Byron Dorgan

Mr. DORGAN

Mr. DORGAN. Mr. President, Senator Murkowski may wish to add some comments, at which point I believe I will send the managers' package to the desk and ask for its consideration.

Mr. DORGAN. I intend to answer the Senator.

Mr. DORGAN. Following that, I will be happy to yield the floor. As I understand it, the Senator from California wishes to follow the Senator from West Virginia.

Mr. DORGAN. The Senator from West Virginia wants 15 minutes. And the Senator from California wants how much time?

Mr. DORGAN. Mr. President, let me defer on the managers' amendment for a moment, and let us begin with Senator Byrd's request for 15 minutes, followed by Senator Boxer. Then my hope would be that we can come back to this bill. We have amendments pending and it is very important that we finish the bill itself this afternoon. Does Senator Murkowski wish to comment at this point before Senator Byrd takes the floor?

Mr. DORGAN. Mr. President, the announcement by the Senator from West Virginia, chairman of the Appropriations Committee is, I think, good news. It is the case that the Appropriations Committee appropriates a great deal of money, and the question about oversight is very important. The Senator from West Virginia talks about understanding and needing to know how the money is spent, where the money is spent. With nearly three quarters of a trillion dollars having been spent on the wars in Afghanistan and Iraq and the war on terror, there has been so much waste, fraud, and abuse, and there has been too little oversight. The Senator from West Virginia is showing great foresight and courage in saying we are going to provide that oversight. I think the Senate and the American people owe him a debt of gratitude for launching this effort. I say thank you. I know the Senator from California is going to speak. When we finish the request, to be able to share with our colleagues, I may ask her to yield so I might propound a unanimous consent request during her presentation.

Mr. DORGAN. Mr. President, has the Senator from California completed?

Mr. DORGAN. Mr. President, I ask the Senator from California to complete her statement, after which I will be recognized.

Mr. DORGAN. Mr. President, we have been patiently waiting for some hours now. It is pretty unbelievable to watch this process work. The old saying about watching sausages being made or laws being made, it is not a very attractive picture. That certainly is true today on the floor of the Senate. We have legislation we reported out from the Indian Affairs Committee dealing with an obligation that this country has to provide Indian health care. It is an obligation we promised in treaties. It is a trust obligation reaffirmed by our courts, and it has been nearly 10 long years getting to the floor to reauthorize the Indian Health Care Improvement Act. It is not as if anybody is speeding around here. We finally get to the floor of the Senate, we are on the third day, and we have all kinds of amendments that have little to do with Indian health care. We have been standing at parade rest for 3 hours while one of our colleagues has been giving speeches downtown and their staff has indicated they must object to this request. I do not understand the 25 stages of approval required in this Chamber to say hello or goodbye. Perhaps we can find a way to move on the issue that confronts the Senate at this moment, and that is Indian health care. Even as we talk, people die out there because there is full-scale rationing of health care. One part of this legislation that we have worked on is called the managers' package. It is not a typical managers' package we see with other legislation where there are a lot of additions. This managers' package is a requirement we had to try to negotiate about five very difficult and very controversial issues. We had great objections to certain areas of the bill, so Senator Murkowski and I and our staffs worked over the last month to negotiate, and we reached agreement on five or six areas. That agreement was pretty difficult to reach, but we did it with a lot of people on both sides of the aisle. That is what is comprised of this managers' package. Amendment No. 4082 to Amendment No. 3899 Our managers' package is at the desk. I ask unanimous consent that the pending amendment be set aside and that the managers' amendment, which is at the desk, be considered.

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

Mr. DORGAN. Mr. President, about 5 hours ago, we were hoping to send that amendment to the desk and have it considered. We hoped to have a vote on it. What we are waiting for at the moment is the remainder of the unanimous consent request. The remainder of the unanimous consent request I will propound, when we determine who offers levels of approval in the Chamber, will be that we have a vote--the way it is constructed is at 3 o'clock, but that was 25 minutes ago--that we have a vote on two amendments. One will be the managers' amendment I sent to the desk on behalf of myself and Senator Murkowski, bipartisan, I believe, an amendment that does not have objections anywhere in the Chamber because we have resolved those objections, but we will have a recorded vote on that, and then we will have a recorded vote on the amendment that has been offered by Senator Coburn, amendment No. 4034. My hope is that we will be able to propound a unanimous consent request that will be approved in a few minutes, with a couple-minute debate prior to each vote, and then we will have two votes. Our hope is to begin that at 3 o'clock. My hope remains that will be the case. I will not propound the unanimous consent request at the moment because I understand it has not yet been cleared. I understand it has now just been cleared, which is great news. I ask unanimous consent for the following: that the pending amendment, which is the managers' amendment that I just filed on behalf of myself and Senator Murkowski, be set aside and that at 3 p.m. today, the Senate proceed to vote in relation to the amendment, the managers' amendment; that the amendment not be divisible; and that upon disposition of that amendment, the Senate resume the Coburn amendment No. 4034; that there be 2 minutes of debate prior to a vote in relationship to that amendment; and that no amendments be in order to either amendment prior to the vote, with the second vote in sequence 10 minutes in duration.

Mr. DORGAN. Mr. President, for the information of Senators, the vote will begin in about 3 minutes, and we will have two votes in sequence.

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

Mr. DORGAN. Have the yeas and nays been ordered on the Coburn amendment?

Mr. DORGAN. Madam President, I oppose the amendment, as does my colleague Senator Murkowski. Senator Coburn offers some interesting ideas here, but he offers them in the context of saying: We will do some different and additional things with Indian health care, but we will explicitly restrict any additional money that is in the bill itself. That means if you have Indian reservations out in the country someplace, there is an Indian health clinic, and that is the only health care available, I guarantee you they will end up with less money to provide health care to those Indians on those reservations given that restriction in the bill. For that reason I do not support it, but I look forward to working with my colleague from Oklahoma on ideas of this type.

Mr. DORGAN. Madam President, if I might, the Senator from Oklahoma is intending to debate and discuss amendment Nos. 4032 and 4036, and requests recorded votes on both. First of all, I appreciate his cooperation. I understand he is prepared to initiate that debate. What I would like to suggest is whatever time he needs for that debate, we could probably, by consent, with the consent of Senator Murkowski, agree to a time for both those votes. I might ask the Senator, how long would he like to debate both amendments?

Mr. DORGAN. Madam President, would it be satisfactory to the Senator from Oklahoma and Senator Murkowski if we set the two votes on amendment No. 4032 and amendment No. 4036 no later than 4:20?

Mr. DORGAN. Let's make it 4:30, Madam President.

Mr. DORGAN. Madam President, let me talk for a moment about amendment No. 4032, the HIV mandatory testing issue. I support that, I think, at the request of the victim. I think that is a thoughtful amendment and would have accepted it. I understand the Senator wishes a recorded vote. I understand why that is the case. But I do think it is an amendment that has a lot of merit. Amendment No. 4036 With respect to the other amendment, No. 4036, I understand what the Senator is trying to do. I am going to oppose the amendment and vote against the amendment. He is talking about using the funds for essential medical services. Yes, I am all in favor of that. But let me also say that the issue of hospice care and some long-term care issues we have added to this bill--if you visited a hospice care setting, it is pretty hard to take a look at what hospice care is offering dying patients and suggest that is not essential as well. That is a wonderful health care option that is available to many in this country. What we have tried to do in the Indian Health Care Improvement Act is to expand some services. That is correct. The Senator and I talked a little bit about that this morning. But they are in most cases services that many other Americans have available to them that we would hope and expect would be made available to American Indians as well. My colleague and I both described this morning our interest in adequately funding Indian health care. He said--and I agree, and I said earlier--that about 60 percent of Indian health care is delivered to American Indians, and 40 percent is withheld. That means you have full-scale health care rationing going on. It should be front-page, scandalous headlines in this country. It ought to be trumpeting the news in this country. But it is not. There is a giant sleep going on about what is happening to people out there who are living in the shadows, desperately poor, in many cases an hour, an hour and a half, 2 hours away from the nearest large-scale health care clinic, so their opportunity to get health care is through the Indian Health Service, and we are trying very hard to improve that. But I understand the purpose of the amendment offered by the Senator. I would hope, however, when we finish doing what he said he is going to do, and what I said I am going to do, and when we talk about what we are really going to fund this year, that we will have sufficient funds; A, that we will have a system we are proud of, that delivers health care to people who are sick and who were promised health care; and B, to fully fund the services that most people expect would be available to them and their loved ones, and that would include hospice care.

Mr. DORGAN. I am happy to yield.

Mr. DORGAN. A large portion? I don't know that I would agree with that. I don't believe I would at all.

Mr. DORGAN. Madam President, if the Senator would yield on that point just briefly.

Mr. DORGAN. Do you know why in many cases the urban Indians are a population that is exclusive? Because we went through a period of time when we did these zigzags. At one point in this country we said to the Indian community: You know what. Yes, you are on a reservation. Here is a one-way bus ticket. We want you to leave. So we sent them to the cities. Now we promised them health care back on the reservation. Now we say: You have a bus ticket one way. Go to the city. In fact, the budget request this year once again says: By the way, we don't intend to fund any--we don't intend to fund any health care for urban Indians. Well, we should, and I think we will say to the President that we don't agree with that recommendation. But we have done a lot of egregious things in this country, even with respect to preventing Indians the right to vote for the majority of the history of this country. They didn't get the right to vote until about 90 years ago or so.

Mr. DORGAN. Yes, of course.

Mr. DORGAN. Madam President, I support the amendment.