John Barrasso

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I come to the floor today to put into perspective some statements made by my good friend from Oklahoma, and he made those with regard to the Wyoming Range Withdrawal Act. This is a bill that I introduced. I am especially pleased to be giving this speech from this desk. People back home in Wyoming ask about the desk and whose desk do you have? As you know, after the election and the new swearing in of Senators, some of the desks switched around. Due to the generosity of Senator Shelby--and I am very grateful to him--he has allowed me to have this desk because this is the desk of F.E. Warren, who was Wyoming's first Senator when we became a State in 1890. He took the oath of office, and he served for almost four decades. This is the desk he got when he came to the Senate on day one. It is important to give this speech from this desk because we are talking about a part of Wyoming's past and a part of Wyoming's future that is very important, and it is the Wyoming range. Wyoming has a long history of getting it right when it comes to multiple use of the land. We have done it for 119 years that we have been a State, and we will continue to do it forever. I am here to tell you and to tell the people of Wyoming, tell the people of America that I introduced this bill, the Wyoming Range Withdrawal Act, to fulfill a commitment I made to the people of Wyoming and to complete the work that was started by my good friend, Senator Craig Thomas. We lost Senator Thomas in 2007. At the time of his death, he was working on this bill. He had traveled the State. He had visited with people, listened to people. That is exactly what I did when I took the oath of office--having town meetings, traveling to all of the parts of the State, visiting, listening to people, and then working to try to improve the bill that is in front of us today as part of this lands package. I am here to tell you that right now, today, there is oil and gas development going on in the Wyoming range. I have a picture of the Wyoming range, a beautiful part of western Wyoming. It means so much to so many people. There are certain places that are so special and so pristine that they need to be protected for future generations. But we do it right in Wyoming. We rely on multiple uses of the land. This legislation we have heard about today seeks to protect from future oil and gas activity--let me say that again--from future oil and gas activity, lands in the Wyoming range that are not currently under lease. And there are lands in Wyoming that are currently under lease. As we can see in this picture, it is still a very pristine, beautiful area, but some of this land is under lease for oil and gas development. The legislation in this lands package does not--does not-- affect areas that have been currently leased for exploration. There are 18 oil and gas leases within the proposed withdrawal area. These leases cover over 70,000 acres. These leases are primarily located in areas that have some of the most significant potential, the most significant potential for mineral development. They represent valid existing rights, and they will not be canceled in any way by this bill. I repeat: These leases represent valid existing property rights and will not be canceled by this bill. In addition, there are 35 oil and gas leases covering almost 45,000 additional acres that have been issued and are under protest or have been sold but not yet issued. The legislation does not cancel any of these areas which are being contested. There does exist an appropriate administrative process whereby the Bureau of Land Management, the U.S. Forest Service is evaluating these contested leases to determine their status. I repeat: This legislation today does not cancel any of these currently contested leases. Everyone should keep in mind that the acres currently leased or currently leased but under protest represent the area where the most promising reserves exist. This bill does not touch that. Now, my colleague from Oklahoma stated that the legislation would take off the table 8.8 trillion cubic feet of recoverable natural gas and over 300 million barrels of recoverable oil. Well, let us first set aside whether those figures are accurate, and we will get to that in a minute. I reiterate: The areas believed to hold the majority of the oil and gas reserves are leased, those areas are leased, and those are valid existing rights and will not be changed by this piece of legislation. Now, regarding the figures. I have an updated estimate, an estimate of the reserves of the Wyoming Range that has been prepared by the U.S. Department of Interior, the U.S. Geological Survey, and this was prepared on June 19, 2008. I have shared these numbers with Members of the Senate. Under the revised estimates, the best minds, the best geological thinking, they believe there is some natural gas potential in this area of 1.5 trillion cubic feet, not 8.8, and an oil potential of 5 million barrels, not 300 million barrels. Mr. President, I ask unanimous consent to have printed in the Record, following my remarks, the USGS letter to the chairman of the Senate Committee on Energy and Natural Resources, Senator Bingaman, who earlier spoke.

Mr. BARRASSO

Mr. BARRASSO. Thank you very much, Madam President.

Mr. BARRASSO. Madam President, I also ask unanimous consent that Senator Nelson of Florida be allowed to speak after me.

Mr. BARRASSO

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

Mr. BARRASSO

Mr. BARRASSO. Madam President, I stand here today holding a 500-page report, a report that was sent to my office yesterday by the Army Corps of Engineers. I will not read the whole report, I am happy to say, but I want to call attention to the Senate and to the country, as well as to the people of Wyoming, what is contained within this report. This report, at a cost of who knows how many taxpayer dollars, says something I have known and the people of Wyoming have known to be true. It says the Army Corps of Engineers is responsible for the contamination of the water wells of the city of Cheyenne. Now, let me clarify. The report does not actually say the words ``we are responsible.'' Washington could never admit its faults so directly. No. Instead, the report states that other potential sources of contamination, other potential sources of this trichloroethylene--the contaminant, the chemical that is in our city's wells--it says that other potential sources ``may be limited.'' I guess that is Washington's way of saying: It was us. The Wyoming Department of Environmental Quality and the city of Cheyenne found evidence of trichloroethylene in the water supply in 1998--10 years ago. The culprit is a dormant Cold War-era nuclear missile area. It is a missile site and has been there for a long time. The Army Corps of Engineers admits that over 1,800 gallons of this contaminant, TCE, was dumped at the Atlas 4 nuclear missile site each year--each year--of the operation of the missile site, beginning in the mid-1960s. Well, the discharge of TCE the Army Corps admits to is a mere 1 mile--1 mile--from the water wells of the city of Cheyenne. The Wyoming Department of Environmental Quality has claimed there is one giant plume of TCE emanating from the former nuclear missile site, working its way into and then contaminating the city's water wells. The missile site is currently being cleaned up under the Superfund laws by the Army Corps of Engineers. Unfortunately, the Army Corps only admits culpability for TCE contamination directly emanating from the nuclear missile site. They allege that there is actually a gap between the plume they admit to at the nuclear missile site and the one around the city's water wells--1 mile apart. Now, you might think it odd that the Department of Defense, given the volume of this chemical that has been dumped year after year in rural Wyoming, would not admit that it was the responsible party for contaminating the city's wells. That would just make sense. They would say: Yes, we dumped it here. It is right here, a mile away in the wells. It is our fault. No. It would just make sense to us that they would admit it. But, in fact, the Army Corps over the last few years has looked to blame almost anyone else, has looked to blame others than to say they are responsible for contaminating the city's wells. Well, such claims have included that there might have been a train derailment and the train might have been carrying TCE into the area. They said it might have been from a nearby oil rig, it might have been from a local shooting range. The Army Corps said: Anybody but us. I became involved in this issue after I felt the city of Cheyenne and the Wyoming Department of Environmental Quality were being ignored by Washington. As ranking member of the Superfund and Environmental Health Subcommittee, I pushed for testing of the ground in that 1-mile area between the nuclear missile site and the water wells of the city of Cheyenne. The Army Corps finally agreed to do the testing and said it would also look into the historical use of this chemical in the Cheyenne area to make sure there was not another responsible party for the contamination. The final results--all 500 pages--were finally released this week. To no one's surprise who lives in Wyoming, to no one's surprise who is familiar with this issue, to no one's surprise but the Army Corps of Engineers, the contaminating chemical, TCE, was found in the ground between the nuclear missile site and the city's water wells, right where we said it would be. The report also revealed they found no other public records of TCE use in the Cheyenne area for any other reason. It just makes sense to us, and the cause is clear. Given these findings, it is time for the Army Corps to provide the funding the city needs to manage and to complete the current cleanup efforts. Now, let me be clear. The city of Cheyenne's water is safe. Untold thousands of taxpayer dollars have gone to keep TCE out of the water supply. The city of Cheyenne and the State of Wyoming have implemented the effective procedures to protect the folks in Cheyenne. Those efforts have been completely successful. But the Army Corps of Engineers and the U.S. Government have the responsibility to fund the cleanup. They have responsibility to fix the problem, and this report says it is so. It is time to do so. Madam President, I yield the floor.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, today I come to the floor to tell the Nation a story, and it is the story of a Wyoming doctor, a doctor by the name of Randy Johnston. He is an ophthalmologist who practices in Cheyenne, WY. He is very qualified. He is very capable. He is also a good friend. The reason I come to tell you this story is because, like many doctors across the country, Randy takes care of people on Medicare, and occasionally in his practice as an ophthalmologist he gives shots to people on Medicare. As a matter of fact, there is a picture of Dr. Johnston on the front page of the American Medical News. This is an article dated November 10, written by Jane Cys, and it shows Dr. Johnston in his office in Cheyenne getting ready to give a shot. Well, in the past, Randy would buy the drugs that his practice uses and then bill the patients for the treatment. The drugs that Randy uses are typically injected, but under this Part B Medicare drug program some are infused through a patient intravenously right into the vein. Two years ago, Randy enrolled in a new program created by the 2003 Medicare Modernization Act. This Medicare Part B program was called the Competitive Acquisition Program--CAP is the phrase they use. It was designed to give doctors a choice in the way they administer the drugs. Under the program, the doctor would first see the patient, then order the medicine from a Government vendor, then get the medicine, and then give the injection. Well, the way it worked is, Medicare would then pay the vendor for the drugs. Medicare also would bill the patient if there was a copay or a premium the patient owed. Randy was only responsible to bill Medicare for the actual treatment of the patient, not for the medicines. Congress and the Centers for Medicare and Medicaid Services hailed this new program as a way to alleviate administrative burdens and reduce Medicare costs--a good idea. Doctors could now spend more of their time with their patients rather than serving as drug purchasers and bill collectors. Randy signed up for the program early, and the program that was passed as part of the 2003 bill finally got started in 2006. Randy thought it made good sense for him, good sense for his patients. Some of his Medicare patients could not afford to pay for their office- administered drugs, and Randy saw great potential in this new program. He could transfer the Medicare billing part of it to someone equipped to handle the administrative redtape, and this freedom would leave him more time to focus on practicing medicine. The program has now been in place for 3 years. What are the results? Well, only 4,200 doctors signed up for the program. You may ask, why is that? Dr. Johnston can tell you, and this article in the American Medical News explains it very well. Administrative hassles, burdensome drug transportation and storage rules, and vendor delivery problems-- and that is just to name a few. For example, the Government rules require doctors to give patients the drugs only in the facility where the vendor delivered the medicine--no exceptions, none. This requirement prevented doctors from moving drugs between their main office and a part-time satellite office they may have in another community. Washington bureaucrats simply do not understand what a burden this policy can be in rural and frontier communities. Seniors living in rural States such as Wyoming often have to travel great distances-- hundreds of miles--to see a specialist like Dr. Randy Johnston. This program, with good intentions, clearly was not designed to meet the unique needs facing rural patients and health care providers who work tirelessly to serve their patients. Dr. Johnston was also required to order the drugs for a specific individual patient by name. He was not allowed to restock a general office supply to use on multiple patients. I understand the Government is trying to prevent drug stockpiling. But this rigid program requirement does not give doctors the flexibility they need to practice medicine. This is especially true in emergency situations. So who is liable when a patient comes to the doctor's office needing immediate treatment but the doctor cannot help because he has to call the Government to send the medicine in the first place, even if he has a supply on hand for another patient? The program's current design has turned out to be a bureaucratic nightmare. After only 3 months in the program, Randy Johnston wrote Medicare a letter begging--I say begging--to be let out of the program. Why? Well, it was not just the excessive paperwork and the excessive phone calls to get the medication; Randy saw how absolutely wasteful this Government program had become. When Dr. Johnston purchased Medicaid vials himself from a local pharmacy, the local pharmacy would divide it into multiple doses that could be used for different patients. Using the new Medicare program, Dr. Johnston had to order an entire vial for each patient, use the one dose the patient needed, and then throw the rest away. Why would Medicare force seniors and taxpayers to foot the bill for an entire vial of medication containing 400 doses when the patient only needed 1 dose? At a time when Americans are facing such painful financial times, this wasteful Government spending is appalling. We are talking about lifesaving medicine, expensive medicine. I do not know anyone who buys a loaf of bread, takes out one piece and eats it, and throws away the rest of the loaf. This makes no sense to anyone. It is well past the time that Washington bureaucrats start treating taxpayer dollars like the money in their own personal checkbooks. When emergencies, illnesses, or major household repairs occur in our families, we find a way to pay the bill. We look at our budgets, we tighten our belts, and we find alternative places to save. We eliminate luxury items. We stop wasteful spending. Dr. Johnston was absolutely right to try to get out of this absolutely wrong, wasteful program. Washington bureaucrats who have never been on the front lines treating Medicare patients developed this program. They do not understand the practical applications. So I was not surprised when Medicare announced in September of this year they were putting the entire program on hold starting in January 2009. Washington bureaucrats claim they are considering alternative ways-- alternative ways--to improve the program because they want it to succeed. The new administration has a tremendous opportunity to learn from Randy Johnston and from the 4,200 other participating doctors. Rather than hamstring providers, perhaps Washington should start to focus its efforts on eliminating waste, eliminating fraud, and eliminating abuse in the Medicare system. This year alone, we have seen one news report after another uncovering Medicare wasting money. These news reports sound the alarm to every hard-working taxpayer in the sound of my voice and all hard- working taxpayers across America. Who is holding these bureaucrats accountable? Just this week, the Department of Health and Human Services issued the Agency Financial Report. This document shows that in fiscal year 2008, these Government check writers made $10.4 billion--$10.4 billion--in improper Medicare fee-for-service payments. We can do better. We can do much better than this. Wasteful spending strips Medicare of the vital resources that are needed to care for our elderly, to care for our frail, to care for the vulnerable. The new administration has a real opportunity to show leadership. Working together, we can fix this flawed policy. Medicare patients, doctors who take care of Medicare patients, and the American taxpayers deserve nothing less. Mr. President, I yield the floor and suggest the absence of a quorum.

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

Mr. BARRASSO

Mr. BARRASSO. Thank you very much, Mr. President.

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

Mr. BARRASSO

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

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I suggest the absence of a quorum.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, this morning I would like to speak about medical safety, about patient care, about the cost of that care, and about how Medicare is dealing with this. In 1999, the Institute of Medicine issued a groundbreaking report on medical errors. The report was called ``To Err Is Human: Building a Safer Health System.'' The Institute of Medicine findings provoked heated and extensive professional and public dialog. The report left few doubting that preventable medical injuries occur and continue to be a serious problem in America. It identified a number of solutions, solutions to stop hospitals and physicians from performing unsafe practices. It also asked lawmakers to partner with health care providers to create and to adhere to strict, ambitious, quantitative and well-tracked national goals. The National Quality Forum Set out to do just that. The forum's mission is to bring people together to create health care quality initiatives that are safe, effective, and patient-centered. In 2001, the former National Quality Forum CEO first coined the term ``never event.'' Well, he was referring to particularly shocking medical errors that really should never happen, medical errors such as surgery performed on the wrong body part, surgery performed on the wrong patient, or the wrong surgical procedure performed on a patient. By 2002, the National Quality Forum had identified 27 so-called never events. Now, the ``group'' is listed in six different categories: surgical, product or device, patient protection, care management, environmental, and criminal. The Agency for Healthcare Research and Quality says that most never events are very rare. They estimate that a typical hospital might have a wrong-site surgery case once every 5 or 10 years. As public reporting on health care quality gained momentum, lawmakers focused on eliminating never events. They did it as a way to increase accountability as well as to contain costs. More and more surgeons began physically signing the surgical site with a marking pen in the pre-op holding area. Now, they did this while the patient was still awake just to make sure everyone agreed what operation was being done on what body part. The Deficit Reduction Act of 2005 required the Secretary of Health and Human Services to select at least two conditions that could be reasonably prevented. This is where Washington went too far. The Washington bureaucrats identified eight conditions as never events. Here is the list: object left in during surgery; air embolism; blood incompatibility; pressure ulcers; falls and trauma; catheter-associated urinary tract infections; vascular catheter-associated infections; and surgical-site infection. Why is this important, this list of eight? Well, it is important because some of this list of eight conditions really should never happen. Some of these eight conditions, though, can and do occur with regularity, even under the best of circumstances. Well, what is the impact of the rules on patients and the medical profession? Medicare says it will pay to treat the underlying diagnosis but will not pay the hospital to treat complications from any of these eight conditions if the medical problem develops during the patient's hospital stay. For example, the patient is treated for a stroke, has no other complications during the hospital stay, and the hospital is paid a little over $5,000 by Medicare. If the same patient was to have a severe pressure ulcer when they arrived at the hospital in addition to the stroke, Medicare pays about $3,000 more for the treatment of both the stroke and the ulcers. But Medicare says: If the pressure ulcers developed after the patient arrived at the hospital, then Medicare will only reimburse to treat the stroke, not to treat the pressure ulcer. The problem with pressure ulcers is they will not show up until the patient has usually been in the hospital for awhile. The damage to the tissue occurs at the time the patient with the stroke or with a broken hip lies motionless at home waiting until someone finds them, as often happens with somebody who lives alone. The damage occurs before the patient is even taken to the hospital, but the hospital is going to lose up to $3,000 to treat the pressure ulcer regardless of the medical condition that caused the problem in the first place. The bureaucrats are saying it should never happen, yet it happens all the time. Although the never events program is in its infancy, I am troubled by the direction these Washington bureaucrats are headed. I believe the negative long-term impact on patient care is going to be significant. This year, Washington bureaucrats expanded the never events. They expanded the list to include even more conditions: surgical-site infections following elective procedures, blood sugar control, and deep-vein thrombosis/pulmonary embolism. When you take a closer look at the entire process, it does show a disturbing trend. I agree that a foreign object left behind inside a patient after surgery is an event that should never occur. The fact is that most of the never events on the Government's list, selected and targeted in the rulemaking process, are impossible to eliminate. These bureaucrats clearly did not fulfill their requirement in the Deficit Reduction Act, a requirement to choose never events that are reasonably preventable by applying evidence-based guidelines. To be reasonably preventable, the Washington bureaucrats must have peer- reviewed, published literature showing clinicians can reduce the incidence of the chosen never event to zero or near zero. Current data shows that even when all appropriate care is administered, we do not know how to reduce the rates to zero or near zero of many of the conditions now on the list. Some patients, particularly high-risk folks, will develop conditions on the list regardless of how good the care is that they receive at the hospital. Here is an example. The bureaucrats have listed deep-vein thrombosis/ pulmonary embolism as a never event. Well, the best scientific studies on large numbers of total hip and total knee procedures--and this is from the time I started in medical school and we were trying to lower the risk of those blood clots--showed that under no circumstances, no matter what different treatments the best scientists have come up with, there is no current treatment available today worldwide that would decrease the blood clot risk to zero. Now, I want to tell you about a patient who had a broken hip, a broken hip on the left side, and at the same time of the injury, she bruised her right hip but did not break it. We know that patients with either a broken hip or who have received an artificial hip, that right after surgery, for the first couple of weeks, they have an increased risk of getting a blood clot. We treat them with blood thinners. Still, blood clots happen. So this is a patient who was given a blood thinner. We were trying to find out what the right delicate balance was. We worked with an internist and others. We thought we had the right delicate balance for the right dose of medication. On her right side where she had the bruise, she bled into that wound, and that bruise got more blood accumulated, a hematoma. On the left side, the side with the broken hip, she got a blood clot. She was on the blood thinners and bled into the one side, had a blood clot on the other side, and yet they call it a never event. How can Washington bureaucrats say that this is a never event? Let's look at another so called never event that made the list. Many of the ventilator-assisted pneumonia cases I saw practicing medicine in Casper, WY, occurred in trauma patients. The Wyoming Medical Center is a centrally located trauma facility. I saw patients brought in from accidents that occurred around all the State. Many of the patients are treated and stabilized at a local hospital 100 to 250 miles away. They are transferred to the Wyoming Medical Center. Trauma physicians have no way to determine whether the pneumonia is secondary to aspiration that occurred right there at the site of the accident or whether it occurred as a result of something that happened at the first hospital. In the physician's initial assessment, a pneumonia has not yet developed. It takes time before it shows signs. Even the Washington bureaucrats that wrote the proposed rule agree. The rule is clear and scientific evidence is clear that 60 to 80 percent of ventilator-assisted pneumonia cases cannot be prevented. How can they call that a never event? I have been a doctor for 30 years. I can share lots of similar examples with Members. Each example begs the following question: So what if the never event occurs in one hospital and then the patient needs to be transferred to another medical facility for advanced specialty care? Medicare says they are not going to pay for that treatment. Does that mean the second physician in the second hospital will not get paid? If the receiving hospital will get paid but the first one will not, isn't that surely going to lead to more transfers from one hospital to another, moving the patient from a hospital where the hospital will not get paid to the hospital where payment will occur? Look at it on the other side. If the receiving hospital will not get paid for a complication that occurred at the first hospital, then why should they accept the patient in transfer for the care they need? Is there any way for hospitals to appeal the decision of the Washington bureaucrats? What impact will this whole process have on medical liability? Will this list of so-called never events lead to increased litigation? After all, if something is never supposed to happen because the Government list says it doesn't but then it happens, does that mean someone is at fault? Where guidelines and proven medical strategies exist, doctors and hospitals strive every day to make sure serious adverse events do not ever occur. Never events should never occur. It is important to remember that the 1999 Institute of Medicine report which called attention to medical errors in the first place said bad systems and not bad people lead to most errors. As an orthopedic surgeon, I have spent my entire professional career trying to make people better. I have been on call in the middle of the night when folks have been involved in traumatic accidents. There are people with incredible talents practicing medicine, trying to do their best, but government policies continue to needlessly hamstring the ability to help their patients. The health care of this Nation is going to be hurt by the direction that Washington bureaucrats are headed. ``Never events'' should never happen. When Washington bureaucrats stretch the meaning of the word ``never'' to keep from paying hospitals, they mislead the public and cheat our Nation's hospitals and health care providers. Perhaps Washington should start to focus its regulatory efforts on eliminating waste, fraud, and abuse in the Medicare system. This year alone we have seen one news report after another uncovering Medicare wasting American tax dollars. Medicare is paying billions for wheelchairs, prosthetics, canes, prescription drugs, and other medical supplies, as the report shows, all prescribed by doctors who are dead, some who died 10 years ago. The Washington check writers honored hundreds of thousands of these fraudulent claims. I wonder who is holding these bureaucrats accountable. In 2001, they pledged to fix the problem identified by the Health and Human Services Office of the Inspector General. That was 7 years ago. Recent reports estimate Medicare loses approximately $70 to $90 billion each year to waste, fraud, and abuse. This strips our health care system of vital resources, resources we should be devoting to care for the elderly, the frail, the vulnerable. Federal officials have an opportunity to show leadership. They could have chosen to work with hospitals and physicians to develop evidence-based guidelines. Instead they have decided to issue a rule aimed at withholding money from hospitals, not improving patient care. It is time to rethink this flawed policy. Policies must work to improve patient care, not to punish hospitals. Hospital doors must remain open. I yield the floor and suggest the absence of a quorum.

Mr. BARRASSO

Mr. BARRASSO. Madam President, I rise today to pay tribute and express our Nation's sincere gratitude to a remarkable young soldier and his family. I was saddened to receive word that on September 17, 2008, Army CPT Bruce E. Hays of Cheyenne, WY, was killed in the line of duty while serving our country in the war on terrorism. Captain Hays died from injuries he sustained while supporting Operation Enduring Freedom when an improvised explosive device detonated near his vehicle in Gerdia Seria, Afghanistan. Captain Hays first enlisted in the Army in 1984, and joined the Wyoming National Guard in 2000. He received his commission and became an officer later that year. He was a versatile soldier, commanding units ranging from field artillery to information technology. Captain Hays is remembered by his fellow Wyoming soldiers as an outstanding officer, commander and leader who was both loved and respected by his troops. It is because of Bruce Hays and the blanket of freedom that he fought to provide that we sleep safely in our beds at night. The brave men and women of this Nation who answer the call to service and wear the uniform of the Armed Forces deserve respect and recognition for the enormous burden that they willingly bear. They put their very lives on the line every day for their fellow countrymen. And because of them and their families, our Nation remains safe and free in the face of danger and those who seek to harm us. Captain Hays represents the epitome of this selfless service to a cause greater than one's self. He was deployed as chief of an Embedded Training Team, charged with mentoring the Afghan police forces to defend the people of Afghanistan against terrorism. Laying aside his own self interest, Captain Hays gave his life in a far off land helping a fledgling democracy and a newly freed people to live the dreams that freedom and liberty bring. In the book of John, Jesus said that, ``Greater love has no man than this, that he lay his life down for his friend.'' CPT Bruce Hays gave his life, that last full measure of devotion, for you, me, and every single American. He gave his life defending his country and its people, and we honor him for this selfless sacrifice. And there are no words to express the profound gratitude that our Nation owes this brave solder and his family. Captain Hays is survived by a loving family including his wife Marie and their children, Bethany, Eleanor, John, Alfonso, and Genevieve, and his parents Barbara and Leonard. He is also survived by his brothers and sisters in arms of the Wyoming National Guard and the U.S. Army. We say goodbye to a devoted family man and an American citizen soldier. Our Nation pays its deepest respect to CPT Bruce E. Hays for his courage, his love of country and his sacrifice, so that we may remain free. He was a hero in life and will remain so in death. All of Wyoming, and indeed the entire Nation, is proud of him. May God bless him and his family, and greet him with open arms. Staff Sergeant Nathan M. Cox.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, the debate over the legal drinking age has continued for decades. As a physician and surgeon, I have repeatedly dealt firsthand with the traumatic results of underage drinking. Recently, a number of college presidents from across the country signed a public statement petitioning that the current legal drinking age be lowered to age 18. I believe changing this law would pose a danger to our youth and communities. Wyoming's First Lady, Nancy Freudenthal, wrote an important editorial addressing drinking on college campuses. It was printed in the Wyoming Tribune Eagle and the Casper Star Tribune. I believe Mrs. Freudenthal presents a compelling argument for keeping the minimum drinking age at 21. I ask unanimous consent to have the editorial to which I referred printed in the Record. There being no objection, the material was ordered to be printed in the Record, as follows: Lowering the Drinking Age Is Not a Good Idea (By Nancy Freudenthal) When the leaders of our nation's institutions of higher learning have something to say, we naturally assume that it will be well-reasoned, responsible and grounded in factual evidence. That is why it was disappointing to see more than 100 college presidents and chancellors have signed on to what is now being called the Amethyst Initiative, which seeks to lower the legal drinking age from 21 to 18 because, as its proponents claim, ``Twenty-one is not working.'' I am very pleased the University of Wyoming has not signed on to this initiative, and in fact is addressing drinking on campus on many fronts, including ``education, training, enforcement and changing the environment around alcohol use,'' according to Dean of Students Dave Cozzens. By viewing this issue through the narrow lens of alcohol- related problems on campus, these college presidents are ignoring the broader societal implications of throwing in the towel on the health and well-being of our young people. The Amethyst Initiative's solution for reducing binge drinking and preventing underage drinking is to make alcohol more readily available to young people, which will only exacerbate the public health concern of underage drinking. We believe that such an approach is irresponsible and would lead to more of the tragic consequences associated with underage alcohol use documented in the U.S. Surgeon General's 2007 Call to Action to Prevent and Reduce Underage Drinking. Teen deaths and injuries, traffic accidents, physical assaults and other violent acts, risky sexual behavior, and school failure, among other potentially lifelong consequences, would increase as a result. Lowering the drinking age also runs counter to scientific research that shows underage drinking can affect brain development, which we now know continues into the mid-to late twenties. Scientific evidence further shows that underage drinking is related to future alcohol dependence and other substance abuse. Approximately 96 percent of alcohol-dependent adults started drinking before the age of 21. For the past 20 plus years, so many have worked tirelessly and diligently to keep our youth and our communities safe and healthy by reducing the prevalence of alcohol use among those under 21, with the current legal drinking age limit a large part of our success. Although we are under no illusion that problems persist, we must continue to confront them head on, vigilantly and responsibly, and resist easy efforts to turn back the clock and undo years of steady progress. Seventy-eight percent of Americans oppose lowering the drinking age from 21 to 18, so the public gets the message. We recognize that colleges have a tremendous problem with binge drinking. Young people are drinking more aggressively than ever before. The solution is really about changing the culture of alcohol consumption. In many respects, we have achieved this change in culture for youth tobacco use. We must now change the culture as it relates to underage drinking. The bottom line is children who are connected to family, community and society are less prone to drink alcohol. It's just a shame that some college administrators didn't do their homework, and our children are the ones who would pay the price. When children drink, America loses.

Mr. BARRASSO

Mr. BARRASSO. Madam President, this act has opened the door to hundreds of thousands of individuals to actively participate and contribute to our great Nation. It has raised the conscience of our Nation regarding disabilities and the impact they have on their lives. The fair treatment of the citizens of the United States is paramount. Every citizen, regardless of the obstacles in their lives, should have the opportunity to work, live and fully participate in our society. There are many individuals with disabilities who are exceptional physicians and professionals. It is clear that situations will arise in which an individual desiring to become a licensed physician has a legitimate disability and a reasonable accommodation can be made during standardized testing. Licensing boards have the responsibility to accurately measure an applicant's skills and abilities to practice in a professional field. The purpose of standardized examinations is to create a set environment in which to carefully determine and ensure that applicants have the knowledge, skill, and ability to perform in the real world. Certain performance measurements can only be evaluated under set parameters. It is vital that standardized testing organizations not be required to fundamentally alter key performance measurements when providing reasonable accommodations to students with disabilities. As a doctor, I understand the need to ensure that future physicians have the ability to safely and skillfully provide medical care. Patients should not have to worry about whether their treating physician is qualified. Public health and safety is based on the ability of these physicians to work under pressure, respond quickly, and do so in a manner that protects the well-being of the patient. The real world requires a physician to concentrate and think clearly, often within a very small timeframe. Licensed physicians throughout the country are required to take a standardized test to meet the requirements expected of the profession. Determining whether an accommodation is reasonable should be left to the licensing board. When a testing organization or a licensing board has made a decision in good faith about an appropriate accommodation, the decision should be given great deference. This is particularly true in light of the important role these examinations play in the licensing process and the safety of the general public. It is important that the integrity of standardized tests for the licensing of professionals in the field of medicine is maintained. The legislation does not require accommodations which would alter key performance measurements. There is no record that this legislation would require standardized testing organizations, such as the State Boards of Medicine, to fundamentally alter their examinations with accommodations that will undermine the essential purpose of their exam.

Mr. BARRASSO

Mr. BARRASSO. Interstate 80, which runs west to east across the lower part of the State of Wyoming, is a national transportation route where people are taking products from the coastal areas, the ports in California or Oregon, and they come to a pinch point in Utah and then they all get onto I-80, west of the Wyoming border at Evanston, and they come all the way across the State. Fuel prices are high, and the miles are long. People who talk about a 55-mile-an-hour speed limit in this body clearly have not driven across I-80, where a speed limit like that didn't work before when they tried it, and it won't work now. I served in the State Senate in Wyoming, a great place. On the third floor of the capital building, there is a large mural on the wall which sort of depicts the State of Wyoming. There is a part of the bottom where I-80 is running across it. Even back when this was painted, years ago, if you count the vehicles on the mural, half of them are trucks. Half of them. And I think the proportion now is even greater than half of them being trucks. Think about all the product that is being moved east and west on I- 80, and I am sure you are seeing it in Colorado as well, with people awaiting the delivery of those products across this Nation and paying higher prices for those products because of the fuel it takes to fill the trucks in order for them to deliver the product. So we are seeing that not just at the pump but also in the pockets of consumers.

Mr. BARRASSO. Mr. President, we started talking a little bit about coal. I wish to say it is not just Wyoming and Montana, coal is abundant throughout the United States. Whether it is Pennsylvania--I see our colleague from Pennsylvania is here. Actually, the whole region of Pennsylvania is called the coal region. He made mention of that. But in West Virginia and Illinois, coal is abundant, it is affordable, it is reliable and secure. I appreciate the efforts my colleague from Colorado is engaged in, in terms of oil shale--another abundant source of energy that is not being utilized. It is American energy that can be used for the betterment and future of our great Nation.

Mr. BARRASSO. Mr. President, I thank my colleague from Colorado. He is absolutely right, Wyoming is a State which has been very blessed-- blessed with abundant sources of energy, and certainly coal, natural gas, oil, uranium for our nuclear power, and also wind, a renewable source of energy. So we have lots of different resources with which we have been blessed. But in terms of coal--and we know half the electricity in the United States comes from coal--what we know is that there is enough coal in Wyoming to power this country for centuries--not decades but centuries. There is that much coal in Wyoming. Coal is available, affordable, reliable, and a secure source of energy for our Nation. To me, this is about being self-sufficient in terms of our own energy. We are sending so much of the wealth of this great country overseas. Every time we buy another barrel of oil overseas. Whether it is $120, $130, $140 per barrel, that is a transfer of the wealth of our Nation to people who are not necessarily our friends.

Mr. BARRASSO. And we have the source of energy here, with the coal, and the technology is incredible. There are ways to use the coal to convert it to electricity and there are other ways to use the coal to convert it to liquids. Aviation fuel. The military uses an incredible amount of fuel. I have amendments I have introduced and am trying to have debated on this floor that deal specifically with converting coal to liquids, to allow us to use that liquid for our aviation. There is another technology, coal to gas. There is a true visionary in Wyoming. His name is John Wold, 91 years old, and he is here today to visit. His granddaughter works in my office. I have talked to him for years about the technology of coal to gas, and it is ready to go and available in Wyoming. It is being done in other places around the world, but not yet here. So it is incredible in terms of the available resources we have. But it is not only one source of energy. We need it all. We need the coal, we need the natural gas, we need the uranium, we need the oil, and certainly we need to be more efficient, as my colleague from Colorado has talked about. We need to be energy efficient, but we need the renewables. So we need the transmission lines, but we have plenty of wind in Wyoming. Look at oil shale. The Senator from Colorado is familiar with that, because Colorado, as well as Wyoming, as well as Utah, is blessed with oil shale. Perhaps I could ask my colleague from Colorado to discuss some of the issues related to that.

Mr. BARRASSO. The people in Wyoming clearly are affected the same way folks in Colorado are in terms of the large distances they have to drive, whether going to see the doctor, or taking the kids to school, or going to shop for groceries. I think statistically, when they look at how many miles on average people drive a year, Wyoming is No. 1 in terms of the longest distances. So when the price of fuel goes up, the price of gas at the pump, the people of Wyoming feel it the greatest because they are driving that many more miles. Many of them have pickup trucks or utility vehicles, because when you are that far away from home during the winter, you need to have those higher profile, larger vehicles. It is a matter of personal safety. It is what we want our kids to be in as well. So the inflation is there at the pump, but it is not only that. There was an article in the Wall Street Journal this past week about a woman in Casper, WY, who runs a bakery. It is a great bakery, down on First Street, and sheoes a nice job. But the supplies, the cooking things she buys to put in the bagels--whether it is the canned apples or the sugar--everything is up pricewise because it has to be shipped in to be used. So it is the fuel we use in our own vehicles but it is also the fuel that is being used to ship products. The people of Wyoming are smart. At all these town meetings I have, they get it. They understand there is going to be a change in the energy we use in this Nation, a change in the different sources of energy. The people in Wyoming know we would be wise to be conserving, and we are, and they know we would be wise to be using the renewables that we have a lot of, but they are also wise in knowing we do need to find more and use less; that it is a matter of supply and demand. And until you can deal with both sides of that equation--not just one side but deal with both sides--people are going to continue to feel the pain not only at the pump but also at the grocery store. So the people of Wyoming get it. They know the importance of the work we are doing here in trying to find solutions that will help America become energy self- sufficient by developing American coal, American oil, American natural gas, American uranium, and American renewable energy sources.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, it gives me great pleasure to recognize the accomplishments of Del Tinsley; the 2008 inductee into the Wyoming Agricultural Hall of Fame. Del's fascination with agriculture began as a small boy. He spent his summers helping ranchers in the community of Guernsey, WY. As the director of the Wyoming Office of USDA Rural Development, Del's enthusiasm for agriculture has become a lifelong career dedicated to Wyoming's farmers and ranchers. Del's boyhood summers on the ranch soon developed into a successful tenure selling advertising for the Wyoming Stockman-Farmer. In 1990, Del went to work building the newly established Wyoming Livestock Roundup from a little known publication to the must-have newspaper for every major implement dealer and livestock auction in the State. As director of the Rural Development office of the USDA, Del has successfully encouraged renewable energy development and business diversification within Wyoming's agricultural industry. Over the years, Del has been a voice of wisdom for Wyoming's farming and ranching communities. I am pleased to honor Mr. Del Tinsley on the Senate floor today. Del is a true steward of the land. Del continues to uphold the Wyoming heritage of farming and ranching.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I wish to speak on S. Res. 482, a resolution designating July 26, 2008, as ``National Day of the American Cowboy.'' The cowboy is the icon of Wyoming, representing our history and way of life. Wyoming's cowboy spirit and western values embodies all aspects of our lives. Independence, courage, family values, and good stewardship of the land are all virtues that every Wyomingite holds dear. The people of Wyoming are proud of our cowboys and cowgirls. They carry on our strong traditions and western values. The National Day of the American Cowboy also holds a special place in Wyoming's heart as we remember our dear friend, Senator Craig Thomas. As many know, this day of recognition initially came about through the efforts of Senator Thomas. Senator Thomas was a genuine cowboy. He led by example instead of seeking the spotlight. He was a dedicated public servant, a powerful leader, and a straight shooter. He was a loyal family man. He was a beloved role model. All who knew Senator Thomas will remember the humble cowboy who was unwavering in his dedication to God, Wyoming, and his country. Senator Mike Enzi and I have continued this effort to honor our American cowboys and cowgirls across the country. I am pleased that the Senate agreed to the resolution. I look forward to celebrating this special day with Wyoming.

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I am pleased to recognize the accomplishments of Jim Magagna, 2008 inductee into the Wyoming Agricultural Hall of Fame. Jim Magagna has spent much of his life fighting for Wyoming agriculture interests at the local, regional and national level. A third generation sheep rancher from southwest Wyoming, Jim is the president and manager of Magagna Bros, Inc. Jim has a long history of service to Wyoming's ranchers and farmers. He has served as president for agricultural groups including the Wyoming Wool Growers Association and the National Public Lands Council. He now serves as the executive vice president of the 135-year-old Wyoming Stock Growers Association. One of many noteworthy efforts, Jim directed the implementation of the Wyoming Stock Growers Agricultural Land Trust. The trust provides farmers and ranchers with conservation opportunities to remain productive and independent. Jim's dedication to the interests of Wyoming agriculture has created a legacy that will serve Wyoming well for decades to come. It gives me great pleasure to honor Jim Magagna, a true Wyoming cowboy. He continues to uphold one of the most trusted, respected, and revered ways of life in America.

Mr. BARRASSO

Mr. BARRASSO. I have heard it time and time again. We are ready to vote and to offer amendments. Clearly, we need to deal with this issue of supply and demand. We need to find more and use less. The people of Wyoming get it. The people of my neighbors to the east in South Dakota know it. The people from Utah understand it completely. The people at home get it. There is a story in the Wall Street Journal from Thursday, ``Want to See Inflation Pressures? Try Wyoming.'' People drive great distances in these Western States, but they are also paying not just the price at the pump but also at the grocery store when they have to buy things shipped in because of transportation costs. They say: Hey, you are sending all of this money overseas to foreign countries, people who are not our friends. We need to be energy self-sufficient. We need to do it at home, which is exactly what we are trying to do with these seven amendments. Wyoming is an energy State--oil, natural gas, uranium for nuclear, and coal. The technology now with coal is there for clean coal technology, coal to liquids. That is energy that can be used for our military airplanes.

Mr. BARRASSO. They have said that because it is the most available, affordable, secure, reliable source of energy we have. We have enough coal to last this country hundreds of years. We have ways to capture the carbon and pump it into the ground of old oil wells and get more oil and leave some of the carbon down below.