Christopher Dodd

Mr. DODD

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 Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. DODD

Mr. DODD. Madam President, I want to take a few minutes, if I may, this evening to speak about what this health care bill means to my constituents in Connecticut. I say to the Presiding Officer, the benefits to our States are very similar in many ways, but, obviously, we like to point out what this particularly means in our own respective jurisdictions that we represent. But before doing so, I want to take a few minutes, if I could, because, again, tomorrow will be a short day, and then there are the votes, apparently, that we are going to have Thursday, and then we will be leaving the Senate for a number of weeks before we return in mid- January, and it might not be possible tomorrow or in the very early hours of Christmas Eve to say a special thanks to the people who work with our offices in this Chamber, both on the minority side and the majority side, who rarely get the kind of recognition they deserve. I have tried periodically over the years to make sure that as to the consideration of every major bill we talk about the staff and what they have done. So I want to take a couple minutes and identify people with whom I have worked. This not an inclusive list. There are many more people who work for individual Senators who have done outstanding work. Our floor staff here, both on the majority side and the minority side, do a remarkable job and have great patience with all of us. I am very grateful to them, as well as for the jobs they perform. I want to take a few minutes and recognize the people I have worked very closely with over the last--well, intensely--over the last almost year now on this issue. Certainly in Senator Reid's office, the majority leader's office, Kate Leone, Carolyn Gluck, Jacqueline Lampert and Randy Devalk deserve a great deal of credit. All of us know them and how much they have been involved in this issue. And for those of us who serve in our caucus, we have listened to Kate Leone on numerous occasions go over the details of these bills, answer the questions Members have raised about the importance of the legislation. So to the members of Senator Reid's staff--and, obviously, there are a lot more people in his office who deserve recognition--but I want to particularly recognize these four individuals with whom we have worked very closely. Senator Kennedy, as we all know, was such a lion of this institution and cared so deeply about this issue. Over the years, he attracted some wonderful people to work with him, as he fought year in and year out to bring us to the moment we are about to enjoy; and that is, to see some national health care legislation adopted for the very first time. Michael Myers had worked on this issue for a number of years for Senator Kennedy, and still is here working with Senator Harkin now as part of the Health, Education, Labor, and Pensions Committee. Mark Childress, again, worked for the majority leader, worked for Tom Daschle, has worked for others in this body, and has just done a fantastic job. He stayed on at my request and the request of Leader Reid to help us work on this issue. He was involved with the White House as well, and really understood the substance of this bill as well as the political navigation that was necessary to bring us to this moment. I thank Pam Smith as well for her fine work for Senator Harkin. Jenelle Krishnamoorthy made a wonderful contribution. She worked closely with Senator Harkin, and I want to thank her. Connie Garner was responsible, for many years, working on the CLASS Act, which is a part of our bill. Portia Wu and David Bowen did a remarkable job. John McDonough and Topher Spiro, as well, are individuals who certainly made a significant contribution to our product her. Senator Baucus's staff: Liz Fowler, Bill Dauster, Russ Sullivan, Cathy Koch, Yvette Fontenot, David Schwartz, Neleen Eisinger, Chris Dawe, Shawn Bishop, and Kelly Whitener--I want to thank them for their efforts as well. Again, we could give separate remarks about each of these individuals and their contributions. In my office, again, like others, I have been blessed with some wonderful people. Jim Fenton is my legislative director and has done a terrific job. Tamar Magarik Haro, who is sitting with me on the floor this evening--I know we are not supposed to recognize people other than Members--along with Jeremy Sharp, they have just done a wonderful, wonderful job, and I know all of my colleagues have gotten to know both of them because of their work. Monica Feit, Joe Caldwell, Bryan DeAngelis, Andy Barr, Lia Lopez, Daniel Barlava, and Rachael Holt all have made wonderful contributions as well. Senate legislative counsel, with special thanks to Bill Baird, who was present throughout the entire HELP Committee consideration, has gone way above and beyond. And legislative counsel never gets the kind of recognition they deserve. They do a tremendous job in drafting the actual legislation. Once these ideas are developed, then they require legislative language to be written. From the administration, Nancy Ann DeParle, whom all of us have gotten to know very well; Jeanne Lambrew--I want to give a special thanks to Jeanne. She has been just incredible in terms of her encyclopedic knowledge of the issues, working very closely with our staffs. Again, individuals who may not be well known to the public, but when this bill becomes law, these are the individuals who deserve special credit for their tremendous work. Mike Hash, Lauren Aronson, Secretary Sebelius, Kathleen Sebelius, who left the governorship of Kansas to come here to be head of the Health and Human Services agency and has done a magnificent job in her new capacity; Jim Messina, who worked with Max Baucus for years up here and has been the Deputy Chief of Staff at the White House and has done a tremendous job. Phil Schilliro and Shawn Maher both worked to represent the administration and their Legislative Affairs Office and they do a great job; Dana Singiser as well, for her work. We will make this list available for the Record. I wanted to thank these individuals again for their fine work. I wish to speak, if I can today, not in my capacity as a senior member of the Health, Education, Labor, and Pensions Committee nor in my capacity as one of the coauthors of the underlying legislation, but rather in my capacity, as I said at the outset, as a Senator representing 3.5 million residents of the State of Connecticut. Our neighboring State, my good friend and colleague, the Senator from New Hampshire, the Presiding Officer, represents New England. If you travel my State, you will meet some of the world's most talented and dedicated health care professionals. You will tour some of the Nation's finest hospitals where patients get world-class treatment. But you will also hear some heartbreaking stories from people in my State who come from middle-class families who have lost everything-- their homes, their life's savings, their hope for the future--just because someone in their family got sick. They needed special care. You will meet hard-working men and women who have seen their insurance premiums skyrocket over the last decade from around $6,000 for a family of four to over $12,000 annually for that same family, and they wonder how much longer they will be able to continue to afford the coverage they have. You will meet small business owners facing an impossible choice between cutting off health care benefits to their employees or laying off those workers. I have talked specifically about constituents of mine, small businesspeople who literally have been faced with that choice or who have had employees who dreaded having to leave the job they had because there were no health care benefits. They took reductions in pay because they just couldn't stay given the health conditions of their family. Having to leave a job they had for 20 years or more to find new work where there was health care coverage; leaving a job they loved for less pay because they weren't able to get that health care coverage--not because their employer didn't want to give it to them but because that small employer just could not afford to do so and stay in business. Even those who are healthy in my State, who have insurance, there is that worry as well. What I have described is not an irrational fear they have that someone in their family will lose their job that provides the coverage as I just described, worrying about that child who may develop an illness not covered by their policies, or worrying about no matter how much they pay in premiums their insurance doesn't allow them to be sure of anything at all. The residents of my State understand the status quo is no longer sustainable because the so-called status quo threatens the basic economic security of every family in my State, as it does across this country. They and their fellow Americans in all 50 States sent us here to take action, and it is action that we shall take. When this bill becomes law, the people of my State will begin to reap the benefits right away. One in four of my constituents have high blood pressure. One in four teens suffers from diabetes in Connecticut. Today, insurance companies can use these preexisting conditions, along with many others, as an excuse to deny these people coverage. Immediately, young people in our State and across the country will be protected against these preexisting conditions to receive the coverage they need. Beginning 90 days after this bill becomes law, every uninsured resident of my State who has been denied coverage because of a preexisting condition will be able to find the affordable coverage they need to treat that condition. Small businesses make up more than three and four businesses in the State of Connecticut, but today only one-half of them are able to offer health benefits to their workers. Beginning in 2010, next year, some 37,000 small businesses in my State, as well as others across the nation, will be eligible for tax credits to make those benefits more affordable. A 50-percent tax break, $40 billion in this bill, is provided specifically for that purpose: to assist the 37,000 small businesses in Connecticut, and others across the country, to get a tax credit, as much as 50 percent, to allow them to defer or reduce the cost of health insurance for their employees. Small business owners throughout Connecticut have experienced persistent annual increases in premiums. In recent years--and this is true across the country, but certainly true in my State--it is not uncommon for small business owners to be told they have to pay 20 percent or more for the same insurance they had the previous year. So the bill we are about to pass will empower the State insurance exchanges such as the one we will have in Connecticut in 2014 to deny insurers access to the exchange if they engage in consumer price gouging in the next few years. That is going to be critically important. For the more than half million seniors in Connecticut, this bill protects Medicare, keeping it solid into the future. Nearly 100,000 seniors in my State hit what is called the doughnut hole in the prescription drug benefit area, costing them an average of more than $4,000 annually. This bill we are about to adopt takes the first critical step toward closing that doughnut hole, and Connecticut seniors should know that I and Chairman Baucus, along with majority leader Harry Reid, have committed to completing that job in conference, and we will do so. Meanwhile, in Connecticut, seniors will see their Medicare premiums go down. They will see major improvements in the quality of care they receive, resulting in as many as 29,000 hospital readmissions being prevented. In my State of Connecticut, 3 in 10 Connecticut residents have not had a colorectal cancer screening. One in six women over the age of 50 have not had a mammogram in the past 2 years. These are important screenings. They and other wellness programs will be provided at no cost to people in my State as well as others across the country. Beginning in 2011, seniors will be able to get a free annual checkup so they can stay well instead of simply receiving care when they get sick. That annual free checkup can make such a difference. I am a living example of that where--because under our health care plan, I can have a free medical checkup once a year. As a result of that, I discovered that I had prostate cancer, and what a difference that made to be able to discover that, to get through the surgery, and to know that I have a bright future ahead of me, not one that I would discover later on when the kind of surgery I received might have been worthless and pointless. So these are the kinds of annual physicals Members of Congress get under our health care plans, and our fellow citizens ought to be able to as well, particularly our seniors. In addition, there are some 255,000 Connecticut residents between the ages of 55 and 64 who will need home health services after they turn 65 because of an illness or an injury. These services, whether they involve installing a handicap shower or hiring a home health care aide, will help these older Americans live in their homes in dignity and with independence. But today these services are not always covered by Medicare or private insurance. Rather than having to impoverish themselves so they can qualify for Medicaid by transferring all of their wealth and assets to a family member or rely on the full-time help of loved ones, these seniors will be able to take advantage of a new voluntary program called the CLASS Act--authored by Senator Kennedy years ago and which is now a part of this bill--that will provide a cash benefit to be used on these services and supports, totally paid for by the individual themselves. Not a nickel, not a penny of Federal money is in that program. It is totally based on the contribution that people make to that program. So when I hear people talk about this as if it was some great robbery from the Federal Treasury, it doesn't involve the Federal Treasury at all. As the bill takes effect, the health insurance exchanges are set up and health insurance will become a buyer's market for people in my State as well. More than 350,000 Connecticut residents who today do not have insurance will finally have affordable options to choose from. Nearly a quarter of a million people in my State would be eligible for premium credits to help take care of the cost of insurance. That doesn't go into effect until 2014, but in 2010, next year, insurance companies will be prohibited from imposing lifetime caps on the amount of care you can receive. Insurance companies will be prohibited next year from taking away your coverage, and they will be prohibited from discriminating based on gender or income in the year 2014. The insurance industry will be forced to spend more of your premium dollars on your health care, not on bureaucrats hired to come up with reasons to deny you the care you need. This is called the so-called medical loss ratios which require that resources be spent on patient care and needs of the policyholder rather than on profits or administrative costs. The industry will also be required to offer an appeal if your claim is denied, and each State will set up its own independent appeals process to keep the industry honest. Next year the industry will be forced to provide more details about their policies so that you can shop for health insurance the same way you shop for anything else, armed with enough information to be a smart consumer. All of these insurance items will take effect at least by 2014, many of them next year, as I have just mentioned. It is not just consumers who will benefit. Connecticut's 15,000 physicians will also benefit. Today these physicians spend, on average, 140 hours and $68,000 every year just dealing with bureaucrats at the health insurance companies. Let me repeat that: 140 hours and roughly $68,000 every year just dealing with bureaucrats at the insurance companies. That is 2.1 million hours and $1 billion in costs overall, time and money wasted in my State alone. That is going to end. This bill cuts down on bureaucratic redtape and needless paperwork. Doctors will be able to spend their time caring for patients, not fighting with the insurance industry. Meanwhile, more than 5,000 Connecticut primary care physicians will qualify for the new 5- to 10- percent payment bonus. That happens next year in 2010. New programs will incentivize many more young doctors to stay in primary care, which we all know is critically important. Today, 9 percent of Connecticut residents can't access a primary care physician because there aren't enough doctors to go around. This bill makes an investment in our medical workforce and a $10 billion investment in community health centers and the National Health Service Corps, which begins taking effect immediately in 2010. It will be phased in over 5 years. That is going to expand dramatically the availability of patient care with our community health care system. As more uninsured people gain coverage, Connecticut will no longer have to subsidize the $383 million it spends in uncompensated care our providers deliver each year--important at a time when my State is already, like every State--almost every State--in serious budget trouble. I have just recited a long list of statistics showing how my State will benefit from this bill--in many instances, benefit immediately. Some will take a little longer, but many of these provisions go into effect in the next year. More important than any statistic will be what you will see when you tour my State, or any other State for that matter, after this bill takes effect--or more accurately, what you will not see. You will not see 100 people losing their insurance, their health insurance every single day, finding themselves cast into uncertainty and fear--100 people every day--that will no longer be the case. You will not see families paying an extra $1,100 a year in health insurance premiums, the so-called hidden tax paid by everyone with insurance as a result of the nearly 50 million uninsured Americans. You will not see seniors facing the loss of their Medicare benefits because overpayments to private insurance companies have rendered the program insolvent. You will not see parents laying awake at night praying that their child's cough goes away because they can't afford to take him or her to see a doctor. You will not see people losing their homes, their life's savings, losing their economic security, all because they got sick or a child or a spouse did. You will not see people dying, as 45,000 do every year in our country, because they couldn't afford access to the health care system. So as a senior member of the Health, Education, Labor and Pensions Committee, and a close and dear friend of our departed colleague, Senator Ted Kennedy, who led this fight for so long, it will be my honor--a deep honor indeed, one of the highest honors I would have had in the 30 years I have served here--to cast a vote in favor of this landmark legislation. As one of two Senators whose job it is to look out for the people of my home State of Connecticut, supporting this bill is nothing short of my duty, and I intend to fulfill it with great pride at 8 a.m. on Christmas Eve. What better gift could I give to my folks at home than to cast my vote as 1 of 100 in this body for health care reform in our Nation, so long overdue, so long waited for. And on this Christmas Eve it will become an accomplished feat of the U.S. Senate. With that, I yield the floor and note the absence of a quorum.

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

Mr. DODD. Mr. President, there were a number of other people I wished to mention. I will not go through the list of all the staff involved in this effort in the Senate. I am sure I would miss some people. It is a lengthy list of those who played such an important role. I was fearful I wouldn't have a chance between now and the actual vote on Thursday morning, Christmas Eve, to express my deep gratitude as one Member who benefited tremendously from the participation of my staff, two of whom are seated with me this evening. I know that is probably a violation of Senate rules to recognize them, but I want my constituents at home and the American public to know how many dedicated people there are whose names they never know, faces they will never see. I ask unanimous consent that a list of staff be printed in the Record.

Mr. DODD. Mr. President, let me say this to the minority staff as well. While we have disagreed, and while they didn't vote for the bill, there are people I admire immensely on the minority staff. On our committee, there were wonderful suggestions and contributions that came from the Republican side of the aisle. While they didn't support the bill, I think they made it a better bill because of their contributions. I want to add their names as well. Mike Enzi of Wyoming, the ranking member--and I worked with every Republican minority member of the HELP Committee--offered amendments that were included. While they may not want to admit it or acknowledge it, they made a contribution to this bill that makes it stronger and a better piece of legislation. I add their names as well for their efforts.

Mr. DODD

Mr. DODD. Mr. President, I ask unanimous consent that the Senate proceed to a period of morning business, with Senators permitted to speak therein for up to 10 minutes each.

Mr. DODD

Mr. DODD. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of H.R. 4284, received from the House and at the desk.

Mr. DODD. Mr. President, I ask unanimous consent that the bill be read the third time, passed, the motion to reconsider be laid upon the table, and that any statements on the bill be printed in the Record, with no intervening action.

Mr. DODD

Mr. DODD. Mr. President, I ask unanimous consent that the Committee on Armed Services be discharged from further consideration and the Senate now proceed to H. Con. Res. 206.

Mr. DODD. Mr. President, I ask unanimous consent that the resolution be agreed to, the preamble be agreed to, and the motion to reconsider be laid upon the table.

Mr. DODD

Mr. DODD. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of S. Res. 386, submitted earlier today.

Mr. DODD. Mr. President, I ask unanimous consent that the resolution be agreed to, the preamble be agreed to, the motions to reconsider be laid upon the table, with no intervening action or debate, and that any statements related to the resolution be printed in the Record.

Mr. DODD

Mr. DODD. Mr. President, I yield the floor.

Mr. DODD

Mr. DODD. Mr. President, I wish to take a few minutes in closing, if I may. I spoke earlier this evening about the importance of the moment we have all come to appreciate, I believe, a moment that has been years in the making, dating back, as all have pointed out or most have pointed out who spoke in favor of this legislation, to the early part of the last century with Theodore Roosevelt, a former Republican, who first advocated the notion of a national health care system in our Nation. Franklin Roosevelt picked up that challenge, and Harry Truman, of course, was the one who articulated it in specific terms. It was 69 years ago this very month that Franklin Roosevelt identified the four freedoms: freedom of religion, freedom of speech, the freedom from want, and the freedom from fear. It is that last freedom that Franklin Roosevelt talked about in December of 1941 that is deserving of our attention in these closing minutes. Whatever else one may argue about the specifics of this bill, it is that fear that so many of our fellow citizens have over whether they will be confronted with a health care crisis and have the resources to address it and the ability to have a doctor, a physician, a health care provider, a hospital to provide them with that kind of help when they need it. That fear is not just for those without health care; it is even for those who have health care insurance. That fear persists. This evening, more than anything else, beyond the specifics of the legislation in front of us is our desire to address that freedom from fear that was addressed so eloquently almost 70 years ago. So this evening we attempt, anyway, to begin that journey of eliminating those fears so many of our fellow citizens have over the loss or inability to acquire that kind of health insurance or the inability to have a doctor. So we are poised to make a monumental vote on legislation that finally makes access to quality health care a right for every American. If you do not believe it is a right, that it is only a privilege, then I suppose you could come to a different conclusion. And there are those, I guess, who believe it is a privilege to have access to health care as an American citizen. Those of us on this side of the aisle believe it is a right, and as a right, you ought not to be denied that right based on economic circumstances, your gender, or your ethnicity in this Nation. You ought to have access to health care as a fundamental right in our Nation. Obviously, we need to participate, engage in responsible activities that will make sure we contribute to the well-being of all our Nation to reduce the cost of health care. This is a comprehensive bill. It has been more than just a year specifically on this effort but goes back 40 or 50 years in terms of drafting, and efforts have been made to achieve what we are trying to achieve this evening. At the end of the day, however, this legislation is really about freedom from fear, as I said a moment ago. The bill frees Americans from the fear that if they lose their job, they will never find insurance coverage again. The bill frees Americans from the fear that they might get sick and be unable to afford the treatment they need. And the bill frees Americans from the fear that one illness, one accident could cost them everything they built--their homes, their retirement, their life savings. In a nation founded on freedom and sustained by unimaginable prosperity, as I mentioned before, this bill is long overdue and critically important. No American can be free from fear when getting sick could mean going broke. This fight is older than most of us who serve in this body. Our path has been illuminated by a torch lit years ago in the days of Harry Truman and sustained for decades by good people, Republicans and Democrats--the Nixon administration, the Clinton administration, Members such as John Chafee, who worked tirelessly in trying to craft a good health care bill. We heard others talk about the regrets they had not acknowledging his ideas when he proposed them or we might have been able to address this issue years ago. Good people have tried to come up with some answers to this issue. It is with a note of sadness this evening that we are going to have a partisan vote on this matter. I wish it was otherwise. I would like to point out that many of us have fought and challenged us to come up with these answers, but tonight this is our answer, the 60 of us who will vote to go forward with this bill. As Senator Harkin just pointed out, it is hardly the final answer on this matter, but it allows us to begin that process of addressing these issues in a more thoughtful and comprehensive way in the years ahead. Of course, no one was a better champion of all of this, as Senator Harkin pointed out, than our deceased and beloved colleague from Massachusetts, Senator Ted Kennedy. He fought these battles for so many years. He understood that you could never solve all of these issues in one fell swoop. It was going to take an incremental approach to get us there. I can guarantee that if he read this bill, there would be disappointments he would have in it. I knew him well enough to say that this evening. If he had written it on his own, he would have written it differently. Were he here among us this evening, he would urge all of us to move forward on this bill to address it, to vote for it, to allow this Nation to begin to grapple with this issue that should have been solved more than 50 years ago. So this evening, again, as we come down to the final minutes of this debate, let's remind ourselves that history will judge us well for taking up this challenge once again and asking ourselves to give Americans the opportunity to live free from those fears they have this very evening. And tonight, we begin to alleviate those fears. I urge my colleagues to support this effort. I yield the floor.

Mr. DODD

Mr. DODD. Mr. President, before he leaves the floor, let me commend our colleague from Massachusetts, Paul Kirk, who has only been with us a brief amount of time under circumstances he has said on numerous occasions over the last several weeks he would much prefer to have avoided. I commend him. Many of my colleagues know that Paul Kirk is no stranger to this institution, having worked as a member of the staff in Senator Kennedy's office for many years. He has had a distinguished career in his own right in Boston. We welcome him here under those very sad circumstances. But his remarks this evening are evidence of the value he has placed in coming to this Chamber and filling a gap here and articulating a view our colleague from Massachusetts would be expressing were he here these days and tonight. Said so well, if it has not been printed in the Record, I ask unanimous consent to have printed in the Record an editorial piece written by Senator Kennedy's wife Vicki Kennedy.

Mr. DODD. Mr. President, she said it very well, as Senator Kirk has, that this is far from a perfect bill. We all know that. It is far from a finished product in terms of health care. The Presiding Officer spent a good part of his career as well working on this issue and would be the first to acknowledge as well that we have a lot more work to be done. Congresses long after all of us who serve in this Chamber are gone will be grappling with the issue of how we can better deliver health care services, create greater access, and reduce the cost of health care while extending quality of life for our fellow citizens and removing the fear so many families feel when they discover that a loved one--a child, particularly--is suffering from some illness or disease that requires attention and yet to be informed that the costs of providing that attention, that care is so prohibitive that they cannot afford to do it and wondering why they, because they lack the economic circumstances, cannot take as good care of their children as someone with access to greater economic power can. That is what we are trying to achieve, to create that availability. I don't know anybody who disagrees with the statement that health care in America ought to be a right, not a privilege. And if it is a right-- then, just as other rights are extended to every citizen regardless of their economic circumstances, their ethnicity, their background, their gender, certainly this right ought to be no different in that regard and available to all of our fellow citizens regardless of their financial circumstances. That is what we are starting to do here. It does not achieve that goal perfectly, but it puts us on that path to achieving that equity, that ability for families and individuals to take care of themselves and their families when afflicted by a medical crisis or medical problem. Having been deeply involved in this issue now for not quite a year but almost a year, since it became very difficult for my friend and colleague from Massachusetts to conduct the kind of daily and hourly efforts he would have been involved in but for his health condition, we have come to a moment now to decide whether we go forward, whether we accept the responsibility as being Members of this body to do the best we can when trying to design something written by 100 people, not to mention 435 in the other body, not to mention an administration and all of their interests, not to mention all of the stakeholders who are involved in health care, which is so voluminous that it would be impossible, even in the time remaining this evening, to mention everyone who has a stake in the outcome of this discussion. Taking all of those elements and trying to bring them together to fashion an ideal or set of ideas to go forward has defied, as I have said on so many occasions in this Chamber over the past number of months, has defied every administration and every Congress since this first challenge was posed by--well, going back to the days of Theodore Roosevelt but more recently since the time of Harry Truman. Every Congress, Republican and Democratic, every President, Democratic and Republican, has at least thought about doing this. Some have actually tried. President Nixon actually tried. President Clinton actually tried to come forward. Those who remember those days, for a variety of reasons, some that seem more clear today than the hour they were being debated, those efforts failed. We are now that third administration, that third effort that has come this far, if you will. My hope is that this evening and in the ensuing few days, we will complete our task in this body and continue the effort by working with the House of Representatives to fashion a final product for the signature of the President of the United States to allow us to begin what will be a long journey to make sure that right of health care is available to all of our citizens. Many of us here may never see the benefits of that just because of life expectancy, I suppose. But to know you are leaving a health care system in place for the coming generation where they can look back on these wintry days in the Senate and be reminded that there was a Congress at the outset of the 21st century willing to face up to the challenges, with all of the accusations, all of the barbs, all of the ad hominem arguments hurled at people, and make an effort to correct a wrong, to right a wrong, to make a difference and improve the quality of life for all of our fellow citizens--that is something I hope coming generations will recognize as a result of the efforts we have made here. Let me take a few minutes to wrap up this part of the debate with my views as to where we stand at this hour. When this body began the process of writing health care reform over a year ago, we knew it would represent a mammoth undertaking, and we knew it would get more difficult as we got closer to the goal line, as every major effort I have been involved in for three decades here has certainly evidenced. As you get closer to the goal line of major undertakings, it gets harder and harder to cross that finish line. This issue involves one-sixth of our economy, affects 100 percent of our fellow citizens, and has been the center of American public policy debate since before many of us were even born. Our path has been long and winding and has been difficult. It has been illuminated by a torch lit long ago in the days of Harry Truman and those who even preceded him and sustained for decades by very good people--Democrats, Republicans, and others--who believe that in a nation founded on freedom and sustained by unimaginable prosperity, no one--no one--in our country ought to have to go to sleep on a night such as this feeling that if they get sick or a loved one does, they will go broke or, worse, be unable to afford the care they or that loved one needs to get well. As I said so many times before, the person who carried this torch as long and proudly as anyone since this debate began so many years ago is not here with us tonight, but he is here in spirit and good conscience. I speak, of course, of our colleague from Massachusetts, Ted Kennedy. He never expected that he or we would cure all our ills in one fell swoop, in one massive bill that would, once and for all, right this problem of health care. Progress, he would argue, is hard, and the simple mathematics of the Senate make it harder all the time. I know our Republican leadership has basically advised their fellow members of their caucus not to vote for this bill no matter what is in it. I regret that. I think it is a sad moment but one with which we have to grapple. We cannot quit because of that political conclusion. We have to move forward. In fact, they went so far as to write a playbook for how to disrupt, delay, and obstruct progress on this issue. I know they do not like the bill and many parts of it. I also know many of them like many parts of this bill, and they acknowledge that when they talk about greater access, cost reductions, and the quality of health care. As one who conducted the hearings and the markup on health care over the last year, I heard over and over that members of that committee, Republicans and Democrats, speak of the very same goals we all seek with health care reform. I know, as a matter of fact, that many of them wrote major provisions of this bill. This bill is not devoid of the involvement and participation of members of the minority party this evening as we come close to voting on a final choice. But I regret it has come to that. I think our best efforts do emerge when we work together as citizens of this great country, regardless of the political labels we bear. My hope will be in the coming days that those doors may open and participation may, in fact, flow and we will end up with a product coming back from conference that is even stronger than the one we are being asked to make a decision on this evening. Someday we will look back on this moment in our Nation's history, and many of those not part of this decision will wish they stood in the arena instead of lobbing rhetorical grenades and cheap shots at a bill that deserves so much better. There is still time for my colleagues to stand and do what is right. I hope they will before the process is over. As it is, our caucus had to work at finding compromise language we could all stand behind, and we have tried to do that over these days. The resulting bill is not one that any one of us would have written on our own given that opportunity. And that goes for me as well, as I know it does the Presiding Officer. We have fought for a strong public option in our committee. I fought to have it included in the bill the majority leader brought to the floor, and I would have happily been fighting for it even today given that opportunity. But as I have said, it is always easier to envision the legislation you want than to pass the legislation we can get. Our country badly needs this legislation, even as imperfect as it may be in some aspects. The preferred outcome of our Republican friends we have in the Senate--deadlock within our caucus and a resulting failure to pass a reform bill--will result in more family bankruptcies, more deficits, and, sadly, more deaths that could have been prevented if everyone had access to decent health care. We do not have to let that happen. In fact, we will not let that happen. We have to be better than that. Yesterday, the majority leader offered a managers' amendment to the original Patient Protection and Affordable Care Act which we have been debating since prior to Thanksgiving. It toughens accountability policies for insurance companies, requiring them to spend more on health care and less on administrative costs and profits, holding them accountable for jacking up premiums, and prohibiting them from excluding coverage of preexisting conditions for children, effective immediately. It provides American families with more health care choices, guaranteeing that in addition to a variety of private sector options, families can choose from at least two national plans similar to the ones we receive right here in the Senate, one of which will be a not- for-profit plan. It strengthens affordability provisions in the bill, starting a tax credit for small businesses in 2010, giving families more information to shop for better deals, and helping to spread cost-saving innovations across the country. It builds on the bill's protections for seniors, children, rural communities, and other vulnerable populations. It preserves the bill's core commitments that no American should go broke because they get sick and no American should die because they cannot afford the care they need to get well. After more than a year of legislating and more than 60 years of hard work on the part of advocates across the Nation, we have an unprecedented opportunity, both later this evening as well as the remaining days of this week. We are standing on the floor of the Senate with a chance to pass legislation that puts our focus on preventing disease, not just treating it, a bill that insures those 31 million of our fellow citizens who today lack any health insurance at all, a bill that guarantees every American access to quality health care at a lower cost. Senator Ted Kennedy always believed we would someday have this chance, and I think he knew this year might be the best and for our generation the last chance. These opportunities do not come around very often. We fought for reform in the 1970s and failed. We fought for health care reform in the 1990s and failed as well. If we fail this time, if we let partisanship triumph over progress, if we lose sight of the goal in the face of political gamesmanship, we who stand here today may never get that other chance. We came here to make this country a better place. I believe every person who serves here believes they came to the Senate to make our country a stronger and a better place. We have before us a bill that saves lives, lowers costs, and frees tens of millions of our fellow Americans from the fear that grips them, as I address this Chamber on this evening. Let's do our jobs. Let's pass this bill. Let's make America stronger and a better place because this Congress and this administration rose to the challenge to grapple with a magnificent issue that deserves our attention and our support. I urge our colleagues to support this bill. I yield the floor.

Mr. DODD

Mr. DODD. Madam President, I wish to resume the conversation about the pending health care proposal. We have had a lot of talk, going back for 60 years, I guess, about health care. But in the last year, if we tried to calculate the number of times there have been meetings and conversations, not including the ones that occur here on the floor of the Senate but throughout the Capitol, both in the other body as well as here, between Members and staffs, it has been voluminous, to put it mildly. We are coming down to what appears to be the remaining few hours before we will decide as a nation whether to move forward or to leave things as they are with the hope that one way or the other things may correct themselves in terms of the cost, affordability, and quality of health care. So the next few days of debates could largely determine whether, once again, the Congress of the United States, Democrats and Republicans, as well as the administration and all of the others who have grappled with this issue now for many months, will succumb to what has afflicted every other Congress and every other administration and every other group of people since the 1940s. That is our inability to answer the question of whether we can do what almost every other competitor nation of ours around the world did decades ago--provide decent, affordable health care for our fellow citizens. If nothing else, this debate has proven how complex this issue is and it has demonstrated the wide variety of viewpoints that exist among those not only in this very Chamber but among people across the country. Certainly, that was evident during this summer's townhall meetings. I held four of them in my State earlier this year. I know most of my colleagues either did telemeetings or conducted them in their respective States. Because this issue affects one-sixth of our economy and 100 percent of our constituents, not only those here today but obviously the millions yet to come, our debates have been spirited and our disagreements at times emotionally charged, not only here in this Chamber but across the country. So to my Democratic colleagues who still have concerns over aspects of the legislation, as all of us do; to any of my Republican colleagues who still desire to put people, as I know they do, ahead of partisanship; and to my fellow Americans who worry that politics will once again triumph over progress, which it has for six decades, let me offer some context for the debate that begins again this afternoon and will arrive at a closure in a matter of hours and days. The answer ultimately will be whether we move forward and do what I think the majority of our fellow citizens want us to do or fall back, once again, into the same paralysis that affected Congresses, administrations, and generations before us. The consensus we have already reached as a Senate is that health care reform would represent a significant victory for the American people--I think we all agree on that point--and it would be a significant moment in our Nation's history. I think all of us can agree that insurance companies should not be allowed to deny coverage because of a preexisting condition, that these same companies shouldn't be able to ration the benefits a family receives, and that citizens of the United States should be guaranteed that the coverage they pay for will be there for them when they need it. I think all of us in this Chamber, regardless of party or ideology, agree that reform should make insurance more affordable; that it should protect Medicare and keep it solvent so that it will be there for future generations; and that it should improve the quality of health care for all Americans, focusing on preventing diseases, reducing medical errors, and eliminating waste from our system so that our health care dollars are used more effectively. I think all of us can agree as well, regardless of which side of this debate one is on, that reform should empower families to make good decisions about purchasing insurance; empower small businesses to create jobs; empower doctors to care for their patients instead of filling out paperwork; and empower the sick to focus on fighting their illnesses instead of fighting their insurance companies. These are the commonsense reforms that will make insurance a buyer's market, keep Americans healthier, and save families and the government an awful lot of money in the years ahead. I think all of us share these views--at least that is what I have heard in the last year I have been so intensely involved in this debate and formulating the policy that is now before us. If we listen to the distinguished minority leader, our good friend from Kentucky, we might be surprised to learn that his conference has decided to not just oppose our legislation but, unfortunately, to obstruct even further progress. After all, he called for a reform bill that incentivizes workplace wellness, allows people to purchase insurance across State lines, and reduces costs. Our bill does all three things. Let me be specific. On page 80, our bill includes a bipartisan proposal allowing employers to offer larger incentives for workplace wellness programs. On page 219 of our bill, it includes a Republican proposal allowing health plans to be sold across State lines. On page 1 of the Congressional Budget Office analysis of this bill, the Congressional Budget Office concludes that our bill would cut the deficit of our Nation by $130 billion over the next 10 years--the single largest budget deficit reduction since 1997. In a body of 100, as we are, in which both parties claim to agree on these principles, we should be able to achieve, one would think, a bipartisan consensus on a matter of this magnitude. But, sadly, it would seem our colleagues--many of them, again, on the other side of this divide--don't seem to care what is in this bill specifically. I am reminded again, as others have been, of what is actually included in this bill--not that I would expect them or anyone on this side of the divide to agree with everything that is here. We don't. There is not a single Member of this body who would not write this bill differently if he or she could. There is no doubt in my mind whatsoever about that. But we serve in a collegial body of 100 where we have to come to consensus with each other even when we don't agree with every single aspect of this bill. Yet, when I read the words of the chairman of the Republican National Committee--and again speaking on behalf of a party, this is why I find this so disheartening. At a time such as this, I expect there to be full debate and disagreement over various ideas. But read, if you will, the words of the national chairman of a major political party in this country. Here is what he is suggesting his party ought to be doing at this critical hour: I urge everyone to spend every bit of capital and energy you have to stop this health care reform. The Democrats have accused us of trying to delay, stall, slow down, and stop this bill. They are right. Let's hear that again: The Democrats have accused us of trying to delay, stall, slow down, and stop this bill. They are right. It is awfully difficult to hear my colleagues talk about wanting to get a bill done, wanting to come together, when the chairman of their national party is recommending they do everything in their power to stop a bill that, in fact, includes many of the very reforms they themselves embrace. Make no mistake, if the status quo prevails, one thing I can say with absolute certainty--if we do what too many of our friends on the other side and clearly what the chairman of the Republican National Committee are recommending--I can predict with absolute certainty the outcome, and that is that premiums will go up dramatically, health costs will continue to wreak havoc on small businesses, our deficit will grow exponentially, and Americans will see premiums nearly double in the next 4 years. In my state of Connecticut, a family of four is paying $12,000 a year right now. It is predicted that those premiums will jump to $24,000 within 7 years if we do nothing. That much I can guarantee. For those who argue for the so-called status quo or keeping things where they are, know that more and more people will lose their health insurance. More families will be forced into bankruptcy. Hundreds of thousands of Americans are going to die unnecessarily, in my view, in the name of that obstruction. I don't think we can let that happen. So it has fallen to the majority to do alone the job we are all sent here to do collectively--the hard and honest work of legislating, as difficult as it is. The factors that make this work so hard are not new or unique to this debate, and, as history shows, they will not be what is remembered a generation from now. The words that have been spoken here in this Chamber, the charts, the graphs--all of these things are slowly forgotten by history. Today, we hold Medicare up as an example of a program worth defending. How many speeches have been given in the last 2 or 3 weeks about the glories of Medicare? I only wish those Members who are here today had been present in 1965. We might have been able to pass that bill without the partisan debate that took place in those days. Today, no one talks about the 50 years it took to bring Medicare to the floor of the Senate. No one talks about what the polls said in 1965 when it took a lengthy debate involving more than 500 amendments, by the way, to achieve consensus on Medicare. I might add, nobody attacks it as socialized medicine as they did in 1965. It is always easier to envision the legislation we want than it is to pass legislation we need. Such is the case here this afternoon. We won't end up with a bill that I would have written if it were up to me, and it won't be the bill that any one of our colleagues would have written either.

Mr. DODD. Madam President, I ask unanimous consent for 2 more minutes.

Mr. DODD. But it will be a bill that improves the health care of all Americans. It will be a bill that makes insurance more affordable, improves the quality of care, and helps create jobs in our Nation. It will be a bill that saves money and saves lives. And it will be a bill that decades from now we will remember not for the differences we had in this Chamber but for the differences it made in our Nation and for the differences it made for our fellow citizens. To get there, we must build on the consensus we have already reached, not tear it down with the petty weapons of political gamesmanship. We must answer not the call of today's poll or tomorrow's election but the call of history that we have been asked to meet, that other generations, other Congresses have failed to meet but we are on the brink of achieving. My hope is that all of us will come together in these closing hours and do that which many predicted we could not do: pass legislation that we need. With that, I yield the floor.

Mr. DODD

Mr. DODD. Madam President, I agree with my friend the majority leader that we must close the doughnut hole. I think it is something all of us appreciate. I second his commitment to doing so with this bill that we will send to the President. As most seniors live on modest incomes, we all know it is imperative that they can afford the prescriptions they need. As the majority leader has noted, seniors who have trouble paying for prescription drugs are more likely to skip doses or stop taking their medications altogether which would lead to more serious health problems and higher long-term costs, both for them and our health care system as a whole. In my State of Connecticut, 25 percent, a quarter of all Part D enrollees fall into the doughnut hole. I understand the significance of delivering on the commitment to fixing this problem. We have a responsibility, as all of us can appreciate, to protect and strengthen Medicare and to improve the lives of our seniors. If we fail to act, the doughnut hole, we are told, will continue to grow in size, doubling in less than 10 years. The size of the doughnut hole is directly tied to drug prices, prices that are rising at an alarming rate. Seniors who have spent thousands and thousands of dollars--not including the cost of their premiums--before they get out of the doughnut hole and get the treatments they need cannot afford to wait any longer to close this costly gap. Our historic reform effort must improve the quality and affordability of Medicare. Closing the doughnut hole is a very clear and concrete way to do that. I understand we may not have the opportunity to fix this issue in the Senate bill before it leaves this Chamber, but I want it to be known that I support the idea of closing the doughnut hole in the conference committee that will meet with the other body.

Mr. DODD. Madam President, I would add, that is my full understanding as well.

Mr. DODD

Mr. DODD. Mr. President, I ask unanimous consent that Lia Lopez, an intern in my office, be granted floor privileges for the remainder of consideration of H.R. 3590.

Mr. DODD

Mr. DODD. Mr. President, could I inquire of the Chair before the Senator from North Dakota speaks how much time remains.

Mr. DODD. Mr. President, I was not a party to the request, but I am certainly prepared to yield 10 minutes of our time to our colleagues for a colloquy and whatever time the Republican side may want to yield to Senator Gregg from their time remaining for that purpose as well. Is that satisfactory?

Mr. DODD. Mr. President, I ask unanimous consent that 10 minutes of our time be allocated to Senator Conrad for the purpose of a colloquy or whatever other purpose he may have.