Thomas Coburn

Mr. COBURN

Mr. COBURN. I am happy to yield.

Mr. COBURN. Mr. President, it is interesting that two-thirds of the airlines don't have pretzels anymore because they have to make a profit, and they have to report to their shareholders. So it is not there anymore. We heard a statement that subsidies have been reduced by 40 percent. That is the operating subsidies. The total subsidies haven't been reduced at all. They are actually going up. They are actually going up by this amount over the next 5 years. These are Amtrak's numbers, based on this bill. These are the numbers of the Department of Transportation, based on this bill. Now, if you would break even on food service, there wouldn't be an increase in total subsidies. But none of us would run a business with a loss leader that would continue to undermine our ability to put the capital into business and to stay in business. We would, in fact, make a change. This amendment gives them 2 years. It says, the first year--you get 2 years to lose money, so the first year if you have lost money, renegotiate it, raise your prices, cut your labor costs. The cost of food service on Amtrak is 52 percent labor costs. The average person doling out the food on Amtrak makes twice what somebody does in the private sector doing the same thing. So what we really have is a subsidy to the food service workers on Amtrak because that is 52 percent of the cost, rather than a subsidy to the food. Again, the question the American people ought to ask is, should we be subsidizing somebody's beer and 3 Musketeers on Amtrak when we don't do it anywhere else? Isn't it common sense that if you are going to offer food service, you at least ought to break even? What we know from the testimony of the head of Amtrak is they use it as a loss leader. The only problem is where they use it as a loss leader, they continue to lose more money. On their profitable routes, they make money on food service. So the question is, should we, in fact, subsidize food? Nobody wants a diabetic not to have food available, and that would not happen. That is why we put 2 years in here. The first year you recognize you have a problem, and the second year you fix it. This isn't an amendment that is designed to get rid of service in terms of train routes. This is an amendment that says none of us would run a business losing this kind of money. It is a quarter of a billion dollars the last 3 years lost on food, on Amtrak--a quarter of a billion dollars.

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

Mr. COBURN. Mr. President, I note that this amendment could be considered nongermane afterwards and could have been held after that. The fact that we are not going to have a discussion on the amendment is somewhat disconcerting, but we will honor the objection of my colleague from New Jersey. Amendment No. 3474 I ask unanimous consent to call up amendment No. 3474.

Mr. COBURN. My attempt is for a colleague, an amendment for Senator Ensign, amendment 3482. I ask unanimous consent that the pending amendments be set aside and we consider 3482.

Mr. COBURN. I need to make it first.

Mr. COBURN. Mr. President, I understand the Senator from New Jersey may object to a unanimous consent request.

Mr. COBURN. Mr. President, this is a straightforward amendment. Last night, at 11 o'clock, I arrived at Union Station, taking the Acela Express from New York City to Washington. It is a great value, with good service. It is one of the areas where Amtrak makes money. But what the American public needs to see about this bill--and I am going to talk about in this amendment, specifically--is we are right here now at this level, as shown on this chart, and total subsidies will not go down, they will go up over the next 5 years for Amtrak. If you consider operating subsidies and capital subsidies, here is where they are, as shown on this chart. What we are going to have is about a $600 million increase between now and 2012 in the amount the American taxpayers are going to subsidize Amtrak. That may be something we want to do. This amendment specifically deals with an area where Amtrak can make a difference right now, and it is on food service. Over the last 3 years, American taxpayers have subsidized food service on Amtrak to the tune of a quarter of a billion dollars. Now, anybody who travels knows when you get on American Airlines, you can buy a Milky Way candy bar for $3. The same thing costs 75 cents on Amtrak. They know you can buy a beer for $5. It costs $3 on Amtrak. Why is it we have food programs and food sales programs that the American taxpayer is subsidizing on Amtrak that we refuse to subsidize on airlines? Now, we have heard during this debate that, well, we subsidize Amtrak, but we subsidize all the rest of them. Here is the analysis of the Department of Transportation on how much we do subsidize the other forms of transportation in this country. It is pretty revealing. If you are driving a car, you are paying in to the Federal Government. It is a negative subsidy. You, the individual driver, are paying $1.79, for every 1,000 miles you drive, to the Federal Government--just for the privilege of you driving. But if you are riding a bus, it is a $4.66 subsidy from us, the taxpayers, to us, the bus riders. If you are flying on an airplane, the subsidy is $6.18 for every 1,000 miles we travel. It is what we pay us to fly. When you get to public transit, it is quite a bit bigger. Could you make justifications for that? I am not saying we should not. But when you get to Amtrak, we are talking about $210 per thousand miles traveled, on average. We know on certain rail lines, certain routes, there is not much subsidy, Amtrak actually makes money. They have slightly improved in certain areas, especially with their latest data. But $210? Now, if you take their total subsidy, which right now is $1.3 billion--which counts all the subsidies, both capital and others--if you were to take out the losses on food, you would save another $125 million to $150 million. Nobody expects, when you get on Amtrak rail passenger service, that the rest of us ought to pay for your beer. Nobody expects we ought to pay for your 3 Musketeers candy bar. Yet, in essence, that is what is happening on Amtrak. This amendment is fairly straightforward. What it says is three things: It says Amtrak has to calculate and report quarterly to the Department of Transportation and Congress on the quarterly profits and losses, by route or rail line, of food and beverage services. What that means is they ought to know where they are losing their money, and we ought to know where they are losing their money. The second thing it says is, Amtrak ought to restructure their food and beverage service contracts for any rail line that is losing money on its food and beverage services. This is not rocket science. This is that if you are going to sell it, you ought to at least sell it for enough to cover the cost. Yet we continue to not do that. We continue not to want to hold them accountable to do that. Then finally, if they cannot present a way to be able to sell food and beverages at a break-even cost at least, then they ought to have to discontinue selling food or have a food service on it. And they have done it on one line because it was losing so much money. The question is, why haven't they either raised the prices or done it on the other lines? All this amendment is is a management audit tool for Amtrak that says: You are going to tell us every 3 months by route where you are making your money. They need to know that anyhow. They don't right now. They do not account for it right now. They cannot tell you how much by line or route they are making or losing on food service. Any manager of any process knows if you do not know the information, if you do not have the metrics, you cannot manage it. If you do not have the metrics, you cannot manage it. The history in this debate on Amtrak is interesting, because in 1997, the Amtrak Reform and Accountability Act of 1997 was supposed to solve all the problems, and by 2003 we were not supposed to have a subsidy in Amtrak. That is what the bill said. It said we will, in fact, by 2003 solve this drain of $1.3 billion per year coming out of everybody else's hands into those people who ride Amtrak. We have not had an authorization since 2003. This bill claims that, in fact, the subsidies will go down. But they will not. That is their numbers. That is the bill's numbers. So now we are saying we are fixing the problem--except the problem continues to grow. If, in fact, we would fix the food service portion of this, the subsidies would do this, as shown on this chart. It would be a flat line. There would be no increase in subsidies--capital or otherwise--if, in fact, we were breaking even on all the food. It is a straightforward amendment. I know there is some consternation with this amendment by the authors of the bill and the managers of the bill. I understand that. But the fact is, it is hard to explain to the American people why we are subsidizing a 3 Musketeers candy bar and a package of pretzels and a can of beer for people who ride Amtrak--and we are. It is interesting; I fly every week, and my total travel time is 8 hours each way. I price bottles of water at airports. A bottle of water on Amtrak is $1.99. Do you know what the average price is for a bottle of water at airports in this country? And that is not even on the airplane. It is $2.49. Yet we are selling it 20 percent cheaper on Amtrak than you can buy it in an airport. If you buy it at a convenience store, you can buy it for 99 cents. But we have a captive audience. The airlines know how to take advantage of that, and we are not subsidizing them, except for the $6, which we pointed out, per 1,000 miles. That comes to 6 cents a mile, by the way, versus $21 a mile for those on Amtrak. So my hope is we will at least look at this issue and say: OK, if you are not going to manage it, at least look at the food side of it. Measure it. Then, if we want to come back in a year and take this amendment away, saying: OK, you have done it--with this amendment, if they start breaking even on the food, it does not have any effect on them, other than reporting. If they are not going to break even on their food and beverage service, what it says is: Give us a plan to show how you are going to do it. It is very simple. But if you are not going to do either of those, then stop losing money on food service and beverage service on Amtrak. With that, I reserve the remainder of my time.

Mr. COBURN. I yield back any remaining time.

Mr. COBURN. Let me finish my point. I would be happy to offer the managers of this amendment, to make a second degree to this amendment that says on long-haul routes, if, in fact, there is no possibility you can never do it on a certain subsidy level, I will be happy to accept that. The purpose is that--we lose a quarter of a billion dollars subsidizing somebody's Heineken every day, every year, when we have this system where we don't make a management decision that is in the best interests. Here is the real reason the decisions aren't made on food service. It is because they don't have to be because we are still going to put the money there. That is the real reason why it is not there. In the private sector, it would have happened already. If there were private trains competing, I guarantee the prices would be higher for the food component of it. Nobody is going to lose it. So it is a straightforward amendment. I have a couple of minutes left, and I am happy to yield for a question from the Senator from New Jersey.

Mr. COBURN

Mr. COBURN. Has the Senate concluded morning business?

Mr. COBURN

Mr. COBURN. Mr. President, parliamentary inquiry: As to the unanimous consent request that we agreed to, was it not agreed to that we were going to have votes on these amendments up or down?

Mr. COBURN. Mr. President, I wish to make a couple of points. I know this is a large step down for San Francisco EMA and a smaller step down for some of the others. But the thing that needs to be kept in mind is the amount of dollars spent per HIV patient in those areas is 2\1/2\ times what the average is around the rest of the country-- 2\1/2\ times. We spend 2\1/2\ times more per HIV case in those areas than we do in North Carolina or Florida or Mississippi or Michigan or Kansas or Texas or Arizona. So what we are talking about is proportionality; giving the same opportunities to everybody who has HIV, not more opportunities. So with the 30-percent cut, you are still going to be spending 1\1/2\ to 1\3/4\ times more per HIV case in San Francisco as you are in the rest of the country. So I appreciate the work of the Senator in the HIV area, which is exemplary, and I understand she would want to protect this, but it is not fair to the rest of the country. It is not fair to tell somebody that you are going to spend 2\1/2\ times as much on somebody with HIV in San Francisco as you are in Dallas, TX, or Miami, FL. That is what this amendment is about--keeping the fairness that was in the Ryan White Act. I yield the floor.

Mr. COBURN. Mr. President, this is a straightforward amendment. It is an amendment about where our priorities lie. Do they lie in our directed spending or do they lie with the children of this country who aren't covered? It is a very simple amendment. I know there are things in the bill for children, but the fact is out of the 9.5 million who are uncovered, we have 3.6 million who have not been covered for a year. So this amendment simply states we are not going to spend any money on the directed spending until the HHS Secretary certifies that we have done our job in terms of taking care of the kids. Whether that is the SCHIP bill, negotiations with the administration or whatever it is, we are not going to spend the money.

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

Mr. COBURN. That was not part of the unanimous consent agreement? Fine.

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

Mr. COBURN. I thank the Chair. I stand somewhat amused that we are so powerless that the bureaucracy is going to decide where everything goes. Earmarks are not the only way to decide how the budget is put out, and the fact that we use the excuse that we don't have any control, it is called oversight. Last year in the last Congress more oversight hearings were held by myself and Tom Carper, true oversight hearings, than all the rest of the Senate. The fact is, we don't want to do the hard work of oversight because it is easy to earmark something. But in fact, in dredging, you can hold the Corps of Engineers to a priority list. You can bring them before Congress and say: Why aren't you dredging this? How is this a priority against something else? We don't do the hard work of oversight. That is our problem. Instead, we want to do it the easy way. I don't deny these are good projects. They are. I am not saying they are not. What I am saying is, what about the long term? What about the fact that a child born today is inheriting $400,000 in unfunded liabilities and that earmarks happen to be the tool that allows us to spend more than we should, not directly through the earmarks but by voting for bills that should not be voted on? But because we have an earmark in the bill, we vote for the bill. We have an unfunded liability right now on Medicare of $34 billion. We are never going to be trusted to fix that problem when we can't be trusted to have an arm's-length separate allocation and look at what the problems are in front of us in terms of labor, health, and human services. I don't deny what people want to do in this bill could be prioritized. But the number of requests were 36,000 this year. The fact is, can we get what are priorities for this country if we continue the process of using earmarks? How about children's health? Yes, we passed a bill. We passed a bill that truly wasn't paid for unless we want 22 million Americans to start smoking. We passed a bill that said: We are going to pay $4,000 to buy $2,300 worth of care. We are great stewards when it comes to the American taxpayers' money on this new SCHIP bill. There is no question we are going to get an SCHIP bill. That SCHIP bill is going to truly reflect the needs of the poor people who are not eligible for Medicaid. We are going to put the money there we need to accomplish that. But to confuse that bill with a process which has got us $9.5 trillion in debt and hung every one of our kids out to dry, that is what this amendment is about. It is the process I am attacking. I am not attacking individual Senators. I am saying if we are going to get control of the spending, at some point in the future we have to look at the process and how it works. For us to say it is easier for us to earmark than to hold the bureaucracy accountable means we are not doing our job. We can hold the bureaucracies accountable. All we have to do is have an oversight hearing three times a week and make them come up here and explain how they are spending their money. They will start spending on priorities Americans want. We don't have our hands tied behind us just because we don't do earmarks. The real question America is asking is, are we going to change our ways about real priorities, the real future for our country, or are we going to continue the same old process that has brought us all the corruption we have seen come through the House in the past that leads to conflicts of interest? We talk about transparency. We gutted the transparency rules as far as appropriations are concerned in this bill and in our ethics bill, because no longer do you say who is getting it or what it is for. You only say where it is going. The very things that are in the House bill in terms of transparency are not available to us in the Senate, so we can't claim transparency. We are going to get transparency in September of next year when the transparency bill comes about. Senator Harkin mentioned that we didn't offer an option. Senator Burr and I both did, the Every American Kid Insured Act. We talked about it on this floor during the debate on the SCHIP bill. There are other ways to do this. Give them all a tax credit. Let them buy the insurance. We have 9 million kids out there uninsured, 3 million more within 1 year. There are ways for us to solve that. But this is not a farce amendment. This is an amendment about a very real problem. Will we have the right priorities when it comes to this country or are we going to send $42 million to international labor organizations with no accountability whatsoever from the United Nations? That is what we are doing. That is what this bill does. We have another $400 million worth of earmarks that are not competitively bid and will never be overseen, and you will never see where the money goes. So the question on the amendment is, will we change the process. It is a serious amendment. We should not be earmarking things until we do our business of taking care of kids' insurance. With that, I yield the floor.

Mr. COBURN. Mr. President, may I inquire as to the remaining time?

Mr. COBURN. Mr. President, amendment No. 3358 is a pending amendment we discussed this last Friday. I believe under the unanimous consent agreement I have 10 minutes, and those in opposition do also. I am going to speak a few moments, if I may. What the country is looking for us to do is to choose priorities, to make good choices about the priorities of what we do with their money. Quite frankly, there has not been a top-down review on all the Government programs, ever. We have had very limited oversight hearings, which should be the No. 1 part of our job. And we have in front of us a bill that has $400 million in directed earmarks, which we think, through what the appropriations process has brought to us, is an important priority. What this amendment says is that we are going to give the Members of the Senate an opportunity to vote on whether those are the most important priorities or whether we ought to have children's health care because what this amendment does is redirects this money in abeyance until we say we have the kids in this country covered. There is a large debate over the SCHIP bill that the President recently vetoed. There are a lot of things wrong with it. It is not wrong to help poor kids get health care. Nobody in the Senate opposed that. What they did oppose is changing, under the guise of a debate for children, a debate of having the Government start running all of the health care for kids. What it did do is spend $4,000 to buy $2,300 worth of care, and a lot of other things. So what this amendment is about is asking the Senate to choose-- choose your directed earmarks for back home or make a statement that says: We really believe kids health care is important, and we are not going to spend the money on directed earmarks until we have solved that problem. I know this makes some of my colleagues bristle, that we would challenge the direction. This is not saying specific earmarks are not good ideas. A lot of the earmarks in this bill are good ideas. What it does say is: Should they be a priority before we take care of one of the greatest problems this country is facing, which is health care? Are we going to go after and really change health care to where we get value, we get controllable costs, we get freedom of choice, or are we going to continue to do the same thing of putting earmarks into bills and ignoring the big problems that are in front of us? So what this amendment says is that until the Secretary of HHS, whoever they may be, certifies that we have the kids under 18 in this country covered, we should not be spending money on directed political benefits for ourselves and our careers; instead, we should be spending our time solving the health care needs of the kids in our country. I reserve the remainder of my time.

Mr. COBURN. Mr. President, I wish to make a few comments about what is in the bill and what is going to happen if we don't accept Senator Enzi's amendment. When we crafted the Ryan White Act, the goal was to make sure the dollars followed the disease and to make sure people who were infected with HIV who had no other means of seeking treatment and having a life that is not the scourge of this disease with the modern medicines that have come about, to create a platform where we could have fair availability for medicines and treatment and care to where the disease is growing. What has come out of the House, with Speaker Pelosi's direction, is to actually take money from African-American women and the medicines they need to stay alive, or medicines to treat their newborn infants, and send it to San Francisco, which in the last few years has not even spent the entire amount of money that has gone to it. Senator Enzi is right in the fact that this violates the very agreement we made over a long period of time to get Ryan White funds to start following the disease. By taking an extra $6.2 million and sending it to San Francisco, it violates, No. 1, the agreement on that bill, but most importantly, it takes away the opportunity for health for minority women, which is where the disease is growing the greatest amount. We have all these women throughout the country who have been on waiting lists for drugs for treatment. They are getting some, but they are not getting what is going to save their lives. And we are going to steal that opportunity for minority women to be adequately and fairly treated under this bill. The Ryan White bill we passed last year was a good compromise, knowing that we needed to shift money to where the disease is. What happened in the House bill is we have actually reneged on that commitment. What we are actually saying is that the establishment age groups in northern California deserve more money than a single African- American woman who was infected with HIV and cannot get the medicines to treat her disease. That is the choice. For the first time, the Ryan White Act changed the direction of where the money went. The Ryan White Act, as we passed it, had the money following the disease, going to those who need treatment rather than to established organizations that are used to a certain budget. So the tragedy will be that if we don't pass the Enzi amendment, we are taking a step backward from the very principle--a public health principle, by the way--that you put the money where the epidemic is. What is in the House bill negates that. What we are doing is playing politics with the lives of African- American women, who are the fastest growing numbers of people who have HIV in this country. We are taking $6.2 million away from them and we are putting it in facilities that, quite frankly, have done quite well under the Ryan White Act. The availability, the access, and the programs are at the greatest level in San Francisco as compared to any other place in this country. Yet we choose, if we do not accept the Enzi amendment, to say that is a higher priority than a poor African- American woman in the South. That is the choice. I support this amendment. I think the Senate, in good conscience, ought to live up to its agreement on the Ryan White Act. I yield back my time.

Mr. COBURN

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

Mr. COBURN. This amendment has been cleared on both sides. I will talk with the Senator about it.

Mr. COBURN. Mr. President, I ask unanimous consent that the pending amendment be set aside and I call up amendment No. 3399.

Mr. COBURN. Mr. President, this amendment, for myself and my colleague Senator Burr, is about the topic of the Children's Health Care First Act of 2007. There has been a lot of debate, a lot of politics on children's health care. The House failed to override what I think was a poor solution to take care of children in this country by expanding children's health care through the SCHIP program and spending $4,000 to get $2,300 worth of coverage for our kids. What we do know is we do have problems with health care. We need to be debating health care. We need to figure out how we are going to do this. Myself and Senator Burr have an amendment that solves the health care problem, which has not been considered yet but which we are soliciting and for which we have received a number of cosponsors. This amendment, however, redirects us toward priorities. It is something we need to talk about. It is something the Senate doesn't talk about. We had numerous quotes in this body about how important it is to make sure kids in this country have access to care. What we do know--and I used the number $2,300 because that is the high end if we were to buy every kid in this country a health insurance policy. It is probably more like $1,700. So if you take the $2,300 that we have as a high-end number to buy kids health insurance, and not put them in something that has a Medicaid stamp or a SCHIP stamp on their forehead but real health insurance, and you look at the earmarks in this bill, which are $398 million, you could, in fact, buy insurance for 173,000 kids, in this bill alone. So 173,000 children could be covered for health care from the earmarks alone in this bill. Now, this amendment is real simple. If everybody in this body claims they want to take care of kids and their health care, they ought to be willing to give up their earmarks to cover kids. So what this bill says is, let's have no earmarks, no directed spending until such time as we have covered the kids in this country. We put kids ahead of us. We put kids ahead of our political interests. We put children's health care ahead of the politics and the consequential action of using politics in terms of earmark spending. Now, $400 million is a lot of money, and $400 million is out of the priorities of what this country ought to be doing that are in this bill that is Member-directed spending. This amendment simply says: We don't direct any of that money--none of it, zero, not one earmark--until we have cared for the kids, until we are caring for the kids. So in essence, what we are doing by accepting this amendment is saying, instead of rhetoric, we are going to say kids count. We are going to start putting the priorities back. If access to care for children is important, is it less important than your favorite earmark? I know if you total up certain of the earmarks of one certain State which has $72 million worth of earmarks, you have enough to cover all the uninsured kids in that State--all the uninsured kids in that State from the earmarks in this bill. So what are our priorities? Are our priorities children? Are our priorities the health care of kids? This amendment is going to be a fun vote because what it is going to tell your constituency is: Kids aren't important if you vote to keep your earmarks, but if you say I am willing to abate on the earmarks, and I am going to do what is right. This amendment says none of this directed spending goes until the Secretary of HHS certifies that kids under 18 in this country have access and have care. We have had months of debate about the children's SCHIP. We are going to have more because another bill is coming. But it seems to me the American public might want to ask: Why are you earmarking special money for special projects when you have a chance to make sure it will go toward children and solving the problem? So this is going to be a tough vote: kids versus my political career, kids versus my political power, kids versus my political earmarks. We are going to see. We are going to begin to see what the real priorities of the Senate are. Is it our ability to direct funds without competition, without oversight to special projects all across this country, or is it to truly solve the health care needs of the kids in this country? It is real simple, real straightforward. It is either yes or no, kids are important, and directed, unaccountable, noncompetitive earmarks aren't or political power, political earmarks, noncompetitive grants, no oversight is more important than kids having access to health care. The $400 million in earmarks will be set aside for children's health care in this bill with this amendment. So the reason it is called the Children's Health Care First Act is because children ought to come first. As parents, we put our kids first, or at least we should. Should the Senate not put the kids first? Should we not put them out in front to make sure they are our priority or are we going to play the game: Well, this isn't the way to do it, Senator Coburn. This is going to speak volumes to the American public about our priorities. I have challenged this body on our priorities. I am going to continue to challenge the body on our priorities. As we vote on this amendment, the American people are going to see what our priorities are. It is either going to be kids or it is going to be us. Let's talk about what is in this bill. This is the bill through which Congress can and should provide funding for health care for children. Yet it diverts $400 million away from children's health in order to pay for earmarks. Here is a little ``smitling'' of what the earmarks are: $350,000 for an art center, $100,000 for a celebration around a lake, $500,000 for field trips, $500,000 for a virtual herbarium, $50,000 for an ice center. How can we spend money on those things when kids in this country don't have access to care? So we are going to debate this again on Monday when we come back in, but it is going to be a test of our true priorities. You are going to see all the rhetoric in the world on the repeat SCHIP bill. You have seen it. You have seen it in television advertisements against people who didn't think that was the best way to do it, and now is the chance to put your words into action. Either kids are important or they are not. But it would seem they are going to be less important than our political power, our political expediency, and our ability to empower the select and the well-connected and the well-heeled in this country. With that, I yield the floor and ask the cosponsor of this amendment to speak.