Thomas Coburn

Mr. COBURN

Mr. COBURN. Let me make this point. If the Senator from Michigan wouldn't have objected, we could start voting tonight, we could vote tomorrow, we could get through those. Half of those will be pulled, and we would be almost to the same number of votes you would have had, that you did have, the last time the bill came to the floor. So do we really want to break this logjam? Let me offer it again. We can move this thing. Let's just do it. Let's go out and vote. Let's take the tough votes. Some of us are going to get bruised. Big deal. We are all grownups. Let's have the votes. Let's move amendments. Let's debate in the Senate. Let's do the country's business. Instead, we are not going to do it. There is a compromise. More than half of those will be withdrawn. My colleagues know that. Let's put them all in order. Let's vote them, let's take care of it, and let's be grown up and get the Senate back to where it is supposed to be. I am going to offer my unanimous consent one more time, that every amendment that has been filed today as of now be considered as read and pending.

Mr. COBURN. Mr. President, fair and balanced consideration to our colleagues is allowing them to have amendments, and the Senator just objected to that. So that is where we are. That doesn't keep her from managing the bill. The Senator still gets to set the priorities of what comes up when. But here lies the problem in the Senate: There are obviously some amendments in there they don't want to vote on; otherwise, we would not have heard an objection. So it is not just Senator Toomey, who has now said he would not object to Senator Landrieu's amendment, it is other objections of people who won't come down here to the floor and show their constituency what they are objecting to. In other words, it is darkness. It is not light, it is not transparency, it is not of good character, it is not of good moral fiber. What it is, is the least of these, the lowest of these, who refuse to participate in an open and honest debate about what is going to happen in our country. I call on all my colleagues, Republican and Democrat alike. We know what has to happen to open the Senate. Let's vote. Let's vote. For my colleagues on the Republican side objecting, I disagree. Go ahead and vote. For my colleagues on the Democratic side, let's vote. Let the chips fall. The American people decide who is to come up here. Gaming this system by hiding behind an anonymous objection, putting it through the chairman--I am proud to see the Senator from Louisiana. She came down here, she showed courage and said, Here is why I am doing it. She spoke honestly to her constituents back home and also to the Members of this body. We don't have enough of that. We had an opportunity just then to move this bill, restore the Senate to the way it should function, and we chose not to do it. The American people have got to be shaking their head right now in disgust, because had the time been spent, instead of figuring out what is OK and what is not OK, actually debating and then voting amendments, we could have voted 30 or 40 amendments by now on this bill. But we chose not to do it. Some of us chose not to do it. Kindergarten is out around most of the rest of the country, except in the Senate, and it is still in session here. We ought to be disgusted with ourselves, and the American people ought to be disgusted with us as well, because we are not allowing this body to do what our Founders intended it to do. I am going to spend a minute talking about that. This place is very different than the House. No matter who is in charge, the tendency is to overuse the power of the majority. But what our Founders intended was the Senate to be totally different than the House. The reason 6-year terms were put there was so you wouldn't be susceptible to the political influence of reelection, so you would become a long-term thinker, and that your motivation would be primarily a motivation for the best will of this country and not your State or your political career. The assessment of the Senate today is that we have lost our focus. It is about politics, not our country. It is about the short term, not the long term. It is about anything but the best interests of the country. Here we have commonsense amendments. I appreciate the fact that the chairman and ranking member have included some of mine in what they were proffering, but let's include them all. What is so bad about voting on a stupid amendment? If it is really stupid, they are either going to withdraw it or lose big. If it is really controversial, the American people want to see us debate and vote on controversial topics. They do not want to see us duck our responsibilities. We have met the enemy. The enemy is us.

Mr. COBURN. Mr. President, since I have an objection to that amendment 1007, I ask unanimous consent that amendment No. 1008 be called up.

Mr. COBURN. Mr. President, even though the amendment has been objected to, I am going to talk about it. The amendment is to require the Rural Utilities Service of the Department of Agriculture to ensure that the grants and loans it makes to provide access to broadband telecommunications services in rural areas are made to rural areas that don't already have access to broadband. Wait a minute. Why would we want an amendment to do that? This is an amendment to tell them to do what they are supposed to be doing. Over the years, the rural broadband program has seen a large amount of Federal funding. In 2009, the Department of Agriculture broadband program received $2.5 billion from the stimulus bill. The inspector general examined the Rural Utilities Service broadband loan and guarantee program, and what he found was that a large majority of the funds went to areas that already had broadband services. In other words, they didn't spend the money where we don't have broadband; they spent the money where we already do. Specifically, this inspector general found that 148 communities that received broadband service funded by this program were within 30 miles of cities with more than 200,000 people--including the cities of Chicago and Las Vegas. Some of the Federal funds going to broadband programs originate from the Department of Commerce as well. So we have the Department of Agriculture and the Department of Commerce both doing the same thing. The issue is highlighted by the problems with the broadband program that occurred in West Virginia, the President pro tempore's State. Specifically, the State could not handle nor had the use for the routers that were delivered to them. Put simply, the libraries and schools didn't have the need for the powerful stuff that was sent to them. So we wasted the money. It was a $24 million error. You get to $1 billion $1 million at a time, and you get to $1 trillion $1 billion at a time. What this amendment does is make them spend the money where we don't have broadband, not where we do. In other words, it prioritizes--which most of us would agree to--that broadband funds through this grant program go to areas that don't have broadband rather than areas that already do. So let's wire the whole country first before we upgrade everybody else. Mr. President, I ask unanimous consent that the pending amendment be set aside, and amendment No. 1010 be brought up.

Mr. COBURN. Mr. President, this amendment is very controversial, I know, amongst my colleagues. But I have practiced medicine for 25 years, and before that I ran a pretty successful business. The Department of Health and Human Services delayed the implementation of ICD-10. Let me explain what that is. ICD-10 is a new diagnostic code book. Why is that important? Well, we use ICD-9 now, which helps us write the diagnostic codes. Whether you are in a hospital, a clinic, a doctor's office, an outpatient surgery center, a home health, whatever it is, those diagnostic codes categorize what we actually did for you. Well-intentioned public health experts thought we aren't broad enough in what we do with the ICD-9, International Classification of Diseases, so as a part of the Affordable Care Act, ICD-10 was implemented. There is nothing wrong with updating it, but let me explain to you what we did. We went from 18,000 codes of diseases to 140,000 codes, the cost of which, at a minimum, in the health care system under various studies will be at least $5 billion a year in added costs. Will there be some benefit? Yes, to the public health experts who study disease patterns there will be some limited benefit. The question we have to ask is, What is our biggest problem with health care? Our biggest problem with health care is it costs too much. What we have done with ICD-10 is, just the implementation--I am talking $5 billion a year from here on. The implementation is going to cost $10 to $15 billion to put it in. What this amendment would do is make a significant delay in the implementation of ICD-10. The implementation of the Affordable Care Act is going to cost enough as it is. This would refocus us on what is important. It is important that providers spend time with patients, not spend time trying to figure out how they fill out a disease code. For any of you who doubt the significance of this now, if there are 18,000 codes now--most doctors write the disease code. They don't have a staff to do that. When you go from 18,000 to 140,000, what are your doctors going to be doing? They are not going to take care of you, they are going to be spending time looking at a book that has 140,000 diagnostic codes and listing that. So we are going to take time away from patient care. Why is it important that the doctors get it right? Because the penalties under Medicare for mislabeling are severe and the sanctions are severe--penalties of 1 percent to 2 percent payment per year on your total billing to Medicare or Medicaid. So the costs associated with ICD-10 are enormous. So it is not only hard and costly to implement it, but it takes people away, the very doctors we want spending time with patients. It limits that because they are going to be spending more time filling out paperwork for the Federal Government. The other thing it will do is it will not improve health care outcomes at all. It does nothing to improve health care outcomes. It will not improve the first patient, so there is no positive benefit in the short run or medium term to the patient. The only limited benefit would be to long-term studies of public health. Let me give some diagnostic codes to think about how foolish this is. The new codes account for injury sites ranging from opera houses to chicken coops to squash courts. Not only do you have to list what an injury was, you then have to go through this book and find out where it was. Was it on a ranch? Was it in the coral? Was it in the chicken coop? If you mislabel it, you are under threat of penalty from CMS. How about nine different codes where you got hurt around a mobile home? How about a burn due to water skis? How about walking into a lamp post? If you hit your head it is important for public health officials to know that you walked into a lamp post. It includes 300 different codes related to every different animal. So if you got a bite from a rat or a chipmunk or a squirrel, there are 312 different codes around each one of those animals. It has 72 codes pertaining to birds. You got pooped on, you got pecked at, you got bit--72 separate codes. How about bitten by a turtle or, the second one, struck by a turtle? Or walked on a turtle? Or kicked a turtle? That is how much foolishness is in ICD-10. We are going to ask our doctors to spend time figuring out 160,000 different codes, disease related, when 18,000 does it just fine right now. What this would do would forego the implementation of ICD-10. I ask the present amendment be set aside and amendment No. 1076 be called up.

Mr. COBURN. I understand the objection. I have no ill will toward my chairman or ranking member for their objection. What this amendment does is during sequester, it prohibits performance awards in the Senior Executive Service. We are paying performance bonuses right now during sequester. The Office of Management and Budget has ordered a freeze on most bonuses for Federal workers during sequestration, but the current law provides an exemption for members of the Senior Executive Service who are among the most highly paid Federal Government employees. This amendment closes that exemption loophole. If we are all going to suffer, everybody is going to suffer. Just because you work in the Senior Executive Service doesn't mean you should not have to participate and lead on the sacrifice this country is going to have to be making and is making. This treats SES personnel just like every other Federal employee. I ask the pending amendment be set aside--actually, I think I will stop with that--one other. Mr. President, I ask amendment No. 1152 be called up.

Mr. COBURN. I have not made that decision.

Mr. COBURN. I will tell you how I go through looking at the farm bill. I believe farmers ought to farm. I don't believe they ought to farm the government. I think you all, over the last few years, have done a good job changing that scenario. I believe food security is an important part of what America can do for both our country and our world. I also know our farmers are some of our hardest working people. Having said all of that, there are a ton of programs in here that do not directly benefit food security in this country or the American public. When we still have the well-heeled, well-connected in this country taking advantage of farm programs, from pro athletes to everything else, who use the farm program as a method, as a tax hedge, and use the supplemental systems, by eliminating direct payments, you have done a great deal. I am all for crop insurance. I think it ought to be a little more costly and spread around. I think crop insurance in terms of the commissions paid to the people who sell it are a little too rich. There are a lot of people who would like to have that book of business for a whole lot less money. We have not done that. It will be a balance to me as I look at improvements. I congratulate the chairman and ranking member for making progress on the farm bill. We have a long way to go. This amendment relates to one of those, which is how do we I make sure, if we are going to take taxpayer money and help people with their needs under the Supplemental Nutrition Assistance Program, how do we make sure we are doing it in a way that actually gives them nutritious food? As a physician who has cared for obesity and heart disease and cancer and high blood pressure for years, diet is a big factor on that. Senator Harkin and I have an amendment together, this amendment, which would create a pilot project in two States to allow States to use a nutrition assessment for setting what can be brought with SNAP. That is what this amendment does. A lot of the companies do not like it. A lot of people say: How can you do that? But I remind our colleagues, for many of the people who do not buy nutritious food when we are helping them, we are paying for it twice. That is because when they make poor choices with our money to buy their food, they are creating disease categories that we are going to pay for in the future, with our money, for their disease. So the idea of trying a pilot project in two States where they use nutritional value to make a determination of what food products are eligible and what are not for the SNAP program, this is a try that most people out in the country would like to see. Most Americans want to help anybody who needs help, but I hear it all the time when people say: I see people buying stuff I don't buy or I can't afford to buy with their SNAP card. There is no good way to do that other than do it on a nutritional basis. That is the only way we should look at that. If we are going to help somebody we ought to help them. There is a great book by Marvin Olasky. It is called ``The Tragedy of American Compassion.'' He talks about how to help people. You do not help people by giving them a blank check. You help people in short term. You help them as long as they have a need. But you help them in a way that they get to help themselves and by that they get to help themselves and get their dignity back. Senator Harkin and I have agreed that this is a pilot project that will have to be evaluated at the end of 2 years. All the costs of it have to be borne by the States. We have checked out all the computer companies. There is no problem in putting limitations on UPC codes or anything on all the checkout items. It is not an issue. We have done all the homework on it. It would be interesting to see, once we do a nutritional evaluation and a limitation on SNAP products, what would happen to the health of the people we are helping. That is the amendment he and I have worked on together. We would love to see it go. We think it is time for that to happen. It certainty will be good. The key is, can we help people get back to being self-reliant? I don't want us to be a big brother, but I also want to make sure the money we are stealing from our kids, from their future, actually does help somebody and doesn't hurt them. With that, I again congratulate both the chairman and ranking member for the bill they brought. It has marked improvements. I thank them for their patience dealing with me today on the floor. I very much regret that you have objected to a way to move this bill forward because it doesn't just have implications for this bill. The courage to stand up and say let's do that will have great implications for how this body functions for the next 16 months. I think we are going to miss a big opportunity if we do not do that. I would love to see the Senate go back to operating the way it did when I first came here. My hopes were dashed, however, with that objection. I yield the floor.

Mr. COBURN

Mr. COBURN. Madam President, 4 percent of the farmers in this country receive 33 percent of the benefits from crop insurance. I don't think it could be said any better than Senator Durbin has said it. The point is, what we ought do is make sure there is a safety net, and crop insurance is the way to do that. But like every other program, we eventually are going to ask those who have more to participate more. I have the location and how much the top five farmers in this country actually get. The No. 1 farmer in the country gets $1.9 million worth of subsidies a year. All we are going to do is cut his subsidy to $1.6 million. His income is far in excess of $750,000. The No. 2 farmer is from Washington State. We will cut his subsidy from $1.7 million to $1.4 million, and, of course, he made far more than that in the last year and in the previous years. No. 3, located in Minnesota, we are going to cut from $1.6 million to $1.4 million. We are still going to subsidize $1.4 million a year for this one individual who is going to make in excess of $2 million this year. All we are asking is to appropriately limit the benefits that are coming from borrowed money against our children's future for the very wealthy in this country. I reserve the remainder of my time.

Mr. COBURN. The No. 1 person who cares about the environmental quality of their land is the farmer. The bigger the farmer, the more they care. The No. 4 farmer, as far as crop insurance in the country, farms 105,000 acres. The average farmer in Oklahoma has 160 acres. They will make an economic decision, and if a 15-percent bump in their premium will cause them to go out, they will go out. But they will not go out because it is too much of a sweetheart deal. We are still going to pay almost half of their crop insurance--50 percent. Does anybody else have that kind of deal going? Nobody else has that kind of deal going. What we are saying is, let's save some money and ask those who are more well endowed with benefits and profits to pay a fairer share of what they should be paying based on the benefits they get. The one thing the chairwoman didn't say is these are the guys who collect the big bucks when there is one. They do pay a portion of it, but their payouts are hundreds of times higher than the average farmer. They will make an economic decision, and they are not going to walk away from this because it is still--even at 48 percent--too sweet of a deal for any of them to walk away. There is no study that says they will walk away. Wait and see. If they walk away, Senator Durbin and I will walk down and offer mea culpas on the Senate floor.

Mr. COBURN. Madam President, how much time remains?

Mr. COBURN. Let me just make the point. The large farmers I know in Oklahoma really don't want the government telling them what kind of agreement they are going to have with their crop insurance and environmental things. We already have a ton of rules. What I do know is there is nobody in Oklahoma who cares more about the environment than our farmers. I disagree there is a disconnect if we limit the crop insurance subsidy to the very large farmers in Oklahoma and that they are not going to do what is in the best interests of the environment since it is a benefit to their own economic well-being. We understand a deal was cut to get us to where we are on the bill, and we are not trying to disturb that. We don't want to disturb that, but we cannot continue to subsidize the very well heeled in this country to the same level that we try to protect those who are marginal. We just cannot do it. We could have made this a whole lot different. We could have lowered it even lower. We didn't do that. The average median family income in this country is less than $60,000. We are talking about almost 15 times more than the average family in this country makes, and saying: If you make more than that, maybe you could take a little trim off the subsidy of your crop insurance. That is not an unfair question. I yield to my colleague from Illinois.

Mr. COBURN. Madam President, I ask for the yeas and nays on our amendment and yield back our time.

Mr. COBURN

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

Mr. COBURN

Mr. COBURN. Mr. President, we are still in morning business, and I will speak in morning business about two amendments I will call up when we leave morning business. One is amendment No. 815 on this bill, which is aimed at lessening State dependence on the Federal Government. We have now, over the period of 50 years, helped with beach nourishment. In this bill is a section that extends from 50 to 65 years of government subsidization of beach nourishment. Really, if we look at the section, we see it is targeted toward a few States because they are running into the 50-year deadline. So all the amendment does is block it from going from 50 to 65 years. The Clinton administration, the Bush administration, the Obama administration, the Obama fiscal commission, all recommended eliminating the Federal subsidization of beach nourishment projects. So we have great bipartisan leadership on both sides of the aisle to bring this back, put back to the States what is truly a State responsibility. What we are doing in this bill is furthering the dependence of States for beach nourishment projects on the Federal Government. So I will call up that amendment. The next amendment is amendment No. 816. This committee has done a great job in setting up a review board that can eliminate authorized projects that no longer make sense, but they have limited what they can look at. They are not letting them look at the whole of water resources projects; therefore, they limit those projects. All we are saying with this amendment is we ought to reopen it. One of the criticisms of this amendment is that a project may be in the midst of completion and the review board might say we should eliminate it. It doesn't mean we will eliminate it because in the wisdom of the committee, they gave the opportunity for Congress to disallow any of this. So I think what the committee has done is a great step forward in getting rid of projects that are no longer apropos to whatever the needs are: But my question is, Why did they limit it to such a narrow package when, in fact, they want this outside input to help guide us on what we should do? So at the appropriate time, when we are out of morning business, I will call up those amendments. I will not speak further on them; I will just call them up so we can move ahead with the bill. I see the chairman of the committee is here. Good morning to her, and I yield the floor.

Mr. COBURN

Mr. COBURN. Mr. President, I ask to set aside the pending amendment and call up amendment No. 815.

Mr. COBURN. Mr. President, I ask to set aside the pending amendment and call up amendment No. 816.

Mr. COBURN. Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. COBURN. Mr. President, I have a question for the chairman through the Chair, if I might.

Mr. COBURN. My question on the deauthorizing commission would be why would they not take into consideration all of the things the Senator just mentioned before they would recommend deauthorizing a program, if, in fact, the only reason they would not deauthorize it was because it was spending money that is not going to have a positive purpose. So my question is, you trust the deauthorizing committee for all these other areas, but you do not trust their judgment to look at projects that are ongoing. Why would we think they would not make a positive decision in the best interests of the country?

Mr. COBURN. The point I would make is the following: The big problem with WRDA bills is they become parochial in nature. So what we have excluded is everything since 1996 forward, which actually includes the present Members of Congress in terms of projects, their parochial wishes. So what we have done is we have said: You may not be capable of defunding or deauthorizing something else, but if it is new, you do not have the opportunity to do that. So what we are doing is we are protecting interests. I yield back.

Mr. COBURN. I ask for the yeas and nays.

Mr. COBURN. Madam President, I ask for the yeas and nays on my amendment.

Mr. COBURN. Amendment No. 816 expands the review commission so that, in fact, it can look at everything. We have given them the responsibility. What the bill does is a great first step, but it protects all the earmarks from 1996 forward, so we are not going to look at any of those. We are not going to allow the review commission, the deauthorizing commission, to make recommendations on everything. We are going to select what they will look at. If we trust them to look at the other things, we ought to trust them to look at all of it. We do have an opportunity to turn them down if, in fact, they are trying to deauthorize something the Congress thinks shouldn't be deauthorized.

Mr. COBURN. I ask for the yeas and nays.