George LeMieux

Mr. LeMIEUX

Mr. LeMIEUX. Including the wars in Afghanistan and Iraq. I thank the Chair, and I yield the floor.

Mr. LeMIEUX. I wonder if I could ask a question.

Mr. LeMIEUX. I have a question for my colleague from Tennessee. I am new here. This is all new to me. I thought the goal was to reduce health care costs while trying to provide health care for more Americans. We are taking money out of health care for seniors to create a new entitlement program. We are taking money out of nursing homes, home health care, hospitals, and a program called Medicare Advantage that people in my State I know enjoy very much. How does it make sense that we are taking money out of Medicare to start a new health care program?

Mr. LeMIEUX. It would seem to me--and again, I am new to this process--that 100 Senators would vote for Senator McCain's proposal because everyone in this Chamber believes we should strengthen Medicare. Who could be for taking money out of Medicare if we don't need to? These are two separate issues. Shouldn't every Senator in this Chamber say let's send this back to the Finance Committee so those cuts can be restored and we can start over and take a step-by-step approach? That only seems fair to me. Perhaps my colleague from Oklahoma could comment on that.

Mr. LeMIEUX

Mr. LeMIEUX. Will the Senator yield for a question?

Mr. LeMIEUX. The Senator is saying that seniors who have Medicare Advantage now will have big reductions in the benefits they receive. My understanding is that includes flu shots, eyeglasses, and hearing aids--as the Senator from Arizona said, programs to keep seniors healthy. My folks in Florida very much appreciate the Medicare Advantage Program. We have more than 900,000 Floridians who are on Medicare Advantage. I want to make sure I understand this correctly--that under the proposal put forward by Senator Reid, we are going to make substantial cuts to Medicare Advantage and the benefits Medicare Advantage provides.

Mr. LeMIEUX. Will the Senator yield?

Mr. LeMIEUX. I wanted to follow up on my colleague's point. With all these cuts to Medicare, $464 billion in this proposal, $192 billion in reductions to most services, $118 billion in cuts to Medicare Advantage, $21 billion cuts to hospitals serving low-income patients, $23 billion from other sources, it seems inevitable that seniors are going to have a lower quality of health care. We were told by the President that if you liked your health care, you were going to be able to keep it. But it seems to me that we need to change that a little bit because under this proposal, you might be able to keep it unless you are a senior and that seniors are going to have a diminished quality of health care under this proposal; is that correct?

Mr. LeMIEUX. Mr. President, I thank the Senator from Idaho for his great remarks today. I want to follow up on what he started to discuss and continue also with the comments from my colleague from Arizona about Medicare Advantage because it seems to me, being a Senator from Florida where we have the second highest senior population in the country, the highest per capita senior population, we have 3 million people on Medicare, more than 900,000 on Medicare Advantage, that Florida is going to receive the worst impact perhaps of any State in the country because of this proposal. I am here today to talk about this not just as an American but as a Floridian because I want my fellow Floridians to know, especially seniors, what is in this bill and what it means to them. That is our job. It is our responsibility to read through this document, this 2,074-page bill that we received a day and a half ago and to talk about what it means for the average American and, in my case, the average Floridian. We find out today this Medicare Advantage Program that 900,000-plus Floridians enjoy is going to have a substantial cut to the benefits. This is not just extras or fringe benefits. These are things people need to stay healthy--eye doctors, hearing aids, programs to make sure folks stay in shape, all sorts of things that contribute to the health and wellness of seniors. Our seniors enjoy this program. The popularity of this program is sky high. But we are finding out today--and I am looking at this map--that Florida is getting the worst impact of any State in America. Only Louisiana is going to get it as badly as Florida. We get the hurricanes, and now we are going to get the Medicare Advantage cuts--an 81-percent reduction in the benefits to our seniors. What is that going to mean? It means they are not going to have the health care they enjoy now, which is what the President promised. Right now this bill says the benefits offered will drop from $135 a month to $42 a month. Florida seniors will lose 81 percent of this additional coverage. I have some constituents who have written to me because they have been hearing about these problems. I want to read one or two of these letters from Floridians who are concerned about losing Medicare Advantage. This one is from Dennis Shelton in Plant City, FL, which is in central Florida. He writes to me: Senator LeMieux, I am writing this letter to express my deep concern about the proposed cuts in Medicare Advantage funding. I am currently enrolled in an advantage program that is crucial for me to get medical attention. The plan provides doctors, medicines, urgent care and my diabetic supplies. The plan does this significantly better than traditional Medicare at a reduced cost. By regular visits . . . I have been able to maintain reasonable health. If the cuts reduce services then my health will suffer along with other seniors that are in the Advantage program. This is distressing and I sincerely hope that you will strongly advise fellow congressmen how important Medicare Advantage programs are to seniors all across the United States. I am new to this body. I have only had the honor of serving here for a couple of months, so I am still learning the ways of Washington. But my understanding of this health care process and this health care bill is we were going to maintain quality, we were going to try to cut costs for people who have experienced the high cost of insurance, and we were going to try to provide more access. But what I am finding out from this proposal is that we are going to cut quality for seniors, and we are not going to reduce the costs of health care for the 170 million people who actually have insurance. It occurs to me that the goals that were set are not being achieved by this plan. Worse still, we are taking a program that seniors rely on and that seniors paid into their whole life through their wages and we are going to cut $\1/2\ trillion out of it, a program that in 7 or 8 years is going to run a deficit and be in tremendous trouble. The question I have--and maybe my colleague from Mississippi can help me with this since I am new to the Chamber--is why are we going down this path? This doesn't seem good for seniors. It doesn't seem good for people in any walk of life in America, especially in light of what my colleague from Mississippi pointed out with the mammogram issue that came out and the self breast exam issue that came out this week. Why are we going down this path?

Mr. LeMIEUX. I thank the Senator for that explanation. That is very helpful to me. What is disconcerting about the path it seems we are on is we are going to have this government-run health care system and if already now people cannot go see their doctor if they are on Medicaid because doctors won't take Medicaid, and if it is growing more and more the case that you cannot see a doctor if you are on Medicare--I have some information here about 29 percent of beneficiaries surveyed saying they are having a problem finding a doctor who will take Medicare. There is a senior from Sanford, FL, Earl Bean, who was interviewed this week and he said: I called about 15 doctors and was told repeatedly that they were not accepting Medicare patients. . . . They wouldn't even take his name when he called. So what I am worried about is we are going to enter into a system where 5 years from now, 10 years from now when everybody in the country is basically on a government-run health care program--Medicare, Medicaid, or this new program which unfortunately we all think will push the private insurers out of the business eventually and we all have government health care-- is we will be going places, there will be 100 people waiting in the room if we can get a doctor at all, they will be rationing the care, they won't be providing mammograms such as this recommendation that came out this week by the Government task force, for women in their forties to be discouraged from self-breast exams, and we will all have very poor health care unless you are wealthy. What is already happening now is that those folks who are wealthy-- there are doctors now who are not taking Medicaid, they are not taking Medicare, and they are not even taking insurance. So what concerns me-- maybe the Senator from Mississippi can comment on that--if we enter on this path, we are going to a world where the majority, the vast majority of Americans are going to have poor quality government-run health care and only the very rich will have access to good doctors and all the best quality of health care. That does not seem to me like an America we want to live in.

Mr. LeMIEUX. Mr. President, I was wondering if I could ask my colleague, the leader from Arizona, a question because we are about at the end of our time. My understanding is we are going to have a vote tomorrow at 8 o'clock. Again I am new here. I was hoping the Senator could explain this for me. My understanding is we are going to vote whether to proceed on this bill. It is not going to be this bill, it is going to be some kind of shell bill or something, which hopefully can be cleared up for me. But I am told by folks who work with me that the Congressional Research Service has said when there is a vote to proceed on a bill, that 97 percent of the time that bill passes. So it seems to me if we are voting tomorrow to proceed, that is really a vote on this bill. Do I understand that correctly?

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, 25 years ago--I will never forget this--I came home to my house, I was 15 years old, I was in high school, and my mom and my dad sat me down and my mom told me that she had breast cancer. After that, as any kid would, I worried about whether my mom was going to live and what life would be like without a mother. It was a very difficult time for our family. The good news is that my mom, through self-examination, found a lump, and she is today, 25 years later, a breast cancer survivor. But I am not sure I could tell this story today and tell about the positive result that occurred if she had not undertaken that self-exam, if she had not received the care she was given so quickly and so effectively because she found the lump after having been trained and encouraged to do self-exams. So she is a success story, and millions of women across this country are success stories because they have heeded the advice of preventive medicine. They have heeded the advice for many years now from the American Cancer Society and other experts that self-exams and mammograms for women in their forties prevent breast cancer, and they prevent us from losing our moms and our sisters and our daughters. But this week, a task force, a government task force, kind of ironically named the ``U.S. Preventive Services Task Force,'' contradicted their previous recommendations and said women in their forties shouldn't be doing self-exams; that women in their forties shouldn't be having mammograms on a regular basis. That makes absolutely no sense. We are in a world where everyone agrees the way to reduce health care costs and to increase longevity of our people is through preventive medicine. We know through the success we have had in recent years that self-exams and mammograms save women's lives. There are going to be what they call false positives, women who find something that turns out not to be a lump. And, sure, they are going to be anxious during that time period while it gets checked out. But would you rather have your mom, your sister, your daughter be anxious for a couple days and get a good result or would you rather have them, on the other hand, not do the self-exam, not get the mammogram, and get cancer and potentially die? It makes no sense. We know these mammograms for women in their forties save lives. We know self-exams save lives. It is not just me saying it; the facts show it. The American Cancer Society notes that deaths for breast cancer since 1990 declined by 2.3 percent, and they have declined 3.3 percent for women in their forties and fifties. Lives are being saved. So why would this government task force that is supposedly focused on prevention want to do away with self-exams and mammograms on a regular basis for women in their forties? What could be the reason? The reason, as my colleague from Texas so eloquently stated, is cost. It doesn't make sense anymore because we are not saving enough lives for the money that it is costing for mammograms. Our moms and our daughters and our sisters are worth that cost. If you want to get a picture of where we are going with this new health care proposal and you want to know what the future is for how the government and your insurance company are going to view your health care, just take a look at this recommendation. Are they next going to say the same thing about men getting prostate exams in their forties? Are we going to start making these cost-based decisions or really furthering them to a degree that we haven't seen before? Are we going to lose our family members because we are rationing health care? These are big issues. The American people, as my colleague from Texas said, need to wake up and they need to watch what is going to happen in this Senate, this great body that debates the important issues. Never has there been an issue as important in modern times as what is going to happen over the next month or 6 or 8 weeks as we discuss these issues that are going to affect our health and our families' well-being. I sent a letter to Secretary Sebelius yesterday on this issue. I saw her comments yesterday where she disagrees with this panel. I commend her for that. Women do not need to get the message now that they shouldn't be doing self-exams. Women should not be getting the message that they shouldn't be getting regular mammograms in their forties. They need to do both things because it is going to help save their lives. No government task force, based on lack of any new information, should contradict its prior recommendations that they do just that. I had a chance to speak with the surgeon general of the State of Florida, Dr. Ana Viamonte-Ros, yesterday about this issue, and she concurs with me, as does the American Cancer Society and other groups, including the American College of Obstetricians and Gynecologists, that women should still do self-exams, and they should still get mammograms on a regular basis in their forties. I wish to read for this Chamber a letter--an e-mail, actually--I received today from a friend of mine down in Broward County from my home State of Florida. She writes: Please thank the Senator for his efforts on this important issue. I am a breast cancer survivor who was first diagnosed before 50 years of age having a mammogram. Subsequent to the mammogram, my tumor was removed surgically. Unfortunately, within 5 years, I was diagnosed again with breast cancer in the other breast and had to undergo surgery and chemotherapy. The second time I found the tumor through self diagnosis. Every day I thank God that I had a lifesaving mammogram and that my doctor showed me how to do a self examination. Just recently I learned through TV that there are also recommendations that women should not utilize self exam as a way to detect breast cancer. It's too unreliable. More hogwash. Most of my breast cancer sisters found their tumors through self exam. Please ask the Senator to dispel any efforts or notions that self exam is not a good means of detection. This is an important issue. We need to get the message out to the women of America that these recommendations are wrong. I only can stand here today with this good story about my mom because if she wouldn't have done that self-exam, she might not be here with us. So I hope the American people will, as my colleague from Texas said, wake up and see what this means and what this portends for the future. With that, I yield the floor.

Mr. LeMIEUX

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

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, I ask unanimous consent to speak as in morning business.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, the clock has struck 12 on a $12 trillion debt. Like Cinderella when she was revealed when the clock struck 12, this Congress is now revealed--revealed for the problem it has in spending more than we can afford. We are being a body and an institution that spends money without thinking about the future of this great country. It spends the money of our children and our grandchildren. It took this country 193 years to spend a trillion dollars and to get a trillion dollars into debt. We are now $12 trillion into debt as of today. That $12 trillion is the equivalent of $40,000 per person, $107,000 per household. This is what American families are now responsible for, because unlike American families who sit around their kitchen tables and try to make ends meet, and unlike the States that have to balance their budgets, this Congress spends more than it has. There is no evaluation in this Congress about how much money is being taken in versus how much money we spend. Instead, we raised this year $1.4 trillion in debt, more debt in a single year than the past 4 years combined. Outside this Chamber, outside the main entrance, is a clock, called the Ohio Clock--the fabled clock that has been in this institution for more than a hundred years. It stands there to tell the time. I suggest that standing next to that clock should be the debt clock to remind the Members of this Senate, and perhaps our friends in the House, that we are spending money we cannot afford to spend, and it is risking the future of our children and grandchildren. As you know, I have three small boys, Max, Taylor, and Chase, 6, 4, and 2, and a baby on the way. We worry for their future--just like Americans across this country and my fellow Floridians are worrying for the future of their children. How can we afford this and continue to spend more than we have? I have been coming to the floor weekly to talk about the various appropriation bills I have been voting on--and, frankly, voting against--because they spend more and more of the people's money and put this country further into debt. Today, we have marked this occasion with $12 trillion in debt--an amount of money that is hard to fathom, an amount of money that is so large it is hard to comprehend. But we know that every family in America is now responsible--every household--for $107,000. That debt now rides upon their shoulders. In a week--perhaps even this week--Democrats in the Chamber are going to introduce a health care reform bill that is estimated to spend another $1 trillion. This bill will raise taxes, cut Medicare, and increase premiums--another large governmental program, when we cannot afford the programs we have. We should focus on spending the money we have, spending it more efficiently and effectively, before we go on to create a new program, a new bureaucracy, and more obligations than we can afford. The Congressional Budget Office estimates that the health care plan being brought forth by the Democrats in this Chamber will spend 24.5 percent of GDP, 19 percent in revenue only. So we have 19 percent in revenue, but 24.5 percent of GDP, which is a huge unsustainable gap. It was recently reported that the deficit for October alone is $176 billion--$26 billion more than estimates by economists. In fact, the debt increased by $40 billion just over this past weekend. Our spending is out of control. The Federal Government does not recognize it. This Congress cannot afford the programs it has, let alone the programs it wants. So I am here to sound the alarm. I could not let this day pass as we hit this $12 trillion mark in national debt. I look forward to coming back to the floor to explain again and again to the American people that this is a problem that must be solved. We cannot continue to spend our children's and grandchildren's future. I yield the floor.

Mr. LeMIEUX

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

Mr. LeMIEUX. Mr. President, I ask unanimous consent to speak as in morning business.

Mr. LeMIEUX. Mr. President, I am here to speak about the recent decision of the Obama administration to bring five terrorists allegedly responsible and who admitted being responsible for planning and executing the 9/11 attacks and having them tried in a criminal court in New York. This is the group of Khalid Shaikh Mohammed and four other alleged 9/11 plotters. The reason I stand before you today is to ask you the question: Why? Why are we bringing enemy combatants, terrorists, to trial in a civil venue in New York? The decision of the Attorney General does not make sense to me. It is not sound in terms of our historical precedent for these types of hearings, and it puts our national security at risk for the future. Criminal trials for terrorists are different and should be different than criminal trials of those who commit crimes in this country. After all, we afford our citizens who commit crimes the presumption of innocence. It is part of the bargain we have with our citizens, that we will not presume them guilty. We afford them rights--rights that are set forth in our Bill of Rights, rights that are guaranteed constitutionally. We do not guarantee these rights for people who are not U.S. citizens. More importantly, we do not guarantee these rights for terrorists who attack our country in an act of war. Right now, we are fighting this war in two theaters--in Afghanistan and Iraq. These are enemy combatants. They are not U.S. citizens. They were not resident in the United States when they committed this crime. I wish to go through the rights we afford the criminally accused in a normal prosecution in this country and show why they are not suited for a terrorist. We extend the right to remain silent; the right to have that silence not used against you; the right to choose between a public trial before a judge or jury; the right to summon and compel the attendance of witnesses to testify on the accused's behalf; the right to a speedy trial; the right to see all the evidence collected against the accused; the right to learn how the evidence was collected; and the right to appeal not only the verdict but almost every ruling a judge performs in the case. Why are we extending these rights to enemy combatants who killed nearly 3,000 innocents on 9/11 through an act of war? They did not wear a military uniform, and the planes they flew were not the planes of foreign countries with foreign flags. But there is no difference between the war we are in with them and wars we have had against other countries. The precedent of what may happen when we afford these rights to these terrorists is not good. Former Attorney General Michael Mukasey talked about what happened when we tried terrorists in U.S. criminal courts. During the trial of Ramzi Yousef, the mastermind of the 1993 World Trade Center bombing, a part of testimony which we thought was innocuous at the time that came out in the public courtroom talked about the delivery of a cell phone battery. It tipped off the terrorists still at large that one of their communication links had been compromised. Mukasey said that link, which had been monitored by the government and provided enormous, valuable intelligence, was immediately shut down and lost in our war on terror. Mukasey also noted that ``In the multidefendant terrorism prosecution of Sheik Omar Abdel Rahman, [also known as ``the Blind Sheik'' for his role in the 1993 World Trade Center bombings] . . . the government was required to disclose, as it is routinely in conspiracy cases,'' the names of the unindicted coconspirators, one of whom was Osama bin Laden. We are giving information in these public trials, which were never meant for terrorism, which was never meant for people we are at war with, that may be used against us in a future terrorist attack. Why are we doing this? What is the purpose? We have military tribunals to perform this function. This is not something new to this country. We have been using military tribunals since the time of George Washington. He used it during the American Revolution to deal with British spies. None other than Franklin Delano Roosevelt used them in World War II. We had eight German agents who sneaked ashore with the intent to plant explosives at railroad facilities and bridges. Roosevelt used military tribunals to try and convict those Germans who came across in World War II, and the Supreme Court upheld it. These military tribunals are not something new. They have to be done right. They have to give due process. We used them against the driver of Osama bin Laden, and one of the charges was dismissed against him. So they are a fair process. Why are we bringing the 9/11 terrorists to a criminal court in New York? These are not bank robbers. These are people with whom we are at war. Why are we affording them extra rights? Why are we affording them extra rights when the information that is revealed during the discovery process in Federal court may compromise our national security and lead to additional terrorist attacks? Why are we doing this? It doesn't make any sense to me. It defies history, and it is going to present and possibly provide future challenges to our national security. Finally, let's think about what these trials are going to be like. We are giving these terrorists an international reality show where they are going to be able to have a platform each and every day to talk about their war against our country and our values. I wish to quote from David Brooks in his column in the Washington Post. He said: Terrorism is an act of propaganda. So now [Khalid Sheik Mohammed] gets to commit the original act of propaganda, which was the attack, and now he's going to have a long trial, an international reality show, which will be followed here, but more importantly, followed around the world. So he's getting a second bite of the apple at spreading his propaganda message. What happens if because of all of the rights that are afforded to a person who is tried in a criminal court in the United States, what happens if because one of those rights and all of the presumptions there are against being found guilty, presumptions that we afford to our citizens because they are part of our constitutional democracy, what happens if Khalid Shaikh Mohammed, the mastermind of 9/11, is acquitted on a technicality? Then what? What are we going to do with him? Are we going to release him? Are we going to let him off on the streets in New York? I don't think so. Then we are going to hold him again. What does that say to the international community? He had a trial, he was acquitted, but we are still going to hold him because we think he is a threat. That is going to backfire on this administration. In conclusion, I cannot understand why we are doing this. I cannot understand, when we have a historical precedent of a military tribunal that we have used since the time of George Washington, that we used during World War II, why we are going to bring these terrorists who killed or were responsible for killing nearly 3,000 innocents on September 11, why we are going to try them in Federal court as criminals and not understand what they truly are, which are terrorists with whom we are at war. Mr. President, I suggest the absence of a quorum.

Mr. LeMIEUX

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

Mr. LeMIEUX. Mr. President, I ask unanimous consent to speak as in morning business.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, before I begin my remarks for today, I wish to say a few words about the tragedy that occurred yesterday at Fort Hood. I know I share the feelings of all Americans who were deeply saddened by the events of yesterday, and our thoughts and prayers go out to the families of the young men and women who were lost and who were injured in the tragic situation that occurred yesterday. I also wish to take this opportunity to add words of appreciation to the first responders and the medical professionals who helped these men and women who were injured yesterday. It is heroes helping heroes that really shows America at its best. Our thoughts and prayers will be with all of these brave young men and women who were tragically slain yesterday, and their families. Mr. President, the purpose for which I rise today is to talk about the spending of this Congress, something I have been doing for the last few weeks since I had the privilege to join this institution as the Senator from Florida. I have big concerns, and the more I have been here and the more I have seen over the past few weeks has given me even more concern. Unlike American families and unlike the majority of American States, this institution spends money it doesn't have. Each day, we go more than $4 billion in debt as we pay for programs we don't have enough money for--$4 billion a day, the national debt grows. Additionally, we spend $253 billion a year on interest payments. It is the fourth largest expenditure in the budget after defense, Social Security, and Medicare. So the fourth largest expenditure that we spend every year doesn't go to a new program, it doesn't go to help a person; it goes to pay for programs in the past that we couldn't afford. It took us until 1982 to go $1 trillion in debt. Yet we are shortly coming upon nearly $12 trillion in debt. In a matter of days, we will hit that number. More troubling still, this past year, 2009, this Congress, for its annual budget, grew a deficit of $1.4 trillion. That is as much deficit as was accrued in the past 4 years combined. So I plan to come to this Chamber every week and talk about the spending problem this Congress has in order to highlight this issue. It is of grave concern to me, not just as a Senator who represents 18 million people in Florida but as a father of three children--Max, Taylor, and Chase, 6, 4, and 2--and a baby on the way. My wife and I are concerned, as every parent should be, about their future. It is our obligation as parents to make sure they have better opportunities than we had. In fact, that is the American creed, that every generation ensures that its children have equal or better opportunities than the opportunities they enjoy. But I am concerned for my children and for all the children in this country that at this present rate of spending, we will not be able to ensure that they have those equal or better opportunities. Congress is spending too much. Both sides of the aisle talk about fiscal restraint and fiscal discipline, and yet we keep spending more than we have. This government took in $2.1 trillion in revenues this year; yet we spent $3.5 trillion. I am not used to this system because, as you know, I come from a State system, where I served as a chief of staff to a Governor. In Florida, we have to balance our budget. Every year we looked at the receipts. We anxiously looked, almost on a monthly basis, to see how much money was coming in to determine how much could be spent, or what kind of tax breaks could be given back to the people, or how much could be put in the reserves. Those were the good times. As the economy declined, we watched the money and made decisions about how much we were going to have to cut. At the end of the day, we had to balance the budget. Congress doesn't do that. Congress spends more than it takes in, and it puts those obligations on our children and grandchildren who some day will have to pay off this debt. But the time to make tough choices should not be tomorrow; the time to make tough choices is today. One of the first pieces of legislation I had an opportunity to consider and to vote on was an appropriations bill for housing, urban development, and transportation--important issues for this country. In the opportunity to consider that appropriations bill, this Congress could have cut spending or increased the deficit. Well, it chose to increase the deficit, and the increase was by more than 23 percent over last year's budget, in a time when we are spending much more than we have. In a time when we are about to have a $12 trillion national debt, we decided to spend 23 percent more than we did last year. What did we spend the money on? Certainly, plenty of good things. Obviously, transportation and housing are important. But we spent money on a lot of questionable things, too. We built transportation museums--monuments to roads we have not yet built. We put up congratulatory signs, saying this is how we spent money on a road, and we funded airports with no planes, as the number of Americans losing their jobs has now risen to a 10.2-percent national unemployment level. We are spending $700 million a day to pay the interest on the debt, and we are funding transportation museums. If we would have stayed at the spending level from last year and cut out these extraneous programs, congratulatory signs that tell us we built a road, transportation museums, and other spending programs--which some amendments sought to cut, but they did not pass--we would have saved $12.7 billion. In Washington, $12.7 billion doesn't sound like a lot of money. We talk about trillions of dollars here. But $12.7 billion could have done a lot of good. What could we have spent that money on? I think it is important to realize that every time we spend a dollar, we are making a choice. It is a choice about how we are going to direct this country's future. We can either return that dollar and not spend it, give it back to the people who paid it, or we could not spend it and not increase our debt and put that on our children's backs, or we could have spent it on something different and maybe better. Here is an example: One thing I applaud the administration for in their stimulus program is they have $8 billion set aside for high-speed rail. That is exactly the kind of thing this country should undertake. The Federal Government should not do much, but they can do things that communities and States cannot often do for themselves. High-speed rail is such a national-sized project, in my opinion, that the role of the Federal Government is there. It makes sense in this difficult economic time, because you will actually create thousands of jobs by building the high-speed rail. Once it is built, you will have a long-term gain, because that high-speed rail will be there to promote infrastructure, to promote jobs, and to ease the burdens on our everyday lives. There is $8 billion in the Federal budget this year that States can apply for to build high-speed rail. My State has an application in, along with 40 other States. We are seeking $2.5 billion to connect Orlando to Tampa, which would be fantastic for our State. I hope our State gets those dollars. But there is only $8 billion to apply for, and there are 40 States that want the money. Imagine if we would have taken the $12.7 billion we wasted here and put it into that program; maybe more States could have had high-speed rail. Let me give another example. What can you do with $12.7 billion? With $12 billion, you could put 427,000 college students through a 4-year college. We have to realize every time we spend a dollar, it is a choice. That dollar could have been spent better, or it could have been returned to the people. President Obama recommended in this appropriations bill that we cut $211 million out of it. I don't think that was enough, but let's give credit where it is due. He suggested we cut $211 million. We didn't even do that. The Senate could only find $15 million to cut and the House only $20 million. Because of Congress's spending and the administration's lack of willingness to cut spending, President Obama has presided over more new domestic spending in his first 10 months in office than President Clinton did in 8 years. One of the first bills I supported when I came here was the Budget Enforcement Legislative Tool Act of 2009. It is a long title. It is a proposal I think both Republicans and Democrats should be able to agree upon. The bill requires us in Congress to do an up-or-down vote on the President's recommendation on spending. In this case, we would have cut more than $200 million if we would have adopted the President's recommendation; not enough but better than what we did. I believe it is time to stop talking about cutting spending and do something about it. I am going to come each week to the floor and talk about the various appropriations bills we have gone over. I will keep a running tally, starting with the $12 billion we could have saved in this appropriation. At the end of the day, hopefully, the comments I make will encourage others in this body and in the House of Representatives to take this spending situation seriously. I guess all of us wish we were in the situation the Federal Government is in, where we could spend more than we have, in terms of income, and never have to pay it back. But the truth is, the Federal Government isn't in that situation either. One day the chickens are going to come home to roost. One day we are going to be accountable for the money we spend. One day it will impact our standing in the world. I believe that day is very soon. We already know that the banks of the world--the central banks--are starting to shed dollars. They no longer want to hold our currency because they are losing faith in the United States of America as the leading world financial power. We already know we are having to sell more and more debt to countries that don't even have our interests--countries such as China--and we already know we are losing our standing and our ability to move forward because the rest of the world doesn't feel we financially manage our situation well. While our economy is straining, while countries look at us as suspect for our spending patterns, countries such as Brazil are on fire, American dollars and investments go there, because people think there is a better opportunity to make money in those countries than in the United States. I want a better future for our children. If we are going to have a better future for our children, we are going to have to restrain our spending and get serious about balancing the budget of the Federal Government, as the States do and as families do across America. Mr. President, I yield the floor and suggest the absence of a quorum.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, I wish to follow up on the comments of Leader McConnell and Senator Crapo concerning Medicare. I don't think there is a State that is more affected by these potential cuts to Medicare than my home State of Florida, where we have nearly 3 million Floridians who enjoy the Medicare Program. Ultimately, the question in our health care debate is: How we are going to pay for this $1 trillion new program--this program that encompasses some 1,990 pages in the House proposal? As Leader McConnell said, it seems it is the opinion of the majority in this Chamber, and in this Congress, that the way we are going to pay for this new entitlement program is to take money from health care for seniors. Frankly, it amazes me that we would have this conversation; that we would take nearly $500 billion--$\1/2\ trillion--out of health care for seniors. It amazes me for a couple of reasons: One is that this money was paid into the system by seniors out of their paychecks for their entire lives. This was not some handout from government. This is a program they have paid into and they expect a return on it. It is a covenant with our seniors--our greatest generation, now retiring. We told them that if they paid into this system, they would have health care for the rest of their lives through Medicare. Now, even though this program is in and of itself, as Leader McConnell said, in jeopardy of going bankrupt in the next few years--because less people will be paying in and more people will be taking out--we are going to take $\1/2\ trillion out of this program to pay for a new program. That doesn't make any sense to me. I received a letter from one of my constituents, Shirley Anderson from Gotha, FL, which is right outside the Orlando area in central Florida, and she gets it. She says to me: I am writing to express my deep concern about the proposed Medicare cuts in reimbursement for outpatient tests and procedures. I understand that these cuts may force doctors to either refuse to take care of me, as I have Medicare, or leave the State of Florida altogether. It has taken me a long time to find a doctor that I trust and I cannot afford to lose him. If this happens I will be forced to go to the hospital for these routine cardiac tests and procedures. My waiting times are going to be longer and more importantly my out of pocket expenses are going to be much higher and I simply cannot afford this. I strongly believe this is going to adversely affect my health care and well-being. What are we doing? We are going to jeopardize the promises we have already made to seniors in order to create a new program that is not going to reduce the cost of health care for Americans, a new program that is fraught with problems. It doesn't make any sense to me. As was stated before, the proposal in the House and what we think will be the proposal in the Senate--although we have not seen the final copy--cuts $135 billion from Medicare Advantage, $150 billion from hospitals that care for seniors, $51 billion from home health agencies, and nearly $70 billion in additional cuts or fee increases. What is this going to do to the process? I talked this morning to Ron Malone, who is the vice president of a health services company that provides home health care in Florida. They have 16 locations, they have 2,000 clinicians, they serve about 25,000 patients. He told me this proposal, as written, is going to put half of the providers underwater and out of business. Half of the home health providers, in his estimation, will go out of business. Which ones will go out of business? The small companies, the companies we are trying to help in this economy where we have over 10 percent unemployment in Florida and nearly 10 percent unemployment in this country. We are going to put those small businesses out of business. Home health care saves costs. Home health care is the more affordable option than a nursing home. Plus seniors like it better because they get to stay in their own homes. We are going to put these people out of business. As Senator Crapo said, where is this home health care most important? In areas where there is not a hospital or nursing home available, out in the rural areas, not only in places in Idaho but places in Florida. So we are going to make it harder for seniors to get the care they want, and we are going to do something that ultimately is going to be more expensive. I want to also talk about Medicare Advantage. This is a program that was started to give seniors more options under Medicare. It is not a requirement, it is voluntary--they can choose it--and it is more like a private program, more like a program in the private sector where the companies actually cater to the seniors, provide them with more benefits, such as eyeglasses and dental care and hearing aids and flu shots. They have someone on the other side of the equation who is trying to give them some service, unlike government usually does. Now we are going to cut that program. We have 915,000 Floridians in Medicare Advantage, and we are going to take $150 billion out of it. So what is going to happen? They are going to get less services. We cannot get blood from a stone. When the money comes out of the program, the program is going to suffer. Who is going to suffer? Our seniors. These are increasingly popular programs in Medicare Advantage. It is also important to note that 40 percent of African Americans and 53 percent of Hispanics who do not have Medicaid or employer-based coverage are now enrolled in Medicare Advantage. Our minority populations enjoy this program also. As a Senator from Florida, the State with the highest per capita population of seniors, the second highest total population of seniors in America--3 million seniors on Medicare--who made this country what it is, who are our greatest generation, who paid into this system and now are going to see less benefits and less care, I can't stand by and let that happen. What I am afraid of is we are going to have two classes of health care in this country. If we pass a bill like this, what worries me is that fewer providers are going to be in the Medicare system because their reimbursement rates are going to have to go down. So our seniors and our disadvantaged are not going to get the best doctors. In fact, someday I don't think a lot of these doctors are going to take insurance. So we will have one quality of health care for the rich and one quality of health care for everybody else. That is not American. That is not what we promised our seniors, and it is not something we should be doing. The Hippocratic Oath tells doctors: ``First, do no harm.'' This proposal, from all we can read about it, first does harm. It harms our most vulnerable people, our seniors, whom we owe and should respect. I yield the floor.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, I wish to follow up on the comments of my colleagues from Nebraska and Arizona. I will not be as eloquent as they, but I also want to lend my voice to the discussion regarding health care. I had the opportunity to receive the House bill, 1,990 pages. It is not an easy read. I am making my way through it. But we have learned a lot through it. I have already found that the taxes start on page 297. There is an estimated over $1 trillion in costs over the next 10 years in these 1,990 pages. This is the House bill, the bill Speaker Pelosi has put forth. We do not yet have a copy of the Senate bill to digest. So this is the text we will go on for now. But I think it is good to see this in the larger context in which we debate health care. It is important to remember that this year, this Congress has passed a budget that has a record-setting $1.4 trillion deficit. That is more deficit than the last 3 years of Congress combined. Americans want and deserve more affordable health care. We have more than 40 million Americans without health insurance, nearly 4 million of them in Florida. They want better access to health care. They certainly want their health care to be less expensive. But keeping this in mind, we have to look at the situation in which we find ourselves. The reckless spending of this Congress must stop or we are going to bankrupt the future of our children and of our grandchildren. The Senator from Nebraska was talking about a letter he received from his constituent. I sat in my office and looked at some of the letters that have come in from Florida. I wanted to read one from John Miller from Valrico, FL, which is in the Tampa Bay area, right near Brandon. He writes--it is in handwriting, it is not typed. It is from October 19. He says: Mr. LeMieux, I am one of those who have not paid enough attention to what is going on. Like others, I am waking up. I have decided to go old school and start hand-writing letters again. It was recently reported the Federal deficit for the 2009 fiscal year was $1.4 trillion, up from $459 billion the year before. I think it is time for Congress to stop all work and start working on ways to cut the deficit. One way is to shrink the government. Good thing Mr. Miller in Valrico, FL, gets it. Before we start embarking upon 1,990-page endeavors to create new entitlement programs that cost $1 trillion, we should focus, as Senator Johanns from Nebraska said, on the programs that we already have, and we should do so through the lens of the debt and deficit we have now that is going to bankrupt the future of our children. Right now, we spend $253 billion a year in interest alone--$253 billion to pay the interest on our debt. That is the third highest expenditure we have in the Federal budget, $700 million a day. The national debt is nearing $12 trillion. In the next few days, we will reach that mark. The White House projects we will be at $23 trillion in 10 years. The national debt rose at a rate of $4 billion a day. It took us until 1982 to hit $1 trillion in debt; now we are near $12 trillion. When I gave my maiden speech a couple of weeks ago, I tried to put some real-world context into what these amounts of money mean because $1 trillion or $1 billion are numbers that are hard to understand. I said in that speech that $1 billion laid edge to edge in one-dollar bills would cover the city of Key West, FL, about 3.4 square miles, and $1 trillion would cover Rhode Island twice. Another way to think of it is if you had one-dollar bills and you stacked up $1 trillion, it would be 678 miles high. These are staggering amounts of money. So where will all of this spending lead us? Well, I think we know. When you have too much spending, you have to increase taxes. When you increase taxes, you reduce prosperity. We know this 1,990-page bill already increases taxes. In the Wall Street Journal this weekend, Peggy Noonan talked about the problems of New York. I do not mean to single out my friends from New York, but I thought what she said in her article was telling because here is a State with high taxes. She said that the Post reported this week that 1\1/2\ million people have left high-taxed New York State between 2000 and 2008, more than a million of them from ever higher tax New York City. They took their tax dollars with them, more than $4 billion in 2006 alone. I do not know that people are going to leave the United States of America because we have taxes that are too high, but, as I said in my maiden speech 2 weeks ago, I am very concerned that one of my three sons--Max, Taylor, or Chase--or maybe the baby we have on the way is going to come to me when they are an adult and say: Dad, my opportunities are better in another country because I do not want to pay 60-percent taxes to pay for the deficit and the debt you have laid on my shoulders. I hope that day never comes. So what should we do? Instead of focusing on new entitlement programs, perhaps we should try to fix the ones we already have. Medicare, health care for seniors, and Medicaid, health care for the poor, have huge amounts of waste, fraud, and abuse, an estimated $60 billion in waste, fraud, and abuse in Medicare alone--$60 billion. There could be as much as $225 billion in fraud and abuse and waste across the whole health care system. I seek to be a problem solver in this Chamber, and I seek to bring Democrats and Republicans together. So last week, I introduced my first bill, S. 2128, the Prevent Health Care Fraud Act of 2009. What that bill does is simply three things: No. 1, it creates in the Department of Health and Human Services a Deputy Secretary, the No. 2 person in the agency who will be the chief health care fraud prevention officer of the United States. They will be responsible for only one job--to make sure we ferret out health care fraud. No. 2, we will bring predictive modeling to health care administration in this government. What is predictive modeling? An easy way to understand it is, it is the same way your credit cards work. If you make a credit card purchase and your credit card company thinks it is a questionable transaction, the computer has a model, and you get a phone call or an e-mail. If you don't call and validate that transaction, the vendor doesn't get paid. It happened to me a week or two ago. I went to buy a television. I am from Florida. I get an e-mail on my BlackBerrry before I walk out the door, saying: Did you authorize this purchase? We don't do that in health care. Instead, we chase the bad guys later and try to get the money back. That would stop the money from ever being paid. The third thing it would do is require background checks for health care providers. The American people would be surprised to learn we don't do this right now. We have people ripping off Medicare and Medicaid, $10, $20 million a shot. My State, specifically in southeast Florida, is the health care fraud capital of the world. We need to do a better job of spending the money of the people now before we embark upon new programs to spend trillions more. Senator Kyl mentioned the Wall Street Journal's editorial of today. It called this bill the worst bill ever--that is a heck of a name--because it implements a spending surge to the tune of more than $1 trillion. It has $572 billion in new taxes, and it threatens to bankrupt the States. Senator Johanns mentioned this as a former Governor. I was the chief of staff to a Governor. I know how difficult it is to make ends meet in a State system where you actually have to balance budgets, not like the Federal Government where you can just spend more money and print more money. The States actually have to balance budgets. In Florida, we spend more than 30 percent on health care. If you spend more money on health care, specifically Medicaid, guess what you spend less money on. Education and other good programs. With these increased Medicaid obligations, the States will be in more of a difficult place. They will have to either cut other programs or raise taxes. The Wall Street Journal said we can't regulate our way out of the reality that we live in a world of finite resources and infinite wants. We should focus on the programs we have before we embark upon new programs. The majority wants to focus on new programs and not on effectively and efficiently running programs we have. I hope my colleagues from both sides of the aisle will join me in supporting S. 2128, the Prevent Health Care Fraud Act of 2009. I yield the floor.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, I rise to talk about issues very similar to those of my friend from Texas and echo his concerns about the current proposal for health care. We found out yesterday the proposal that was put forth by the Speaker of the House is nearly 2,000 pages. It is a $1 trillion proposal. That is $\1/2\ billion per page. It is sort of staggering to think about. When I came to Washington, just a couple months ago, appointed by my Governor--Charlie Crist of Florida--it was my cause to come and be a problem solver, to help work on issues that both Republicans and Democrats could work on together. I learned from Gov. Charlie Crist that there are lots of issues we can disagree about principally, but there are plenty of issues we can work on together and do things that are right for the people. That may not be in vogue in Washington, DC. It may not be in vogue to try to find issues--the low-hanging fruit--we can work on together to solve problems, but it is something I wish to pursue. Additionally, when I came to Washington, I recognized--and I spoke about this last week in my first address in this August body--there are lots of times most folks in Congress would like to discuss grand new plans, grand new ideas for the future of this country. That is exciting to talk about--a new program or a new administration, more government employees working on a new program, perhaps, in some new government building. But I don't have a passion necessarily for following up on those great ideas for future plans. I have a passion for helping us do better what we already do. Oftentimes, in government, that is not the case. We spend billions, trillions of dollars a year on existing government programs, but many times we don't do it effectively and efficiently. If we spent as much time caring about the money we are spending now, as opposed to the money some in this Chamber want to spend, I suspect we could find plenty of money to either return to the people or to find money for these new programs. Today, I wish to talk about just such an idea, an idea to recover some of the waste, fraud, and abuse that is currently happening in our system of government. We know in our current provision of health care-- in Medicare and Medicaid--there is tremendous waste, fraud, and abuse. Estimates are that some $60 billion to a staggering $226 billion a year to waste, fraud, and abuse. This health care proposal that was put forth by Speaker Pelosi and that we are discussing in the Senate, just for comparison purposes, is $1 trillion over 10 years. I think anybody who has watched the government knows that if you estimate something is going to cost $1 trillion, it is going to be a whole lot more than that when it actually gets implemented because we don't do much in government that comes in under our estimates. Most times, almost every time, it is a lot more than is estimated. But let us compare these numbers, $1 trillion over 10 years. That is about $100 billion a year. We may be wasting $226 billion a year. If we captured just half of that, we might be able to pay for this program. Better still, we could take those dollars we are wasting in fraud and abuse and we could put them back into the Medicare Program to pay for health care for seniors. Wouldn't that be a good idea? Because the estimates tell us that in 8 years we are going to be in a situation in Medicare where we are going to be in a deficit. We are going to be taking in less money than we need to spend. Workers will be paying in less than retirees need for their health care. We will have to, as the Federal Government, shore up Medicare certainly at that point. So why don't we concentrate now, while we can, on an issue Democrats and Republicans can agree upon, which is trying to stop waste, fraud, and abuse. Yesterday, I had the honor of filing my first bill in the Senate--S. 2128--and I wish to talk to the Senate and the American people about that bill. S. 2128 is the Prevent Health Care Fraud Act of 2009. What this bill simply will do is try to go after the waste in the health care system the government currently runs. It is estimated that $1 out of every $7 we spend on health care for seniors is captured by criminals or is wasted and is not going to help seniors--$1 out of every $7. That is where we get to that number of potentially $226 billion a year. I have a lot of experience in this. Before coming to the Senate, I had an opportunity to serve as the deputy attorney general in Florida and to run--under then-attorney general Charlie Crist--an office of about 400 lawyers. Within that office, we had a Medicaid fraud control unit where we focused on fraud in Medicaid. We were able to recover $100 million a year--just in Florida--by stepping up enforcement actions to capture bad guys who were taking dollars out of the system. What I wish to try to do with this new act, in S. 2128--the Prevent Health Care Fraud Act of 2009--is not just go after these bad guys once we have figured out they have taken the money but to prevent them from getting the money in the first place. The American people would be shocked to know how little we do to prevent health care fraud. You might expect, sitting at home in Orlando or wherever you are in the country listening to this address today, that we have a very comprehensive system to stop health care fraud; that if the government is spending billions of dollars, trillions of dollars over time on health care, that we would have hundreds and thousands of people who would be working to stop health care fraud; that we would have sophisticated computer models that stopped health care fraud before it happened. That is simply not true. I introduced this bill yesterday, and I am speaking about it today, to help try to stop this fraud before it starts. My goal is to be a problem solver in Washington, to work on issues everybody can agree upon. Let me tell you about what S. 2128 does. It does three things, basically. We are going to create, within the Department of Health and Human Services, a Deputy Secretary who will be the chief health care fraud prevention officer of the United States. That individual will be in a No. 2 role in that agency. That person will report directly to the Secretary and will be nominated by the President of the United States. That Deputy Secretary will not have seven different jobs. He or she will have one job--to prevent health care fraud. If that Deputy Secretary does not do his or her job, they will come to the Senate and the House of Representatives and be called on the carpet. This chief health care fraud prevention officer of the United States is going to run a division that is going to work every day to stop this health care fraud before it starts. How are they going to do it? Oftentimes, the private sector gives us a model that we can use and we can copy in the government to help us prevent health care fraud or anything we do in government, to do it more efficiently and more effectively. So what model is out there to prevent fraud that is being used every day and that affects all our lives, that stops fraud before it starts? That model is the credit card business, a business that is roughly the same size as the health care business. A couple of trillion dollars a year passes through the exchange of credit cards for the purchase of goods and services. The health care industry is a multitrillion-dollar-a-year industry as well. The level of fraud in the health care industry is $1 out of every $7. The incidence of fraud in the credit card industry is 7 cents for every $100--$1 out of every $7 versus 7 cents for every $100. How do they do it? Well, we all have had this experience. You use your credit card to purchase something and then a couple minutes later you get a phone call or e-mail which asks: Did you authorize the purchase that just happened with your credit card? This just happened to me a week ago. I went to buy a television, in Washington, DC, at Best Buy. I have my family here so they can be close to me during my time in the Senate, and we have to have a television. So I go to Best Buy and use my credit card. I walk out the door and my BlackBerry vibrates. There is an e-mail from my credit card company asking: Did you authorize the purchase of a television at Best Buy? Why did that happen? They have a computer modeling predictive system that says this is a questionable transaction. George lives in Tallahassee, FL; someone is using his credit card to buy a television--which is something that is probably bought a lot of times on a stolen credit card--something is up. The computer--no person does this, this has been programmed--goes into action and I get an e-mail. That transaction is not authorized for payment until I call my credit card company and tell them, yes, I actually authorized that purchase. Why can't we do the same thing the credit card companies are doing for health care? Why can't we use a predictive modeling system that says a health care claim is not going to be paid when a red flag comes up? Right now we are on a pay-and-chase system. We pay these people who provide health care, allegedly--many of whom are not providing health care because a good portion of them are criminals, frankly--and then we try to go after them to enforce the law, and we barely ever capture the money back. We capture some but not near enough. If we put this model in place, it stops the fraud before it happens. S. 2128--the Prevent Health Care Fraud Act of 2009--would put this predictive modeling system in. The Federal Government would have to go out and hire folks to do it. We would have a competitively bid process. It is no different than what we do in other parts of the government. In the Defense Department, we go through a bunch of checks before there is an acquisition for the Defense Department. Why can't we put this predictive modeling system over in health care to use real-time data to stop these fraudulent transactions before they happen? According to Harvard University Professor Malcom Sparrow, the credit card industry establishes benchmarks for acceptable business risk and their threshold is one-tenth of 1 percent. By contrast, fraud losses in the health care business run from 3 to 14 percent. That is 100 times the acceptable business risk. Another thing this bill does is it requires background checks for all health care providers. If you are supposedly providing health care, whether you are providing a wheelchair or a doctor providing actual health care services--someone who is a physician's assistant or whoever it may be--if those folks are being reimbursed by the Federal Government, getting paid for the health care they are providing, they should not be criminals. You might think that right now we are doing background checks on all these health care providers, but we are not. I know this, specifically, because Florida, unfortunately, is ground zero for health care fraud. We have tremendous problems in Florida, especially the southeast part of Florida, where I am from--Fort Lauderdale, Miami-Dade County--with health care fraud. Let me cite some examples. Mr. President, ``60 Minutes,'' last week, aired a special on this. They talked about the rampant fraud in south Florida. One of the perpetrators was responsible for $20 million of health care fraud alone, and he said: We get a Medicare book of codes and our bidder tells us which ones to use and we run the codes. So they get one wheelchair and they sell it a thousand times and get reimbursed a thousand times for it. There is no computer modeling system that puts the red flag up, such as there would be on your credit card, that says: Stop that; wait a minute; after the third wheelchair is sold in 60 seconds, maybe we should not pay this guy's claim. It has gotten so easy to steal money from the Federal Government that organized crime has gotten involved. There have been stories of a Russian-Armenian organized crime ring that defrauded Medicare by $20 million, and they said it was easier than trying to be involved in the illicit drug business because there was no one going after them. I wish to take a moment to applaud my colleague from Delaware, Senator Kaufman, who just introduced some legislation called the Health Care Fraud Enforcement Act of 2009 to increase the penalties for health care fraud. I think that is great. We should be doing that. But in combination with that, we should do what we propose in S. 2128, which is to stop the fraud before it happens. These instances of fraud across the country are rampant. I will give you another example. South Florida is home to 8 percent of the Nation's AIDS patients, but 72 percent of Federal AIDS medication payments are paid in South Florida. That is 72 percent, when we only have 8 percent of the patients. Why is this happening? These medications for AIDS are extremely expensive. Some bad guy runs the code all day and says: I have given this many injections of AIDS medication at $2,500 a pop; runs 1,000 codes and we pay them. We pay them. It makes no sense to me. So we have had big disagreements about how we are going to solve health care, how we are going to provide more affordable health care to our people in this country, how we are going to provide more access to health care. But we certainly can agree we should run whatever program we have efficiently and effectively. We can certainly agree we should not have waste, fraud, and abuse. If we can reduce the $60 billion to more than $200 billion in fraud a year by simply putting somebody in charge of health care fraud prevention, put predictive modeling in such as we have in the credit card industry, and not let people be health care providers unless they have a background check and, if they are a criminal, not let them provide health care, we can save billions of dollars. Those dollars can go back into Medicare, which is running at deficits. As I said when I opened my remarks today, it is very much in vogue in Washington to propose brandnew plans. I understand that. But we need to be focused and have as much zeal about brandnew plans as running the programs we have efficiently and effectively. I hope my colleagues will join me in supporting this piece of legislation, S. 2128, the Prevent Health Care Fraud Act of 2009. I yield the floor and I suggest the absence of a quorum.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, it is an honor for me to stand on the floor of the Senate, on behalf of my State of Florida and before this Nation, to give my maiden speech. First, let me thank my wife Meike for her support. No one succeeds in life alone. That is certainly true for me. She is the strength of our growing family of five, soon to be six. I would not be here without her love and support. It is humbling to think of those who have come before me and spoken before this body on the great issues of the day. I will not seek to match their skill in poetry or prose, but I will work to honor them with clear and straightforward language, passion to find solutions to the challenges that face us, and resolve to follow words with deeds. It is the tradition of this Chamber, as Senator Ted Kennedy stated in his maiden speech nearly 50 years ago, that ``a freshman Senator should be seen, not heard; should learn, not teach.'' But similar to Senator Kennedy, who asked for the dispensation of his colleagues to speak to the great cause of civil rights being debated at the time, I, too, seek the consideration of my colleagues to rise and speak at such a critical time in our Nation's history. During my first week here, the senior Senator from Ohio, Mr. Voinovich, told me that while my time in the Senate may be short, just 16 months, it might be the most important 16 months in modern history. My brief experience here has confirmed the wisdom of his insight. The issue that commands the attention of this Congress is the health of our people and proposals that address the problem of those who cannot afford or simply do not have health insurance. We seek solutions to the rising costs of medical procedures and hospital stays. We are in search of ways to ensure that every American has access to affordable and quality health care. These are noble goals. Floridians and Americans are struggling with the high cost of health care. Premiums for family health care have risen 131 percent over the past 10 years. Working families are finding it harder and harder to make ends meet. Between the demands of taxes and insurance, families have less and less to save and spend on their own priorities. Health care costs are burdensome on seniors as well, who, while covered by Medicare, often buy additional insurance to supplement their needs. Rising costs for seniors living on fixed incomes prove more than difficult. Still more troubling are those who have no insurance at all--some 4 million Floridians and an estimated 45 million Americans nationwide. For many of the uninsured, a serious illness or an accident is all that may separate them from bankruptcy. I believe the problem of health care must be addressed. No American should be denied access to quality health care. No American should be rendered destitute by illness. No American family should have to live paycheck-to-paycheck because they cannot find affordable health care. The problem is great, and it is one worthy of our full attention. But before we can address health care and the cost of reform, we need to consider the broader state of affairs in which we as Americans find ourselves. We need to draw back the curtain, widen the lens. No issue, even one as important as health care, stands alone. We have responsibilities in other equally important areas such as national defense, education, and the economy. Balanced equally with all these priorities must be our ability to afford them. Our Nation's spending problem is not a topic that many like to discuss. It is, after all, more desirable to speak of new ideas and grand plans for the future, but that very future is at stake if we do not address the problem now. Our national debt grows at an alarming rate of nearly $4 billion a day. When I took office, just 5 weeks ago, our national debt was $11.7 trillion. Today it is nearly $12 trillion. During the time it will take for me to give this address, it will increase by another $50 million. Since the debate on health care began in March to the time it likely concludes at the end of this year, we will have amassed an additional $1 trillion, near to the very amount we are discussing for this health care proposal. Instead of spending less to stem the tide, we learned last Friday that in the fiscal year we just completed, Congress amassed a record-setting $1.4 trillion budget deficit--a larger single-year deficit than the deficits of the last 4 years combined. Our Government spending is out of control and it is simply unsustainable. Why does it matter? What is the consequence of accumulating trillions of dollars in debt? What does it mean for us, for our children, and for our grandchildren? The consequences are a government hamstrung by its obligations and a people taxed beyond their ability to prosper. Last year, our Nation spent $253 billion alone on the interest payments for our debts. That is a statement worth repeating. Last year, our country spent $253 billion alone on interest payments, the third highest expenditure in the Federal budget. That is nearly $700 million in taxpayer dollars spent on interest, every day-- money that could be spent on worthwhile programs or, better still, returned to the people because, after all, it is their money. In 10 years, the White House projects our national debt will be a staggering $23 trillion, surpassing the total value of goods and services made in the United States in 1 year. I have not been in Washington for long so it is hard for me to comprehend the idea of $1 billion, let alone $1 trillion. I think that is true for most Americans. So it is worth a moment to understand the enormity of these figures. If you were to lay down single dollar bills, edge to edge, $1 million would cover two football fields; $1 billion would cover the city of Key West, FL, 3.7 square miles; and $1 trillion, laid edge to edge, would cover the State of Rhode Island--twice. Still more staggering, from the time our Government began in 1789, it took 167 years for the Federal Government to spend its first $1 trillion. This year we will spend $3 trillion. Increasing debt and increasing costs of entitlement spending and increasing interest payments mean we are on a path which is unsustainable. The American people know this and they are showing their frustration with Congress's out-of-control spending. We need to learn from families in America. Families in America and across Florida deal with their budgets every day. They sit around the kitchen table. They look at what they make and what they spend and they try to make ends meet. But the Federal Government is similar to that family with the credit card debt--every month the debt grows, the interest compounds. The family spends more and more just to make the minimum payment. Yet the balance due continues to grow. In order to get out of debt, the family has to do the right thing, it has to cut spending or mom or dad have to get another job. If the family does the right thing, pays off its debt, it can save a little, build a nest egg, and recover. If they do not, they reach that point where the debt grows out of control. They reach the point where they are too far gone. The Federal Government has reached that moment in time. In the past 27 years, we have gone from $1 trillion to $12 trillion in December, and it is estimated that by the end of 10 years, we will be $24 trillion in debt. The point of no return is upon us. We must recognize this simple truth: We cannot afford the Government we have, let alone the Government the majority in this Chamber wants. We ought to be cutting taxes, not raising them; we ought to be spending within our means, not increasing our debt; we ought to be fighting with the same vigor to cut waste, fraud, and abuse that some fight to create new entitlement programs we cannot afford. It has also become clear that our policies of limitless spending threaten to devalue the dollar. Recent reports suggest a rush by U.S. investors to pull their money from domestic investments and instead seek opportunity in emerging markets. Investors find markets such as China and Brazil to be more attractive because those nations use their financial reserves to weather the economic crisis. There is also talk in the international community that perhaps the dollar is no longer the best benchmark for their reserve currencies. According to the International Monetary Fund, the dollar is held now at its lowest point on record in reserve currency of the central banks around the world. Our unsustainable spending and debt and our inability to make the difficult decisions necessary to change course is decreasing confidence in our Nation abroad, and if not corrected, it will impact the quality of life for all Americans. What is the answer? The answer is we have to stop. We have to stop financing today's programs on the backs of future generations. Common sense tells us we need to balance the Federal budget. The Federal Government has not done that since 2001. There is no reason why it cannot happen again. The Framers' ideal of limited government is one we need to pursue and we need to do it if we have the will to make it so. As the father of three young sons and a baby on the way, one of my greatest concerns is that 1 day one of my children will come to me when they are grown and say that they are moving to another country, perhaps a place such as Ireland or Chile, because they believe the opportunities are greater than the promise and the opportunities of America. Even now, as many as 200,000 skilled American workers could leave for places such as China and India in the next 5 years. America has always been the land of opportunity, a beacon for those who seek a better life. That life cannot be darkened. Let us not stand witness to the decline of our great Nation. Let us not sit idly by so that the work and sacrifice of those who came before us can be squandered. Let us not miss out on this moment in time to shoulder the burden of leadership to do what we must do for our children, their children, and the American dream. Their future is bound to the decisions we make. I come from a State where a balanced budget is a constitutional requirement, where lawmakers are required to spend within their means. And it is not always easy. In fact, it is often a painstaking process that requires leadership and tough choices, with Republicans and Democrats sitting down together to make responsible decisions. In the past 3 years in Florida, Governor Crist and the Florida legislatures have cut spending by more than $7 billion, almost 10 percent of the State budget. Florida has made tough choices because it must, because lawmakers in 1838 adopted language requiring our State to have a balanced budget. It works for Florida and 41 other States, and it can work for our Nation. The Federal Government should be held to the same standard. This Congress must balance its budget. There is no reason why Congress cannot do what American families and the majority of States do. There is also no reason why the President of the United States should not have the same powers as 43 Governors do to strike wasteful spending with a line item veto. These issues are not partisan. Republicans and Democrats alike should chart a course to a balanced budget to reduce the national debt and restore the American dream. We were promised a budget deficit-neutral health care plan. President Obama said to a joint session of Congress, he ``will not sign a plan that adds one dime to our deficit now or in the future.'' I am encouraged by the President's words, but I am concerned by the proposals we have seen. Cutting a half trillion dollars from Medicare is not budget neutral. Shifting costs to the States for increases in Medicaid is not responsible. And taxing medicine and lifesaving devices will increase, not decrease, the cost of health care. That is not reform. The fact is, we do not know where the money is coming from to pay for the proposed health care plan, and in light of our desperate financial situation, we cannot budget on faith alone. Last week I participated in a hearing to discuss runaway premiums in a program designed to let Federal employees buy long-term health care. Employees were given two options: a fixed option that had a higher cost but guaranteed that premiums would not go up, and a variable option which was less expensive but it provided no guarantee. Smart Federal employees paid a little more to get that guaranteed Federal plan. But it is not going to be that way. Because now the Federal Government has come back and said: We were wrong. We cannot insure the premiums at the guaranteed rate. We are going to raise your rates by 25 percent. The government made a mistake. The government got it wrong. And now these Federal employees who did the right thing are going to have to pay for it, more than 6,000 of them from Florida. If the Federal Government cannot get it right for 250,000 Federal employees, how is the government going to get it right for 45 million Americans? I stand with my colleagues on this side of the aisle ready to create access to health care without sacrificing quality. But it has to make financial sense. We stand ready to address the issue of portability, allowing people to keep their health insurance whether they change jobs or move across State lines. We stand ready to offer ideas to make health insurance more affordable for small businesses, which can join exchanges to offer lower premiums for their employees. We stand ready to address the high incidence of doctors practicing defensive medicine, which steadily drives up costs. Finally, we stand ready to focus on stopping the estimated $60 billion in Medicare waste, fraud, and abuse, and using those funds to care for our people. Current proposals do little to address these problems. We want to work in a bipartisan fashion to create a bipartisan bill. Spend less, save more on this and in everything. The reality is that our Nation is hungry for a new course, a course that takes greater care of the people's money. Some may call this thinking naive, but I call it hopeful. Since our Nation was founded, there has been one constant our people have carried forth. I consider it the American creed, and the creed is this: Each generation has the obligation to provide a better future for its children than the generation before. We cannot fulfill this promise on our current course. That truth is so evident even our children understand it. I close with the words of one of my constituents, 12-year-old Joshua Mailho of Niceville, FL. Joshua is concerned about the very issues we are talking about today. He is concerned with his share of the national debt and how he is going to pay for it. He wrote to me in September and this is what he wrote: Here is an example of how long me, a 12 year old, would have to pay off my share of the national debt. If I worked at Home Depot and I get paid $10 per hour . . . it would take me almost 8 years of full-time work [to reach $161,000] . . . my share of the national debt. He goes on to say: This debt will affect all of the kids in America . . . so please find a way to fix your own mistakes, before the children of today have to pay for your mistakes tomorrow. I yield the floor.