Pete Domenici

Mr. DOMENICI

Mr. DOMENICI. I say to the Senator, Senator Grassley is in charge. I will just wait to see what he says.

Mr. DOMENICI. Mr. President, I understand we have a Senator who is coming over to use that time. Until they do, I will yield that time to Senator Grassley.

Mr. DOMENICI. Sure.

Mr. DOMENICI. Mr. President, today I rise in support of the Medicare Prescription Drug and Modernization Act. I thank the Senate and the House conferees, as well as the leadership of both bodies, for their work over the past few months. Their perseverance has paid off. This bill represents a major step forward for this body on behalf of the seniors of this country. Experts and fair-minded people have known for many years that the Medicare Program must be reformed. For more than 6 years, Republicans have led efforts to overhaul the Medicare system and ensure American seniors continue to have access to high-quality, comprehensive health care in the future. First, a little history. The Budget Act of 1997, when I was chairman of the Budget Committee, created the National Bipartisan Commission on the Future of Medicare. This Commission was created to address the issue of modernization. The Commission supported changes to the program that would have provided an additional prescription drug benefit as well as modernized the Medicare system-- not one without the other, but both. Unfortunately, that Commission failed in part because of lack of support from the previous administration's appointees to address the fundamental problem of the program's design. A majority of the Commission was for it, but we structured it where 60 percent was required, and the President withheld his support after all the work that was done. The point is, clearly even back then we were tying modernization to prescriptions. In 2001, again as chairman of the Budget Committee, the budget resolution provided $300 billion, and we are now up to $400 billion. The budget resolution said $300 billion for prescription drug benefits and it required modernization of the program. It said $300 billion way back then. Don Nickles, as chairman, took it up to $400 billion. It did not say for prescription drugs, it said for prescription drugs and modernization. Why? Because one without the other is never going to work. If you have a prescription drug benefit for the seniors and do nothing to the underlying Medicare Program, you have taken care of one of the problems for a couple of years but you will be back with a bigger problem. That bigger problem is the Medicare system itself. With the great change in demographics this country is going to be experiencing, we will be in big trouble. Medicare beneficiaries have waited too long for prescription drug coverage. I am pleased this year appears to be a breakthrough year. Before we are finished, there will be many Senators we will be able to thank. This will be the year we finally help millions of Medicare beneficiaries obtain affordable prescription drugs. The bill will also provide substantial relief for those with the highest drug costs. It will also provide prescription drug coverage at little or no cost to those with low incomes. When this bill passes, we will be providing seniors with prescription drug coverage for the first time since the program's creation in 1965. Across America, there are still millions of people who do not know that Medicare provides by law not one nickel's worth of prescription benefits. It is not that the benefit is inadequate or that it is written wrong, it just did not provide for a benefit; that need was not contemplated in 1965. It has been hard to get a bill that really has a chance. This bill has a chance. It contains new accounting safeguards that put the program on a stronger financial foundation. The legislation contains preventive care measures, including screening for diabetes and cardiovascular disease. It provides benefits for coordinated care for people with chronic illnesses. None of these benefits was provided under the 1965 act because the need was not contemplated as part of the health delivery system. These benefits are needed today, but they are excluded from the current Medicare system. This is by far the best opportunity, speaking on behalf of my constituents in my home State, that New Mexico has had to get doctors, hospitals, home health care providers, nursing homes, and Medicare beneficiaries fair and equal treatment. Before this bill, each of these groups had been shortchanged by the health care laws of our country. I am particularly pleased this bill contains $25 billion in initiatives aimed at providing health care in rural areas. We can thank Senator Grassley for being so steadfast on that provision. The Finance Committee estimates my home State of New Mexico can expect approximately $140 million over the next 10 years in increased doctor and hospital reimbursements. That is because we are so low. This brings us to parity and fairness. This bill includes $50 million to equalize payments between large urban hospitals and rural and small hospitals, $15 million to increase payments to disproportionate share hospitals, $1 million in payments to critical access hospitals, $50 million in increased payments for doctors, and $3 million in incentive payments to encourage physicians to practice in areas where there are shortages. Beginning in 2006, again for my State, all 250,000 Medicare beneficiaries living in New Mexico will be eligible to get prescription drug coverage through a Medicare-approved plan. This bipartisan agreement will give 55,000 Medicare beneficiaries in New Mexico access to drug coverage they would not otherwise have. Nearly 17,000 of those beneficiaries will qualify for reduced premiums, lower deductibles, coinsurance, and no gap coverage. Unquestionably, these provisions will help improve access to health care and treatment for seniors. We have a great opportunity, fellow Senators, to fulfill our promise to the American people and provide our seniors with high-quality prescription drug benefits. I believe prescription costs will be manageable, even with the baby boom generation that will then be retiring. Some worry about the costs of this bill, but I am confident about the future of American ingenuity and competition, America's science achievements, and America's wellness achievements. As I said this spring when we were debating this bill, we are not living in a stagnant world. American scientists today are reaching for health care breakthroughs linked to the mapping of the human genome. Advances in nanoscience and microtechnology will change medicine and health care as we know it today. However, while that work continues, this long-awaited prescription drug plan is what we need now. I am suggesting when I talk about the future breakthroughs that we may be astonished at how much we are going to be able to do that we cannot do today that may save lives and save money. I encourage my colleagues to put their differences aside today and, most of all, to put their politics aside, and do what is best for the American people. Overwhelmingly, my constituents have contacted me and asked that I support this legislation. Seniors need affordable prescription drugs, and if Congress fails to act this year, it will likely be many more years before beneficiaries are able to access prescription drugs through Medicare. It is for those reasons--all of them; the national reasons and the parochial New Mexico reasons--that I have indicated that lead me to saying I will support this bill. And I hope we do it quickly. Now, we have an additional Senator. Mr. President, how much time do we have left in this block of time?

Mr. DOMENICI

Mr. DOMENICI. Mr. President, I want to make sure that we understand the timing. I asked Senator Craig if he would come to the Senate floor so I could give him some time. I wonder if 5 minutes would be enough. I yield 5 minutes to the Senator.

Mr. DOMENICI. I thank the Chair.

Mr. DOMENICI. And you are going to wait 60 more because there is nobody going to pass another bill like this with these kinds of things in it for a long time. Why do I know that? Because I have been through it. And every time we just about get there, somebody has some objection, and we have a big hole, it all falls in, and nothing gets done.

Mr. DOMENICI. I say to the Senator, thank you for your effort. I appreciate it.

Mr. DOMENICI. How much time do I have remaining?

Mr. DOMENICI. I yield 1 minute to Senator Burns.

Mr. DOMENICI. I yield 3 minutes to the Senator from Wyoming.

Mr. DOMENICI. Yes. I say to the Senator, we are not using your time.

Mr. DOMENICI. Mr. President, I yield myself 30 seconds.

Mr. DOMENICI. Mr. President, I say to the distinguished Senator from Louisiana, I am very pleased I got to know you in the past year and a half. I do not think we would have had a chance to meet each other but for the energy crisis. I visited your State. And everything you have said today, and on the floor time after time, about what is going to happen in your State because of what is happening to the water line is true. We can kill this bill and kill that. You know how long you have been waiting for it.

Mr. DOMENICI. How much time remains on each side?

Mr. DOMENICI. Has Senator Burn's minute expired?

Mr. DOMENICI. Mr. President, first of all, there are a lot of people to thank for getting us where we are. We are a long way from where we started. I want to thank them. In particular, on the Democratic side I thank the distinguished Senator from Louisiana--from the very beginning; thank you very much for all your help and all the others who put a lot of work into this. I regret very much the statements that this bill was done in privacy and secrecy, in some way different in terms of a conference than most conferences around here. But I would like to tell the Senate, energy is a big hole in the Congress. Energy policy is a big hole, and we keep dropping problems in it but we never solve them. Everyone talks about conservation and renewables, but we happen to be talking about those and production. As soon as you start talking about production, somebody produces and they are certainly not nonprofit corporations. So as soon as you say ``produce and we'll give you an incentive,'' you are ``giving money to big companies.'' You are giving it to companies who will do the job and wouldn't otherwise do it. I want to repeat, for everybody, the history. Last year we could not write a bill in committee. Think of that. My good friend, Senator Bingaman, talks about how poorly we conducted ourselves. They couldn't write a bill in committee. So we wrote it on the Senate floor. Do you all remember that? We were down here, humiliated that we had to write an Energy bill on the Senate floor because we couldn't write it in committee. Then what happened? We went to conference with the House. And, boy, if it was ever a storybook conference, it was wide open. And it took month after month, and guess what happened, Senator Burns--zero. Nothing was done. So there is another one, the big hole sucked it up. But we did it right. We had a conference. We had it open. This Senator decided that to do it that way would yield nothing. For the first time I decided that we should write the bill differently and we should circulate it differently. Most of this bill was put on the Internet. In fact, that is the first time in history that a conference report was on the Internet. Anybody who wanted to read this bill had weeks and weeks to read all but the last 15 percent. It was on the Internet. It was delivered to every single office. If you didn't read it, that is not my fault. Then for the last part we gave the opposition 48 hours' notice on the Internet to everybody. Do you know, this bill was more discussed by the press, piece by piece, than any conference report in the history of America? You will never find a conference report that is reported piecemeal in the media of America. So where was the clandestine bill? Everybody knew about it. The problem is, just as before, the Democrats didn't like it. Yet they offered amendments. For not knowing anything about it, the distinguished Democrat leader offered 21 amendments, or at least he had them ready. We discussed them. The fact they didn't win them, does that mean the bill is no good? What would you expect when you go to conference? I heard somebody say we should have passed the 15 or 20 percent mandates for renewables. Yes, we should have. We did in our committee. But what do you know about it, the House said no. Not only ``no,'' but ``absolutely no.'' So what do we do, throw the bill out? Of course not. We have the most powerful renewable provisions in history. I want to tell everybody the true facts. We have worked harder for the farmers of America than anybody in history. The farmers who are looking to see who is for the farmers, once and for all, you can look to the Republicans, not the Democrats; for the Democrats are leading a parade to kill the most important provision ever thought up for the farmers. The Republicans are here, trying to get it done. Senator Grassley stood in a corner with his arms out, put on the armor and said, ``It will be this way or we don't have a bill.'' We got it. And guess what. We are just about to throw it away. If I were the farmers of America, I would ask: Who threw it away? And they are going to all know, the people who killed this bill threw it away. And guess what. Over the last 3 or 4 days, an array of people who build wind energy and solar energy in America walked up to our office. Incidentally, Senator Grassley, before they opened their mouth about the bill, they thanked you because they said all significant wind energy will stop if this bill is not adopted. They didn't say ``tone down; we will come down at half mast.'' They say it stops, because wind energy is predicated upon the credits in this bill, the most significant credits in history; solar energy, the most significant credits in history. Renewables will go faster and farther with this bill than they ever have. But I don't believe you can leave here today having voted, especially if you vote to kill this bill, and walk out and tell people: Oh, don't worry, we will take care of the farmers next week. Next week is not going to come because I am aware of what it is. You will not get this ethanol bill through the House again. So it is gone and there are some people walking around liking that. Some people have a smile on their face. But I tell you there is no way to get this ethanol bill through the House. I can't imagine another format where Senator Grassley can do what he did and we get this issue out of conference and here. Then we have all the other things in this bill that we thought were interesting and good for America. They are all falling by the wayside because, for the first time, people have brought an issue called MTBE to the floor and talked about it. The United States House said we ought to hold harmless the product called MTBE--just the product, not people who spill it, not people who cheat with it, not people who, instead of putting it in cars pour it on somebody's lawn--we didn't protect those. We just said the product is OKed by the Environmental Protection Agency, approved by the U.S. Government, and whether I liked it or not, the House said let's hold them harmless for the product itself. Frankly, I am just beginning to read some stories about the lawsuits on MTBE. In fact, if we had another day at it, I would give you some that would shock you as to what is going on in the United States with these MTBE lawsuits. I can tell you there is one in one State--we got a message on it. Somebody is walking around trying to drum up the lawsuits. It happens to be the chairperson of the bar association of the State. She went to one city that wrote us a letter and said: We told her we are not interested. As far as we know there is no problem in our city with MTBE. Go someplace else and look for your lawsuits. Precisely what I said yesterday--precisely.

Mr. DOMENICI. In addition, if you like blackouts, then you vote to kill this bill because this bill provides a clear, absolute remedy for blackouts.

Mr. DOMENICI. I thank the Chair. I think the majority leader is here. I yield at this time.

Mr. DOMENICI

Mr. DOMENICI. Mr. President, today I recognize the outstanding achievement of a hospital in my home State of New Mexico. Nor-Lea General Hospital, which is located in Lovington, New Mexico, was recently honored as one of the Nation's ``Top 100'' Hospitals by Solucient Corporation, a healthcare information company, in their 10th National Benchmarks for Success study. Nor-Lea was recognized because they have demonstrated superior clinical, operational, and financial performance in overall service. I am proud to recognize Nor-Lea Hospital for its strong commitment to help the community. Too often we hear about hospitals that are struggling; hospitals asserting they can not save money and improve patient services and thus are not able to meet the needs of their communities. Nor-Lea represents the exception. They represent the value of management, not only to save money, but also to improve efficiency. Nor-Lea is demonstrating what kind of performance is possible when this is done and they are setting new targets for performance improvement across the industry. Nor-Lea General Hospital is a 25-bed Medicare-certified facility. Medicare, Medicaid, private insurance and private pay are accepted for services rendered. Nor-Lea General Hospital offers comprehensive outpatient services, which include a state-of-the-art laboratory facility with national lab affiliations, radiology services, MRI, bone densitometry, fluoroscopy, x-ray, ultrasound, and respiratory services. The hospital also has a newly enlarged emergency room which is open 24 hours a day, 7 days a week. Each month about 385 individuals utilize this emergency room. Nor-Lea was recognized as a top performing ``Small Community Hospital'' because of their higher survival rate and because they spend less money, release patients from the hospital faster, and have fewer employees. In short, Nor-Lea treats more of the sickest patients, while maintaining high customer service and preserving profits in a difficult marketplace. Congratulations, Nor-Lea General Hospital. I hope that your success will be a catalyst for continuous hospital performance improvement.

Mr. DOMENICI

Mr. DOMENICI. Mr. President, I ask unanimous consent that the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs be authorized to meet on Thursday, November 20, 2003, at 9 a.m., for a hearing entitled ``U.S. Tax Shelter Industry: The Role of Accountants, Lawyers and Financial Professionals.''

Mr. DOMENICI

Mr. DOMENICI. The Senator can speak after the Senator from California. That is fine. She is right here.

Mr. DOMENICI. And I am going to speak for 20 minutes now.

Mr. DOMENICI. I have no objection, but I would like to add, with that agreement, that the distinguished Senator from the State of Kentucky would like to speak, and he will either speak before the Senator from Vermont, if the quarter of 2 has not yet arrived, or after the Senator from Vermont speaks.

Mr. DOMENICI. That is the junior Senator from Kentucky who is asking for time.