Kay Hutchison

Mrs. HUTCHISON

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

Mrs. HUTCHISON. Mr. President, this is an amendment that would allow the Under Secretary for Emergency Preparedness and Response--basically the disaster relief part of the homeland defense agency--to provide advance funding for nonprofit entities performing duties they are asked to perform in major disasters. Organizations such as the Red Cross have been unable to bring their coffers back up because of the many disasters we have had in our country over the last few weeks. It is essential that they be able to be called by the Under Secretary to go to a disaster and to provide immediate help to people. The Red Cross is often first to arrive with real help, such as medical help and help for people because their homes are flooded, or they have been in a hurricane. They went to Guam in the last few months when Guam had this terrible hurricane that wiped out so much of the island, and they spent about $17 million. They were able to recoup some, but not all, of those funds. So their coffers are low. This amendment allows them to have advance funding when they are called to respond to a disaster and they are not able to provide that funding up front, as you would hope you would be able to do in the future. I think this amendment is acceptable. It will certainly help the Red Cross and other nonprofit agencies that just don't have the capability to run to the bank and borrow, in 24 hours, money for their disaster needs. Until they can get their coffers built back up, I hope we can help them with this problem because we are asking a lot of them in return. They do a great job, and we want to provide the help for them to do that job for the disasters they are called to serve. Mr. President, I offer this amendment.

Mrs. HUTCHISON. Mr. President, I will speak for a couple of minutes about the big State formula in the Department of Homeland Security. I am not going to take long. It is very important we address the issue of the formula in the bill just passed. The formula is not fair to the large States where the greatest risk is. The large States generally have the larger population centers which generally have the highest risk for homeland security. Yet the formula under which we are proceeding is a formula that takes away from our 13 largest States because of a floor put in for the smaller States. I don't think any of the large States want to be totally whole but the large States would like to have more of a fair shake than the formula underlying in this bill. I hope the Senate will agree to hear the bill that has come out of the Committee on Governmental Affairs which does authorize new formulas and will seek to change the formulas in a way that is more fair. To give a couple of examples, the State of California on a strict population basis would get $216 million; the State of California has a long coastline, they have major cities, they certainly have a high-risk designation. Under the bill, they will get $146 million for a deficit to California of $64 million. Georgia should get $53 million; it would get $46 million for a deficit of $5 million. New York should get $118 million; it will get $86 million for a deficit of $28 million. My home State of Texas should get $134 million; it will get $96 million for a deficit of $34 million. This does not make sense. It does not pass the fairness test. The large States do not ask for complete parity but we do ask for fairness. There is a formula we used in the State aid package in the most recent tax cut legislation that does not give the big States full parity but it does give them a much more fair formula. That is what I intended to offer in the bill. It would have been subject to a point of order, so I withheld. But I am serving notice that I, along with Senators Voinovich, Specter, DeWine, Santorum, Warner, Chambliss, Cornyn, and Levin, am going to readdress this issue and hope that everyone will come together, small States and large, for something that is fair to the States that are at the highest risk. That is a very important component of securing our homeland. If we are going to leave our biggest States and biggest cities vulnerable, that is not protecting the part of our country that is most at risk. I thank you, Mr. President. I am serving notice we will try to address this issue in the bill. I ask the majority leader and minority leader to please assure that we will address this issue in the bill that has come out of the Governmental Affairs Committee so that we can correct this inequity. I yield the floor.

Mrs. HUTCHISON. Mr. President, Senator Dole worked very hard with me on this amendment. It was a joint effort. I particularly thank Senator Cochran and Senator Byrd, along with Senator Inhofe and Senator Jeffords and Senator Reid, for helping us work out the language on this bill. A lot of people had jurisdictions and everyone agreed that this was necessary. I appreciate the cooperation of all of the Senators who helped work this out. I yield the floor.

Mrs. HUTCHISON

Mrs. HUTCHISON. Mr. President, I thank the Senator from Montana for that wonderful speech. He did remind us once again the stakes we have in the war on terrorism. What is happening in Iraq is a high-stakes game. We are committed. America is not going to walk away. We are not going to start a job that we do not finish. The job is to bring peace and stability to the people of Iraq and to the entire Middle East. I thank the Senator from Montana for coming forward with that message. How much time remains?

Mrs. HUTCHISON. Madam President, I will continue on the same subject as the Senator from Montana and talk about what we are doing in Iraq. The meetings we had with Ambassador Bremer brought much more clarity to the progress being made in Iraq. Everyone is stunned and saddened by the loss of life of our soldiers that we see, unfortunately, on a daily basis. This gets worse every day because we are sick about losing these soldiers. Part of the reason we have not been able to capture these people who are doing these horrible acts to our soldiers--one and two and three at a time--is because Iraqi people do not yet believe we are there to stay until they have a democracy in place. There is widespread belief in Iraq that Saddam Hussein is coming back. When we were able to capture the sons of Saddam Hussein, and they are now dead, that sent a message to the people of Iraq that we are going to capture Saddam Hussein. We are not going to stop until we know he is captured or dead. Two of his sons are dead, the two who would have been heirs to his incredibly cruel regime. They are dead. They are gone. I applaud the President for saying he is going to show the dead bodies so the people of Iraq will be assured. In our culture, that would be horrifying. We would never show dead bodies in a newspaper in our country, particularly identified dead bodies. However, we have a different problem in Iraq. We have a problem that the people do not believe these people are really dead. Therefore, they fear coming forward and giving information about the people who are killing our soldiers. They fear coming forward and embracing Americans in many parts of Iraq. If that, in their culture, is what is necessary to show that these two sadistic tyrants are dead, that they can no longer cut off arms and legs, put children in shackles in jail, abuse children, abuse women, that they can no longer do these horrific acts, if that is the way we must show the Iraqis that these people are gone, I applaud the President for saying we will do it. I hope the President does. We must get the trust of the Iraqi people. I do not think we are going to have that trust until they know that Saddam Hussein is dead, they know the sons are dead, and they know we are going to keep our commitment; that we are going to try to make life better for the Iraqi people and put their own people in charge of their own fate. That is what they are looking for. We must show them we are not going to give up because times are tough. Times are tough over there right now. For people I talk to on the streets, it is incomprehensible they do not appreciate what we have done. We have to understand what they have lived through for the last 25 years in that country. They are used to being abused for no reason. If they look the wrong way, they may be shot at close range. That is what they have lived with. We cannot even imagine that in our country. We must try to win their trust in this slow and methodical way. Madam President, our administration is making great progress. We are showing we will have the resolve to see this through. If we can bring a quality of life and of freedom to the people of Iraq, then we do hope this will also stabilize the rest of the Middle East so we can bring a peace between the Palestinians and Israel, the two can live side by side in peace, and have at least the ability to live in peace if not trade together and work together. That will also send a signal to the people of Iran that they can have freedom once again. It will send a signal to the people of Syria and throughout the Middle East that they, too, do not have to live under dictatorial regimes that allow them no freedom and do not have good education systems. We want the people of the Middle East to know what freedom is, to know what having an education is, so people can have jobs and have an economy and be able to live a life that has a quality of life. We are bringing quality of life to Iraq through this administration. We are bringing health care services. Madam President, 90 percent of the people in the north have basic health care, 80 percent in the south, 75 percent in Baghdad. We are putting $210 million now into pharmaceuticals and basic health care services. This is an important quality-of-life issue for these people, and one of the first that we have addressed. We have brought in 1.2 million tons of food since we ceased the hostilities in Iraq on March 30. We now have the ability to purchase local harvests in Iraq, so food will be available from the Iraqi people and for the Iraqi people. I am very pleased with the progress. Is it enough? No. Is it going to take more time? Yes. Is it going to take patience? Absolutely. But America is not going to walk away when times get tough. We are going to see this through, and the world will be better when we do. I yield the floor.

Mrs. HUTCHISON

Mrs. HUTCHISON. Mr. President, it is a privilege today to pay tribute to the memory of the late Strom Thurmond. Often outspoken, sometimes controversial, but always passionate, Strom was an unparallel servant of the people. He always put his Nation first, whether in combat on the beaches of Normandy or here in the halls of the Senate. He made a career of giving back to his country. But he was also a wonderful human being. Strom often reminded me that Colonel William Barret Travis, who was in command at the Alamo, was from his home county in South Carolina. While Strom himself missed the Alamo by a few years, he demonstrated that he too embodies the spirit of the Alamo and the sense of duty and commitment to his country that we Texans associate with Colonel Travis. Strom's journey into the history books began back in the 1920s when he graduated from his beloved Clemson. He went on to become a teacher and athletic coach, county superintendent of education, town and county attorney, eleventh circuit judge, South Carolina governor, soldier, president of the Reserve Officers Association and finally, a U.S. Senator--a position he held for a remarkable 48 years. For many, that would be five lifetimes of careers. But not Strom. It was just enough to keep him busy for the century he was on this Earth. Strom lived every day of his life to the fullest. I'm still amazed that he volunteered to return to active duty military service, though he was way past the age of being drafted. At the age of 41 he flew onto the beaches of Normandy in a glider--staring death in the face, and smiling. He served in the Pacific and European theaters, earning 18 decorations, medals and awards including the Legion of Merit, the Purple Heart, and the Bronze Star for Valor. He rose to the rank of Major General in the U.S. Army Reserves. In the Senate Strom focused particular attention on taking care of our men and women in the military. I served with Strom while he chaired the Armed Services committee and saw the reflection of his time in the service in everything he did. He worked for one purpose--to ensure our country's national defense remained strong. From military health care to quality of life for service members and their families, he knew that to recruit and retain our Nation's finest, we had to treat them well. The Capitol has not been the same since Strom left last year. The wit and wisdom he collected over a century of living made him one of the most entertaining and enlightening figures in modern politics. There will always be an empty place in the heart of the Senate created by his absence. The eulogies that came from both sides of the aisle at his memorial service last week were testament to the evolution Strom undertook during his time in the Senate. A career once marked by division ended in unity and with dignity. He will be greatly missed by his family, friends, colleagues and his country. He began his career in public service as a coach--eight decades later he was a coach and teacher to us all to the very end.

Mrs. HUTCHISON

Mrs. HUTCHISON. Madam President, I thank the kinder and gentler Senator from Arizona. I am very pleased that he looked at our bill and found that we did meet the criteria because that is exactly what we intended to do. The kennel is for dogs at an Air Force base. The dogs are security dogs, and they do need a place to stay.

Mrs. HUTCHISON. Madam President, to clarify the record, and before the Senator from Arizona turns into the ``Incredible Hulk,'' there was no managers' amendment.

Mrs. HUTCHISON. At Elmendorf Air Force Base. I think the Senator knows that is in Alaska. Dogs in Alaska need a place to stay, too. Maybe it is cold up there and they need shelter. I think it is certainly legitimate. With that, we did work hard to make the priorities that we thought were right for our military personnel. No one deserves better treatment right now than the military personnel of our country. I thank the Senator from Arizona for his continuing interest in assuring that our military personnel have a quality of life. That has been his hallmark here. I thank, once again, the chairman of the committee, Senator Stevens, and Senator Inouye, the ranking member, Senator Byrd, Senator Feinstein, my ranking member, and our respective staffs. I am very proud of the work we did on the bill, and I do hope our military personnel do see better health care facilities, better barracks, better living quarters, and from this legislation I think they will.

Mrs. HUTCHISON. Madam President, I am very pleased to join with my ranking member of the Military Construction Appropriations Subcommittee, Senator Feinstein of California, in bringing forward for the Senate's consideration the fiscal year 2004 military construction appropriations bill. This is a bipartisan bill which received the unanimous approval of the Committee on Appropriations. I want to take a moment to say Senator Feinstein is in the Judiciary markup. She is the best ranking member a chairman could ever have. We have a great relationship. We work together well. We see things the same way. And our priorities are the same. So this is very much our bill together, and it would not have been nearly as easy without her wonderful cooperation. This is a bill that does focus on quality of life for our troops because both Senator Feinstein and I believe it is very important at a time like this, when we are asking so much from our troops, that we do right by them. This bill provides $9.196 billion for military construction, military family housing, and base realignment and closure costs. This bill is $79 million above the President's budget request, but $1.5 billion below the amount appropriated last year. The budget constraints under which we all are laboring this year did force us to make difficult choices about our spending priorities, but I believe we have crafted a bill that attends both to the President's most pressing requirements and the concerns of Senators. The bill provides $4.6 billion for military construction, $3.95 billion for military family housing, and $370 million for base realignment and closure. Our military forces have been severely strained by the extraordinary burdens they have been asked to shoulder in the last several years. They have undertaken nearly 2 years of continuous combat operations in harsh conditions, endured long deployments and reserve activations. They have had to deal with severe disruptions to family life resulting from lengthy separations. We have asked much of our service personnel and their families; and, for that reason, we have paid special attention in this bill to military construction projects that promote our troops' quality of life. For example, the bill provides $1.1 billion for 40 new, modern barracks projects; $166 million for the design and construction of new hospital and medical facilities; and $16 million for child development centers to serve our military families. The intense demands of the past few years have extended well beyond our Active-Duty forces, and no component has borne a heavier burden in that time than our Guard and Reserve Forces who have met the call to duty with a high degree of professionalism. Unfortunately, military construction for the Guard and Reserve continues to be severely underfunded. The administration's fiscal year budget request for Reserve components was $370 million, a little more than half of what was appropriated last year. This is just inadequate for the task we are asking these components to perform. As a result, this bill increases funding for the Guard and Reserve by 87 percent to $691 million. This bill differs from the administration's request in only one significant way, and that is in the area of military construction overseas. The budget request included over $1 billion for military construction at U.S. installations outside the United States, much of it destined for facilities constructed for the cold war. For several years, Congress has expressed its concern that our overseas basing structure has not been updated to reflect the realities of the post- cold-war world. Our Nation is dealing with new threats, new strategies, new force structure, new deployment concepts, and new geopolitical realities. Yet a basing structure designed for the cold war endures. We have questioned the wisdom of continuing to expend taxpayer dollars on overseas facilities that may not be appropriate to the Nation's future military needs. The Defense Department continues to study this issue and has under way an overseas basing and presence study that will lead to, among other things, recommendations for a major overhaul of the U.S. overseas basing structure. That study is not yet complete. But in testimony before the Military Construction Subcommittee in April, two of the combatant commanders, General James Jones, Supreme Allied Commander Europe, commander of U.S. European Command, and General Leon LaPorte, commander of U.S. Forces Korea, presented their visions for military basing in their respective areas of responsibility. General Jones described a concept for Europe that features fewer large bases, several smaller, more austere bases in forward locations, and greater use of rotational forces in and out of these facilities rather than permanent stationing of large forces with the attendant support infrastructure. General LaPorte described a vision for Korea in which U.S. forces are consolidated at a greatly reduced number of facilities located further south on the Korean peninsula than at present. We have been impressed by the combatant commanders' boldness and creativity in reassessing basing needs, and we believe their respective visions hold great promise for a more efficient and effective basing structure that will enhance the ability of the United States to meet new threats. When fully developed, this vision will provide a sound basis on which Congress and the administration will be able to determine the future of our overseas basing structure. However, at this point the vision has not yet been developed into a comprehensive plan on which decisions to pursue new construction initiatives can prudently be based. The overseas basing and presence study involves far more than military facilities. According to public statements of Defense Department officials, it will result in a dramatic change in the disposition of U.S. forces abroad, including where they are based, how they operate, how they move to and from their theaters of operation, and even the number of forces deployed in specific theaters. In various press accounts, administration officials have acknowledged considering new bases in Australia; Navy ships ported in Vietnam; increased U.S. presence in Malaysia and Singapore; bases in Algeria, Morocco, and Tunisia, as well as Senegal, Ghana, Mali, and Kenya; bases on territory of the former Soviet Union; a rotational model for deploying forces overseas; significant reductions to force levels in Germany; a major relocation and possible reformation of forces in the Republic of Korea. Summarizing the extent of the changes under consideration, the Under Secretary of Defense for policy, Douglas Feith, stated: Everything is going to move everywhere. If the sweeping changes under consideration are to be implemented, they will require extensive diplomatic efforts both in the nations in which the United States seeks a new presence and in those where it will reduce or reshape its presence. Because a comprehensive plan is not yet developed, we are unwilling to recommend undertaking extensive new military construction projects that would begin the implementation of a plan without a thorough and deliberate review by Congress. We have been particularly concerned about proposed projects in Europe and Korea. For example, the budget request includes a number of projects in areas in Germany that, according to public statements of the Army and other Department of Defense officials, are likely to see significant force level reductions. In a June 23 letter updating the status of planning Europe, General Jones said: We have made considerable progress in determining the installations required to support theater goals and the force structure needed to implement our strategy. It is an arduous process but a necessary one. While I realize fully the importance of our progress on these matters, the timeliness, and the effect these decisions will ultimately have on our fiscal year 2004 military construction projects, I must tell you candidly that we have not reached the end point of this process. The changes we are proposing represent the most significant undertaking to realign forces and basis in theater in the past 50 years. The decisions made in the coming weeks will have broad and far-reaching implications; therefore, it is imperative that we get it right. General Jones is absolutely right. I appreciate his candor. His statements underscore our concern that we are not yet ready to begin implementing the restructuring of our overseas bases in Europe. We have similar concerns about proceeding too fast in Korea. In the budget amendment received May 1, the administration proposed moving some $213 million in military construction projects to a single base, Camp Humphreys. However, nearly half of that construction is to occur on land that the United States does not yet control. Although the Korean National Defense Minister has pledged to try to buy the land for our use, he is far from clear that this can occur for these projects to be fully executed in fiscal year 2004. According to a July 7 article in the Korea Times, there is fierce local opposition to the expansion of U.S. presence at Camp Humphreys. The budget amendment also asked to move a $40 million barracks project from an airfield to Camp Humphreys, but then that was reversed. There are other examples, but I think this is making it clear that we don't really have a fully thought out and reviewed plan from which we can base the needs in Korea. Evaluated against a backdrop of uncertainty about fundamental aspects of a revised overseas basing structure which the department has not yet proposed, the Defense Department's overseas basing and presence plan is not yet sufficiently mature to enable the Senate to commit to extensive new construction. The failure to fund these projects at this time does not indicate dissatisfaction with the general direction in which the Department is headed. We support the direction. But we do believe that Congress should know the extent of the restructuring and the price tag before we determine our Nation's priorities. It would be premature to begin new construction at this time in these areas. We look forward to receiving and evaluating the Department's full recommendations once they become available and taking the time to consider these changes. Reflecting our continuing concern about this issue, our bill includes a provision establishing an independent commission to thoroughly study the structure of our overseas military facilities and advise Congress on its conclusions. This commission, proposed by Senator Feinstein and myself, would provide Congress with an independent view of the Nation's overseas basing requirements to help inform our decisions about the restructuring of our facilities. The report accompanying this bill also directs the Defense Department to submit several reports that will aid Congress in its oversight role, including a report on the feasibility of privatization and the use of commercial building practices in barracks construction, a study of the impact of privatized housing on local school districts, and a report on the Department's activities related to perchlorate, a chemical used in solid rocket propellant that has been found in drinking water supplies in 29 States. Senator Feinstein has more to say on perchlorate, but I want to say, this is a concern of mine as well. While a national standard for perchlorate levels has not yet been established, it is important that the Department of Defense be prepared to deal with this containment at defense installations once a standard is agreed upon. All of the projects added to the bill have been carefully vetted by the military services. All are top priority for installation commanders, and all are included in the services' future years defense plan. Madam President, the bill before the Senate is a bipartisan product that was approved by the Appropriations Committee on a vote of 29 to 0. I am pleased to offer it for the Senate's consideration.

Mrs. HUTCHISON. Madam President, before we move off this bill, I so appreciate the chairman's remarks. We could not have done it without our excellent staff work. On the majority staff, Dennis Ward has done an incredible job of research. He is the most thorough person we could have on the committee. I appreciate him very much. Also, Christina Evans and B.G. Wright on Senator Feinstein's staff, without their working relationship being so good, we could not have done so well. I wanted to add that to the record before we moved away from the bill.

Mrs. HUTCHISON

Mrs. HUTCHISON. Madam President, I rise to speak in support of the nomination and confirmation of someone for whom I have a great deal of respect, Susan Braden, to be a Judge for the U.S. Court of Federal Claims. I cannot think of a better person for this court. She is currently counsel at Baker & McKenzie. She earned her bachelor degree in 1970 and her law degree in 1973 from Case Western Reserve University. She has worked as a trial attorney in the Department of Justice. She has served as a senior attorney at the Federal Trade Commission. For the past 18 years, she has had a distinguished career in the private sector, specializing in Federal litigation, antitrust, international trade practices, and intellectual property. Her work on international trade gave her the opportunity to accompany a delegation led by Justices O'Connor, Kennedy, Ginsburg, and Breyer on an official visit to several European courts in 1998. She is very qualified, and I wish to say on a personal note that she and her husband, Tom Sussman, have been friends of mine for a long time. I went to law school with Tom Sussman. I have a great deal of respect for both Tom and Susan, and I urge my colleagues to support this qualified nominee. She will be a wonderful public servant. Madam President, I urge approval of the three nominees.

Mrs. HUTCHISON. Madam President, I ask unanimous consent to speak for up to 2 minutes on the nomination of Susan Braden before the vote.

Mrs. HUTCHISON

Mrs. HUTCHISON. Mr. President, I would just like to say that we have help for our teaching hospitals in the managers' amendment. It is not much. But I am working with all of the managers, the ranking member as well as the chairman, to try to increase funding for teaching hospitals. I want to point out our teaching hospitals must have the support that is in this bill at a higher percentage if we are going to keep the young physicians trained and if our country will keep the greatest health care system in the world. I thank the managers for helping me put that in the managers' amendment.

Mrs. HUTCHISON

Mrs. HUTCHISON. Mr. President, I ask unanimous consent that the pending amendments be set aside.

Mrs. HUTCHISON. I ask unanimous consent following the vote this afternoon in relation to the Dodd amendment No. 969, the Senate vote consecutively in relation to the following amendments: Pryor amendment 981, Boxer amendment 1001; provided further that there be 2 minutes equally divided between each of the votes with no amendments in order to the amendments prior to the vote.

Mrs. HUTCHISON. No, I have not.

Mrs. HUTCHISON. And I ask the Democratic leader work with me to be in the next series of votes.

Mrs. HUTCHISON. I was going to ask unanimous consent for the Pryor amendment and the Boxer amendment and then ask my amendment be in the next series of votes.

Mrs. HUTCHISON. Mr. President, I ask that amendment No. 1004, which is at the desk, be called up.

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

Mrs. HUTCHISON. Mr. President, today I rise, along with Senators Kennedy, Talent, Biden, Kerry, Murray, Reed, Specter, Bond, Clinton, Feinstein, and Durbin to offer an amendment for America's teaching hospitals. The teaching hospitals in our country perform a vital role in training the doctors and nurses who conduct medical research and provide care to the needy. But the foundation of this essential public service is beginning to crack under the strain of Medicare reductions and a range of other financial pressures. As my colleagues are aware, the Balanced Budget Act of 1997 made cuts to indirect medical education, called IME, which is an add-on for Medicare reimbursements to teaching hospitals. The add-on was reduced from 7.7 percent in 1997 to 6.5 percent in 1999. Further reductions were scheduled beginning in 2000, but those cuts were delayed until last October, and now the reimbursement rate has been dropped from 6.5 percent to 5.5 percent. That 1 percentage point means our Nation's teaching hospitals will lose almost $800 million this year, $4.2 billion over the next 5 years. My amendment restores the reimbursement rate to 6.5 percent in fiscal year 2009. By putting this off until fiscal year 2009, of course, we are avoiding any Budget Act point of order. There are 1,100 teaching hospitals in our country where Americans receive world-class care. Every State has at least one, so every Senator will have affected constituents. Teaching hospitals train nearly 100,000 doctors every year, and chances are, Mr. President, your physician and mine were trained at teaching hospitals. In 1983, the Federal Government recognized that teaching hospitals cost more than their nonteaching counterparts because they incur costs to train our health care providers of the future. They provide clinical research in new procedures, technology, and treatments. Perhaps most importantly, they ensure a steady stream of high-quality physicians who are equipped to meet the health care challenges of the 21st century. They are also a major provider of indigent care in the United States. But education and training costs extra money. The Government added the IME payment to encourage teaching hospitals to invest in our future, but, unfortunately, we have chipped away from 11.6 percent in 1983 to today's rate of 5.5 percent, which is a factor based on a hospital's resident-to-bed ratio included in Medicare reimbursement. We cannot continue to decimate funding at these hospitals that educate our medical students and expect quality medical care in the 21st century. Teaching hospitals in Texas have lost $26.8 million in reimbursements in 2003 alone. Our State is not the hardest hit. New York lost $141 million; Pennsylvania, $78 million; and Michigan, $50 million. One example in my State exemplifies what is happening in every teaching hospital in our country. Methodist Hospital in Houston trains more than 200 residents a year and works closely with Baylor College of Medicine to effectively train physicians in radiology, cardiology, and neurology with the newest technology. Methodist purchased an MRI machine for $4.5 million. That MRI will not only provide preventive medicine to help diagnose illnesses sooner, it also teaches the next generation of health care professionals what they cannot learn in the classroom. This week, as we debate Medicare reform, it is imperative to reaffirm our commitment to America's teaching hospitals as these hospitals are in financial distress. If we do not restore funding, not only will they suffer, so will our health care system, particularly patient care. I ask for the support for this amendment. I ask for the yeas and nays. I will ask for unanimous consent to stack the next two votes, but I also ask unanimous consent the vote on my amendment be in the next series of votes.

Mrs. HUTCHISON. I was going to offer that unanimous consent.

Mrs. HUTCHISON

Mrs. HUTCHISON. Mr. President, I have heard the Senator from Michigan describe her amendment. I have to say I would be concerned about a Government-run prescription drug benefit because of what it would do to our free enterprise system and our capability to have competition which I think is very important. I think the underlying bill provides the competitiveness that will be so important for a balanced system, and it is also one that will give seniors the best prices and the best choices. I would like to make a statement in general about the bill we have before us. I have to say that we have been talking about reform of Medicare for years--maybe for the 10 years I have been here. But today we are now talking about a real bill and maybe a real chance to reform this very important program. I think it is clear that any time there is reform we must include a prescription drug component. We must have a choice which is similar to that in the private sector, and we must admit that Medicare has not kept pace with the rapid changes in our health care system. As our research community pushes the envelope and develops lifesaving medicines and procedures, our Nation's health care system must take that innovation into account or it will not be the greatest health care system in the world. Pharmaceuticals have revolutionized medical care. Increasingly, ailments are treated with medication as opposed to invasive surgeries. It is imperative that those who rely on Medicare have access to affordable prescription drugs. When Medicare won't pay for medicine to treat diabetes but will pay for the amputation of a limb caused by complications of diabetes, I think we can admit that we have a problem. A prescription drug benefit alone is not the answer. True reform must provide our Nation's seniors the freedom to choose physicians and benefits based on their individual needs. If a beneficiary is satisfied with existing coverage, the beneficiary should have the option to stay put. But if she chooses to enroll in a private insurance PPO or HMO, she should be allowed that choice. This choice is incorporated in the underlying bill. Also, I have an amendment, cosponsored by Senators Kennedy, Durbin, Specter, and Talent, to restore cuts in Medicare reimbursement to teaching hospitals. Texas hospitals are facing the loss of $26 million in 2003 due to Medicare reimbursement cuts. Nationwide, teaching hospitals will lose $794 million this year and $4.2 billion over the next 5 years. Every State will be similarly affected. Teaching hospitals are experiencing a terrible financial crisis. My amendment restores the fiscal year 2002 level of reimbursement for indirect medical education--they are called IME payments--to teaching hospitals. This allowance has been cut incrementally since the Balanced Budget Act of 1997 from 7.7 percent to 5.5 percent in fiscal year 2003. Teaching hospitals have higher costs due to their critical role in educating tomorrow's physicians. They run more tests, they have newer technology, and they require more staff because they are training our future health professionals. The additional payment is vital to continuing this training. A disproportionate percentage of the most seriously ill and injured patients recover and convalesce in teaching hospitals. These hospitals have 78 percent of all trauma centers and 92 percent of all burn beds. Although only 21 percent of all hospitals are teaching hospitals, they deliver over two-thirds of charity care. They conduct groundbreaking research. The University of Texas Medical Branch in Galveston--as one example in my State--will lose $1.9 million in these payments this year if the amendment is not adopted. UTMB leads research on anthrax, smallpox, and plague. We cannot afford to have teaching hospitals cut back on research that benefits every individual. In the budget we passed earlier this year, $400 billion was set aside for Medicare reform. It is our responsibility to use that $400 billion wisely and to bring this incredible program into the 21st century so that America's seniors will have the medical coverage they need and deserve. I think the bill before us needs work. We all agree that it is not a perfect bill and we want to make it better. We want to make sure it does two basic things: that it increases the quality of health care for our seniors, and, secondly, that it does so at a reasonable price for our future generations. We do not want another huge commitment that is going to turn into an entitlement that is unbearable in the future. But when Medicare will cover the cost of a hospital stay for 5 days for the amputation of a limb but it will not allow you to pay for the medicine that will keep you from having to amputate that limb, something is wrong in the system, and we must fix it. This time we can do it. Thank you, Mr. President. I yield the floor.