Max Baucus

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I ask unanimous consent that the Ad Hoc Subcommittee on Disaster Recovery of the Committee on Homeland Security and Governmental Affairs be authorized to meet during the session of the Senate on Tuesday, September 23, 2008, at 10 a.m. to conduct a hearing entitled ``After Action: A Review of the Combined Federal, State, and Local Activities to Respond and Recover from Hurricanes Gustav and Ike.''

Mr. BAUCUS. Mr. President, I ask unanimous consent that the Select Committee on Intelligence be authorized to meet during the session of the Senate on Tuesday, September 23, 2008, at 2:30 p.m. to hold an open hearing.

Mr. BAUCUS. Mr. President, I ask unanimous consent that the Committee on Homeland Security and Governmental Affairs' Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security be authorized to meet during the session of the Senate on Tuesday, September 23, 2008, at 10:30 a.m. to conduct a hearing entitled ``A Reducing the Undercount in the 2010 Census.''

Mr. BAUCUS. Mr. President, I ask unanimous consent that the Committee on Homeland Security and Governmental Affairs' Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia be authorized to meet during the session of the Senate on Tuesday, September 23, 2008, at 2:30 p.m. to conduct a hearing entitled ``A Reliance on Smart Power--Reforming the Public Diplomacy Bureaucracy.''

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I think someone is getting the colloquy together. We don't have it at the moment. However, I think we can basically have an impromptu colloquy right here to handle most of it, and if we want to do more later, we can do so. Essentially, the Senator from Texas very correctly and appropriately called me and said we need to do more for Texas, including Galveston, and some other coastal counties. I said to the Senator, if the disaster provisions in the tax bill, which were somewhat patterned--basically patterned--after the Katrina provisions, many of those would apply to Texas. With the consequences of Ike and Gustav, we went back and looked so we could do more. The slight problem we faced is it takes some time to pinpoint and to write precise tax provisions that affect the areas that are hit by disaster. We don't want to give relief to counties or portions of counties where there is no disaster. That would not be the correct thing to do. In fact, we ran into that problem back during the time of Katrina when the initial request, which was, on the surface, appropriate, but when we looked more closely, there were too many dollars spent inappropriately and not enough spent appropriately. It takes a little time to work that out. After about 2 months, we talked to mayors, local people, and disaster people to make sure we tailored it well. We ended up with a result that was quite good and appropriate. It wasn't as large as the initial estimate, but the initial estimate was way overblown. It was not well tailored. I mentioned this to the Senator from Texas, and she said she understood. On the other hand, she said, ``We need help here.'' I appreciated that and said: You bet. I tried to find some ways to provide additional disaster assistance in the bill that I hope we take up on Tuesday. Essentially, what we worked out is an increase in the allocation of low-income housing tax credits, as well as an increase in the allocation of private activity bonds. The total amount is geared for those counties on the coast. I think there are four or five coastal counties which were hit the most. But to make sure we are not too locked in, we also give the Governor the right to reallocate the benefit of these provisions to other areas in Texas but under the total amount. The thought is that we are helping, that way, tailor the assistance most appropriately and specifically. I say to my friend from Texas, it was good to work with her to find the combination, as I said to the junior Senator from Texas, and there would be an opportunity to come back later for more if that is appropriate.

Mr. BAUCUS. Mr. President, if the Senator would briefly pause, I wish to thank the Senator from Texas. The Senator has been great to work with as we worked out some provisions to help that State, especially the Galveston area, and the coastal States in getting additional disaster assistance. I thank the Senator as well as his colleague from Texas. We will come back to do more at a later date, but we are doing what we can on this bill, and I say thanks to my colleague for working so well with us.

Mr. BAUCUS. The Senator is correct. That is my understanding, and that is what we intend to provide.

Mr. BAUCUS. The Senator is correct. Allocations for both, that is correct.

Mr. BAUCUS. Mr. President, I might say to the Senator from Texas that I had a nice conversation with the mayor this afternoon, too. He was helpful in explaining what needed to be done. He appreciated the efforts both Senators from Texas have undertaken. I think he would like more, but he understands where we are.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I ask unanimous consent that the following Finance Committee staff be granted the privilege of the floor during consideration of the tax bill: Mary Baker, Matthew Berkeley, Matt Kazan, Bridget Mallon, Katheena Mussa, Ford Porter, Sean Thomas, and Caroline Phil.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, as the old saying goes: If it were not for the last minute, a lot of things would not get done. Well, God willing, we are nearing the last minutes of this Congress and, God willing, we are close to getting a lot of things done. For the better part of this Congress, we have been working on passing three major tax bills. One has been to put America on sounder energy policy. The second has been to prevent the AMT from raising taxes for millions of American families. The third has been to extend a series of tax incentives that are vital to American jobs and families. Frankly, on these matters, what unites us is far greater than what divides us. And now, at the last minute, it is time to get these bills done. With this in mind, I have worked with my good friend Chuck Grassley, the ranking Republican member of the Finance Committee. Together, we have worked with the majority leader and with the Republican leader. We have worked with Senator Durbin and with Senator Kyl. All of us have come together on a way to get these major tax bills done. What has divided us on tax measures has been mostly whether to pay for them. Democrats have said we should. Republicans have said we should not. So we and the leaders have come up with an honorable compromise. We propose that we pay for the energy tax bill, that we not pay for the AMT bill, and that we pay for roughly half of the tax extenders bill. With this structure, we believe we can pass these bills, we can get a lot of things done, and we can help to bring on the last minutes of this Congress. Passing these bills would get a lot of things done. The Energy bill would help to create well-paid jobs in the growing field of new energy technologies. It would help to secure America's independence from high- priced foreign oil. It would help us to move closer to addressing global warming. The AMT patch would keep some 21.5 million taxpayers from being hit by a tax increase. We must not let more families fall into the AMT. The tax extenders package would help provide relief in a time of economic uncertainty. The economy clearly is struggling and so are America's working families. Markets are experiencing volatility. In times such as these, Americans need tax cuts they have come to count on to help them get by. The tax extenders package includes the research and development tax credit to spur new, high-paying jobs. It includes a teacher expense deduction to help teachers who put out money from their own pockets to buy school supplies. It includes a tuition deduction to give families needed relief from rising college costs. As well, this package includes the mental health parity bill. The bill has been a long time in coming. We must pass this bill for many reasons. It would ensure that families facing mental health challenges would receive fair treatment--treatment the same as those facing other health challenges. This legislation is a tribute to the hard work of Senators Paul Wellstone, Ted Kennedy, and Pete Domenici. This package also includes disaster relief. It would aid the victims of the Midwest floods. It would help the victims of all recent federally declared disasters. It includes relief for the victims of Hurricane Ike and Gustav. This is a good package. It would make real progress on energy policy. It would extend needed tax relief in hard times. It would give us a chance to show American families that Congress can work for them. So let's hasten the last minutes of this Congress. With that, let's finally get a lot of things done. Let's do the work of governing that the American people sent us here to do. I yield the floor.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I am very grateful to Senators for working to put this together for several reasons: One, this is going to help to create jobs in America. It is going to very much help American families. Third, it is going to help us move more quickly toward energy independence, something we all need. On a procedural basis, I very much appreciate that this was worked out on a bipartisan basis. I worked with my good friend from Iowa, Senator Grassley, also with the staffs of the majority leader and minority leader, and other key Senators who worked together to put this together. I am very grateful, frankly, that we see a glide path now. We are going to get this legislation enacted, hopefully, on Tuesday. Again, my thanks to everyone involved. I yield the floor, and I suggest the absence of a quorum. The PRESIDING OFFICER (Mr. Sanders.) The clerk will call the roll.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, today, I join with my colleague Chuck Grassley, the Finance Committee's ranking Republican member, to introduce the Energy Independence and Innovation Act of 2008. This bill will create jobs. It will help consumers with high energy costs. It will contribute to energy security. It will help secure America's place as a world leader in clean energy technology. It will help to prepare this country to address global warming. For more than a year, we have been trying to pass meaningful energy tax legislation. In June of last year, the Finance Committee passed a roughly $30 billion energy-tax package. It received a resounding bipartisan committee vote. The bill proposed the largest-ever series of clean energy tax incentives. It was largely offset with reductions in tax breaks for oil and gas companies. That package's clean energy incentives included a long-term extension of tax credits for wind and solar power, long-term extensions of credits for building efficiency, and extensions and modifications of credits for clean coal technology. The June 2007 bill also included innovative new items. It included a credit for consumers for plug-in hybrids. It included a new credit to promote capture and storage of carbon dioxide. And it included incentives to transform our electricity grid, so that far-flung sources of renewable power--like wind and solar--can be brought to market. But many on the other side objected to the bill, because it included reductions in oil and gas tax breaks. We needed 60 votes to pass the Senate. But our bill got 57, and died on the floor. We tried again in December of last year. We scaled back our oil and gas offsets. And we wrote a smaller, roughly $20 billion package of clean-energy incentives. But Senators--again, generally from the other side of the aisle-- continued to object to provisions cutting tax breaks for oil and gas companies. That bill failed as well, by just one vote. In response to those concerns, this year, I wrote an energy tax package without oil and gas offsets. That bill, S. 3335, was paid for by closing tax loopholes and by delaying a tax benefit for multinational corporations that has yet to take effect. That bill included about $18 billion in energy-tax provisions, including scaled-down versions of the original Finance Committee bill. This ``extenders'' bill also included billions in non-energy extenders. These tax incentives are vital to supporting a range of activities, from research and development to higher education. Unfortunately, S. 3335 has been objected to, as well. It has not cleared the Senate. But now energy prices are sky-high. And we have learned that many Senators from the other side of the aisle have come to agree that it makes sense to scale back oil and gas tax breaks. Accordingly, Senator Grassley and I have worked together to rewrite our original Finance Committee product. And that is largely what is represented in the bill that we are introducing today. Our bill invests about $26 billion in renewable energy. It pays for it largely by repealing tax breaks for oil and gas firms. These are largely the same tax offsets that we included in our original bill. For example, the bill would deny a tax benefit that was enacted in 2004, when oil traded at about $50 per barrel. Oil trades at more than $100 per barrel now. Recently it reached nearly $150 per barrel. I am pleased that my colleagues have come to agree that with energy prices this high, these oil and gas tax incentives are not needed. What do we get for repealing those oil and gas tax breaks? We get long-term extensions of vital clean energy incentives, like the credit for wind and solar electricity. With passage of tax credits for wind power in 2005 and 2006, the American wind energy industry has installed capacity in the last 2 years that equals the capacity it installed in the last 2\1/2\ decades. The solar industry is also booming. It accounts for a growing number of high-paying jobs in America's clean tech sector. This bill includes an 8-year extension of the credit for solar power. And that extension will fuel this already impressive job growth. Let's consider what happens if we do not extend these credits. According to a February 2008 study, failure to extend the wind and solar credits would result in the loss of 114,000 jobs. Renewable energy is simply not yet cost-competitive with fossil-based power. It needs the incentives in this bill. Absent broader mandates on renewable power, we need to continue tax support for renewable electricity production. With those tax incentives, the private sector will continue to invest in this worthy cause. This bill also contains many other important provisions. It contains extensions of efficiency incentives for buildings, which account for about 40 percent of American energy use. It contains the new plug-in hybrid credit for consumers, at a higher level than last year's bill-- up to $7,500. As did last year's package, the bill we introduce today includes a provision to promote what folks call ``smart meters,'' which provide real-time feedback on electricity usage. These smart meters have been shown to cut consumer energy costs and carbon emissions, as well. Finally, the bill includes a new production credit for carbon dioxide, providing an incentive for capturing and storing harmful carbon dioxide. This provision was also part of last year's Finance Committee bill. I am pleased that it is part of this bill as well. This bill does not do everything that I want. If I had my druthers, we would extend and possibly modify--many of these credits for a longer period. And the bill includes some items that I am not overly thrilled about. But those compromises are part of the legislative process. That process will continue after today's introduction. Meanwhile, I am again pleased that consensus may well be building to redirect tax incentives and invest in the clean technology this country desperately needs. For the sake of American jobs, for the sake of our Nation's security, and for the sake of our planet's environment, I urge my colleagues to support this bill. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, today, I join with my colleague Chuck Grassley, the Finance Committee's ranking Republican member, to introduce the Energy Independence and Innovation Act of 2008. This bill will create jobs. It will help consumers with high energy costs. It will contribute to energy security. It will help secure America's place as a world leader in clean energy technology. It will help to prepare this country to address global warming. For more than a year, we have been trying to pass meaningful energy tax legislation. In June of last year, the Finance Committee passed a roughly $30 billion energy-tax package. It received a resounding bipartisan committee vote. The bill proposed the largest-ever series of clean energy tax incentives. It was largely offset with reductions in tax breaks for oil and gas companies. That package's clean energy incentives included a long-term extension of tax credits for wind and solar power, long-term extensions of credits for building efficiency, and extensions and modifications of credits for clean coal technology. The June 2007 bill also included innovative new items. It included a credit for consumers for plug-in hybrids. It included a new credit to promote capture and storage of carbon dioxide. And it included incentives to transform our electricity grid, so that far-flung sources of renewable power--like wind and solar--can be brought to market. But many on the other side objected to the bill, because it included reductions in oil and gas tax breaks. We needed 60 votes to pass the Senate. But our bill got 57, and died on the floor. We tried again in December of last year. We scaled back our oil and gas offsets. And we wrote a smaller, roughly $20 billion package of clean-energy incentives. But Senators--again, generally from the other side of the aisle-- continued to object to provisions cutting tax breaks for oil and gas companies. That bill failed as well, by just one vote. In response to those concerns, this year, I wrote an energy tax package without oil and gas offsets. That bill, S. 3335, was paid for by closing tax loopholes and by delaying a tax benefit for multinational corporations that has yet to take effect. That bill included about $18 billion in energy-tax provisions, including scaled-down versions of the original Finance Committee bill. This ``extenders'' bill also included billions in non-energy extenders. These tax incentives are vital to supporting a range of activities, from research and development to higher education. Unfortunately, S. 3335 has been objected to, as well. It has not cleared the Senate. But now energy prices are sky-high. And we have learned that many Senators from the other side of the aisle have come to agree that it makes sense to scale back oil and gas tax breaks. Accordingly, Senator Grassley and I have worked together to rewrite our original Finance Committee product. And that is largely what is represented in the bill that we are introducing today. Our bill invests about $26 billion in renewable energy. It pays for it largely by repealing tax breaks for oil and gas firms. These are largely the same tax offsets that we included in our original bill. For example, the bill would deny a tax benefit that was enacted in 2004, when oil traded at about $50 per barrel. Oil trades at more than $100 per barrel now. Recently it reached nearly $150 per barrel. I am pleased that my colleagues have come to agree that with energy prices this high, these oil and gas tax incentives are not needed. What do we get for repealing those oil and gas tax breaks? We get long-term extensions of vital clean energy incentives, like the credit for wind and solar electricity. With passage of tax credits for wind power in 2005 and 2006, the American wind energy industry has installed capacity in the last 2 years that equals the capacity it installed in the last 2\1/2\ decades. The solar industry is also booming. It accounts for a growing number of high-paying jobs in America's clean tech sector. This bill includes an 8-year extension of the credit for solar power. And that extension will fuel this already impressive job growth. Let's consider what happens if we do not extend these credits. According to a February 2008 study, failure to extend the wind and solar credits would result in the loss of 114,000 jobs. Renewable energy is simply not yet cost-competitive with fossil-based power. It needs the incentives in this bill. Absent broader mandates on renewable power, we need to continue tax support for renewable electricity production. With those tax incentives, the private sector will continue to invest in this worthy cause. This bill also contains many other important provisions. It contains extensions of efficiency incentives for buildings, which account for about 40 percent of American energy use. It contains the new plug-in hybrid credit for consumers, at a higher level than last year's bill-- up to $7,500. As did last year's package, the bill we introduce today includes a provision to promote what folks call ``smart meters,'' which provide real-time feedback on electricity usage. These smart meters have been shown to cut consumer energy costs and carbon emissions, as well. Finally, the bill includes a new production credit for carbon dioxide, providing an incentive for capturing and storing harmful carbon dioxide. This provision was also part of last year's Finance Committee bill. I am pleased that it is part of this bill as well. This bill does not do everything that I want. If I had my druthers, we would extend and possibly modify--many of these credits for a longer period. And the bill includes some items that I am not overly thrilled about. But those compromises are part of the legislative process. That process will continue after today's introduction. Meanwhile, I am again pleased that consensus may well be building to redirect tax incentives and invest in the clean technology this country desperately needs. For the sake of American jobs, for the sake of our Nation's security, and for the sake of our planet's environment, I urge my colleagues to support this bill. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, how much time is available?

Mr. BAUCUS. On this side?

Mr. BAUCUS. Mr. President, I rise to discuss legislation vital to this Nation's transportation infrastructure. The highway trust fund, the means by which we fund our Nation's roads, highways, and bridges, is in trouble. Tomorrow, the U.S. Department of Transportation will slow down payments to States for infrastructure investments. That is highway projects. This is happening because forecasts now suggest that a shortfall of billions of dollars to the highway trust fund will occur in the near future. The shortfall stems from the agreement of the 2005 highway bill negotiations, when the Bush administration and the Republican-led Congress agreed to spend down the balance of the fund. Last year, we learned the trust fund would run out of money faster than anticipated. Accordingly, the Finance Committee reported out a bill at that time to address the problem. We tried to move a $5 billion highway fix earlier this year as part of a larger FAA reauthorization bill, and that proposal was blocked. So we had to find other ways to pass this critical highway fix. In the meantime, the highway trust fund problem worsened. As gas prices rose dramatically, fuel tax receipts, which finance the lion's share of the highway trust fund, dropped sharply. In short, as Americans drive less and purchase less fuel, the trust fund shortfall has worsened, even more so than we previously expected. So we tried to pass the highway trust fund as a stand-alone bill. Recognizing the dramatically worsening state of the fund, we proposed an $8 billion fix--not $5 billion but up to $8 billion. In fact, the $8 billion fix matched the amount that was taken from the highway trust fund when its balance was deemed to be too large back in 1998. We worked with the House in developing that measure, and the House sent it over to the Senate with a resounding vote of 387 to 87. We attempted to clear that bill through the Senate by unanimous consent on June 26, but the bill was blocked again. Then before Congress recessed in August, I again attempted to move this $8 billion highway trust fund fix as part of the Jobs, Energy, Families, and Disaster Relief Act. But that measure also failed to pass. Ensuring the highway trust fund remains solvent means my State of Montana will not have to suffer more than $98 million in funding cuts, as well as approximately 3,500 job losses in the next year. Nationwide, the industry experts tell us the funding cuts to States would be at least $14 billion, with job losses approaching 400,000 if we fail to address this trust fund need. This will occur at a time when nationwide unemployment is at its highest level in 5 years. In transferring $8 billion from the general fund into the highway trust fund, we will ensure delivery of the full $41.2 billion in guaranteed highway funding for fiscal year 2009. It is important to remember the States have been relying on the 2005 agreement between the Bush administration and Congress when developing State budgets over the last several years. They relied on us. Fixing the highway trust fund will preserve Federal funding for roads, highways, and bridges, and it will preserve good-paying jobs that rely on construction and maintenance projects. An important point here, too, is no offset is required to fix the highway trust fund and that is because the $8 billion transferred is intergovernmental. The Congressional Budget Office indicates this fix does not constitute a spending outlay and, thus, would not violate the pay-go rules. Likewise, the Joint Committee on Taxation confirms this transfer will have no revenue effect. I am pleased the Bush administration has finally come to its senses and realized the need to address this problem. I am pleased my colleagues in the Senate across the aisle have removed their objections, and I am pleased we are now finally going to do what needed to be done for over a year. I wish to note that the chairman of the Subcommittee on Transportation, the senior Senator from Washington, has joined me in doing everything she could do to get this problem fixed. She talked with me innumerable times and many Senators. She was very concerned about this situation and worked so hard. She deserves the lion's share of the credit for all the work she has done. I congratulate her for her staying efforts in that regard. We should not delay any further. We should remember the old adage: There are no Democratic roads, there are no Republican roads, only American roads. We need to fix this trust fund now. Our States and constituents are relying on it. Mr. President, I yield back the remainder of our time.

Mr. BAUCUS

Mr. BAUCUS. Madam President, I move to lay that on the table. The motion to lay on the table was agreed to. Amendment No. 4979

Mr. BAUCUS

Mr. BAUCUS. Mr. President, in 2006, America spent more than $2 trillion on health care. By any standard, $2 trillion is an enormous figure. Health care accounts for 16 percent of our Nation's economy. That means that for every $100 in goods and services produced and consumed in America in 2006, $16 were for health care. And the health care share of the economy is expected to reach 20 percent in just 10 years. These projections are cause for concern. If so much of our Nation's resources are devoted to heath care, we need to ask ourselves what we are--or are not--getting for it. The answer is that we are getting a mixed bag of goods. Some patients receive medical treatments that work well. Some patients receive treatments that don't work well. In many cases, doctors and patients don't have enough reliable evidence to know whether treatments work or don't. Of the $2 trillion spent on health in 2006, only \1/10\ of 1 percent was spent to assess what works and what doesn't. At the Federal level, only $15 million was directly appropriated to compare the effectiveness of health interventions and services. People who purchase other goods-- anything from cars to computers--use information to compare the value of the different products before they purchase. Physicians and patients deserve better. We should devote more than \1/10\ of 1 percent of health spending to study how well health goods and services actually work. Rapid innovation has led to an ever-changing array of new and sometimes expensive technologies. The age of personalized medicine and genetic engineering will provide even more choices for patients and their physicians. Indeed, patients and physicians can face great difficulty in choosing among treatment options. But much of the information about those options is biased. Much information about those options is of poor quality. And for many treatments, there are large gaps in what is known to be most effective. With a paucity of sound evidence, clinical guidelines and treatment protocols can vary widely. If there has ever been a need for better information--on what works, for which patients, under which circumstances--it is in this age of rapid innovation of technology. Several august bodies--including the Institute of Medicine, the Medicare Payment Advisory Commission, and the Congressional Budget Office--have called on Congress to create a national entity charged with conducting research to determine what works in health care. Today, I am proud to introduce the Comparative Effectiveness Research Act of 2008. I am joined by the Chairman of the Budget Committee, Senator Conrad. He and I share a deep concern about rising health care costs. And we share a deep commitment to finding ways to address it. This bill does what the experts suggest. It would create a new entity responsible for generating better information on the effectiveness of health care treatments. Specifically, the bill would create a nonprofit corporation responsible for setting national priorities for comparative effectiveness research. The corporation, which would be called the Health Care Comparative Effectiveness Research Institute, would be a private entity. But it would be governed by a public-private sector Board of Governors. It would not be an agency of the Federal Government. In addition to setting national priorities, the Institute would provide for the conduct of research studies that answer the most pressing questions about what works in health care. The Institute would have the authority to contract with experienced Federal agencies, such as the Agency for Healthcare Research and Quality, or AHRQ, and the National Institutes for Health, or NIH, or with private researchers if appropriate, for the conduct of the actual research. The Institute would also be charged with disseminating the findings of the research in ways that patients and providers can understand. The Institute would be required to assess the full spectrum of health interventions, including pharmaceuticals, medical devices, medical procedures, medical services, and other therapies. This type of research is often called ``comparative effectiveness research,'' because it evaluates and compares the clinical effect of alternative medical treatments. This type of research provides better quality evidence concerning the best treatment, prevention, and management of the health conditions. Most importantly, this type of research helps patients, providers, and payers of health care to make more informed decisions. While many experts have called for creation of a new entity, they do not specify how the entity should be structured. This bill would create a private, nonprofit institute rather than a new entity within the executive branch or legislative. Keeping it private would remove the potential for political influence on the development of national research priorities. Comparative effectiveness research will be more credible, and more useful, if it is done independently of political influence and with broad stakeholder input. This bill includes stringent requirements for public input, transparency of process and findings, and integrity of the research. For example, the Institute would be required to publish its rules, proceedings, and reports on a public Internet site. Its meetings would be open to the public. It would be required to provide public comment periods at key stages, in addition to open forums to solicit and obtain public input on the Institute's activities. This bill would also require accountability and government oversight of finances and the mission. The Institute would be subject to annual financial audits. And the Comptroller General would perform periodic audits of the activities of the Institute to ensure that the Institute would meet its statutory mission and would do so in a fair, open, and credible way. Finally, this bill would provide a stable source of funding for the Institute. For the first 3 years, general revenues would be used to start up the Institute. In the 4th year, funding would move to an all- payer system--from both public and private sources. Annual contributions would be made from the Medicare Trust Funds, from revenues generated by a fee on private health insurance policies, and from general revenues. The work of the new Institute would benefit Americans who receive health care through the public and private sources. Therefore, public and private sources should contribute to this type of research. The private insurance fee would be $1 per insured person per year. Funding from Medicare would also be $1 per beneficiary per year. All sources of funding for the Institute would sunset after 10 years. That way, Congress could review a report from the Comptroller General on the value of the research to the public and private insurance sectors. Total funding for the first year would be $5 million, and funding would increase to $300 million a year by the year 2013. It is high time that America invested more than a fraction of a percent to generate knowledge about what works in health care, to improve the efficiency and the quality of our health care system, and to give patients and doctors better information to make treatment decisions. It is high time that we built a foundation of evidence for the trillions of dollars spent on health in America each year. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, in 2006, America spent more than $2 trillion on health care. By any standard, $2 trillion is an enormous figure. Health care accounts for 16 percent of our Nation's economy. That means that for every $100 in goods and services produced and consumed in America in 2006, $16 were for health care. And the health care share of the economy is expected to reach 20 percent in just 10 years. These projections are cause for concern. If so much of our Nation's resources are devoted to heath care, we need to ask ourselves what we are--or are not--getting for it. The answer is that we are getting a mixed bag of goods. Some patients receive medical treatments that work well. Some patients receive treatments that don't work well. In many cases, doctors and patients don't have enough reliable evidence to know whether treatments work or don't. Of the $2 trillion spent on health in 2006, only \1/10\ of 1 percent was spent to assess what works and what doesn't. At the Federal level, only $15 million was directly appropriated to compare the effectiveness of health interventions and services. People who purchase other goods-- anything from cars to computers--use information to compare the value of the different products before they purchase. Physicians and patients deserve better. We should devote more than \1/10\ of 1 percent of health spending to study how well health goods and services actually work. Rapid innovation has led to an ever-changing array of new and sometimes expensive technologies. The age of personalized medicine and genetic engineering will provide even more choices for patients and their physicians. Indeed, patients and physicians can face great difficulty in choosing among treatment options. But much of the information about those options is biased. Much information about those options is of poor quality. And for many treatments, there are large gaps in what is known to be most effective. With a paucity of sound evidence, clinical guidelines and treatment protocols can vary widely. If there has ever been a need for better information--on what works, for which patients, under which circumstances--it is in this age of rapid innovation of technology. Several august bodies--including the Institute of Medicine, the Medicare Payment Advisory Commission, and the Congressional Budget Office--have called on Congress to create a national entity charged with conducting research to determine what works in health care. Today, I am proud to introduce the Comparative Effectiveness Research Act of 2008. I am joined by the Chairman of the Budget Committee, Senator Conrad. He and I share a deep concern about rising health care costs. And we share a deep commitment to finding ways to address it. This bill does what the experts suggest. It would create a new entity responsible for generating better information on the effectiveness of health care treatments. Specifically, the bill would create a nonprofit corporation responsible for setting national priorities for comparative effectiveness research. The corporation, which would be called the Health Care Comparative Effectiveness Research Institute, would be a private entity. But it would be governed by a public-private sector Board of Governors. It would not be an agency of the Federal Government. In addition to setting national priorities, the Institute would provide for the conduct of research studies that answer the most pressing questions about what works in health care. The Institute would have the authority to contract with experienced Federal agencies, such as the Agency for Healthcare Research and Quality, or AHRQ, and the National Institutes for Health, or NIH, or with private researchers if appropriate, for the conduct of the actual research. The Institute would also be charged with disseminating the findings of the research in ways that patients and providers can understand. The Institute would be required to assess the full spectrum of health interventions, including pharmaceuticals, medical devices, medical procedures, medical services, and other therapies. This type of research is often called ``comparative effectiveness research,'' because it evaluates and compares the clinical effect of alternative medical treatments. This type of research provides better quality evidence concerning the best treatment, prevention, and management of the health conditions. Most importantly, this type of research helps patients, providers, and payers of health care to make more informed decisions. While many experts have called for creation of a new entity, they do not specify how the entity should be structured. This bill would create a private, nonprofit institute rather than a new entity within the executive branch or legislative. Keeping it private would remove the potential for political influence on the development of national research priorities. Comparative effectiveness research will be more credible, and more useful, if it is done independently of political influence and with broad stakeholder input. This bill includes stringent requirements for public input, transparency of process and findings, and integrity of the research. For example, the Institute would be required to publish its rules, proceedings, and reports on a public Internet site. Its meetings would be open to the public. It would be required to provide public comment periods at key stages, in addition to open forums to solicit and obtain public input on the Institute's activities. This bill would also require accountability and government oversight of finances and the mission. The Institute would be subject to annual financial audits. And the Comptroller General would perform periodic audits of the activities of the Institute to ensure that the Institute would meet its statutory mission and would do so in a fair, open, and credible way. Finally, this bill would provide a stable source of funding for the Institute. For the first 3 years, general revenues would be used to start up the Institute. In the 4th year, funding would move to an all- payer system--from both public and private sources. Annual contributions would be made from the Medicare Trust Funds, from revenues generated by a fee on private health insurance policies, and from general revenues. The work of the new Institute would benefit Americans who receive health care through the public and private sources. Therefore, public and private sources should contribute to this type of research. The private insurance fee would be $1 per insured person per year. Funding from Medicare would also be $1 per beneficiary per year. All sources of funding for the Institute would sunset after 10 years. That way, Congress could review a report from the Comptroller General on the value of the research to the public and private insurance sectors. Total funding for the first year would be $5 million, and funding would increase to $300 million a year by the year 2013. It is high time that America invested more than a fraction of a percent to generate knowledge about what works in health care, to improve the efficiency and the quality of our health care system, and to give patients and doctors better information to make treatment decisions. It is high time that we built a foundation of evidence for the trillions of dollars spent on health in America each year. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. BAUCUS

Mr. BAUCUS. I ask unanimous consent that during the remaining time, the Senator from Montana be allocated the remainder of that 5 minutes on the majority side.

Mr. BAUCUS. I thank the Senator from Texas, and I thank the Chair.

Mr. BAUCUS. Mr. President, I remind my good friend from Texas that there are a lot of things he favors and I think we all favor. He mentioned plug-in hybrid automobiles and clean coal technologies, and they are in this bill. Frankly, I believe most Senators want to pass this bill. I urge Senators on both sides to vote for it. We can, frankly, pass it and send it back over to the House and be done with it. The American people want us to pass this legislation. Mr. President, the great writer William Faulkner said of the artist: Only what he creates is important, since there is nothing new to be said. Writers could say much the same about us. What is important is not what we say, but what we create. What is important here is not the speeches, but the laws that we pass. Today, we have a chance to do something important. Today, we can choose to legislate. We can proceed to a bill that addresses what's important. It is a bill about jobs. It is a bill about energy. It is a bill about families. I am speaking of S. 3335, the Jobs, Energy, Families, and Disaster Relief Act of 2008--what some call the tax extenders bill. Today, we can choose to do something important. We can move to this bill. This bill would do something to create jobs. This bill would extend the research and development credit. This credit encourages businesses to invest in research. It helps to keep America competitive in the global economy. America accounts for one-third of the world's spending on scientific research and development, ranking first among all countries. Relative to the size of our economy, however, America stands in sixth place. Our R&D tax credit expired on December 31 of last year. American corporations are at a competitive disadvantage. They are unsure if they will be able to obtain the benefit of the credit this year. They need to plan for the future. About 70 percent of R&D spending goes to salaries. That helps to create jobs. These are jobs that help America stay in the forefront of several global industries. We can do something today to create high-paying R&D jobs, with this bill. This bill would also create jobs in infrastructure, by repairing a shortfall in the highway trust fund. The highway trust fund relies on fuel taxes for 90 percent of its revenues. And as fuel prices have risen to record highs, Americans are driving less and buying fewer gallons of gas. As a result, fuel tax receipts are down sharply. The Department of Transportation reported that Americans drove 9\1/2\ billion fewer miles in May than they did a year before. And OMB projects a highway trust fund deficit for 2009 of more than $3 billion. We have a problem with highway trust fund finances. And that financing problem is a jobs problem. Failing to fix the highway trust fund's shortfall will cause Federal transportation funding cuts of more than a third. Industry experts have calculated that funding cuts of this magnitude would result in the loss of about 380,000 jobs. We can do something today to create well-paid infrastructure jobs, with this bill. This bill would do something about energy. This bill would take real action to break America's dependence on oil. Gasoline is more than $4 a gallon across the country. Americans want Congress to steer away from foreign oil. They want us to turn toward alternative and renewable energies. This bill has the right energy incentives to help America to turn the corner. It would support renewable electricity from wind, water, biomass, and other sources. It would boost biodiesel and solar energy. It would reward energy-efficiency, and push for cleaner coal plants. It would even provide a brand new tax credit for plug-in electric cars, so that Americans could choose vehicles that use less fossil fuel or none at all. Mr. President, do you know what. If every time a car went up to the gas pump and filled up and the vehicle also had electric power, with a battery in the car, and it would go 50 miles on that electric power, guess what. Crude oil imports in this country would fall by 50 percent--It would be cut in half if every time a car would drive up to the pump and, when it fills up, 50 miles that that car drives is on electric energy--a battery. It would cut oil imports by 50 percent-- something as simple as that. I ask that I be notified 30 seconds before my time expires.

Mr. BAUCUS. With gas at $4 a gallon, why would we wait another minute to get these energy technologies moving? We can do something today to create alternative sources of energy, with this bill. This bill would do something for American families. This bill would keep the alternative minimum tax from ensnaring new taxpayers. Without this legislation, 21 million additional taxpayers would have to pay the AMT. We can do something today to protect families from the AMT, with this bill. This bill would help teachers who have taken it upon themselves to spend money from their own pockets on classroom supplies. The average teacher's salary is about $38,000 a year. But in 2005 alone, 3\1/2\ million families took the teacher expense deduction. We can do something today to help teachers' families, with this bill. This bill would help families with tuition expenses. The average tuition and fees at a 4-year private college in New England is now more than $30,000 a year. Four and a half million families took the qualified tuition deduction in 2005. But the provision expired at the end of 2007. We can do something today to help families paying for college, with this bill. This bill would help families with the State and local sales tax deduction. This deduction gives a tax benefit to taxpayers who live in States without an income tax, including Florida, New Hampshire, Nevada, South Dakota, Tennessee, Texas, and Wyoming. In 2005, this deduction benefitted more than 11 million families. This bill would expand the child tax credit. Current law bars about 6 million working families from receiving any relief under the child tax credit. Families with 10 million children receive a partial credit. With this bill, the families of nearly 3 million more children would be eligible for this tax relief. We can do something today to help working families with kids, with this bill. This bill would also help improve health care for countless families dealing with mental illness. It includes the mental-health-parity legislation advanced by Senators Ted Kennedy, Pete Domenici, and the late Paul Wellstone. This bill would require private insurance plans that offer mental health benefits as part of their coverage to offer the same level of benefits as they offer for medical-surgical benefits. Mental illness is a disease like any other. We should treat it that way. We can do something about it, today. This bill would provide much-needed relief to families who have suffered from natural disasters. This bill contains a package of disaster relief provisions developed to address all Federally-declared disaster areas with immediate, reliable, and robust tax relief. We can do something today to help families struck by disasters, with this bill. I say to my Colleagues: If you want to do something about creating jobs before you go back home, then vote for this bill. If you want to do something about energy before you go back home, then vote for this bill. If you want to do something to provide tax relief for American families before you go back home, then vote for this bill. What's important is not what we say. What is important is the laws that we pass. Let us pass a law that creates jobs. Let us pass a law that fosters new forms of energy. Let us pass a law that helps the American family. Today, let us do something important. Today, let us choose to legislate. And today, let us move to this bill. Mr. President, I ask unanimous consent that a list of supporters of the bill be printed in the Record.

Mr. BAUCUS. Mr. President, parliamentary inquiry.