John Barrasso

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I come to the floor as a physician who has practiced orthopedic surgery in Casper, WY, for 25 years. I come to offer a second opinion on the health care bill that was recently passed and signed into law. My opinion on this bill is very different than what I have heard from the administration, from the Speaker of the House, and from the majority leader because my opinion is that this bill--now law--is going to be bad for patients, bad for patients all around this country, bad for health care providers: The doctors, the nurses, the folks who work in our hospitals, the therapists. I believe it is going to be bad for the taxpayers--people who are going to be left with this large bill to pay for a bill that is not to save a health care system but to create new entitlements and new obligations. As I have looked at this, it struck me last week when they were having the debate in England. They are having an election, and the candidates for Prime Minister were having a debate. It was the first nationally televised debate ever in England in an election. They compared it to the Kennedy-Nixon debate when people were up there debating and discussing. The question presented to the Prime Minister of England was: What about the national health service? Those of us on my side of the aisle have been very concerned that with this new law we are going to be seeing a nationalization of our health care in a way like we are seeing in other countries, whether it is Canada, whether it is England--a system I think is not what the American people want. But I wish to read to you from the transcript of the debate because they asked the Prime Minister, Gordon Brown, about the National Health Service. He said: My priorities for the health service are that we give people personal guarantees-- So this is what he is promising-- that every individual patient will know they will get a cancer specialist seen within two weeks if [they] need it. They'll get a diagnostic test within one week, and the results to them. They will also be able to know that their operation-- So now they know they have cancer-- will be in 18 weeks if you're any patient in need of an operation. So here you are, you have had your opportunity to see a cancer doctor, you have had your test, you have your diagnosis. What is the best the people of England are being promised by their Prime Minister? The best they can expect is to have an operation within 18 weeks. The question here is, How many Americans, how many Members of this body, how many people across this country are going to see that as satisfactory? Because that is where we are heading with this health care bill that is now signed into law. How many people want that: You will have your operation in 18 weeks. So here you are, if you are diagnosed next week in the United States--if this were the situation they have now in Britain--you would be looking at having your operation in September. See you in September. Come back for your operation. Now you can worry about it. You can worry about your diagnosis of cancer the rest of April, all of May, all of June, all of July, all of August. That is what the candidate for Prime Minister and the current Prime Minister of England is promising the people of that country with their national health system--a system that is the model of many people on the other side of the aisle of what they want American medicine to be like. This story, once again, demonstrates that coverage does not equal care. Because everyone in Britain has coverage, but they sure cannot get care. Then you ask yourself: Does it truly matter? Does 4\1/2\ months--18 weeks--of waiting for your cancer surgery truly matter? There is not just the emotional worry of: Is that cancer spreading within my body? Should I leave the county of England and go to the United States where I can get immediate care? You have to worry because the statistics back up the fact that the care in the United States is much better than it is in England--not that the doctors are any better here than they are in England but that the timing of when you can receive the care from those qualified professionals is much better in the United States. So if you take a look at the statistics behind this from the researchers who look at this--and I will just go through it because my wife is a breast cancer survivor. She has had a series of three operations. She has been through chemotherapy twice, and she is now surviving 6 years after her diagnosis. I am grateful she was treated in the United States, where the day after the diagnosis was made they wanted to get in immediately to do the operation. So let me tell you, it says that today the United States leads the world in treating cancer. These are scientific studies. For breast cancer, for instance, the survival rate, after 5 years, among American woman--a woman who is diagnosed in the United States with breast cancer and is treated--83 percent are still alive 5 years later. For the women in Britain, 69 percent. Where do you want to get your care? The bigger question is, When do you want to get your care? For men with prostate cancer, the survival rate is 92 percent in the United States; 74 percent in France; 51 percent in Britain. American men and women are more than 35 percent more likely to survive colon cancer than their British counterparts. In an article from the August 2008 edition of Lancet Oncology, the cancer Journal there, the United States is No. 1 again. In almost 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. American survival rates are also better than survival rates in France. You can go on and on with this, but it is evidently clear--evidently clear--that the timing on when one gets their care is critical. It is interesting to me that just this week--just this very week--the President made his nomination for a new Director of the portion of the Health and Human Services Department that deals with Medicare and Medicaid. The President has been in office for 15 months. We have had a debate and discussion in this body for almost all that time on health care. In this body, the Democrats have voted to cut Medicare by $500 billion from our seniors who desperately depend upon Medicare. Why is it the President has waited 15 months to finally nominate someone to be the head of the part of government that oversees Medicare and Medicaid? The President has put 15 million to 16 million more people on Medicaid, has cut Medicare, has told us we can trust him on this. Yet he would not put somebody up to go through the confirmation process to head Medicare and Medicaid? Why? Because, in my opinion, he did not want anybody to answer the questions because they are tough questions. Why wouldn't you nominate somebody for all that time and leave the post open, essentially, and not have somebody to come to Congress and say what are the implications to the American people of dumping another 16 million people onto Medicaid, of cutting $500 billion from Medicare? Well, because the person he has put in has a long history of a love of rationing care. It is a Dr. Donald Berwick. He has a history of support for government rationing of government health care resources on the grounds of cost--not on the grounds of quality, not on the grounds of survivability but on the grounds of cost. He has said, as recently as last June: The decision is not whether or not we will ration care--the decision is whether we will ration with our eyes open. So here we are, the newly nominated person has basically said: I am going into this to ration care. He is a big supporter of what they have going on in Britain right now. In Britain, they call it NICE. It stands for National Institute for Health and Clinical Excellence. Well, this is what Dr. Berwick has said about it. He said: Those organizations are functioning very well and are well respected by clinicians, and they are making their populations healthier and better off. Well, let me tell you what a London doctor, a colon cancer specialist, had to say. This doctor said: A lot of my colleagues also face pressure from managers not to tell patients about new drugs. He said: There is nothing in writing, but telling patients opens up a Pandora's box for health services trying to contain costs. He further went on--this now being again Dr. Berwick saying about this British group: NICE is an extremely effective and conscientious, valuable and--importantly--knowledge-building system. What did the BBC, the British broadcast group, say? They say: Doctors are keeping cancer patients in the dark about expensive new drugs that could extend their lives . . . A quarter of the specialists-- one in four specialists-- polled by Myeloma UK said they hid facts about treatments for bone marrow cancer that may be difficult to obtain from the National Health Service. Doctors said they did not want to ``distress, upset, or confuse'' patients if drugs had not yet been approved by the National Health Service drugs watchdog

Mr. BARRASSO

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

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I rise today to express our Nation's deepest thanks and gratitude to a special young man and his family. I was deeply saddened to receive word during the past recess that that on March 24, 2010, LCpl Jacob A. Ross of Gillette, WY, was killed in the line of duty while serving our country in support of Operation Enduring Freedom. Lance Corporal Ross was killed in combat in Helmand Province in southern Afghanistan. Lance Corporal Ross was assigned to the 2nd Battalion, 2nd Marine Regiment, 2nd Marine Division, II Marine Expeditionary Force out of Camp Lejeune, NC. Lance Corporal Ross graduated from Campbell County High School in 2008. He is remembered by his friends as hard-working, intelligent and kind-hearted. He was athletic and was on the swimming and soccer teams in high school. Jacob had a passion for the outdoors and loved to hunt, fish and camp under the Wyoming skies. He always wanted to be a marine. After graduation, he followed in his father's footsteps and joined the U.S. Marine Corps. It is because of Jacob Ross that all Americans are able to live our daily lives as free people. Freedom is not free. It carries a very high price. And that price has been paid over and over by America's men and women who answer the call to service and willingly bear the burdens of defending our Nation. They deserve our deepest respect and gratitude. They put their very lives on the line every day, and because of them and their families, our nation remains free and strong in the face of danger. The motto of the U.S. Marine Corps is ``Semper Fidelis.'' It means ``Always Faithful.'' LCpl Jacob Ross lived up to these words with great honor. He gave his life, that last full measure of devotion, for you, me, and every single American. He gave his life serving and defending his country and its people, and we honor him for this selfless sacrifice. He was always faithful to our country and its citizens, and to his fellow marines. Lance Corporal Ross is survived by his wife Brittney, and his parents Karen and Dennis, his sister Katie and his brother, Nathan. He is also survived by his brothers and sisters in arms of the U.S. Marine Corps. We say goodbye to a son, a husband, a brother, a friend, and a marine. The United States of America pays its deepest respect to LCpl Jacob A. Ross for his courage, his love of country and his sacrifice, so that we may remain free. He was a hero in life and he remains a hero in death. All of Wyoming, and indeed the entire Nation, is proud of him. May God bless him and his family. Lance Corporal Ross, Semper Fi.

Mr. BARRASSO

Mr. BARRASSO. I heard the Senator, my good friend from Michigan, a few minutes ago say it is the United States versus China. My good friend from Michigan said we are laser focused on China and that China is spending money every day to beat us. I think the problem is the government in Washington is spending money every day--the taxpayers' money, money we do not have, and that is what is going to beat us. It is money irresponsibly being spent by this government in this city, voted on time and time again by a Washington government that doesn't live within its means, doesn't do what the States in this country do, where we do live within our means. I served in the Wyoming Senate where we did balance the budget. The Governor had a line-item veto. We had to balance our budget. It is the spending by us in the United States that is going to lead to China beating us, not money being spent in China every day. That is why on the front page of the Wall Street Journal today, above the fold, right there, Wall Street Journal, Friday, March 26, 2010, ``Debt Fears Send Rates Up.'' The fear of the debt is sending rates up. What it means is people do not think we are responsible in the way we are living. We are not living within our means. We are not doing what a family does in this country, where a family says we have to live within our means. When the Senator from Iowa says you can't go down and get an extended line of credit if you have already tapped your credit, this country continues to do it. Washington continues to overspend and not live within its means. The amount of spending being done, often under the guise of saying it is an emergency, has been irresponsible, unsustainable, and my concern is it will soon be irreversible. I believe in this country. I believe in America. We are a strong nation. We are a resilient nation. We are a proud nation. And we are a nation that has faced down some of history's most vicious tyrants, we have faced down some of the most incredible obstacles, challenging obstacles, and we have risen to the occasion time and time again. Today, here we are, faced with many challenges, none of which is too large or too difficult for the American people to overcome. But the President of the United States has determined the people cannot be trusted to overcome the obstacles we face. Instead, here in Washington, Democrats believe the government continues to be the answer. I am here to tell you that government is not the answer. The government is the problem. Americans have been promised transparency, accountability, hope, and change. Instead, what the American people have been given is irresponsible and unsustainable spending, along with unthinkable government intervention into nearly every aspect of our lives. This country needs an economic environment where people, where individuals, where families, where businesses can recover and thrive. What the administration has done is give us more bureaucracy and more debt and it is going to get worse now that the health care bill has been signed into law. To make matters worse, this government in Washington is sending the bill to our children and our grandchildren. Look at the proposals that are ahead of us here--costly cap-and-trade proposals which are going to raise costs and raise energy prices for American families, government-run health care, irresponsible bailouts of every industry in sight, one takeover after another, where government says we know better than the American people. Government is wrong. I have great concern that people here in Washington are completely out of touch with what is happening in the real world. I go home to Wyoming every weekend. I am going today. That is the best way to do it, to go home and listen to people who have to balance their checkbooks, people who have to live within their means, and then visit with State legislators who know when they go to the capitals of their respective States that the States have to live within their means, balance their budget, don't overspend, tighten the belt, cut spending if we need to. Watching this debate in the last couple of weeks with health care, having practiced medicine for 25 years, we need to focus on the overall health of people as well as the economy, because if people cannot put food on the table or a roof over their head, no matter what additional bill is passed in Washington--which spends more money--that is not going to make it easier for the families of America. Spending billions to combat global warming--global warming--billions, it seems senseless for somebody who is retired and can't afford to heat their home in the Wyoming winter. There was a time when our leaders recognized that America's most valuable asset was the American people. I continue to believe that. There is a reason the preamble to our Constitution begins with, ``We the people,'' not ``You, the people.'' Our forefathers created a system of government through which free Americans get to decide their own fate. Today the very fabric of America is in danger of being tattered beyond repair, and every time I go home, as I travel around the State of Wyoming, people continue to tell me we are losing our country. I am not the only one who is hearing it. When Senators, when Representatives go home--and many of us do go home every weekend--we are hearing it State by State. Those Members of Congress who choose to not go home, to not go visit with the people they represent, to not hold town meetings because they are told by leadership don't go listen to the people, listen to us--those are the kinds of people who continue to vote for irresponsible spending. I am hoping Members go home over the upcoming Eastertime, go home and listen to people in their own home communities who will say Washington needs to live by the same rules families in America live by--live within your means. American families know what it means to live within your means. Since the beginning of this crisis, Americans have been forced to make some very difficult choices and to tighten our belts. Financially stressed Americans balance budgets for food, for gas, for electricity, for tuition, for clothing, rent, mortgage payments, and much more. When your neighbor maxes out the limit on their credit card they are keenly aware this is a clear indication of a spending problem. They cannot call the credit card company and simply say increase the credit limit. Unfortunately, we know Washington is not your average consumer. President Obama said it best. He said: In the long run we can't continue to spend as if deficits don't have consequences, as if waste does not matter, as if the hard earned tax dollars of the American people can be treated like monopoly money. Let me repeat that. This is President Obama who said last year, right before Christmas, ``We can't continue to spend as if the hard earned tax dollars of the American people can be treated like monopoly money. That's what we have seen time and time again.'' He said ``Washington has become more concerned about the next election than the next generation.'' Those on this side of the aisle are most concerned about our economy, our Nation, jobs, growth, opportunity, the families of this country. This is a long-term problem and it must be addressed in the short term. We cannot afford to wait. We cannot continue to call everything emergency spending without paying for it. The American people are demanding action. Time and again Washington's insatiable appetite for spending is met with more of the same. Only in Washington can you max out the country's credit card at $14 trillion and simply keep on spending. Unlike your average American, Washington has refused to make the tough choices needed to rein in unsustainable deficits we are now facing. Since we are not making the tough choices, the cost of handling the debt is continuing to go up. Interest rates are rising which means the amount of money that is going to go to pay that debt will continue to rise. Yet we are looking at a deficit that continues to rise, $1 trillion a year, all the way through 2020, and a Presidential budget that will double the national debt in 5 years and triple it in 10. The current national deficit for this fiscal year is $1.4 trillion. That is three times the previous record high. As I said, according to the budget projections, the deficit is going to be close to $1 trillion a year through 2020. This budget deficit is simply appalling. All you need to do is go home, have a townhall meeting, listen to people. People around the country are incensed with this sort of reckless, wasteful Washington spending. The worst part is people do not believe they are getting value for their money. In a recent poll, of every $1 you send to Washington in taxes, how much do you think is being wasted? The American public said 50 cents on every dollar sent to Washington in taxes is being wasted. That is an all-time record high number. People are not seeing that Washington is being responsible in how taxpayer dollars are being used and the American people simply do not believe they are getting value for their money. I agree, the people are not getting value for their money. All you need to do is look at the Washington wasteful spending and it is no surprise that the American people are incredibly upset. Year after year, monstrous deficits are leading us to a national debt crisis. In 2009 alone, the public debt grew 31 percent. It now is almost half of the gross domestic product. By 2020 it is expected to balloon to over 70 percent of the gross domestic product. So when I look at this and I talk to people at home and I think about this and I look at the great threats, the great threats to our Nation, to me the debt is the threat. As a result, I take a look at this major spending bill, the so-called stimulus package--which was supposed to keep unemployment down below 9 percent and said if you didn't pass it, it might go to 9 percent--they passed it, and it still went to 10 percent. Do you know only 1 in 16 Americans believes it actually created jobs. The President is out there saying it created jobs, traveling around the country, and only 1 in 16 Americans believes it. That is how severe this problem is. With that, I see my part of the time has expired and I wish to turn the remainder of this time over to Senator Coburn.

Mr. BARRASSO. Mr. President, it was fascinating to be here in the Senate Chamber this morning when first the Senator from Iowa made the statement, ``I'm all for paying for things.'' I am all for paying for things? But not for this. Not for that. Not for the next thing. Watching the Senator's voting record, it seems that everything is an emergency. He certainly does not seem to want to be paying for anything, just add it to the debt.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, my amendment protects families and protects small businesses from dramatic increases in insurance premiums. My amendment directs the Department of Health and Human Services to certify that insurance premiums will not rise faster under the new health care law than they would have if the law had not been passed. If they find that premiums are higher, then the new law would sunset. This month in Pennsylvania, the President said the Senate bill would reduce most people's premiums. I say to my friends on the other side of the aisle, if you believe the President and you believe that this bill lowers premiums, prove it. Vote for this amendment. This is a reasonable, straightforward amendment. It holds the President and it holds the Members of Congress accountable to the American people for promises made. Thank you, Mr. President.

Mr. BARRASSO

Mr. BARRASSO. Madam President, I ask unanimous consent to have printed in the Record the letter that Senator McCain referenced from the 85,000 doctors across the country opposing the bill.

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

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

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

Mr. BARRASSO. My colleague is absolutely correct. That is exactly what is happening. They call this a health care bill. It doesn't seem to address the major issues that patients across the country are concerned about. My colleague is absolutely right, we need a patient-centered approach. It doesn't address the issue that doctors are concerned about, which is the issue of making sure a doctor and a patient can work together toward the best health for that patient. Doctors and patients alike are very much opposed to this bill. When Senator McCain talks about the doctor fix to make this bill work, they say they are going to cut doctors across the country 21 percent in what they get paid for taking care of patients who depend upon Medicare for their health care, and then keep that price frozen for the next 10 years. That is the only way the Democrats can say, well, this actually saves money. In reality, in terms of health care in the country, it does not. This bill, if it passes, is going to end up costing patients more. It is going to interfere with the doctor-patient relationship. It is going to result in an America where people truly believe their personal care--and that is what people care about: What is in it for me? How will this bill affect me and my life and my children? If they are providing for adult care, how is it going to affect their parents? They believe the care they receive, in terms of the quality of care and the available care they receive, it is going to be worse. They believe it is going to end up costing more. That is why, in a recent poll this week, 57 percent of Americans say this plan, if it passes, will hurt the economy. We are at a time where we are at 9.7 percent unemployment in this country. People are looking for work, and the place people find jobs in this economy right now seems to be working for the government. For decades and decades, the engine that drives the economy of our Nation has been small businesses. That is who we rely upon to stimulate the economy and get job growth. That is who we should be relying on, not Washington, not the Federal Government. That is why 57 percent of Americans who are focused on the economy say we believe this economy will be hurt if this bill passes. People are focused on the debt and the cost, and 81 percent of Americans say it is going to cost more than estimated because of the fact, as Senator McCain has said, that doctors are going to be cut 21 percent across the board and continue for the next 10 years with their Medicare fees. The people of America realize that is not going to work for health care. People are going to say how am I going to get to see a doctor? I am on Medicare. I want to see a doctor. That is why people believe Medicare in their own personal care is going to get worse if this bill passes. Then the President promised we are not going to raise taxes on anyone. Seventy-eight percent of Americans believe there will be middle-class tax hikes if this passes. That is why people are opposed to a bill that cuts $500 billion from Medicare for our seniors who depend on Medicare for their health care. It is not just cutting payments to doctors; it is to hospitals, to nursing homes where we have so many seniors across the country. It affects home health agencies, which is a lifeline for people who are at home, and keeps them out of the hospitals. They are even going to cut payments for people who are in hospice care, who are at the terminal point, who are in the final days of their life. They are cutting that out. All of these are reasons the American people say I am not for this bill and it is time to stop. Half of America says stop and start over. One in four says stop completely. Only one in four actually believes this is going to help. That is not a way to pass legislation in this country. That is not a way to find something the American people agree with. That is not the way to get successful implementation of a program. I spent 5 years in the Wyoming State Senate. On major pieces of legislation, we always sought broad bipartisan support because if you have broad bipartisan support, then people all around the community and the country would say this must be the right solution to a significant problem we are facing. We are facing a problem with health care in this country and we need health care reform. We just do not need this bill that cuts Medicare, raises taxes, and for the most part most Americans will tell you they believe their own personal care will suffer as a result of this bill becoming law. For whatever means or mechanism or parliamentary tricks are used to try to cram this bill through and cram it down the throats of the American people, the American people want to say no, thank you. They are saying it in a less polite way than just saying no, thank you. They are calling, they are showing up, they are turning out to tell their elected representatives that we do not want this bill under any circumstances. Let's get to the things we can agree upon and isolate those and pass those immediately, not an over-2,000-page bill that is loaded with new government rules and new government regulations and new government agencies and new government employees at a time when 10 percent of Americans are unemployed and people are looking for work in communities around the country. One of the things I found so interesting and also distressing when the President says everyone will have coverage is he wants to do it by putting 15 million Americans on Medicaid. Having practiced medicine for 25 years and seen all patients, regardless of ability to pay, I can tell you there are many doctors across the country who do not see Medicaid patients because what they receive in payment from the Government for seeing those patients is so little. Even the people at the Congressional Budget Office--who look at this health care bill with the cuts in Medicare and with so many people put on Medicaid--say one in five hospitals is going to be unable to stay open 10 years from now if this gets passed because they are not going to be able to even cover the expenses of staying open. The same applies to doctors' offices and to nursing homes. We need a program approach that is sustainable, not something like this, that we know is irresponsible and unsustainable. That is what we are going to do if we put 15 million more people on Medicaid by sending them a Medicaid card. But, as Senator Alexander has said, that is like giving somebody a bus ticket when a bus is not coming--because coverage does not always equal care. As a surgeon in Wyoming, I took care of people who came from Canada. They came to Wyoming from Canada for health care. They had coverage in Canada because Canada covers all the people, but they do not get care in Canada. That is why 33,000 Canadians last year came to the United States for surgery. Why? Because the waiting lines were so long in Canada. Even a Member of Parliament had cancer--and my wife is a breast cancer survivor--a Member of Parliament in Canada came to the United States for her cancer care because the survival rates for people treated in the United States are so much better. Why are they better? It is more timely care. People come for artificial hip replacements because they do not want to wait in Canada. In Canada, come Halloween--it is called trick-or- treat medicine--they have spent the amount of money they are going to spend on a procedure, whether it is cataract surgery or total joint replacement, and they say: OK, we are done. Wait until next year. Go get in line again. I hear it time and time again in patients who come from Canada to the United States because they have coverage but they do not have care. Then we look at Medicaid and Medicare and we look at the model the President has lifted up as the one that is a good model for health care in America, and he pointed to the Mayo Clinic, which is a wonderful place with wonderful care. Yet the Mayo Clinic in Arizona said we can't take more Medicare patients. They said we have to limit the number of Medicaid patients we take. Why? Because, by taking care are of those patients in the past, the Mayo Clinic has said they have lost hundreds and hundreds of millions of dollars because Washington is the biggest deadbeat payer of all for health care. When it comes to actually rejecting patients' claims, the No. 1 rejecter of claims in this country is Medicare. The highest percentage of claims rejected is Medicare, over other insurance companies. Having practiced medicine for 25 years, I have fought with Medicare and I fought with insurance companies, all on behalf of patients. When you are fighting with an insurance company you can always actually appeal that if they reject it. It is very hard to fight with Washington. This health care bill we have been debating in the Senate and is now before the House is the one where the American people say don't make me live under this. Don't cut my Medicare. Don't raise my taxes. Don't interfere with my relationship with my doctor. Don't make it tougher for me to get care. Don't lessen the quality of that care. I ask how much time I have remaining.

Mr. BARRASSO. I am not aware of that article, but I look forward to hearing about it from my colleague from Arizona.

Mr. BARRASSO

Mr. BARRASSO. I heard that just this morning. We had a number of county commissioners from Wyoming here in Washington. They were at a speech yesterday given by Speaker of the House Nancy Pelosi, and she told these county commissioners, this group from all around the country, we need to first pass the bill so then later the American people will know what is in it. She said this to them and they laughed. They laughed at the Speaker of the House at this meeting yesterday because these are county commissioners. They know they are not going to vote on something the people in the community don't know about. The people in the community come, they want to know what is going to be discussed and then voted on. The people of America do not know what is in this bill. They know this bill is going to raise taxes by $500 billion. They know this bill is going to cut Medicare for our seniors who depend upon Medicare by another $500 billion. They know they are going to be paying for this thing for 10 years, but there are only 6 years of services. It is amazing how much the people of America know about the gimmicks of this bill that, in fact, those who are pushing the bill wish they didn't know. That is why three out of four Americans say stop. A quarter of them say stop, a quarter of them say stop and start over, and only a quarter of them support what is happening here.

Mr. BARRASSO. Well, Mr. President, that is exactly what I am hearing at home from Wyoming's voters and from my patients. I was in Wyoming this past weekend. I have had the privilege of practicing medicine there for 25 years, taking care of families in Wyoming. When I talk to people, their concerns are the national concerns the Senator from Kansas has just mentioned--the debt and what our Nation is facing long term. But they are also very focused on their own personal care. If you have a town meeting or just talk to people at the coffee shop, the people of America believe that if this bill passes, the quality of their own personal health care will go down; that their opportunity to go to the doctor they have enjoyed a relationship with for years, where they know them and they know their family, may be gone. We are also seeing that health care providers all across the country--even the Mayo Clinic--are saying this bill is a huge lost opportunity. It was supposed to be designed to help get the cost of care down, and it is not doing that. It is going to raise the cost of care. It was designed to improve the quality of care, but it is going to cost people the quality of their own health care. That is why Americans don't like this bill. They do not like anything about it. The Mayo Clinic was used early on by the President in this debate as the model for how we should have health care in this country. The Mayo Clinic has said ``no thank you'' to patients on Medicare in Arizona, ``no thank you'' to patients on Medicaid. Yet the President plans to push this program through. He says he is going to provide coverage for more Americans, and he is going to do it by putting 15 million more people on Medicaid--a program that many doctors won't see because the reimbursement is so low. If all a provider saw were Medicare patients, they couldn't afford to keep their doors open--not at the hospital or the clinic. And we are hearing that from hospitals and doctors across the country. That is why the Mayo Clinic said: No thank you, Mr. President. We can't take those patients, whether it is Medicare or Medicaid. This bill will cut Medicare--the program our seniors depend upon--by $500 billion for patients who depend on Medicare. It cuts Medicare Advantage, and that program is an advantage, and the reason people signed up for it is because it provides preventive care and coordinated care. But it is not just that; there will be $135 billion in cuts to hospitals in all our States and communities, $42 billion to home health agencies. These are the folks who help provide a lifeline for people who are at home, and it saves money by keeping them out of the hospital. There are cuts to nursing homes, to hospice providers-- providing services to people in the final days of their lives. That is why the American people are offended that this bill is being crammed through. I see we have the former Governor of Nebraska here on the floor, who has experienced these issues with Medicaid, with Medicare, and with nursing homes. So I would ask my friend and colleague whether this the same thing he is hearing at home in Nebraska.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I would say to my colleague from Arizona--and there is actually a Mayo Clinic in Arizona, as there is in Florida and as there is in Rochester, MN, which is the home of the Mayo Clinic--one would think, since the President early on talked so much about the Mayo Clinic being a model for health care in the country, the Mayo Clinic might agree with what the President had to say. But if you go to the Mayo Clinic's blogs, they say: The proposed legislation misses the opportunity-- We have an opportunity now-- to help create high-quality, more affordable health care for patients. In fact, it will do the opposite. So here you are. The proposed legislation misses the opportunity to help create higher quality, more affordable health care for patients. In fact, it will do the opposite.

Mr. BARRASSO. Mr. President, I just heard the Republican leader talk about the issue of health care in America and the goal which we heard so much about of getting the cost of care under control. I have practiced medicine for 25 years in Casper, WY. I was in Wyoming yesterday visiting with physicians, visiting with nurses, visiting with those who are patients, as well as those who are providers, and talking with them about what is happening in this country and in this body with the discussion about health care in America and the legislation. No matter whom I talk with in Wyoming, when they look at this massive, 2,000-page bill and they think about it and then they ask questions about it, they say: How in the world is this actually going to get the cost of care down? How is this going to help them save money? Because as they read it and as they look at the rules and the regulations and the new mandates for more bureaucracies-- they say it is going to be more government employees at a time when there is 10 percent unemployment in the country--they say: It is going to likely cause my own cost of health care to go up, my own insurance coverage to go up. They have great concerns that the quality of their own care will go down--go down. Americans, and certainly the people in Wyoming, are very worried that if this bill becomes law, the cost of their care is going to go up and the quality and availability of their care is going to go down. That is not what they want. The President was speaking in Philadelphia yesterday. The front page of one of the papers this morning says: ``[The President] Turns Up the Volume in Bid for His Health Measure.'' And he said, as a challenge to Democrats, ``If not us, who?'' Mr. President, it should be all of us. This should not be something that is being rammed through the House and the Senate and force-fed to the American people at a time when 75 percent of them want nothing to do with this bill. Three out of four Americans say: Stop, we don't want this, because they are worried about the cost of their own care and the availability and the quality of the care they are receiving. So when the President gives his speeches, as he did yesterday, I would say: Involve all of us. Involve all of us in the discussion, which is what we should have been doing for over a year. I look at what he said in his speech, and he talked about an insurance broker who apparently told some others there was so little competition--this is the President now talking, saying there is so little competition in insurance, that allows people to drive up the cost. The solution to that is the Republican solution that says: Increase the competition, increase the competition. That is what we need. Patients, people, citizens of this country want to be able to shop around, buy insurance across State lines, look for what is best for them and best for their families. If we did that, if we did that today, there would be 12 million more Americans with insurance by merely being allowed to have more competition, to be able to shop across State lines and to look around for something that is best for them and for their families--not the limited choices they may have in the State in which they happen to live. So I look at this from the standpoint of practicing medicine for 25 years, visiting with patients, visiting with providers, talking with nurses, talking with doctors, saying there are things we can do to get down the cost of care. Unfortunately, they are not included in this 2,000-page bill that is now sitting over in the House, with all of these different approaches to force this through in a way that undermines what the American people want, what the American people are asking for--the opinions of the American people--by a group of people in this body who say: We know better than the American people. This body does not know better than the American people. The House does not know better than the American people. It is time to listen to the American people, which is why I go home every weekend to visit with those folks in my State, in my home State of Wyoming, to visit with them about their needs, their concerns. And they have great concerns about this bill. It is not just people in my home communities. Warren Buffett, the great investor, says Washington should scrap this health care bill and start over. He said they should focus, as our Republican leader said a few minutes ago, on the costs. He said we should say we are going to focus on the costs and not dream up 2,000 pages of other things. Warren Buffett says get rid of the nonsense, and this bill is loaded with nonsense. This bill is loaded with nonsense--nonsense that is going to drive up the cost of care and decrease the quality of care in this country. So we have now been going through this for a year. The President is out trying to make an appeal to the Nation to say: Yes, buy this package I am trying to sell. The American people are too smart for that. They realize this package cuts $500 billion from Medicare patients who depend on Medicare for their health care--$500 billion in Medicare cuts. Part of it is to hospitals and part of it is to a program called Medicare Advantage. There are 10 million Americans on Medicare Advantage. The reason they signed up for this, they choose this, is because there is an advantage for them as seniors to participate in this program because this is a program that actually works with preventive care, with coordinating care, things that regular Medicare does not do. They are going to cut over $100 billion from our nursing homes and money from home health, which is a lifeline for people at home. They are going to cut money from hospice for people in their final days of life. That is part of this big bill the President is supporting and that he is asking the House to vote for. It is a bill that raises taxes by another $500 billion. It is a bill the House is going to be asked to pass that includes every one of the sweetheart deals because their first act in the House is going to have to be to pass the bill the Senate passed on Christmas Eve and that includes all the sweetheart deals, whether it is to Nebraska or Louisiana or Florida. Thirteen different Senators had sweetheart deals put into that bill the Democrats are going to be asked to vote for because the Republicans see through this whole thing. So the opposition to this is bipartisan. It is bipartisan opposition. Those who support it is one party only. We are looking now at a mandate where every American is going to be forced--forced--to buy a product, to buy insurance--forced under this-- or they will either have to pay special taxes, have their wages garnished or pay a fine or a penalty under this plan that the American people, three out of four, have absolutely rejected. I see my colleague from Arizona has taken to the floor, and I would ask him if he is hearing similar things when he goes home to Arizona to visit with the people and what concerns he is hearing because there are certainly many seniors in the fine State of Arizona.

Mr. BARRASSO. Absolutely.

Mr. BARRASSO

Mr. BARRASSO. I thank the Senator very much. I agree exactly with what the Senator has said because my experience has been very similar. I served 5 years in the State senate in Wyoming, and before that I was a physician practicing in Wyoming, taking care of so many families. Just this Monday I was at the Wyoming Medical Center, the largest hospital in our State. It is a hospital where I have previously been chief of staff. What I hear from the people of Wyoming is, I am sure, what the Senator has heard from the people at home in Mississippi. They say: Why don't you just stop and start over? It is not just the people from our States. In a recent CNN poll, 50 percent of all Americans say it is time to stop and start over. We do need health care reform, but we don't need this 2,700-page bill with all of the unintended consequences that may come with it, all of the new government boards and commissions, a program that cuts $500 billion from our seniors who depend upon Medicare for their health care, and raises taxes by another $500 billion. The American people are saying stop and start over. They know we have good ideas. They listened to that summit last week that I was able to attend at the White House, and they have heard Republicans say to let people buy insurance across State lines. That will help 12 million more people get insurance today. They say let's deal with lawsuit abuse. That will help cut down the cost of these unnecessary tests which are done as defensive medicine. The American people understand the value of allowing small businesses to join to help more effectively get down the cost of care. That is why half of all Americans say stop and start over. One in four say just stop. Only one in four Americans say, yes; pass the bill. So three and four do not want what the President seems to be wanting to shove through Congress and shove down the throats of the American people. The American people are incensed. That is what I heard in Wyoming this weekend, and I am sure that is what my colleague from Mississippi heard as well. So the President made his speech yesterday, which seemed to be a new sales pitch, but it is for the same bill. It is why so many folks have said stop, start over, focus on ideas that we know will work. Give individuals as patients, as citizens, rights to make more choices that affect their own lives. Give them those opportunities. We don't need a government bureaucrat standing between the doctor and a patient. We don't need a government bureaucrat. We don't need an insurance bureaucrat. I see my colleague, Senator Coburn, is on the Senate floor, another physician who has, as have I, fought against government bureaucrats and insurance company bureaucrats all for our patients because we need a patient-centered health care program, and we need health care reform, but we do not need this massive bill. I also see my colleague from Florida has joined us. He knows we have positive ideas that will make a difference because we need to be focused also on the cost of care. People like the quality of care they are getting. They like the fact it is available. But the cost is what is affecting us. That is why Warren Buffett just on Monday has said we need to focus on cost. They need to take 2,000 pages of nonsense out of the bill and focus on getting the costs under control. And so many of the ideas that the Republicans have brought forth have focused specifically on that. So I would ask my colleague from Florida, are there things he has heard as he has visited with his constituents and the people in his State that he might wish to add to this discussion right now?

Mr. BARRASSO. Right now--and we just passed a 1-month extension the other night--Medicare is supposed to cut the fees for all doctors across the country by 21 percent. Seniors know Medicare underpays right now. As one of my colleagues in the State senate in Wyoming used to say, government is the biggest deadbeat payer because they do not even pay enough to cover the cost of the care that is delivered in our hospitals. With ambulances, they do not cover enough to pay for the gas to fill up the ambulances to go the long distances we have in Arizona or in Wyoming. But right now, to deal with some promises that were made years ago, the fees for physicians should be cut 21 percent, according to Medicare. A number of years ago, they were supposed to cut it by 1 or 2 percent, and they said: Well, we will not cut it, but next year we will cut it by 4 percent and then next year 8 percent and then 10 percent. Well, now they have continued to kick the can down the road enough so that this year they are supposed to cut the fees for physicians by 21 percent.

Mr. BARRASSO. Madam President, if I could, several things. There is a wonderful Paul Ryan op-ed in today's Wall Street Journal, and I would recommend it to anyone to look at that because he specifically points out that the President's own chief Medicare actuary says the Senate and House bills are bending the cost curve up, making the costs go up, which is what you hear if you go to a town meeting in Arizona or in Wyoming. When you ask people: If this bill passes, will the cost of your own care go up, the hands go up. When you say: Well, how about the quality; will the quality of your care go down? Again, the hands go up. So that is a continual concern of people all across America, which is why three- quarters of Americans have told CNN it is time to either just completely stop or stop and start over and only one-quarter of Americans support this proposal, because they realize this is going to do that. The Senator from Arizona mentioned, and it was interesting, the 11 pages from the President. The gimmicks are still there. They may have taken out one of the gimmicks, but the spending gimmicks are there, plus the Louisiana purchase, the special carve-out for 800,000 people in Florida who are on Medicare Advantage. They are protected, but there are another 10 million Americans who will lose their Medicare Advantage. Then the question came up of what we refer to as the ``doc fix.'' The way the numbers are moved around----

Mr. BARRASSO. Madam President, I ask unanimous consent to continue for an additional 5 minutes.

Mr. BARRASSO. It puts the government between you and your patient, which is what you never want to have happen. As Dr. Coburn said, that is the wrong approach. It is not the way medicine has ever been practiced in America. It is not the way patients want it; it is not the way doctors want it. We don't want bureaucrats, whether government or insurance company bureaucrats, between doctors and patients. As we saw at the health care summit on Thursday of last week, the President kept talking about covering people, health coverage, but he wants to put 15 million more people on Medicaid--a program where half the doctors don't see them because the government pays so little; a program where the Mayo Clinic, which the President has held up as a model for health care in America, says: We can't continue to see Medicaid patients from a number of States because we lose too much money. And now they have said the same with regard to Medicare. So when they are talking about $500 billion of cuts to Medicare, the Mayo Clinic, on January 1, said they can't handle additional Medicare patients because last year they lost, they said, $800 million by taking care of Medicare patients because the government pays so little.

Mr. BARRASSO. Well, it would have affected me in several ways. It would have affected my life in that my wife Bobbi is a breast cancer survivor. She had a screening mammogram when she was in her forties-- something this Task Force on Preventive Services says was unnecessary. If it hadn't been for that screening mammogram, her cancer would not have been detected. And by having the screening mammogram, which the American Cancer Society and others recommend for women in this country, and following the guidelines of the cancer society as opposed to this new government-mandated guideline, her cancer was detected. She has had three operations, several bouts of chemotherapy, and is alive today, a breast cancer survivor, 6 years later, because she did what scientists and what those who know what is best for patients recommended as opposed to what a government panel might have recommended trying to focus on their cost-effectiveness.

Mr. BARRASSO. Absolutely.

Mr. BARRASSO. If I may, one of the phrases the Senator used about using reconciliation was ``hijacking,'' hijacking the system, hijacking the way this works. That specific word was used by then-Senator Barack Obama when he was a Senator and very much opposed to this approach. One of the other things he has said, when we talk about the $500 billion being cut from our seniors on Medicare, he talks about a program called Medicare Advantage. That is only a part of the area that is involved. For people on Medicare Advantage--and there are about 10 million of them--they know they are on it, and they like the program. There are some advantages. One is it actually works to help coordinate care. It works with preventive care. Those are things that are very important. But there are also cuts in Medicare for nursing homes, for payments to doctors, for home health care, which is a lifeline for people, for hospice care, for care at the end of someone's life. That is all going to get cut under these $500 billion of Medicare cuts.