Thomas Coburn

Mr. COBURN

Mr. COBURN. I have no objection.

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 President, I ask unanimous consent that the order for the quorum call be rescinded.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, I will spend a few minutes talking about the Commerce-Justice-State-Science appropriations bill and about my reasons for voting against it when it comes up today. This year we added $538 billion to our debt as of September 30 for the last year. That translates into $1,783 for every man, woman, and child in this country. The cost of every project or program that we cannot afford will be borne with compounding interest by our children and our grandchildren. The American people choose every day to determine their financial priorities. It should be not too much for them to ask Congress to do the same thing. There are multiple projects that are funded in this bill that should not be considered within the priorities of what we have. The first is, as we are fighting a war, we have a Katrina, Rita, and Wilma disaster, we have $538 billion that we could not pay for last year that we added to the debt, and we are going to put $680 million into a program at NASA to go to Mars? I believe Mars should wait. I don't believe we should be spending $680 million to go to Mars. I believe we should spend $680 million to help our neighbors and our friends in the hurricane-ravaged States. We are going to spend $80 million for the Advanced Technology Program. Granted, that is less than what we spent before, but since 1990 the American taxpayers have given over three-quarters of a billion dollars to Fortune 500 companies for technology programs where they, in fact, could have financed those things themselves. We are going to spend $1.5 million to study highly migratory sharks, $825,000 to study Hawaiian monk seals, and $235,000 to study yellow- finned tuna. We are going to spend $7 million on the Alaska Fisheries Marketing Board, which this year just spent $500,000 to paint an airplane to have a salmon on it. The priorities are wrong. We need to readjust the priorities. I hope my colleagues will look at that and make the effort. The other thing I think is critical with this bill and is underfunded----

Mr. COBURN. Mr. President, I thank the Senator from Illinois. Byrne-JAG funding is cut in this bill. If there is anything we know that our sheriffs, our police departments, our drug courts, our drug rehabilitation programs need, it is help in terms of fighting the battle on drugs. I am very disappointed. The Senate passed $900 million for Byrne-JAG grants. It was paid for. It was offset when we passed it through the Senate. It came with full offsets to prioritize, to meet the needs of those people who are presently caught up in drugs. In Oklahoma, we have had fantastic results with drug courts and drug rehabilitation. Eighty-one percent of the people who now come through these drug courts have a full-time job and never regress back to drugs. What we know is drug treatment works. What we know is drug courts work. It is time for us to reconsider our priorities. I ask the Members of this body to reconsider this conference report in light of the lack of priorities that should be there. With that, I yield the remainder of my time and thank the Senator from Illinois for his courtesy.

Mr. COBURN

Mr. COBURN. Mr. President, I come to the floor today because, as I travel around Oklahoma, one of the things I find is a lack of recognition of the war we are in, why we are there, what the problems are associated with it. Every one of us has a heavy heart for the fact that we now have troops committed and dying and sacrificing every day in the war on terrorism. As I thought about what to say to my constituents in Oklahoma but also to the American people, I found that I could not say it as well as retired MG Vernon Chong of the U.S. Air Force. I wish to read, for a few moments, a commentary he has written, dated October 1, 2005. If you would indulge me to read that, I think it will give us some enlightenment to where we are. He says: To get out of a difficulty, one usually must go through it. Our country is now facing the most serious threat to its existence, as we know it, that we have faced in your lifetime and mine (which includes WWII). The deadly seriousness is greatly compounded by the fact that there are very few of us who think we can possibly lose this war, and even fewer who realize what losing really means. First, let's examine a few basics. When did the threat to us start? Many will say September 11, 2001. The answer, as far as the United States is concerned, is 1979--22 years prior to September 2001--with the following attacks on us: Iran Embassy Hostages, 1979; Beirut, Lebanon, Embassy, 1983; Beirut, Lebanon, Marine Barracks, 1983; Lockerbie, Scotland, Pan-Am flight to New York, 1988; First New York World Trade Center attack, 1993; Dhahran, Saudi Arabia, Khobar Towers Military complex, 1996; Nairobi, Kenya, U.S. Embassy, 1998; Dares Salaam, Tanzania, U.S. Embassy, 1998; Aden, Yeman, USS Cole, 2000; New York, World Trade Center, 2001; Pentagon, 2001; and Shanksville, Pennsylvania, Plane Crash, 2001 Why were we attacked: Envy of our position, our success, and our freedoms. The attacks happened during the administration of Presidents Carter, Reagan, Bush, Clinton, and Bush. We cannot fault either the Republicans or Democrats, as there were no provocations by any of the Presidents or their immediate predecessors, Presidents Ford or Carter. Who were the attackers? In each case, the attacks on the U.S. were carried out by Muslins. What is the Muslim population of the World? Twenty-five percent. Isn't the Muslin Religion peaceful? Hopefully, but that is really not material. There is no doubt that the predominantly Christian population of Germany was peaceful, but under the dictatorial leadership of Hitler (who was also Christian), that made no difference. You either went along with the administration, or you were eliminated. Although Hitler kept the world focused on the Jews, he had no hesitancy about killing anyone who got in his way of exterminating the Jews, or of taking over the world--German, Christian, or any others. Same with the Muslim terrorists. They focus the attention of the world on the U.S., but kill all in the way--their own people, or the Spanish, French, or anyone else. The point here, is that just like the peaceful Germans were of no protection to anyone from the Nazis, no matter how many peaceful Muslins there may be, they are no protection for us from the terrorist Muslim leaders, and what they are fanatically bent on doing--by their own pronouncements-- killing all of us ``infidels.'' I don't blame the peaceful Muslins. What would you do--if the choice was shut up, or die? So who are we at war with? There is no way we can honestly respond that it is anyone other than the Muslim terrorists. Trying to be politically correct, and avoid verbalizing this conclusion can well be fatal. There is no way to win, if you don't clearly recognize, and articulate who you are fighting. So with that background, now to the two major questions: Can we lost this war? What does losing really mean? If we are to win, we must clearly answer these two pivotal questions. We can definitely lose this war, and as anomalous as it may sound, the major reason we can lose is that so many of us simply do not fathom the answer to the second question-- ``What does losing mean?'' It would appear that a great many of us think that losing the war means hanging our heads, bringing the troops home, and going on about our business, like post-Vietnam. This is as far from the truth as one can get. What losing really means is: We would no longer be the premier country in the world. The attacks will not subside, but rather will steadily increase. Remember, they want us dead, not just quiet. If they had just wanted us quiet, they would not have produced an increasing series of attacks against us, over the past 18 years. The plan was clearly, for terrorists to attack us, until we were neutered, and submissive to them. We would, of course, have no future support from other nations, for fear of reprisals, and for the reason that they would see that we are impotent, and cannot help them. They will pick off the other non-Muslim nations, one at a time. It will be increasingly easier for them. They already hold Spain hostage. It doesn't matter whether it was right or wrong for Spain to withdraw its troops from Iraq. Spain did it because the Muslim terrorists bombed their train, and told them to withdraw the troops. Anything else they want Spain to do, will be done. The next will probably be France. Our one hope on France is that they might see the light and realize that if we don't win, they are finished too, in that they can't resist the Muslim terrorists without us. However, it may already be too late for France. If we lose the war, our production, income, exports, and way of life will all vanish, as we know it. After losing, who would trade or deal with us, if they are threatened by the Muslims? If we can't stop the Muslims, how could anyone else? The Muslims [Islamo-fascists] fully know what is riding on this war, and therefore, are completely committed to winning, at any cost. We better know it too, and be likewise committed to winning at any cost. Why do I go on at such lengths about the results of losing? Simple. Until we recognize the costs of losing, we cannot unite, and really put 100 percent of our thoughts and efforts into winning. And, it is going to take that 100 percent effort to win. So, how can we lose the war? Again, the answer is simple. We can lose the war by ``imploding.'' That is, defeating ourselves, by refusing to recognize the enemy and their purpose, and really digging in and lending full support to the war effort. If we are united, there is no way that we can lose. If we continue to be divided, there is no way that we can win! Let me give you a few examples of how we simply don't comprehend the life-and-death seriousness of this situation. President Bush selects Norman Mineta as Secretary of Transportation. Although all of the terrorist attacks were committed by Muslim men between 17 and 40 years of age, Secretary Mineta refuses to allow profiling. Does that sound like we are taking this thing seriously? This is war! For the duration, we are going to have to give up some of the civil rights we have become accustomed to. We had better be prepared to lose some of our civil rights temporarily, or we will most certainly lose all of them, permanently. And, don't worry that it is a slippery slope. We gave up plenty of civil rights during WWII, and immediately restored them after the victory, and in fact, added many more since then. Do I blame President Bush or President Clinton before him? No, I blame us for blithely assuming we can maintain all of our Political Correctness, and all of our civil rights during this conflict, and have a clean, lawful, honorable war. None of those words apply to war. Get them out of your head. Some have gone so far in their criticism of the war and/or the Administration that it almost seems they would literally like to see us lose. I hasten to add that this isn't because they are disloyal. It is because they don't recognize what losing means. Nevertheless, that conduct gives the impression to the enemy that we are divided and weakening. It concerns our friends, and it does great damage to our cause. Of more recent vintage, the uproar fueled the politicians and media regarding the treatment of some prisoners of war, perhaps exemplifies best what I am saying. We have recently had an issue, involving the treatment of a few Muslim prisoners of war, by a small group of our military police. By the way, all of those have gone to trial or are going to trial, and will be punished. Again, these are MG Chong's words: These are the type of prisoners, who just a few months ago, were throwing their own people off buildings, cutting off their hands, cutting out their tongues, and otherwise murdering their own people, just for disagreeing with Saddam Hussein. And just a few years ago, these same types of prisoners chemically killed 400,000 of their own people for the same reason. They are also the same type of enemy fighters who recently were burning Americans, and dragging their charred corpses through the streets of Iraq. And still more recently, the same type of enemy that was, and is, providing videos to all news sources internationally, of the beheading of American prisoners they held. Compare this with some of our press and politicians, who, for several days, have thought and talked about nothing else but the ``humiliating'' of some Muslim prisoners--not burning them, not dragging their charred corpses through the streets, not beheading them, but ``humiliating'' them. Can this be for real? If this doesn't show the complete lack of comprehension and understanding of the seriousness of the enemy we are fighting, the life and death struggle we are in, and the disastrous results of losing this war, nothing can. To bring our country to a virtual political standstill over this prisoner issue makes us look like Nero playing his fiddle, as Rome burned--totally oblivious to what is going on in the real world. Neither we, nor any other country, can survive this internal strife. Again I say, this does not mean that some of our politicians or media people are disloyal. It simply means that they are absolutely oblivious to the magnitude of the situation we are in, and into which the Muslim terrorists have been pushing us, for many years. Remember, the Muslim terrorists' stated goal is to kill all infidels! That translates into all non-Muslims--not just in the United States, but throughout the world. We are the last bastion of defense. We have been criticized, for many years, as being ``arrogant.'' That charge is valid, in at least one respect. We are arrogant in that we believe that we are so good, powerful, and smart; that we can win the hearts and minds of all those who attack us; and that with both hands tied behind our back, we can defeat anything bad in the world. We can't. If we don't recognize this, our Nation as we know it, will not survive, and no other free country in the world will survive, if we are defeated. And finally, name any Muslim countries throughout the world that allow freedom of speech, freedom of thought, freedom of religion, freedom of the press, equal rights for anyone--let alone everyone, equal status, or any status for women. This has been a long way of saying that we must be united on this war, or we will be equated in the history books to the self-inflicted fall of the Roman Empire. If, that is, the Muslim leaders will allow history books to be written, or read. Democracies don't have their freedoms taken away from them by some external military force. Instead, they give their freedoms away, politically correct piece by politically correct piece. And, they are giving those freedoms away to those who have shown, worldwide, that they abhor freedom, and will not apply it to you, or even to themselves, once they are in power. They have universally shown that when they have taken over, they then start brutally killing each other, over who will be the few who control the masses. Will we ever stop hearing from the politically correct, about the ``peaceful Muslims''? I close on a hopeful note, by repeating what I said above. If we are united, there is no way that we can lose. I hope the factions in our country will begin to focus on the critical situation we are in, and will unite to save our country. It is your future we are talking about! Do whatever you can to preserve it. After reading the above, we all must do this not only for ourselves, but our children, our grandchildren, our country, and the World. Whether Democrat or Republican, conservative or liberal, and that includes the politicians and media of our country, and the free World! Those are the words of retired MG Vernon Chong, U.S. Air Force. I think it brings to mind the very important facts that face us today. We are at war. The war is real. The threats to our country and to our freedom are real. We must come together as a nation and recognize this threat, or we stand to lose the very principles, the very freedom, we each cherish so much. I yield the floor.

Mr. COBURN

Mr. COBURN. Mr. President, I thank the leadership for giving me an opportunity to express some concerns with the version of ``value-based purchasing'' for physicians in the Medicare program, as presented in the Senate reconciliation legislation. While I commend the committee's efforts in finding budget off-sets to stop the Medicare payment cuts facing physicians next year I believe the committee, and Congress as a whole, has accepted the idea of ``value-based purchasing'' with little discussion, vetting and evidence that it will actually do what people say it will do. We have a big problem in the Medicare system. Our physicians, the bread and butter of the Medicare program who provide millions of services each year to Medicare beneficiaries, are facing unprecedented cuts in their reimbursement at a time when their own costs are skyrocketing. We have known about this problem for years, have taken action to prevent previously scheduled cuts and once again we must take action this year to prevent more cuts. I commend the Senate Finance Committee's efforts for at least preventing these cuts for a year and recommending that physicians receive a modest one percent increase instead of a 4.4 percent cut. I know the physician community is grateful for this effort in a time of budget deficits, hurricanes and other problems. I am concerned about another provision included in the bill-- specifically, value-based purchasing, a.k.a. ``pay-for-performance.'' My concern is that this concept is not ready to be codified and be taken to prime-time. In the last decade, we have already declared two Medicare physician payment systems--the current sustainable growth rate formula and the volume performance standard--dysfunctional and unworkable. I do not see the value of diving so quickly into adding a new, untested and unproven system on top of an already declared disaster--the sustainable growth rate or ``SGR.'' As a physician, I can attest that most doctors are dedicated to improving the quality of care they provide their patients. The concept of continuing medical education and continuous quality improvement is engrained in our medical culture. For years, physicians have been involved in peer review, the development of clinical guidelines and best practices, and outcome measurement. The concept of value-based purchasing is to turn these practices into a payment system that pays higher performers more and pays less to those who cannot make the grade. In theory, this has great promise and I believe it will improve the quality of care provided to all Medicare beneficiaries while increasing efficiency in the system. However, I am concerned that the language included in S. 1932, the ``Deficit Reduction Omnibus Reconciliation Act of 2005'' will not achieve these goals. While it does give physicians a 1 percent update for 2006, it does not address the impending cuts scheduled for January 1, 2007. The proposed legislation does not fix the SGR, it instead places cuts on top of cuts, and infuses a system that mandates greater volume on top of one that penalizes physicians for volume increases. Value-based purchasing and the SGR are not compatible and cannot work together. In exchange for a one percent increase in 2006, physicians could receive cuts of up to 7.5 percent in 2007, 2008, 2009, 2010 and 2011. If you think your physician constituents are frustrated now, wait until they understand this. Under the suggested program, some physicians may have the opportunity to earn back that additional two percent cut if they meet specific ``quality'' and/or ``efficiency'' measures. Many of these measures have not yet been developed, have not yet been vetted by consensus building groups like the National Quality Forum and may or may not be evidenced- based. Before there is value-based purchasing, there must be agreed upon, comprehensive quality and efficiency measures for each medical specialty developed by the specialties themselves. In this proposed legislation, bureaucrats in Baltimore would primarily develop the measures that physicians across the country--with limited input from the physician and specialist community. I can tell you as a doctor that I am not interested in having some bureaucrat in Baltimore tell me how to deliver a baby in Muskogee, OK, and my patients are not either. Physicians must be the ones to develop these measures if they are going to be held accountable and if it is really going to improve quality and not just be another layer of paperwork and bureaucratic administration. I believe pay-for-performance is critical to improving quality in our healthcare system. But we must get it right. Our physicians are facing year after year of cuts and beneficiaries are facing a loss of access to the physicians they know and trust. I believe the correct course is to deliberately and methodically build up toward a new physician payment system that accurately accounts for the cost in providing care to beneficiaries while encouraging and rewarding high quality and improvement.

Mr. COBURN

Mr. COBURN. Mr. President, today the Senate accepted two modified amendments that I authored. Amendment 2230, as modified, will reduce the amount appropriated for travel, conference programs and related expenses at the Department of Health and Human Services, HHS, by $15 million. Currently $68 million is available for these activities. The $15 million saved by this revised amendment would ensure sufficient funding for travel and conference expenses that may be necessary while recognizing that the current amount spent on these activities by HHS is excessive and can be reduced. In 2005 alone, HHS spent $68.5 million on conferences. This is a 50 percent increase in conference spending during a 5-year period. At a time when our Nation is fighting a global war against terrorism, recovering from the most expensive natural disaster in our history, and facing an ever growing debt that now surpasses $8 trillion, we must be more frugal with the taxpayers' dollars we have been entrusted and prioritize how they are spent. This amendment ensures that a greater amount of Federal health dollars will actually be spent on health care, which should be the goal of HHS. In the context of the $2.5 trillion Federal budget, $15 million may not seem like much until you put it into a real world perspective. According to the American Institute of Preventative Medicine, the average doctor visit costs $55. The $15 million saved by this amendment could be made available to pay for nearly 273,000 doctors visits in the next year. The 2004 Census Bureau report on Income, Poverty, and Health Insurance in the United States shows that 45 million Americans are without health insurance. The annual premium that a health insurer charges an employer for a health plan covering a family of four averaged $9,950 in 2004. For single coverage is $3,695 annual average premium. The $15 million saved by this amendment could provide 1,500 American families of four or 4,060 single Americans with health insurance for a year. HHS spends significantly more on conferences than any other Federal department. In fact, the total spent on conferences by HHS in 2005 is comparable to the amount spent by the Energy Department, Education Department, Environmental Protection Agency, Department of Housing and Urban Development, Labor Department and Transportation Department combined. In 2002, HHS spent $3.6 million on a single conference, the International AIDS Conference, held in Barcelona, Spain, to which 236 HHS employees traveled to attend. Then-Secretary Tommy Thompson was among the HHS employees who traveled across the globe for this conference and was scheduled to speak. Yet he was prevented from doing so by activists that turned what was intended to be a scientific gathering into a political statement. Members of Congress rightfully were outraged that the Secretary was treated so rudely at a conference that cost the U.S. taxpayer millions of dollars. In a May, 2003, letter to members of Congress, Secretary Thompson reassured that HHS ``will work to further reduce our costs associated with that event, while continuing to assure essential scientific personnel can attend this meeting.'' He went on to note that ``the Department is currently revising the HHS travel manual, which will formalize international and domestic travel policies to ensure frugal use of taxpayer money. My staff is taking unprecedented steps to ensure American taxpayers will no longer be asked to foot the bill for wasteful HHS spending, including in the area of travel. . . . Every trip proposal is . . . evaluated on an individual basis by a member of my staff to guarantee that taxpayer money is not wasted.'' Despite this pledge, HHS has continued to spend more and more on conferences and to send hundreds of employees to participate in the same conferences. In 2004, HHS sent 100 or more employees to at least 59 conferences, including 1,036 to a conference in Orlando, Florida. Just this past August, HHS was listed as a primary sponsor of the 2005 conference of the Harm Reduction Project, an organization that supports tacit legalization of drugs. Among the sessions at this federally supported conference was ``We Don't Need a `War' on Methamphetamine'' and the discussion groups include ``Tweaking Tips for Party Boys.'' ``Tweaking'' is the most dangerous stage of meth abuse. A tweaker is a meth addict who probably has not slept in days, or weeks, and is irritable and paranoid. HHS officials later denied ``sponsoring'' the conference, although the Department provided taxpayer dollars for it and sent six employees to participate. As a practicing physician, I believe that Federal funds expended to support this conference would have been far better spent providing treatment to those suffering from addiction. This is just one example of taxpayer dollars that have been misspent on conferences. The bottom line remains that at a time when important health care programs are faced with financial difficulties, we do not have the luxury for excessive spending on conferences. While Congress is trying to control the growth of spending on important health programs like Medicaid and Medicare, we should first impose restraints on nonessential spending at HHS including conferences. Conferences may provide interesting opportunities for bureaucrats and others to network and exchange information in person, but they do not make people well or provide life saving health care. Furthermore, in the modern telecommunications era, it is unnecessary to spend time and resources to finance so many conferences. Teleconferences and video conferencing, for example, can save money while allowing the same type of interaction and information sharing at a mere fraction of the cost. The second amendment, No. 2336 as modified, directs the Secretary of HHS and the Secretary of Education to estimate improper payments as required by the Improper Payments Information Act of 2002 and report to Congress on specific actions taken to estimate improper payments within 60 days of this bill being signed into law. The Improper Payment Information Act was enacted in November 2002 for the purpose of finding and eliminating payments that should not have been made, or were made for incorrect amounts, by government agencies. This law requires that all agencies, at the very least, perform a risk assessment of all programs and activities to determine whether or not a program is at risk of making ``significant'' improper payments. ``Significant'' as defined by the Office of Management and Budget means at least 2.5 percent of all payments made are improper, and the absolute dollar figure associated with that 2.5 percent or more, totals at least $10 million. Federal programs and activities deemed to be at ``significant'' risk of making improper payments their respective agencies are required under the Improper Payments Information Act to first, develop a statistically valid estimate of improper payments; and second, develop a corrective action plan for all programs where the improper payment estimate exceeds $10 million annually. This corrective action plan must also contain annual targets for reducing improper payment levels. At the end of each fiscal year, agencies are to report the results of the Improper Payments Information Act activities in their Performance and Accountability Report PAR; and submit them to Congress. The Improper Payments Information Act exempts no agency from compliance. Improper payments--which include inadvertent, fraudulent, and irresponsible payments--are costing the taxpayers at the very least, over $45 billion each year. Even worse, this $45 billion represents only 17 of 70 agencies that are currently reporting improper payment information as required under law. The Medicare program, which is already reporting, makes up nearly half--$21.7 billion--of the government's $45.4 billion reported improper payments for fiscal year 2004. The magnitude of the Government's improper payment problem is not yet known because some of the largest programs are not reporting, as required by law. Medicaid, with outlays that exceed $175 billion annually, is one of the programs that is not reporting. The Medicaid program has been required to report improper payments under the Office of Management and Budgets, OMB, A-11 Circular requirements since 2001; and under the Improper Payments Information Act since 2002, yet it still has made no estimate of its improper payments. In its November 2002 Performance and Accountability Report, Centers for Medicare and Medicaid Services reported that it would be able to report improper payments for the Medicaid program by 2006; however, they have pushed that date back to 2008--six years after the date by which they were to have begun reporting improper payments. Similarly, the Temporary Assistance for Needy Families, TANF, program has not even been able to estimate when it will be able to report improper payments for a law that has existed since 2002. TANF spent over $17 billion in fiscal year 2005 ($18.6 in outlays). Foster Care spent $6.4 billion in fiscal year 2005. State Children's Insurance Program spent $5.129 billion in fiscal year 2005. Child Care Development Fund spent $4.9 billion in fiscal year 2005. Title I, within the Department of Education, spent $22.916 billion in fiscal year 2005, fiscal year 2005 outlays: $21.18 billion. This amendment does not debate the merits of any of these programs, it simply demands compliance with transparency and accountability measurements for expenditures already in existing law. After all, eliminating improper payments ensures more funds actually reach those who are intended to benefit from these programs while protecting the taxpayer. However, we must first understand the magnitude and source of the problem to correct it. We can only do this if all agencies are monitoring and reporting their improper payment information. Together these amendments make small, yet important steps, towards making federal agencies more fiscally responsible and accountable. I thank Chairman Specter for accepting these amendments and his commitment to fight for inclusion of these provisions in conference with the House of Representatives.

Mr. COBURN

Mr. COBURN. Mr. President, this amendment does not save us any money but saves hundreds of lives. Some 5 years ago, we embarked on making major changes at the CDC through a construction program, through advancing the facilities there by increasing the capabilities of the CDC. At the end of this fiscal year, September 30, they had unspent moneys in excess of $240 million going toward this construction budget. This year, the President asked for $30 million to be in that construction budget. The House passed $30 million in the construction budget. I believe we have in this bill $225 million for additional construction moneys, making available almost $500 million for expenditure in the next 12 months. This amendment is a simple amendment. It is backed by thousands of groups in the country, and it says while people are dying from HIV, they cannot get medicines under the ADAP program because we cannot fund it significantly. We have multiple States with people on waiting lists. We have multiple States that cap the available benefits. It is a death sentence to those people with HIV today. This moves $60 million from that account into the AIDS Drug Assistance Program, a vital program to keep people working, to keep people active, and to make the lifesaving drugs available to those people with an infection of HIV who have no other access to lifesaving drugs. I believe priorities ought to be directed toward the emerging disease program at the CDC. As a matter of fact, that building is complete. It is in the works. We are working to finalize all of that. This $60 million, which still brings us down to $165 million plus the $240 million that is in the account, will put us at $400 million still for CDC to move forward, and we will do something that has never yet been done since ADAP started: We will have enough funding to make sure everybody with HIV in this country has the medicine they need to stay alive. I know it is a controversial question for my fellow Senators from Georgia. The CDC happens to be there. This puts no risk to the CDC expansion in Colorado, as it is directed in the budget. It puts no risk to that whatsoever. I believe we ought to be thinking about people, not buildings. We have moved on the emerging diseases portion of this. This will not slow down any of that construction. It will, however, maybe slow down the Japanese gardens and the tremendous waterfalls and all of the gardens that are going to be there. One other thing, the CDC has just completed a $62 million visitors center. I am asking for $60 million for people who have HIV, who are never going to get to visit the visitors center. I do not know how we spent $62 million on a visitors center for the CDC, but I believe that priority is wrong when people are dying from HIV and do not have the available medicines. I yield until a further time.

Mr. COBURN. Mr. President, how much time do I have remaining?

Mr. COBURN. I call up amendment No. 2232.

Mr. COBURN. I ask that the pending amendment be set aside.

Mr. COBURN. I thank the chairman.

Mr. COBURN. My only request is that the Senator would allow my staff to be there as they make this presentation. We have done significant research on their expenditures on these conferences, and we would love to have the opportunity, if the Senator so allowed it, for us to participate as they make their presentation.

Mr. COBURN. Mr. President, I have an amendment that will transfer $60 million to save the lives of people who are infected with HIV. There is no question where I get this money. It is a good goal. Enhancing the CDC, the buildings, the development of that, is all good. We have been on a fast track to do that in 5 years. That ought to continue. What I am saying with this amendment is, since this amount is eight times what the President requested, we ought to put saving lives right now in this country at this time ahead of speeding up buildings. If my colleagues agree with that, then they ought to be supporting this amendment. If they do not, do not support it. I reserve the remainder of my time.

Mr. COBURN. Mr. President, I will be calling up a series of amendments. Before I do that, I visited with the chairman of this subcommittee. I have four amendments to offer. I ask unanimous consent that we not exceed 45 minutes on them, equally divided between myself and those opposing this amendment. I think a couple of these amendments will probably be accepted. One of them will have some significant debate; the other one probably will not.

Mr. COBURN. Mr. President, I call up amendment No. 2231.

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

Mr. COBURN. I call up amendment No. 2230.

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

Mr. COBURN. Will the Senator yield for a question?

Mr. COBURN. Mr. President, I have to leave the floor to chair a subcommittee hearing. I want to spend 2 or 3 minutes. No. 1, the head of the CDC, Dr. Gerberding, I know very well as the former head of the President's Commission on HIV/AIDS in this country. No. 2, her submission to Congress for building funds this year was $30 million. No. 3, the total budget for CDC is $4.5 billion. We are asking that we take $60 million in construction money and slow it down and save the lives of thousands of people in this country by making available drugs to them. We need the facilities at CDC; I am not debating that. This is about saving lives and the priorities of putting that money in a place where it will save lives. I yield the floor, and I thank the chairman and the Senator from Georgia for their collegiality in working on this amendment.

Mr. COBURN. This is a very straightforward amendment. Growth in conferences in the Federal Government has exploded in the last 6 years in this country. Over the past 5 years, the Department of HHS has spent $300 million on conferences. The idea of conferences and using communication to put forward ideas, to promote health, to promote programs is a good idea, but the expanded growth of these programs through each of these departments, Labor and Health and Human Services, has grown exponentially at the same time that technology has grown even greater. There is a lack of utilization of those technologies in a time of budget duress, in a time of tremendous debt, in a time where last year we added $546 billion to our children's debt, and we are struggling with Katrina. This amendment caps the conference costs for each of these departments so that the other moneys can be used in more productive ways. It forces creativity through conferences. It promotes videoconferencing. It saves millions of dollars in travel and hotel costs and still allows the flexibility of the Departments for conferences, but does it with the technology we have today, a smarter, more current, and more effective means of accomplishing communication with which each of these agencies is charged. I will limit my comments to that and respond should the chairman and ranking member have questions.

Mr. COBURN. Mr. President, I will be happy to set the amendment aside, but I have to let you know we have looked at all the ads. There has never been recruitment of anybody for vaccine trials in any of the ads they have ever run. The American people ought to be asking, why would we be spending $1 million a year? Everybody in this country knows HIV is deadly. There is no lack of knowledge on that issue. To spend $1 million on HIV Vaccine Awareness Day is $1 million to help people with HIV through the ADAP program, $1 million to fund an extra research model or it is $1 million to fund three researchers on an HIV vaccine a year. I believe we would be well advised to prioritize the money that is going there. I would be happy to set this amendment aside, as per the chairman's request. I am adamant that I think that we are not spending the money properly.

Mr. COBURN. Mr. President, all this amendment does is say that money spent for HIV vaccine research ought to be spent on HIV vaccine research. There has been $5.2 million spent in the last 4 years to create an HIV Vaccine Awareness Day. It is not used for recruitment of candidates. It is not used for recruitment for anything other than to celebrate the fact that we are working on an HIV vaccine. I believe it is very important that dollars for research on HIV go to research on HIV and a vaccine, in particular. The hope is that sometime in the next 5 to 10 years, we will have a vaccine. We do not have a cure for HIV, no matter how hard we work, how many hundreds of millions of dollars we are putting into that. And for us to have spent $5.2 million over the last 4 years and another million dollars over the next year in promotional activity to make Americans aware that we are working on an HIV vaccine is an improper placement of the dollars being spent. I believe the dollars will be better spent toward HIV vaccine efforts rather than an effort to make people aware of that fact. I hope the Senator from Iowa and the Senator from Pennsylvania will accept this amendment.

Mr. COBURN. Mr. President, I call up amendment No. 2233.