John Barrasso

Mr. BARRASSO

Mr. BARRASSO. Madam President, I ask that the time in this block be allocated as follows: Senator Bond, 6 minutes; Senator Collins, 7 minutes; Senator Enzi, 6 minutes; Senator Chambliss, 6 minutes; Senator Brownback, 5 minutes.

Mr. BARRASSO. I yield the floor.

Mr. BARRASSO. I think my colleague makes a key point. My colleague from Idaho has been discussing what has been described as the worst disaster in American history, and it is what is happening right today in the Gulf of Mexico. Should the Environmental Protection Agency maybe be focusing its efforts there, where we know there is a real problem, a real job to be done, real concerns, and the American people are looking or should the Environmental Protection Agency spend its time and spend our resources driving up the cost of energy and doing it with the idea that perhaps 100 years from now it might make a difference? The efforts ought to be placed today where the efforts are needed most. The Environmental Protection Agency ought to be focused on the gulf, not on something that theoretically may make a difference 100 years from now. At a time when emissions are going up in China and going up in India and going up in Russia, going up all around the world, the Environmental Protection Agency says: I want to handcuff the American economy, handcuff the small businesses of this country. At a time with 9.7 percent unemployment, let's make it tougher on Americans--that is what the Environmental Protection Agency wants to do. If this Senate goes ahead and defeats the Murkowski amendment, they will be saying exactly the same thing. We are going to make it tougher on small businesses. For the small businesses in the western part of the country, we have our small refiners, we have our agricultural folks, tourism folks--all of the different people as part of the Western Caucus. What is this impact going to do to you? What is your position? We contacted agricultural groups all around the West. Look at this map of the United States. More than half of the square miles of the United States included in here support the Murkowski resolution because they know it is key to their economy. It is key to those parts of the country. It is key to agriculture. It is key to energy production. And it is key to families who are trying to balance their budgets, live within their means. They do not want to see an increase in taxes, which is what this is--an increase in energy costs at a time of 9.7 percent unemployment. I tell you, I am here to support the Murkowski resolution of disapproval. The EPA's endangerment finding starts the process of taxing everything Americans do: driving cars, heating homes, powering small businesses. This will cost millions of Americans their jobs. It is fascinating. The Small Business Administration wrote to the EPA a couple of times reminding the Environmental Protection Agency to stop the endangerment finding and look at its impact on small businesses, on small communities. The SBA basically said: Comply with the Regulatory Flexibility Act, the law meant to protect small businesses from excessive regulation from Washington. I will tell you, when you talk about excessive regulations from Washington, we have seen them in the last year and a half. This bedrock law was meant to protect the ranchers, the small refiners around the States, restaurant owners in Utah, dairy farmers--you name it. But with unemployment hovering at about 9.7 percent, it is unacceptable that the Environmental Protection Agency has failed to evaluate the impact of greenhouse gas regulations on the small businesses and the communities across America. Who grows jobs in America? Small businesses. In the last 15 years, small business owners have been responsible for 64 percent of all job creation in America. But additional regulations, additional rules, additional taxes make it that much harder. Is it going to actually have an impact on the global environment? No, not at all, not when you take a look at what is happening in China, where their emissions are going to go up every year all the way through 2050. India's emissions are going up; more and more energy is being used. If you want to use energy well, the United States does the best job in using it efficiently. It just seems that when I go home on weekends to Wyoming--and I will be there again tomorrow--and I talk to people in various parts of the State, they say: What are they thinking back in Washington? Why are they going to make it harder for us to compete? Why are they going to make it harder for us economically? The food producers in our Nation compete globally to sell food products, and they do it in a way where we need to use energy. Agriculture is a hugely energy-intense operation, and anything that increases the costs of producing that food is going to get passed on to consumers in this country and consumers in other nations as we go ahead and try to compete and sell our products overseas. It does seem that this EPA endangerment rule will ruin the small business engine that drives the economy on jobs.

Mr. BARRASSO. I think the Senator from Utah has made a clear point. The costs are real. The costs of doing this are very real. The benefits, however, are theoretical. I see my colleague and friend from Idaho here. I ask him, who elected the Environmental Protection Agency? Because we sure know the American people are against these increased costs for energy and these job- killing regulations.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I rise today to address comments made on the floor of the U.S. Senate on June 8, 2010. The senior Senator from Montana accused me of slandering an individual. That individual is President Obama's nominee to be the next Centers for Medicare and Medicaid Services, CMS, Administrator, Dr. Donald Berwick. The Senator from Montana is incorrect. I want the record to accurately reflect the foundation on which I made my comments on the floor. I told the Senate that the nominee to be the next CMS Administrator ``loves the British health care system and says we are going to need to ration care. The new Director of Medicare is planning to ration care.'' I based my comments solely on historic statements made and articles written by the nominee about the British health care system and rationing care. These statements include: 1. ``The decision is not whether or not we will ration care--the decision is whether we will ration with our eyes open.'' You can find this statement in: ``Rethinking Comparative Effectiveness Research,'' An Interview with Dr. Donald Berwick, Biotechnology Healthcare, June 2009. 2. ``I fell in love with the NHS to an American observer, the NHS . . . is such a seductress.'' You can find this statement in: ``Celebrating Quality 1998-2008'' by Donald Berwick, M.D., speech at London Science Museum, September 30, 2008. 3. ``The NHS is not just a national treasure; it is a global treasure. As unabashed fans, we urge a dialogue on possible forms of stabilization to better provide the NHS with the time, space, and constancy of purpose to realize its enormous promise.'' You can find this statement in: ``Steadying the NHS'' by Donald Berwick, M.D. and Sheila Leatherman, BMJ, July 29, 2006, p. 255. 4. ``Cynics beware: I am romantic about the National Health Service; I love it. All I need to do to rediscover the romance is to look at health care in my own country.'' You can find this statement in: ``A Transatlantic Review of the NHS at 60'' by Donald Berwick, M.D., BMJ, July 26, 2008, p. 213. 5. ``Here [in Britain], you choose the harder path. You plan the supply; you aim a bit low; you prefer slightly too little of a technology or a service to too much; then you search for care bottlenecks and try to relieve them.'' You can find this statement in: ``A Transatlantic Review of the NHS at 60'' by Donald Berwick, M.D., BMJ, July 26, 2008, p. 213.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I ask unanimous consent to speak as in morning business.

Mr. BARRASSO. Mr. President, I come to the floor today because the President of the United States earlier today had a townhall meeting to talk about the new health care law, the law he has promoted and talked about and which has been a major point of discussion, debate, and then vote in this Chamber over the last year. I come as someone who has practiced medicine in Casper, WY, since 1983, as an orthopedic surgeon, taking care of families all around the State of Wyoming, and working on prevention, working on early detection of medical problems through what is called Wyoming Health Fairs. I come to the floor today, having watched and read the comments by the President, to take a look at some of those comments and see what the American people heard from the President and what I see as my doctor's second opinion about this health care law. It is a law that I believe is bad for patients, bad for payers--the American taxpayers-- and bad for our medical providers--our nurses and our doctors--who take care of those patients. Like most Americans, I believe this is going to, unfortunately, raise the cost of care for American families and lower the availability and quality of that care. I wish to point out a few of the comments the President of the United States said today, and I want to do that from my perspective as someone who goes home to Wyoming on weekends and visits with patients. Just a few minutes ago, earlier today, I visited with a patient, someone I had operated on, done surgery on her knee about 10 years ago. One of the things the President talked about today was Medicare Advantage. Medicare Advantage, in my opinion, is a program that has a lot of advantages. That is why one out of four Americans on Medicare signs up for Medicare Advantage. It deals with preventive care. It deals with coordinating care, so care is coordinated in a way that patients get better care. The President said Medicare Advantage benefits will not change. He said: First and foremost, what you need to know is that the guaranteed Medicare benefits that you've earned will not change, regardless of whether you receive them through Medicare or Medicare Advantage. Seniors who know a lot about Medicare Advantage know that is not the case. You do not have to go very far back to find it. Yesterday's Wall Street Journal talked about Medicare, and specifically Medicare Advantage. I will quote from this article. It says: Dozens of Medicare Advantage providers-- These are the insurance companies that help with Medicare Advantage-- plan to cut back vision, dental and prescription benefits. ``Plan to cut back vision, dental and prescription benefits.'' Some plans are eliminating free teeth cleanings and gym memberships, and raising fees for hearing aides, eye glasses and emergency-room visits. Wait a second. The President of the United States said Medicare Advantage benefits will not change. This says there are a couple of reasons why he is wrong. One of the reasons is that the rate the government will pay private insurers to run the plan is frozen. It is frozen in 2011 at the 2010 levels, while medical costs are expected to increase an average of at least 6 percent. I thought we went into this whole health care debate and discussion with the idea of getting the costs down. Now what we are seeing is, no, costs are going to go up in spite of, or perhaps because of, this legislation. ``Such price increases and benefit cuts will help'' the companies ``recoup that difference . . . ''--the losses. Medicare Advantage benefits are certainly going to change, and they are going to change in a way that is detrimental to the seniors of the country regardless of what the President said today in his townhall meeting. Then he went on and said the health bill ``will actually reduce the deficit, reduce costs.'' That is what the President said today at his townhall meeting in Maryland. It is astonishing because I do not believe any person in this Chamber believes that. I do not think anyone listening at home or at the townhall meeting believed it. And the President's Chief Actuary does not believe it. Actually, the Chief Actuary a month or so after the bill was passed, after it was signed into law, released projections that said the health care overhaul will likely cost about $115 billion more--more--in spending over the next 10 years than the original cost projections, taking the total estimated costs to above $1 trillion. The President says this will actually reduce the deficit and reduce costs. This is at a time of record deficits, when the American people are very concerned about the deficits and the incredible debt. From the transcript of the President's speech, as he goes through, he says: And finally, we're going to reduce by half the amount of waste, fraud and abuse in the Medicare system. . . . That is an admirable goal. There is significant waste, fraud, and abuse in the Medicare system. How much waste, fraud, and abuse is there? I am not sure anyone knows for sure exactly how much there is, but the Associated Press, with a lot of study, has said it is about $47 billion a year--$47 billion a year. What do the budget people who looked at this health care law say about how good is it going to be, how effective? The President is talking about cutting it in half from $47 billion. If you can save $23 billion a year, that is an accomplishment. The Congressional Budget Office estimated that Medicare, Medicaid, and the Children's Health Program, with the integrity provisions--those are the provisions aimed at waste, fraud, and abuse--they are thinking that over the next 4 years, they will save about $2.2 billion and over the next 10 years, they will save almost $7 billion. Savings are good, but they are going to save $7 billion over 10 years when, according to the Associated Press, we are losing almost $500 billion over 10 years to waste, fraud, and abuse. The savings, according to the Congressional Budget Office, are minuscule, but yet the President today, talking to this crowd, said we are going to reduce it by half. I don't know, maybe he is talking about introducing a new law because it sure is not in the health care bill that was signed into law and passed with 60 votes in this body. After the President went through all of these, he then said: So that's what the law does. Now, having said that, there-- some of the folks who were against health reform in Congress-- I don't think anybody is actually against health reform. But I will say there are a lot of people who are against this bill. He said: In fact, you have an entire party out there that's running on a platform of repeal. It is not a party. Sixty percent of the American people are saying we should repeal and replace this health care law. The President had this meeting, but there are a lot of things the President of the United States did not tell the American people. It is those things--that is the reason 60 percent of the American people are opposed to this new law. He did not mention that Medicare cuts will be $550 billion, and those are cuts to hospitals, cuts to nursing homes, cuts to home health agencies, cuts to hospice to help people in the final days and hours of their lives. He did not mention that at all. He did not mention that the new Medicare Director--someone he recently named--loves the British health care system and says we are going to need to ration care. The new Director of Medicare is planning to ration care. We did not hear that mentioned to the seniors today. We did not hear him mention the fact that up to $18 million has been spent on a mailer about the new health care law that many have referred to as propaganda because it fails to clearly and honestly express what is going to happen to people on Medicare as they cut $550 billion from their health care over the next years. I do not think he mentioned that one in six hospitals is going to find they are in the red living under the new system. That is what the Chief Actuary has said. I don't think he mentioned the $25 million plan that was mentioned yesterday in the New York Times: ``White House and Allies Set to Build Up Health Law and Democrats Who Backed It.'' It said: President Obama and his allies, concerned about deep skepticism over his landmark health care overhaul, are orchestrating an elaborate campaign to sell the public on the law, including a new tax-exempt group that will spend millions of dollars on advertising to beat back attacks on the measure and Democrats who voted for it. That is what we hear. We now have a health care law that, as Nancy Pelosi said, you have to pass before you get to find out what is in it. The American people are finding out what is in it. Week after week, they are finding some new unintended consequence, something they do not want, something they do not think is good for them. That is why week after week I come back to the floor to talk about a health care law that failed to pay for doctors who take care of patients, failed to pay to train doctors, and failed to deal with lawsuit abuse. It did have money for a lot of new IRS agents to try to enforce the law that is mandating everyone to buy insurance. But I think if you talk with people in any of our home States, they are going to say: We need more new doctors; we don't need more IRS agents. That is why I come to the floor with my second opinion, an opinion which says it is time to repeal the legislation and replace it with legislation that is really a health care system and program that is patient centered, that will allow Americans to buy insurance across State lines, that will provide the same tax relief for individuals who buy their health insurance personally--they would get the same tax relief that the big companies get--that would provide individual incentives, such as premium breaks, to encourage healthy behavior, that would deal with lawsuit abuse, and would allow small businesses to join together to provide less expensive health insurance for their employees. That is why today I offer my second opinion that it is time to repeal and replace this bill and get patient-centered care for the American people. I yield the floor. I suggest the absence of a quorum.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I rise today to remember the life of Senator Craig Thomas. Senator Thomas passed away on June 4, 2007. On that day, the people of Wyoming lost a native son. His presence back home is still missed. One week from tomorrow will be the third anniversary of Craig's death. A column recognizing Craig's life and the Craig and Susan Thomas Foundation will be circulated across Wyoming next week. It reminds us of Craig's toughness, his love for Wyoming, and his commitment to challenging young people to succeed. It is an appropriate tribute to Senator Thomas. I ask unanimous consent that the column be printed in the Record.

Mr. BARRASSO

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

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I ask unanimous consent to speak as in morning business for up to 10 minutes.

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

Mr. BARRASSO. Mr. President, I come to the floor today, as I have done each week for over a month now, to give a doctor's second opinion about the health care bill that has now been signed into law. I do this as somebody who has practiced medicine, taken care of families in Wyoming since 1983. During that time, I was medical director of something called the Wyoming Health Fairs, offering low-cost blood screening for people all around the Cowboy State, giving them an opportunity to take more personal responsibility for their own health, to learn about their health, to help get their blood pressure under control, get their cholesterol down, and get their blood sugar under control, and diagnose cancers early. All of this is aimed at early prevention, meaning better care, better survivability, which is what we need to do in this country--work on patient-centered health care. Today, I bring to the floor of the Senate my second opinion because I think the bill that was passed into law has failed. It has failed and gotten the diagnosis and the treatment wrong. The goal of health care reform should be to lower costs, increase quality, and increase access. I continue to believe the new health care law is bad for patients; it is bad for payers, the American taxpayers who are going to be footing the bill, and it is bad for providers, the nurses and doctors of this country who take care of those patients. Fundamentally, I believe, unlike what the President said, this whole law is now going to increase the cost of care. The American people believe that overwhelmingly, that this is going to increase the cost of their care and it is also going to decrease the quality and availability of the care, to the point that a national poll released just this Monday shows 62 percent of Americans would like to repeal and replace the bill that has now been signed into law. As the Speaker of the House, Nancy Pelosi, said: First you have to pass the bill to find out what is in it. As more and more Americans are finding out what is in the bill, they are finding there are more and more broken promises. The President gave a speech, and he said: If you like your health care plan, you will be able to keep your health care plan, period. He then went on to say: No one will take it away, period. He said: No matter what, period. But the Chief Actuary of Medicare and Medicaid says that 14 million Americans will lose their employer-sponsored health coverage under this law. The President is saying one thing, but the Chief Actuary for Medicare and Medicaid is saying something very different. That is why the American people do not feel this bill--now the law--was passed for them. It is for somebody else. Most Americans have health insurance they like and are happy with, except for the cost. Unfortunately, what this body passed and what the President signed is going to increase the cost and decrease the availability. For people who like what they have, they are not going to be able to keep it. One might say: Where do you come up with that? There was a lengthy article written called ``Documents reveal AT&T, Verizon, others thought about dropping employer-sponsored benefits.'' Why would that be? Because of a very different regime, it says, a ``radically different regime of subsidies, penalties, and taxes.'' That is so much of what is involved in this health care law--penalties, subsidies, and taxes. ``Many large companies,'' it goes on to say, ``are examining a course that was heretofore unthinkable, dumping the health care coverage they provide to their workers in exchange for just paying penalty fees to the government.'' It goes on: In the days after President Obama signed the bill on March 24, a number of companies announced big write downs due to the fiscal changes it ushered in. The legislation eliminated a company's right to deduct the federal retiree drug-benefit subsidy from their [companies]. As a result, AT&T, Verizon, and others ``took well-publicized charges of around $1 billion.'' This annoyed Henry Waxman, Democrat from California, ``who accused the companies of using the big numbers to exaggerate''--that is what he said, ``exaggerate''--``health care reform's burden on employers.'' So he summoned top executives to hearings and he requested documents. The bottom line is, taking a look at 1,100 pages of documents from four major employers--AT&T, Verizon, Caterpillar, and John Deere--``No sooner did the Democrats on the Energy Committee read'' the documents ``than they abruptly cancelled the hearings.'' Why? Because they found out that what the companies had said was true, and it was proper in accordance with the rules and the laws within which they have to operate. All four of these companies are taking a look at the costs and the benefits of dropping health care coverage of people who like the coverage they have. What are the alternatives if you do not want to provide health care? You pay a fine. You pay a fee. AT&T, a major company, employs up to 300,000 people with health care coverage they like, and they are in a situation where the company is saying: If we drop their coverage and pay the fine, we as a company can save $1.8 billion. Is that what this Congress intended? Is that what this Congress imagined? Is that what the people of this country deserve? No. What this shows is a bill that was crammed through and down the throats of the American people by an administration desperate to have something passed into law, something that many people never even read before they voted in favor of it. And the people who read the bill carefully could see what was coming down the line, came to the floor, and pointed out these things to the American people. The American people heard, but the Members of Congress did not. There is a new study out that was reported today in the Associated Press. It talks about what other businesses are doing. It was a poll of 650 leading corporations talking about, what do you think this is going to mean for your business? What is this going to mean for the employees? What is this going to mean in terms of health care for those folks and the cost of doing business? Here it is. What do the employers want? They want to have three goals, and they are the goals all Americans would have. They want to bring down the cost of care, whether you are an employer or an employee. No matter who you are, they want to bring down the cost of care. Contain costs--absolutely, at a minimum. They want to contain costs. Good. They want to encourage healthier lifestyles. Good. This bill hardly does that at all. There are very few, if any, individual incentives. And they want to improve quality of life. A mere 14 percent of all responding--650 companies--think health care reform will help contain health care costs. An overwhelming majority-- 90 percent--of employers believe health care reform will increase their organization's health care costs. Why should they be any different from what the government Actuary says? The government Actuary, who took a look at the bill, also said the cost curve is going to go up. The cost is going to go up. The amount Congress promised the American people this would cover in terms of the costs--Congress said: Oh, we are going to save money. No, that is not what the people who actually added up the figures said. They said this is going to cost money. Yesterday, when the President visited with the Republican Members of the Senate, I specifically asked him about this point. He still takes the tact that ultimately the cost curve will go down. The American people, and certainly someone who has practiced medicine now since 1983, and the Actuary, who takes a look at these issues, who actually does the addition and puts a line and puts the total numbers at the bottom, all say: Sorry, Mr. President, that is not true. The cost is going to go up. Insurance costs are going to go up. Quality of care and availability of care will go down. I come to the floor as a physician offering my second opinion just to tell my colleagues and to tell the American people what I have been hearing from talking with people all around the country. A majority of Americans are pleased with the health care coverage they get from their employers. But now, because of the President's new law, companies are considering canceling employees' coverage because it would be cheaper for them to pay the government's penalty than to provide health care coverage for their employees. This is not the change Americans want. This is not the change Americans can believe in. This is the change that makes Americans lose sleep at night. In this economy, with 9.9 percent unemployment, the last thing Americans need is a new law that makes it easier for companies to pay a penalty instead of providing health coverage for their employees. This is not the companies' fault. It is the administration's fault. It is misguided incentives, and that is why the American people are sick of Washington. What we have seen now with regard to the incentives, if you are a big company, is to drop insurance and pay the fine. If you are a small company and you want the tax relief and a tax credit that has been offered, the incentive is to actually fire workers and pay those workers who are still working with you less. That is the way to get a better tax credit. If you are an individual with a preexisting condition and you have been living by the rules, paying those higher insurance rates through some of the State-authorized funds that have been set up, programs that have been set up to help people with preexisting conditions, to help people who need extra help, so they get their health care covered and even pay more, if you are one of those individuals, the incentive is to drop that coverage, stop paying, and basically go uninsured for 6 months. And if you take that risk of being without insurance for 6 months, only then do you qualify for what is included in this new health care law. We need a health care law that actually lowers the cost of health care and allows Americans to keep the coverage they have. That is why I come to the floor every week to tell the American people it is time to repeal this legislation and replace it with legislation that delivers more personal responsibility and more opportunities for individual patients; that is, patient-centered care that allows Americans to buy insurance across State lines; that gives people their own health insurance and the same opportunities and the same tax relief for people who get insurance through their jobs; that provides individual incentives for people to stay healthy, exercise more, eat a little less, get their blood sugar under control and blood pressure under control and deal with health care needs as they come along; that deals with lawsuit abuse and the incredible expense of all the defensive medicine practiced in this country; and that allows small businesses to join together to provide less expensive insurance to their employees. Those are the things we need. Those are the things we need to allow us as a nation to deliver high-quality care, available care, at a more affordable cost. This health care bill that has been crammed through the Senate with a lot of gimmicks and things such as the ``Cornhusker kickback'' and the ``Louisiana purchase'' and ``Gator aid''--those are the things that make the American people look at this city and say: We have had enough. That is why today I come to the Senate floor and offer, again, my second opinion that it is time to repeal and to replace this health care law with something that will actually work in the best interest of the American people. Mr. President, I yield the floor and suggest the absence of a quorum.

Mr. BARRASSO. Mr. President, I ask unanimous consent to speak as in morning business for up to 15 minutes.

Mr. BARRASSO. Mr. President, it is with great pride as well as regret that I rise today in the Senate to recognize a great son of the State of Wyoming. He is my chief of staff, Shawn Whitman. He joins me today on the Senate floor. Shawn is leaving the Senate this month after a consummate career working for our State and for our country. Many in the Senate know Shawn. To know him is to like him. He was the chief of staff for our late Senator Craig Thomas. For nearly 3 years, he has continued in that role serving me. In all of that time, he has demonstrated what it means to be a loyal and trusted adviser, a superior manager, and a terrific friend. I know that all in the Senate will want to join me in wishing Shawn well and to thank his wife Kristen and his two daughters, Lauren and Katherine, for sharing their dad with us. All of us are sorry to see him go, and we will miss him. Shawn has actually served three different Wyoming Senators. He began in 1994 right after he graduated from the University of Wyoming. He came to work as an intern for Senator Al Simpson. Later he joined Senator Thomas's staff and filled just about every role, every position that a congressional office can have. He was actually a receptionist. He was a press intern. He was a staff assistant. He was legislative correspondent, legislative assistant, senior legislative assistant, legislative director, and finally chief of staff. It is the example of Shawn's career path that defines the character of who he is. He completed every task, whatever was asked of him, equally well. He brought enthusiasm, smarts, and good humor to every job from the front desk to the corner office. It is his willingness to do whatever is needed and to take on any task. That is what makes him so valuable and such a great friend. Shawn was truly tested. In June of 2007, Wyoming lost a great friend when we lost Senator Craig Thomas. As some of my colleagues know, after Senator Thomas's passing, Shawn led the staff alone. He kept them together in serving the people of Wyoming, even while the Senate seat remained empty. In the face of this extraordinary challenge, at a time of great sorrow for our State, Shawn continued to lead. Despite his own sorrow and his own grieving, he led others. Shawn showed grace and confidence through it all. Perhaps it was his early years working the family ranch outside Laramie, WY, that made him so tough. It is his sense of duty, once again doing the job that needed to be done and completing the task, any task that was required. It was my good fortune to inherit Shawn Whitman. We hardly knew each other when I was sworn into the Senate. It did not take me long to understand his value and to appreciate--fully appreciate--his indispensable leadership. President Eisenhower once talked about the many jobs he had throughout his private career, his military career, and finally as President. He said his goal was, whenever he was leaving a job, the people there were sorry to see him go. Shawn Whitman personifies that. Everyone in our office--everyone--is sorry to see him go. All who have had the pleasure and the privilege to know Shawn Whitman in the Senate will miss him as he starts a new chapter in his life. Shawn leaves the Senate with a wonderful reputation--a reputation for integrity and a reputation for leadership, and not just for Wyoming but for the entire Senate, as Shawn led not just my office, but he also led the organization of the Senate chiefs of staff. He was the chief of all the chiefs. Shawn has been a trusted adviser, manager, a confidante, and a friend to me and to my wife Bobbi. His service has been invaluable. While I am losing a very important member of my staff, I know I will not be losing his friendship, his advice, and his counsel for the future. It is here today on the Senate floor that I say: Thank you, Shawn. Thank you for your service to the Senate, to the country and, most importantly, to the people of Wyoming. I wish you well in all you do. Mr. President, I yield the floor.

Mr. BARRASSO. Yes.

Mr. BARRASSO

Mr. BARRASSO. Madam President, I come to the floor as someone who has practiced medicine in Casper, WY, since 1983, as an orthopedic surgeon taking care of many of the families in the great State of Wyoming. I come to you to talk about the health care bill that has been signed into law and to provide a doctor's second opinion about what is now the law of the land. I come to you as someone who has worked very hard for many years, working with preventive medicine and early detection of problems as a medical director of the Wyoming Health Fairs, a program designed to give people information to stay healthy and keep down the cost of their care. I come to you with a second opinion on what is now the health care law because I believe the goal of health care reform should be to lower costs, improve quality, and increase access to care. Unfortunately, the new health care law, in my opinion, is going to be bad for patients, for providers--the nurses and doctors who take care of them--and for the payers, the people paying the bills--the patients as well as the American taxpayers. I am concerned that the health care bill signed into law is going to increase the cost of care, provide less access to care, and is going to lessen the quality of the available care in this country. I come to you with new information that has come to light on the health care bill and, specifically, an article that was in Politico this Monday, May 17, written by Kathleen Sebelius, the Secretary of Health and Human Services. What she said in this article is: We are collaborating with States to set up federally funded high-risk insurance pools to make sure that the Americans with the greatest need for health insurance will be able to get it. Madam President, you know as well as I that there is an old phrase in politics that goes: ``How does it play in Peoria?'' It is referring to Peoria, IL, and means what is the average American thinking about this. Regarding this health care law, it is not playing very well in Peoria. Peoria is a place that President Clinton referred to when he was running, as did George W. Bush, Ronald Reagan, and President Obama. Those Presidents went to Peoria to talk with people. Yet, when you look at what the Peoria Journal Star has reported about this health care bill, which is now law, in the President's home State, a place that is felt to be the bellwether for political thought in the country, Peoria, IL, the verdict is not good about this health care bill which is now law. I will start with an article that appeared in the Peoria Journal Star that talks about what is happening in Illinois today. It says: For thousands of Illinois residents who pay high health insurance premiums because of medical problems, the new federal health care legislation won't offer relief. It will not offer relief, this says. Continuing: The 16,000 residents who already pay into Ilinois' high- risk health insurance pool will keep paying high rates, while others who enroll this summer under a new, similar program will get coverage at lower, more reasonable prices. What happened here? This is one of the fundamental flaws. Only the people who have been uninsured for 6 months are eligible--meaning those in the current State pool cannot switch and save money. How do the people of Illinois feel about this? How is it playing in Peoria? Quite poorly. Julie Kramer is quoted in the article. She is 53. She said she is ``feeling a bit cheated,'' in her words, by this health care law. She has paid high premiums for nearly 7 years in the Illinois high-risk pool; she has played by the rules and has done what she needed to do. Is she being helped by the new health care law? Not at all, and she is feeling cheated. She went on to say that: . . . it feels very unfair. It goes against the spirit of what health care reform was supposed to be. Ms. Kramer is a self-employed writer and owner of Full Moon Marketing Communications in Vernon Hills. She said: ``This does seem like a low blow.'' Members of the Senate voted for the bill about which this person says she feels a bit cheated, it seems unfair, and it seems like a low blow. The existing program is called the Illinois Comprehensive Health Insurance Program. Thirty-four other States have similar programs. People in this Illinois program pay 25 to 50 percent higher--more than standard rates. So they pay their premium; they pay every month. They continue to pay. Yet they are feeling cheated, they feel it is unfair and is a low blow. Even the Illinois Department of Insurance--their director-- understands this lady's frustrations. To even the playing field, the director said the State legislature would have to act to reduce the premiums. You cannot rely on Washington. Illinois expects to receive money from the Federal Government to start the new high-risk pool. The insurance department says there might be enough money to cover about 5,000 people in the new plan. How does that compare? Far fewer-- according to the article in the Peoria, IL, paper, far fewer than the number of people who may qualify. A Government Accountability Office report said about 218,000 people might be eligible for a high-risk pool in Illinois. Well, what does the Illinois high-risk pool Web site say? They sent a letter to enrollees--the people who pay their premiums month after month and play by the rules--and it says it is unlikely Federal funds will be available to reduce premiums paid by the current enrollees--the people who have played by the rules and have continued to pay the bills. They didn't actually send out this letter. They put it on their Web site. They wanted to send it out, but they didn't have the $5,000 for postage to send this letter to the people who have been sending thousands and thousands of dollars into this high-risk pool every year. The director said: No, we have not mailed the letter because the cost of mailing was prohibitive, given that we have, at this point, not received any actual funding. He said it would be inappropriate to withdraw funds to send such a letter. Well, Julie Kramer was shown the letter on the Web site, and she said: You know, I did feel a little flash of anger and disappointment when I read it. I say to the Secretary of Health and Human Services--who wrote a letter to those in Washington via Politico, who said we are doing what we can to make sure we are helping these people--the people of Peoria do not agree and do not believe what she has to say. That is why, across the board, a majority of the Americans who need health care, who are concerned about the cost of care, look at this health care law and believe, in terms of a law this Congress has passed and this President has signed, that it is going to actually make the cost of their own care go up and the quality of their own care go down. That is why, overwhelmingly, the American people have rejected this health care law. That is why I come to the floor again with my second opinion, and my opinion is it is time to repeal this law and replace it--replace it with solid ideas that will help people lower the cost of their care, improve the quality of their care, and increase their access to care. That would be patient-centered health care, health care that allows people to buy insurance across State lines, that gives people who buy their own policies the opportunity to get the same tax relief that big companies get, to provide individuals incentives to stay healthy and get the cost of their care down by lowering their risk factors for disease because half the money we spend in health care in this country goes to 5 percent of the people--those who eat too much, exercise too little, and smoke. We need to find solutions that deal with lawsuit abuse, to get down the cost of all the defensive medicine that is practiced in this country and allow small businesses to join together to provide less expensive insurance for the people who work for those businesses. Those are the things we know will work, the things we know will be able to allow us to deliver higher quality care, that will allow us to lower the cost of care. That is why it is my opinion, as a physician who has practiced medicine since 1983, that we need to repeal this health care law and replace it with something that will work for the people of America. I yield the floor.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I agree absolutely with my colleague because that is exactly what is happening in the British health care system. It is delayed care, and delayed care, to me, equals denied care. This has been such a major topic for discussion among the people in Britain that it was brought up in the recent debate for the prime ministership in the election, in the first televised debate ever. One of the questions that was asked of then-Prime Minister Gordon Brown was what about the National Health Service; people have to wait too long. Here is the quote. We have a transcript because I read about this in the local papers and got the transcript. He talked about people with cancer. Now, this is very important to me, Mr. President, because my wife Bobbi is a breast cancer survivor. She was diagnosed in her forties as a result of a screening mammogram. So we spend a lot of time thinking about, talking about cancer, as do many families in this country. Well, this is what he said about people who have cancer. This is Gordon Brown answering the question, what about the National Health Service and the long delayed time before treatment. He said, ``They will also be able to know that their operation will be in 18 weeks.'' Mr. President, 18 weeks, if you are a cancer patient in need of an operation--18 weeks for your cancer operation. That is what the Prime Minister of England is promising the people as an aspirational goal. It makes you wonder how long is the delay right now. So it is no surprise that the British medical journal, the Lancet Oncology, in their August 2008 summary of statistics, says in every category Americans survive cancer at higher rates than patients in other developed countries. American cancer patients have a higher survival rate for every major form of cancer than patients in Canada and Britain. American women have a 35-percent better chance of surviving colon cancer than British women. American men have an 80- percent better survival rate for prostate cancer. I have a list, cancer by cancer--breast cancer, colon cancer, prostate cancer--and the survival rates are much better in the United States than they are in Britain. It is not that our doctors are any better, it is that the treatment is more timely. Imagine, Mr. President, being diagnosed with cancer and being told that your operation will be coming in September. Here we are in May, so 18 weeks from now--September--is when you will have your operation. All of that time the cancer can be growing. The cancer can be spreading. As a patient in the United States, you may say: Do I really want Dr. Berwick? Do I want somebody who favors the National Health Service of Britain, someone who says they have incredible respect for the way it works and thinks it is the right way to go? Would an American citizen want that person to be in charge of Medicare and Medicaid for this country? So I just have to respond to my colleague that, as a physician who has practiced for 25 years, and as a husband of a wife who is a breast cancer survivor--who has had detection through a screening mammogram and then very rapid surgery, where there actually was the spread of the cancer from the breast to one of her lymph nodes--I think she is alive today because of the screening mammogram and the timeliness--the timeliness--of her surgery and treatment in the United States. I see the minority leader, and I see he is incredulous that we would be considering that sort of a system and that sort of a director for Medicare and Medicaid in this country.

Mr. BARRASSO. Mr. President, I come to the floor today--and the Republican leader has already addressed this body--to discuss the issues of health care, about new revelations, new information that has come forth in terms of the specifics of the costs of the health care bill that has been signed into law--the costs that far exceed what was ever anticipated. I come here as somebody who has practiced medicine in Wyoming for 25 years as an orthopedic surgeon, taking care of families in Wyoming, as medical director of the Wyoming Health Fairs, a program that provided low-cost health screening in Wyoming. This gave people an opportunity to take more responsibility for their own health and keep down costs of their medical care. I come to the floor with a second opinion, as a physician--a practicing physician, taking care of patients; it is a second opinion about the health care law. Today, I come to the floor because the goal of the health care bill was truly to improve quality and access and get the cost of care down. Those are the things I think all of the Senate wanted to have achieved. But having seen this bill that has been passed and signed into law, I believe the bill is going to be bad for patients, bad for our providers, the nurses and doctors who take care of them, and bad for the payers--the American people, who will foot the bill for this health care bill. I believe this bill will fundamentally, as it has been passed into law, result in higher costs for patients and in less access to care for people all across America. It is going to result in unsustainable spending, at a time when we are running record deficits. I think about the things the President said when he was not just running for office but as President. He said: The plan I am announcing tonight--it was a joint session--will slow the growth of health care costs for our families, for our businesses, and for our government. But in fact, the Chief Actuary for Medicare and Medicaid has said that the President was wrong. He said the cost of care will actually go up by $311 billion through 2019. And now we heard the revelation yesterday from the Congressional Budget Office that when you look at some of the things that hadn't been scored, as they say, costed out, it will add another $115 billion on top of that. The President said if you like your health care plan, you will be able to keep it, ``period.'' He said the word ``period.'' He said nobody will take it away, ``period.'' No matter what, ``period.'' The CBO and the Chief Actuary said that 14 million Americans will lose their employer-sponsored health coverage under the new law. Today, I come to the floor to also mention that recently the Secretary of Health and Human Services, Kathleen Sebilius, had an epiphany about the doctor shortage in America. Last week, she said a nationwide primary care physician shortage had to be addressed before over 30 million Americans get access to subsidized health insurance coverage. This is her quote: How are we going to be ready when we already have a shortage in too many parts of the country? This shortage should not have been a surprise to the Secretary of Health and Human Services. The American Association of Medical Colleges tells us that at the current graduation and training rates, we are facing a shortage of 150,000 doctors in the next 15 years. Over the past year, medical experts warned Congress--this body--and the administration that any health reform bill should tackle the issue of physician shortages. Instead of helping doctors, the new law actually discourages the next generation from becoming doctors. This new bill cuts payments for doctors and cuts patients on Medicare, and it doesn't include enough money to train new doctors. I believe it was intentional. Maybe the Secretary, maybe the Obama administration, and maybe the Democrats in Congress should have paid attention to the experts before jamming this health care law down the throats of the American people. Maybe they should have heeded the calls I heard from medical professionals all across Wyoming and the country to slow down, let's get it right. But, no, they didn't. And now the American people are stuck with a law that costs too much, doesn't solve America's doctor shortage--doesn't even address it--and doesn't deliver good care for patients. This should not have been a surprise to the Secretary, because the Wall Street Journal, over a month ago, said that the medical schools can't keep up. As the ranks of the insured expand, the Nation faces a shortage of 150,000 doctors. Right here, it says a shortage of primary care and other physicians could mean more limited access to health care and longer wait times--more limited access and more wait times. What about the training of doctors? The Secretary just realized this, but it has been in print for months. Doctors' groups and medical schools had hoped the new health care law passed in March would increase the number of funded residency slots--you know, where they train family doctors--but such a provision didn't make it into the final bill. With over a trillion dollar bill, are we going to train doctors? No, they left it out. Then what about hospitals? Here it is in the Wall Street Journal--the headline ``Hospitals Under the Knife. New York City System Aims to Cut 2,600 More Jobs as State Funding Drops.'' Not enough doctors? All you have to do is go to the New York Times, and this headline: ``More Doctors Giving Up Private Clinics.'' That is the end of it. So why would so many doctors behave this way? Let's look at Congress Daily this past week, May 4: ``Latest CBO Figures Show Higher `Doc Fix' Price Tag.'' That is to pay doctors for the doctor bill. Of course, it was left out of the health care bill. How can we have a national health care law that fails to address training doctors and paying for them? It is astonishing. It says that scheduled cuts take effect June 1, an option outlined Friday by CBO to freeze Medicare payment rates which, under the new figures, would cost $275.8 billion through 2020. That is an amazing amount, because physician payment rates for Medicare are expected to be cut 21 percent on June 1. That is what we are looking at now. That is why, today, I come to the floor to give, as a doctor, a second opinion, because it is time to repeal this legislation and replace it with legislation that delivers more personal responsibility and more opportunities for individual patients. We need a patient-centered health care bill, one that provides individual incentives, such as premium breaks for people who behave in a way that encourages healthy behavior and gets down the risk factors that increase the cost of care; that allows people to take their health insurance with them when they switch jobs; that gives people who buy their own health insurance the same tax relief available to people who get their insurance through work; that allows Americans to buy health insurance across State lines; that deals with lawsuit abuse and that allows small businesses to join together to offer health insurance to their employees. These are the things that will work to get down the cost of care and deliver higher quality of care to the American people. They are not in the health care bill that passed the Senate, that passed the House, and was signed into law. That is why today, once again, in light of this brandnew information on the increased costs and the final realization that the Secretary of Health and Human Services now says: Gee, we don't have enough doctors to cover the situation, it is time to repeal this bill and replace it with what we know will work for the American people. I yield the floor.

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

Mr. BARRASSO. It is interesting, looking at this whole thing, because what we see happening in Britain right now--they call it NICE, but there is nothing nice about it--National Institute for Health and Clinical Excellence--what Dr. Berwick has had to say about it is very much the opposite of what doctors who practice there have said. What he has said about this system is that: Those organizations are functioning very well and are well respected by clinicians, and they are making their populations healthier and better off. But a London colon cancer specialist says: A lot of my colleagues also face pressure from managers-- Managers in the British health system-- not to tell patients about new drugs. There is nothing in writing, [he says] but telling patients opens a Pandora's box for health services trying to contain costs. So it gets down to not quality of care, not availability of care but the cost of care. Dr. Berwick says NICE is extremely effective and a conscientious, valuable and--importantly--knowledge-building system. This is what--someone--says: Doctors are keeping cancer patients in the dark . . . These are specialists, polled by Myeloma, United Kingdom: Doctors are keeping cancer patients in the dark about expensive new drugs that could extend their lives. . . . So let's keep people in the dark rather than tell them what is there that can help extend or save their life. That, to me, is not a system that the American people want.

Mr. BARRASSO. My take is that it wouldn't work for Wyoming. But this entire health care bill--law, travesty--isn't going to work for Wyoming. We look at the numbers, and the Congressional Budget Office says 15 percent of hospitals in a few years are going to find they are losing money and they can't stay open. People are going to have to travel long distances, very long distances, to get quality care. Sometimes with weather and with winter, it is very difficult. So I have lots of concerns for all of the rural communities in this country because we have somebody from Boston, or the big city, who doesn't think the way we do in Wyoming or Kentucky or in Kansas. The other travesty of this is that the President of the United States has been in office now for well over a year--almost a year and a half-- and it is only just now he has nominated someone to be in charge of Medicare and Medicaid. I have continued to ask on this floor why that is. Why has the President intentionally refused to send a name to the Senate to be in charge of Medicare and Medicaid at a time when this country was debating health care legislation; at a time when the President was proposing cutting $550 billion from our seniors on Medicare; at a time when the President was pushing--cramming--into Medicaid another 18 million people?

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I first thank the chairman for the acknowledgement and thank him for the opportunity to take the floor. I come here because of new information that has come to light about the health care bill that has been signed into law. As a physician who has practiced medicine in Wyoming for 25 years, as an orthopedic surgeon, I come to offer a second opinion on this bill and now this law. I went into this focused on the sorts of things the President had talked about--lowering the cost of care, improving the quality of care, increasing the access to care. But I come to the Senate floor today with my second opinion because I think these things have not been accomplished by the bill that has been signed into law. For many years, I have been the medical director of the Wyoming health fairs--giving low-cost blood screening to people around the Cowboy State, giving them opportunities to learn about themselves, their health, and to focus on getting down the cost of care. Today, when I come with my second opinion, it is that this bill--this bill now signed into law--is going to be bad for patients, bad for providers--the nurses and doctors who take care of these patients--and bad for payers, the people who are going to be paying the bill for this new law, the taxpayers of the country. I believe fundamentally that in passing this law, this is going to result in higher costs for patients, not lower costs. It will result in less access for patients, not more access. This is going to result in unsustainable spending at a time when we are looking at record unemployment and record debt. I come today to talk about what I have seen in the new information that has been coming forth since the bill was signed into law. I have an editorial written in the Columbus Dispatch: Almost daily the ill effects of the health care overhaul passed by Congress are becoming apparent. The editorial in the Columbus Dispatch goes on: As employees and government bureaucrats analyze the law's effects on the bottom line for the private sector and for government, the alarm bells are ringing. The tragedy is that these ill effects could have been and should have been calculated before the law was passed, not after. It goes on: In fact, many of them were prophesied before passage of the bill, but the prophets were ignored by President Barack Obama and the Democratic majority in Congress. That is because their uppermost goal was not to pass the best health care bill possible but merely to pass anything that could be called health care reform and could be claimed as a political victory by a President desperate for one. I come today with my second opinion on the high-risk pool which has been in the headlines the last couple of days. When the President and Democratic Members of Congress were pushing the health care bill, they promised that people with preexisting conditions would receive immediate relief. The bill has been signed into law, and Americans with preexisting conditions remain as confused as ever as to how this new law will impact them, will impact their lives and will impact their pocketbooks. Unfortunately, hundreds of thousands--that is right, hundreds of thousands--of Americans with preexisting conditions are going to end up getting the short end of the stick. In fact, even USA Today recently reported that the new law is going to trap 200,000 Americans in pricey, State-operated, high-risk plans. Here is the front page of USA Today from last Thursday: ``Health law traps some in pricey state plans; 200,000 hard to insure can't get federal option.'' Mr. President, 200,000 Americans trapped. These are the folks who have been paying for coverage through the State high-risk insurance programs that exist today. One might say: How can that be? What is the catch? These 200,000 people are not eligible for the brandnew, low-cost, high-risk program that is created by the law. Are these not the people we were trying to help? The law requires that for people to get into this new plan, they have to have been without insurance for the last 6 months. We have 200,000 Americans with preexisting conditions who have been playing by the rules, who have been doing what is right. What happens? They are not going to have any access to the benefit the President and the Democrats in this Congress promised would be available to them. Don't just take my word for it. Here is what the Kansas insurance commissioner had to say. She said that we have people who have struggled to stay in our existing pool and take care of their existing health needs. And then this new pool comes along, and it is more generous and they are not going to be eligible for it. What is the difference? With the new pool, the maximum amount someone is going to have to pay for an individual is $5,950; for a family, $11,900. That is 100 percent of the standard market rate. But many of these high-risk pools across the country are at a point where they are charging twice the standard market rate because these people are an increased risk because of their preexisting conditions. The people who have been playing by the rules, doing it right, and, as the insurance commissioner said, people who have struggled to stay in the existing pool, they are going to be left out, ignored, and rejected by this new law the President has signed into law. This week, all 50 States were given the opportunity to tell the administration whether they wanted to run their brandnew, high-risk pool for individuals with preexisting conditions. The answer has not been positive. Just yesterday, Tuesday, May 4, the Washington Post said: ``18 states decline to run `high-risk' insurance pools.'' Eighteen States said to Washington: No, thank you. Eighteen States have refused to participate. Why? Mainly, they do not know, if and when the Federal money runs out, how it is going to be paid for. One may say: What do you mean, the Fed money runs out? They just passed this health care bill that is going to cost almost $1 trillion. For this high-risk pool, the amount of money that was put in, $5 billion--in the Chief Actuary report of Medicare and Medicaid, they said the money is likely to run out before 2012, even though it is supposed to last until 2014. What is going to happen to these States? No one knows, and the administration is not saying. The Governor of Wyoming, Dave Freudenthal, looked at this as a Governor and asked: What do I want to do? Do I want to participate or not? He is one of the Governors who looked at it very carefully, and he is one of the Governors representing the 18 States that said, ``No, thank you,'' to Washington. This is what he said in his letter to the Secretary of Health and Human Services, Kathleen Sebelius. He said: The State of Wyoming has operated a very successful high risk health insurance pool for nearly 20 years, which has served Wyoming citizens well. And we have. I was involved with this when I was in the State senate, where I served for 5 years. As he said, a very successful, high-risk health insurance pool for nearly 20 years, which has served the citizens of Wyoming very well. Then he goes on to say: . . . necessary requirements have not been set out and key terms have not been defined. Without such guidance, I find it unwise to further consume my staff and Department of Insurance with the guesswork currently necessary to implement this program. Mr. President, these Governors are just guessing--guessing if it will work, guessing if it would not work--and nobody knows. That is why, in an interview with the Associated Press yesterday, the Governor of Wyoming said: . . . the $8 million the federal government offered the state to run the high-risk insurance program until 2014 wouldn't be enough. He also said he's concerned the state wouldn't have been allowed to administer the federal pool together with its existing state program. Sorry, States--this is what the Secretary is saying--we in Washington know better than you. You might have a program that has worked for 20 years very successfully in your home State of Wyoming, but we don't want to know about it. We want you to either set up a new program and do it our way or forget about it. And that is what the people of Wyoming have decided because the Governor said: When I looked at it, it just didn't seem to make financial sense. So, once again, the administration is saying: Trust us. They want to act now and ask questions later. Well, Americans and Governors across our country have serious questions about this new high-risk insurance program--how much it will cost the States, how much it will cost the taxpayers, and why all American patients with preexisting conditions would not have access to the immediate benefits they were promised. Unfortunately, Washington's lack of answers clearly demonstrates that this administration doesn't have its act together. The administration has not delivered on the President's promise to help all Americans who have preexisting conditions have access to the same affordable health insurance coverage. That is why all across this country people are saying: This bill, rammed through the Congress, with all the sweetheart deals, and signed into law, wasn't passed for somebody like me. It was passed for somebody else. So I come to the floor of the Senate today to say it is time to repeal this legislation and replace it with legislation that delivers personal responsibility and opportunities for individual patients, that will get down the cost of care, that will improve the quality, and will improve the access to care. We need patient-centered health care-- something that will provide individual incentives, such as premium breaks for people by encouraging healthy behavior; that allows people to take their health insurance with them when they move from State to State or when they change jobs; that gives the uninsured and the self- insured the same relief when they buy insurance that the big companies get; that allows people to buy insurance across State lines; that deals with lawsuit abuse; that allows small businesses to join together to get down the cost of their care. These are the things that will work to get down the cost of care, to deliver high-quality care, and improve access to care. Those things are not in the health care bill that was signed into law. They are not in the health care bill that passed this body and passed the House. So that is why I come to the Senate floor to once again offer my second opinion that it is time to repeal this bill and replace it-- replace it with something that will work well for the American people. Mr. President, I yield the floor.

Mr. BARRASSO

Mr. BARRASSO. Madam President, I come to the floor as someone who practiced medicine in Casper, WY, for 25 years. I was an orthopedic surgeon for the people of Wyoming, as well as medical director of the Wyoming Health Fair Program, which reached across the State with low- cost health care screenings, aimed at giving people the opportunity to take more responsibility for their own health and essentially keep down the costs and get down the cost of their medical care. Today, I come to the floor with a second opinion on what this Senate has passed, what the House has passed, and what has been signed into law by the President. I come today because I continue to believe that what is now the law of the land with health care reform is going to be bad for patients, bad for providers, the nurses and doctors, and those who take care of our patients, and bad for payers--the American people--who end up paying the bill for health care in this country--the taxpayers of this Nation, people who pay for their own care. I believe fundamentally, as this bill has been passed into law, it is going to result in higher costs for patients, as well as for taxpayers, less access to care for people all across America, and unsustainable spending at a time when we are running record deficits. That is not just my opinion. If you ask what the public believes, in polling across the country the American people have overwhelmingly rejected this bill that is now signed into law by the President, because they believe the cost of their own personal care is going to go up and the quality of their own personal care is going to go down. Fundamentally, they believe this bill was not passed for them but for someone else. The reason I come to the floor today to talk about it is because the report has just come out by the Centers for Medicare and Medicaid Services Actuary, Richard Foster, the Chief Actuary. He has come out with a report to go through methodically, page by page, what is actually in the health care bill. You will remember that when the bill was in front of the House, the Speaker of the House, Nancy Pelosi, said you will have to pass the bill before you get to find out what is in it. In a rush by this body to pass the bill--which to me was irresponsible--they have missed the things the Actuary has outlined now in a very thorough report to the American people. I want to go through that with you. Fundamentally, this says that health care costs are going to be higher, access to care is going to go down, and the spending is unsustainable. It is fascinating, because this is in light of a speech by President Obama in June of 2009, when he said if any bill arrived from Congress to his desk that is not controlling costs, ``that is not a bill I can support.'' He said it is going to have to control costs. Well, the Actuary tells us that the bill now signed into law by the President, as well as the additional bill, because there are actually two new laws--one the initial bill and then the fix-it bill--will increase costs, raise Federal spending, threaten access to care for seniors, and will result in higher insurance premiums. That is not a Republican Senator saying that; that is the Chief Actuary for the United States in charge of Medicare and Medicaid in a well-documented report that came out April 22, 2010. What is actually in the report? Let's go through it page by page. The first thing is, it says this is going to bend the spending curve--the rate at which we are spending on health care in the country. The President said we want to get the spending cost curve down. This says the opposite, that the cost curve is going to go up. That is on page 2. Turning to page 4, What about overall national spending on health care over the next 10 years? Between 2010 and 2019, national spending on health care is going to go up by $311 billion. The President said he wanted a bill that was actually going to get the cost of care and spending down on health care. Turn to page 7. The President said he wants to make sure if you have care you like, you can keep it--keep the care you like. We all heard that. We heard it time and time again. Yet, on page 7 in this report by the President's agency, it says about 14 million people will lose their employer coverage by 2019. Again, the President said if you like what you have, you can keep it. His Actuary, who actually did the numbers on the bill, said, sorry, 14 million people will lose their employer coverage by 2019. Let's turn to page 8. An estimated 23 million people will remain uninsured by 2019. This is at a time when the President said he wanted to provide coverage for all these people. But even 10 years out, 23 million people will still remain uninsured in the United States. Many of them are going to have to pay a penalty because of that. They will be fined because that is how the rule and that is how the law has been written. I talked with a lot of seniors. I was home this past weekend in Wyoming visiting with a number of seniors around the State. I was in Torrington, WY, and Casper visiting with folks. They are concerned about their Medicare. What does the report say about Medicare? Turn to page 9: Unsustainable. The cuts we are looking at are going to become unsustainable even within the next 10 years. With the cuts to Medicare of over $500 billion, one would think at a time when we are looking at more and more seniors coming of age to be on Medicare that we would have used that specific Medicare money to keep it in Medicare, use it to save Medicare, not to start an entirely new government program. As you work your way through this, you say: What does this mean for seniors on Medicare? That gets us to page 9 and page 10 of the national report of the Centers for Medicare and Medicaid Services. These are the people who know. They looked into the numbers. They said they did not have time to do it while the House and the Senate were rushing to pass the bill. They said we should have given more thought and time to this bill. What happened when they actually looked at what has been signed into law? They talk about cuts to providers, to the people who take care of the patients on Medicare. They are expecting many providers, medical professionals to ``end their participation in the program.'' This is going to jeopardize access to patient care. The report says 15 percent of all the hospitals in this country, all the nursing homes in this country, and similar providers--we are talking about home health care agencies, that link, that lifeline to people who are at home needing care; hospice, for people who are in the final days of their lives--about 15 percent of all of them, as a result of the way this bill has been put together, are likely to be operating at a financial loss by 2019. Are they going to be able to stay open? Are they going to be able to provide care for people? Absolutely not. Are they going to close down? Very likely. Is that going to impact a lot of rural communities across this country? Absolutely. As we go through this actuary report, it brings to light what Nancy Pelosi meant when she said we have to pass the bill to find out what is in it. What a shame it is that the American people, although they sensed what was in it, had to wait until this point so they could continue to express their concerns to those who voted in favor of it. Let's take a look at some other provisions. Those who supported this bill said there are other Medicare savings provisions in the bill that will help save money and that will help control future health care growth. No--the report on page 13--they said those things people in this Chamber said would help control future health care costs would have a ``negligible financial impact over the next 10 years''-- ``Negligible financial impact over the next 10 years''--even though Members of this Senate stood on the other side of the aisle and absolutely swore that this was going to improve care, as well as get down the cost of care. Let's turn to page 15 of the report, the CLASS Act. That is the long- term care insurance program that so many in this Chamber thought was going to be a wonderful thing, and those on my side of the aisle said: This cannot work. The numbers are not going to work for our country. They are not going to work for this bill. Who are you trying to kid? The Democrats who supported the CLASS Act were not able to kid the people at the Health and Human Services Centers for Medicare and Medicaid Services. No, they saw right through it. But, of course, the report came out after the bill had been signed into law by the President. What the report says is that the CLASS Act faces ``a significant risk of failure''--``a significant risk of failure.'' It says there is a very serious risk that the CLASS Act program will be unsustainable. People on this side of the aisle said that. We said it before the vote. We heard from the other side of the aisle: Oh, no, you have it all wrong. People who looked at it and know--and these are the President's own people--said: Unsustainable. What about premiums for insurance? Last year the President said he expects to lower the health care premiums for the average family in this country by $2,500. That is an incredibly admirable goal, something all Americans would support because, after all, early on the President said: My goal is to get down the cost of care, clearly something he abandoned early on. What this says on page 17 of the report from the Actuary is that the new laws, fees, and excise taxes, higher drug prices, device prices-- this is all going to result in higher insurance premiums for American families, the exact opposite of what the President promised. Let's go to page 16 because we have talked about funds allocated for the new high-risk insurance pools. I think it is important to have these pools. They work well in various States. A number of States have these pools. It is a commitment by the State. We want to involve the Federal Government, have people working together with folks with preexisting conditions, people who absolutely need care. The CMS report says what this body has done is insufficient. It says the amount of money they decided to put in this program is going to be exhausted by the year 2012. Once again, this body who said they knew better than the folks who studied the bill, those who said we just have to pass it to get something done, have created a monster, and the American people are going to be paying the price for a long time. Let's look now to page 20. So many of the people who are going to be covered under this program, how are they going to be covered? The President said: I want to cover all these people. What he decided to do and what this body decided to do is to cram another 18 million people on to Medicaid, a program we know right now is fundamentally flawed. It is broken. Half the doctors in the country do not want to see patients on Medicaid because the reimbursement to them is so low. Hospitals tell you they lose money when those patients are in the hospital. Doctors say they cannot keep their offices open if they take more and more Medicaid patients. The only way they are allowed to see them is by charging other patients more--the cost shifting that happens in health care in America. What does this say about Medicaid? Eighteen million more people are going to be put on Medicaid by the year 2019. Is that going to be care? The President talks about coverage, but he does not talk about care. These people are very unlikely to get care. This is what the report says on page 20: A significant portion of the increased demand for Medicaid services, because there are all these millions more people on Medicaid, the increased demand for Medicaid services could be difficult to meet. All these patients are going to be put on Medicaid, and they are not going to be able to get care. I say it is hardly fair and it is misleading to the American people. Everybody in Canada has coverage. They have coverage but they cannot get care. Madam President, 33,000 Canadians came to the United States last year to pay for their own health care because even though they had coverage in Canada, they could not get care there. So they came to the United States and paid for care. About a year ago when the President of the United States was talking about health care, he always held up the Mayo Clinic for excellent care in America, and it is a model for excellent care. The Mayo Clinic said: We do not want more Medicaid patients, because they lose too much money by taking those people, and they want to keep their doors open to fulfill their mission. Here we have the Actuary who is looking at this page by page--and, obviously, the Centers for Medicare and Medicaid Services knows what they are talking about. They looked at the numbers and item after item, page by page and said: This is not working. One of the things we talked about at the Health Care Summit was the issue of Medicare fraud. I sat at the table and discussed the issue with the President. This law does almost nothing--almost nothing--to limit actual fraud and abuse. Last year, Medicare paid $47 billion in claims that were suspect. We know in Florida, drug dealers have been moving from dealing in drugs to Medicare fraud. One may say: Why? Why would they do that? They are doing it for a couple of reasons: One, it is more profitable; two, it is less likely they will get caught; and, third, if they do get caught the penalty is less. They say: More profit, less chance of getting caught, less punishment. I think I ought to go into Medicare fraud. That is what they are doing. What does the Actuary say when he looks at the new bill? He estimates the fraud provision in the law will save only about 2 percent, only $1 out of every $50 of Medicare fraud. As we look at this, it is no surprise the American people want a second opinion about this bill. It is no surprise the American people are saying it is time to repeal and replace the bill. That is why I come to the floor of the Senate with my second opinion, with 25 years of practicing medicine. On the way over, I picked up USA Today. It is so interesting, a big story in the paper today: ``Next Phase In Health Care War: Applying The Law.'' The subheadline is ``Cabinet''--we are talking about the President's Cabinet, the Cabinet of the United States--``Cabinet Braces For Lobbying Blitz By Industry Advocates.'' The Cabinet is bracing for a lobbying blitz. I thought the President of the United States said he did not want lobbyists in the White House, did not want lobbyists impacting on his Cabinet. They are weighing right in. Absolutely. The President did have them in the White House, obviously behind closed doors, cutting the deals. That is the way we ended up with a health care bill that is bad for patients, bad for providers, and bad for payers, the American payers, the taxpayers of this country, and the people who are paying for their health care. That is why I come to the floor to say it is time to repeal this legislation and replace it with legislation that is actually patient centered, that gives more responsibility and opportunities for individual patients, just what I tried to do through the Wyoming health fairs where we give people more information so they can use that information to get their cholesterol down, get their blood pressure under control, find out if they are diabetic and if they are, get their blood sugar under control, give people incentives to stay healthy and keep down the cost of their care. We need a patient-centered health care bill. We sure do not have one. We need a health care bill that allows people to buy insurance across State lines. That increased competition will drive down the cost of care. The University of Minnesota did a study: 12 million more Americans would have insurance today without this bill if all we did was allow Americans to buy insurance across State lines and allow small groups to join together to get better opportunities to buy insurance to get the cost down. Then, of course, we need to deal with abusive lawsuits that exist in this country which drive up the cost of care for patients because all the tests that doctors routinely order are not to help the patient get better but to make sure the doctor does not miss something. That is why I come here today to tell you, Madam President, that there are things that will work to get down the cost of care. There are things that will work to provide additional treatment for more people in America; more patients, better care. But they are not in this health care bill that passed the House, passed the Senate, and was signed into law by the President. That is why today I offer my second opinion that it is time to repeal this bill and replace it with what will work. I yield the floor and suggest the absence of a quorum.

Mr. BARRASSO

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

Mr. BARRASSO

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