Richard Burr

Mr. BURR

Mr. BURR. Indian Health.

Mr. BURR. The Senator from Arizona has stated this case very well over a number of days, and it will continue to be stated--they are cutting Medicare to fund a new government program. They are taxing the American people through drugs and devices and more money for their own insurance policies so that government can have a larger hand in health care. You know what. At the end of the day, the American people realize now that they are going to pay more and the quality of their health care is going to go down. It is no more obvious than the current amendment on slashing the reimbursements to nursing homes or to hospice or to any other area under Medicare. This is wrong, it should be stopped, and the American people's voices should be heard in this debate. I thank the Senator.

Mr. BURR. How could a group such as AARP, whose primary role, by design, is to represent our Nation's seniors, be in favor of a reform package that doesn't provide any additional benefits to our Nation's seniors?

Mr. BURR

Mr. BURR. If the Senator will yield for an additional question: Is this board empowered to find $23.4 billion worth of cuts?

Mr. BURR. Will the Senator show me that language?

Mr. BURR. Will the Senator yield for a question?

Mr. BURR. I would ask the distinguished Senator from Connecticut if we empower the independent Medicare advisory board to come up with $23.4 billion in cuts under Medicare? Can the Senator from Connecticut assure me that the independent Medicare advisory board would not find a benefit that they would suggest cutting?

Mr. BURR

Mr. BURR. I thank my colleague from Tennessee. I think it is important, throughout this education of the American people of what is in 2,074 pages, to remind them that for every word in here, it costs the American taxpayer $6.8 million; for every page, $1.2 billion. I think one has to look a little further at this reform aspect. Does this bill truly reform health care? I think as you read through the bill what you find are the words ``require,'' ``must,'' or ``shall'' 4,677 times. You find the words ``tax,'' ``fee,'' or ``revenue'' 899 times. You find the word ``agency,'' ``department,'' ``bureau,'' ``commission,'' or ``panel'' 470 times. But we are told this bill does reform health care. We are told it increases competition, it provides more choice, it stimulates innovation. Yet we find the word ``choice'' 40 times. We find the word ``innovation'' 25 times. We find the word ``competition'' 13 times. I suspect their intent is to fix what they haven't reformed by allowing the Secretary of Health and Human Services, in 1,677 spots, to define or determine what congressional intent was. Think about that. This bill basically turns over a lot of the decisionmaking to the current or future Secretaries of Health and Human Services to decide what we meant in the Congress. Well, my good friend from Tennessee raised a lot of things on Medicaid, and I wish to talk about Medicaid, but I also wish to mention that, once again, we are paying for this by cutting $464 billion from our Nation's seniors. That is a trust fund. They have paid in premiums. Similar to the CLASS Act--it shouldn't be a surprise to us that they are going to steal money out of the CLASS Act that hasn't even been created yet because in the bill it is taking $464 billion from seniors who have paid into it for a lifetime, and within that group of seniors, 11 million seniors are going to have their benefits cut because they chose Medicare Advantage as their preferred insurance product. It is not a question of whether they can keep what they have; they can't keep it because their benefits are going to be cut, and that affects America's low-income seniors the most. As a matter of fact, in this bill, we fix doctor payments for 1 year. So, in 2011, doctors' reimbursements are going to be cut 23 percent. I see Dr. Barrasso on the floor. So we know more doctors are going to stop covering Medicare beneficiaries. The pool is going to get smaller. We are going to affect every senior's health.

Mr. BURR. The Senator from Tennessee is 100 percent correct. Today, 40 percent of our Nation's physicians under Medicaid will not see patients because the reimbursements are so low. Reform in health care means you have to eliminate cost shifting. As Dr. Barrasso knows, cost shifting means when somebody goes in for a service, gets health care delivered, and doesn't pay or somebody goes in who is underinsured, gets delivered a service, and their reimbursement doesn't sufficiently meet the needs of the cost of that service delivered. But it doesn't stop there. Medicaid reimburses at 72 cents of every dollar of service provided. Today, for every Medicaid beneficiary in America, every time they receive a service from a doctor, a hospital, or wherever, 28 cents is shifted over to the private side to those who pay out of pocket, to those who have private insurance. If you are reforming health care, you can't reform health care without eliminating cost shifting. Yet in this plan, we increase the rolls of Medicaid by 15 million individuals. In essence, what that means is we are going to have cost shifting on steroids now. We are going to have more cost shifting than we had before, which means a higher inflation rate on private health care, that which we pay out of pocket or that which employers, in fact, provide for their employees. As a matter of fact, incorporated in this bill is a disincentive for small business success. I am not sure everybody has read to that point in the bill yet, but for a company that today can't afford, because of their competition to offer health care--the day they hire their 51st employee, the Federal Government will send them a tax bill of $38,250. At a time when we have 10.2 percent unemployment, 11 percent in North Carolina, small business is going to be the engine of job creation in this country, and we are saying as soon as you are successful enough that you hire the 51st person, if you don't offer the health care we tell you you have to offer, we are going to send you a tax bill of $38,250. Unfortunately, it doesn't stop there. For the Medicaid beneficiaries, for the Medicare beneficiaries, for everybody in America where we have said drugs are too high, devices are expensive, innovation costs money, what are we going to do? We are going to tax drug companies. We are going to tax medical device companies. We are going to actually raise the cost of our ability to detect something earlier, where our options are greater and, hopefully, through having those options earlier, in fact, we are going to be able to treat a disease or cure it much cheaper. I might add it is somewhat ironic that we are going to tax vaccines at a time when the industry is trying to meet the needs for vaccines for H1N1 across this country. This bill puts a new tax on the vaccine industry we have tried to revitalize in America. Let me suggest to my colleagues, this is not a health care bill. This is a layaway plan. In fact, what we have been presented is a plan where they are asking Americans to pay for it for a number of years--4, to be exact--before they get their product. We are going to pay in, in taxes; we are going to pay in, in Medicare shift; we are going to begin to increase the rolls in Medicaid, to wait 4 years down the road before we get the product, before we get any benefit out of it. What we are going to find 4 years down the road is that costs change. You see, it sold as a $849 billion plan today, an $849 billion health care reform package. Well, that is not what it is. If you look at it truly over 10 years, it is a $1.2 trillion plan. If you wait to start until the benefits are paid and look at it for a real 10 years of revenue and benefits, it is a $2.5 trillion plan. We can't even be honest enough with the American people that we tell them exactly what it is going to cost. But you would expect that out of a layaway plan, and, in fact, that is what we have in front of us. Let me suggest to my colleagues that if you reform health care, you can have coverage expansion without additional taxpayer investment. You can't take the things that are broken in our system and actually increase their use, such as Medicaid, and expect at the end of the day you are going to be able to save money, provide a better level of care; more importantly, that you are going to have a population that gets the benefits everybody else does: a medical home, preventive care, chronic disease management. It doesn't happen in Medicaid today. It will not happen when you increase the rolls of Medicaid. It will only happen when you reform health care, and this bill does not do it. I thank my colleague from Tennessee.

Mr. BURR

Mr. BURR. But in that 10-year period, if you took Medicare, the proposal to shift over, if you face the reality that we will not cut doctor reimbursements 23 percent, which is another $246 billion worth of revenue, and the creation of a new program called the CLASS Act actually has people paying in for 20 years before the first person might take out a benefit, those three items alone come to $700 billion of the $800 billion we are paying for it with. Most Members would agree there are cuts that probably will never happen. On the face, it says it is going to contribute to the deficit. It will continue to add to the deficit at greater numbers, as the ranking member of the Budget Committee has stated. But let me try to point out something I know my colleagues understand. This is a bill about coverage expansion. This is not a bill about health care reform. There are very few reforms, if any, in this bill. The Senator from Wyoming was talking earlier about Medicaid. One of the fundamental reforms that has to be made in health care is that we have to eliminate cost shifting where an individual who is uninsured goes in, receives a service, does not pay, and the cost is shifted to the private side, with people who pay out of pocket, people who have insurance. For the underinsured, the person goes in and receives a service, but the reimbursement is less than the cost of the service, and what is left over is shifted. Usually that is where the debate stops. But under Medicaid, the current system, we reimburse 72 cents of every $1 provided, meaning 28 cents is shifted to the private pay side, out-of-pocket and insured side. In this reform package, we are increasing the rolls of Medicaid by 15 million Americans. We are taking a program today where, if the attempt is to eliminate cost shift--which it should be in health care reform--we would be eliminating Medicaid and we would be putting the Medicaid beneficiaries in a program that actually provided them a medical home, provided them an opportunity at prevention, wellness, and chronic disease management. But, no, we are keeping Medicaid intact. And in the bill it says to the States: You cannot change your program. You have a maintenance of effort. You may find a more efficient way to do it, but if that efficiency means you are cutting any benefit, you are asking them to select where they choose health care differently, you cannot do that, States. We are locking you in for 10 years. And we are going to increase the rolls in Medicaid by 15 million Americans. We are actually exacerbating the problem we are trying to solve, which is, either shifting from people who do not pay or where there are reimbursements that underreimburse for a service. We are increasing the rolls by 15 million Americans. Forget the fact, as the good doctor from Wyoming knows, that when you lock them into Medicaid, you have locked them out of having a medical home. You have locked them into a system that is there to treat them when they get sick and not to spend a dime on trying to keep them well. The truth is, health care reform, in large measure, is about our ability to change the lifestyles of the American people so we make healthier choices. In part, you do that by creating a medical home. It is the reason most of us, if not all of us, have argued that everybody should be covered in some fashion. Health care should be accessible and affordable. The debate is over: where and what type. And, more importantly, should the American people have the ability to have choice? Should the American people have the ability to construct a health care plan that meets their age, their income, and their health conditions? What we are doing is, we are taking on a one-size-fits-all government approach to say: If you do not like what is out there, we are not going to let what is out there change. We will give you an option, and it is to be insured and to be managed and to be run by the Federal Government. I am not sure how others in other States have found it. In North Carolina, it has been overwhelmingly rejected by the population. I daresay, I think we have the greatest health care delivery system in North Carolina, both public and private, some based in academia. I think what North Carolina says is: Do not hurt my quality of care. If we are going to talk about reforms, let's talk about how we increase the quality of care, not decrease it. Unfortunately, this misses the boat on reform. It is the most expensive approach to coverage expansion that anybody could ever imagine. The question is, if we took some time, if we worked in a bipartisan way, could we find a way to do this more efficiently and more effectively for quality of care, where the outcome was different? This is a town obsessed with process, as my colleagues know. This is a product where we should be focused on outcome, not process. Because at the end of the day, there is an American family who is going to be the recipient of the rules, the regulations, and also the outcome of what this produces.

Mr. BURR. I might add, that level of innovation is what makes the U.S. health care system unique to the rest of the world. We may not do primary care very well, and I think we have all admitted that, but if you get sick, where do you want to be treated? Right here in the United States of America because of the innovation that takes place.

Mr. BURR. I think the Senator from Wyoming, being a medical professional, would probably agree with this: that every disease that can be detected at an early stage provides, one, more treatment options, greater survivability and, in the long run, less expensive cost to treat that disease. It troubles me we have these determinations being made on cost that are not true costs because they are not putting into the calculation the treatment cost. But, more importantly, incorporated in this bill we are putting fees on medical device companies, we are putting fees on pharmaceutical companies, we are putting fees on health care equipment companies. Why? Because they have to pay for them. We are replicating the same thing. We are disregarding the fact that when an innovative drug comes off the research bench, there is a likelihood we could cure disease versus maintaining, that we might have a new treatment option that cuts down on the cost. As the Senator knows, even though he is an orthopedic surgeon, we have cholesterol-busting drugs that now people take who would have been in line for bypass surgery. And after that, we got stents that we put in, in place of bypass surgery, and that bypasses the last resort. Sure, the creation of those blockbuster drugs was expensive. As they go off patent, generic competition comes in, and they become very inexpensive. But when compared to the $70,000-plus of bypass surgery, those drugs all of a sudden look inexpensive. But, more importantly, when you look at the quality of the care, where a patient did not have their chest cracked, they did not have rehab time, they did not have a hospital cost, we save a tremendous amount of money in the health care system.

Mr. BURR. I think the Senator makes a good point. I think many in the Congress who have worked on health care for a period of time have seen private businesses across this country reach new efficiencies in health care. Why? Because they have self-insured their employees. Where have they focused? They have focused on exactly what the Senator has talked about: prevention, wellness, chronic disease management, paying employees to enroll in chronic disease management courses, working with dietitians to make sure they lose weight, having cessation programs that are offered for free. The things we have seen in private companies across the country that have brought down health care costs are absent in this piece of legislation. It is as though they have come to Washington and shared their tremendous experience, and we have ignored it when we sat down to write the bill.

Mr. BURR. Well, the Senator makes a tremendous point about the rational, reasonable reforms that the American people are looking for, and saying: Why can't we purchase insurance across State lines if that creates competition? Why can't we have insurance reform that allows us to construct the products? Why does the Federal Government have to mandate: Here is what the structure is? Many Americans have chosen over the past several years to have flexible spending accounts, to have the ability to put their money in to take care of their health care needs. What does this bill do? It basically reduces the ability to fund flexible spending accounts at the amounts that are sufficient to let them continue to access their health care, in many cases with their own money. In fact, that is going backwards from what we have learned. The Senator from New Hampshire mentioned earlier this shift of money from Medicare to this new program. Think about our Nation's seniors, those who are relying on Medicare for their health care, and the next generation that is getting ready to go in--some of us in this room. Well, when you shift $464 billion, you are shifting $1,063 per senior per year. Over the 10-year life of this score, we are going to shift $10,363 per senior, per beneficiary on Medicare today. Is that fair to our country's seniors who have paid a lifetime of premiums into Medicare to receive a benefit, that because of fiscal irresponsibility that benefit may be cut in the future or the premium may go up for the next generation? And, thank goodness, the current beneficiaries in Medicare are screaming as loud as anybody because they understand the ramifications of what we are getting ready to do. As the Senator from New Hampshire said, this is all going to happen tomorrow. This is going to happen at 8 o'clock Saturday night. People are going to come to the floor and they are going to vote on a bill, 2,074 pages--one that, at best, takes a team of people reading and a computer searching words in hopes you can identify everything of importance that is in the bill.

Mr. BURR. That is exactly right.

Mr. BURR. I thank my colleagues from New Hampshire and Wyoming. Let me say on the same note, an $800 billion-plus bill, when you ask anybody in America, do you think this will increase the deficit, everybody's hand goes up. But the claim is that this is deficit neutral, that there is no no continuation of increasing the debt. Let me pick three areas, one you were just talking about, Medicare. This bill proposes that we shift $464 billion over 10 years to pay for this new program.

Mr. BURR

Mr. BURR. Mr. President, I thank and congratulate the chairman of the VA Committee. This is important legislation in front of this body. It is my belief that this will move very quickly, as we can see from the short time agreement: one amendment--one amendment that I think is extremely important for all Members of the Senate to consider. I rise in support of S. 1963, the Caregivers and Veterans Omnibus Health Services Act of 2009. This is actually the combination of two bills reported out of the Veterans' Affairs Committee this year, and it did enjoy bipartisan support. The centerpiece of the legislation is the support it would provide to caregivers of severely injured veterans of current wars. The bill would provide counseling, support, living stipends, and health care for those caregivers. As my colleagues know, family caregivers play an extremely important and, I might say, unique role in helping to meet the severely injured veterans' personal care needs. For some veterans, family members serve as their primary caregiver, some of whom have lost their jobs but, more importantly, have lost their health care as a result of that commitment to that family member. As the chairman spoke about a servicemember he had remembered in this--Ted Wade is a North Carolinian--he made the same impression with me. I also think about caregivers Edgar and Beth Edmundson from North Carolina as well, the parents of Eric Edmundson, a severely injured veteran from Operation Iraqi Freedom. They have been caring for Eric since the day they took him out of the VA hospital--out of a VA hospital because the VA basically had come to the point where they said they could not improve Eric's life. After Eric was injured on patrol along the Iraqi/Syrian border, he went into cardiac arrest while he was awaiting transport to Germany. It was in fact that cardiac arrest, that traumatic brain injury, that put Eric in a situation where he couldn't walk and he couldn't talk. As he lay in that long-term care provided by the Veterans' Administration, he got no better. He couldn't walk and he couldn't talk. Eric's father stepped to the plate and immediately began researching all the options for Eric's treatment. Despite being told his son would not emerge from his vegetative state, Ed Edmundson pushed on. He sold his business, he cashed in his savings and retirement pay, all in an effort to provide Eric 24-hour care as a father. Under his father's constant attention and relentless pursuit of new options, Eric received the treatment he needed. Without his dad's commitment, without the commitment of the rest of Eric's family--who basically dropped everything else important in life to focus on his needs--Eric would not be doing as well as he is today. I might say he walks and he talks and he continues to make progress every day because his most important caregivers, his parents, believed in him and they believed in what they could accomplish. Let me tell you the rest of the story. Beth, Eric's mom, recently suffered a compound fracture of her ankle while caring for Eric's daughter Gracie. Because Beth and Ed have no health insurance, they are on the hook for $36,000 worth of medical bills. Had Eric chosen Beth, his mother, as his caregiver, and this legislation was in effect, we would have provided coverage for Beth to have health care coverage. I believe that is what this legislation is about--recognizing the individuals who make life-altering commitments to members of their family or servicemembers who, without that commitment, might not have the quality of life they have. As I mentioned, assistance to caregivers is just one part of this bill. Other provisions would remove barriers to emergency care provided to veterans at non-VA facilities. It would expand health care services for women veterans, provide additional outreach to veterans in rural communities, provide additional improvements in mental health care services provided to veterans, enhance services to homeless veterans, improve the ability of VA to recruit and retain the needed health care professionals, authorize major medical facility construction projects, test a concept I introduced of providing veterans and their survivors with dental coverage, and much more. This is a good bill. It is not perfect. It can be better. I urge my Senate colleagues to strongly consider supporting the amendment of Senator Coburn, and let me explain why. When the committee passed this bill, we did not limit it to current veterans of current wars; we extended it to all veterans. Since it came out of committee in a bipartisan way, we have narrowed it down not to include all veterans. The amendment of Senator Coburn expands it to all veterans. When the committee considered the caregiver bill, we considered it because we wanted to keep veterans out of nursing homes. That was the goal, to give them an alternative because the traditional role of the nursing long-term care facilities had not worked at improving the quality of care and the quality of life for these veterans. That was our goal. Senator Coburn brings some definition to who is eligible for this based upon the fact that they would be headed toward a nursing home. We may tinker a little bit with the definition as to whether it is exclusive or totally as inclusive as we would like, but make no mistake, it is not different from the intent of the committee as to why the committee passed the caregivers act. Let me mention one probably even more important piece of the amendment of Senator Coburn. It actually pays for what we are doing. We say the Secretary ``shall''--that means he has to implement everything in the caregiver bill. The amendment of Senator Coburn is going to say: You know what. We are going to take some money out of the funds that we pay to the U.N., and we are going to fund our veterans. I, for one, am tired of coming to the floor and spending money we don't have. Why don't we take some of the money we have already appropriated and let's shift it? This is something novel for the Senate, but it is called prioritizing. Let's prioritize where the Federal investment should go. Let's make sure we pass the Caregivers and Health Care Act. Let's make sure we pay for it with the Coburn amendment, and let's pull that money out of already-appropriated funds so we can not only look at our veterans, but we can look at our children and tell them this is a good bill. I yield the floor.

Mr. BURR. Mr. President, I wish to reiterate, as the ranking member of the Veterans' Affairs Committee, this bill was reported out unanimously. I think it will receive unanimous support in its passage later this afternoon in the Senate. Let me restate for Members, when the committee passed this bill out, we passed it out with all caregivers being included. It was after the committee reported it out that we narrowed it to OEF and OIF veterans and their caregivers. It was the intent of the committee to include all the people Senator Durbin, the majority whip, said we might consider later on but not now. The committee's intent was let's do it in the bill now. It was also the committee's intent that these were individuals who were targeted for us to provide this caregiver benefit to so we can keep them out of nursing homes because of the Ted Wades, because of the Eric Edmundsons. Senator Coburn's amendment is consistent with the bill that was passed out of committee unanimously. The bill says the Secretary ``shall;'' therefore, it means he has to. The Secretary will then have to prioritize spending within the Veterans Administration to fund these programs. The third piece of what Dr. Coburn's amendment does is rather than force the Secretary to prioritize within just VA programs, meaning there are going to be veterans who win and veterans who lose, why not say as a Congress: Why shouldn't we do what we are supposed to do? Why should we not prioritize the spending here? What my good friend from Illinois suggested was why should we prioritize for the United Nations? Let me say the answer is quite simple: It is our money. The suggestion that the Congress doesn't have a fiduciary responsibility to fund programs we implement at a time we are borrowing 50 cents of every dollar we spend is ridiculous on its face. To suggest that the Senate, the Congress can operate any differently than a family in America suggests that we ignore the input of everybody who asked us to represent them. We do represent the American people, 100 individuals who represent the entire country. How can we do it differently than any family who is out there struggling to meet their end-of-the-month obligations and when their revenue does not meet their expenses? What do they do? They either cut back their expenses or they find a place to raise more revenue. Let me suggest this is as simple as, Is it time for us to prioritize where we are placing money? Members will have to decide: Is pulling money from the United Nations an appropriate place for us to pull money from to then spend on our country's veterans? I believe we have an obligation, I believe we have a promise, even for programs that did not exist prior to this time, that when we see it is in the best benefit of the quality of life of our troops, that we provide that benefit for them. But I believe we also have an obligation to this generation and the next one and the next one to pay for it. This is not a choice that is tough for Members. If you support the Coburn amendment, you support practically everything the committee supported when we passed the bill out by unanimous consent. If you support the Coburn amendment, you believe we have an obligation to pay for it. The only reason you would vote against the Coburn amendment is because you don't think it is appropriate for us to deprive the United Nations of this money to use as they see fit. I suggest this is where the disconnect is with the majority of America. They would prefer the Senate to decide where that money went and to use it on these caregivers and these veterans programs. I encourage my colleagues to support the Coburn amendment, support passage of this bill this afternoon when we take it up. I wish to shift gears slightly because I think it is somewhat ironic that we are talking about expansion of services to our Nation's veterans at a time when some herald the introduction of a bill that, in all likelihood, will deprive other Americans of the ability to have affordable health care. We have gone through several months of debate now about health care being accessible and affordable for all Americans. We have talked about reforms; let's change the system; let's reform the system; let's make it accessible and affordable; let's bend the cost curve down. In the last 24 hours, some have come and said we have accomplished that, it is amazing. Let me remind my colleagues, we have all said health care is unsustainable in its current level of investment, 17 percent of our gross domestic product. I find it somewhat odd that we would start the debate given that it is unsustainable in its current financial investment with how much more money does it cost to reform health care. The obvious answer to me is it should cost zero. If you are already spending too much, we should look at the reforms before we look at the coverage expansion. I agree every American ought to be covered. As a matter of fact, Dr. Coburn and I have offered comprehensive bills to do that. But it is matched with real reform. What was heralded in the last 24 hours is, in fact, a $2.5 trillion health care bill--$2.5 trillion--over a 10-year period of collecting the revenues and paying out the expenses. This is where gimmicks, smoke and mirrors--whatever you want to call it--are used in Washington. If you collect revenue for 10 years but you only pay benefits for 6 years, you don't get a true picture of what it is going to cost over 10 years. You get a true impact of the revenue stream which is over $800 billion. From where will that $800 billion in new revenue appear? Taxes. They go up $493.6 billion--$493.6 billion. We will cut $464.6 billion out of Medicare. A $\1/2\ trillion we are going to take from a program with a designated population of beneficiaries of our Nation's seniors and those who are classified as disabled and we are going to take $\1/2\ trillion from Medicare and shift it over to meet the new burden of a health care plan yet to be constructed. Why is this problematic? It is $1,063 per Medicare beneficiary every year. Over the 10-year cycle of this health care plan, we are going to steal from every senior in this country $10,363 worth of health care money. We are going to take it from their program, and we are going to put it over in this new program because it is paid for. Legitimately, when you raise taxes, when you raise fees, when you raise revenue, you are making tough choices. I think when you go in and tax health plans and that raises $149.1 billion; when you increase a penalty for a nonqualified health savings account and you get $1.3 billion--these are revenues. They are legitimate. It is no smoke and mirrors. I don't think the American people believe for a minute this is deficit neutral. I don't believe for a minute they believe we are going to take $464 billion out of Medicare. If they do believe it, they know we are going to pay it back with future taxes on the American people. That is fine, if that is the way we want to prioritize. But health care reform affects every American. This is a very personal issue for every American and every family. It touches them unlike anything else we do. The truth is, they know if you take it and you put it in one pocket and you take it out of the other pocket, the effect on them either has not changed or it is negative. Let me suggest to my colleagues this bill is 2,074 pages. I will admit--I may be the only one--I have not read it since it was introduced at 6 o'clock last night. I am not sure there are many Members who have or could have. But let me suggest there will be a question about whether, for the first time, we use taxpayer money to perform abortions. Personally, I believe that is wrong. I will not support a piece of legislation that does that. This bill does that. An employer mandate, at a time when American companies are trying to be competitive in a global marketplace? We raised $28 billion in employer mandates. I am not sure that is making U.S. companies more competitive in a global marketplace. I think the economy is the No. 1 challenge we have in America. I think 10.2 percent unemployment and going up--if it were a disease, we would be on the floor of the Senate calling it an epidemic and we would be doing whatever and spending whatever to help turn it around. But we are doing nothing. As a matter of fact, we are doing everything we can to try to drive up unemployment, to dry up the economy, and to make companies less competitive in a global market. The President said one of the objectives of health care reform was we need to bend the cost curve down, we need to make sure there are cost savings in health care for every American. Let me tell you what the Congressional Budget Office says: Under the legislation, federal outlays for health care will increase during the 2010-2019 period, as would the federal budgetary commitment to health care. That is Washington language for: You know what. Our expenditures on health care are going to go up. What happens when Federal expenditures go up? Everybody's go up. That is a known fact by the American people. The coverage expansion would drive a new increase in government spending on health to the tune of $160 billion over 10 years. Make no mistake, this does not bend the curve down, it bends the curve up. We spend more money. CBO scored the bill as reducing the deficit by $130 billion over 10 years, 2010-2019. What does it take into account, to come to that calculation? It assumes doctors are going to get cut 23 percent in their reimbursements in 2011. We have less than 1 million doctors to serve 300 million people. Does anybody believe for a minute we are going to allow a 23-percent cut to go in at a time when we are starved--trying to attract people to go into medicine as a profession? If it does go in, we are going to take $247 billion out of the pockets of doctors we rely on to perform the surgeries, to make the diagnosis for us and everybody else in this country. The new creation of the CLASS Act, long-term care policy, shows in the CBO score a $72 billion savings. Let me explain it like this: Nobody qualifies today because it doesn't exist. People are going to pay premiums to be eligible for this long-term benefit. It takes about 20 years of paying in before somebody is going to be eligible to pull out. It is not similar to Medicare, when we created it, where, even if you never paid in, you started on day one. We are collecting revenues for 20 years before we ever pay out the first dime. It is not hard to understand why you would have a $72 billion surplus out of this. Let me ask, what happens after that? What happens after you get past that 20-year number? The truth is, it starts to get into the trillions and trillions of dollars for which the Federal Government is obligated, based upon the premiums and the benefits people have assigned to it, that they pay out. If you eliminated these two gimmicks, just on its face this bill would be $189 billion out of balance, in the red. It would not be paid for. I suggest that is just two smoke-and-mirror tools. The start date was moved from 2013 to 2014. No longer is our focus on how do we get care delivered as quickly and as efficiently. We just pushed it off a year because we said the Congressional Budget Office says we are short on raising money, and we have raised all we can in fees and taxes. Maybe not all. I think they probably have some things targeted that are still yet to come out. The key thing is, even if you did implement it, there are 24 million Americans who are still without insurance. The objective to cover everybody was not met. There are $25 billion worth of unfunded mandates to our States. I don't know of a State that is in financial health today. There may be one or two. My State of North Carolina was $4 billion out of balance. Last year, the Federal stimulus was $2 billion of closing the gap. That $2 billion, by the way, we didn't have. We borrowed to give to North Carolina and other States to create jobs. It was used to close budget gaps so they didn't have to make tough decisions. As a matter of fact, we found out this week, on one of the news channels, there is $98 billion that didn't have anything to do with stimulus. We are the laughingstock of the world on the way we applied the stimulus package. But the sad part is not the fact that it has been uncovered, it is that it didn't do anything to put Americans to work. Now we are saying to the States we are going to put another $25 billion on you. In Medicare, we are going to cut from the fee-for-service payments $192 billion. So we already have $247 billion over here that we are getting from doctors if we go through with the payment cuts. Now we are targeting another $192 billion out of Medicare reimbursements, right out of the pockets of doctors and hospitals. Is there a community hospital in America that will be able to survive, given the cuts that are getting ready to hit them? We cut Medicare Advantage $118 billion. Some cheer that. I tell you who doesn't cheer it: the 20 percent of America's seniors who chose Medicare Advantage as their preferred choice to traditional Medicare because it required of them less out-of- pocket obligation, it didn't hit them for $750 deductible the day they walked into a hospital. What about those 20 percent of our Nation's seniors when they lose Medicare Advantage? What about the $43 billion in DSH, disproportionate share payments, we pay the hospitals to make up for the uncompensated care they deliver? I guess the authors of the bill would say we are covering everybody so there is no uncompensated care. Wrong; 24 million are still without insurance. There is going to be uncompensated care, and we are taking away the money we are providing the hospitals to make up for the uncompensated care they delivered, meaning it is coming right out of their hide, that local hospital in the community we live in; $23 billion in unspecified cuts by the Medicare Advisory Board. Is America comfortable with us turning to another advisory board to cut $23 billion? We just had an advisory board say: If you are 40 to 50 and you are female, you don't need to worry about your breasts, don't need to go get a mammogram, don't need to do self-examinations--trust us. One of the reasons the health care system in America is the best in the world is because we spend money to innovate. We hope companies find breakthroughs. We look at diagnostic abilities in an effort to try to detect early, so the options are greater and so the cost is less. But now, all of a sudden we are saying that is not important. There are 162 million Americans who currently have employer-based health care. In this bill, regardless of what that employer does, they will not be eligible for subsidy. If they currently have coverage but they may be below income and for some reason their employer has to drop their health care or cut back on the plan because--maybe they are not competitive after this in the global marketplace--even though they would qualify from an income standpoint, they will not qualify because they were provided health care before. Our favorite, the IRS says it will take another $5 to $10 billion so they can actually go out and collect these fees and taxes. The cost of the subsidies alone in the exchange is estimated by CBO to grow at 8 percent a year. I ask you, if the reason we have gotten into this discussion, had this debate, was we are trying to turn the cost curve down on health care, and we have quoted a 6-percent increase a year and a 5.5-percent increase a year and a 7-percent increase a year, why in the world would we be considering a plan that CBO tells us is going to have a cost increase for the subsidy of 8 percent a year? I would hope, if we had real reforms that worked, the cost of the subsidy would decline 8 percent a year. I know there are others seeking time. I will not belabor this point. I ask Members: Support the Coburn amendment on the veterans bill. Support passage of the veterans bill. Read the health care bill. Be prepared to debate the health care bill for a very long time and be prepared to stand for the American people on what is right. I yield the floor.

Mr. BURR. Mr. President, I wish to be recognized under the 6 minutes I currently have available to me, and if the clerk will notify me at the end of that time, then I will go into Senator Coburn's allotted time.

Mr. BURR

Mr. BURR. Mr. President, I wish to speak to amendment No. 2743 which would reallocate $750,000 from the general operating expense account to fund programs to end veterans' homelessness, including the Department of Veterans Affairs' Homeless Provider Grant and Per Diem Program, and VA's Supportive Services Grants Program. This money will help more than 131,000 veterans who are homeless on any given night including the estimated 1,659 homeless veterans in my home state. Many veterans are considered homeless or at risk due to their poverty, lack of support systems, and poor living conditions. Homeless veterans are comprised of middle-age and elderly veterans, as well as younger veterans returning from Iraq and Afghanistan. The VA has identified 1,500 homeless veterans who fought during the current wars and of those, only 400 have participated in programs specifically targeting homelessness. Sadly, homelessness among the ranks of recently separated combat veterans is not a new phenomenon, and their plight for the Nation's compassionate assistance is just as strong today as it was centuries ago. According to Todd DePastino, a historian at Penn State, homeless veterans of the post-Civil War era sang old Army songs to dramatize their need for work. After World War I, thousands of veterans marched and camped in the Nation's Capital to express their frustration over bonus money. Many of these veterans were either homeless or at risk of becoming homeless. After the Vietnam war, returning veterans were faced with serious physical, mental, and socio-economic problems that put them at serious risk of becoming homeless. According to VA the number of homeless male and female Vietnam era veterans is greater than the number of servicemembers who died during the Vietnam war. It is important that Congress and VA remember the lessons learned from previous wars. We must work together to prevent homelessness before it begins with the goal of eliminating homelessness. Much progress has been made, but we can do better. My amendment targets two specific areas within VA's medical care budget for more funding. The Homeless Provider Grant and Per Diem Program offers funding to community agencies that provide services to homeless veterans. The purpose of the program is to promote the development and provision of supportive housing and/or supportive services with the goal of helping veterans achieve and maintain residential stability. The supportive services programs allow veterans who are at risk or who are reentering the workforce to receive services that will reduce their likelihood of becoming homeless. Supportive services include health care services; daily living services, personal financial planning; transportation services; income support services; fiduciary and representative payee services; legal services; child care; housing counseling; and other services necessary for maintaining independent living. In short, these programs are comprehensive and they work. My original intention was to offer an amendment that would reallocate $43,387,240, on top of the money in this amendment, for homeless programs. Ten years ago that money was originally appropriated for the Multifamily Transitional Housing Loan Guarantee Program. Since that program has been suspended, I believe this money could be put to a better use. However, the Congressional Budget Office tells me that rescinding the $43 million and spending it on this bill would run afoul of our budget rules. I will therefore look for another opportunity to put this unused money to a better use in the near future. In the meantime, CBO has informed me that the amendment is compliant. I thank my colleagues for their support of my amendment.

Mr. BURR

Mr. BURR. Mr. President, I come to the floor today to talk about an issue I have been working on for 2 years--namely, ending the arbitrary process through which our own government takes away the second amendment rights of veterans. Let me briefly describe what I mean about this issue. As most of my colleagues know, the Federal Gun Control Act prohibits the sale of firearms to certain individuals, including convicted felons, fugitives, drug users, illegal aliens, and individuals who have been ``adjudicated as a mental defective.'' Furthermore, the Gun Control Act prohibits possession of firearms by any of these classified individuals. Needless to say, it is a serious matter. Criminal prosecution is an option against those who violate the law. The Brady Handgun Violence Prevention Act requires the government to maintain a database of these individuals. We call this the National Instant Criminal Background Check System, NICS. The Brady law and the NICS database aim to prevent those who may pose a danger to society or to themselves from purchasing a firearm. Gun owners reference to the NICS screen customers--again, it goes without saying it is a serious matter to have one's name on NICS. Every American should expect a rigorous and fair process before their right to buy arms and bear arms is taken away, especially when criminal prosecution is involved. Unfortunately, when it comes to certain veterans, their spouses, their dependent children, their dependent parents, the process is neither rigorous nor fair. Since 1999--now 10 years--the Veterans' Administration has sent the names of 116,000 of its beneficiaries to the FBI for inclusion under the NICS list. Again, the NICS list means those 116,000 individuals can never purchase a firearm. None of these names were sent to the FBI because they were determined to be criminals or a danger to themselves or, for that fact, a danger to others; they were listed in NICS because they couldn't manage their own financial affairs. We should not take away a constitutional right because someone can't balance their checkbook on time. VA's review process for assigning a fiduciary is meant to determine one's financial responsibility in managing VA-provided cash assistance, such as VA disability payments, pension benefits, and other benefits. For example, a veteran may be assigned a fiduciary if they have a credit problem. The VA focuses on whether benefits paid by the VA will be spent in a manner for which they were intended to be spent. If you held that threshold to every veteran, you would probably assign a fiduciary to all of them because we don't know in fact where the payments go or what they were intended for. Nothing involved in the appointment of a fiduciary even gets to the question of whether an individual is a danger to themselves or others or whether the person should or should not own a firearm. Yet that is exactly what happens when the VA appoints a fiduciary to one of our Nation's veterans. Let me put a human face on the issue, if I can. I want to read excerpts from a letter I received from Jennifer Briest. I have her approval to read it. Jennifer is the wife of Corey Briest. Corey served in Iraq. He was a paramedic. He was severely injured in an IED explosion in 2004, which caused severe burns, damage to his lungs, and severe traumatic brain injury after shrapnel entered his skull. Corey has spent the last 5 years recovering from his injuries. Jennifer reports that he is walking, talking, and enjoying life at home with his two children. Now it gets really sad. Because of his head injury, Corey still requires help with certain things. The VA said he needed help managing his disability compensation payments, and they named Jennifer, his spouse, as his fiduciary. That is where I would like to read from her letter. Again, I quote from her letter: On May 19, 2009, we had our annual fiduciary meeting with the VA field examiner. At the end of the meeting our field examiner said he needed to read a statement to us. He read the Brady bill statement and then stated that Corey can't own, possess, use, be around, et cetera, any firearms. He then went on to say that anyone in our household can't own a gun while living in this household. I asked him about Corey going on adaptive hunting trips and he said that he couldn't. Corey stated that he had a gun that was handed down from his grandfather and that Corey was going to hand it down to his son and the field examiner told him that he couldn't have it. He stated to Corey that if he did own a gun or be around a gun that he would be threatened with imprisonment. The way that field examiner talked to Corey about this issue was not appropriate. The field examiner said that I could challenge it and handed me a blank sheet of paper with a VA heading. I asked the field examiner for the statement he read to me, but he said that he had to ask his boss [if he could actually provide a copy of that statement]. After two weeks of me e-mailing him, I finally got the attached papers in the mail. I think the VA is taking this way out of concept and I would greatly appreciate your support. Well, in case any of my colleagues think the government would never prosecute someone like Corey Briest for possession of a firearm, being around a firearm, I wish to read to my colleagues excerpts from a VA directive that went out to all VA regional offices on September 29, this year, on this very issue. The directive is meant to inform fiduciary field examiners of their obligation if they were to witness a violation of the Brady Act. I am going to quote from this VA memorandum to their field examiners. Field Examiners or other VA employees who encounter beneficiaries believed to be in violation of the Brady Act are required to notify the Fiduciary Activity Manager as soon as safely possible. At no time should the employee place him/ herself in danger. The Fiduciary Activity Manager at the VA regional office of jurisdiction must immediately report the alleged violation to the Bureau of Alcohol Tobacco and Firearms at 1-800-ATF-GUNS. That is straight out of the Department of Veterans Affairs memorandum to their field examiners. For 2 years I have gone through this in the VA Committee. I have tried to plead with my colleagues that this is a breach of the second amendment of our country's veterans, that no veteran who has had their name reported of the 116,000, have ever been judged by a court to have a mental deficiency. In most cases, this is because there is a fiduciary needed to make sure they stay up to date. But there is not an incapacity on their part that has been judged to be a flaw in their judgment. Quite frankly, I find it offensive. I find the language of this directive offensive because the premise seems to be that our veterans are dangerous. But as I mentioned, there is nothing about the current process that even gets to the question of an individual as dangerous. The current process is also a double standard. Only VA beneficiaries fall under these guidelines. The Social Security Administration assigns fiduciaries to help beneficiaries every single day. Yet it does not send their name to the NICS list. We have a policy on the books that discriminates against individuals because they wore our Nation's uniform, because they fought on behalf of this country. I find it unacceptable and it must end. I have a bill, S. 669, that would prohibit the VA from continuing this arbitrary and unfair practice. It would require a judge, a magistrate, or another judicial authority to determine that a VA beneficiary is a danger to themselves or to others before their name could be sent to the NICS list. Twice the Veterans Affairs Committee approved this bipartisan legislation to afford veterans with due process before their second amendment right was snatched away from them. But twice the bill languished on the Senate floor. S. 669 was approved unanimously by the committee back in May. But it has gone nowhere. And the question is: Can veterans wait any longer or should veterans wait any longer? I am not here to ask that we put guns in the hands of dangerous people. I am here to ask you, to plead with you, that we treat veterans fairly and that their rights are protected like every other citizen. Many of our veteran organizations and other groups agree with me. The Veterans Second Amendment Protection Act has the support of the American Legion, the Veterans of Foreign Wars, AMVETS, the Military Order of the Purple Heart, the National Alliance on Mental Illness, the National Rifle Association, and Gun Owners of America. I plead with my colleagues: Ask for S. 669 to be brought to the floor. Do not sit back and say this is an obscure thing that the VA sometimes engages in and sometimes does not. Again, September 29, 2009, 1 month ago, this directive goes out: Subject: Reporting violations of Brady Handgun Violence Prevention Act. This letter provides guidance to our field personnel who may encounter violations-- Violations by a veteran who served his country, is not a danger to himself or to anybody else, but has been deemed to need fiduciary help even if it is a spouse and a second amendment right was yanked from his hands, and now the VA says to their field examiners: Report it because we will prosecute these individuals. I am not exactly sure how to respond to Jennifer Briest. That letter she sent me about: Corey continues to make progress after an IED explosion December 4, 2005. How do you say to a kid who served his country, who is raising a family: One, we had to turn you in so you can never own a gun. And, two, that gun your father handed down to you, Corey, you have to get rid of it. You cannot hand it down to your child, because even if you handed it down today to your son living in your home, they cannot have that gun, because the Veterans Administration says you cannot. But if a fiduciary was assigned to Corey's father or to his mother, the Social Security Administration does not send that in to the NICS list to deprive them of their second amendment right. This is the most unfair thing I have seen this country do. It is time we end this practice. It is time we respect our veterans. It is time we treat them fairly. It is time we uphold the Constitution of this United States. I yield the floor and I suggest the absence of a quorum. The PRESIDING OFFICER (Ms. Klobuchar.) The clerk will call the roll. The assistant bill clerk proceeded to call the roll.

Mr. BURR

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

Mr. BURR. Mr. President, are we in morning business?

Mr. BURR. I ask unanimous consent to speak in morning business for 20 minutes.

Mr. BURR

Mr. BURR. Mr. President, I thank Senator Coburn for yielding. Let me just say the reason he is gray is because he cares. This is a Member of the Senate who typically on Monday morning delivers babies, and all weekend long. Before he comes back to Washington, he practices medicine. This institution looked at what he did and said: You can't charge for what you do even though it costs you $200,000 a year to keep your practice open, your license in place, to buy your liability insurance. They said that is illegal under Senate rules. So Tom Coburn is a unique individual. He sees women who are pregnant. He delivers babies. But he doesn't take any payment for it. He keeps his license up to date. To some degree, it is charity care because he believes it is the right thing to do. More important, he understands that what we do here affects what our children and our grandchildren get in inheritance from us--not financial inheritance, in opportunity. Why are we passionate about the debt? Why are we passionate about trampling on the Constitution? Because every time we do it, we take an opportunity away from the next generation. We reduce their ability to be successful, whatever their definition is. Tom Coburn covered it very well. We are somewhat impassioned about our criticism toward the bills that passed out of the HELP Committee, the Finance Committee soon, and the three bills in the House. Why? Because we introduced our bill first. We laid our cards on the table. We offered to work in a bipartisan way with anybody, and we had no takers. I believe when you lay it out there and you come up with a successful plan, you have every right to be critical. I do question the ones who do not offer an alternative. But we have offered a solution, and that solution was based on three fundamental principles: One, it had to cover everybody. The way our bill is structured, every American receives the same financial stipend regardless of whether they work or whether they don't, regardless of where they live. We treat everybody the same. Two, if you are going to get cost savings, then you have to make direct investments in prevention, wellness, and chronic disease management. The Patients' Choice Act makes direct investments in prevention, wellness, and chronic disease management. Three, is it financially sustainable into the future? We probably should have started with this one versus save it for last. Why in the world would we create a health care system in America if it is not sustainable? If it is not financially sustainable, why would we even consider that legislation in the Congress of the United States? If it did not pass the test of time, why would it even be worthy of debate? Unless we expect people outside of America to continue to finance our urge to spend, then I have to tell you, we are not going to have any money--either that or we are going to have to tax the American people to a point where they are not going to want to be successful, they are not going to want to work overtime, they are not going to want to switch jobs because the benefit to them of being successful is to be punished by taxes. This bill is filled with new fees, new taxes. True reform that expands coverage would pay for itself. Think about that. If you truly reformed health care, would the reforms through savings not pay for the expansion? Shouldn't this be a net sum game? We have left out of the bill shopping across State lines for insurance. It saves money. The American people are sitting there: Why aren't you doing this? Tort reform saves money. The American people are sitting there: Why aren't you doing this? Let me end on one that I think the American people are really plugged into. Congress, which plan are you putting yourself under? You designed this plan for everybody in America. Is it the plan you are going to have? You know what, in the Finance Committee, in the HELP Committee, in the House committees, there have been amendments that said Congress has to take the plan they create for the American people. That government option, that is what Congress has to be under. It has been rejected every time it has been offered. But you see, Dr. Coburn and I took a different approach because in the Patients' Choice Act, we had to set what the basic minimum plan was going to be. Do you know what we put? The Federal Employees Health Benefits Program. We didn't put them into the FEHBP, but we said it had to be equivalent to what Members of Congress had. How could we ask the American people on a plan we create to have less than we have? The American people expect us to look after them, they don't expect us to give them less than we have. It was rejected every time that was offered to move Congress to their plan. But I think it tells you a lot about the way Tom Coburn and I approached the bill we worked on because we never thought about taking us and putting us into their plan, we thought about taking them and raising them to our plan. There is a big difference in that. There is a big difference in looking at the American people and saying, you should be here; not the American people saying, you should be where we are. We want people to be successful in this country. Tom Coburn said this is not a bipartisan bill. He is right. But I will end with this tonight: This is also not a reform bill. If you want to talk about expanding coverage, it does an equal job to what the Coburn-Burr bill does. If you want to judge it based upon reform, it accomplishes no reform. I encourage those who are not satisfied with the options that have been presented in the House or the Senate or that will be debated, go on Tom's Web site, go on my Web site, Google ``Patients' Choice Act.'' Read the bill. It is only 200-some pages, it is not 1,000. The truth is, if we have a real debate--at some point, we will have one about health care reform--I could suggest to the American people one word that would drastically reform health care, that could replace all 1,000 pages of a House or Senate bill. It is called portability. It is called the ability for an individual employee to take their insurance from one employer to another, not to be construed in any way because they have a preexisting condition, but also to recognize the fact that when you do portability, you change drastically the way insurers look at covered lives. I think the American people would be shocked to know the average person is under a health care plan for an average of 4\1/2\ years right now. Ask yourself: If I am an insurer and I am going to invest in somebody's lifestyle changes and I am only going to have them 4\1/2\ years--how much are you going to invest? The answer is, probably very little. By the time they lose weight or quit smoking, you haven't reaped the benefits of those savings, and all of a sudden you create portability. That means a 24-year-old covered by an insurance company-- that insurance company has an opportunity to keep him until he is 64 years old, 40 years. How much are you going to invest in that insured if you are going to have them for 40 years? You are going to invest a heck of a lot because you will want to keep him well as long as you can. You are going to reimburse doctors to do the education; you are going to make sure you keep them out of the hospital; you are going to make sure that if they go into the hospital you get them the treatment they need to get them out as quickly as you can. You are not going to deny a prescription a doctor wrote for them. You are not going to question a treatment a doctor chose because all of a sudden the doctor is a partner to the insurance versus just a cost to the insurance. You see, true reform has to change health care across the board. It has to change the relationship between patients and insurers, between doctors and insurers, between hospitals and insurers. Ask yourself: Does the Baucus plan accomplish any of it? The simple answer is no, it does not. That is why it costs $829 billion, and that is why to pay for it you don't get it through savings, you get it through taxing and fees. You get it through the insurance costs of everybody who has it. You achieve the costs by cutting Medicare, by knocking seniors off the health care plan they prefer. You get there by increasing the income limitations on Medicaid, making States actually pay for the expansion of 11 million Americans who are going to be covered under the most inefficient health care system in the country, Medicaid, where only 60 percent of the health care professionals will even see Medicaid beneficiaries because the reimbursements are so low. But we are going to grow that population by 11 million people. We are doing an injustice to these people to put them in a plan where only 60 percent of the health care professionals will see them. They will not get the education they need for chronic disease management. They will not make the lifestyle changes because Medicaid does not pay for prevention, wellness, or chronic disease management, nor does Medicare, nor does the VA, nor does Indian Health. Show me a government plan that pays for prevention, wellness, and chronic disease management, and I will quit coming to the floor and quit talking about the lack of reform. The truth is, the Baucus plan tries to replicate what the Federal Government has, and it does not have prevention, wellness, and chronic disease management today. It will not have it tomorrow, and it will not have it next year. Mr. President, I thank you for your patience. I assure you and our other colleagues that Dr. Coburn and I will be frequent visitors here as we get ready for this debate, as we have this debate, and probably after this debate is over, depending upon the outcome of it. But let me make it perfectly clear, if any Member in this debate is looking to try to achieve a bipartisan solution to health care, you can sign Tom Coburn and Richard Burr up today to sit at the table with you, to forget about who is the author of legislation, to talk about real solutions to real problems that deal with health care. I am committed to doing it, but I am not committed to rolling over and just accepting another expansion of the Federal Government and Federal Government spending. Mr. President, I yield the floor.