the world how much money we spend on covert activities, and we are going to share that with them. We shouldn't be sharing that information. That information should not be out there, and yet we have decided to do it to our own disadvantage.

I know there has been great work put in on this bill both by Chairman Lieberman and Ranking Member Collins, and I appreciate it.

One final point that I will mention. We had in our bill some oversight in the BBG, the Broadcasting Board of Governors. Here is what we know about Farsi Voice of America TV and Arabic TV. What we know is most of the time they are not presenting America's viewpoint. They are presenting our enemy's viewpoint, and we know this because my office has been translating and having translated their broadcasts. We put into the bill to have those translations become public as a part of BBG, and that got rejected.

So we are going to continue to have a foreign policy where we are paying money to have radio programs go into Iran that are counter to what our own policies are, and yet we are not going to have accountability in this bill, to hold BBG accountable. It is not there. It has been taken away.

Transparency is a great thing for this country, and when we spend money to create an American position in a foreign land, to not have transcripts and for them to not want us to have transcripts of what is going on, the first thing one has to ask is, Why not? Why shouldn't American taxpayers know where they are spending their money and know what the message is that they are sending? Unless the message is something different than what it should be. And that is the case with Radio Farsi and Radio Farda.

There are several other things I will not spend any more time on but that I think the American people ought to ask themselves. Last year, $434 billion on credit cards was charged to our grandkids. We have $14 billion worth of grants in this bill over the next 5 years; $7 billion that we don't know if it is going to be spent well. We certainly don't know if it is truly going to be spent on homeland security and at a priority of what is best and what is based on the highest risk.

So I am disappointed that we didn't get a lot of things in the bill that we should, and I know this is an effort at compromise, but it seems to me that certain things that are common sense, such as spending money to make sure our message is right, and knowing that it is right; making sure we are spending the money where the highest risk is, rather than where the greatest political need is, ought to have been principles that should have gotten into this bill.

I voted against this bill not because I don't think we should be protecting the homeland, not because I don't think we should be following these recommendations but because we have ignored the No. 1 recommendation of the 9/11 Commission, which is the money ought to go where the risk is. We ignored it. We ignored it. We played the political game that makes us all happy, but we didn't fix the problem. If we have another event where we should have put the money, then how will we answer that? How will we answer that?

They didn't say some of the money should go to the highest risk. They said all the money should go to the highest risk. What we have are three grant programs, one of which is very good at risk and two of which are not. So we ought to ask ourselves: Have we done the best we could have done?

The effort by Senator Lieberman and Senator Collins was extraordinary. We had great debate in our committee on a lot of these issues. By the way, they supported me in these things. We didn't get them out of conference. The question we are going to be judged on is how effective we did this. My hope was and my feeling is we could have done better.

Mr. President, I ask unanimous consent to set aside the pending amendment and call up amendment No. 2369 and ask for its immediate consideration.

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

Mr. President, I wish to thank Senator Kennedy and Senator Enzi for allowing me to offer this amendment. Everything I try to do is toward transparency in our Federal Government, because what you cannot measure, you cannot manage.

This is a very simple amendment. What we know is that in the last 7 years, the cost of a 4-year college education has doubled. It has gone from $2,700 to $5,800 at State universities. It has gone from about $10,500 to $23,000 at private universities. The costs have doubled. It is the only thing in this country that is rising twice as fast as the cost of health care. We ought to ask ourselves why.

This amendment is very clear. What it says is if you are a university and you are lobbying Congress, you have to certify to Congress that you are not spending tuition money or other Federal money that you have gotten for a project for your students or for your university in terms of lobbying to get more money.

This, by the way, was excluded from the lobbying and ethics bill we considered. I have some experience on it because last year, as chairman of the Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security of the Committee on Homeland Security and Governmental Affairs, I queried 500 colleges and universities in this country, asking them about their earmarks. I asked them how they spent the money. The interesting thing is only 50 percent of them replied, and of the 50 percent that replied, only half of them actually knew where the money went. The other half didn't dare reply, either because they didn't know where the money went or the money didn't go for the purpose it was earmarked. So we have a grave problem in terms of earmarks.

Let me give my colleagues some statistics about what has happened. First of all, in 2005, $127 million were spent by universities to lobby our institution to get earmarks--$127 million. Divide that and see how many kids we could educate in this country with that amount of money that was spent on lobbying.

What we do know is between 1996 and 2005, the number of earmarks at the Department of Education increased by 29,375 percent. I wonder if that has anything to do with this marked increase of 14.5 percent per year in the cost of a college education.

Those earmarks--the overall cost of the earmarks came to a half a billion dollars a year last year--a half a billion dollars in earmarks. What we also saw--that was in the Department of Education. Then, separate earmarks for separate universities and colleges in the same time period increased from 369 to 1,964, up to $2 billion a year. Now, you would think that for $2.5 billion a year, we ought to be able to see where the money is spent. We ought to have transparency to see.

There are several problems with our earmarking, and the biggest problem is we choose to pick winners and losers. When we do that on research and development at our universities, which are the ones we want to do it to, when we do it, we say that the peer review scientific community shouldn't have any input. That is what we are saying. Consequently, when we spend $2.6 billion on earmarking specific projects at universities, what we are doing is getting a whole lot less value for our money. What we do know is if we let the scientists, through peer-reviewed guidance of scientific discovery, tell us where to go next, we will get two to three to four times return on our research than when I, as a Senator from Oklahoma, decide to earmark a specific research project at a university in the State of Oklahoma.

Now, the question we should be asking--similar to the amendment of the Senator from Illinois--where is the money going to come from? The true deficit last year was $434 billion. That is not what we told the American people, but that is how much our debt increased, so that is what the actual increase in expenditures over the increase in revenues was. If I was a prosecutor, I would love Senator Durbin's amendment, if I owed the money.

But the principle we should be thinking about is this: Why are we having trouble getting the best into the offices of the public defenders and the prosecutors? Because we don't pay enough. What Senator Durbin is attempting to do is a State function. It is an indirect payment. We are going to pay off loans, we are going to have loan forgiveness for this group of people when, in fact, the way we should be enhancing that is having States choose to increase reimbursement for people who fulfill that very worthy task.

So what we are actually doing is jumping all over States' rights, because States haven't increased those fees, as they should, because they don't evidently value it the way the 38 cosponsors of the Durbin amendment do, and we are saying: Time out. It is not your responsibility; we are going to do it. It is the same type of thing we have in terms of earmarks.

This amendment is very simple. Certify to Congress, if you are getting Federal funds and you want more Federal funds in terms of earmarks or grants, that you are not going to spend that money or your students' tuition to come up here to get more money. What you ought to do is use your endowment.

There are some very interesting statistics on endowment that I would like to alert my colleagues to so everybody can be aware. I commend to my colleagues a 2006 National Association of College and University Business Officers Endowment Study.

The top 25 universities in this country have $178 billion in endowments. Now, if they earn 6 percent on that, that is $9 billion a year that they have funds available to them to do research with, or whatever else they want to do. If you take the entire group of endowments, which is some 20 pages long, what you find is a massive amount of money that is endowed.

Why do people give to universities? They give to universities to secure their future because they felt rewarded by the gift they gave them of education. Yet we have almost $1 trillion in endowments in this country in universities, and we are saying we need earmarks. We need extra moneys. Fine. If we do need extra moneys for research, let's let the peer-reviewed scientific community tell us where to go. Let's put the research at the place that it is going to get us the best return, rather than one that has the greatest

political pull. That makes absolute sense to anybody outside of Washington.

Now, it doesn't make sense if you are trying to get something for your university, and University X obviously has the expertise, but you want it at your university. So what do we do? We end up paying double. We are going to fund one that is not as efficient, not as capable, and not as successful at the expense of the university that is far more capable of doing that.

A lot of the university earmarks came about because it was stated they couldn't compete on the grant process; that the major universities--those top 25 research universities in the United States-- could outcompete them all on grants. So we did some things when we doubled NIH funding. We did allow for things. What has happened is a pox on our house. We have gone to this large number of earmarks, 2,000 earmarks a year for universities, and we are not getting our money's worth for them.

I come back to one of the reasons I would like for us to consider this amendment: How do you tell a student who is working a second job, who can't afford a tutor, he has borrowed student loans up to his gills and is trying to make it, that a percentage of his university's budget out of his tuition is coming up here to get another earmark that is not necessarily going to be efficient or not going to enhance or advance his education or her education?

So it is real simple. Transparency creates accountability.

I ask unanimous consent to have printed in the Record four case studies--one from the University of Alaska, one from the University of North Carolina, Chapel Hill, one from the University of Georgia, and one from Iowa State University--on what they have done with earmarks and how they have spent them. It is remarkable.

With that, I will cease discussing this other than to say we ought to figure out why a college education and the costs thereof are growing twice as fast as health care, which is four times as fast as everything else in this country. Something isn't right. Transparency is the key to getting accountability for that problem. To vote against this amendment would be saying you don't want the universities to be transparent, to be accountable. I believe they should be accountable and certify to us that not one penny of tuition, one penny of Federal money is spent back here. Mr. President, $127 million was spent last year to lobby this body on university grants and earmarks. We ought to change that. That could educate a ton of our young people.

With that, I yield the floor.

Yes.

No. What I am looking at is for them to, in a positive, forward way, assert that as they take Federal funds, those funds are not used to, in fact, pay a lobbyist. When a university President calls you, he is not calling as a lobbyist. He has a right to lobby this as an individual. My amendment is fairly narrow in that those funds are not spent to lobby, i.e. lobbying payment.

No.

No, sir.

Will the Senator yield?

I am trying to get to this paradigm where we pay $200,000 a year for lobbyists, and the lobbyists work to get an earmark for the university back in that is out of the priority of the peer review, scientifically evaluated, and at the same time, some of that $200,000 somehow ends up in campaign coffers, for some reason. I cannot figure out why, but it seems to. This doesn't stop it. What this says is they are going to just certify that the money they used for that wasn't their students' tuition and other Federal dollars that were designed for another purpose and coming back against that. It doesn't mean they cannot pay a lobbyist or hire a lobbyist or that anybody in there government affairs office cannot contact us to lobby for a particular position, which is their right. This is very narrowly defined to say: Do not spend the money you get from us, or your students, to hire the lobbyists to earmark something that is outside the peer review.

It does not limit that in any way.

Will the Senator yield?

What we are trying to get is this. It is true that the Byrd amendment makes that illegal. The problem is that nobody has to certify it. So whether it is illegal or not, it is obviously happening. Yet we don't have any proactive basis going on at the universities for them to certify that they are not doing it. That is the difference between this and the Byrd amendment.

If the Senator will yield, it put forth a parliamentary idea that the Byrd rule applies on bills consistent with reconciliation, if I am correct. What this is intended to do is proactively have--this does two things: It requires the university to know what they are doing, which is one of the things we found in my subcommittee--that they didn't know what they were doing. They weren't aware of where the money was going or how they were spending the money. It makes them look at that. Two, it makes them proactively say they are within the law in terms of how they are spending the student money and the Federal money.

I appreciate the colloquy on this issue. I hope we have clarified the intent of the amendment. I am more than happy to accept a second degree that would clarify it more and that would give Senator Kennedy the safeguards he is concerned about. Nevertheless, there is a gigantic problem out there today, not the least of which is that it is hard to find in the Constitution where we should be earmarking $2.6 billion a year to private and State universities for education.

Mr. President, how much time do I have remaining?

If I can be recognized, Mr. President?

Mr. President, Senator Kennedy makes my point. In 1980, we had a program that was designed on merit, scientific, and peer- reviewed analysis. We had no earmarks then. Now we have 2,000 earmarks, and about 1 out of every 3 accomplishes something, and then not to the level of what it should because most of the money did not go to the best place to get the research done.

The Senator makes my point. We have a corrupted process in how we fund much of the money that goes to universities. Personally, the Senator from Massachusetts recognizes, I believe, that is not necessarily a legitimate role for the Federal Government, but it is one that is there. So if it is there, it ought to be transparent. We ought to be able to hold all universities accountable, and we ought to know where the money goes, how it is spent, and what money was spent to accomplish the receipt of that money in the first place.

Those who vote against transparency like the status quo. You cannot fight against transparency. The facts are the facts. You cannot put a political spin on it. The facts will be the facts. The American people--actually, our American grandchildren, against whom we charged $434 billion this last year, ought to have the right to know where their money is being spent, and the devil is in the details on whether they are taking Federal money and using that Federal money to turn around to hire a lobbyist to get more Federal money. That is a corrupt system, and transparency will clean that up.

I ask consideration of the amendment, and I ask for the yeas and nays.

Mr. President, is there an order in which the votes are going to roll this evening? Can this be combined into those votes? I thank the Senator.

I suggest the absence of a quorum.

Madam President, I do not speak very often on the floor on issues such as that we are talking about today. We have a wonderful heritage in this country, and somehow we find ourselves in the midst of a mess. We find ourselves in a position where we have made decisions, some of them poor, some of them good, but we find ourselves--and I agree--at a crossroads.

The question in front of us is threefold: One is we have a plan which we instituted less than a month ago and that we set up early this year, which we are now wanting to change with the Reed-Levin amendment before we have data to tell us one way or another, and that is debatable. We have a large number of Americans who have given the ultimate sacrifice in the war in Iraq. But the question before us is what is the world like today? What is it that is going to change if we leave Iraq? What are the consequences?

Senator Lieberman spoke very eloquently about what the plans of al- Qaida are and what they have told us, but what happens to the Middle East when we leave?

I am reminded of the history of this country that we do not walk away if we have a mess and allow millions of people to die and millions of other people to be displaced without having a strategy that will solve that situation. And I do not see that in the Reed-Levin amendment.

I know the contention is that because we are there, we incite more violence; because we are there, al-Qaida has focused there. But the very thing we attempted to do in Afghanistan, we will recreate the situation prior to our going into Afghanistan if we leave Iraq. But the more important question for me is: Do we as a nation have a moral obligation, regardless of the past?

The fact is we are in Iraq today and some situations are improving and some are not improving nearly as fast as any and all of us want. But is there a moral obligation for this country not

to allow this to lead to 2 to 3 million deaths, not to allow for sure the 450,000 people who have been successful helping us who will come under the threat of death, not to allow the displacement of another 2 to 5 million Iraqis out of Iraq? Do we have a moral obligation not to allow Iran to be in control and use Iraq as a basis for their dominance of the Persian Empire again in the Middle East? Is there any obligation for us in that regard? I think there is.

I look at the situation in Iraq as a cancer, as a physician and also as a cancer survivor. There is lots wrong in Iraq right now. We are at the point where we have to make very hard choices about whether the patient can be saved. My concern is that because the treatment is tough, because the risk of the treatment is high, we are to the point where we are going to let the patient die. The fact is the patient does not have to die.

I do not dispute my colleagues who have a different opinion on where we should go in Iraq. What I do dispute is whether we recognize fully the obligations we have for the future.

What is going to happen as we withdraw? Can anybody in this body guarantee to me 2 or 3 or 4 years later down the road that we are not going to put a whole lot of American lives at risk because of the decision we made to turn off the chemotherapy, to turn off the radiation for the patient? What we are saying is, we are going to ration this; we started down the road, but we are not going to finish it.

There has not ever been a time in my life, being alive during the Korean war, the Vietnam war, and this war, that I have not seen controversy about any war we have been in. Anybody who has been around those three wars knows that is the truth. The question for me is what is the best long-term--long-term, not short-term--policy for our country in terms of stabilizing the Middle East? What is the moral obligation for us as a nation? Having invaded Iraq and set in motion many of these situations, how do we measure it and how do we live up to the heritage we have as a country that stands to fulfill moral obligations?

I have to answer a couple of statements that were made earlier. Any innuendo that members of the Republican conference are having their arms twisted to support the President in this war is a bold face misrepresentation of the facts. On issues such as this, all my colleagues know nobody is twisting their arm to be against it and no one is twisting my arm to support the policy. As a matter of fact, the statement by the Senator from Ohio that Vice President Cheney comes in every week and gives us a pep talk on the issue--I have been attending the conference for 2\1/2\ years, and I heard him speak once in 2\1/2\ years on Iraq. So the politics of negative comments taken out of context should be labeled what they are.

The other fact I know, the Senator from New Jersey talked about maybe more of the Members of the Senate should have our children in Iraq. I know the Presiding Officer had a son recently return, but I know there are people in this body who have children in Iraq--one of Senator McCain's sons is due to ship out this month--who have an opinion, a different opinion than what the Reed-Levin amendment would consider.

So I think it is highly unfair to speculate as to what I think is divided with those who have had children with this experience.

There are some facts I do know about our country. I do know the war is tearing at the fabric of our Nation. I do know that we as a nation are war weary. I think we ought to talk about what is great about our country, what is good about the military.

My impression from being in Iraq and here is I do not know of finer individuals in our country than those who are serving in the military. I can also tell you I do not know of more informed citizens of all the issues that face our country than the military.

We have made a lot of mistakes in the policy in the Middle East, there is no question. I think we can agree with that point, and I think we can all admit to it. But it does not change where we are and what the consequences are if we leave.

I served as a medical missionary in Iraq after the first gulf war. I developed friendships with Kurds and Shia and Sunni. We talk in the abstract over here about the Iraqi people and their leadership. But I wish to tell my colleagues, I didn't see a whole lot of difference in what those people wanted and what we want for our families. For us to speak in a sterile way that there will be no impact whatsoever on all those Iraqis, no matter what their faith or their heritage, belies the fact that millions will die. That is not my estimate, that is the estimate of many very learned scholars on the Middle East.

We heard this week a mention from the Secretary General of the United Nations advising against a precipitous withdrawal from Iraq in terms of how that would play out in the Middle East.

I think of the children that I did skin grafts on in Iraq who are now in their middle twenties, and the hope that they have for a safe and secure freedom, to actually have a Government that is a function of the beliefs of the multitudes who live in Iraq. Despite all our mistakes, should their hopes be dashed?

We look at the sacrifices, we look at the moneys we have spent, but we never look at it in terms of the lives of the Iraqis. The contention is we cause more violence because we are there than what will happen when we withdraw. If I could know for sure that what the experts tell us is wrong and millions of Iraqis will not die, I could probably be in agreement with some of the positions of those who want to change our course right now. But I don't know that and, as a matter of fact, the experts say the exact opposite will happen and millions will die. So we do have a moral obligation.

The other question we ought to bring forward is the contention we want to change the rules of the Senate on a vote tonight when everybody knows that a cloture vote and a requirement of 60 votes on major issues has been the rule of the Senate for years. It is a precedent longstanding that we have found on both sides of the aisle, no matter who is in charge, works well on contentious issues.

The vast majority of Republicans are ready to vote on cloture tonight. We didn't have that opportunity. We are going to vote on cloture tomorrow morning at 11. But we also know that if cloture fails, we probably will not be on the Defense bill.

The question I have for my colleagues is, they control the Armed Services Committee. They wrote the Defense authorization bill. Why in the world, when our troops need guidance, when we need new reauthorizations, when we need items for the military that are highly important to the success now, not just in Iraq but throughout the world, would we pull a bill and not continue to work on it?

As a matter of fact, this debate, which we had 2 months ago and now are having again, is keeping us from doing some of the business we need to be doing in terms of observing and doing oversight of the Federal Government.

This Defense authorization bill has $13 billion worth of earmarks, earmarks that the Pentagon does not want, but we want, we want for constituencies, we want for campaign supporters, we want because we know better--the very type of thing that is going to hurt in the long run the confidence of the people in this Chamber. So instead of continuing to work on the Defense authorization bill, it is going to get pulled in the morning and we are going to go to higher education reconciliation.

The question we ought to be asking and what the American people ought to ask is, because one vote fails on cloture, do we not have an obligation to go on and authorize defense expenditures? I believe we do. One vote should not make or break that bill. It was not part of the original Defense authorization bill that came out of committee. Why would we not continue to work on it and give our military the authorization to do what they need to do in the future?

Someone asked me earlier today if this was a political stunt? No, I don't think so. I think we need to have this debate. I think the more the American people learn about what the consequences are when we leave Iraq, the more likely they are to have a second thought about the pressure and tension they feel on this terrible situation. And as they learn what the consequences will be and also see a perspective about

at least giving General Petraeus until September 15, as they hear that debate, I think minds will be changed or at least attention will be turned to it.

A couple of things that I think also ought to be asked on the Reed- Levin amendment are, How does the Reed-Levin amendment address Iranian influence in Iraq in the future? How does the Reed-Levin amendment address increasing Iranian influence in the region, including Iran's adverse influence on the Arab-Israeli peace process? How does the Reed- Levin amendment guard against a regional conflict? If the policy of the Reed-Levin amendment became law, would the United States stay out of the humanitarian catastrophe and ethnic cleansing that will surely follow with a precipitous withdrawal of U.S. forces? If the policy of the Reed-Levin amendment became law, would the United States offer financial assistance to neighboring countries forced to absorb the massive number of refugees fleeing such a conflict? If the policy of the Reed-Levin amendment became law, what would the cost be to the U.S. Treasury in lives if the United States eventually had to return to the Middle East, in terms of forces?

I don't think those questions can go unanswered in this debate, and yet they have not been addressed. What we do know is we have a tinderbox. What we don't know, but some are suggesting, is the tinderbox will quiet down if we leave. If we leave, I hope they are right. I don't think they are right.

I think this is a time that will really test the mettle of this country. I think the conflict we see over the debate in this body is not bad for our country; I think it is good for our country. It is one of the attributes that make us strong.

Leaving Iraq, losing in Iraq will be terrible for our country in the long run--not in the short run but in the long run. It will limit our influence in the Middle East. It will limit the trust and viability of our Nation with every other nation under which we have any type of security arrangement. But most importantly, it will put us back 10 to 15 years in terms of doing what we need to do in the world.

Senator Durbin and I are working hard on the Darfur situation. Darfur is going to seem like a blip on a screen compared to what is going to happen in Iraq when we leave.

What we do know is what is happening in Iraq today, the concentration of the violence, especially the suicide bombers. Two things are happening. One is they are moving away from the areas in which the surge is employed. That is why you see Kirkuk the first time hit. But we also know that 85 percent of the suicide bombers aren't Iraqis; they are al-Qaida, from outside of Iraq. I suspect they are going to overplay their hand like they did in Anbar Province, which is why those Sunnis now are allied with coalition forces.

So I would ask the Members of this body, No. 1, to not assume that any of us who support the present course until September in Iraq have had our arms twisted. We have not. We actually believe it is the best policy. I don't believe we need to have our moral compass checked, as suggested by the Senator from New Jersey. We just happen to have a difference of opinion. And the difference really doesn't stem on any factual basis, but it stems on long-range versus short-range thinking.

When I took the oath for this office, my oath was to uphold the Constitution and to do what was best for the country--not for my political career, not what will win the next election, not what will get me more seats in the Senate, but what I truly thought in my heart and mind would be great and best for this country.

The Iraq war is a perplexing situation for all of us. I believe it is wrong for us to stop in the middle of a surge that is having some progress. Not what we would like, maybe, not to the degree we would like, but for the first time, in approximately 2 years, it is making positive things out of things that were very negative.

It is my hope that as we continue this debate, we will recognize that the most important question is, Then what? What happens if the Reed- Levin amendment becomes law? What happens to our military? What happens in the Middle East? What happens in Iran, which is now known to be training a vast number of people to influence the outcome? What happens to the morale of our military? What happens to our relationship with allies around the world when we can no longer be counted on as a reliable partner? What next?

That is the question we should be debating--what next? What are the consequences of not fulfilling a moral obligation to clean up a mess we helped create? You can say we don't have that obligation, but we do. History will judge this Nation on how it handles this situation. We may, in fact, walk away, but if we did, and if we do, I believe we belie the heritage of the sacrifice that has been made by so many people for so many years in our history that predates us.

Madam President, I yield the floor.

Madam President, I ask unanimous consent that Major Thomas Rogers, a Department of Defense fellow in Senator Pete Domenici's office, be granted the privilege of the floor for the duration of the debate on the fiscal year 2008 Defense authorization bill.

Reserving the right to object.

I object.

Mr. President, I say to the majority leader, I do not mean to delay this bill. I am on that subcommittee. I worked hard on this bill. I agree with the majority leader that many of those recommendations need to go forward.

This bill spends $12 billion over the next 3 years. We have worked tirelessly and worked hard. Mr. President, $9 billion of that $12 billion is grants. It is certainly not in the best interest of those most at risk, but I lost that fight. So I am willing to let that go. But the postgrant review process, which we asked for and were told would be in the bill before we went to conference, is not in it. Every time we ask about it, we get pushed back.

Until we look at how we are going to spend the money, until we can satisfy that, I don't believe we are ready to go to conference, and I also believe there are still some problems with ports in terms of solving those problems and some of the tier 1 issues we have.

My objection is not meant to be dilatory or anything else, other than to make the point that if we are going to spend $9 billion in grants to carry these recommendations out--and that is a small portion of the recommendations of the 9/11 Commission, but it is the $9 billion--and we refuse to have a postgrant auditing process where we look to see-- because we know from what IGs have told us and the GAO, much of the money we have been spending post-9/11 has been wasted, and it hasn't gone to prevent the next terrorist act.

I have a personal interest as well. I have a daughter who lives in New York City. I want her protected. I don't want to do something that might stop that, but we have to do it in a way that makes us good stewards of the taxpayers' money.

That is my reason for objecting. It is not on behalf of the Republican leadership. It is on behalf of myself and my staff in trying to get good value for our money.

My staff has relayed to me, the Federal Financial Management Subcommittee minority staff, who have been working on this issue since we passed the bill, relayed to me before I came over that they still will not grant us that access in the bill.

Mr. President, if I might be recognized, I say to my colleague for New York, I have been working on this for 6 months. This isn't new. They knew this was coming. These are commitments that were made that were not kept. This is not a reflection on Senator Lieberman. This is a staff-driven problem. The only leverage I have to get staff to do what they are supposed to be doing is this.

I apologize to the Senator and to his constituents. If my colleagues fix it over the break, when we come back, I would not have any objection.

Yes, I yield.

That is the only objection I have.

Mr. President, I have no knowledge, I say to the majority leader, that has been worked out. The last memo I have from my staff director is that it has not. If that is the case, again, I will live up to my word that I promised the majority leader and senior Senator from New York that you would not have an objection from me--

If that is the case, then I don't have a basis for objection.