Robert Bennett

Mr. BENNETT

Mr. BENNETT. Last night, I held a telephone townhall meeting. As usual, because we get over 10,000 people on the telephone townhall talking to us, I said: This is a meeting that is open to any subject you can talk about. Overwhelmingly, they all wanted to talk about health care. I had one call where the fellow said he liked this health care bill. He was a small businessman. He said: This will help me as a small businessman, and why are you opposed to it? I said to him: I have been a small businessman, and I would like to point out to you that NFIB, the organization that helps small business, is opposed to it. And I went through some of the reasons. Then I told him of other small- or medium-size businessmen in Utah who have said to me: If this bill passes, we are out of here. We could do our manufacturing overseas. We could send our product to South America and have it made there. We have stayed in Utah more out of patriotism than money. But if this bill passes, the impact on us in small business will be sufficiently great that we will leave Utah. We will leave America. We will take all of these jobs and go overseas. That was that one discussion with the one caller. Every other caller talked about the health care bill and said: Don't pass it. Every other caller was opposed. There was only the one who made comments in favor of it, comments on which I think I was able to dissuade him. Every other one came up: Do you want to talk about Afghanistan? No, we want to talk about health care. We are opposed to this bill. Do you want to talk about some other aspects of what is going on in Washington? No, we want to talk about health care, and we are opposed to this bill. Over and over, the only other subject that came up that I can recall with any regularity--there were several calls that talked about cap and trade and expressed their opposition to that. But, overwhelmingly, the entire hour was people who were saying: We are opposed to this bill. I want to share with the Members some aspects of the reaction of Utahns to the campaigns that have been mounted by various groups in favor of this bill. Let's go to the campaign that has been mounted by the AARP. AARP is one of the strongest lobbying organizations in the country. Indeed, there are those who say it is the most powerful lobbying organization. AARP, in an effort to make sure this bill gets passed, has prepared preprinted petitions and sent them out to their members. Here is a copy of one. It is addressed directly to me and was sent to people in the State of Utah: ``Petition to Senator Robert F. Bennett. Dear Senator Robert F. Bennett, As one of your constituents . . . '' so on and so forth. Then all the AARP member has to do is sign it and send it to me. This one was sent to me. But as we can see, he didn't just sign it, instead he wrote on it. This is what it says in handwriting: Absolutely not! Please vote against current legislation being proposed by the current administration and endorsed by the AARP. The ``not'' is underlined. He signed his name. I have taken it off this facsimile to protect the man's privacy, but he made it clear that he was not in favor of what the AARP was saying and doing in this situation. We have others who have said the same kind of thing. Here is a letter I will quote from: Senator Bennett, please do not vote to pass the health care bill that contains a public option. The present medical is broken and surely needs fixing. However, it should be done in ways that do not bankrupt the country, close hospitals and doctors offices. Who is saying this? He says: I will probably withdraw from AARP since they support the present health care proposals. Several of my doctor friends have withdrawn from the AMA due to its support of these proposals. Then he signed his name, and his initials make it clear he, too, is a physician, a member of AARP who clearly wants to drop out of AARP, and a member of AMA who supports those who drop out of the AMA. Let me quote from another physician who wrote a lengthier letter, more analytical. I will quote from parts of the letter. He starts out: As a practicing Utah physician, I see and treat patients every day. I try to accurately diagnose what their troubles are and offer an incremental plan for their recovery. I am thorough, methodical and exacting in my plan, purposely first doing no harm, as my Hippocratic oath reads, not making the situation worse, not causing more pain or suffering. The Senate bill before you will make America more ill, with increased pain and suffering. I plead with you to first do no harm. Please do not make the situation worse as with the current bill. It is beyond repair. Please recognize that the Senate plan will add to America's ills. Then he goes on later in the letter to make this comment: Patients ask me why the AMA appears to support this bill. They sense that the AMA is not looking out for patients and doctors. I agree that the AMA is misdirected and explained that the AMA represents fewer than one in five U.S. doctors and has compromised its mission. I find that interesting. I didn't realize that the AMA membership had dropped so low. When I first became interested in politics, the AMA represented virtually every doctor in the country. Not anymore. I tell my patients about the multitude of other medical organizations of which I am a member, state medical organizations, speciality groups, and the Coalition to Protect Patients Rights, representing thousands of doctors who actively oppose the Senate bill in its entirety and are fighting for patients and the right fixes for affordable, quality care. Well, as I found out in my telephone town meeting, which covered the entire State--and with no filtering on the part of my staff as to who could get in and who could not--this is, indeed, very clearly the majority opinion for members of the State, seniors who presumably belong to AARP, and physicians who either used to belong to the AMA or understand the AMA. Here is an e-mail from a doctor. I cannot pronounce the specialty he is in. He says: As a constituent and practicing-- And then he goes on to say whatever kind of ``ologist'' he is-- I strongly urge you to oppose the passage of the current Senate healthcare reform legislation. . . . Although our nation would benefit from targeted healthcare reform, the proposed legislation is not the answer and will harm, not help, healthcare delivery in our nation. . . . As surgeons, we take pride in our work and strive to provide the best patient care possible. We will support reform efforts that truly preserve access to high qualify specialty care without jeopardizing the physician-patient relationship. As such, I oppose the ``Patient Protection and Affordable Healthcare Act'' as it has the potential to seriously compromise the delivery of healthcare in the United States by creating additional pressures on an already overburdened healthcare system. Well, I have a number more. I will not go into all of them; I will just pick a few from the stack I brought with me. Here is one: I am a Surgeon who has been practicing for about 30 years. I am against the total overhaul of the health care system. All entitlement programs are not cost effective and all are in danger of bankrupting the U.S. Here is one, who is a retiree, who says: Please vote against these healthcare ``reforms'' that will limit options, cost us all more and reduce our freedoms. We need real change: portability, tort reform, and less government control. Back to the doctors. He says: Dear Mr. Bennett, I am a pediatrician in Utah and met you at the hospital in Orem. Thank you for your opposition to the current process happening in Washington. We do not need to rush through and push the American people into government run health care and more red tape. Medicaid is already my biggest head ache in my practice. And so on and so forth, as I say. I want to make this other point with respect to all of these people who are so concerned that we will have an immediate bad impact if this bill passes. They do not realize--and I did my best to point this out to those who were on the telephone townhall meeting last night--that this bill will not fully take effect--indeed, most of the aspects of this bill will not take effect--until January of 2014. That is correct, January of 2014--4 years away. Here we are meeting on weekends, coming in here on Sunday, driving to get this done by Christmas because it is so pressing that we have to do it, and, by the way, we are not going to start, really, any of these reforms for 4 years. So these people who are writing me, these doctors who are complaining about AMA's endorsement, these people who are complaining about AARP not representing them, are worried about an immediate impact. Let me tell you what the immediate impact of this bill will be. The immediate impact of the bill will be financial. The taxes will take place immediately upon passage. The increase in premiums will begin to start on passage, as the pressure on the insurance companies, the pressure on manufacturers, the pressure on pharmaceutical companies will all begin with the passage of this bill. But all of the wonderful things we are being promised as benefits from this bill will be delayed for 4 years. Why? There is only one reason why: in order to use smoke and mirrors in the budgetary process to make it look as if this is cheaper than it really is. If you get the money coming in for 10 years but the expenses only going out for 6 years in your calculation, it looks as if it is a whole lot cheaper than it really is. The only honest way to score this is to say the expenses start the same day the taxes start, the expenses going out start the same day the revenue coming in starts. Then you get an accurate description of how much this costs. I cannot imagine any businessman going before his board of directors and saying: I have a new program I want to institute in this company, and it is going to cost X, and here is how I have calculated it is going to cost X. I am calculating the revenue from the sales of the product over a 10-year period, but the actual sales will only occur in the last 6 years. His board of directors would take one look at him and say: There is no way we can make a strategic plan based on that kind of smoke and mirrors. What in the world is wrong with you to do accounting of that kind? He will say: That is the kind of accounting I learned from the U.S. Senate--start counting the revenues immediately, but don't count the expenses until 4 years later. Well, let's look at the impact of that 4-year gap and tie it to the messages I am receiving from my constituents, and I think we will see something very interesting happen. Between now and the time the benefits of this bill begin to take hold, there will be three or four open seasons of people who will look at their health care plan and be allowed to make changes in it. They will see the costs go up, and they will say: Wait a minute, what is happening here? The costs are going up, but there are no changes coming from this bill the Senate passed back in 2009--or 2010, if we push it until next year. What is happening? Well, your costs are going up in anticipation of the costs of this bill that will take hold in January of 2014. At that point, the anger we are seeing from constituents now will get worse. The anger we are seeing in the e-mails and letters I am receiving now will get more intense, and people will start to say: You mean I am being forced to pay extra premiums in 2010 because the government needs to accumulate cash against the time when these great changes hit us in 2014? When they start writing me that kind of complaint, I will say: That is exactly what I mean. The government is going to start taxing you in 2010, but they are not going to do this program until 2014--at which point, the outcry from constituents will be: Well, let's stop the taxes and let's kill the effective date of 2014. I am not sure I can predict that with certainty, but I can go back in history and remember the catastrophic bill that was passed with respect to Medicare, and the senior citizens suddenly discovered how much it was costing them. The outcry was so overwhelming that the Congress, within a matter of 6 months of the passage of the bill, repealed the bill. I remember the pictures that appeared in national magazines of Congressmen Rostenkowski, who was at the time the chairman of the Ways and Means Committee, being accosted physically when he went home to Chicago by seniors who would stand in front of his car and not allow him to move, who would sit on the hood of his car to block his way in every conceivable way. The outcry was enormous when they saw this increased cost for something where they did not see a corresponding benefit, and Congress responded to that outcry and repealed that bill. In this case, there will be a 4-year period for the outcry to build before they start to see the benefits, if, indeed, the bill does confer benefits. There will be a 4-year period with that many open seasons for people to look at their programs and see their premiums go up and see their plans change and see the adjustments made in preparation for this, adjustments they will not want; 4 years in which they will see the statement of the President of the United States, that ``if you like your plan, you don't have to lose it,'' prove not to be the case. In that 4-year period, it is entirely possible that the outcry from constituents, like the ones who are complaining now, will have tremendously more impact and more force. I hope that is, indeed, the case, if we pass this bill. I hope that in that 4-year period, before we start to see the wonderful things we are being promised from the other side of the aisle come to pass--the increased premiums, the increased taxes, and the increased costs will be with us--the people of this country will rise up and say: We want this bill repealed. They have 4 years in which to do it, 4 years in which to think about it, 4 years in which to experience it. Why are we rushing to get this done before Christmas when we have 4 years before the thing finally kicks in? Let's take the time to do it right. Let's take the time to listen to our constituents. Let's take the time to listen to the American people who are examining this bill and, by ever-increasing margins, telling us again and again that they do not like it. We have heard from many people the reactions of the polls. The Quinnipiac Poll made the comment: It is a good thing the Senate is not letting the American people vote on this bill because the American people are against it. We have seen the Gallup Poll show a tremendous swing, as their people are against it. The more they know about it, the less they like it. Yet we are trying to rush it through in the holiday season to get it done before Christmas even though it is 4 years away before all of the wonderful things that are being promised will surface. Mr. President, I think my constituents have it right. I think those people who belong to AARP who are saying they are going to drop out because of AARP's endorsement are right. I think those physicians who say they are either not members of the AMA or they are going to drop out from the AMA because of the AMA's position are right. And I think if we cram this thing through in a sense of urgency, even though it is 4 years from implementation, we will see an outcry in the intervening 4 years from the American people that will cause Members of the Senate to wish they had taken more time to examine it all, to do it right, and not to panic over pressure from various special interest groups that see ways in which they can profit from this. The American people, the American physicians, the American patients all see ways in which they will be hurt, and I speak for them, as they say: Slow this down. Do this thing right. Do not panic under pressure of an artificial time deadline. I yield the floor.

Mr. BENNETT

Mr. BENNETT. Mr. President, I ask unanimous consent to proceed as in morning business, not to exceed 10 minutes.

Mr. BENNETT. Mr. President, in this morning's Washington Post, we have, once again, an outstanding article by Robert Samuelson, this one entitled: ``Health-care Nation: Medical spending threatens everything else.'' Mr. Samuelson has been critical of Republicans--and he is in this article--and he has been critical of Democrats--and he is in this article--but he makes some points I think are worth bringing to our attention, the primary one being that we are not focusing on the right issue, which is making some kind of attempt to turn the cost curve down--using the budgetary doublespeak--with respect to health care. Let me quote a few comments from Mr. Samuelson's presentation. He says, first: The most obvious characteristic of health spending is that government can't control it. As demonstrated by our past history, that is a very true statement, which I will show in a moment. He goes on to say: [The] consequence is a slow, steady, and largely invisible degradation of other public and private goals. Historian Niall Ferguson, writing recently in Newsweek, argued that the huge Federal debt threatens America's global power by an ``inexorable reduction in the resources'' for the military. Ferguson got it half right. The real threat is not the debt but burgeoning health spending that, even if the budget were balanced, would press on everything else. ``Everything else'' includes universities, roads, research, parks, courts, border protection, and--because similar pressures operate on States through Medicaid--schools, police, trash collection and libraries. Higher health spending similarly weakens families' ability to raise children, because it reduces households' discretionary income either through steeper taxes or lower take-home pay, as higher employee-paid premiums squeeze salaries. He concludes: . . . Obama talks hypocritically about restraining deficits and controlling health costs while his program would increase spending and worsen the budget outlook. Democrats congratulate themselves on caring for the uninsured--who already receive much care--while avoiding any major overhaul of the delivery system. The resulting society discriminates against the young and increasingly assigns economic resources and political choice to an unrestrained medical-industrial complex. Mr. President, I ask unanimous consent to have printed in the Record the entire article at the conclusion of my remarks.

Mr. BENNETT. To demonstrate the accuracy of what Mr. Samuelson has to say, I have some charts. This one shows the breakdown of Federal spending in 1966. Why do I pick 1966? Because that was the year for the beginning of Medicare. At that time, 26 percent of the Federal budget went for mandatory spending--overwhelmingly Social Security--7 percent went to pay interest on the national debt, and 44 percent went for defense, with 23 percent for nondefense. Where are we now? In 2008, mandatory spending had more than doubled and had gone to 54 percent, interest costs remained about the same--8 percent--defense had shrunk to 21 percent, cut in half, and the nondefense discretionary, 17. The difference? Medicare and Medicaid taking over the mandatory side. What do we see as we look out to 2019. We can't break down the difference between defense and nondefense because that would require an analysis that is not available to us in that future year. But mandatory by that time will have grown to 61 percent. The size of the debt increasing costs now, interest costs have grown to 10 percent and defense and nondefense discretionary have shrunk to 29--a complete reversal. That is roughly what mandatory was when Medicare was started. I am not saying we should not have Medicare, and I am not saying we should not have Medicaid, but I am saying we should be focusing on how we make people healthier, how we reward people for not using the system, how we do something to control the costs, instead of increasing the status quo with respect to health care spending. This chart was drawn up before we had the bill before us. I think it is very likely, if the bill before us passes, this mandatory will grow even further and we find ourselves in this situation with respect to 2010. I watched the budget as it came down and it said, in 2010, Federal revenues were going to be $2.2 trillion and mandatory spending was going to be $2.2 trillion, which means every dime of everything else had to be borrowed. I worked with Senator Wyden and a number of others on both sides of the aisle to craft a health care plan that would turn the cost curve for health care down. We didn't even get a vote in the Finance Committee. We didn't even get anybody to consider what we had to say because everyone was focused entirely on the issue of let's cover the uninsured. The position is: Let's cover the uninsured by taking what we are doing now and spreading it even wider. As Mr. Samuelson says, very clearly, in his column today: That squeezes out the money for everything else. That is an uncontrolled expenditure. We are not focusing on changing the system in a way that can cause cost curves to come down, we are focusing on taking the present system and spreading it wider. The cost curve can come down. I have quoted this before. The Dartmouth study talks about where the best health care is available in America, and it is in three cities, according to Dartmouth: Seattle, WA, Rochester, MN, and Salt Lake City, UT. Then they go on to say, if every American got his or her health care in Salt Lake City, UT, it would be the best in the country and one-third cheaper than the national average. It is one-third cheaper than the national average because the focus in that plan, as it is in Rochester, MN, at the Mayo Clinic, and other places, is trying to make health care better and, therefore, cheaper, instead of focusing on taking the present system and perpetuating it. If we don't get into that mentality, if we just take the present system, which this bill does, and spread it over a wider number of people, which this bill does, we will see the spending go up and we will see everything else suffer as a result of it and the health care will not get any better for the people who are involved. Exhibit 1 [From the Washington Post, Dec. 7, 2009] Health-Care Nation (By Robert J. Samuelson) President Obama's critics sometimes say that he is engineering a government takeover of health care or even introducing ``socialized medicine'' into America. These allegations are wildly overblown. Government already dominates health care, one-sixth of the economy. It pays directly or indirectly for roughly half of all health costs. Medicine is pervasively regulated, from drug approvals to nursing-home rules. There is no ``free market'' in health care. What's happening is the reverse, which is more interesting and alarming: Health care is taking over government. Consider: In 1980, the federal government spent $65 billion on health care; that was 11 percent of all its spending. By 2008, health outlays had grown to $752 billion--25 percent of the total, one dollar in four. Even without new legislation, the health share would grow, as an aging population uses more Medicare (insurance for the elderly) and Medicaid (the joint federal-state insurance for the poor, including the very poor elderly). Obama would magnify the trend by expanding Medicaid and providing new subsidies for private insurance. Thirty million or more Americans would receive coverage. All this is transforming politics and society. The most obvious characteristic of health spending is that government can't control it. The reason is public opinion. We all want the best health care for ourselves and loved ones; that's natural and seems morally compelling. Unfortunately, what we all want as individuals may harm us as a nation. Our concern sanctions open-ended and ineffective health spending, because everyone believes that cost controls are heartless and illegitimate. The recent furor over proposals to reduce mammogram screenings captures the popular feeling. The consequence is a slow, steady and largely invisible degradation of other public and private goals. Historian Niall Ferguson, writing recently in Newsweek, argued that the huge federal debt threatens America's global power by an ``inexorable reduction in the resources'' for the military. Ferguson got it half right. The real threat is not the debt but burgeoning health spending that, even if the budget were balanced, would press on everything else. ``Everything else'' includes universities, roads, research, parks, courts, border protection and--because similar pressures operate on states through Medicaid--schools, police, trash collection and libraries. Higher health spending similarly weakens families' ability to raise children, because it reduces households' discretionary income either through steeper taxes or lower take-home pay, as higher employer-paid premiums squeeze salaries. A society that passively accepts constant increases in health spending endorses some explicit, if poorly understood, forms of income redistribution. The young transfer to the elderly, because about half of all health spending goes for those 55 and over. Unless taxes are increased disproportionately for older Americans (and just the opposite is true), they are subsidized by the young. More and more resources also go to a small sliver of the population: In 2006, the sickest 5 percent of Americans accounted for 48 percent of health spending. Political power in this system shifts. It flows to groups that promote and defend more health spending--AARP, the lobby for Americans 50 and over, and also provider organizations such as the American Medical Association (AMA), which represents doctors. Predictably, AARP has been active in the present debate. It claims to have participated in 649 town- hall and other meetings and to have reached more than 50 million people through ads this year. Not surprisingly, AARP and the AMA recently conducted a joint TV ad campaign. The rise of health-care nation has confounded America's political and intellectual leaders, of both left and right. No one wants to appear unfeeling by denying anyone treatment that seems needed; no one wants to endorse openly meddling with doctors' independence. It's easier to perpetuate and enlarge the status quo than to undertake the difficult job of restructuring the health-care system to provide better and less costly care. Obama's health-care proposals may be undesirable (they are), but it's mindless to oppose them--as many Republicans do--by screaming that they'll lead to ``rationing.'' Almost everything in society is ``rationed,'' either by price (if you can't afford it, you can't buy it) or explicit political decisions (school boards have budgets). Health care is an exception; it enjoys an open tab. The central political problem of health-care nation is to find effective and acceptable ways to limit medical spending. Democrats are no better. Obama talks hypocritically about restraining deficits and controlling health costs while his program would increase spending and worsen the budget outlook. Democrats congratulate themselves on caring for the uninsured--who already receive much care--while avoiding any major overhaul of the delivery system. The resulting society discriminates against the young and increasingly assigns economic resources and political choice to an unrestrained medical-industrial complex.

Mr. BENNETT. Mr. President, I see the Senator from Iowa wishes to ask me a question and I am happy to respond, but tell me how much time I have remaining. Maybe some of it will have to come off his time.

Mr. BENNETT. In my 2 minutes remaining, unless it is a long question, I will be happy to respond to any question my friend may ask.

Mr. BENNETT. Mr. President, if I can reclaim my 2 minutes to respond to the Senator from Iowa, I can give you data that indicates it is not just the fact there are a lot of people who don't smoke and don't drink in Utah that makes them healthier. I agree there are many things in this bill that are for wellness, and I approve of that. But the fact is, the bill does not go anywhere near far enough in this direction to change the paradigm that has created the situation we find ourselves in. Every expert I have talked to, in the 3\1/2\ years I have immersed myself in this issue, has repeated that. They have said the only way you are going to deal with this is to do something dramatically different, which is what Senator Wyden and I tried to do and we got the cold shoulder. All right, I understand, if you don't have the votes, you can't get anywhere. But the fact remains, we are not going to be able to afford all the things we want to do in this country, militarily and otherwise, in this cost projection that we are on with respect to health care right now.

Mr. BENNETT. That is right; my time has gone. I will be happy to respond to the Senator from Montana, if he wants to take the time to let me.

Mr. BENNETT. If I may, it is not just Intermountain. There are other agencies in Utah that do a good job.

Mr. BENNETT. Responding to the question of the Senator from Montana, I am delighted there is as much of that in the bill as there is, but I still believe the basic structure of the bill is fatally flawed because it perpetuates the present system in ways that will guarantee the cost curve will continue to go up. I disagree with him about the Samuelson article. I do not think he is being overly pessimistic. I think he is being very realistic.

Mr. BENNETT. Mr. President, I certainly hope this legislation will surprise me by producing----

Mr. BENNETT. The result the Senator from Montana is hoping for.

Mr. BENNETT. I am not going to hold my breath, however.

Mr. BENNETT

Mr. BENNETT. I say to the Senator from Arizona and others who have commented, home health care is not the only way seniors will be hurt by this. I am quoting from an article by Tom Scully, one of the designers of the Medicare Part D benefit, on the impact of this bill on Medicare Part D for seniors. Let me quote the key points of the article. I ask unanimous consent to have the entire article printed in the Record.

Mr. BENNETT. He says: There is a little-noticed provision buried deep in both the House and Senate health care reform bills that is intended to save billions of dollars--but instead will hurt millions of seniors, impose new costs on taxpayers, and charge employers millions in new taxes. Here is the core of it: This fall, congressional staff, looking for a new revenue source to pay for health reform, proposed eliminating the tax deductibility of the subsidy to employers. The supposed savings were estimated by congressional staff to be as much as $5 billion over the next decade. It sounds smart--except that nobody asked how many employers will drop retiree drug coverage. Clearly, many will. The result is that, instead of saving money, the proposed revenue raiser will force Medicare Part D costs to skyrocket as employers drop retirees into the program. He concludes with this comment: There are many reasons to pass health care reform. There is no reason to hurt seniors, employers and taxpayers in the process. Businesses are struggling and the Medicare trust funds have plenty of problems as it is. It makes no sense to make these problems worse. So not only are the programs going to be cut, but the drug costs are going to be dumped into the program, with an increased number of people involved. You are going to see tremendous financial distortions as a result of the passage of this bill.

Mr. BENNETT. Mr. President, I thank the Senator from Arizona. My mind goes back to a personal experience I had that I would like to share with my friends on the left. It was an entirely different bill-- No Child Left Behind. We were all for it on this side of the aisle because our President had proposed it. My staffer said to me, listening to the debate: You know, Senator, if President Clinton had proposed this, you would vote against it because you would think it was too heavyhanded with government interference. I said: You know, you are right. I have to do the right thing. I was one of the few Senators who voted against it. If we had proposed what the Democrats had proposed, every argument we are currently hearing from the right side of the aisle would be coming with great roars and insistent statements on the other side of the aisle. But because it is their President who proposed it, they are somehow keeping their consciences under control. I hope they will recognize the irony of that and that at least one Senator--that is all we need in order to stop this bill--would recognize that conscience ought to prevail and this bill ought to be stopped. Let's be clear. If this bill is stopped, health care reform will not die as a cause. Indeed, health care reform will be reborn in a bipartisan sense of, let's solve the problem, rather than in a partisan sense of, let's jam something down somebody's throat. I hope that is what will happen, that conscience will prevail somewhere and one member of the Democratic Party who feels in his or her heart that this is a dumb idea will let his or her conscience prevail. I see the Republican leader.

Mr. BENNETT. Mr. President, I have enjoyed this colloquy. I have enjoyed the enthusiasm that is here. I noticed that the sense of passion to get something done properly for the American people is on this side of the aisle. A great of sense of defensiveness is on the other side of the aisle. We all have an been caught one time or another in the struggle between support for a leadership position or a Presidential position and our own sense of what is the right thing to do. I join with my leader from Kentucky in saying that the people of Utah have never been more worked up about any issue than this one. I have never seen any circumstance where they have been more firm and unanimous in their demand that this bill be stopped. The Senator from Kentucky said if there is somebody in Kentucky who is for this bill, he has not met him. I have met some people in Utah who are for this bill. They have spoken to me about it, as I pass through airports or I walk down the street in the hearing of other people from Utah. As soon as anybody hears someone tell me, Vote for this bill, there is a chorus of voices that spontaneously come up around that and say: Don't listen to him; listen to us. This is a terrible bill. This is a terrible circumstance. I have been proud in the debate to point out that in Utah, the Dartmouth study says we have the best health care available in the United States, and if everybody got their health care there, it would not only be the best, it would be one-third cheaper than the national average. I have spent a lot of time talking with the people who provided that result. Unanimously they tell me this bill would damage that result. It would damage the quality, and it would raise the price. Why in the world would we want to do those two things?

Mr. BENNETT

Mr. BENNETT. Mr. President, I listened with some interest to the comments made when I came on the Senate floor. I simply want to make this one observation about Medicare Advantage. President Obama promised that Americans who have coverage they like would not lose the coverage they have. There are a number of Americans who have Medicare Advantage. They like it, and they want to keep it. This Congress is about to say: No, you can't. This Congress, through this bill, if it passes, is going to eliminate Medicare Advantage. Frankly, the people who go after Medicare Advantage because they like it are going to be the ones who are disadvantaged. They are going to be the ones who will see President Obama's pledge violated. Frankly, I don't think they much care about how much an executive is paid or what happens in the company. They care that they have coverage they like, coverage they are paying for, coverage they have chosen, and they are being told by the Federal Government they cannot have what they want. There is another aspect to this that I would like to explore in the time I have. We keep hearing so much about the CBO and all of the scores the CBO is pointing out along with rhetoric that says we can't afford to wait, we need a solution now, the status quo is unacceptable. I would like to point out that the status will remain quo for 4 years if this bill passes. In the budget smoke and mirrors that have been put into this bill in order to make it look as if it costs less money, they make the effective date in 2014, so there will be 4 years after the passage of this bill where Americans will not see any kind of change in their plans. What they will see is an increase in their premiums. They will see an increase in taxes. Why do I say that? Between January of 2010 and January of 2014 there will be four open seasons in which plans can be changed. As the taxes start to hit, as the costs start to hit, those companies that are involved in offering these plans will say: OK, we have to get ready for the expenditures. What do we do? We have four open seasons in which to change our plans before this thing hits. Obviously, that cannot be scored by CBO because CBO does not know what changes will be made. But do we really think we can go through four open seasons with no change whatsoever in the face of this enormous change that will hit in January of 2014? Do we really think everything is going to remain static? That is what the CBO computers are. Do we really think the $500 billion they want to take out of Medicare to help pay for this will not be hashed over again and again? One of two things will happen. No. 1, the Democrats will blink in the face of the anger of senior citizens and say: We really didn't mean it. Yes, the bill cuts Medicare by $500 billion, but we really didn't mean it. We have 4 years in which to fix it; that is, 4 years in which to replace that $500 billion. Of course, when that $500 billion is replaced, if that is the way they decide to go, then we will know that the numbers we are getting out of CBO are completely phony. Then we will know the statement that this bill is revenue neutral is a nonstarter. Then we will know there was never any intention to try to deal with this cost. Suppose future Congresses stand firm and say: Yes, we are going to stand firm in this 4-year period. We are going to stand firm against the anger of senior citizens who are seeing their Medicare benefits get cut. We are going to take the $500 billion out of Medicare. Then we will see the promises that are being made around here--that there will be no cut in Medicare services--all disappear. I hear people say: We are not cutting benefits. We are just cutting payments to providers. That statement is being made over and over again on the other side of the aisle: We are not cutting benefits. We are going to take that $500 billion away from the providers, but the benefits will remain the same. In my State, I have plenty of providers that are on the edge, right now, financially. They are on the edge of going out of business, right now, financially because of the cuts that have been made in Medicare in the name of cutting down payments to providers. What happens to the people who are in a nursing home that is currently dependent upon Medicare payments in order to survive if they come in and say: All right, we are not going to do anything to the benefits these people are entitled to in this nursing home, we are just going to cut enough payments to the nursing home that the nursing home goes out of business. What happens to the people who are in the nursing home under that circumstance? Well, they are going to have to go someplace else and there is going to have to be money to pay for them to go someplace else and the money is going to have to flow through Medicare someplace else and then we are back to the first option I talked about, which is we were not serious when we said we were going to take $500 billion out of Medicare. We were not serious. In order to make sure you do not lose your benefits, we are going to have to start reinvesting in some of these providers. We have seen providers go out of business because of the cuts into Medicare. We need to start putting that money back into Medicare. Then we are back into the circumstance we have been talking about all along: This thing is not paid for. One final point I wish to make: We had a hearing today with the Chairman of the Federal Reserve. Ben Bernanke is up for reappointment and, of course, the entire conversation was about the economy and what is the future of the economy. There were a number of people who had a conversation about the past, but I wished to focus on the future. I pointed this out to the Chairman and asked for his comments with respect to the future of our economy. Most of my constituents do not understand what I am about to say. Frankly, most of the people in the press do not understand it, and maybe even some Members of this body do not understand it. When we talk about the Federal budget, two-thirds of the Federal budget is beyond the control of this Congress. Two-thirds of the Federal budget is on autopilot, unless this Congress changes entitlements. Somebody says: Well, what does this word ``entitlement'' mean? Why do you talk about entitlements? Entitlement means, by law, these individuals are entitled to this money, whether we have it or not. The Federal Government has made a contract with them. All right, it is a social contract rather than a legal contract, but it is as binding politically where the Federal Government has to spend the money, whether it has it or not. Indeed, that is what we have seen in fiscal year 2010. The budget we passed said revenues are going to be $2.2 trillion and entitlement spending is going to be $2.2 trillion, which means every function of the government--our Embassies overseas; our troops, wherever they may be; education; national parks; whatever it is--every dime will have to be borrowed in fiscal year 2010, every single dime because every penny coming into the Federal Government is already programmed to go out, without coming through the Congress. It does not go through the appropriations process. We do not get to vote on it. People are entitled to receive this money, and it is going to go out there. What are we talking about? We are talking about creating a new entitlement, a very expensive new entitlement. How are we going to pay for it? According to this bill, we are going to pay for it by transferring money from an existing entitlement. Anyone who thinks that is what is going to happen, in the face of the anger that is being generated by people who read about this, believes a fairytale. The whole notion of trying to balance the cost of this tremendous new entitlement by somehow a bookkeeping entry that says we will take it out of the Medicare account and we will put it in this account, and the computers that do not think--the computers simply compute--will say: Well, then, if you put it in this account, then this account is revenue neutral. But the government's account is not revenue neutral. This thing is going to cost $500 billion, wherever we get the money. It is a cynical ploy, smoke and mirrors of the worst kind, in a budgetary bait and switch, to say we are going to take this out of Medicare. I hear from my constituents--I hear from people who are not my constituents who recognize me as a Senator in airports and other places--as they say, increasingly: Do not pass this bill. We see it in the polls, but we see it in the passion of the people who come up to us and let us know how firmly they are opposed to this bill. The American people do not want it, and the American people are right. I yield the floor.

Mr. BENNETT

Mr. BENNETT. Mr. President, I wish to commend and congratulate Real Salt Lake for winning the 2009 Major League Soccer Cup. I am delighted to do so, and feel it is a privilege to honor the MLS Cup champions on the Senate floor. The story of Real Salt Lake is more than just a story about a soccer team capturing the MLS title; it is a story about banding together to overcome obstacles and defying the odds after being counted out and dismissed by ``the experts.'' In many ways, the story of Real Salt Lake is part and parcel of the American experience. On November 22, 2009, in Seattle, WA, Real Salt Lake, or RSL, faced off against the better-known and widely acclaimed L.A. Galaxy. Just to give a sense of what RSL was up against, listed on the roster for the Galaxy were U.S. National Team star Landon Donovan, and the internationally acclaimed, indeed iconic, David Beckham. The RSL roster, on the other hand, didn't include what's known as a ``designated player,'' or in other words, a recognized superstar. If that wasn't enough, the Galaxy entered the postseason riding high, having finished at the top of the Western Conference in the regular season with a 12-6-12 record, and were expected by most to perform well if not to win the championship. RSL had a far different experience during their regular season, finishing with an 11-12-7 record. Indeed, they barely managed to make it into the eight team playoff that would determine the MLS Cup Champion. Considering these facts, it would have been easy for RSL to give up. But that wasn't their attitude. When asked about not having a star player, instead of bemoaning that fact, the team's captain, Kyle Beckerman, said, ``We've really bought into the `star is the team' here in Salt Lake. When we work as a team and [are] doing well it's because everybody's playing well. It pays off.'' This team unity had initially paid off in the postseason for RSL as they defeated the defending champion Columbus Crew, and beat the Chicago Fire in the Eastern Conference finals. Despite this, many doubted whether they could win against the Galaxy in the championship game. When asked about their chances, head coach Jason Kreis sarcastically replied, ``Wow, it sounds like we better not even go. We don't even have a chance, do we?'' He knew RSL possessed something special. Even in the final match, such outspoken optimism would be tested. By halftime, RSL was trailing 1-0. Two of their key players were unable to continue playing, sidelined by injury and illness. If ever there was a time to give up, it seemed that this was it. But that wasn't their attitude. Coach Kreis made a pair of substitutions, and encouraged his players to ``be confident,'' and play aggressive. And, well you can see where this is going. After 90 minutes of play, 30 minutes of overtime, and seven rounds of penalty kicks that included two blocked shots by RSL goalkeeper Nick Rimando, defender Robbie Russell converted the final penalty kick to seal the victory, establishing RSL as the champions of Major League Soccer. Now I wish to place this victory into some context. This was significant for Utah in that it was the first professional sports crown to go to the State of Utah since the Utah Stars basketball team won the American Basketball Association title back in 1971. RSL's victory was notable not only because Jason Kreis, at the age of 36, became the youngest manager in MLS history to lead his team to the title, but also because RSL became the first franchise in professional sports history to win a championship after finishing the regular season without a winning record. Think about that for a minute--if there is ever a reason to dismiss a team, a losing record in the regular season should be it. But that wasn't RSL's attitude. Rather than dwelling in self- pity and regret, RSL fought on, determined to prove their detractors wrong. They believed they could beat the entire league, and they went out and did just that. Their story exemplifies the American values of hard work, resilience, and overcoming the odds. Once again, I congratulate RSL for their victory; I join with their fans in celebration of this championship; and I hope that this is one of many more championships to come for Utah.

Mr. BENNETT

Mr. BENNETT. I ask unanimous consent that during the next hour, those Senators who come to the floor may be allowed to proceed in a colloquy.

Mr. BENNETT. I came to the floor early so I could listen to what my Democratic friends have had to say. I found it quite enlightening, and I have a few comments with respect to it. They have been debating vigorously against the status quo. They have been giving us examples, heart-tugging, real-life examples of people who are finding difficult problems in the situation as it now exists-- as if the debate were between the status quo and doing something. The debate is between the solution that has been offered by the majority leader and other solutions, which people on this side of the aisle have been trying to bring forward through the entire time and have not been allowed to come forward. We recognize that things need to be done to fix problems with respect to the health care situation. We realize the legislation we have been living with for all these years needs to be amended. We have been unable to get any of our ideas to come forward. Now we are told there is such urgency to deal with the status quo that we must pass this bill, and we must pass it virtually without amendment. I would like to point out, as I have done before, if there is such urgency with respect to the challenges we have in health care, why do we wait until 2014 to have those changes come? We have heard all these examples coming on the Democratic side of the aisle of people who have terrible problems under their health care plan. We must act, we must act immediately, and the act will be to say to all of these people: We will solve your problem in 2014. We will delay all of these reforms we are talking about until 2014. I made that point the other day, and the Senator from Maryland said, no, some parts of this bill will begin immediately. And he is exactly right. The parts of the bill that would begin immediately are the taxes. We will start taking in money in 2010 if this bill passes. The annual pharmaceutical manufacturers fee would drive up the price of everybody's drugs, an annual nondeductible $2.3 billion fee. That will begin in 2010. The medical device manufacturers fee, another $2 billion, will begin in 2010. The medical insurance provider fee, that will begin in 2010. The cosmetic surgery fee, that will begin in 2010. In 2011, there will be a limit on contributions and in 2013 a high-cost insurance excise tax. All the taxes are front-loaded, but all of the reforms they promise this bill will bring to all of the people whose stories they told us will not take place until 2014. The status for them will remain quo. For all of these attacks on the status quo, the one change we will get is they will start charging the taxes but they will not start delivering any kind of health care reform until 2014. Why are we delaying until 2014? Not because they do not think people need it but because they realize that if they start spending at the same time they start taxing, the score they will get out of the Congressional Budget Office will point out the true cost of this bill. And it is the true cost of this bill that is the kind of thing we need to be debating and talking about rather than listing story after story. My State is full of them, and I am just as sympathetic as anybody of people who have problems with the present health care system. That is a false debate. We all realize, all 100 of us realize that something has to be done to make the health care system better. This is not, should we do nothing; this is a debate about what should be done. The proposal we have from the majority leader is not the answer to the problems we face.

Mr. BENNETT. I say to my friend from Arizona, he reminds me of a real-life experience of a husband who at Christmastime came back to his wife and presented her with a brilliant Christmas present that she had not been expecting. She said to her husband: How could we afford this because the only amount we had in our Christmas budget was--pick a number--$200, and this is obviously worth more than $200. He said: Oh, don't worry about it. I paid $200 for it. She said: How in the world did you get $200? He said: The department store agreed to take the other $1,000 in payments later on. That is exactly what is happening here. We are making a downpayment and telling ourselves that the total cost is covered as outlined by the Congressional Budget Office.

Mr. BENNETT. I say to my friend from Arizona, and then I will yield to my friend from Tennessee, Senator McCain just asked a question: Does anybody really believe these cuts will take place? I share with him an experience I had driving home from the Senate just this week. I was listening to the radio, and the first story on the radio was this vote coming up. The Senate is going to vote at 8 o'clock on Saturday. The second story was that the House of Representatives just passed a doc fix of $200 billion. So we already have action by the House of Representatives proving that the comment by Senator McCain is exactly right. Before this bill even gets passed, they are reversing the cuts over in the House of Representatives. Senator Reid tried to do it here before we got to this bill, and we voted him down. So the House is going to take care of it, and they will ping-pong the bill over here. There is no question that these cuts will not take place. My friend from Tennessee wishes to comment.

Mr. BENNETT. If I could make the comment, Mr. President, among the people who do not believe these changes would not occur is CBO itself. CBO itself agrees this is smoke and mirrors. They do it in very polite language, but let me share with you the language. They say: These longer-term calculations assume that the provisions are enacted and remain unchanged throughout the next 2 decades, which is often not the case for major legislation. That is about as gentle a way as CBO can put it. They don't believe this thing is going to stand without these kinds of changes. Yes, they have come forward because their computers say: You put the numbers in this way, this is the result you get. But human beings are saying that is not what is going to happen over the next two decades.

Mr. BENNETT. Obviously, I would not respond in the way the folks across the aisle have responded to this health care crisis. The example the Senator has given is a valid one. That is not how you deal with it. The other point I would make is that if I had a serious problem that was causing difficulty for the survival of the company, I would not put the solution off for 4 years while I raised prices on the existing products to try to pay for it. I would try to do what I could to get the fix upfront as soon as possible. As both Senators have pointed out, we Republicans have fixes that could start now and don't have to wait until 2014 in order to get a good CBO score.