Thomas Coburn

Mr. COBURN

Mr. COBURN. Mr. President, a lot has been said about Saxby already, but I have an observation I have noticed over the last 10 years since I have been here, and it is about leadership. We see elected leadership on both sides, but then we see real leadership. We see the person people go to for advice. We see the person people go to for counsel. We see the person whom people go to for wisdom and judgment. That is what I have noticed the last 10 years. More than anybody in this body, whether it is from the other side of the aisle or this side of the aisle, the person whose counsel is most sought is that of Saxby Chambliss. That is real leadership that is earned, and it needs to be recognized and honored for what it is. Because what it says is his leadership comes without judgment on the person asking the question, without condemnation of a position that may be different than his. It is giving of himself for the benefit of the rest of us. Hear, hear, my friend from Georgia. I yield the floor.

Mr. COBURN

Mr. COBURN. Madam President, I first wish to spend a few minutes talking about my colleague and chairman of the Homeland Security and Governmental Affairs Committee. The last 2 years have been a real pleasure on my part, and I have grown to have a great friendship with the chairman of the committee. I can truly say in our committee we have done a lot of great work. We have both compromised on a lot of issues to try to move the country forward, and to him I am thankful for that. I don't think either of us have had to break on any principles we have had to be able to do that. I think our committee has been a model in terms of doing bipartisan bills and on bipartisan approval of nominees. For him, I would say I appreciate his leadership this past year. He has the unfortunate attribute of having the same initials I do, so it is somewhat confusing on our committee. But maybe that is why we have been as successful as we have. I also wish to recognize the hard work of so many of the staff members on both sides, the work they put in, and the cooperative nature under which they have worked. We have before us a bill we are trying to clear called the Taxpayers Right-to-Know Act, and it is actually a continuation of a bill that Senator Carper, myself, and several others--including the President-- started when we started the transparency act back in 2009. This follows along with the DATA Act which was passed this year. What this bill does is says the American people ought to know where the money is being spent, and so it says the agencies are going to list the programs they have. It is done in a stepwise fashion so it doesn't put too much pressure on OMB as they try to implement it. I believe at this time we are waiting to make sure we have clearance for this before we ask for a unanimous consent. I yield my remaining time to the chairman of the committee, Senator Carper.

Mr. COBURN

Mr. COBURN. Madam President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 531, S. 2113; that the committee-reported substitute be agreed to, the bill, as amended, be read a third time and passed, and that the motion to reconsider be considered made and laid upon the table.

Mr. COBURN

Mr. COBURN. I ask unanimous consent to speak for at least 5 minutes.

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

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

Mr. COBURN

Mr. COBURN. Mr. President, I ask unanimous consent to have printed in the Record letters related to my resignation as a Member of the U.S. Senate.

Mr. COBURN

Mr. COBURN. Mr. President, while I was unable to vote on the motion to concur in the House Amendment to S. 1086, Child Care and Development Block Grant Act of 2014, I would have recorded a vote in opposition to this bill, just as I did when this bill was originally before the Senate in February. I have three reasons to oppose this bill. First, the Constitution does not permit the Federal Government to operate this program. Article 1, Section 8 of the Constitution lists all the powers given to the Federal Government, none of which includes funding for and oversight of State and local child care programs. Second, this bill will increase the authorized size of the Child Care and Development Block Grant, CCDBG, program by over $1 billion without eliminating or reducing a lower priority program elsewhere. At a time when our national debt is over $17 trillion, Congress continues to spend away the future of the next generation. This reauthorization will exacerbate this problem, and our children will deal with the harsh consequences of our Nation's future fiscal insolvency. Third, this CCDBG reauthorization does not address previously identified duplication and overlap in existing Federal child care programs and tax expenditures. While it does include a provision for the Department of Health and Human Services to study the issue, I do not believe it goes far enough. The Government Accountability Office has already identified 33 programs for which child care is an eligible use of funds. For example, States often transfer billions of dollars in funding from the Temporary Assistance for Needy Families block grant program to use in their child care programs. Ultimately, this kind of overlap and duplication underscores Congress' reckless disregard for our future well-being.

Mr. COBURN

Mr. COBURN. I wish to spend a few minutes talking about a bill that passed the House that has 37 bipartisan cosponsors in the Senate that came out of my committee. It is an important transparency item for the American taxpayers called the Taxpayers Right to Know Act. What most Americans don't realize is there is only one agency that knows how many programs it has--only one. None of the rest of the Federal agencies know how many Federal programs they are running. They can't put them down, can't list them on a piece of paper. The GAO has recommended for a long period of time--starting about 3 or 4 years ago--that we should be putting this down when we have the truth in transparency and the truth in accountability act and the transparency act with President Obama. We started this process where the GAO would look for duplication and report it to Congress. We have a bill that has passed unanimously in the House. It is a bipartisan bill that came with a voice vote out of our committee. All it says is that every agency ought to have to list their programs every year so we can know what they are doing. GAO says that will help immensely in terms of eliminating this $200 billion to $300 billion a year in duplication. We are going to have some unanimous requests later today, and we will have a bill that is on the floor for which the majority leader has once again filled the tree, which allows no amendments whatsoever on the bill. This bill should be on the floor, should be standing on its own, and should be passed because nobody can honestly object to the agencies not knowing what programs they run, not having a complete list. I mean, it is counterintuitive that anybody would vote against it. It makes no sense that we don't know that, and we know we need to have it. It is an easy vote for everybody, and the majority leader isn't going to allow an amendment. So we are not at a new day yet with this present majority leader. This is something that helps every American--Democrat or Republican. It helps us run our government more efficiently, more effectively. It is a good-government amendment, and yet it is not going to be allowed. I am disheartened that at the end of the year we could actually do some things together that would actually allow us to accomplish real things for the American people that will make a real difference in the long run, but we won't because we don't want to have what was guaranteed to the minority when the Senate was set up--the right to offer amendments. I yield the floor, and I suggest the absence of a quorum.

Mr. COBURN

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

Mr. COBURN

Mr. COBURN. I can stick to 7 minutes. I will hear the gavel come down and I will quit.

Mr. COBURN. What I would simply do is ask unanimous consent that I have 7 minutes to make a statement.

Mr. COBURN. I have an inquiry of the Chair. It was my understanding that I had 4 minutes remaining on our side and that Senator Rubio had time granted to him by the chairman of the Appropriations Committee. Is that not correct?

Mr. COBURN. I thank my colleague.

Mr. COBURN. First, I give praise to the chair and the ranking member of the Appropriations Committee for the cooperative nature of the committee this year in terms of inserting good government amendments into appropriations bills. It was a real pleasure to be able to work with them and to put some of the oversight results that we have done over the past few years into appropriations bills. The bill we have on the floor, even though the chair is supporting the bill, is not her bill. It is a bill that came to her from House Republicans. So any criticism I might have of the bill is certainly not directed toward the chair of the Appropriations Committee. But it is important to be reminded of what the Congress told the American people less than 2 years ago, that we were going to go on a diet, and then 1 year ago when we had the Ryan-Murray agreement. I will outline where we are with what we are getting ready to vote on, because we are about $47 billion above what we agreed to in the Ryan-Murray budget, and that doesn't include emergency funding. Appropriators didn't write this bill. This bill came out of the House. We understand the timing of it, we understand the process. But this bill doesn't keep our word to the American public that we said we were going to keep. That is No. 1. No. 2 is the chair of the Appropriations Committee attempted to put bills on the floor, and she was open to an amendment process. One bill was pulled because there was no agreement to allow any amendments to $3.6 trillion worth of spending--none, zero. That wasn't her desire. She is a fair broker in this body for what needs to be done when it comes to spending. So I would make the point on the fiscal aspect of this bill. When criminals in this country hurt other people, judges throughout the country--and Federal judges--impose a penalty, and criminals who are convicted end up paying into a Crime Victims Fund. The Crime Victims Fund isn't Federal tax dollars, it is individual payments by felons to make amens for damage and injury to people upon whom their crime was cast. In this bill is $20 billion worth of false savings, but the way we calculate it is since we are not going to spend the money that is due to the crime victims, we are going to say that is going to save us money and, so, therefore, we can spend that money somewhere else. If you did that on your income taxes or if you were a corporation and filed that with the SEC, it wouldn't take long for you to be in jail. But that is what the appropriators in the House did and we just got through doing this last December, the same amount of money on the same fund. What I want the American people to see is regardless of whether you think we ought to pass this bill, shouldn't there be some clarity about the integrity of our numbers? Shouldn't we, if we can't meet the guidelines, just admit it and say we can't meet it rather than saying we are meeting it and create a false set of numbers? Shouldn't we at least do that? Aren't the American people worth that? But instead, we have $11.8 billion from the Crime Victims Fund and $6.3 billion from the Children's Health Fund, which are false savings. They are not real savings. So we are not going to be honest. Well, I am going to be honest. The American public, the Senate, and the authors of this bill in the House will be lying to you if you believe the numbers in this bill. They are not true. That is not the chair of the Appropriations Committee who made that decision, it was the House appropriators who made that decision to use false numbers to create a false set of achievements. Finally, and I think I am about out of time, I would say there is one other aspect that disturbs me about this bill. We have a mess in the Middle East today. Sitting on the Intelligence Committee and sitting on Homeland Security, I don't disagree we ought to be involved in terms of going after ISIS, but I think we ought to recognize that we created the problem in the first place. We created the vacuum that allowed that to flourish. I will state my assessment of where we are. We now have recognized this threat and we have a political plan but no real policy plan to confront ISIS. Having just heard from both the head of the CIA and also the Defense Department in response to the President's plan, what I can tell you is we know that something needs to be done, but your government doesn't yet know what to do. I know there is authorization for monies in here. We need it. We are going to have to fight it. But let's be very clear, as Members of this body, to ask the important questions so that we don't go down a road that is made even worse. We have the brain power in the Senate, the experience, and the gray hair to do that. I ask my colleagues to be very careful--not with this; this is going to happen. This CR is going to happen. It is a terrible way to run the government. The appropriations chair doesn't want to run it this way, but let's be very careful on the questions we ask in the future. I thank the chair of the Appropriations Committee for her kindness in yielding me the time. I yield the floor.

Mr. COBURN

Mr. COBURN. I object.

Mr. COBURN. Mr. President, reserving the right to object, let me explain to the people watching what is happening here. We have a bill that everybody agrees to that is not going to get passed because everybody does not agree to another bill that is linked to it. We have offered multiple compromises on the battlefield protection act. We just have a $17.8 trillion deficit. We are going to have a $599 billion debt this year. Yet this program they want to authorize that will keep this program that the Senator from Arkansas would like to honor our Desert Storm from happening--they refuse to take yes for an answer. There are 26 critical sites that need to be protected that we know of. We said: Do that. We have said: Do not authorize more than we can afford. We will not do that. We have made compromises so that we can do what the intent of the battlefield protection act is and accomplish the leverage against the bill honoring our Desert Storm veterans. But that is not good enough. So what we have asked for is to quit allowing States and localities to game the system with any kind of pay-fors and do not have the Federal Government pay for the State's share or the local community's share plus the Federal Government's share. We have said some good government stuff. You can pass this bill today if, in fact, they will take some adjustments to the bill. So what I would offer is rather than object, I ask unanimous consent that the Senator from New Jersey modify his request so that my substitute amendment to H.R. 1033, which is at the desk, be agreed to. If you agree to these simple, straight-forward, good government, financially secure items, you do not get the full basket, but you get the things that are critical to this country in terms of protecting battlefield sites and we will honor our Desert Storm veterans. I ask that we have that modification be agreed to which is at the desk.

Mr. COBURN

Mr. COBURN. Mr. President, I became a practicing physician over 30 years ago. I delivered well in excess of 4,000 babies. And right now in my Senate career and where the Senate is, I feel as if I am the father in the waiting room. I keep wondering when we are going to make any progress, when we are actually going to have the delivery of something positive for the country. What we are seeing this week is really disappointing to me because if you read just the headlines in the last 4 days, here are the headlines about Congress. Here is today's Politico: ``The Lamest Lame Duck Looms Over Congress.'' ``Lame Ducks Will Roost in a Do-Nothing December.'' ``December will be the lamest lame-duck session in a long time.'' The Economist: ``Congress is useless.'' America's legislature has become something of a joke in recent years, a place where good policy ideas go to die and where decent policy ideas go to be twisted into something incomprehensible. It is enough to make one lose faith in representative democracy, I tell you.

Mr. COBURN. Mr. President, I ask that the order for the quorum call be rescinded.

Mr. COBURN

Mr. COBURN. What we are talking about is an errant CBO score that doesn't fit with reality or the information given to them by the VA.

Mr. COBURN. Mr. President, I will be very quick. What our colleagues should know is, since 2009, the VA budget has increased 58.7 percent, a 40-percent increase in the number of providers, with a 17-percent increase in the number of veterans using those providers. The problem is not money at the VA. The problem is management, accountability, and culture. So we are going to borrow $12 billion from our children and reward the poor behavior and charge it to our children. I ask for the yeas and nays.

Mr. COBURN

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

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

Mr. COBURN. Madam President, this is my 10th year in the Senate. Every time we come to a close of the session for a summer break or for a holiday break all of a sudden we start hearing all these unanimous consent requests--they come to the Senate. For those of you who are listening to this and to my colleagues, these are requests that bills be passed without a vote. I am fine with that, as long as they meet certain characteristics and considerations. But what the American public does not know is that about 70 percent of the work the Senate does happens by unanimous consent, with no recorded vote on the back of any one Senator. Today is no different. I have heard of five or six requests for unanimous consent. They are fine with a couple of provisions. The first provision is they ought to be within the powers of Congress as enumerated by the Constitution in the enumerated powers. The tendency is: Oh, we have to do this; it has to happen now. For some of the things that is true, but the reason it has to happen now is because we had not done it before now because we failed to do it. We utilize the end of the session to force people to give on positions they would never give on otherwise because they do not want to take the heat for being responsible for stopping something from happening, even though it might not fit within the enumerated powers, it might not be under our constitutional authority. But the most egregious of all of this is the fact that we are going to be asked today, probably 7 or 10 times, to pass pieces of legislation the very cost of which will fall on the backs of our children and our grandchildren--not us. With over $400 billion in waste per year in the Federal Government--waste, fraud, duplication--to ask us to spend $200 million here or $2 billion here or in the case of the veterans bill, $17 billion, of which $5 billion of it is actually paid for, without doing the hard work of not transferring more debt to our children is not acceptable to me. So my rights as an individual Senator are going to be utilized today--until we go home--to make sure we do not transfer another penny, if I can stop it, onto the backs of our children. It would be different if we were efficient, if we did not have any waste, if we did not have any fraud, if we did not have any duplication. But you see, it is an excuse to not do the hard work we were sent to do. So I am putting my colleagues on notice that if they want to pass any bill that is going to go by unanimous consent, they better find some waste somewhere to offset it with or I will object. I do not mind taking the heat, no matter what the issue. I have done it before, I will do it again. Our children and our grandchildren are worth any amount of heat that creates a future opportunity for them that is at least as equal to what we have had. I wanted to say that before I start talking about the veterans bill. I voted for the veterans bill that went out of the Senate. My background as a physician and businessman--businessman first, a physician second, regrettably a politician third--but I voted for that because I thought in conference we would actually fix it. What is wrong with the VA? Leadership, a culture of corruption, a culture of not caring. That does not apply to all of the VA employees, it does not apply to all of the VA hospitals, but it certainly does apply to a number of them. How did we get there? I would note for the record that VA spending is up 60 percent since 2009. Let's start in 2010, 2011, 2012, 2013, and 2014. It is up 60 percent. Patient demand is up only 17 percent in that same period of time. The number of providers has increased by 40 percent. So it surely cannot be a problem of money. If we look at the increased utilization of those services over the next progressive 10 years, it will be less than 20 percent. We did some good things in the bill in the Senate, most of which are capped, but we did not do enough. If we are going to manage the VA, we have to give the head of that organization the ability to be able to manage it. Senior Executive Service, the Secretary of the VA is going to have that capability to hire and fire. For a very limited number of title 38 employees--those are hospital managers, physicians--for a very limited number, he will have that as well. But for where we have seen a lot of the problems, he will not be able to fire people who have directly harmed our veterans. So we have not given him the tools to create the environment and the change that has to happen and a cultural change that has to happen in the veterans organization. The other thing I would note is that if we look at the requirement for primary care physicians and physician extenders--nurse practitioners and PAs--their load is about one-fourth of the load of private practitioners in this country. That is not true clinic to clinic, but on average that is true. In Oklahoma we have some great physicians who work every night until 10:00 taking care of veterans. We have great caregivers in lots of instances. But we have a lot of stinkers, and on average we are not demanding of them what the private sector routinely does. One of the good things in the bill is we are going to finally have VA hospitals and clinics reporting outcomes, just as every other hospital in this country has to report. If they take Medicare or Medicaid dollars, they have to report to CMS their outcomes--their readmissions, their death rates, their infection rates, their quality of care. They have to be reported. Also, physicians have to be credentialed. Not true in the VA. So if they are not credentialed, the VA patient is going to know what their credentials are--if they have lost their medical license. Those are positive aspects of this bill. What is not positive is the fact that we won't fix the real problem, and we are going to say we did and we are going to spend our grandkids' money saying we did over a very short period of time, and we are still not going to hold the organization accountable. It is unconscionable to me, after a 60-percent increase in funding over the last 4 years, that we would borrow against our children's future an additional $12 billion when we have all this waste throughout the Federal Government and in the VA and say that is the best Congress could do. I think that is an incrimination upon Congress, and it is a dereliction of our duty--to our Republic but also our future. So I will be doing a couple things: No. 1, I will be raising a point of order against this bill; and No. 2, I will be voting against it. Let me say a little bit about why I am voting against it. Yesterday I talked to a Vietnam veteran who is 100 percent disabled and presented to the emergency room of a major VA hospital in this country with chest pain. This patient was observed for 2 hours. She had no acute changes on her EKG, but she had--as any doctor would know--unstable angina. Her pain never went away. She was sent home. In less than 48 hours she presented to an emergency room in her local community and an hour after that had three stents placed in her left coronary artery. She was ignored medically. That is happening today as we have had this discussion. Another wonderful retired veteran in Oklahoma had to have a knee replaced. She was service-connected. She went to the VA and had her knee replaced. It was a failure. She had to have it done again. A couple years later her other knee needed to be replaced. They replaced her knee. It failed. As they replaced the second knee, as can happen, they fractured her femur. Today she has a replaced knee, and she walks with a terrible limp because her left leg is 1\1/2\ inches shorter than her right one. The likelihood of that happening to one individual is about 1 in 10 billion, but the outcomes never get reported. A femur can break while doing a knee prosthesis, there is no question about it. But five major surgeries? That means outcomes don't compare. When this VA episode started soaking in, as a physician I went to the medical literature and looked at all the studies that have been published on VA care. I did a LexisNexis. I looked at them all. What did they show? VA care is better than anyplace in America. That is what the studies show. Except when we drill down on it, what we find is the way they were cheating on appointments is the way they were cheating on outcomes. In other words, the outcomes weren't accurate. So the culture is one of looking good, protecting those within the VA, and not protecting our veterans. Again, I would say that does not apply to all VA employees. The vast majority of them are great. But the leadership has stunk. We have to have a bill that fixes that. I don't believe this is going to do it. I also wish to talk about whistleblowers because I have had a multitude of whistleblowers whose complaints I have investigated and found to be truthful. The culture at the VA against whistleblowers has been a channel in the past from whistleblowers back to management. And what happens to them? They get fired. They get demoted. They get harassed. They end up ultimately leaving. These are the people who care, who want to make it better. There is a big job ahead of Secretary McDonald. He has the capability and he has the experience to fix this but only if we give him the tools. My fear is that we will not give him the tools with this bill. The final point I would make, and I think we all ought to think about it--every American ought to think about it. Remember, we are an All- Volunteer Army right now. If somebody has served this country in combat, putting their life on the line to protect us, to protect our way of life, to protect the very freedoms we cherish, should that same individual ever be at the back of the line on anything related to health care that is associated with their service? They should be in the front. They should be ahead of every Senator, every President, every doctor. They should get the first care, not the last. They should get the best care, not the worst. That is how it ought to be. It is the veterans VA system, not ours. It is for them. And when they no longer are the object of service by this country, for them, for their sacrifice, then we are in a whole lot more trouble than any of us realize. We have turned things upside down. Union representation at the VA is more important than the VA patient. Benefits for VA managers are more important than the VA patient. The one critical thing that really needs to happen to clean up the VA is to give veterans the absolute choice to go wherever they want, their freedom to choose whatever care they want based on what they have done for us. By doing that, the VA will either have to become competitive and just as good or they should die. We have not done that in this bill. We need to do that in this bill. We have centers of excellence in the VA that beat all the private industry, all the private health care. When it comes to prosthetics, when it comes to closed-head injuries, when it comes to traumatic brain injury, when it comes to post-traumatic stress disorder and depression, we are great. The VA is great, but in too many areas it is not. Tell me this bill will change all that, and I will vote for it even if it does sacrifice our children. But it won't. I won't be here when the results are assessed, but I can predict what they will be--more of the same, too much money and not enough leadership. With that, I yield the floor.

Mr. COBURN

Mr. COBURN. I object.