Bill Frist

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 thereto be printed in the Record.

Mr. FRIST. Mr. President, I ask unanimous consent that the EPW Committee be discharged from further consideration of H.R. 3682, and the Senate proceed to its immediate consideration.

Mr. FRIST

Mr. FRIST. Mr. President, I want to pause for a moment and comment on the bill we just passed. I am proud that the Senate, in this bill, is choosing to protect an important memorial that honors our Nation's fallen veterans. With the passage of this legislation, the Mt. Soledad Veterans Memorial Protection Act--this memorial being in San Diego, CA--I believe we pay a real tribute to our fallen veterans. This memorial will be controlled, with this legislation, by the Federal Government, which will ensure that the men and women it memorializes will continue to be so honored. The memorial is very important to our veterans. It is a key symbol of our religious freedom. Just a very brief comment on the history. Since 1954, a 29-foot cross has stood atop Mt. Soledad in San Diego memorializing the American war dead of World War I, World War II, and the Korean War conflict. Over the years, the memorial has grown and now includes six large, concentric walls covered with granite plaques commemorating individual service men and women, bollards, pavers, and a flagpole proudly flying the American flag. The Mt. Soledad Memorial, in its entirety is a world class war memorial. In 1989, a plaintiff who claimed to be offended by the memorial sued the city for its removal. The city of San Diego went to great lengths to divest themselves of the property by selling it to a private party who could choose to keep the memorial cross. That sale was blocked, however, by the Ninth Circuit Court of Appeals. Last year, the voters of San Diego passed a ballot measure providing for the donation of the memorial to the Federal Government, but again that transfer was blocked by the courts. This bill, H.R. 5683, which we just passed, directs the Federal Government to acquire the property and enables the Mt. Soledad Memorial to be federally owned and continue to memorialize Americans who have fallen in service to their country. I do commend my colleagues for taking this significant step.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that at a time to be determined by the majority leader, with the concurrence of the Democratic leader, the Senate proceed to the immediate consideration of Calendar No. 191, S. 1566. I further ask that the Chambliss amendment at the desk be agreed to, and that the only other amendments in order be the following four amendments, the text of which is at the desk, with no second-degree amendments in order: a Smith-Stevens amendment on petroleum prices, 1 hour equally divided; a Cantwell amendment on petroleum prices, 1 hour equally divided; a Feinstein amendment on electronic energy transactions, 4 hours equally divided, with 30 minutes of the minority's time under the control of Senator Levin; a Conrad amendment on CFTCs authority, 1 hour equally divided. I further ask that, in addition to the time specified on the amendments, there be 30 minutes of debate equally divided on the bill, and that following the use or the yielding back of time, the bill, as amended, be read the third time. I further ask that the Senate then proceed to Calendar No. 358, H.R. 4473, the House companion, and that all after the enacting clause be stricken and the text of S. 1566, as amended, be inserted thereof, the bill, as amended, be read a third time, and the Senate proceed to a vote on passage, and S. 1566, as amended, be returned to the calendar.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that when the Senate completes its business today, it stand in adjournment until 9:30 a.m. Wednesday, August 2. I further ask that following the prayer and the pledge, the morning hour be deemed to have expired, the time for the two leaders be reserved, and the Senate then resume consideration of H.R. 5631, the Department of Defense appropriations bill.

Mr. FRIST

Mr. FRIST. Mr. President, today, we overwhelmingly passed a very important bill that will affect the lives of all consumers, which is everybody in this country in the future. The gulf coast energy security bill was passed overwhelmingly today with a vote of 71 to 25. We just passed this bill an hour and a half ago or so. At that point, we thanked our various colleagues. But in conversations after that among my colleagues, Democrats and Republicans, we all remarked that this is the way legislation should be passed: bipartisan, working together, a lot of hard work on the floor, a lot of preparatory work, involvement of staff soliciting a lot of input as we go through careful deliberation and passage of a bill that will be to the benefit of every American. It is a great victory for the American people. Our colleagues were recognized earlier. Most people pointed, first and foremost, and appropriately, to Senator Domenici who stayed focused on the bill, who led the bill that was passed last year, now 54, 53 weeks ago, a bill that has transformed the framework through which we review advances in energy and energy policy, and this bill being the next major step in addressing supply and production of American homegrown energy. We thank Senator Domenici for his leadership on both those bills. This evening, the Senate turned to the Department of Defense appropriations bill. I appreciate Chairman Stevens and the ranking member, Senator Inouye, for very rapidly turning to that bill and beginning debate with their opening statements and beginning on the amendment process which should start tomorrow morning. Tomorrow we will resume consideration of this appropriations bill. It is my hope that we can complete this legislation before we leave for the August recess. I say that after having talked with a number of our military leaders over the last several weeks and the Secretary of Defense today who stressed how important it is to get these appropriated funds flowing for the support of our troops overseas and at home and the infrastructure that supports them, especially in this time of war. We have a lot to do over the course of the week. So late nights are possible each night. I laid out the schedule early this morning. I mentioned the importance of this bill which links three bills together--the death tax, the tax extenders, and the minimum wage--on Friday morning. Late nights are possible--in fact, likely--as we continue on the Department of Defense bill tomorrow and on Thursday night as well, and then the pension bill we absolutely must address before we leave before the recess. I thank the Democratic leader, in particular, for understanding and working with our leadership in scheduling and being able to proceed with the Nation's business in a very short period of time because the American people deserve it. He understands that; their leadership understands it. Even though we don't agree on all the legislation that is coming before us, the ability to move and to move effectively and efficiently is something I really appreciate as we come into these last 5 or 6 days in the Senate.

Mr. FRIST

Mr. FRIST. Mr. President, if there is no further business to come before the Senate, I ask unanimous consent that the Senate stand in adjournment under the previous order.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 528, S. 2146.

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

Mr. FRIST

Mr. FRIST. Mr. President, today we will start a period of morning business until 3 p.m. Following that time, we will return to the debate on the Gulf of Mexico energy security bill. We have a cloture vote scheduled for 5:30 on this bipartisan bill. I hope cloture will be invoked and that we can then work together to bring that bill to a close at the earliest opportunity. This is our final week of business prior to the August adjournment, and we have some extraordinarily important measures to consider before we leave. We now have a freestanding pensions bill that has arrived from the House which we will need to consider before the close of the week. We also have a bill that relates to an increase in the minimum wage, death tax reform, and some other very important tax provisions. I expect to schedule that bill at the earliest time, and I hope we can get cooperation from all Senators. The Senate will address that package before we adjourn for the recess. Chairman Stevens is ready to bring the Department of Defense appropriations bill to the floor, and we will look for a window to have that bill debated and voted on as well. There are a number of nominations--judicial and otherwise--that I hope we can consider this week. We have a very aggressive agenda this week that has been laid out before us--a very important one because I believe the importance and weight of each of these bills demands that we address them this week. We have acted on a number of issues over the past several weeks, and most of the recent debate has been on the issue we will consider later today, the Gulf of Mexico Energy Security Act. Today we are scheduled to conclude that debate on this important piece of legislation. It fundamentally is a bill which will substantially reduce overwhelming dependence on foreign sources of oil. It would move us toward energy independence. It strengthens our national security, and it helps reduce the cost of living for American families and businesses. Moving toward that energy independence is not only possible, but it is the key to reducing the energy prices that people feel every day when they fill up their cars with gas, when they cool their homes, or other times of the year when they heat their homes. The high energy prices affect people in their everyday lives. I believe energy independence can be achieved, but a first and very important major starting point will be to make sure we bring more of America's energy to American consumers. That is what the bill does by allowing deep sea exploration in the Gulf of Mexico. As I mentioned, we have a cloture vote this afternoon, and I expect the final vote on the Energy Security Act hopefully sometime tomorrow. There are a number of different issues before us as we continue to move and produce meaningful solutions to the problems facing Americans--and that is what we will continue to do. Order of Procedure I ask unanimous consent that following the remarks by myself and Senator Reid, Senator Hagel be recognized for 30 minutes.

Mr. FRIST

Mr. FRIST. Mr. President, I move to reconsider the vote, and I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. FRIST. Mr. President, I suggest the absence of a quorum.

Mr. FRIST. I thank my friend, the Senator from Minnesota, for his question because I truly believe energy security is one of the great challenges this Congress must continue to address. As we all know, America is dangerously dependent on foreign sources of energy--much of it coming from countries with unstable governments or with interests contrary to those of the United States. And this disparity will only increase if we do not take action to increase the amount of American energy that we use here in America. The bill before us today, the Gulf of Mexico Energy Security Act, will do just that. As my friend from Minnesota mentioned, it will reduce our dependence on foreign oil and natural gas by opening more than 8 million acres in the Gulf of Mexico to domestic exploration. The area opened up under this bill is estimated to contain 1.26 billion barrels of oil and 5.8 trillion cubic feet of natural gas. However, as I said on the floor last week, while this bill is a critical step toward addressing the energy challenges we face, it is only a first step. There is more that we can--and must--do to break what the President called our ``addiction'' to oil. We must diversify our energy resources, increase the use of renewables and alternative sources such as ethanol and biodiesel, clean coal technology, and nuclear power, and we must take steps to reduce consumption by consumers. Finally, we must do more to encourage the development of the innovative new technologies that will wean us off of foreign oil in the future.

Mr. FRIST. I will tell my good friend from Minnesota that I do not consider the Gulf of Mexico energy bill to be the last word on energy policy this year. I am well aware of your proposals promoting renewables and energy conservation, and I look forward to working with the Senator and Chairman Domenici on many of these important ideas in the months ahead.

Mr. FRIST

Mr. FRIST. Mr. President, while my distinguished colleague from Alabama is on the floor, I thank him for his leadership on this particular issue because it gives us that opportunity to act with meaningful solutions to problems everyone is feeling. So many things that we do here are issues that seem so macro, so big. I am sure when people are watching C-SPAN or television or they even read about what we do, they wonder, are those people up in Washington doing anything to address the issues that affect me, the squeeze that I feel, the cost of living that we know has to be addressed? Then you say, What are those things? Where is that squeeze coming from, despite the record low unemployment rate of 4.6 or 4.7 percent and the creation of 5 million jobs? It comes back again and again--those energy costs, filling up that gasoline tank, getting ready to go on vacation, or altering your vacation, or paying that heating bill, or this time of year that air conditioning bill. And it comes back to energy. Now we are acting and we are acting in a way that in the past has been stopped--and that is by looking right here at home at the good old American homegrown supply. Everybody knows that ultimately in the market-based system there is supply and demand. Now we are addressing supply directly, as my colleague mentioned, in a way that is very protective of our environment, of our coastlines, that is environmentally sensitive but in a way that we know will open as much as a million or more barrels. I thank my colleague for his leadership and also for his explanation so people fully understand the impact of that legislation which is now on the floor. There is a lot going on. I want to make a couple of comments because there are some things going on right now. The House of Representatives will probably be out tomorrow. We will be in session tomorrow. We are working on a whole range of issues in conference and in our discussions as we look ahead for the next week that we will be here, and then the 4 weeks in September when we come back. I am very hopeful that the House will pass the pensions conference report and sometime here in the next 24 hours. I know our colleagues from the Senate who are on the conference are working very hard to get the House Members to move ahead on the issue that we know is very important to the American people. Individual retirement security. Again, it goes back to this cost of living and the squeeze that people feel. That is what this pensions bill is all about. Other issues that are being addressed are so-called tax extenders because we have to act now every year. We would like to make these tax cuts permanent, but we have to act every year and extend them for 1 year or 2 years. What is also interesting in terms of message is the great impact that tax cuts put forward by this body under the leadership of President Bush have had--a huge impact on individuals and families. One of interesting things that I find when you say we are going to make the tax cuts permanent and extend them for 3 or 4 years, people do not understand fully what that means and how it affects them as individuals. But 3\1/2\ years from now for a family of four making a median income of $62,000 or $63,000, what percentage of this Federal tax will go up if we don't act to make these tax cuts permanent? Usually, when I ask a crowd of people if the Bush tax cuts are not made permanent, if the Senate doesn't act for whatever reason, or it is obstructed from acting, they say, Maybe my taxes will go up 10 percent or 20 percent, or 30 percent. Not many people say 30 percent. But the fact is, if we don't act in this Senate to make those tax cuts permanent, for a family of four, their Federal taxes will go up, 3\1/2\ years from now, 58 percent. And now people say: I see the importance of what you are doing in Washington, DC, why you are following President Bush in terms of his tremendous leadership in cutting taxes, keeping taxes low, and working hard to make those tax cuts permanent. Then it comes together. We are looking at a tax extender package, and we are also looking at what my colleagues feel strongly about--a permanent solution to the death tax. First of all, the death tax does not make sense. It is not fair. It discourages savings and discourages thrift. Therefore, we need to have a permanent solution. I say bury it forever, but the will of the Senate is not to bury it forever and eliminate it totally. Therefore, we are working with what is a very reasonable compromise position. So there is a lot of discussion on that underway. What we have is crazy. We have a death tax. It used to be high and is coming down. In 2010 it disappears, and in 2011 it goes back up to 55 percent. Talk about things that do not make sense, that does not make sense. We need to fix that. I hope we can do that in the next 6 to 8 weeks. One last thing I comment on because there has been huge progress today in the House of Representatives which allows us to move forward on an issue that will affect just about everyone listening to me now, an issue we have acted on with meaningful solutions to a real problem, is health information technology. The House today passed a health information technology bill. We have passed one in the past. Now we can marry those two in conference. And we will save lives. Medicines cure, but medicines can also kill. Last week, the National Academy Institute of Medicine, which we all respect, we all look to, which looks at things very objectively--the committees they put together are experienced, have broad expertise, and take current issues that are challenging and address them in an environment that is very constructive. They released the most extensive report ever done on drug or medication, medicine errors, mistakes that are made, whether they are inadvertent or mistakes just made. The report is fascinating. Why do I say it affects everyone? Right now, four out of five American adults today--so in all likelihood, everyone listening to me-- take one medicine, at least one medicine over the counter or a prescription. One out of three adults listening to me now take five medicines. That is amazing. Being a physician, it wasn't true 10 years ago, it wasn't true 20 years ago. When my dad began to practice medicine 70 years ago, no one would believe the power we have in medicines today--the power to cure but, if misused or mishandled, the power to kill. This report just came out last week, and it is fascinating. The report addresses lots of things. I will come back and cite some of them. I will look at findings. How these medicines are administered, if not done correctly, with real care, can result in serious injury, hurt the patient, can cause death--all related to how they are administered, the dosage they are administered in. Before coming to the Senate, I spent 18 years in hospitals, always 5 days a week and 95 percent of the time 6 days a week, working in hospitals, taking care of people. There you see it all. You see doctors inadvertently writing prescriptions for drugs that interact and are not compatible with certain drugs. Maybe they didn't know the patient was on that particular drug or they just didn't know there would be an interaction of the two drugs, and it hurts the patients. Nurses or health care providers mistakenly put the wrong medication in the IV bag, the intravenous bag that runs into your hand, or administer the wrong blood type. A pharmacist might dispense a 100-milligram pill instead of a 50-milligram pill. These errors are wasteful, obviously, but can also be harmful and can be deadly. The Institutes of Medicine found that at least 1.5 million Americans are sickened, injured, or killed each year by errors in either processing, dispensing, or taking medications. These errors are widespread. The IOM report found on average a hospital patient is subjected to one medication error every day they are in the hospital. That is pretty amazing. A hospital patient is subjected to one medication error each day he or she occupies a hospital bed. That is costly. Not only does it occur, and it occurs frequently, it costs a lot. The IOM report estimates the extra expense of treating drug-related injuries in hospitals alone is $3.5 billion a year. The report--again, it just came out last week--is the most comprehensive report today. It sends a very clear signal; that is, we need to act. The good news is that we have acted with a first step in this Senate, and as I mentioned earlier the House acted today, which means together we can produce a bill, and have the President sign it, which will make a difference. The IOM report offered several recommendations to prevent these errors. In many ways, the recommendations they put forward reinforce my vision or a vision I believe is very important as to where we need to be in health care in the future. We have to start today in that direction. That is what the recommendations do. That vision is really pretty simple. It is a vision of a health care system that is not centered on HMOs, bureaucrats, Washington, or hospitals or clinics. It is centered on the patient. The patient is in the middle of the system. In this system also is the importance of having the driving force of the consumer. You have the patient, and it is driven by decisions being made by consumers all over the country. The third component is that it needs to be provider friendly. You need physicians participating, nurse practitioners participating, nurses and other health care providers, technicians, the people who draw the blood, and the lab technicians all participating in a way that there is a comfortable exchange of both information services as well as trust. So it is a patient-centered, consumer-driven, provider-friendly system. Now, the engine to that system has got to be value, has got to be outcome, has got to be results. When I say ``value,'' I really mean almost in simple terms of the product, the outcome, in terms of value, divided by how many dollars you put in. So you want as much health produced per dollar injected into the system. That has to be the engine of this system, and it has to be fueled by three things. That is where the exciting part comes in. That is where this health information technology plays such an important role. It has to be driven by information, 21st-century information that simply was not around the last century. It really was not around when I was doing heart transplants every week 10 years ago, 12 years ago. You just didn't have that sort of information generated. It was the knowledge revolution, the explosion of information, computers, the Internet. That knowledge is out there today. The second fuel has to be choice. You have to have people out there making prudent decisions for themselves each and every day. Obviously, that is very consistent with my principles as a Republican in terms of maximizing choice. The 21st-century information, with empowerment of the consumer by choice, and third, some element of control. The control really comes in if people have to have resources to make those decisions or, if not, need to be assisted. You have to have a strong safety net for a patient-centered, consumer-driven, provider- friendly system based on values, driven by information and choice and technology. You have to have a seamless flow of information which is privacy-protected and which is secure. No single piece of legislation incorporates all of that, and no single piece of legislation incorporates all the IOM recommendations. But there are things we can do to move in the direction toward that vision. I have sponsored bills in this Senate and urged industry-wide changes that made considerable progress that caused us to move toward achieving that. Last summer, on this floor, I publicly called on the pharmaceutical companies to implement a voluntary 2-year restriction on direct-to- consumer advertising for newly released drugs. What is direct-to- consumer advertising? It is what you see on television each night or over the course of today in terms of the drug ads, in magazines. It is the full-blown pictures you see every day--newspaper ads--where the advertising is directly to the consumer, to the individual, to the patient. What I called upon the pharmaceutical companies to do is to review their procedures and on a voluntary basis give a 2-year restriction on direct-to-consumer advertising for lots of reasons. I will come back do that. I also publicly asked the GAO, the Government Accountability Office, to analyze the Food and Drug Administration oversight of such advertising. Are we doing enough to make sure that information which comes out to the consumer is filtered appropriately, to make sure it is accurate, that it is honest, that it shows the pluses but also shows the dangers and the weaknesses as well? Spending on direct-to-consumer advertising and prescription drugs was steady over the years. In recent years, it has skyrocketed. Why? Because you put advertisements out there and people buy the drugs. The problem is, and the reason I brought it up in the Senate and made this public call, this advertising can lead to inappropriate use of drugs using too many of these drugs, using them for the wrong indications, overuse and underuse of the drugs. It could be an underselling of the risks that are actually in a drug. You see all the good things and the beautiful pictures and people running through fields, but at the same time you really do not see the dangers, the side effects that could be harmful, that could compromise your safety, the patient's safety and care. The good news, based on that call, at least in part, is the pharmaceutical industry responded and I would say responded fairly aggressively. They soon after issued a set of guidelines for prescription drug advertising on newly released drugs. They got together and talked about the importance of their responsibility in this direct-to-consumer advertising, the fact that it is not just to improve their bottom line but it is health care, it is patient- centered, that you have to have the strengths but you have to give weaknesses of these drugs when you put them forward. So I applaud them. And that response is making a difference. That is one example. That is sort of a first step in guaranteeing patient safety and care. I mentioned the GAO report. It has not come back yet. I look forward to receiving their findings, their results on the FDA's oversight, to come soon. Other progress: Last summer, we passed the Patient Safety and Quality Improvement Act. It became law July 29, exactly a year ago, 2005. It also contributed to this patient-centered system which is consumer driven. It helps improve the quality and gets rid of the waste. When I say value, that is results, as I said, per dollar of input. You want to maximize that. So you want to get rid of the waste. You want to get rid of the abuse. You want to get rid of inefficiency. And we did a lot in that regard. What this Patient Safety and Quality Improvement Act did was to help both improve quality and weed out waste by minimizing the fear of litigation. Now, why does that matter? It really comes down to--and I oversimplified it a little bit, but if you are a physician or you are a nurse and you are in a hospital and you make a mistake, and you feel bad about it, you should be able to share that information with other people so they can learn from your mistakes. Quality improvement: We see it in airlines. We see it in general aviation. But we do not see it in health care--or we didn't before passing this particular bill. What we have been able to do in that particular bill is basically ease--without fear of a lawsuit coming after you. The reason it is not shared is because you know some greedy, predatory trial lawyer is out there and saying: Oh, there is a mistake. Let's go after them. What it does is put a barrier up there so no longer does that individual practitioner, doctor, or nurse have to have the fear of sharing information of an inadvertent mistake so others can learn. The IOM report's most striking finding was that many providers do fail to report these medication errors that ultimately don't result in an injury. They fear these lawsuits. But without reporting this information, clearly, we cannot learn from our mistakes. That is what the Patient Safety and Quality Improvement Act addressed. That brings me, finally, to information technology. The Senate passed a health information technology bill. It was bipartisan. I thank Senators Kennedy and Enzi and Clinton, all of whom worked with me and all of our colleagues in producing this bill--a bill called the Wired for Health Care Quality Act. What it does is it promotes the use of electronic medical records. It jump-starts America's transition to this 21st century system based on choice and based on value and based on outcomes by having a seamless network that is fully interoperable in terms of the transmission of health information, so doctor can communicate with hospital, can communicate with pharmacy, can communicate with patient in a seamless way, where records can be stored electronically. They can be transmitted electronically. If you are in Nashville, TN, and you live in Princeton, NJ, and you have an automobile accident as you are on I-41 through Nashville and you are taken to Vanderbilt Hospital, they can push a button, and in a secure, privacy-protected way, your record instantaneously shows up at the Vanderbilt emergency room and they can see what allergies you have, what medicines you have, whether you had previous heart disease, whether you can tolerate anesthesia--instantaneously; otherwise, they would have to repeat all those tests. They might not even be able to get that information. That is the power. What it does is it builds a platform for the interoperable transfer of information--interoperability standards--that has the ability to transform the practice of medicine. That is how big these bills potentially are. Doctors write about 2 billion prescriptions each year. We still write them, for the most part, by hand. And that spelling, what you look at, unfortunately, is misinterpreted. And as the IOM report documents, a lot of errors are still being made in that transmission of reading what a doctor had written at the pharmacy or at wherever the hospital might be distributing those drugs and then delivering it to the nurse and having the nurse give it to the patient. You get rid of all that--not all of it but most of it--by having that seamless flow of electronic information. I think back to transplantation. I would have a patient. I would transplant the heart in Nashville and take care of them and have them on a drug called cyclosporine. And they would go back home, maybe 2 or 3 hours away, where another doctor would take care of them. If they got a cold, the local family doctor might put them on erythromycin, not knowing--because transplants were so new at the time--that if you put somebody on cyclosporine on erythromycin, their liver would fail. But it happened. They may not know that cyclosporine was there. Well, with the electronic transfer of information, that physician would know that patient is on cyclosporine, and it would be instantaneous and immediate. If he wanted to put a patient on erythromycin and tried to prescribe it, a red flag would come up and say: No, you can't do that because the patient is on cyclosporine. All this makes so much sense. Medical records today are stuck in the stone age. But every other sector of our economy has information presented in what is the information age. It is now time to bring medicine--it is amazing that medicine is still stuck in the stone age-- into this information age. I will close on all this, but, as you can see, I am very excited about it. This particular bill which we passed and which will be married with the House bill helps fix all of that. It is going to go a long way to addressing the concerns that were in this IOM report last week. Electronic medical records will improve health care. They will promote the secure exchange of privacy-protected information, and they will seamlessly integrate quality standards with information technology, all of which means to say better care, lower costs, greater accessibility, the elimination of waste, elimination of inefficiency as well as the medical errors themselves. So the House has moved. We have moved. Now it is time to get to conference as soon as we possibly can. And if we do that, we will move our system toward that vision of the patient-centered system which is driven by consumers and 21st century information. It will save lives.

Mr. FRIST. Madam President, we are on the Gulf of Mexico energy security bill, a bill that has been very carefully crafted in a bipartisan way. It has been our approach from the outset. One of the real challenges we have is taking a bill which is delicate, in the sense that it has been carefully crafted, vetted, and addressed for the last year--and there are many other people who would like to add other energy amendments or bills to this single, focused step, this being built upon the comprehensive energy bill, a bipartisan bill that was passed a year ago this week. So it is a challenge to keep the body focused on this issue. In doing so, there are procedures here shortly that are important to accomplish delivering as many as a billion barrels of oil to the American people and over 5 trillion cubic feet of natural gas, enough gas to heat or cool 6 million homes for 15 years. We have it within our grasp. We had a good vote yesterday morning in terms of getting on the legislation, which we are on, and now, from a leadership standpoint, we have to stay focused on this bill, even though there are a lot of other good ideas out there, and complete this step and our action in the Senate. Thus, I will go through a series of steps here, and we will have comments on that. Amendment No. 4713

Mr. FRIST. Madam President, I send an amendment to the desk.

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

Mr. FRIST. Madam President, I ask for the yeas and nays on the amendment.

Mr. FRIST. Madam President, I send a second-degree amendment to the desk.

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

Mr. FRIST. Madam President, I send a cloture motion to the desk.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate now proceed to the consideration of S. Res. 359.

Mr. FRIST. 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. FRIST

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