Saxby Chambliss

Mr. CHAMBLISS

Mr. CHAMBLISS. If I understand what the Senator is saying in his amendment, he is requiring the Office of Management and Budget as well as CMS to certify to Congress, basically, that the savings that are referred to in the Bennet amendment as well as in the Senator's amendment are, in fact, being used to fund Medicare benefits versus being used to fund other benefits outside Medicare until such time as Medicare is fully funded.

Mr. CHAMBLISS. Let me address a question to our friend from Wyoming who is a medical doctor, in addition to being an outstanding Senator. What we are being asked to believe from the folks on the other side and what the American people are struggling with and having a hard time believing is, they are saying that even though they are cutting Medicare by a total of $450 billion-plus over a 10-year period, actually the solvency of Medicare is going to be extended. They expect the American people to believe that somehow. The fact is, we know from the information we received this spring from the bipartisan Medicare Commission, unless something is done, Medicare is going to become insolvent in the year 2017, pure and simple. What we are doing is not taking the savings they are proposing--and we don't agree with them, but irrespective of that-- irrespective of the savings they are saying are going to be achieved, instead of applying that back, we are going to use that to grow the size of government, tie some reimbursement payments to physicians to the Medicare Program, and now we are looking at about a 23-percent reduction in payments to physicians as reimbursement under Medicare if we don't take some action next year. When you put all this together, the American people are saying: You have to be kidding me. How in the world are you going to extend the life of Medicare by cutting it by almost $500 billion?

Mr. CHAMBLISS

Mr. CHAMBLISS. From this letter that is not going to happen. I yield back, and I thank the ranking member.

Mr. CHAMBLISS. Mr. President, I thank the ranking member on the Finance Committee for allowing me to speak for a few minutes to simply respond to some of the statements, just as Dr. Coburn has done, that were made earlier. My friend from Massachusetts, whose heart, I know, is in the right place, talked about the AMA, as if it were the last word in the medical arena, being in support of this bill. Well, Dr. Coburn is a practicing physician, and he can speak to this maybe even better than I can, but what we know is that the AMA represents 10 percent of the practicing physicians in America--10 percent. That means 90 percent of the docs in America do not belong to this group that sent this letter in support of the Senate bill. I speak to this with authority because my phones have been ringing off the hook since this debate started months ago--the calls coming in from docs around the State of Georgia, who are violently opposed to the Senate bill--as it was being discussed and as it came out of the closed-door session that took place across the hall after the leadership in the Finance Committee, after the leadership in the HELP Committee could not agree on the direction on which we want to go. The Senator from Massachusetts said we are here scaring seniors. Well, I hope we are. Seniors ought to be scared. They ought to be scared to death of what is going to happen here because we are taking almost $500 billion out of Medicare, a program that a bipartisan Medicare Commission has said is going broke. And the Senator recognized this: It is going broke. We are taking $500 billion out of it. Whether you agree or disagree that the cuts in Medicare proposed by the Democrats are legitimate, we ought to be taking that money and putting it back into Medicare to save that program for the long term. The Senator from Tennessee asked the right question to the Senator from Montana, and he took 10 minutes responding to the question. And Dr. Coburn is right, he did not answer the question. There is a good reason why he did not answer the question. Because there is no legitimate answer to taking this $500 billion out of Medicare and creating an entirely new entitlement program that in and of itself is destined to go broke. If seniors are not scared by what we are saying, simply go to your doctor. Go to your doctor and ask your doctor about this. I know what happens to patients, Medicare patients who go to physicians who are generally in the range of 45 years or younger. Those physicians are not taking additional Medicare patients or any Medicaid patients because they can't afford it. The reimbursement rates to the physicians are less than the cost of the services they render. The Senator from Montana said: Well, we understand that, yes; there is $250 billion in reimbursements over the next 10 years that we need to take care of. And we are going to take care of. And I appreciate that because we need to. But it is in the House bill, and the House bill is $1.2 trillion. It is not in this bill, other than the 1-year fix the Senator alluded to. That is the reason the House bill is $1.2 trillion and this bill is about $800 billion. That is the sole difference in the two, basically. But we are coming back, and in addition to the $800-plus billion expenditure in this bill, we still have a hole to be filled to try to take care of these docs or there is going to be a wholesale refusal on the part of the medical community to see Medicare patients. That should scare seniors. So I hope that message is getting out there. I wish to close with one other response to my friend from Massachusetts who said the National Association for Home Care and Hospice is the leading organization in America in dealing with this issue, and we ought to listen to them. Let me tell my colleagues what they say about what is going on in my State. I quote from a letter that has already been introduced dated December 4 from the Georgia Association for Home Health Agencies. In this letter the executive director says: According to a study conducted by the National Association for Home Care and Hospice, under Senator Reid's bill, 72 percent of home health agencies in Georgia will have negative margins by 2016 in the Senate bill and approximately 68 percent of the 100 Medicare Certified home health agencies in Georgia will go out of business and the patients they serve will be rehospitalized or forced to seek alternative more costly care. Well, I don't know how it is in the other 49 States, but I want to see our patients, our Medicare patients in Georgia, do what they want to do, which is stay at home for the most part and receive the good home health care they are getting today which, frankly, allows them to live a better quality of life and a longer life. It is pretty obvious-- --

Mr. CHAMBLISS

Mr. CHAMBLISS. Mr. President, I thank the Senator from Nevada for yielding. Senator Graham and I do have an amendment we have filed today with respect to reforming the health care system in a real, meaningful way. It is an amendment that deals with tort reform, and it is a true loser pays system. We are going to talk about that in a few minutes. Before I get to that, I wish to go back to some of the points the Senator from Nevada has talked about. I particularly appreciate his work on the mammogram issue, especially since this has been highlighted over the last couple weeks with regard to the recommendation that has come out of the independent board that advises HHS. I thank him for his work on that issue. He is dead on. All of us know our wives are told every year, when they reach a certain age, they need to have a mammogram to make sure. Just like we do every year, go in and get a physical, they need to get their mammogram. The Senator talks about those kinds of checkups providing you with the kind of preventive health care that is going to hold down health care costs. I am a beneficiary of that. During a routine medical examination in 2004, it was determined I had prostate cancer. I was very fortunate it was picked up when it was, at an early stage. Instead of having to go through a lot of expensive procedures I might have had to go through, we were fortunate to be able to treat it. We are working on getting cured. Senator Ensign is exactly right, this is the kind of test we need to make sure we encourage females to get and not put barriers in front of them. Medicare is such a valuable insurance policy and program that 40 million Americans today take advantage of it. Mr. President, 1.2 million Georgians are Medicare beneficiaries. Again, I am one of those who is a Medicare beneficiary. So this is particularly important to me. More importantly, in addition to these 40 million Medicare beneficiaries who are in the country today, there are another 80 million baby boomers who are headed toward Medicare coverage. We have an independent Medicare Commission that was established by Congress years ago that is required to come to Congress every year and give Congress an update on the financial solvency of the Medicare Program. The purpose of that bipartisan Commission is to allow this body, along with our colleagues over in the House, the benefit of the work they do every year in looking at the amount of revenues that come in, in the form of the Medicare tax, and the outlays that go out, in the form of payments to medical suppliers for our Medicare beneficiaries. In the spring of this year, 2009, the independent Medicare Trustees Report reported back to Congress and said that unless real, meaningful reforms are made in the Medicare system, Medicare is going to start paying out more in benefits than it takes in in tax revenues in the year 2017. Mr. President, what that means is that in 2017, Medicare is going to be insolvent, and it is just a matter of time before Medicare goes totally broke. And those individuals who are baby boomers, who have been paying into this program for 40 years, 50 years, or whatever it may be, are all of a sudden going to reach the Medicare age, where they expect to reap the benefits of the Medicare taxes they have been paying for all these years, and guess what. Not only are benefits going to be reduced, but unless something happens, unless there is meaningful reform and it is done in the right way, there is not going to be a Medicare Program. I want to go back to something the junior Senator from Illinois said a few minutes ago. In talking about this issue of cuts in Medicare, he said this bill we have up for debate now that was filed by Senator Reid does not have cuts in Medicare. He could not be more incorrect. And that is not a Republican statement. It is not a statement by anybody other than the Congressional Budget Office. I refer to a letter that has already been introduced during the course of this debate--a letter dated November 18--to the Honorable Harry Reid, the majority leader. I would refer the Senator to page 10 of that letter in which the Director of the Congressional Budget Office says this in reference to provisions affecting Medicare, Medicaid, and other programs: Other components of the legislation would alter spending under Medicare, Medicaid and other Federal programs. In total, CBO estimates that enacting these provisions would reduce direct spending by $491 billion over the 2010-2019 period. Then the letter goes on, on this page alone, to delineate three areas where Medicare provisions are going to be reduced or cut, and I would specifically refer to them, but first is a fee-for-service sector, and this is other than physician services. It is going to be reduced by $192 billion over 10 years. The Medicare Advantage Program--a program that literally thousands of Georgians take advantage of today and millions of Americans take advantage of--is going to be reduced by $118 billion over 10 years, over the period 2010 to 2019. Medicaid and Medicare payments to hospitals--what we call disproportionate share payments, DSH payments--are going to be reduced or cut by $43 billion over 10 years. What does a reduction in these benefits mean to each individual community or each individual State? I can tell you what it means to the local hospital in the rural area of Georgia where I live. The reduction in DSH payments is going to amount to a reduction in income at Colquitt Regional Medical Center in Moultrie, GA, by $16.8 million over a 10- year period. These cuts in Medicare are going to result in a reduction in payments to Emory Hospital in Atlanta in the amount of $367 million over a 10-year period. So anybody who says these aren't cuts in Medicare spending simply has not read the bill and certainly has not read the letter from the Director of the Congressional Budget Office to Senator Reid dated November 18, 2009. I want to turn this over to my colleague from South Carolina after this final statement with reference to reductions in Medicare spending. There is a specific reduction of $8 billion in this bill over a 10- year period in hospice benefits. Again, we have heard a number of personal stories around here, and I have a particular personal story myself. My father-in-law died when he was 99 years old. It was 3 years ago. The last 2 years of his life, he lived in an assisted-living home and he had hospice come in 2 or 3 or 4 days a week, for whatever he needed. Had he not had the benefit of hospice, he would have had to go in a hospital, and no telling how much in the way of Medicare medical expenses he would have incurred. But thank goodness we had hospice available, and he spent 2 days in the hospital. Otherwise, he was able to live in his assisted-living home, have my wife go by and spend quality time with him, which she will tell you today were the best 2 to 3 years of her life as far as her relationship with her father was concerned, because she had hospice there to take care of him. Yet here we are talking about reducing a benefit by $8 billion that saved no telling how many thousands of dollars in the case of my family, and you can multiply that across America, and it is pretty easy to see we don't need to be reducing a benefit that is going to save us money in the long run. I would like to turn it over to my friend from South Carolina, who also has some comments regarding Medicare, and then we will talk about our loser pays bill.

Mr. CHAMBLISS. I thank my colleague from South Carolina, Senator Graham, for his thoughtful process that we went through in thinking through the loser pays bill and the amendment we have filed. Just like you, having practiced law for 26 years before I was elected to the House, the same year you were, and then we were elected over here, I tried plaintiffs cases as well as defendants cases. I never represented a defendant in a malpractice case. I was always on the other side. I have great sympathy for individuals who are wronged by a physician who is negligent. You and I agree that anybody who is the victim of negligent action ought to have their day in court. That is what we provide for under our bill. There is absolutely no question about the fact that anybody who is subject to negligent acts on the part of a physician, they can have their day in court, and they should have their day in court if that is what they decide they want to do. But under a loser pays provision like we have designed, we can eliminate, hopefully, the frivolous lawsuits that add significantly to the cost of health care delivery in this country. In 2003, direct tort litigation costs in America accounted for 2.2 percent of our GDP. That is double the percentage of Canada, Great Britain, Germany, France, and Australia--all of which have loser pays systems. The State of Alaska has had a loser pays system since 1884 and tort claims in the State of Alaska constitute a smaller percentage of total litigation than the national average. Florida, which applied a loser pays rule to medical malpractice suits from 1981 to 1985, saw 54 percent of their plaintiffs drop their suits voluntarily. It does make a difference on frivolous suits. In the State of Florida during that same period of time, the jury awards for plaintiffs rose significantly. Just as in our situation, anybody who had a legitimate case in Florida during that period of time had the right to have their case adjudicated by a jury. Those who made the decision to do so received more significant awards. That is the way the system ought to work. This is a win-win situation for the cost of health care delivery. It is a benefit to the physicians--sure, because they eliminate part of their significant cost of delivering health care services. But it also is a huge benefit to those individuals in America who are subject to negligent acts on the part of physicians. I ask unanimous consent that a letter to Senator Graham and myself from Bruce Josten at the U.S. Chamber of Commerce, dated November 3, 2009, be printed in the Record, and I yield the floor.

Mr. CHAMBLISS

Mr. CHAMBLISS. These are not people who are on the extreme right or extreme left who are bombarding us with phone calls, e-mails, and letters as all of us get on airplanes, as I did Monday. I had people come up as I walked through the airport, and as I was on the airplane, and when I got off the airplane, saying: Please stop this bill. Don't pass this foolish bill that you all are talking about up there now. It is amazing, the type of folks who will come up and say that. I have two quick anecdotes I would like to read. One is a letter I got from a doctor. It reads: Dear Senator: I am a vascular surgeon in Rome, GA, with a patient population that is 70 percent Medicare. I am deeply concerned about the proposed Medicare cuts. After 8 years of college and medical school, and 7 years of training, I have accumulated a large debt in loans and interest. Plus there is the huge administrative burden of a large Medicare population in my practice. I don't know how I and other physicians are going to be able to afford to continue to see Medicare patients if these cuts go through. As it stands now, I am paid only 23 cents on every dollar charged. I would appreciate help in staving off these cuts. The other one is an e-mail I got in the last few days about a good friend of Senator Isakson and mine, Bob Lovein, a funeral director in Nashville, GA, which is close to my hometown. It says this: A lady walked into the funeral home and gave him a letter from the VA. The letter stated that they (the VA) owed her $307 on her husband's death benefits. Bob pulls her husband's file and he had buried him 10 years ago . . . and we trust the government to run health care? That is how ridiculous it is in the minds of people in this country who are calling and writing our offices--certainly the offices of every one of the Members of this body--because they don't understand why we are mortgaging and sacrificing our children's future, or why, as Senator Brownback says, when the President goes to China to see their banker--China owns almost $1 trillion worth of our debt--the Chinese Premier asked the President about the health care bill because he is concerned about the way we are spending money here. I can never remember any foreign leader ever asking the President of our country about anything to do with the financial condition, particularly a program like this, which would affect us.

Mr. CHAMBLISS. I don't think we can overstate what the Senator has said. Not only is the Federal Government looking at the largest deficit we have ever seen in the history of our country--just this past year, $1.3 trillion--but every State is having the same problem. That deficit is trickling down. In Georgia, for example, we have one county that has run into these education reductions that Senator Alexander is talking about, which universities are facing. That one school system reduced the days the children are going to school from 5 to 4 days to save the cost of buses running and other bills, for heating and whatnot, for that extra day. That is not what we need to be doing as Americans. We need to figure out a way to struggle through this. Instead of struggling through it, we are now in the toughest times we have ever seen, as Senator Brownback said, we are adding these huge taxes that will stifle the small business community on top of the debt that we have seen created in this country just in the past 12 months.

Mr. CHAMBLISS. I ask my colleague from Georgia, we talked about this, and he has had extensive experience at the State level with respect to Medicaid. Take our State--and I think we are representative of all 50 States. We have a Medicaid Program now that provides for coverage or eligibility at 100 percent of the poverty level. This bill takes that to 133 percent of the poverty level. Talk for a minute about the impact of going from 100 to 133 percent to cover some of those uninsured I referred to earlier. What is the impact on our State?

Mr. CHAMBLISS. Mr. President, I thank both my colleagues from Tennessee and Georgia. I want to talk just for a minute about what Republicans are for. We have been criticized by the folks on the other side of the aisle for being just against what they are for, and that is not at all true. There are actually four other plans that were filed in both the HELP Committee and the Finance Committee, three of which were strictly Republican plans, one was a bipartisan plan, that never saw the light of day, simply because the folks on the other side of the aisle had their minds made up that they were going to have their plan with a government option, and they were going to do whatever they could to move us toward universal health care coverage. I want to say to those folks on the other side of the aisle who have stood up and said on the floor of this Senate: Yes, by putting a government option in place, our intention is for the government to take over health care--some of them have been very straightforward about that, and they have been honest. There have been others who have been not so honest about that. But that truly is the reason there is a government option in the plan we have up for a vote tomorrow night. But what are Republicans for? First of all, everybody in this body is in agreement that we want to drive down the cost of health care and we want to drive down the cost of insurance, and those are integrally linked. If you drive down the cost of health delivery, then you will drive down the cost of health insurance. There are a number of ways we can agree today to enact legislation that will help drive down the cost of health care. What are those things? Preventive health care. Well, there is some mention of preventive health care in Senator Reid's bill somewhere in these 2,074 pages. There is the mention of preventive health care, but there is not the incentive in place to encourage people to move toward preventive health care as was done in the private sector with Safeway, a grocery store chain where the CEO has visited both Republicans and Democrats and talked about the way Safeway was successful in doing that. We all want to make sure those who do not have insurance today are covered. We want to cover preexisting conditions. We want to make sure we put competition into the insurance market by allowing policies to be sold across State lines. All of those things will work in concert to drive down the cost of delivery, as well as the cost of insurance policies per se. There is another measure that will significantly improve the cost of delivery; that is, putting in some measure of tort reform. In this bill, with these 2,074 pages, that seeks to totally reform the health care industry in America today, there is not one mention of reforming the tort system in this country, the malpractice reform area. If you go to any doctor and you ask him what is the No. 1 issue on his mind when it comes to reducing the costs in his office, I bet in 99 percent of the cases--maybe 100 percent--they are going to tell you that tort reform must be implemented if we are ever going to hope to drive down the cost of the delivery of health insurance in this country. Senator Graham and I have an amendment we will be talking about that is a tort reform measure that is a loser-pays style of tort reform. It does not take away the right from anybody who is injured. Anybody who is injured ought to have the right to have their day in court. But it does eliminate the potential for the extensive, frivolous lawsuits that our docs and our hospitals have to deal with every single day that drive up the cost of health care. I want to talk, too, about one other measure we are for that has been talked about a lot today; that is, covering the uninsured. I think, without question, if you want to drive down the cost of delivery and the cost of health insurance, you need to cover those people in this country who need to be covered. We have a little disagreement with folks on the other side of the aisle as to the exact number they seek to cover with this 2,074-page bill. But there is one area where we do agree; that is, there are somewhere between 47 million and 50 million people in America today who are truly in that uninsured category whom we all, as a body of 100, would like to see have affordable insurance available to them. Now, who are these uninsured? First of all, there are about 6 million people in this country today who are uninsured who are here illegally, and they are illegal, undocumented aliens. Folks on the other side--and there is some question about this when you look at the language in this 2,074-page bill, whether they cover those illegal aliens, but let's assume we all agree they ought not to be covered. There are another 14 million people in America today who have health insurance available to them from the Federal Government in one form or another. Either they are Medicaid eligible or they are eligible for some form of SCHIP, the State Children's Health Insurance Program. In Georgia, it is called PeachCare. For whatever reason, these 14 million people have not taken the initiative to go out and sign up, for example, in Georgia, at the Department of Family and Children Services. I do not know what it is in Tennessee, I say to Senator Alexander, but there is a comparable office in all 50 States for that to be done. What do these 2,074 pages seek to promote as to the 14 million people who have insurance available to them today to go in and take that insurance? Nothing. So these 14 million people are not even addressed. Then there are another 15 million people to whom Senator Isakson just referred. They are people who are either those independent contractors or they are employees who work for employers who do not provide health insurance, but all of them are gainfully employed, and they have the ability to purchase health insurance. Some of these people are dealt with in this 2,074-page bill. Some of them are not because if you are an employer with 50 or fewer employees, then you are exempt, you would not be covered, still, as a part of that 15 million. Then there are about another 12 million to 15 million whom I refer to as the hard-core uninsured. Those are the folks whom we really ought to try to reach, and those are the folks to whom the bulk of the $2.5 trillion this bill is going to cost during the 10 years when it becomes fully implemented seeks to reach. I would simply say, if we are going to truly have a health reform bill, we need to start and take it step by step. If the folks on the other side of the aisle are serious about health care reform, we can get the appropriate committee chairmen together this afternoon, tomorrow, or whenever, and begin work on these issues I have just laid out about which there should be no disagreement. We could move forward with developing a true and meaningful health insurance reform package. I want to come back in a minute and talk about Medicare taxes and the way Medicare is going to be dealt with here. But I would simply throw it back to the Senator from Tennessee, as well as to my colleague from Georgia, because they have both been involved in a very honorable way at the State level. Senator Alexander is a former Governor of Tennessee. Senator Isakson was an elected member of our State house, as well as our State senate. I say to the Senators, you gentlemen have experience dealing with Medicaid, and you know what the taxation side of Medicaid does from a State level. I would like to ask for your thoughts on what this 2,074- page bill is going to do to Medicaid in this country as we know it today.

Mr. CHAMBLISS. In addition to that, we are going to continue to tax young people who are in the workplace for additional Medicare taxes that are intended to be used by them in what is called the CLASS Act, which is another part of this monstrous bill, and chances are those people are never going to see those benefits. There is one tax after another in this bill that applies to Medicare. One other aspect of Medicare that is of such critical importance here is that they have an $850 billion pricetag, according to the Democrats. According to the numbers and the figures of Senator Gregg, the ranking member of the Budget Committee, who came down here this morning and talked about it, that $850 billion is for the first 10 years. The taxes begin next year. The benefits don't begin until 2014. When you look at 2014 to 2025, the first 10 years of full implementation, the cost of this bill is actually $2.5 trillion, not $849 billion. Why is it $2.5 trillion? Well, it is because the scope of government has broadened to such an extent that the expense of providing the services is going to be greater. We are going to have more people coming onto Medicare. We know now, as Senator Alexander said, according to the bipartisan Medicare Commission, we will be paying out more in Medicare benefits than we receive in Medicare taxes in the year 2017. There are only two ways to fix that: either raise taxes or decrease benefits. The majority that is in power in Congress today has a habit of not seeing a tax they don't love, so my guess is that is the direction in which they are going to want to go: Raise taxes on Medicare beneficiaries and those in the workplace again to ultimately pay for Medicare benefits down the road. The other part of this I wish to address with respect to Medicare is the Senator from Florida got up as we were coming on the floor and talked about this so-called deficit reduction. What do they mean when they say we are going to have a $32 billion deficit reduction over 10 years? Well, here is how it works. The deficit reduction is brought about primarily by the addition of a program in this bill to Medicare, what is called the CLASS Act. The CLASS Act is a long-term policy of insurance to take care of long-term health care needs. Young people are going to be required--young people in the 20, 30, 40-year age bracket will pay into the so-called Medicare trust fund that will be used to pay benefits for long-term care for those individuals when they start reaching the age where they need long-term care. So CBO has said that because these folks are 20, 30, and 40 years old and they are going to be buying these policies, they are not going to be getting any benefits for another 20, 30, or 40 years. So we are going to take the position that all of those premiums, which go into the general fund, by coincidence, will go to reduce the deficit. But guess what is going to happen, even according to CBO, when all of these young people who have been paying into the CLASS Act start getting benefits. All of a sudden we are going to start seeing deficits in the outyears, and our children and our grandchildren are going to have an additional debt put on them because of the way this particular provision is scored--and it is being touted as a deficit-reducing provision right now--that truly is going to be a provision that adds to the deficit and the debt our children and grandchildren are going to have to pay.

Mr. CHAMBLISS. I would ask the Senator from Kansas if he would yield for a question. The question is: The Senator from Kansas and I were elected to Congress in the same year. This is our 15th year, I believe, of serving. You have been over here longer than any of us have, and you were involved in State government as well. Have you ever seen a Federal program that was projected to be at X number of dollars of expenditure which came in on time and on budget?

Mr. CHAMBLISS. Whether it is paid by the Federal Government after that 3 years or by the State of Georgia, whose pocket will it come out of?

Mr. CHAMBLISS. Do you think that when Senator Reid comes down here and says this bill is going to cost $849 billion over 10 years, that is a correct figure for a massive reform of health care?

Mr. CHAMBLISS

Mr. CHAMBLISS. Mr. President, I obviously am very disappointed to see my colleagues on the other side of the aisle object to my amendment. It is a pretty simple, straightforward amendment. We have voted several different times when appropriations bills have been on the Senate floor over the last couple of weeks, wherein the folks on the other side of the aisle insist on allowing the transfer of prisoners from Guantanamo Bay to the United States for trial. My amendment prohibits that. I simply think it is not appropriate to bring battlefield combatants into article III trials inside the United States for any number of procedural reasons relative to the treatment of Guantanamo Bay prisoners within our Federal courts. But even beyond that, the potential for the release of those enemy combatants, once they arrive on U.S. soil, certainly is increased. This is not the way we need to be treating enemy combatants. Those men who are at Gitmo are the meanest, nastiest killers in the world. Every single one of them wakes up every day thinking of ways they can kill and harm Americans, both our soldiers as well as individuals. Some of them were involved in the planning and the carrying out of the September 11 attacks. Others were arrested on the battlefield in Iraq and are at Guantanamo. We are not equipped nor have we ever in our history dealt with trials in article III courts of any enemy combatant arrested on the battlefield. The FBI has not investigated cases prior to arrest. These folks were not given Miranda warnings because our soldiers captured these individuals with AK-47s in their hands with which they were shooting at our men. These are not the types of individuals that our criminal courts are designed to handle or can feasibly handle. I am disappointed we are not going to get a vote on this amendment. I will continue to raise this issue as long as we possibly can between now and the time that Guantanamo Bay is scheduled to be closed and, from a practical standpoint, until it is closed, if that ever does happen. We have the courts at Guantanamo Bay equipped to handle and try these individuals before military tribunals. Those tribunals have been established, just reauthorized. We are capable of handling the trials at Guantanamo Bay, and that is where they should take place. I want to make sure the time I utilized is charged against Senator Vitter, which has been agreed to by the Senator.

Mr. CHAMBLISS. Mr. President, I rise in strong support of the Graham amendment, and I wish to echo the sentiments expressed by my friend from Alabama, who, like me, has had extensive experience in trying cases for many years. In this country, over our 225-plus years, we have been involved in many different military conflicts. In each of those conflicts, dating back to the early years, there have always been prisoners captured, and we have always had a procedure whereby we incarcerated and ultimately tried those individuals who were captured on the battlefield. The process of how we operate from an article III criminal standpoint relative to criminals in America who commit offenses against the United States of America is one thing. The process we have always used to deal with those individuals whom we capture on the battlefield has been entirely different and all for the right reasons. I know there are those who have gotten up here over the past several weeks and months as we have talked about this issue from time to time, and I have had any number of amendments on this issue and have spoken on the floor numerous times about it. It is important for the protection and security of the American people to keep all these individuals whom we capture on the battlefield, who are incarcerated at Guantanamo, outside America. We have the mechanics set up to try them. We have a very safe place for them to be incarcerated. That is, frankly, where they ought to stay until some method can be worked out to deal with them, to have them housed somewhere outside the United States. Unfortunately, the President has made a commitment to close Guantanamo by January 22, without ever having a plan in place as to how he was going to deal with them. What we are talking about doing is making sure, because folks on the other side of the aisle have already said: We want to bring the prisoners from Guantanamo to American soil, we try them there. Ultimately, I guess they are saying: We want to house them in American prisons. I think that is wrong. This amendment, though, is even narrower than that. That is why it is so important. This amendment says: We are going to take the meanest of these individuals, who get up every day thinking of ways to kill and harm Americans, and make sure they never come to American soil for trial and are never subjected to the process that is developed in article III courts for average, ordinary criminals who are tried every single day in America. Khalid Shaikh Mohammed is the admitted mastermind of September 11. He is one of the individuals who today is housed at Guantanamo Bay. He is one of the individuals who is going to be directly affected by this amendment. Does Khalid Shaikh Mohammed want justice? No. Khalid Shaikh Mohammed wants a platform. He wants a platform on which to exude his arrogance and his hatred of America and his hatred of Americans, as exhibited by the plan he put in place to fly airplanes into the Pentagon, the World Trade Center, and another entity that was probably the U.S. Capitol. That airplane, ultimately, crashed in Pennsylvania. There were over 3,000 victims on September 11. It is my understanding family members of those victims have written letters and made phone calls urging the passage of this amendment. They are an indication of the strong feeling that prevails all across America relative to how we deal with these individuals who, particularly--particularly--intended and did, in fact, carry out an attack against America, an atrocious attack that took the lives of over 3,000 people. I commend Senator Graham for even thinking of the idea of narrowing this amendment to include just those individuals who participated in the September 11 attack. I would rather broaden it to include all those who are housed at Guantanamo. I defy anyone to stand and say that trying any of those individuals who are housed at Guantanamo, who were captured on the battlefield, in an article III court in the United States would be similar to some other terrorists we have tried in this country. That is wrong. We have never tried anybody who was arrested on the battlefield in an article III court in the United States. So Senator Graham's amendment is very appropriate. It ought to be passed. It ought to be passed with a large margin. A vote against this amendment is simply a vote to give Khalid Shaikh Mohammed that platform he wants to have to talk about why he hates America and about everything that is wrong with America. That is not what we ought to be doing in this body today or at any other time. I urge a positive and affirmative vote on the Graham amendment. I yield back, Mr. President. Amendment No. 2631

Mr. CHAMBLISS. Mr. President, I ask unanimous consent that when the Senate resumes consideration of H.R. 2847, that it be in order for me to offer amendment No. 2676, which is filed at the desk.

Mr. CHAMBLISS

Mr. CHAMBLISS. Madam President, as we begin to slowly emerge from the economic pitfalls of the worst recession this country has seen in decades, the long-term issues that remain are real and affect Americans of all walks of life. Out-of-control government spending has resulted in a skyrocketing deficit, fueling fears of an unsustainable financial future for America. A stifled free market drags down our economic growth and impairs our ability to work toward reducing this enormous burden on our children's and grandchildren's future. In spite of this volatile forecast, there are some who feel that the best way to reinvigorate our economy is to impose heavier costs, higher fees, and greater taxes on businesses and individuals, while forcing the Federal Government to oversee and manage health care in the United States, ultimately adding an additional one-sixth of our economy to the government's balance sheet. Make no mistake, this financial instability is not disconnected from Americans' everyday lives. It is being felt at bill-paying time, discussed at dinner tables, and it is weighing on the minds of the very people who drive this country's economy. The other side would have you believe that greater government control, increased spending, and less money in Americans' pockets is the way toward economic stability and growth. Since there has been no legislative language circulated on the proposed government takeover of health care at this point, we can only consider the conceptual language as passed by the Senate Finance Committee. Here is 1,502 pages of conceptual language that has come out of the Finance Committee and is being proposed as meaningful health care reform. This phantom health care proposal imposes $\1/2\ trillion in new taxes, fees, and penalties on individuals and businesses. While some would have you believe these taxes will only be borne by the wealthy in the form of a 40-percent excise tax on high-value insurance plans, both the Congressional Budget Office and the Joint Committee on Taxation--as alluded to by the ranking member on the Finance Committee, the Senator from Iowa--have testified that these taxes will almost entirely be passed on to the consumer, irrespective of their tax bracket. Under the tax provisions of this health care proposal, in my home State of Georgia, a young, healthy individual under certain health plans would see his monthly premiums almost double. Additionally, $92 billion of this new burden will be in the form of new fees on manufacturers and importers of branded drugs and certain medical devices, as well as on health insurance providers. Again, all this is going to be passed on to consumers, resulting in higher health insurance premiums and higher costs for health-related products. While a majority of the health reforms in the Finance Committee bill do not go into effect until 2013, such as the tax credit for health insurance and the individual mandate, both of which are designed to lower health care costs, these so-called fees are effective on January 1 of next year. This means health insurance, in general, will become more expensive before any government assistance or policies intended to make health insurance more affordable even take effect. Also included in the Senate finance proposal is a tax on individuals without essential health benefits coverage, which would subject individuals who fail to maintain government-approved health insurance coverage to a penalty of $750 per adult in the household. While Democrats complain this contains savings for low- to middle- income families, CBO has stated that almost half those families paying this tax would be between 100 percent and 300 percent of the Federal poverty level--or a family of four earning between $22,800 and $68,400 in 2013. Additionally, proponents of this bill say it reduces the deficit while providing relief from high health care costs from lower income families. However, what they do not tell you is, under their refundable tax credits, families who earn nearly four times the Federal poverty level will have almost 91 percent of their health care costs paid for by other taxpayers. The CBO--the Congressional Budget Office, the independent Congressional Budget Office--estimates that by 2019, out of 253 million Americans with health insurance, only 18 million will be eligible for these tax credits to purchase insurance. So this supposed health care cost-reducing tax credit at the heart of the Democrats' health care reform is only available to 7 percent of the population. Increasing taxes on 91 percent of Americans to pay for 7 percent of the population is not reform, it is business as usual. While I am in favor of tax credits to purchase health insurance, I do not support placing limitations on who can receive such credits or what type of coverage they can purchase. Madam President, as if increasing the size of government even more in the health care sphere isn't going to make matters worse, who do you think is going to administer, implement, and enforce these tax increases? None other than the Internal Revenue Service. With a new influx of complex health care policies being legislated through the Tax Code, the IRS would be tasked with overseeing all aspects of the millions of taxpayers now burdened with even more filings to the IRS. Additionally, the IRS would likely be entrusted with enforcing these new provisions as well as protecting against fraud in certain cases. These new responsibilities of the Internal Revenue Service would mean only one thing: a bigger and more intrusive IRS. As I continue to say, I am in support of reforming the health care system in this country because we do have problems. We need greater transparency in health care costs, increased competition, more individual portability for peace of mind for those who change jobs, a better focus on prevention and wellness and real reform of the health insurance industry. Republican-backed plans do exactly that. There are ways to lower health care costs and be more fiscally responsible, and there are opportunities to pay for this coverage without expanding entitlements and increasing taxes on middle-class Americans. Americans deserve a patient-centered approach to health care reform. The 1,502 pages being discussed this morning as we speak--behind closed doors, by the majority leader and other Democrats--puts politicians and bureaucrats in charge of the health care industry in this country, and that is not what the American people want or deserve. Madam President, I yield the floor.

Mr. CHAMBLISS

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

Mr. CHAMBLISS. Madam President, I ask unanimous consent that I be allowed to speak as in morning business.

Mr. CHAMBLISS. Mr. President, may I inquire, what is the business before the Senate?

Mr. CHAMBLISS. Mr. President I rise, regrettably, to oppose the conference report for the fiscal year 2010 National Defense Authorization Act. For the record, this will be the first Defense authorization bill I have voted against in my 15 years in Congress. There are many provisions in this bill with which I agree and strongly agree that represent major steps forward in support of our men and women in uniform and the national security responsibilities of the United States. For example, the bill includes a significant pay raise for our troops, re-authorizes numerous bonuses and special pays, authorizes billions of dollars of much needed military construction, both in the United States as well as overseas, and authorizes $6.7 billion for Mine Resistant Ambush Protected Vehicles or MRAPs. Also, the bill includes the Military and Overseas Voting Empowerment Act, which I worked on in conjunction with Senators Schumer, Ben Nelson, Cornyn and Bennett and which was cosponsored by over half this body. The MOVE Act is one of the most substantive and comprehensive military and overseas voting reforms we have seen in years. It will fix a significant problem we have had in this country, that of the men and women of our military; who are putting their lives in harm's way being denied the ability to, No. 1, have the opportunity to vote, and No. 2, to have their vote counted. However, the bill includes at least three provisions which I strongly oppose, and for those reasons I cannot support this final bill. First, the bill includes hate crimes legislation, which I firmly believe is unnecessary, irresponsible, and certainly not germane to this bill. There is little evidence that indicates that violent crimes, motivated by hate, go unpunished in the United States. Every single State has criminal laws that prohibit the antisocial behavior addressed by hate crimes legislation, including laws against murder, rape, arson, assault, and battery. I oppose the creation of Federal hate crimes legislation for several reasons. First, I do not believe the Federal Government should interfere with the criminal laws already on the books in our States. Second, this hate crimes legislation would establish a protected class of crime victims who would receive special protection under the law. Finally, we already have laws to prosecute individuals who commit violent crimes. Those people guilty of violent crimes against anyone should and will be prosecuted under existing law and should be punished to the hilt when found guilty. For all these reasons, I strongly oppose the hate crimes legislation in this bill. Secondly, the bill contains no funding for the procurement of additional F-22s. On May 19, 2009, the Chief of Staff of the Air Force, General Schwartz, affirmed under oath that 243 is the right number of F-22s to have in our inventory. Nevertheless, inclusion of additional F-22 funding received a veto threat from the administration and funding was stripped out of the Senate bill after an unbelievable lobbying effort coming out of the Pentagon and the White House. I readily acknowledge there is a difference of opinion on this issue and that others do not necessarily share my views on this subject. However, what I will not acknowledge is that support for additional F- 22s is simply an example of doing business as usual and the influence of special interests. Congress is entitled to disagree with the executive branch on significant procurement and policy decisions, and there are countless examples of where we have done so and history has proven Congress to be right. Time will tell, but the F-22 may very well be an example of where the supporters of the program were, without question, correct. I hope we are never put in a position as a country where we once again must fight to maintain air dominance, but there is not a single weapon in our inventory that ensures that we will maintain air dominance other than the F-22. The F-35 is a great weapon system, but we now know it is going to be delayed by 2 years. It was kind of interesting that the announcement on the 2-year delay on the F-35 came out about 3 or 4 days after the final vote on the Defense authorization bill on this floor. But the F-35 is an air-to- ground weapon system that will not guarantee us the air superiority the F-22 will. If we are going to rely on 187 F-22s from an air dominance standpoint in every potential sector of the world, against every potential adversary, it is simply not enough. General Schwartz was right when he said 243 is a more correct number. I believe stopping production at 187 puts our Nation at high risk in the near to midterm, and there is no reason our Nation should accept that amount of risk given our global responsibilities. Third, section 1041 of the bill provides for the transfer of Guantanamo detainees to the United States. While the bill specifies conditions for transfer as well as requiring a plan for each detainee who is transferred; the bill nevertheless allows for the transfer of those detainees. The conditions for the transfer of those detainees are similar to those that are present in the fiscal year 2010 Department of Homeland Security appropriations bill which I voted against earlier this week. I made a much more detailed statement at that time about my reasons why I was voting against that bill relative to this issue of the transfer of Guantanamo detainees to the United States, but that bill authorized the transfer of detainees to the United States for the purpose of prosecuting the detainees or for detaining them during legal proceedings. This bill allows the transfer of detainees not just for that purpose but for any purpose. This will allow those detainees to have access to U.S. criminal courts, which I strongly oppose, because these are individuals who were arrested on the battlefield, not by the FBI or local police or any other law enforcement agency inside the United States. These are battlefield combatants. This also goes against the will of the American people and opens up the possibility that these detainees may one day be released in the United States. Therefore, I cannot support this provision in the underlying bill. Mr. President, I strongly support our troops, and I support the missions we have asked them to carry out. Shortly, I will be going back to Afghanistan for my third trip. I also have been to Iraq on eight different occasions, and I get very emotional and excited about the opportunity to look our men and women in the eye, with their boots on the ground, and tell them how much we Americans appreciate the great job they are doing. I am going to continue to support them in every way possible. But the fact is, here we have provisions in a Defense authorization bill that go against the will of the American people and that, frankly, don't have much of anything to do with our troops in theater as well as our troops here. So, Mr. President, regrettably, I am going to be opposing this bill on the grounds of the issues I have outlined. I yield the floor.

Mr. CHAMBLISS. Madam President, I rise today to commemorate the 70th anniversary of Colquitt Regional Medical Center in my hometown of Moultrie, GA. For seven decades, residents of southwest Georgia have been fortunate not only to have a state-of-the-art facility but also to be served by a hospital that has boasted visionary leadership. Back in 1935, the Public Works Administration approved $50,000 for a new hospital in Moultrie, but only if the community could match those funds. That is when Moultrie businessman W.C. Vereen stepped up and pledged $50,000 and, in turn, made his offer contingent on the community matching his funds. Thereafter, a grassroots campaign to build a hospital was born, at a total of $140,500--a very significant amount of money in those days. On October 17, 1939, the Vereen Memorial Hospital was dedicated, and the first operation was performed a week later. From those humble beginnings, the now-rechristened Colquitt Regional Medical Center has grown into a comprehensive health care facility, boasting medical services that include dialysis, physician offices, oncology, and a home health care component, among others. It speaks volumes about the community, the camaraderie, and the success of Colquitt Regional Medical Center to know that in 70 years, this hospital has had only four CEOs, and the first one only served for 2 years. Its first two CEOs--Pierina Egan and Nora Manning, both of whom obviously were female--in addition to dealing with the day-to-day challenges of managing a hospital, also had to contend with growing the facility and coping with a doctor shortage brought on by World War II. Ms. Manning was succeeded by Millard Wear, who served as CEO for 14 years and oversaw the creation of a brandnew 126-bed facility. In 1982, Mr. Wear was succeeded by the very able Jim Lowry, who continues to head the hospital to this day. Under Mr. Lowry's tutelage, Colquitt Regional Medical Center has become a force to be reckoned with in physician and specialist recruitment. It has also undergone four expansion projects and added off-campus facilities, making it a truly regional endeavor. In 1992, Colquitt Regional Medical Center was named the Georgia Hospital Association Rural Hospital of the Year. In 2007, it received the hospital association's Community Leadership Award. It has consistently performed at the top of Georgia's hospitals in patient satisfaction. On a personal note, my son Bo was born at Colquitt Regional. I have had the unfortunate situation of needing five surgeries at Colquitt Regional but was very fortunate to be treated by the very finest doctors our country has to offer and a very skilled and excellent group of nurses. All of the employees and operators at Cochran Regional--from the professionals, the administration, as well as the day-to-day personnel, including our pink ladies, who are our volunteers--do an outstanding job of making this hospital a truly fine medical facility serving a very broad area in the rural southwest part of my State. The folks at Colquitt Regional Medical Center do a tremendous job in serving the community. In fact, they also constitute a large part of our community in southwest Georgia, and we are thankful to have them in our midst. I congratulate Colquitt Regional Medical Center on 70 wonderful years of service. With that, Madam President, I yield the floor.

Mr. CHAMBLISS

Mr. CHAMBLISS. Mr. President, I rise today to speak about the conference report to accompany the Department of Homeland Security Appropriations bill. When this bill was originally before the Senate, I joined 83 other Members of this body in supporting it. But at this time I cannot support the conference report because it includes language that was not included in the Senate-passed bill relating to the detainees being held at the Guantanamo Bay Naval Facility, or Gitmo. This bill would prohibit the transfer, release or detention in the United States of any of the detainees held at Gitmo as of June 24, 2009. However, it does allow detainees to be brought into the U.S. for prosecution. I cannot support this. I have been very outspoken on this issue and believe it is wrong to bring these detainees into our country to try them in our criminal courts. These terrorists have committed violations of the laws of war and should be held and prosecuted according to the procedures Congress laid out in the past. Prosecuting these individuals in our U.S. courts simply will not work and there is too much at stake to grant the unprecedented benefit of our legal system's complex procedural safeguards to foreign nationals who were captured outside the United States during a time of war. Allowing these terrorists to escape conviction, or worse yet, to be freed into the U.S. by our courts, because of legal technicalities would tarnish the reputation of our legal system as one that is fair and just. Prohibiting the detainees from entering into the U.S. is one small step in the right direction. However, this legislative loophole is a step in the wrong direction. In May, the Senate voted 90 to 6 to prohibit any of these hardened terrorists from being brought to the United States. Despite this clear objection, the administration transferred one detainee, Ahmed Ghailani, to New York City in June. He is facing a trial in the Southern District of New York for his role in the August 7, 1998 bombings of two U.S. embassies in Africa. Some of my colleagues in the Senate have touted this as an example of how we can bring criminal charges against the Gitmo detainees and try them in our courts. However, Ghailani was indicted on March 12, 2001, a full 6 months prior to the terrorist attacks of 9/11 and after a full investigation by the Federal Bureau of Investigation. The case against Ghailani was built long before he was transferred to Gitmo in 2006. To imply that other detainees, many of whom the FBI has not investigated or collected evidence against, may be prosecuted similarly in U.S. courts is naive. Worse yet, just recently, the Attorney General ordered the U.S. attorney not to seek the death penalty in this case, despite the fact that his participation in the bombings resulted in the death of over 200 people and injured over 4,000. In contrast, six of the charges brought against Ghailani in his military commission carried the death penalty. Now there are press reports that the administration is considering transferring Khalid Sheikh Mohammed or KSM to the United States. KSM is the self-proclaimed, and quite unapologetic, mastermind of the 9/11 attacks. KSM admitted he was the planner of 9/11 and other planned, but foiled attacks against the U.S. In his combatant status review board, he admitted he swore allegiance to Osama bin Ladin, was a member of al- Qaida, was the Military Operational Commander for all foreign al-Qaida operations, and much more. These admissions are unlikely to be admitted in a Federal court. Bringing KSM to a U.S. court will do nothing but allow defense lawyers to expose our intelligence sources and methods used in interrogating KSM to the world. Time after time since President Obama's January 22, 2009 announcement stating that he would close Gitmo within a year, I have seen hasty and ill-advised comments and action taken with respect to the Gitmo detainees. The detainees at Guantanamo are some of the most senior, hardened, and dangerous al-Qaida figures we have captured. It is imperative that the President satisfy the concerns of Congress and the American public before we should fund the transfer of any of these detainees to U.S. soil for any reason.

Mr. CHAMBLISS

Mr. CHAMBLISS. Mr. President, I rise to honor a giant in the world of journalism, Furman Bisher. Last Saturday, after nearly 60 years of elegant observation of the sports world for the Atlanta Journal-Constitution, my friend Furman Bisher pecked out his last and final column before retirement on the thinning keys of his trusty, old Royal typewriter. His choice of instrument to convey his thoughts in this age of instantaneous, inane chatter says a lot about why newspaper readers, after all these years, have continued to seek out his column on the AJC's sports page. It all comes down to this: Furman's graceful prose, courtly voice, and sharp observations are unfailingly backed up by his old-fashioned shoe-leather reporting. He gloried in doing his homework, making that extra call, interviewing one more player or assistant coach or trainer in order to breathe even more life into the game or the race or the fight for his readers. It is also why Furman has become a Georgian--and American-- institution. Simply put, Furman Bisher loved sports and he loved journalism. At age 90, he was still driving out on summer nights to cover minor league baseball games. In his career, Furman scored many journalistic knockouts, including a 1949 interview with Shoeless Joe Jackson, the only one Jackson ever gave regarding his involvement in the 1919 Black Sox scandal. He got stock tips from Ty Cobb and watched every Masters, including Jack Nicklaus's 1986 Masters victory, which he gloried in. He sat in the press box at countless Falcons games at Atlanta-Fulton County Stadium and the Georgia Dome and covered the Olympics, both winter and summer. He wrote 11 books, including coauthoring two editions of a Hank Aaron autobiography. At the Masters Tournament in Augusta every April, Furman reigned among the azaleas and oaks as the dean of the sports press corps. In a testament to his longevity in a tough business, Furman has covered every Kentucky Derby since 1950 and every Super Bowl but the first one. Furman even branched out into TV. Although I did not grow up in Atlanta, I have heard from many people that preachers across the city would cut a sermon short so that their congregations could be home for Furman's kickoff on ``Football Review.'' Along the way, he earned the respect of his colleagues and the loyalty of his readers, garnering writing awards too numerous to mention. Red Smith is acknowledged as probably the dean of all journalists from a sports perspective, and Furman Bisher has often been referred to as the ``Red Smith of the South.'' He served as president of the National Sportscasters and Sportswriters Association from 1974 to 1976, and of the Football Writers Association of America from 1959 to 1960. His features have appeared in The Saturday Evening Post, Golf Digest, and Sports Illustrated, to name but a few. In 1961, Time magazine named him one of the five best columnists in the Nation. I would argue that even today, that honor still fits. No less than the great Jack Nicklaus said of Furman's retirement: He might be turning in his last column for the newspaper, but Furman will never stop writing or giving his opinion. I guess you could say that when it comes to the last writings of Furman Bisher, I will believe it when I don't see it. Furman would close every column with a single valediction--the word ``selah,'' a Hebrew word that ends many Psalms and that exhorts the reader to reflect. It is appropriate then to reflect on Furman's long, fruitful career, one that began in Atlanta as the Korean war was starting, when Joe Louis was still boxing, when the Minneapolis Lakers were the NBA champs, before Willie Mays had joined the Major Leagues, and before Sports Illustrated even existed. Ever since, with wit and style, Furman Bisher has chronicled the triumphs and the travails of the sports world and its often all too human heroes. Furman is leaving the AJC at almost 91 years old, and he is still going strong. While we may not be seeing his column on a regular basis, I am quite sure we have not heard the last of Furman Bisher. As Furman would say, selah. I am thankful for Furman Bisher. I yield the floor, and I suggest the absence of a quorum.