Bill Frist

Mr. FRIST

Mr. FRIST. I ask unanimous consent the concurrent resolution and preamble be agreed to en bloc, any statements be printed in the Record, without any intervening action or debate.

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of H. Con. Res. 475, at the desk, and just received from the House.

Mr. FRIST

Mr. FRIST. Mr. President, I now ask for their second reading, and in order to place the bills on the calendar under provisions of rule XIV, I object to my own request en bloc.

Mr. FRIST. Mr. President, I understand there are three bills at the desk, and I ask for their first reading en bloc.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the bill be read the third time and passed, the motion to reconsider be laid upon the table, and that any statements relating to the bill be printed in the Record.

Mr. FRIST. Mr. President, I ask unanimous consent that the Foreign Relations Committee be discharged from further consideration of H.R. 4654 and the Senate proceed to its immediate consideration.

Mr. FRIST

Mr. FRIST. I ask unanimous consent that the Senate concur in the House amendment, the motion to reconsider be laid upon the table, and any statements relating to the bill be printed in the Record.

Mr. FRIST. Mr. President, I ask unanimous consent the Chair now lay before the Senate the House message to accompany S. 1663. The PRESIDING OFFICER laid before the Senate the following message:

Mr. FRIST

Mr. FRIST. I ask unanimous consent that the resolution and preamble be agreed to en bloc, the motion to reconsider be laid upon the table, without intervening action or debate, and that any statements relating thereto be printed in the Record.

Mr. FRIST. I ask unanimous consent that the Senate proceed to the immediate consideration of S. Res. 438 submitted earlier today by Senators Biden, Hatch, Kohl, and others.

Mr. FRIST

Mr. FRIST. I ask unanimous consent that the resolution and preamble be agreed to en bloc, the motion to reconsider be laid upon the table, without intervening action or debate, and that any statements relating thereto be printed in the Record.

Mr. FRIST. I ask unanimous consent that the Senate proceed to the immediate consideration of S. Res. 439 submitted earlier today by Senators Feingold and Kohl.

Mr. FRIST

Mr. FRIST. I ask unanimous consent that the resolution be agreed to, the preamble be agreed to, the motion to reconsider be laid upon the table, and that any statements relating to this matter be printed in the Record.

Mr. FRIST. I ask unanimous consent that the Senate proceed to the immediate consideration of S. Res. 440, which was submitted earlier today by Senator Hatch.

Mr. FRIST

Mr. FRIST. I ask unanimous consent that there now be a period for morning business with Senators speaking for up to 10 minutes each.

Mr. FRIST

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

Mr. FRIST

Mr. FRIST. Mr. President, part of the scheduling is to do just that, so we can have another amendment fully considered and then yet even another amendment. For planning purposes, 4:30 p.m. seems to be the most appropriate time. We will continue to debate and vote on amendments. Then hopefully by 4:30 p.m., we will be able to schedule additional votes as well. Again, I encourage all Members to come forward now and notify us of their amendments and to work through the managers to offer appropriate amendments.

Mr. FRIST. From our side, because of various commitments, 4:30 p.m. is the best time.

Mr. FRIST. Good. Mr. President, as you can hear, this is a bipartisan effort, with full cooperation back and forth between the managers and the leadership. We felt it was important to restate the sense of efficiency with which we have to address this bill. That is what we would like to see happen. Again, please let us know your amendments in the next several hours. Mr. President, I ask unanimous consent that the vote occur in relation to the pending amendment, that is, the Hutchison amendment No. 3711, at 4:30 p.m. today, with no amendments in order to the amendment prior to the vote; further, that there be 2 minutes equally divided for closing remarks prior to the vote.

Mr. FRIST. I will.

Mr. FRIST. Mr. President, we are making very good progress on this significant bill that does focus on the safety and security of the American people. This morning the Democratic leader and I opened up stressing the importance of making very efficient use of our time on the floor. A lot has been accomplished even since this morning, but we have a lot to do. This morning the leadership on both sides of the aisle talked, and we have talked in our caucuses, of the importance of collecting today all of the amendments that might potentially be offered on this bill. People have been studying the issue since August. The bill was marked up in committee in a very thorough way. A lot of amendments were offered and debated, some of which will be debated again on the floor. Because we need to finish the bill this week, if at all possible, it means, given the fact that there are a lot of evening commitments which will preclude us from doing a lot of voting tonight, we have to get this universe of amendments today. Thus, I ask all of our colleagues to give us, through the managers, their potential amendments today, and if they plan on offering amendments, we absolutely must have them today. We are not looking for amendments, but if people have serious amendments they feel need to be debated, if we have that list, and shortly thereafter--and it would be in all likelihood some time tomorrow--we will ask to have the complete language of each of those amendments. The initial reaction by some is: you are moving too fast. Again, this is something we announced several weeks ago, that we would be going to the bill yesterday. We have made progress. The bill has been out, and people have had time to address it. We ask people over the next hour or couple of hours to let us know what amendments they may want to offer so we can have that list, and then shortly thereafter--not tonight, but shortly thereafter--we will have a deadline by which we need to have those amendments, to have the language. It is the only way we will have an orderly process to address the substance of this very important bill.

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

Mr. FRIST

Mr. FRIST. Mr. President, on leader time--and we will come right into morning business shortly--I want to continue on the intelligence reform bill that is underway and make a very brief statement. Just a few minutes ago, the Democratic leader and I urged our colleagues to come forward and submit their amendments. We just had further discussion with the assistant Democratic leader. Over the course of the day, we must see these amendments. Today, we continue debate on a bill to overhaul the intelligence community of the United States Government. It is a huge undertaking. The reforms are the most comprehensive since the National Security Act of 1947. But nothing less than the security of the United States of America is at stake. We have determined enemies who will use any means available to take the lives of as many Americans as possible. They cheered when the Twin Towers fell. They dream of even larger calamities. They must be stopped. And that requires an intelligence system that finds them, before they harm us. Under the leadership of Senator Collins and Senator Lieberman, the Government Affairs Committee has produced a bill that is worthy of this task. It was passed unanimously out of committee. It has received support from the White House. And it is supported by the Senate leadership. The Senate will examine this legislation in a comprehensive and deliberate manner. We will be focused and expeditious. We have a unanimous consent agreement that restricts amendments ``to the subject matter of the bill or related to the 9/11 Commission recommendations.'' I urge Senators that if they have, or are considering, amendments that they inform or file them with the manager today. I am confident we will come to agreement on this package in a timely manner. I know that it is ambitious, but my hope is that we can complete this bill by the end of this week. This would give us time to conference with the House. Reforming the executive branch and the legislative branch is key to improving the security of the American people and our great Nation. I am proud to say that we have worked in a bipartisan manner at every level, from individual Members, through committees, to leadership. We have also worked closely with the administration, which has embraced the findings and recommendations of the 9/11 Commission. The administration has taken additional measures to further improve our counter-terrorism and intelligence efforts. These efforts deserve our praise. The committee has worked to produce a bill that addresses fundamental issues facing our intelligence community. It contains a number of key recommendations consistent with the 9/11 report. First, and most critically, the legislation creates a national intelligence director with robust budgetary and personnel authority over the intelligence community. As recommended by the 9/11 report, the NID will be the President's primary intelligence advisor. This official will be Senate-confirmed and separate from the CIA Director. The NID's primary mission is to break down stovepipes, and knit the intelligence agencies into an agile and effective network. The NID will develop and present to the President the annual budget request for the National Intelligence Program. Critically, the national intelligence director will receive the appropriation for the program. The NID also will have parallel authority over major acquisitions funded through the appropriations that the NID will control. The NID will have the authority to transfer funds within the National Intelligence Program. He or she will have authority to set our intelligence priorities. The director will set standards for security, personnel, and information technology across the intelligence community. The director will also play an active role in selecting the heads of the key entities in the National Intelligence Program. Critically, the legislation requires the NID to provide intelligence that is independent of political considerations. To this end, the legislation establishes an analytic review unit to provide an independent and objective evaluation of the quality of analysis of national intelligence. The NID will chair a cabinet-level Joint Intelligence Community Council. The purpose of the council is to advise the NID on setting requirements, financial management, and establishing policies across the intelligence community. The council will help ensure the implementation of a joint, unified national intelligence effort to protect national security. In addition to creating the national intelligence director post, the committee bill also establishes the National Counter Terrorism Center. Currently, our intelligence agencies are not maximally integrated in their efforts against terrorism. The committee seeks to remedy that through the creation of the counterterrorism center. The center will have a directorate of intelligence--in essence, a national intelligence center to integrate intelligence capabilities against terrorism. The National Counterterrorism Center will also have a directorate of planning to develop interagency counterterrorism plans, assign agencies' responsibilities, and monitor implementation. The center's directorate of planning will concentrate on developing joint counterterrorism plans, meaning plans that involve more than one agency. Such planning will be at both the strategic level, such as ``winning hearts and minds'' in the Muslim world, and at an operational level, such as hunting for bin Laden. In addition to these two major reforms--the national intelligence director and the counterterrorism center--the legislation also includes provisions to strengthen the FBI and transform the CIA's capabilities. The legislation before us is comprehensive. It is ambitious. And it contains the reforms that are critical to strengthening the intelligence community and protecting our country. I am confident that this overhaul of our intelligence community--the largest since 1947--and the pending overhaul of the Senate oversight of intelligence--the largest in three decades--will make our country safer and more secure. We have no higher responsibility to our fellow Americans than protecting the homeland. Our lives, our freedoms, our liberties are at stake. We have made tremendous progress in the days since 9/11. We've taken a hard look at our intelligence system, what it did right, where it went wrong. Many dedicated men and women have spent countless hours examining the facts and finding ways to fix the system. I am confident that the United States Senate will do our part to defend the homeland and make America more secure. I yield the floor.

Mr. FRIST

Mr. FRIST. Mr. President, today we will begin a period of morning business for up to 60 minutes. The majority will control the first half of that time and the minority will control the remaining second half. Following the 1 hour of morning business, the Senate will resume the pending intelligence reform legislation. I do once again congratulate the chairman and ranking member, Senators Collins and Lieberman, for their opening remarks yesterday. I am pleased we are now underway on this historic bill. We had a good start yesterday. We had a number of Members participating in the debate yesterday. Three amendments were offered, and they are now pending. It would be my hope we could continue to make progress on the bill over the course of today, continue the good progress from yesterday and dispose of a number of amendments in addition to the ones that have been offered. Thus, we can expect votes over the course of the day on the intelligence reform amendments. As is usual on a Tuesday, we will be breaking from 12:30 to 2:15 for the weekly policy luncheons. Again, as I mentioned yesterday, as we all know, we have scheduling challenges over the course of the week during the nights, which in many ways is good because it means we absolutely must focus, beginning right up front in the morning, and work through the day to process the bill, to process amendments, and to, of course, vote. Again, I think every evening this week there are major commitments by both caucuses and the caucuses working together. Thus, we really absolutely must continue to work aggressively over the course of the day. There are a lot of people with a whole range of amendments to offer. We have had a long time for people to both now look at the bill but also, since late July, to have Senators and their staffs address the important issues and the recommendations which were made public in late July by the 9/11 Commission and since that time through a lot of hearings during August in the Governmental Affairs Committee that had a superb markup where a number of amendments were offered, debated, and adopted. It gave the Senators on that committee the opportunity to highlight the important issues, to dispose of a number of them, but also, I believe, to make it so on the floor, when we address amendments that are similar to and in some cases maybe even the same amendments, we can deal with those in very expeditious ways since so much groundwork has been laid. I am going to encourage, with the leadership on both sides of the aisle, the managers to gather these amendments just as soon as possible. All 100 Senators need to recognize that we have very few days, really just a few more than a handful of days, before we depart on October 8. Although we have dealt with many of these issues over the last several days and weeks, it is critical that we see the amendments so we can plan out the next several days on the bill. I have encouraged all of our colleagues to bring those amendments to the managers today, this morning. With that, I will close my remarks and turn to the Democratic leader either for general comments or comments on the course of the week.

Mr. FRIST

Mr. FRIST. Mr. President, this article is about Dr. Jim Schwieterman and his brother, Dr. Tom Schwieterman. Both are family physicians who practice in Mercer County, OH. This month ``Dr. Jim'' and ``Dr. Tom,'' as their patients call them, will deliver their last baby, bringing an end to a distinguished 100-year run of their family providing care in delivering babies in their community in this corner of Ohio. The brothers' final delivery will be the baby of a woman who their father delivered. Their grandfather delivered the woman's mother, and their great-grandfather, who founded the family practice, delivered the woman's grandmother--a wonderful, rich tradition of caring in that community. Why will this long and honorable family history of physician service come to an end? Because of out-of-control medical liability costs. The Schwieterman brothers simply cannot afford to deliver children because of the skyrocketing insurance fees they must now pay. It is a tragedy, and we all suffer in one way or another. I was in Philadelphia earlier this month to speak to a group of physicians. Did you know that the average or the typical obstetrician/ gynecologist now pays over $134,000 a year for liability insurance just for that privilege of being able to deliver babies? That is a tripling of the cost just since 2000, a $100,000 increase in just 4 years. It is not surprising that Pennsylvania is on the crisis list and physicians are leaving the State. That means diminished access for the people of Pennsylvania. And it applies to orthopedic surgeons, to trauma surgeons, to obstetricians. The trial lawyer special interest lobby is next to impossible to beat at the State level, but, fortunately, some States are taking action. They see what is happening to their neighbors, and they know they could be next. Without restoring common sense to the legal system, it is just a matter of time before their health care is hijacked by the lawsuit lottery. Take California, for example. Because California has acted and adopted comprehensive medical liability reform, including limits on pain and suffering awards, liability insurance costs for OB-GYNs in the Los Angeles area are less than half of what their colleagues pay in Pennsylvania, Illinois, or Florida. Everything else is more expensive in California but not health care. Texas is another State pursuing comprehensive, commonsense legal reform. Recently, my distinguished colleague from Texas, Senator Cornyn, spoke passionately on the Senate floor about the need for lawsuit abuse reform. His State recently adopted medical liability reforms similar to those passed in California, and they are working. Texas Medical Liability Trust, the largest medical liability insurer in the State, is now decreasing its rates for the second time in the 2 years since this reform was instituted. The new 5-percent cut comes in addition to a 12-percent reduction implemented earlier this year. These cuts are a direct result of Texas's constitutional amendment capping liability costs. According to the trust president and CEO, Thomas Cotton, 12,000 Texas doctors will save $34 million in a single year. This represents almost half of all Texas physicians. And when doctors pay less, patients pay less, premiums fall, and health care becomes more available for all. Before Texas passed the new liability law, the same insurer had raised rates over 146 percent between 1999 and 2003. Now that the medical malpractice insurance market has stabilized, 13 new insurance companies have entered the Texas market and doctors are returning to their practices. That is the way it should be. The lesson is clear. If we adopt Federal reforms based on the commonsense laws that are working in States such as California and Texas, we will dramatically lower health care costs, in turn providing more affordable and more accessible health care to our communities, to the American people. That means our precious health care dollars will be spent in the operating room and not in the courtroom. The Senate has tried three times during the 108th Congress to debate comprehensive medical liability legislation. We have tried three times to have a simple debate about the merits of ending the abuse of our health care system by personal injury trial lawyers and their frivolous lawsuits, and each time my colleagues on the other side of the aisle have filibustered, obstructed even consideration of this legislation. They block consideration of a solution. No action, no vote, no accountability, and no change is partisan politics at its worst. It hurts the doctor. It hurts the patient. It hurts the consumer. It hurts you. That is plain wrong and, again, America deserves better. Senator Kerry and Senator Edwards have made it clear that they oppose the laws that are working today in California and Texas. They have also made it clear that as long as they are in the Senate, they will not even allow a vote on real reform. Why, you ask? Why oppose reforms that provide more health care services than ever before? Why oppose reforms that ensure doctors and hospitals will be more involved in providing care? Why oppose health care services that are more accessible and more convenient? And why oppose health care services that will be there when you need them? America deserves an explanation. Finally, Mr. President, I want to comment on one other issue, and that is the new drug discount card available to seniors today. I will turn to some compelling testimony that was provided to the Senate Finance Committee, I guess it was 2 weeks ago. I had the opportunity to chair that Finance Committee hearing, and I listened very carefully as Dr. Mark McClellan, who is the Administrator for the Centers for Medicare & Medicaid Services, discussed the Medicare Modernization Act, which this body passed, which was signed into law by the President. In his testimony, Dr. McClellan said that 4.3 million seniors have already enrolled in the Medicare Prescription Drug Discount Card Program, which was signed into law by President Bush last year. Over 1 million low-income seniors are today, because of this new law, receiving an additional $1,200 of free prescription drugs on top of the already deep discounts available to all seniors who have signed up for this card. Those discounts are making a difference. They make a difference in the lives of those seniors. They make a difference in the health care of those seniors. It is beyond belief how anyone could tell seniors, don't get that card; it is too confusing. That is wrong. We should be encouraging seniors to sign up for the card. Why? A recent Kaiser Family Foundation study reported that the Medicare drug cards are providing a savings of 17 to 24 percent off retail prices in urban and rural areas. That means if you have the card, you have a savings of 17 to 24 percent than if you don't have the card. How could anybody tell our seniors today, don't get the card, with those demonstrated savings? A Lewin Group study analyzing the 150 drugs most frequently used by seniors found that people participating in the Medicare drug discount program can, beginning this year, save an average of well over $1,200 on their prescription drug purchases with this card. A study by Consumers Union found that in California, the Medicare prescription drug discount cards provided drug prices that are even lower than the State's Medi-Cal program. I say ``even lower'' because the Medi-Cal prices are 20 percent below those typically available at retail pharmacies. The Democratic leader indicated last week that too little has been done to control prescription drug costs in America. The facts--study after study--show otherwise. In my colleague's own State of South Dakota, 40,000 Medicare beneficiaries who do not have prescription drug coverage stand to gain the most from that drug discount card; 28,000 South Dakotans are eligible for an additional $1,200 over the next 14 months. How can they be told not to sign up for that card? The discount drug card is only the beginning. In the year 2006, all Medicare beneficiaries will be eligible for prescription drug coverage under the Medicare program. Tens of thousands of South Dakota's seniors and citizens with disabilities will receive coverage with no premiums, no deductibles, no gaps in coverage, and copayments of no more than $2 for generics and $5 for brand-name drugs. There is a better way to provide affordable prescription drugs and health coverage to the American people. Texas and California have chosen the right path. I ask: When will Senator Kerry and Senator Edwards choose theirs? Make no mistake, we need health care reform now. Costs are way too high today, and they continue to rise. Quality chasms and health care disparities exist in our health care sector today. But I can tell you from personal experience--both in medicine for 20 years as a physician and as a policymaker today--these are tough and challenging issues. Reform is a challenge that is not easy, but we have begun to address it and we will continue. The health care challenge is complicated, and it is much more complicated than a lot of politicians would have you believe. They simply are not going to be solved overnight. Let us pledge today to get it right the first time. Let us pledge today to give that power back to the patients. Let us pledge to tackle the challenges today and to stop the partisan politics and to stop the foot dragging that becomes an embarrassment to this institution and a source of frustration for the American people. With the President's leadership and the bipartisan reforms that we have enacted during the past several years, we are on the right track. A lot of work remains to be done. We need to pass medical liability reform. We need to expand those health savings accounts that are now the law of the land. We need to give small businesses the ability to ban together to buy more affordable health care coverage for their hard-working employees. Because as a matter of principle, every family deserves access to affordable, reliable, and quality health care that can never be taken away. I yield the floor.