Thomas Coburn

Mr. COBURN

Mr. COBURN. The reason it is there is because they wanted the direction on where to spend it. I understand the intention of the Senator from Philadelphia, his purpose. The reason I raise this question is I believe this is the wrong way we should be doing things. We need to stop. Our future depends on the integrity of a budgeting and appropriations process that is not based on politics but is based on having the future best will for our country. I don't have anything further to say on this, other than the Senator has given a great explanation. I understand what it is. He is trying to do something. The problem is, the military doesn't necessarily want to do that. I yield to my chairman, the Senator from Pennsylvania.

Mr. COBURN. I ask for the regular order on amendment No. 450.

Mr. COBURN. Mr. President, I ask unanimous consent to withdraw the amendment.

Mr. COBURN. Madam President, again, great words. True. We need to do it. But that doesn't address the issue of why that money should not go through the regular process on the outyears. I understand the tough job the chairman has to do. Amendment No. 467, withdrawn With that, I will move, if I may, to the next amendment, No. 467. Madam President, this is an amendment that ought not have to be brought forward. There is no question that there was, in fact, significant damage and flooding at the University of Hawaii. There was, in fact, significant loss of records and volumes at the University of Hawaii. There was, in fact, over $30 million in FEMA money that was sent to the University of Hawaii. There was, in fact, a $10 million matching contribution from the State of Hawaii for that matching grant. There is at least $25 million in insurance proceeds to go with the State assembly that was also trying to actively increase that amount, and public statements were made by the president of the University of Hawaii outlining the damage assessment, with this $10 million that is not truly an emergency anymore in this bill. This is not directed toward the Senator from Hawaii in any way. I wanted to talk about this, and then I am going to withdraw this amendment, if I have a unanimous consent to do it. But I want to use it as an example of what we shouldn't be doing. The fact is, they haven't even spent all the money that has been sent out there for the repair of this facility right now. On an emergency basis, we are going to appropriate $10 million more. If you total up everything, if you take what the University of Hawaii said and others have said about the total cost of the flood, $50 million, there is going to be $100 million that goes toward the University of Hawaii for a $50 million flood. That is bad enough. But this is not the way we ought to be doing this process. I am standing on the floor of the Senate today to offer amendments, not critical of any one individual but critical of the process because I believe if we don't have a functional, structural process change in how we appropriate taxpayer dollars in this country, we are going to undermine the standard of living for the next few generations. We very well could be the first generation of Americans to leave the next generation worse off. I believe things that are in an emergency bill ought to be truly emergencies. No. 1, they ought to have to be spent out in a short period of time, and with that comes the authorization for further spending so the appropriations committees can have the direction, so they don't have to spend it all and then rescind it. I believe we need to change things. We look around to our children. We see a future, we see hope, we see promise. But we see all of that in light of what we see today. We don't think down the road about what potentially can happen to our country--now $9 trillion in debt, with $600 billion worth of trade deficit every year with multiple poor countries in the world that export agricultural products holding large amounts of our dollars that are also dependent on our dollars staying at a certain value. We have to think long range about how we do this. I am challenging how we think, not to make a mark or to direct anything toward any individual person. We have to change. I will stand on every appropriations bill to come in the future and I will personally read the appropriations report language to find out what is there, and use the privilege granted to me as a Member of this body to raise these issues until we change how we do it. It is my hope I don't have to do that. I don't want to have to do that. But it is very important we start down a new road. It is not a partisan issue. It does not have anything to do with Democrats or Republicans but it has to do with our children, the future of our country, the viability of defending ourselves. Every dollar we waste or do not spend appropriately is $1 we cannot use to defend ourselves or create the technology to compete in this global economy. We have to do what is right for future generations. I will withdraw this amendment, as well, but I want to put my fellow Members on notice that I will be bringing this up. It is time to change. I don't do that with any ill will. I don't do it saying I have all the knowledge. But what I do know is I want a future for our country and for the children. We cannot continue doing what we are doing in terms of spending. We cannot continue either the process or the procedure on how we are doing it. With that, I ask unanimous consent to withdraw amendment numbered 467.

Mr. COBURN. I ask for a voice vote on the amendment, amendment No. 450.

Mr. COBURN. Mr. President, I want to visit amendment No. 471, which reduces funding in the supplemental for the Iraqi Embassy. According to the report language on this bill, $592 million is to be appropriated over the next 7 years for an embassy in Iraq. I do not have any objection. I think there ought to be tremendous hearings on the amount of money expended on that, but $592 million? Mr. President, $106 million of that is all that will be expended over the next 2 years. So what is going to happen is we are going to have $486 million hanging out there that will be rescinded and spent on something else. First of all, we had a vote in this body, of which 61 Members of this body voting on the Byrd amendment this week agreed that the President ought to put everything that he sought for the war in Iraq and for its needs in the regular budget and the regular appropriations request he sends to the Congress. By far, 61 Members out of 100 of this body will agree with the principle that I am bringing forward. They voted for it. The idea with this amendment is to trim the appropriations from what is expected to be spent for the next 2 years. And it is even questionable whether that is an emergency. I also note that the House, in passing the supplemental bill, eliminated the ability of this money to be spent for an embassy. I will state that the purpose of the emergency wartime supplemental ought to be to fund operations and projects that are emergencies. Money that is going to be needed for this embassy and complex in 2007, 2008, 2009, 2010, 2011, and 2012 can be appropriated at that time. It can be authorized before then, but it can be appropriated at the proper time. Again, quite simply, the emergency supplemental should only contain items we need right now in order to fight the war on terror. I will have trouble finding somebody who will actually debate on why we need to spend $586 million on an embassy complex, and we need to do it now rather than run it through the regular appropriations process.

Mr. COBURN. Mr. President, I want to make certain everybody understands. This was appropriated. It was not directed clear enough for the Department of Defense to want to spend the money. What we are seeing is they want a clearer direction. I do not fault the Senator from Pennsylvania at all for trying to give them a clearer direction. I would like to do that for some companies in my area as well. The fact is, it is not the way to run an airline, it is not the way to run a company. The omnibus appropriations process is not the way to run a country either, and it is my hope we don't get there this year either.

Mr. COBURN. I would be happy to yield to the chairman.

Mr. COBURN. Mr. President, I rise today to discuss what we are doing and why we are doing it and the overall evaluation of this bill. We are going to run at least a $600 billion deficit this year, a real deficit. What is said out there is that it is going to be $410 billion, but it is not. We are going to take $150 billion worth of Social Security money and spend that, and then we are going to have this supplemental, which is now at $81 billion. So we are going to be at about $630 billion, $640 billion in deficit. What is that deficit? That deficit is money we don't have today, that we are going to go borrow, but we are going to ask our grandchildren to pay it back. I don't want anybody to have any misunderstanding. I believe we need to have an emergency supplemental appropriation right now. I believe it ought to be designed for emergencies--true emergencies. That is what it is here for. I believe we ought to do whatever is needed for our troops and our efforts in the war on terrorism. I also believe we need to meet the commitments in terms of catastrophic weather events and the tsunami. I think we ought to pass out of this body what can truly be spent on that in the near term. What I don't think we should be doing--and I realize I am in a minority--is spending money and authorizing money to be spent from 2007 to 2012 that is surely and obviously not an emergency. I will have a hard time going home and looking at some of the poor children in Oklahoma when we spend this extra $21 billion out of this emergency. Each one of those poor children, when they grow up, is going to have to pay back about $5,000. That is what the difference is personally to them after 30 years of us borrowing. It is interesting to note that we have not truly paid off any of our bills, except for one short period of time, around 1999, 2000. So when we borrow the money, it continues to go up and it continues to compound and it continues to undercut the standard of living of future generations of this country. If there is anything our heritage teaches us, it is that the prices that were paid for us to have the opportunity we have today is something that we ought to transmit to future generations. I understand there are going to be objections to me bringing up my amendments; they aren't germane. I understand I need to have unanimous consent to be able to bring those up. I am not going to call for them at this time, but I will continue to talk about each one of those issues. I think it is important that the American public understand what is in this bill.

Mr. COBURN. Yes.

Mr. COBURN

Mr. COBURN. Mr. President, I rise to speak on this issue because I think we find ourselves fixing the wrong problem again. The real consequence of not having addressed the immigration problems in this country means we have problems with crops that are not going to be harvested because we don't have workers. But the time to do that is right after we finish this bill. The American people as a whole do not want an amnesty program, but they will accept an amnesty program if we fix the border, and we have not secured the border. We have not done what we need to do in this body, in the House or through the administration, to enforce the laws of this country. It is illegal to come here and we should not reward illegal behavior. But you can't even begin to address that until you say we are going to enforce closing this border for national security purposes but also for competitive purposes. We need to have a national debate about how many people need to come in and supply an effort to our Nation as we grow. All of us in this country are immigrants except for the Native Americans. We would welcome others. But it has to be done legally. We have not done our job as bodies of the legislature, along with this administration, of first securing the border. We have a national priority in terms of our own safety. Yet the politics of securing that border plays into every Presidential candidate who is running today. It becomes a political football. The fact is, for our children we need to secure that border to make sure we don't have terrorists coming across. ``60 Minutes'' 3 or 4 weeks ago showed a person from Croatia who came across the border illegally, became a legalized citizen after that, and ran guns and exported them throughout our country. He had access illegally to get here in the first place. That is not what we want. We need to solve agricultural problems. I come from an agricultural State. But the American people are not going to accept an amnesty program, I don't care how you design it, based on any type of emergency, until we fix the obligation we have, which is to control that border. We have the capability to do it. We have the technology to do it. We have the money to do that and a lot less of other things if we would do it. If we will in fact control that border, then we can solve every other problem that comes about. There are going to be consequences of not fixing the problems that were outlined by Senator Mikulski and Senator Craig, but rightly so, because we haven't done our job. There are consequences when we do not do our job. So I support Senator Cornyn's resolution fully. We need to come back and address this. We need to address every other area, but we have to first recognize that the American people are counting on us to do what is right in terms of securing the border. As long as we continue to ignore that because it is not politically acceptable in certain circles, then we are not going to fulfill our duty to protect this country. When we have troops fighting in Iraq and in Afghanistan and around the rest of the world, and we will not even enforce the law when we have the capability to do it, we dishonor them. So this is fixing the wrong problem. It is a problem, yes, but it is not the real problem. The problem is the border and controlling the border. I am convinced the American people are compassionate and will deal with any other issue of those who are here and those who want to come here in an orderly fashion, once they have the confidence that we have the border controlled. But we fail to do that at our peril, we fail to do that at the peril of the safety of this country, and we fail to do that at the peril of these areas that need specialized help in a short period of time. We are going to suffer the consequences of that and we should. I yield the floor.

Mr. COBURN

Mr. COBURN. Madam President, I thank Senator Enzi and all those who have worked hard on this bill. I have a few questions in terms of my concern about prenatal testing. Do I understand from the remarks of the Senator from Wyoming that this legislation is directed against a wide range of cases with which individuals of families may be discriminated against in health insurance coverage based on the results of genetic tests conducted on any family member?

Mr. COBURN. I thank the Senator. Based on that interpretation and my understanding that the Senator will ensure the conference report includes language that makes clear that a dependent child will be protected from discrimination under this legislation regardless of when the genetic information was acquired, including any information gained from ante- and prenatal testing, I will support the bill. I congratulate Senator Enzi and thank him for his hard work and for the colloquy.

Mr. COBURN. One example of such discrimination cited in the past is based on prenatal testing. A 1996 report by the National Academy of Sciences cited a case in which a California HMO threatened to deny health care coverage to a child because that child, before being born, antenatal, tested positive for a genetic defect associated with cystic fibrosis. Would this legislation protect against this type of discrimination?

Mr. COBURN

Mr. COBURN. I suggest the absence of a quorum.

Mr. COBURN

Mr. COBURN. Mr. President, I am struck as a newly-elected Senator from the State of Oklahoma. I must say I am extremely disappointed that my first opportunity to speak on the floor of this body is on the basis to refute the claims that are being made against a gentleman that I believe has already served our country miraculously and has been an example in this country of what can happen from very humble beginnings if somebody applies hard work, great effort, and perseverance. I am also struck by the claims that are made which don't have anything to do with history. I was sitting here asking myself this question: Were President Kennedy, President Johnson, and President Nixon responsible for My Lai, Vietnam? Was it their policies that caused that to happen? The atrocities that occurred during the Korean conflict, was that the fault of President Truman? The atrocities that occurred during World War II, was that the fault of President Roosevelt? No. And to make the reach and to make the claim that Alberto Gonzales, in his role as adviser to the President, as a legal counsel, to do what is expected of him in that position and to do that in a way that gives the President of the United States the advice, the knowledge, and the legal opinion of the Justice Department--not his opinion but the legal opinion of the Justice Department--that he somehow has disqualified himself from the position of Attorney General. I come to the floor today to make a statement in support of Alberto Gonzales's nomination to be the Attorney General of the United States. I believe an injustice is being carried out against him, both personally and professionally. Instead of looking at his qualifications, many have used him as a lightning rod for their complaints about the administration's handling of the war on terror. Specifically, many blame him for the administration's policies on the treatment of detainees and for its inquiries about the definition of torture. I am reminded that the President stated in 2002 that we would offer humane treatment to all prisoners. I am also reminded of how important it was for him to have a definition of what that was according to the Geneva Convention, but also according to our own law. What have the President and Judge Gonzales done to deserve the criticism they received? We saw Monday the results of Sunday's elections in Iraq. The allegations against him are based on two sets of advice that were given to the administration by the Attorney General and Department of Justice. First, the President made a decision based on the legal advice that he received from the Attorney General and the Department of Justice that certain detainees should not receive prisoner-of-war status while they were held in U.S. custody. Second, Judge Gonzales asked the Department of Justice Office of Legal Counsel under its statutory authority to render legal opinions to determine the precise meaning of the U.S. anti-torture statute. The Department of Justice responded to this request August 1, 2002, and December 30, 2004. I must say that torture is not a pleasant subject for us to discuss, but one might ask why the President and his top lawyer needed a clarification on an issue as unsettling as torture. I believe it is good to repeat the words of Senator Cornyn in his discussion. Why would we not use every legal means which are appropriate to protect this country? Finding out the definition of appropriateness is well within the purview of what Alberto Gonzales did. It is remarkable how quickly we forget. Just 3 years, 4 months, and 21 days ago, this Nation came under attack. We all watched helplessly as more than 3,000 of our fellow Americans were murdered, and nearly an equal number were severely injured in an assault that we had never seen before in this country. As the horrors of September 11, 2001, unfolded before our eyes, we quickly realized that we were not under the attack of another country, we were not assaulted by a nation that respects and obeys the laws of war and international order. We were ripped from a world paradigm that we understood, one where states follow rules while fighting each other, and thrust into a new world where a nonstate enemy infiltrates society and targets our citizens. Our enemy does not acknowledge that while at war soldiers must wear uniforms, carry their weapons openly, obey a chain of command, and treat captives--especially civilian captives-- humanely. What they do is cut their heads off. They don't hide the fact. The nightmare that began on September 11 has not ended. We watch daily as our enemy attacks our soldiers who are risking their lives and limbs to better the lives of the citizens of Iraq and Afghanistan and drive out terrorist cells. Gone are days when our soldiers were able to face the enemy on the battlefields, eye-to-eye. Today, enemy combatants launch surprise attacks by hiding among civilians and behind the bodies of the wounded. Gone are the days when combatants understood how important it was to protect civilians from harm. Enemy combatants today brutally and repeatedly behead innocent civilians. As our leaders first faced the aftermath of September 11, a dark reality set in: Our enemy would not play by the rules that civilized people and nations have developed over the course of history. Our leaders needed to understand exactly what our laws required and what we needed to do to survive in this new world we faced. They needed to make strong policy decisions based on our country's domestic laws and international obligations. First, our leaders needed to understand who we were fighting. Under customary international law, civilians are not allowed to engage in combat. Because soldiers are not supposed to target civilians in battle, it is essential that civilians are distinguishable from combatants. If civilians wish to be protected from harm, they must look different than combatants; therefore, every person who wishes to engage in combat and if captured receive the protections accorded to prisoners of war by the Third Geneva Convention, they must fulfill four conditions: that of being commanded by a person responsible for his subordinates; that of having a fixed distinctive sign recognizable at a distance; that of carrying arms openly; and that of conducting their operations in accordance with the laws and customs of war. We saw none of that. If someone engaged in combat does not follow these rules, he or she is an illegal combatant. Illegal combatants have long been recognized by state practice in the law of war field. In Ex parte Quirin, the U.S. Supreme Court held that ``by universal agreement and practice the law draws a distinction between the Armed Forces and the peaceful populations of belligerent nations and also between those who are lawful and unlawful combatants.'' Furthermore, the state practice of the United States does not evidence any understanding of a customary international law norm extending the Geneva Convention and prisoner-of-war treatment to combatants who commit terrorist acts. Instead, international law regards such individuals as illegal combatants who cannot claim the protection of the laws of war that extend to legal combatants. Only lawful combatants, members of fighting units who comply, again, with the four conditions--being commanded by a person responsible for subordinates; having a fixed distinctive sign, recognizable at a distance; carrying arms openly; and conducting their operations in accordance with the laws and customs of war--are license to engage in military hostilities. Only those who comply with these four conditions are entitled to the protections afforded to captured prisoners of war under the laws and usages of war. In fact, the denial of protected status under the laws of war has been recognized as an effective method of encouraging combatants to comply. As we hear those opine about what has gone on, I ask the American people to think about it. Who are these people who are killing our soldiers? Who are these people who are blowing people up? Who are they? They meet none of the criterion for a legal combatant. How has the President applied these principles to the War on Terror? In the February 7, 2002, Order on the Humane Treatment of al-Qaida and Taliban Detainees, President Bush stated unequivocally that all detainees are to be treated humanely, ``including those who are not legally entitled to such treatment.'' Therefore, even though many of the fighters our soldiers encounter are not entitled to prisoner-of-war treatment, they are still being treated humanely. Furthermore, the President has unequivocally stated the Third Geneva Convention applies to detainees captured in Iraq. Even those Iraqi prisoners who do not meet the four requirements to receive POW status are subject to an appearance before a Third Geneva Convention Article 5 tribunal to determine their status. Prior to that, they must receive POW protection until their status is determined. Second, while the President agrees with the Department of Justice that he has the authority under the Constitution to suspend Geneva, as between the United States and Afghanistan, he has declined to do so and has stated that the provisions of Geneva apply to our present conflict with the Taliban. However, common Article 3 of Geneva, and article 4, POW status, do not apply to the Taliban because they are unlawful combatants. Finally, none of the provisions of Geneva apply to the conflict with al-Qaida in Afghanistan or elsewhere. Al-Qaida detainees are not prisoners of war but are unlawful combatants. Next, the administration officials acknowledge that there could be circumstances where detainees hold information that could literally be a matter of life or death for thousands or even millions of American citizens. Judge Gonzales needed to understand what we are allowed to do under the laws of our Nation to save the lives of our people. Therefore, Judge Gonzales sought the legal expertise of the Department of Justice--not his opinion, but the Department of Justice's opinion-- to understand the definition and meaning of torture in the United States anti-torture statute. This request by Judge Gonzales did not in any way indicate the desire of the administration to use torture. It is a far reach to claim it. As a matter of fact, it is absolutely untrue to claim it. In fact, the official position of the administration is that neither torture nor inhumane treatment are to be used against anyone by the United States regardless of whether they have prisoner-of-war status or not. Because the administration's position is so strong, it was critical that the President and his advisers fully understand what constitutes torture so that no lines would be crossed. What does all this mean? Members of the Taliban and al-Qaida detainees do not receive the luxuries afforded prisoners of war because they are unlawful combatants. Iraqi fighters, even if they are terrorists, and most are, receive prisoner-of-war status until they receive a hearing before an article 5 tribunal to determine their status. None of these detainees are to be tortured or otherwise treated inconsistently with U.S. constitutional principles. It would have been irresponsible for Judge Gonzales to have not sought to understand the legal rights of enemy combatants and the law. He had a duty to the President and to the United States to understand these concepts and pass those on to the President in his private executive position as legal counsel to the President. We all went to sleep in a different world on September 11, 2001, very different than the one we lived in the night before. Our leaders needed to understand our domestic and international obligations well to respond to the new needs of our country. Alberto Gonzales should not be faulted for doing his duty for his client, the President of the United States. He is well qualified to serve as a U.S. Attorney General, and he should be confirmed. I also conclude by saying the following: In late November, I came to Washington to go through a process of orientation as a new Senator in this body. The message I heard from the other side of the aisle is, We want cooperation. We want bipartisanship. We do not want to politicize. The opposite of that is happening at this very moment in this body. Here is a good man who has demonstrated tremendous ability through his life. Everyone says he is well qualified. Everyone knows he will make a great Attorney General. The fact is, politics is getting in the way of his confirmation. I urge my fellow Members in this body to support and confirm him as the next Attorney General of the United States. I yield the floor.

Mr. COBURN

Mr. COBURN. Mr. Speaker, a young woman visits a health clinic. She consults with a nurse, undergoes a series of tests and exams and then is sent home with a clean bill of health. She is not, however, perfectly healthy. She is infected with HIV. The clinic tested her, without her knowledge, and never told her the results. Because she was never told, she has been denied medical treatment that would have kept her healthy. Because she is never told, she unknowingly places others at risk for contracting the disease, including her husband and children. And because she is never told, her life is prematurely cut short and she dies from AIDS. At 51 clinics across the country, the federal Centers for Disease Control and Prevention (CDC) is financing such a project. As a practicing physician, I find this to be highly unethical and appalling. In essence, government scientists have reduced men and women to bacteria in a Petri dish, disposal subjects for experimentation. Because the CDC has failed to properly monitor the HIV epidemic with the same reliable reporting system used to track every other disease, the agency implemented these so called serosurveillance, or ``blind'', studies to determine the size and demographics of the HIV/AIDS epidemic. The director of research at the Pediatric AIDS Foundation in California, Arthur Amman, has compared the CDC's blind testing to the notorious Tuskegee study that followed 400 black Alabama sharecroppers infected with syphilis in order to observe the disease's progression. Begun in the early 1930s, the Tuskegee `experiment' financed by the Public Health Service, continued until 1972 despite the fact that treatment became available in the 1940s. Likewise, the CDC's `blind' HIV testing began in the 1980s and continues today even though medical treatment for HIV is now available. Of those found to be HIV-positive through these government funded tests, up to 90 percent did not themselves receive an HIV test at some clinics according to the CDC's own data. That means at these locations, nine out of ten individuals that the CDC diagnosed as infected, were never told they are infected with a terminal and contagiouis disease. The CDC rationalizes these `bline' tests by conducting the surveys in facilities which offer counseling and voluntary HIV testing to all patients. Regardless of whether testing is or is not otherwise available, it is criminal that anyone diagnosed with a life threatening, contagious disease is not told and is instead allowed to die and infect others. It is even more despicable that those charged with protecting the public's health are running this program. The Right to Know Act will prohibit the CDC, or any other federal agency, from conducting or supporting such an unethical practice. It will require that whenever an HIV test is conducted using federal funds that every reasonable effort is made to find and disclose to the tested individuals the results, together with appropriate counseling. Never again should anyone ever be denied the knowledge of an HIV diagnosis or the medical care that can save their lives. I am hopeful that Congress in the remainder of the 106th Congress will include this life saving proposal in an appropriate legislative vehicle headed to the President's desk.

Mr. COBURN

Mr. COBURN. Mr. Speaker, the gentleman from Arizona and I have been here almost 6 years, completing 6 years; and we have seen a lot of instances in which Washington sees a problem and then fixes the wrong problem. And we heard the gentleman from New Jersey (Mr. Pallone) talk about a Medicare drug benefit, and we have heard how they want to add that to the Medicare program. Mr. Speaker, Medicare is going to go broke in 2015, and adding a Medicare drug plan as he would like to add, what that will do is just ensure that it is bankrupt about 2007. My point being that it is easy to do mischief and to do the wrong thing here, but it is even easier to fix the wrong problem. I believe that we have another chart there that I think really summarizes what we want to talk about, that is, if we want to empower patients and doctors, and by that meaning we want more patients to get care and we want them to get the right care the first time from the managed care firm, and we want to incentivize those people who are supplying the money to pay for that care to do the right thing and to do it in an economically efficient and prudent fashion, then what we want is to put doctors with a check on them by other doctors, not doctors with a check on them by a lawsuit, in charge of that care. Why would we let lawyers today decide the care in the country? And why would we take it from the managed care firms now and not give it to the doctors, but yet give it to the lawyers? For the life of me, I do not understand. And for the doctors in Oklahoma that I have talked to and I hope will be aware of what is going on, for the life of me I do not understand why the most recognized body in health care in this country has chosen to move the decision-making on care not back to the doctors from the HMOs or managed care, but rather has decided that they are going to endorse a bill that moves it to the courts and the trial lawyers. Mr. Speaker, it makes no sense for care, it makes no sense for costs, and it makes no sense for those people who have no insurance. It is just going to inflate the cost of their care as well as put more people in the ranks of the uninsured. I yield back to the gentleman from Arizona.

Mr. COBURN. Mr. Speaker, if the gentleman will yield, I wanted to make one more point. As a practicing physician who has been exposed to liability in the past, one of the things we know is that if we do what the Dingell-Norwood bill would set forth, the one thing we do know is that costs would rise significantly. The second thing we know is there will not be any learning history, because the ideal will be to get a patient and sue a managed care plan rather than to change the behavior, either on the part of the HMO or the practicing physician. We ought to incentivize people to do what is right. We should not incentivize additional torts in this country. In terms of full disclosure, I want everybody to know, I voted for Dingell-Norwood. I made a commitment to the gentleman from Georgia (Mr. Norwood) to do that, not because I agreed with the bill, but because I wanted to move the process along; because I, like the gentleman, believe Mrs. Corcoran and the future Mrs. Corcorans have to have a remedy; that if, in fact, somebody does something wrong to them, they have to have a remedy. It is amazing. My brother-in-law would find it really ironic, as much as the doctors have railed against trial lawyers, they have done us great service in many areas in our country, and we do need to have a mechanism for remuneration and remediation for when somebody is injured. However, we do not need, and what this Norwood-Dingell bill does, is create a system where all the money is not going to go to health care, it is going to go to the trial lawyers.

Mr. COBURN. Mr. Speaker, I want to thank the gentleman for taking the time on the House floor on an evening when we are supposed to be either home in Oklahoma or home in Arizona working with our constituency to explain this. I want to just kind of go through those charts with the gentleman for a minute, because I see another big defect in the Dingell, or the Norwood-Dingell bill that is so espoused by President Clinton, Vice President Gore and the American Medical Association. I also want the Members of this body to know that the American Medical Association represents 25 percent or fewer of the physicians in this country. I happen to be a member of the American Medical Association, as the gentleman knows, and I am amazed at the position that the American Medical Association has taken on this bill. But the point I want to make is that the bill that the gentleman and I designed, its first goal was designed to give people care and give it quickly and appropriately. And the bill that Norwood, Dingell has passed, or passed the House, but not passed the Senate, thank goodness, was not designed to give care quickly. What it was designed was to give a revenue source for the trial bar so that we would in fact punish the HMOs for bad actions in the past. It is almost like it is a revenge bill. But the point I want to make is what we tried to do is create a system where everybody learned. Think for a minute. I am a practicing physician. Since I have been in Congress, I have delivered over 400 babies, and I have delivered almost over 3,500 in my career. I have three great partners who are covering for me. I should be there and on call tonight, but they are kind enough to cover for me. What has happened in terms of what we have designed is that if a doctor recommends a treatment that is not appropriate as judged by a 3- doctor panel, a couple of things happen. Number one is the doctor learns, the doctor improves, the doctor gets up to speed on where he or she should be in terms of the latest professionally accepted standards of care. Mr. Speaker, in Texas where they have a bill similar to what we have proposed, 45 percent of the time the doctor panel finds that the doctors are wrong. Well, what is good about that is that it improves the care. The other part of the time, the 55 percent of the time when the plans have been deemed to be wrong by the doctor panel, the plans learn what is or is not appropriate care. If we bypass all of that and send it to court, we do not get the benefits, number one, of improving the quality of care and educating the managed care company; we bypass all of that, and we spend a tremendous amount of dollars doing that, and the loss is, we do not improve care for the next person. Mr. Speaker, that is one of the most important aspects of our bill, besides getting care and letting doctors decide, independent doctors, is we designed a system under which we would raise the level of care and the quality of care for everyone in America, whether they had insurance or not insurance, HMO or PPO or managed care, but that doctor who got turned down learned something by being turned down. So therefore, the next time they saw that situation, they were improved in the quality and skills and care that they gave.

Mr. COBURN. Mr. Speaker, if the gentleman will yield, I wanted to clarify and ask the gentleman a couple of questions. Several times in the gentleman's discussion, he used the word HMOs. What we really also mean is managed care, which means PPOs and managed insurance products that deny one adequate care. I believe that is correct, is it not?

Mr. COBURN. Mr. Speaker, I would make one point. I believe the gentleman has hit on something. I believe that most people really do not understand the impact of the Norwood-Dingell bill. I believe that we can bring people together. I believe that we can put people before politics. I know this is an election year issue. I am not running for reelection, so I do not have a dog in this fight as far as the election. But what I do know is that our job is to bring people together. And I want to thank the gentleman from Arizona (Mr. Shadegg), for first of all his insight and understanding of what has gone on with this legislation. Also, his tremendous effort, the amount of time that he have given up away from his family; the amount of time he could have been in Arizona that he was here meeting in a conference, trying to do the right thing. Not for HMOs, not for trial lawyers, but for doctors and patients. For that I am forever grateful.

Mr. COBURN

Mr. COBURN. Madam Speaker, I rise this morning to remember Andrea Aulbert, a woman whose life, though brief, was one of impressive accomplishment. Andrea served as the Director of Legislative and Legal Affairs for Concerned Women of America until her death on July 2 at the age of just 33. Andrea spent her life in service to others, from her student days as a camp counselor in her native State of Michigan, to her advocacy on behalf of persecuted Christians in China and other countries, to her tireless efforts in her professional career in support of moral renewal and the sanctity of human life. After completing her studies at the University of Michigan and Valparaiso Law School, Andrea spent some time in my home state, Oklahoma, on the faculty of Bartlesville Wesleyan College. But shortly after taking a position in Washington with the Concerned Women of America, Andrea learned that she was suffering from a rare form of lung cancer. In 1998 she under went a difficult and risky lung transplant at the University of Alabama in Birmingham, and within a few months she was back at work. This spring, however, her cancer returned, and, again, the wait began for another transplant operation. Her last night in Washington was, ironically, spent at an event given in my honor. She was excited and hopeful that evening. She had received word that she had qualified for an additional lung transplant. That surgery was performed a week later, but, sadly, she did not survive the surgery. However, her memory lives on with her family, her friends and her colleagues, and those of us in Washington that knew her. The good that she did in her short life will be felt for years to come by thousands of people who never knew her at all. That is the definition of a true American hero, Andrea Aulbert.

Mr. COBURN

Mr. COBURN. The other thing is, had Mrs. Corcoran had the freedom to choose and had she had her own health insurance as part of her benefit and her control, her baby would be alive today as well, probably. I just want to summarize a couple of things. Number one, there are two real false claims out there in the political arena today. One is the only way to solve the prescription drug for seniors is to create a Federal program. I believe that is wrong. I believe in the long run all that does is hurt seniors, and it will hurt everyone else, because it fails to fix the real problem, lack of market, lack of competition, to allocate those resources. The second thing is that we are required under the political arena that we have today to defend passing a Patients' Bill of Rights, and what has happened is we are about to pass a very bad law. It passed the House. It has not passed the Senate. What will happen if what comes is a tremendous increase in costs, tremendous loss of insurance, and exactly the opposite direction. Now, I happen to be cynical enough to believe there are certain people that want that to happen, because they believe we ought to have a government-controlled health care system. Believe you me, when we get that, if you love the post office today, wait until you see totally government-run health care. There is not one individual that I talked to that knows anything about health care, from the pharmacist to the physical therapist to the operating room nurse to other doctors to nurses or employees in my office. When I mention the word HCFA, Health Care Financing Administration, they go ballistic, because HCFA does not know what is going on, but they are running all the rules. For us to create another system in which we hand more to HCFA is asinine.

Mr. COBURN. I want to thank the gentleman for sharing this time with me. I look at the American health care system today. Prior to being a physician, I managed a fairly large business and my first degree is in accounting. As I look at the health care system in our country today, it reminds me of a Soviet-style run health care system, and here are some facts that people should know. That HMOs actually cost more for care than fee-for-service; a recent study, 18 percent more. Also it is funny that that 18 percent, that is the amount of money that comes out of an HMO for paperwork and profit. So only 82 percent of the dollars that are paid in to managed care actually ever go for care. If we could somehow in America through competition and efficiency make that 5 percent or 6 percent, we would have 12 percent. Well, we are going to spend about $1.1 trillion dollars this year on health care, and if we take 12 percent of that, what you can see is that we would have about $150 billion to $160 billion that would go to care. Well, nobody would be lacking in this country. We would be able to care for everybody that is not insured, everybody that does not have care today, if, in fact, we had a system that was not bound up in paperwork. I have almost 33 employees in my medical practice with three great partners that have covered for me since I have been here. Of that group, somewhere between 8 and 11 every day are doing nothing but chasing paper associated with health care. It has nothing to do with getting somebody well. It has nothing to do with anything except for us getting paid or sending something to lawyers or sending something to insurance companies. That is eight people that could be working to make somebody well. To me, I think that the fact that 18 percent of the dollars in the insurance managed care and HMO industry today are going for paperwork and profits rather than for care leaves a whole lot lacking. There is no wonder that we are having difficulty keeping up with the rising costs. The last point that I would make is that the fastest growing segment in the cost of health care this year is prescription drugs. Our economy will not work unless we have competitive markets. There is no doubt, if you just get on the U.S. Government FTC's web site, you will find where they have four large pharmaceutical companies through the last year that have accounted for more than a billion dollars worth of price fixing, a billion dollars in excess prices. Well, that is 1 percent of the cost of pharmaceuticals this year are associated with price fixing that we know of, that there has already been consent decrees against. How much more is there? The second thing that we know is that they are going to spend somewhere between $4 billion and $6 billion this year advertising on television. Who pays for the $4 billion to $6 billion? We do. What happens with that? You see something, oh, I need that. So I go to the doctor so, number one, we are increasing utilization. What I have found in my practice is it takes me twice as long to take care of a patient that comes in because they want a drug from a prescription that they saw on TV because now I have to figure out is that the right drug for their symptoms? And if it is not, I have to convince them it is not the right drug. So I spend my time working against the advertising to get the patient what they really need. The third thing is the pharmaceutical companies spend $5 billion a year courting doctors, and it ought to stop. They spend $5 billion buying lunches in doctor's office. They spend $5 billion for golf outings for doctors. They spend $5 billion on dinners for doctors. It is time the American people said that is enough. We do not need to pay $5 billion for benefits for doctors, $6 billion for television advertising, and let us get rid of the $1 billion to $5 billion in collusion. If you add that up, we would see a 15 percent reduction in pharmaceutical prices, not a 15 percent increase.