George LeMieux

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, I thank my colleague from Oregon for his good words tonight and for his approach in trying to do things in a bipartisan way. There are some good things in this jobs bill. I think the issue we on this side of the Chamber have had is we would have liked to have offered some amendments. The 18 million people I represent in Florida expect that we have the opportunity to offer amendments, to bring up ideas, good ideas, and let those ideas rise and fall depending upon their merit. Unfortunately, we did not have the opportunity to have amendments. My colleague, the Republican leader, said earlier what was done on the majority side was something called filling the tree. What does that mean? It means we do not have the opportunity to bring forward our good ideas. The people of Florida, the people of all of our States, expect that we get to do that. So while there are some good things in here, it is a shame that we could not have made this bill better. What I really want to speak about tonight is the debate Americans are having around their living room tables and around their kitchen tables about this health care bill. This is a trillion-dollar bill that is being discussed in this country and that we now hear is going to go through the House of Representatives and possibly come back to this Chamber through a procedure called reconciliation. It occurs to me that what we are dealing with here is a little bit of fantasy land. Why do I say that? This weekend, I took my kids to see ``Alice in Wonderland.'' That is a famous story. It occurred to me that we are creating our own sort of wonderland here in the Senate. A lot of things have been said about this health care bill, what it does and what it does not do. I thought tonight it would be important to go through the representations that are being made to the American people as to whether we should pass this health care bill. Let's go through all the things we have heard, things that President Obama has said, things that Members of the majority have said in this Chamber as to why we should pass this health care bill. Let me first say that everybody believes we need health care reform in this country. We have 4 million-plus Americans who do not have health insurance. Nearly 4 million Floridians do not have health insurance. We know the cost of health insurance is too high for those Americans who have health insurance. In the last 10 years, health insurance costs have risen by 130 percent. That is unsustainable. It is something that is afflicting the people of Florida and all across this country. It is hard to make ends meet when your salary may be going down or you may have lost your job but your health care costs continue to go up. So there is no debate within this Chamber that we should do something. Of course, we should do something. The debate is about what we should do. On this side of the aisle, we would like to take a step-by-step approach. We would like to go after the cost of health care. We would like to increase competition in health care so that costs could actually go down. We would like to put patients back in charge of their health care purchasing decisions. We know if the consumer is back involved the price of health care will go down. But we find ourselves having to vote on this massive new government entitlement program, a program that I cannot support because I do not believe it will be in the best interests of Floridians. Last Monday I was down in South Florida, down in Miami and Fort Lauderdale. In Fort Lauderdale I had the opportunity to have a townhall meeting where we specifically talked about health care. In that meeting I had many Floridians come up to the microphone and ask questions. Most of them were bewildered about this plan. They wanted to know why we cut a $\1/2\ trillion out of Medicare. Medicare is health care for seniors. Why would we create a new program by cutting a program we have now that is already in financial trouble? We know in the next 7 years Medicare is going to have its own solvency problems. Why would we take money out of health care for seniors--more than 3 million Floridians in that program--to start a new program? They want to know why we are going to raise taxes on medicine and health care devices which we know will increase the cost of health care. They want to know why we are creating a $1 trillion new entitlement program when we cannot afford the entitlement programs we have, when we cannot afford the $12 trillion debt we are saddling upon our children and our grandchildren. So with that, I would like to go through some of the myths, some of the myths that have been created in this wonderland I spoke about before, and try to debunk those myths and say what is in this bill and let the facts speak for themselves. The first myth--and the President likes to say this; he said it again today in a rally--if you like your health insurance, you can keep it under his proposal. Well, it is simply not true. The Congressional Budget Office has said between 8 and 9 million people who would be covered by employment-based plans under current law would not have the offer of such a proposal. Why is this going to happen? Because under the incentives and penalties this bill creates, businesses are going to drop health insurance for their employees and put them into the government-subsidized system. So for those 8 or 9 million Americans, they are not going to get to keep the health insurance they have now. They are not going to be able to keep the health care they want. Rick Foster, the CMS Actuary--and those are the folks who administer Medicare and Medicaid--says the number could even be higher. He concluded that 17 million people will lose their employer-sponsored coverage. Seventeen million people will not be able to keep the health care they enjoy today. So what the President says is simply not the case. Second, we know under this myth that you will be able to keep the health care if you like it, that people who have Medicare Advantage, Medicare Part C, a lot of them will not be able to keep their program either. Medicare Advantage is a promise that offers extra benefits for folks on Medicare. If you sign up for it, you get wellness benefits, you get hearing benefits, you get dental benefits oftentimes. People like it. We have more than 1 million people in Florida on Medicare Advantage. This bill cuts $120 billion out of Medicare Advantage. Now, I am not sure how it is going to impact Florida. There was this Florida fix that was going to be an off-ramp, not an exit. But over several years they would be in the same situation as the rest of the folks in America. I do not know whether that is going to make it into the final bill. But I do know we are going to cut $120 billion out of Medicare Advantage. When that happens, according to Rick Foster, the CMS Actuary, lower benchmarks will reduce Medicare Advantage rebates to plans and thereby result in less generous benefit packages. He estimates in 2015, enrollment in Medicare Advantage plans would decrease by about 33 percent. So for many folks, they are going to get dropped by their employer and not be able to keep the health care plan they have now. For many folks on Medicare Advantage, they are going to get dropped as well, as much as 33 percent by 2015. You are not going to be able to keep the health insurance you have now. We also know these mandates that exist in this bill are going to change your health insurance policy. If the government deems that your health insurance plan does not pass muster, they are going to mandate that your health insurance plan change. Now, you may like your health insurance plan the way you have it. You may have a high deductible. You may have bought catastrophic insurance. You may not want to buy a comprehensive health insurance plan that is soup to nuts; you may only want certain things covered. Well, under this plan, under this bill, there are going to be certain mandates put in place, and you may not be able to keep the type of insurance you have. So for those three instances alone--for people who are going to get dropped by their employer and get forced into the public plan, for people who are Medicare Advantage, and for people who have a certain type of insurance plan--they may not be able to keep it. So we know, unfortunately, what the President is telling us about this bill is not true. Myth No. 1 is busted. Myth No. 2: Your health insurance premiums will go down. Why did he get involved in this whole debate to start with? What was told to the American people during the Presidential campaign in 2008 and since the time that we have discussed this health care plan? That we were going to lower the cost of health insurance for most Americans. That is not going to happen under this plan. We are not going to lower the cost of health insurance. In fact, for some Americans the price is going to go up. Table 1--I hate to get into the weeds, but let's look at the facts. We have the CBO report I cited earlier. There is a Table 1 on page 5 of that Congressional Budget Office report that analyzes this plan. It goes through what people have in the current insurance market. There are about 25 million people in the small group market. There are 134 million people in the large group market. That is 159 million Americans who have health insurance. So the small group market, it is estimated the cost increase or savings is between a 1-percent increase or down 2 percent. For those in the large group, it is zero to potentially minus 3 percent. So this is not reducing the cost of health insurance in any meaningful way. For individuals who are out there who are not in a group, who are purchasing insurance individually, the Congressional Budget Office says their cost of health insurance will go up 10 to 13 percent. So the whole very reason, the primary reason we are about the business allegedly of debating health care and passing this big bill was to lower the cost of health insurance for most Americans. Not only is it not going to lower the cost of health insurance for most Americans, it is going to increase it for those who are in the individual market. I ask unanimous consent that Table 1 be printed in the Record.

Mr. LeMIEUX. So you are not going to be able to keep your health insurance, for a lot of Americans, if you like it, and the cost of health insurance is not going to go down. Those two myths have been busted. Myth No. 3: This plan, the Democratic plan, will lower costs, lower the cost of health care overall. We have all heard about--and I said before the rising cost of health care, 130 percent in the past 10 years. There is an expression, ``bending the cost curve down,'' making sure that we can get control of costs. This plan is not going to do that. This plan does not have mechanisms, true mechanisms in it to really control costs. In today's Washington Post, Robert Samuelson takes on the President's claim that his plan will control costs. In this article, he talks about the fact that when people get insurance they use more health services; that spending rises and by the government's latest forecast health spending goes from 17 percent of the economy in 2009 to 19 percent in 2019. According to the CMS Actuary, he estimates overall national health expenditures under this bill will increase by an estimated total of $222 billion during 2010 to 2019. It is also going to increase the government's share of health care spending. According to the CBO, under the legislation, national outlays for health care would increase by $210 billion over the next 10 years. So we are just chasing our tails. We are going to put a lot more money into health care, but we are not going to reduce costs. How could we reduce costs? How do we get at the problem of increased health care? Well, we could try to foster more competition among health insurance companies instead of creating these subsidies, which is going to plow more money into the insurance companies. We could make the insurance companies compete across State lines. That is one of the ideas the Republicans have brought forward. We also could go after meaningful lawsuit reform. There is one estimate we would save more than $50 billion a year if we had meaningful lawsuit reform. My colleague, Senator Coburn from Oklahoma, talks about the fact, being a practicing physician, that doctors are engaged in defensive medicine, and when thousands of kids across this country this year get hit in the nose with a baseball they are going to show up at the emergency room. Instead of just watching the patient and making sure the kid is going to be OK, they are going to order a CT scan even if one is not necessary because that has become the standard operating procedure in order to protect the doctor from lawsuits. The CBO says if we had real medical malpractice reform, we could save as much as $54 billion over the next decade. We also do not have transparency. Here is the essential problem with health care costs. We do not know what anything costs. In the next couple of days my wife and I are going to be fortunate enough to have our fourth child. She is due any day now. When we go to the hospital, we are going to get back--after that baby is born, just like we have done with the last three kids, we are going to get back a bill. It is going to be page after page after page of things that we cannot understand. At the bottom of the bill, we will pay some small fraction because we have good health insurance in the Senate. We will pay some small fraction of the total bill, and we will never question the pages and pages and pages of line items of information we do not understand. We will not because we do not have to pay for it, and we, as consumers, have been removed from the transaction in health insurance because of third-party payers, whether it be Medicare, Medicaid, or insurance companies. We are not involved in that transaction. Now, let me give you a different example. If we had to look at that bill because we were responsible for a portion of it because we were given, say, a tax credit to go out and buy insurance, and we were trying to get the most bang for the buck, and they tried to add $75 for a bedpan or gauze or for Band-Aids, Mrs. LeMieux would not pay for that. Mrs. LeMieux would be in there saying: Wait a minute. I can go to Target and I can get Band-Aids for $1.50, not $75. I guarantee you that the men and women of this country, if they really had to look at those bills because they really had to pay them, we would not have these exploding costs. We also would not have all of the cost shifting that is going around. The dirty secret about health care is that if I have insurance, my full payment on insurance or close to the full payment is going to pay for the Medicare patient and the Medicaid patient because Medicare and Medicaid do not pay enough for the services they render. The hospitals cost shift all the money around. At the end of the day, we don't have a transparent system or a market-driven system. What we should do is give every American who needs it a tax credit to buy health insurance on their own. If they were out in the marketplace, that would lower cost, because competition would reign and they would insist on bang for their buck. But that is not in this bill. We know now that, one, you will not be able to keep, in a lot of cases, your health insurance, if you like it. We know, two, it is not going to reduce your cost of health care. And we know, three, it will not lower the cost of health care in general. Those myths have been busted. Let me go to the next one, myth No. 4: The Democrats' plan will reduce the deficit. We have heard this estimate that over $100 billion is going to be saved over the next 10 years. Not true. The way this is scored or evaluated by the CBO is that whatever you send them, they have to give you an answer back on the confines and the specifications of what you sent. So the Democrats' bill has 6 years of spending or benefits and 10 years of taxes. If they have 10 years of taxes and only 6 years of spending, then they can get to a situation where the CBO will come back and say: It is going to reduce the deficit. But if you compare apples to apples, spending to deficit, if you compare spending to taxes, we know it is going to run a deficit. You cannot create a new entitlement program and not run a deficit. It is going to cost us, by some estimates, more than $400 billion over a 10-year period, in the first 10 years, and $1.4 trillion in the next 10 years. We know that myth is busted. It is not going to reduce the deficit. Let me also say this is going to be a budget buster for States. The States, unlike the Federal Government, have to make ends meet. The States have balanced budget requirements. As we increase the requirements of Medicaid, which this bill does, then we will be putting increased burdens upon our States. Our States are going to have to find more money to put into Medicaid. They can't print money like the Federal Government. They can't spend more than they take in. What is going to happen? They are going to have to cut other programs, or they will have to raise taxes. What is going to get hurt? I can cite the example of Florida where they are suffering under a huge and emerging Medicaid problem. Medicaid and Health and Human Services is the No. 1 portion of the budget of the State of Florida. It grows every year. So what loses out? Education, money for teachers and schools, law enforcement, protecting the environment, and economic stimulus. Florida has to live within its means, unlike the Federal Government. This is not a Republican or Democratic issue. Governors of both sides of the aisle are very concerned about the increased mandates placed upon States. Governor Phil Bredesen of Tennessee called this bill the mother of all unfunded mandates. The head of Washington State's Medicaid Program believes that States facing severe financial distress may say they have to get out of the Medicaid Program altogether. CBO released its first estimate of expected discretionary spending under this bill, confirming that $10 to $20 billion in discretionary spending over the next decade will be used to implement this legislation. We are going to spend $10 to $20 billion to implement this bill; $5 to $10 billion to the IRS and to Health and Human Services. Also in terms of this topic, of looking at how the plan will reduce the deficit, which it will not, we know this is going to be a $1 trillion program over time. With rare exception, when this Congress creates a program, especially an entitlement program, it does not stay within its estimates. It grows and grows. We have a debt. When I first came to the Senate and had the privilege to serve here back in September of last year, we were at something like $11.6 or $11.7 trillion. Now we are already at $12.4 trillion. It is unsustainable. The fifth myth: Medicare cuts won't affect seniors. This bill cuts half of a trillion dollars out of Medicare. Some say this is savings. The money that is going to be saved is not going back into Medicare to prolong the life of Medicare. We had an amendment from my colleague Senator Gregg who said that any savings would have to go into Medicare. The majority party defeated that amendment. It makes no sense to me that we would take half a trillion dollars out of Medicare to create a new entitlement program. I can't go back to my seniors in Florida, more than 3 million of them, and say: Your Medicare Program is already facing insolvency in about 7 years, but we are going to take a half a trillion dollars out of it now to create a new health care program. This could not be good for seniors. On its effect on Medicare, there was a letter from the CBO Director to the majority leader, Senator Reid. He warned that while the effects of the cuts to Medicare remain unclear, they could reduce access to care or diminish the quality of care. Let's go through the cuts: $135 billion from hospitals; $120 billion from Medicare Advantage; nearly $15 billion from nursing homes; $40 billion from home health agencies, $7 billion from hospice. The CMS Actuary says that many of the Medicare cuts are unrelated to the providers' cost of furnishing services to beneficiaries. That means it is not about savings. That means the money is being taken from Medicare, robbing Peter to pay Paul. He concludes it is doubtful that providers could reduce cost to keep up with these cuts. The CMS Actuary also finds that because of the bill's severe cuts to Medicare, providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and might end their participation in the program. What does this mean in plain language? We are not paying these health care providers enough under Medicare, but we are going to take out still more money, and they will not be Medicare providers anymore. They will not provide health care for seniors. If you want to see the future of this, look at Medicaid. Medicaid is even one step worse in trouble than Medicare is. We know now that folks who are entering into the Medicaid system who are trying to find a specialist in a metropolitan area, half of them can't find a specialist. We know in Medicare, according to a June 2008 Medicare Payment Advisory Commission Report, that 29 percent of the Medicare beneficiaries it surveyed had trouble finding a primary care doctor. That is up from 24 percent in 2007. If the doctor is not in, it is not health care reform. How can I go back to my seniors in Florida and say: We are creating a new program by taking money out of your program, and you may not be able to find a doctor who is going to see you anymore? That is not conscionable. Florida will be disproportionately affected by these cuts. It has the second highest population of seniors and highest concentration of seniors in the Nation at 19 percent. Let me tell you how it will specifically hurt one portion of health care for seniors, home health care. I talked to Ron Malone, vice president of Gentiva Health Services, one of the largest providers of home health services in Florida. He said: Look, it is not going to hurt us so much. We are a big company. We can spread costs. We will get more market share. But it is going to hurt the smaller companies, and a lot of the smaller companies are going to go out of business. How is that health care reform? Who do we owe an obligation to provide health care more than to our seniors? I recently visited with the president of the Florida Medical Association, which is the largest physician association in Florida, with 20,000 members. They say: . . . this legislation does not adequately fix what's wrong with our current system. It contains many provisions that would allow government bureaucrats to interfere with patient care decisions and actually raises the cost of health insurance unnecessarily. This is from the doctors association in Florida. They say it is going to interfere with the doctor-patient relationship and increase costs. Why are we doing this? The sixth myth I want to tackle is this idea that emergency rooms are going to be less burdened. You hear this justification. People now are uninsured. They go to the emergency room to get health care. If we give folks insurance or they have the ability to purchase insurance at a subsidized rate, they will stop going to the emergency room, and that will lower the cost of health care because emergency room procedures are expensive. It will free up the emergency room for its intended purpose, for people who really have an emergency. But according to the Urban Institute, after Massachusetts adopted a somewhat similar plan, emergency use remained higher than the national average. More than two- fifths of the visits in these emergency rooms were nonemergencies and, of these, the majority of adult respondents said it was more convenient to check into the ER. More convenient? We know we are going to be paying health care providers less. What does that mean? There is going to be less of them providing health care. That means your lines at the doctor's office, which are already too long, are going to get longer. So what are folks going to still do? They are going to still show up at the emergency room. If we look at the Massachusetts model, that has happened. We also know that ultimately we are going to have a severe doctor shortage. We have not prepared, nor does this bill prepare, to make sure we will have sufficient health care providers to meet new demands. Seventh myth: The Democrats' plan takes on the insurance companies. You have heard the President say we are going to fight against the insurance companies; we are going to make sure that we are putting the patient first. Basically what we are going to do, in reality, is create a lot of new business for the insurance companies. This subsidy plan is going to force a lot of new people into health care with an insurance company. That is why the insurance companies are for it. What we need to do is empower individuals. What we need to do is give individuals money that is in their own pocket and let them go out and be consumers. If they were consumers, it would lower the cost of health care. What we need to do is let insurance companies compete across State lines so we as consumers have more choices. Look at auto insurance. It is so easy a caveman can do it. In 15 minutes, you can save 15 percent on your auto insurance. These folks are out there competing. We need that in health care. Why do I only get to pick from the insurance companies that are in Florida? If there is an enterprising insurance company from South Carolina that wants to come into my State and offer cheaper prices, why should I not have that opportunity as a consumer? There are commonsense things we can do, market-driven things we can do that will lower the cost of health insurance and, by doing so, when it is less expensive, more people can afford it and you have more access. The eighth myth: It has been said that this bill takes an unprecedented step to fight health care fraud. It is going to go after waste, fraud, and abuse, and we will save billions of dollars. In fact, the $500 billion being cut from Medicare is often described as an elimination of waste, fraud, and abuse. It is not. It is just taking money out of that program and putting it in this program. To be fair, there are some provisions of this bill that go after health care fraud. They are good, but they go around the margins. They are going to save a billion or two, which is a lot of money, I will grant you that, but it is not the kind of money we need to save. We believe there are $60 to $100 billion of fraud in Medicare every year alone, not talking about Medicaid, not talking about veterans health care, just Medicare, $60 to $100 billion, $1 out of every $7 spent. What we need to do is implement a plan that is going to stop the health care fraud before it starts. I have a bill, S. 2128, that has bipartisan support, has more than a dozen Senators who sponsor it. It would do three things. One, it would create a person at HHS who would be the No. 2 person at the agency for Health and Human Services, appointed by the President to be the chief health care fraud prevention officer of this country. No other job, not focused on worrying about H1N1, not focused on anything else that should be done in health, focused on stopping health care fraud, someone we could measure against performance to make sure we are doing everything we can to stop wasting the people's money. The second thing it does is it takes a page from another business that exists in the marketplace that does an excellent job at stopping fraud. There is another business that is about the same size as health care, about $2 trillion a year. That business, instead of having a $1-in-$7 fraud ratio, has a ratio of 7 cents out of every $100. That is the credit card industry. We have all had this experience. You go somewhere to use your credit card and you get a phone call or an e-mail that says: Did you mean to make that purchase? If you do not say yes, they do not pay. What we do in health care is we pay, and then if we think something is fraudulent, we chase. When we chase, the money is gone. The credit cards stop the fraud before it starts. Now, why couldn't we implement that kind of computer technology? In health care, it is called predictive modeling. So when someone tries to sell a wheelchair 100 times in an hour, the bells go off, the phone call is made, and if it is not verified, we do not pay. We have people--unfortunately, a lot of them in my home State of Florida--who are bilking the system for tens of millions of dollars a year because it is much easier to steal from Uncle Sam than it is to steal from anybody else because nobody is watching. One group in town that has evaluated my bill with this predictive modeling system, where we would set up a computer program to stop the fraud before it starts and make people verify when there is a questionable transaction, has said it will save $20 billion a year. During the health care debate we had last December, I asked to amend my bill on to the main health care bill, and my colleagues on the other side of the aisle objected. Why we wouldn't implement real waste, fraud, and abuse reform is beyond me. But this bill we are talking about does not have it. That myth I, too, believe is busted. The third part of my bill is, it will require background checks for all health care providers. Can you believe we do not do background checks on people who bill Medicare and Medicaid in this country? We have folks who are convicted felons who are billing alleged ``health care'' providers. It is so bad that in reimbursements for AIDS treatment under Medicare, while south Florida only has 7 percent of the AIDS population, they bill 78 percent of the treatment--only 7 percent of the population and they bill 78 percent of the treatment. It is just fraud, and it should stop today. The ninth myth I want to tackle is that this Democratic health care reform bill will not impact the doctor-patient relationship. In fact, it will. I agree with my colleague, Dr. Barrasso, who supports a patient-centered approach. Real health care reform should ensure a doctor and a patient can work together to the best efforts in the health of the patient. As I said before, we are still going to have third-party payers. We have to put the patient back in charge of their health care. That is the only way we are going to reduce costs. There is a common thread throughout our governmental programs that has led entitlements to expand and expand and expand; that is, people do not have what is called skin in the game. If I am not paying, I do not care. But if I have to go out as a consumer, if the government would give me a tax credit to go buy health insurance, all of a sudden I am in the game. If I have a reasonable deductible where I have to pay a little when I go to the doctor, all of a sudden I am in the game and I am not going to ask for a procedure I do not need. I am going to sit there and talk with my health care provider about whether this is something I really need. Now, if you tell me it is free, I will take it. And if you advertise to me on television every drug in the world, I will go to my doctor and say: Sign me up for that because I get it for free. We have to change the whole structure of how we do health care because this will just continue to expand. Medicare will continue to expand. Medicaid will continue to expand. If this program passes, it will continue to expand. While it might be great to throw all this money into these programs, we cannot afford it. We cannot afford the programs we have, let alone the programs the majority in this Chamber want. The tenth and final myth I want to tackle tonight is that taxes will not go up. This is a jobs bill for the tax collector. We already said there is going to be $5 billion to $10 billion to the IRS and HHS to implement this bill. Remember, if you do not buy health insurance for yourself, you are going to have to pay a tax, a fine, a penalty to the IRS--$750 a person. Small businesses that do not provide certain levels of health insurance will be fined. And what do you think they are going to do? Pay that fine or drop to under 50 employees so they do not have to pay the fine anymore, which will cause more people to be out of work. Can you believe that in the United States of America, we are going to tax you if you do not buy health insurance for yourself because the government cares more about you than you care about you? If the government can tax you for not buying health insurance, what else can they tax you for not doing? Not working out? Not eating your spinach? That cannot be what our Founders intended. Remember, we give up our rights to the government. Our institution was created that it governs with the consent of the governed, that we have the inalienable rights. In our social contract, we give those rights up to the government. It is not the other way around. How is it the government can fine me for not doing something? So at the end of the day, when this entitlement program increases beyond its means, when it is more than we can afford, and when the $500 billion we take out of Medicare starts to put Medicare in insolvency even quicker, what is going to happen? Is the majority in this Chamber really going to cut Medicare? Probably not. So what are they going to do to help pay for this new program without their cuts? They are going to raise your taxes--raise your taxes to levels that are going to be hard to imagine when you factor in what we are going to have to do for all the other entitlement programs we cannot afford, when you factor in what we are going to have to do with our $12 trillion debt that is estimated to be $10 trillion higher by 2020. That is why the National Federation of Independent Businesses has said: When evaluating health care reform options, small business owners ask themselves two specific questions. First, will the bill lower insurance costs? We know the answer to that is no. Second, will the bill increase the overall cost of doing business? The answer to that is yes. They say: In both cases, the Patient Protection and Affordable Care Act fails the small business test and, therefore, fails small business. It has been my goal tonight to present facts. I know others have a differing view. As a Senator from Florida with more than 3 million folks in Medicare, as a Senator who cares about health care reform and wants to create more access but also wants to lower the cost of health care, I cannot support this bill. I hope my colleagues in the House who are being faced with this option of voting for this bill and then passing something on reconciliation will do the right thing. I hope they will not be pressured politically to change their votes from ``no'' votes to ``yes'' votes. I hope they will stand for the people of their State and for the American people. We could get this right. We could work together on a bipartisan way, as all of the other big, important bills over time have been done, with 70 or 80 Senators working together to do the right thing for the American people. I sign up for that. I am standing ready to do that if that opportunity presents itself. But I cannot vote for this bill that will not lower the cost of health insurance for most Americans, nor will it put us in a situation financially that is tenable going forward. With that, Mr. President, I yield the floor. [GRAPHIC] [TIFF OMITTED] TS15MR10.001

Mr. LeMIEUX. I yield the remainder of my post-cloture time to the Republican Leader, Senator McConnell.

Mr. LeMIEUX

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

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

Mr. LeMIEUX

Mr. LeMIEUX. Madam President, yesterday, the President was in St. Charles, MO. He talked about a new effort the Federal Government would undertake to go after waste, fraud, and abuse in the health care system. He focused on the use of payment recapture audits and the teams of auditors who will now go through the process of looking at the payments being made in Medicare, for example, health care for seniors, to make sure the money is actually going for health care to seniors and not going to criminals who are stealing money from the system. I commend the President for doing this. It is the right thing to do. Republicans and Democrats can work together. This is a good initiative. But I would like to request of the President, as I have requested of this Congress, to take further steps and more bold steps to stop fraud in the system. I thank Leader McConnell who, in his opening remarks this morning as the Senate opened its session, commented on a piece of legislation I have offered that will not only go after the fraud after it happens, which is what the President's proposal does--and I commend him for it; it is estimated by folks looking at his proposal that it might save $2 billion a year by going through and auditing and trying to find out where the bad guys have taken the money. I have some experience in that. When I was deputy attorney general in Florida, working under then-attorney general Charlie Crist, we had a Medicaid fraud control unit. On the Medicaid side--health care for the poor--we did just what these teams the President is putting together now are going to try to do for Medicare. We had teams that looked at the data. We would break down the list of the top 50 folks who were receiving reimbursements from the Federal Government, and if the number and the amount of money they were receiving was abnormally high, we would look at it and make sure it was legitimate. You could go where money is. Right? They say: Look where the money is going. And if you can find out where the money is going, you can find out what the problems are. We looked at the top 50 or top 100 folks who were receiving reimbursements from Medicaid, and we found problems. So the President's idea is effective. But let's not just do pay and chase. That is what we have been doing in health care for years and years and years. The Presiding Officer, the Senator from North Carolina, agrees with me on this issue. She has been a leader in advocating that we stop the health care fraud before it starts. We were trying to change the health care bill last year at the end of the year to put in something more robust. We do not have to start from scratch. There is an idea out there that already exists that is already working in another sector of the economy that is very similar to what could be done in health care. Health care is about a $2 trillion a year business. We know that in Medicare, there is at least $60 billion if not $100 billion a year of health care fraud. That is worth repeating: $60 billion to $100 billion a year of waste, fraud, and abuse in Medicare alone. My colleague, Senator and Dr. Coburn, has been a leading advocate about trying to go after this waste, fraud, and abuse. So what could we do with that money? We could put that money back into Medicare to make sure we are actually helping patients and make Medicare solvent for years to come, instead of where we are looking at it right now: that in the next 7 years Medicare is going to have a real financial crisis. So how do we get at that $60 billion to $100 billion a year of waste, fraud, and abuse? Well, the health care industry is about a $2 trillion industry. Another industry that does a fantastic job of fighting fraud that is also an industry of about $2 trillion is the credit card industry. In health care--at least in government health care--we believe $1 out of every $7 is fraud. In the credit card industry, they lose 7 cents on every $100. Madam President, $1 out of every $7 versus 7 cents on every $100. How do they do it? They do not do just pay and chase; they do not just set up auditors and prosecutors to go after the bad guys after they have stolen the money. They stop the stealing before it starts. Technology is a wonderful thing, and it has created tremendous abilities for us to prevent fraud before it begins. You all have had this experience. You have gone somewhere and used your credit card, and your credit card company has e-mailed you or called you and said: Was that really you making that purchase? And why is that? Well, a mechanism was triggered by their computers, where you were doing something you normally do not do. You were outside your normal spending habits. You were in Washington, DC, visiting, not at home in Orlando, FL. That is not something you usually do. A red flag goes off because they built a computer model that tracks your normal purchasing, and if something is out of normal--if you are traveling or you are purchasing more than you usually do, or you are buying things that are the target of people who steal credit cards--the model goes off, the phone call happens, and if you do not verify, they do not pay. This is called predictive modeling, and it makes all the sense in the world that we put this into our health care system. And we can. I have a bill, S. 2128. It has bipartisan support in the Senate with about a dozen cosponsors. It is a bill to do three things. One, create the predictive modeling system, set up a computer program where if we have health care fraud, we can try to detect it before it starts. Let me give you an example. My home State of Florida is rampant with health care fraud--rampant. In fact, I think south Florida is the capital, unfortunately, of health care fraud. Here is one example to give you: We have in south Florida 8 percent of the Medicare beneficiaries with HIV or AIDS nationwide, but 72 percent of the reimbursements to these patients are sent there. Is that because they are getting the best health care in the world? No. It is fraud. There are people in organized crime who are running these health care codes, stealing medical records from hospitals, finding out your patient information, saying that you have AIDS, running a $2,400 vaccine, and running those vaccines all day long, sending the bill to the Federal Government. The Federal Government is paying. It is a lot better deal for the crooks. It is a lot better than illicit drugs. We hear from these criminals they would much rather be stealing from the Federal Government. No one is shooting at them, and it is a lot easier to rip off Uncle Sam. We have to stop this. So if you put this predictive modeling system in place, you could actually have a trend that occurred, and the computer would say: Wait a minute, this ``health care provider'' has sold this wheelchair 100 times in an hour, or they sold this other medicine, this very expensive AIDS medication. They have prescribed that more than anybody else. The model goes off and the payment stops until they are verified. We stop the fraud before it starts. My bill does two other things. One is, it requires a background check for every health care provider in America that is going to try to bill Medicare or Medicaid. Can you imagine that we do not do that right now? We do not do background checks of people who are allegedly providing health care to our seniors and to the poor. Can you imagine, we have a convicted murderer in Florida who was an alleged health care provider who was scamming the system? There are bad guys scamming the system for $10 million, $20 million, $50 million, $60 million. So we have to do a better job. The third thing this bill does is it creates some accountability. We are going to create an Assistant Secretary of Health at the Department of Health and Human Services whose only function will be to fight fraud so we have some person accountable who we can call in front of our committees and say: How are you doing in the battle to fight fraud? As much as I appreciate what the President did today--and that could save $2 billion--a group here in town has evaluated this bill that has bipartisan support and they say it could save $20 billion a year. So why aren't we doing this today? I know this health care bill is very important. We have differing views on whether we should pass the big bill. But why can't we pass my bill now? Why can't we start preventing this health care fraud now and save $20 billion a year? Imagine what we could do with that money. Imagine what we could do to put that money back in Medicare and make it more resilient so our seniors know their health care is going to be paid for. I applaud the efforts of the President of the United States today. It is a good step. But it is on the pay-and-chase side. It is not on the prevention of fraud side. I keep coming to the floor and talking about this because I feel so passionately about it. It is a commonsense thing to do. It is problem solving. It is not partisan. No one is for fraud. Everybody should believe that we should try to spend the government's money more effectively and more efficiently. With that, Madam President, I yield the floor.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, I rise today to speak in opposition to the tax extenders bill. I do so with a heavy heart because there are good things in this bill that would be good for my State of Florida. It would be good to extend unemployment benefits. It would be good to extend COBRA, it would be good to extend and help with Medicaid funding, and it is important to make sure we have enough money going to doctors in Medicare so that they can provide services. But I can no longer stand by, even on a bill such as this, and vote for it when it is going to add $100 billion to our deficit. If the majority party in this Chamber did the right thing and paid for this bill, if we cut wasteful spending, if we cut duplicate programs in other areas and paid for this bill, 80 or 90 Senators would vote for it. But at some point, even though these programs may be good for your State, a Senator has an obligation to stand up and say: No more, no more spending our kids' future, no more putting debt on the next generation, no more bankrupting the promise of this country. No more. We cannot afford it. We have a $12.4 trillion debt. We are supposed to have pay-as-you-go rules here. One month ago, we passed a pay-as-you-go law. The President signed it. And all of the language was laudatory: We are not going to spend our children's money anymore. We are going to be fiscally responsible. And then here comes this bill, $100 billion in spending, and we declare it an emergency so that we do not have to follow the rules. It occurred to me this weekend as I played with my 6- and 4-year-old sons that this is not pay-go, it is Play Doh--you can make whatever you want of it. But it is not real enforcement. We in this chamber should pay for the spending so that we do not increase the debt on our children. So we should vote against cloture on this bill, not because the leadership has not allowed us to have amendments--they have, and I appreciate that. But we should vote against it because this bill should only pass if we can pay for it. No matter how good the program is, it is not good if we saddle our children with $100 billion more in debt. The public debt in this country is going to double in 5 years and triple in 10. It is has now come out that the estimate of the national debt in 2020 will add another $10 trillion. The day of reckoning is at hand, and we just cannot stand by, even though there are good things in this bill, things that would help my State. On this occasion, I have to put country first. I yield the floor, and 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. I ask unanimous consent to speak as in morning business.

Mr. LeMIEUX. Mr. President, I rise today to speak about our relations with our neighbors to the south in Latin America. I recently had the opportunity to travel to Latin America and visit the countries of Honduras, Panama, and Colombia. These meetings were very productive. During these meetings I had the chance to meet with the new President of Honduras, President Lobo, as well as our great ally and friend, President Uribe of the country of Colombia. Our partnership and friendship with Latin America goes back many decades. In recent times we have used wonderful programs such as USAID and the Millennium Challenge Corporation to help build the infrastructure of Latin America as well as provide the tools to create jobs that will be sustainable in these countries. Our goal in Latin America is simply this: We want them to succeed. We want strong neighbors with good democracies, with a respect for the rule of law, a place where their people can be free and prosper and hopefully establish great trading partnerships with us in the United States of America. But the history of Latin America, even recently, is while there have been many successes, there have also been setbacks. We have recently had troubles in Honduras with President Zelaya, the former President who tried to stay in office, and then we had an ouster of him. There is a debate among us as to whether that was a coup or whether it was legally done. But, nonetheless, it was a disruption in that country's emerging democracy. In meeting with President Lobo, I was impressed that he has put together a national unity government endeavoring to create those democratic institutions and strengthen the ones that Honduras was building upon and establish a rule of law that will give countries such as America and business people from our country the opportunity to transact business in that country. I believe that under President Lobo's leadership, we have got a good chance for Honduras reemerging on the stage in Latin America as a good and healthy democracy. I was pleased that Secretary Clinton recently recognized the democratically elected president. I encourage President Obama to receive President Lobo. We need friends in the region. We need friends for a number of reasons. We need friends in Latin America, specifically Central America, because of the devastating and harmful drug trade. The drug trade in Latin America that funnels drugs and guns to this country is not just a challenge in and of itself because of the deadly narcotics it brings to America, it is a challenge because of the violence and the organized structure of violence that goes with it. Recently we saw drug gangs in Mexico extract the worst form of vengeance upon a family of a young military officer. A military officer died in Mexico killing the head of a drug cartel. He was celebrated by that country in what would be akin to a state funeral. And the drug cartel, to exact vengeance and to send a signal, killed all of the members of that soldier's family. That is terrible. The money that is provided by these drugs that run from northern South America, the Colombia region, and then through Central America, these connections, that violent chain is very dangerous to this country. It is dangerous for many reasons, but there is an increasing danger. There is an increasing danger that has occurred with the entrance of Iran and its progeny into Latin America. We now know that Ahmadinejad is trying to show his sphere of influence in Latin America; that Hezbollah and Hamas, surrogate groups for Iran, who have done most of their damage in Lebanon and in Gaza, are now setting up shop in Latin America. One of the reasons I am here to speak on the floor today is I am concerned that the same networks that transported violence and drugs and guns to this country could be used by Hezbollah and Hamas to provide a national security threat to us in this country and potentially bring terrorism to us in that way. So our friendship with these countries such as Honduras, our friendship with countries such as Panama, our friendship with countries such as Colombia matter. It not only matters because we care about the human rights of the people in those countries and we want them to be prosperous and free, but it matters because of our own national security. Good, stable democratic partners are good for the United States of America. So we should continue to acknowledge President Lobo. We should restore the visas that were suspended during the Zelaya incident. We should do everything we can to encourage trade to continue with the Millennium Challenge Corporation, continue with USAID so that country can be prosperous and free and secure. The same goes for Panama. Panama is a wonderful friend and partner to the United States. The Panama Canal, which the United States had for many years but now is in the hands of Panama, is a tremendous trading conduit to our country, and the Panama Canal is expanding. Right now, dredging and other works are being put in place to allow larger ships to come through the Panama Canal. Why is that important to the United States of America? Well, no longer will these post-panamax ships from China have to go to California to let off their goods. No longer will they have to go around the bottom of South America. Now they can come through the Panama Canal and service the eastern seaboard of the United States. For a State such as mine in Florida this is very important. So we have to do the work in this country to make sure we are ready for those, what they call post-Panamax ships, that our ports are dredged deep enough that we have the security and the infrastructure in place to make sure we can receive those large ships. I have been an advocate for making sure that Florida's ports are ready to receive those ships, because that trade will create thousands of jobs not just in my home State but all across this country. That brings me to the point of trade. We have pending trade agreements that have not yet been sent over by the White House to be ratified by this Congress; trade agreements with Panama that need to be ratified, trade agreements with Colombia that need to be ratified, and also with South Korea. It makes no sense not to ratify those agreements. Let me turn my attention, if I can, to Colombia. We have no better friend in Latin America than President Uribe. President Uribe will go down in history as one of the greatest leaders in this hemisphere. He, in my mind, is akin to Abraham Lincoln to their country, because when he came into office about 8 years ago, we were on the verge of Colombia turning into a narcoterrorist state, in which the drug gangs would have taken over the country. In fact, before President Uribe came to office, the previous President sought to negotiate with the FARC by setting aside a part of the country as a safe haven for the FARC. It was a disaster. I am told that when President Uribe was sworn into office, almost 8 years ago, that the FARC was shelling and bombing Bogota to try to kill him on his inauguration. It is hard for us to realize what a civil war would be like, but that has been the situation in Colombia. Because of the efforts of the United States of America, and because of our military and trade support, and Plan Colombia, which we put $1 billion into, Colombia turned the tide. The good guys are winning, and the FARC, the narcoterrorists, are losing. We are doing a very good job of beating those folks back. President Uribe must be commended. But of all of our friends in the hemisphere, we have not ratified the free trade agreement with Colombia. We have done it with Peru, we have done the Central America Free Trade Agreement, CAFTA, but not Colombia. This agreement is 4 years old. I have spoken to our United States Trade Representative and urged him to urge this administration to send these trade agreements here. I know the problem is not the Senate. The problem is down the hall with our colleagues in the House. I know they are concerned about certain issues in Colombia. I want to point out for my friends in the House of Representatives, because they are concerned about organized labor in Colombia, that under the leadership of this government in Colombia, homicides of union members are down nearly 80 percent since 2002. Homicides, in general, are down 45 percent in 2008, the lowest point in 22 years. Kidnappings are down by more than 80 percent, and acts of terrorism are down 63 percent. I had a chance to go to Bogota. It is a beautiful and wonderful city. It rises nearly 8,000 feet above sea level, which is 3,000 more feet than Denver. Yet it is green and verdant, and it is one of the world's most unbelievable places to grow flowers, and 75 percent or more of the flowers that come in this country that you get at your florist come to us through Colombia. When they come from Colombia, guess where they go through to get to the United States of America. They all come through Miami, which makes me proud as a Senator from Florida. That trade we have right now, the Colombians benefit from free trade but we do not benefit in return. We must ratify this agreement. We must acknowledge our friends in Colombia. By not ratifying the agreement, the signal we are sending is that perhaps our relationship with them, under this administration, is not as good as it has been with previous administrations. We do not want to send that wrong signal to a model country for Latin America. But let me again talk about this concern I have about the emerging threat of Iran and its influence in Latin America. There is a deadly combination forming between Ahmadinejad of Iran and Hugo Chavez of Venezuela. I ask unanimous consent that this newspaper article which I am about to read from be printed in the Record.

Mr. LeMIEUX. This article from March 2, 2010, I believe it is a Wall Street Journal article, talks about the revelation that has occurred that Hugo Chavez and his government were involved with the Basque separatist group in Spain in an effort to assassinate the President of Colombia, President Uribe. This article from March 2, 2010 says that: Spanish National Court Judge Eloy Velasco alleged Monday that the Venezuelan government had collaborated with Basque separatist group ETA and Colombia's main guerrilla group [which is the FARC] in a plot against leaders living in or traveling to Spain that began in late 2003. The allegations were part of an indictment that ordered 12 alleged members of ETA and of the FARC to stand trial on charges of conspiracy to commit murder and terrorism. This was an effort to assassinate the President of Colombia. And it was done, according to this judge, in combination with the President of Venezuela, Hugo Chavez, who is just as bad as Raul Castro in Cuba. He is trying to spread the same tyranny to the country of Venezuela, a country that was formerly free. He is shutting down media, he is arresting college students, he is destroying the economy to the point where there are now brownouts because they cannot provide enough electricity, a country which has tremendous oil reserves and energy reserves. But he is not using those to bring money into the country, he is shutting the economy down. He is bringing despair to his people. The Cuban Government is now involved in the operation of Venezuela. They are calling it Vene-Cuba. This is a danger to us. Who is received by Hugo Chavez in Venezuela? Ahmadinejad from Iran. And what do we believe and what are we concerned about? That Hezbollah and Hamas are now setting up shop in Venezuela, in the region as well. I have another article that I ask unanimous consent to have printed in the Record from the Associated Press by Curt Anderson. ``Three men charged in Miami with financing Hezbollah.''

Mr. LeMIEUX. Three men were charged in an indictment unsealed Friday with illegally exporting electronics and video games to a South American shopping center that U.S. officials claim funnels money to a Hezbollah militant group. John Morton, assistant Homeland Security secretary for ICE, said the arrests will disrupt a network in ``the illicit trade of commodities that support terrorist activities and ultimately threaten the national security of the United States.'' In his book ``The Gathering Storm,'' Winston Churchill described all the failed attempts and all the missed opportunities of Europe in the years building up in the 1930s to World War II. The failure of courage, the missed opportunities to stop Nazi Germany in its rise, Winston Churchill described it as a gathering storm because there were signs all along the way of fascism and the war machine that Adolf Hitler was building. What did the allies do when Germany reestablished its presence in the land between France and Germany, in that Rhineland region, and sent their troops back in? They did nothing. What did the allies do when the Germans went into Czechoslovakia? They did nothing. There were these steps along the way. It was a gathering storm that was ignored until it was too late. The point I am trying to convey is, we have an existential threat with Iran. Ahmadinejad is an existential threat to this country. We know he is trying to build the ability to have nuclear weapons. We know he is talking with Hugo Chavez about mining uranium. That is our concern, and the sanctions and the discussions we are having are not working. I give credit to Secretary Clinton on recently coming out and saying we don't even know that Ahmadinejad is in charge of Iran. It may be the Revolutionary Guard, the military, that is running Iran. But the time for talk is over. We have to work on the world community to impose sanctions against Iran. We need to stop trading as a world community with Iran. We need to stop buying oil from them. We need to shut them down until the people of Iran can take their country back, bring back human rights, democracy, the right to petition the government, the right to elect leaders, the right to free speech. Iran was a progressive society before 1979. We see the young people in the streets who have been beaten down, trying to express their views, trying to say the election of Ahmadinejad was not legitimate. I explain these things because I believe Iran is trying to set up shop in Latin America. We need strong, bolstered friends in the region to defend against this. We do not need Hezbollah and Hamas posing a national security threat right here in our own hemisphere. There is a gathering storm. The steps we take today, if we are strong, bold and vigilant, can stop the storm from breaking upon us. I yield the floor and suggest the absence of a quorum.

Mr. LeMIEUX

Mr. LeMIEUX. I appreciate my colleague, Dr. Barrasso, for referring that question to me. Certainly, the people of Florida are concerned about this bill. They want their costs to go down. They thought the whole reason we were doing this health care bill was to address the skyrocketing costs of health care, which have gone up 130 percent on average over the past 10 years. But what we find out with this bill is not only does it not lower the cost of health insurance for Americans, some Americans are going to have to pay more. So why would we undertake this huge enterprise of creating a $1 trillion new program, multitrillion dollars over time, a program that cuts $\1/2\ trillion out of health care for seniors, and raises taxes by $\1/2\ trillion, why would we undertake all of that if we weren't going to reduce the cost of health insurance for most Americans? That is what they think we are doing. They don't think we are creating some brand new entitlement program. They don't want us to do that. They want us to lower the costs. So Republicans have put forward proposals, and some of them my colleague just mentioned: allowing insurance companies to sell across State lines, trying to get rid of junk lawsuits. My wife Meike is pregnant with our fourth child. She goes and sees her doctor in Tallahassee, FL--not a big town. He is paying $120,000 a year in medical malpractice insurance. That affects not only the cost of care, but it also creates defensive medicine which runs up costs. We have some real, concrete, step-by-step solutions on our side of the aisle that will make things better and reduce the cost of health care. One thing I have had the privilege of working on with Dr. Coburn is going after waste, fraud, and abuse. In the Medicare system, we know there is $60 billion a year--$60 billion--in waste, fraud, and abuse. My State of Florida, unfortunately, is the capital of this health care fraud. I will give my colleagues one statistic that I think says it all. In Miami Dade County, we have 7 percent of the country's AIDS population. Yet reimbursements for health care for AIDS patients in Miami Dade County constitutes 83 percent of what is spent in the entire country. Now, why is that? It is because folks are committing fraud on the system. Health care providers in warehouses and strip shopping centers, or nonexistent offices at all--they are not providers; they are just scam artists running the codes, running these medical codes and submitting them to Medicare and Medicaid. Why shouldn't the first thing we do be to fix the system we have, stop this bleeding of billions of dollars and put it back into Medicare and Medicaid which are programs that are going broke? The President is right. There is a health care emergency in this country, and the No. 1 emergency is Medicare and Medicaid, not creating a new program. We should make sure that Medicare for seniors is viable. We should stop the waste, fraud, and abuse, and get the money back in Medicare. Then we should do the same thing for Medicaid. Once we have those programs more solvent and we meet the commitments we have already made, then we could take the step-by-step approach on trying to provide lower cost health insurance for people who have it and more access for people who do not. We have offered solutions, but as we understand it, what is going to happen is they are going to take the Senate bill that was passed on a party-line vote in December on Christmas Eve, send it over to the House, and then try to convince the House Democrats they are going to have a makeup bill that is going to fix their problems and try to send that over here and make us vote on that on a simple majority, which is not what was intended by the rules. I am new to the Senate, so I want to defer to my colleagues and perhaps the Senator from Oklahoma can speak to this point and whether that is appropriate to do, and also speak to the good step-by-step measures we have to combat the problems with health care.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, the Baucus substitute amendment gives preferential treatment to the extension of three programs: unemployment insurance, COBRA, and what is known as FMAP, which is the Federal Government's aid that it provides to States in the payment of Medicaid. These are laudable things to do, especially in this difficult economic environment. In my home State of Florida, we have nearly 12 percent unemployment. It is the highest anyone can remember, and people are struggling. So these are laudable things to do. The challenge is we are not going to pay for these spending programs. We are going to put them on the backs of our children and grandchildren, as my colleague Senator Burr remarked in his comments. A couple of weeks ago, we passed a bill here in the Senate called pay-go, and the President just signed this bill into law. I struggled with my vote on pay-go, being a new Member to the Senate and being very concerned about spending, and I thought about voting for it. I thought about voting for it because anything that cuts spending around here, on its face, seems like a good idea to me. But the challenge for me came in learning from some of my colleagues that we don't enforce pay-go. They came to me and said: Look, they are not going to use this as a real measure to control spending. So the bill passed along party lines. And although I didn't support it, I hoped for the best. But here we are, a couple of weeks after the President signed the pay-go law, and I want to remind the Senate of the comments of Majority Leader Reid upon arguing for the passage of the bill. He said: This pay-go--pay-as-you-go rule--we are proposing for the government is the same one Americans use every day in their individual lives; the same ones we teach our children. In order to spend a dollar, we have to have that dollar in our wallet. This law will enforce that commonsense approach. Sounds reasonable. Sounds like the right thing to do. The President, when he signed the law, said: You have to make hard choices about where to spend and where to save. Well, here we are, a few weeks later, and unfortunately the prediction of my colleagues that this was not a true enforcement mechanism on spending has come true. Because we are going to designate the extension of these three programs as emergencies. They are emergencies. And if they are emergencies, then we don't have to make them play by the rules. We don't have to cut spending in order to pay for these programs. Unfortunately, we seem to designate whatever we choose as an emergency and, therefore, we don't have to do the things Leader Reid said. We don't have to do the things President Obama said. But families sitting around their tables who have bills to pay can't say: This is an emergency; therefore, I can go and spend money I don't have. Families can't do that. Businesses can't do that. Even State governments, that have to balance their budgets, can't do that. So what is an emergency? What does the law tell us is proper to designate? Certainly we could think of circumstances that could be an emergency: a situation of war, the financial meltdown we had a couple of years ago. Certainly things such as that would justify being an emergency. Well, the Budget Act of 1974 lays out five different criteria that must be met. First, necessary, essential, or vital; second, sudden, quickly coming into being and not building up over time; three, an urgent pressing and compelling need, requiring immediate attention; four, unforeseen, unpredictable, unanticipated; five, not permanent, temporary in nature. None of these three extensions is that. We saw these coming. To say this is an emergency is like putting $5 of gasoline in your car and then running out of gasoline and saying: I have an emergency. I couldn't foresee that the $5 wasn't going to get me very far. Again, these are laudable programs, and the point of order I am about to make is not going to stop this going forward. All it is going to say is that you can't declare something an emergency that is not an emergency, and that we should pay for this by the end of the year. What a commonsense idea to bring to Washington and perhaps to the Congress, that we pay for the programs we decide need funding, that we don't balance it on the backs of our kids and grandkids. As Senator Burr said, we shouldn't borrow $10 billion to spend $10 billion. The spending in Washington is unsustainable. Let's do these good programs, but let's take a novel approach and let's pay for them. Mr. President, at this time I wish to make a point of order. Pursuant to section 4(g)(3) of the Statutory Pay-As-You-Go Act of 2010, I raise a point of order against the emergency designation provision contained in the pending substitute amendment.

Mr. LeMIEUX. With all due respect to my colleague, the chairman of the Finance Committee, my point of order will not stop these programs from being extended. What it will do is it will make sure we have to pay for them by the end of the year--a novel idea, that we actually pay for a program. So we will have to look at programs we have now, perhaps, and we cut other programs. Do we not think there is some inefficiency in the administration of the Federal Government? We had a proposal we tried to pass last year to require all the agencies of the Federal Government to cut 5 percent--just 5 percent--when they have had 5, 10, 15 and 20-percent increases year after year after year. Surely governing and leadership is about making decisions. I voted for the 30-day extension. I want to vote for this bill, but I want to pay for it. I want to make sure we are not borrowing money from the children and grandchildren of Floridians and other Americans to pay for this bill. I want to make sure we are not going to be paying interest to the Chinese to pay for this bill. I think it makes perfectly good sense that we are required, by the end of the year, to find the money to pay for this. Every dollar we spend is a choice. It is a choice on what we should spend it on. In this body and in this Congress it is a choice, unfortunately, to put a burden upon our children and grandchildren because we spend much more than we have. I am supportive of extending unemployment compensation. I am supportive of extending COBRA, which is health care. I am supportive of helping out the States with Medicaid payments. All I am asking is let's pay for it. Surely, there is some other program, duplicative in government, inefficiencies we can find to offset this payment. This is not a killer, this is just responsibility. I yield the floor.

Mr. LeMIEUX. Mr. President, I made this point of order not because I am not in favor of the extension of the unemployment insurance or the COBRA or the money for Medicaid but only that it be paid for. Just a few weeks ago, this Chamber voted to pass a pay-go bill, which the President signed, and it said we will pay as we go. But we have designated each of these three extensions as emergencies. They are not emergencies under the 1974 Budget Act requiring that it be sudden, quickly coming, unforeseen, or unpredictable. It is not an emergency. All my point of order does is to say that by the end of the year, we will have to pay for these. It will not stop them from going forward, but it will make sure we have to pay for them, just as the pay-go law requires. These are nonemergencies. I urge my colleagues to oppose the motion to waive the point of order.

Mr. LeMIEUX

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

Mr. LeMIEUX. Mr. President, I come to the floor today to speak on the issue of health care. Right now the leaders of this body, as well as the House of Representatives, are meeting with the President of the United States and members of his Cabinet at the Blair House to discuss the current health care reform proposal and where we should go forward to improve the health care of the people of this country. I come to the floor today to talk about a specific portion of their discussion concerning health care fraud prevention. Today, my colleague from Oklahoma, Senator Coburn, brought up with the President of the United States the issue of health care fraud prevention. As a Senator from Florida, this is something I have great concern about because, unfortunately, we are the capital of health care fraud for this country. I have put forward a proposal--S. 2128, the Health Care Fraud Prevention Act--to go after this very problem. Today, Senator Coburn brought up the fact that we believe that $1 out of every $3 spent on health care through Medicare or Medicaid or other public programs--$1 out of $3--is fraud, waste, or abuse--a shocking number. In fact, the belief is that $60 billion a year in the Medicare system alone--health care for seniors--is waste, fraud, and abuse. Unfortunately, we don't have systems in place to go after and prevent that waste, fraud, and abuse. What we do in the Federal system when we think there is fraud is we send prosecutors and law enforcement folks out to combat the fraud. These folks are doing a very good job, and there has been a lot of good work done in my home State of Florida. But the truth is, that is going after the fraud after it has already happened, and oftentimes there is no money left to collect. What we need to do is what I have proposed, and what the Health Care Fraud Prevention Act, S. 2128, accomplishes is it stops the fraud before it starts. I was happy today that the President agreed we need to prevent health care fraud. He said we have already incorporated all of the good ideas on this. I hope that means we are going to pass S. 2128. It is a bipartisan supported bill. It is a bill that will stop the fraud before it starts. It is not, however, in the Senate bill we passed in December. When I tried to bring this measure to the floor as an amendment, it was objected to. Since that time, I have worked with my colleagues on both the Democratic and Republican side of the aisle to move this measure forward. Senator Baucus and I have spoken about it. In the 11-page memo the President put forward, it references doing in part what S. 2128 would accomplish. So I hope that in the new proposal, we will put forward S. 2128 and pass it. Quickly, what does the bill do? It does three things: One, it creates a chief health care fraud prevention officer of the United States. That person, appointed by the President, would work at the agency for health and human services, and their only job would be ferreting out fraud. When there is $60 billion in Medicare alone and potentially that much in Medicaid and across the health care system--we think $\1/4\ trillion a year in fraud, waste, or abuse--it is worth having one person whose whole job is to try to prevent that fraud. Remember, if this money is recovered, we can use it to provide health care, we can improve the quality of care because there will be more money going into actually helping our seniors, helping the poor, helping our veterans. The second thing the bill does is it takes a model from the private sector--it borrows a page, if you will--because we have an industry in this country that does an excellent job of preventing fraud, and it is the credit card business. We have all had this experience. You go somewhere and use your credit card, and you get a phone call or an e- mail from your credit card company. They tell you some transaction has just occurred and ask: Did you really mean to have that transaction? Did you authorize that purchase? And you call them up and say either yes or no. I have a young family, Mr. President, as you know. When I got appointed to the Senate, I brought my kids and my wife up here so we could be close. I have three children 6 and under and a baby coming in a month, so we are here in Washington, DC, most of the time. I had to do what any good dad would have to do: I had to go out and buy a television. I went to Best Buy and bought a television. I live in Tallahassee, so before I left the store, my credit card sent me an e-mail. You live in Florida, is what this system is doing and thinking, and you are buying a television, which is a highly suspicious purchase, and you are doing it in Washington, DC. So I tell them yes, and the transaction goes through. If I tell them no, they do not pay Best Buy. They do not pay unless there is a verification on the front end. We can use that same technology in health care to set up a predictive modeling system to prevent the fraud before it starts. I called the worldwide head of fraud prevention for MasterCard and asked him: Can we do what you do in health care? He said: Sure you can, and I will help you. There is no reason we can't stop billions of dollars of waste, fraud, and abuse. Mr. President, before we go on to all the other issues in health care that we can't agree upon, we should call up this bill and we should pass it. We would get 100 votes, I bet, in the Senate, and we could save what one group here in Washington thinks is $20 billion a year. That is $20 billion we could use to maybe pay down the debt and the deficit or put it back into Medicare, which is hurting and is going to run out of money in a few years. We could do good things with that money. The third thing this bill does is it requires a background check for every health care provider. Can you believe we don't check the criminal records of people who claim they are providing health care to our seniors? We don't check to see if they are felons. We had a guy in Miami who was a convicted murderer who claimed to be a health care provider. This would require we do a background check. And if you are a criminal, guess what. You don't get to provide health care. You don't get to dupe the system. So I hope we will take up this bill. I am appreciative of Senator Coburn. I am glad the President recognizes we can all agree on this. If we can all agree, let's get something done. Let's call the bill up and let's pass it. Haiti Mr. President, I had the opportunity to go on a congressional visit to Haiti a couple of weeks ago--actually, 2 weeks from tomorrow. We were there on the 1-month anniversary of the tragic earthquake that killed more than 200,000 people. Two hundred thousand people died in Haiti. Myself and the other Members of the Senate and the House who went there were able to see some of the tragedy. We visited the cathedral in Haiti. You often hear President Clinton talk about this wonderful Catholic cathedral in Haiti that stood the test of time but could not stand the test of this earthquake. In fact, really the only prominent part of this cathedral that still stood, unbelievably, was the cross. We talked to the people who were there. They are a wonderful and resilient people, and it is amazing that they could go on with the tragedy they had experienced. I had the great honor to visit the Gesco Ford Operating Hospital, staffed mostly by American doctors and nurses, some of them from Miami, some of them from Orlando, in my home State of Florida. They are doing wonderful work. We met with the President of the country and the Prime Minister and Ministers of the President's Cabinet, and we talked about what are the next steps. Mr. President, I ask unanimous consent to have printed in the Record a letter I authored to the President of the United States, to which I will be referring.

Mr. LeMIEUX. Mr. President, this letter is cosigned by myself, Senator Nelson, my colleague from Florida, Senator Klobuchar, as well as Senator Lautenberg, all of whom were on the trip with me. The letter basically asks the President to do four things in trying to focus our help and relief for this country. We have been involved in trying to help the Haitian people for decades, and the American people have opened their hearts and their wallets to help the situation in Haiti, but the situation is dire. I cannot think of a more complicated, difficult problem than trying to bring Haiti forward to a sustainable place. Haiti was already in bad shape, but it had a path forward and progress was being made. Now, as you drive the streets of Port-au- Prince, it looks like a bombed area. It looks like a war zone. You will randomly see three buildings standing as if nothing had happened and then a building that is completely and utterly destroyed. Right now, thousands of people are huddled together in these makeshift camps in low-lying areas. My great fear for the short-term is that when the rains come, which they will in the next weeks in Haiti, there will be another great tragedy. So we have to be focused in our help. So I, along with my colleagues, sent this letter to the President and asked the President to do four things: First, create a long-term sustainable plan for Haiti and put in charge of that plan, on behalf of our relief efforts, a trustee, along with an inspector general, along with a board of advisers, to work in partnership with the Haitian Government to make sure the money is spent wisely. We cannot just send billions of dollars into Haiti and let the money evaporate in short-term solutions. There needs to be a long-term sustainable plan. Second, we have to provide funds to the Haitian people directly. Small businesses need microloans so they can provide jobs for the people of Haiti. We can't just give the money to third-party contractors. Third, we have to be focused on this orphan issue. We have to make sure it is done legally, and where it is done legally, we have to make sure we get those children to their adoptive parents as quickly as possible. Fourth, we have to make sure Port-au-Prince is not the center of the entire population for the country of Haiti. We are putting too many people in one place when tragedy strikes. We need to encourage development throughout the country. I had the honor of having the President of Royal Caribbean cruise lines in my office yesterday--a Floridian, Adam Goldstein--and we talked about tourism to Haiti. There is a beautiful citadel in Haiti that would be a wonderful attraction for cruise ship tourists. There have been all sorts of difficulties building a road to it and making sure it is safe and secure. We need to find ways to create jobs outside of Port-au-Prince, outside that city, so that fragile humanity is not all focused in one place. Finally, we need to make sure the Diaspora of Haiti, the Haitian- American people--for example, we have about 250,000 Haitian Americans in Florida--are involved in the rebuilding of Haiti. They need to be welcomed. They are dying to get involved. They are hungry to get involved in this process of rebuilding their home country. So I hope the President will put together this commission, appoint a strong leader--a Colin Powell or someone of that magnitude--as the trustee to work with the Haitian people to rebuild the island of Haiti, and I hope we can get effort and energy behind that proposal quickly so we don't have any other significant challenges in the coming months ahead for the Haitian people. With that, Mr. President, I yield the floor.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, this week marks the 65th anniversary of the liberation of the Auschwitz-Birkenau Nazi concentration camp. It was 65 years ago this week when the Soviet army entered Auschwitz and liberated more than 7,000 prisoners. It is estimated that a minimum of 1.1 million people were murdered in the camp as part of the Nazis' deliberate and systematic campaign to exterminate as many as 6 million European Jews and Roma. Winston Churchill called it a ``crime that has no name.'' Stories from the survivors are a chilling reminder of the unspeakable horrors that can be perpetrated by evil men when the forces of good are slow to respond. Some of these personal testimonies are preserved in museums around our Nation, including the U.S. Holocaust Memorial Museum. In 1948, the United Nations pledged in the Genocide Convention that the horrors of the Holocaust would ``never again'' be repeated. Sadly, this pledge has not been upheld. In Cambodia, Rwanda, Bosnia, and Sudan people have been murdered solely on the basis of their national, ethnic and religious affiliations. I urge my colleagues and members of the international community to renew our commitment to ``never again'' allow genocide to take place. I also call upon the Obama administration to continue upholding our pledge to protecting the personal freedoms of individuals around the globe.

Mr. LeMIEUX

Mr. LeMIEUX. Mr. President, I rise again to talk about the unsustainable spending of this country and the debt that we cannot afford. Just a moment ago a proposal by Senator Conrad and Senator Gregg to put together a commission to tackle the spending of this country was defeated in this Chamber. I supported the proposal. It was not a perfect proposal. It was a proposal that some Republicans did not like because of the opportunity it might promote to have a tax increase. It was a proposal some Democrats did not like because they thought the spending might be too tough on entitlement programs such as Social Security and Medicare. But it was a proposal that both Democrats and Republicans, I hoped, would like enough to move forward. The spending problem we have is like a cancer. This Chamber refuses to seek any treatment. While I did not like the proposal completely, I at least supported it because I knew we needed to do something. Our spending is out of control. We have a $12 trillion debt. The deficit of last year was $1.4 trillion, more than the past 4 years in the Bush administration combined. I am new to this Chamber so the bizarre still seems bizarre to me; and perhaps the longer you are here, bizarre starts to seem normal. But we cannot spend more than we take in. We cannot continue to amass debt for which our children will have to pay. Right now we have to borrow money from countries such as China because we can no longer raid Social Security and Medicare because those programs now need those dollars to be paid out. At some point this country is going to have to pay the piper. At some point we are going to have to dramatically cut spending or dramatically increase taxes. At some point investors from around the world will not invest in this country anymore because we will not be a good investment. That is already starting to happen. We are already seeing folks from around the world investing in countries such as Brazil because they see it as a superior opportunity to this country. At some point we will not be a first-rate economic power unless the people in this Chamber and the Chamber down the hall have the courage to do something about it. What we should be doing is balancing the budget. We should be proposing a balanced budget amendment and a line-item veto for the President. I put forward this measure. The majority of the States do it, the majority of the Governors have that line-item veto, but it is tilting at windmills. I know it is unrealistic because this Chamber will not even do what Senator Conrad and Senator Gregg tried to do just a few moments ago. I will continue to stand up and speak on this because if we do not sound the alarm, the future of this country is in peril. Now we are about to embark upon raising the debt limit. This time, $1.9 trillion. I have talked about this before, and for those who have heard it, it is going to seem like old news. But I feel as if I have to continue to stress how much money this is. If you take $1 million and lay it edge to edge, it will cover two football fields; $1 billion will cover the city of Key West, FL, 3.4 square miles; and $1 trillion will cover the State of Rhode Island twice. If you stack $1 trillion from the ground up to the sky, it would go more than 600 miles. This is an enormous amount of money. We throw these amounts around, trillions and billions. It is hard to grasp how much it is. Now our interest payment has become one of the largest payments we make every year, nearly $200 billion alone on interest. We cannot put bandaids over this. We cannot say we are going to freeze spending; we have to cut spending. In the State of the Union Address on Wednesday, apparently the President of the United States is going to offer the idea that we are going to cut spending in some discretionary spending items, about 17 percent of the budget. Leader Boehner over in the House said it is like going to a pie-eating contest and deciding you are going to go on a diet. It is like that family sitting around the table and trying to decide how they are going to cut their spending. Instead of making meaningful cuts, it is like saying: OK, we will cut our spending on beer and pizza. It is not enough. It is not enough. We are spending much more than we can afford to. And my three kids--soon to be four-- are not going to want to live in this country because they are not going to have the same opportunities as they could in other places in the world. Shame on us if we fail our children in that way. So I stand with my colleagues--Senator Coburn, Senator McCain, and Senator Enzi--in support of amendment No. 3303, which is an alternative to increasing the debt ceiling. Instead of increasing the debt ceiling and borrowing more money when we cannot afford to, we are going to cut spending by $120 billion, which is a good start. How do we do it? We go across all of the agencies and say they have to cut 5 percent. Right now, American families are cutting more than 5 percent from their household budgets. Small businesses in places such as Florida and around the country have to cut more than 5 percent. These are difficult times. When is the last time a government agency cut anything? I bet you could cut 20 or 30 percent out of these agencies and not have a meaningful impact on the services they render. And this asks for 5 percent, a 5-percent cut across the board. It also directs that agencies consolidate more than 640 duplicative programs that have been found. We know there are more than that. That is just the 640 that have been found. This requires the Government Accountability Office to identify other duplicative programs that can be cut and rescinds unobligated funds--the money sitting out there in the budget for these agencies that they have not spent. Let's take that money back and put that against the deficit. We are borrowing money now. We should not have money sitting around when we are borrowing money and paying interest on it. So it is a good proposal, and I hope it passes. But the truth is, it probably will not because there are folks in this Chamber, Democrats and Republicans alike, who will not stand up and face the hard truth that we have to cut spending. If we do not make the hard choices and stand up as leaders in this country, our future is in peril. When we look back 10, 20 years from now and it is too far gone, the only folks whom we are going to have to blame are ourselves. This is not a Democratic problem, not a Republican program, it is a problem of this Congress. Go back to March 2006. The President of the United States, then a Senator, said: The fact that we are here today to debate raising America's debt limit is a sign of leadership failure, is a sign that the U.S. Government cannot pay its own bills. Do not take it from me, take it from the President of the United States. We have to do more. I am disappointed that Gregg-Conrad failed. It was not perfect, but it was something. I hope Senator Coburn's measure prevails, but I am skeptical. The American people get it. The American people understand this is a problem, and that is why we have these big swings in these elections. The same passion that propelled President Obama into office is the same passion that propelled our new Senator from Massachusetts into office, from two opposite parties, because the American people are frustrated that this body does not work. And if we do not change the rules and start to get serious and if we keep muddling along the path of disaster, we are going to fail our country. We may not get it done while I am here in the Senate. I only have this year. But I am going to keep coming to the floor and I am going to keep speaking out about it because somebody has to sound the alarm. 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 rise today to speak about the incident that occurred on Christmas Day, when our Nation was targeted by a terrorist who attempted to bring down a plane with 278 passengers and 11 crew members. This attack would have resulted in mass casualties. Thankfully, it did not occur. Much in part due to the vigilance of nearby passengers and for the grace of God, this terrorist was unable to detonate the explosives he carried with him under his clothes. We should be responding as if the worst happened. What would we be doing today if that plane had exploded over the skies of Michigan and all of its passengers had died? When the plane landed, the Nigerian terrorist, Umar Farouk Abdulmatallab, was taken into custody and questioned by authorities. But what happened next is very worrisome. Instead of treating Mr. Abdulmutallab like the terrorist and enemy combatant he is, he was afforded all of the protections of the U.S. Constitution, as if he were a U.S. citizen. He was provided his Miranda rights--the right to remain silent, the right to have an attorney, and the information that if he did not remain silent, it could be used against him. Of course, as best we know, once he was provided with these rights, he stopped talking to those who were questioning him. What information did we fail to learn? What information about Yemen, the newest breeding ground for al-Qaida and other terrorist groups launching attacks against our country, did we fail to learn? What did we fail to learn about the next attack that is coming, whether it will be again in an airplane or another type of terrorist attack? Those questions were not asked, and they could not be answered because we treated the terrorist like an American citizen. We gave him all of the constitutional protections. Yet those protections were never meant for people we are fighting against in a war. That is why I come today to the floor of the Senate because we are treating these terrorists--from the Christmas Day bomber to Khalid Sheikh Mohammed, whom we are going to try in a Federal court, a civil court in New York--as if they are common criminals. In so doing, we are losing ground in the war on terrorism. We cheapen the value of being an American citizen, with all the rights that are afforded to us, when we grant terrorists who seek to end our way of life with those same protections. Why are we providing Miranda rights and other constitutional protections to terrorists at the expense of the security of the American people? Who in our government is making this decision? Who is saying these terrorists should have these rights? Who made the decision to Mirandize the Christmas Day bomber and treat him as a criminal defendant instead of an unlawful enemy combatant? Instead of treating this as a criminal law enforcement action, we need to recognize that we are at war. It is not the kind of war that our grandfathers fought in World War II or the one our fathers fought in Vietnam; it is what they call an asymmetrical war. But it is a war nonetheless. The people who are waging this war against us are trying to destroy America as we know it--not unlike the enemies we have had in our past wars. We lose the edge against these enemies in this war by failing to gain the information that we could gain, and should gain, from lawful and proper interrogation--information that is not gained as soon as Miranda rights are given. This week the Director of National Intelligence, Dennis Blair, the National Counterterrorism Center Director, Michael Leiter, and the Department of Homeland Security Secretary, Janet Napolitano, all testified before committees of the Congress and the Senate surrounding the incident concerning Umar Farouk Abdulmutallab. Each of them admitted they were not consulted by anybody in the administration, specifically the Department of Justice, on prosecuting Abdulmutallab in a civilian rather than a military court. These are the people who are supposedly on the frontlines of protecting the homeland and fighting against terrorism. The Director of National Intelligence, a position created to stand on top of all of the other intelligence-gathering organizations, to break down the silo so we could gain information and connect the dots--which as you hear, of course, did not happen for this event--but the chief intelligence officer of the United States of America was not informed as to why we were prosecuting him as a civilian. I had the opportunity to question Michael Leiter, the head of the National Counterterrorism Center, who is trying to counter the terrorism that is affecting our country. Although he was careful not to contradict the administration, it is clear to me that he would rather we treat these enemy combatants as what they are and not as common criminals. So who made this decision? Was it the Attorney General of the United States? Was it the President? Whoever made this decision, we need to know. That information needs to be before the Senate because it is a questionable call at best. In fact, I submit it is the wrong call to treat these non-American citizens as if they had all the rights we do. We are losing the war on terrorism if we do not gain the valuable information to stop terrorist attacks before they start. Someone from this administration needs to come forward and own up to this decision. I call upon the administration to do so. The American people deserve answers. Our policymakers have to come clean. We should be able to ask them questions and ask the right person questions as to why this decision was made. We should not be trying terrorists in civilian courts. We should not be giving them Miranda rights and other constitutional protections. We should be fighting the war on terrorism as if our very lives depend upon it because they do. Haiti Mr. President, I wish to speak about the situation in Haiti and the tragic events that occurred last Tuesday around 5 p.m. when a massive earthquake, measuring 7 points on the Richter scale, occurred near Port-au-Prince, the capital of Haiti. As a Senator from Florida, I have a deep connection to the Haitian people because we have more than 200,000 Haitians in our community in Florida. Watching what happened on television and the graphic pictures we have all seen on the news of the tragedy that has occurred--families have been separated and lost, children have been orphaned--we have also seen encouraging shots, those of people being rescued. We all saw the shot a couple days ago of the 75-year-old lady who was rescued, and yesterday a small boy and his sister were pulled out of the rubble, amazingly buried alive for a week and they made it out. It gives us hope. But the projections are grim with perhaps as many as 150,000 Haitians dead. It is a staggering figure. It is a tragic loss of humanity. Last week, I was in Miami, along with the Governor and other officials, as we met to talk about what our response would be. We worked with the Coast Guard and Southern Command to make sure our rescue teams from Miami that have done work all around the world would have the opportunity to join the other search-and-rescue teams to help bring out the living and to find the dead to return them home. We have been very successful in doing that. We are very thankful for all of those Americans and very proud, as I am, especially of the ones from Florida, who have been doing such great work. While I was down in Miami, I had the chance to go to Little Haiti, which is our largest Haitian-American community, and visit the students at St. Mary's School. It is the school next to the Catholic cathedral in Miami, Dade County. I visited with Monsignor Terence Hogan and Sister Jane Stoecker, who is the principal of the school. I saw these beautiful Haitian children who were there in their school uniforms. They came to school that morning, the day after the earthquake, crying because they have family and loved ones on the island of Hispaniola. They put their pennies and quarters together to raise $500 to send to rescue and help the Haitian people. It is a touching story. The American people have been touched, too, because now we know tens of millions of dollars have been raised. Former President Bush and former President Clinton have come together under the request of President Obama to lead a relief effort so that we all can contribute, and we all must and we all should. I am thankful to RADM Steve Branham of the 7th District of the U.S. Coast Guard who has been on the ground and instrumental in making sure the relief efforts and the Coast Guard could be there to help these folks. One thing specifically he has been able to help with, which I will talk about in a moment, concerns the students from Lynn University in Boca Raton. I would like to talk about some of the heroes, some of our Floridians who have been so instrumental in helping the Haitian people. I wish to talk about a Fort Pierce-based nonprofit organization called Missionary Flights International that began flying food and supplies to Haiti daily. Since the earthquake, the organization has collected donations and gathered volunteers to load food, water, and supplies on their planes. In 1 day alone, the organization sent more than 400,000 ready meals to be eaten in Haiti. Another organization, the Big Heart Brigade in Palm Beach, is shipping 140,000 meals ready to eat this week. The Big Heart Brigade provides meals to many in South Florida, but in the wake of the tragedy, they have focused their efforts on Haiti. I wish to talk about Mr. Hank Asher in Boca Raton, FL, whom I happen to know well, who immediately took his plane and started flying doctors and nurses from Jackson Memorial and needed supplies into Haiti and brought back the wounded and the injured to Florida. We were able to give them some assistance in getting in and out shortly after the disaster. The good people of Florida and the good people of this country are opening their hearts and wallets and pocketbooks to help the people of Haiti, as they should. I look forward to going to Haiti once the search-and-rescue portion is over to assess the situation myself to see what I can do to help that nation recover. Also, as I mentioned a moment ago, I wish to talk about Lynn University students. Many folks watching on television today have seen the parents of these students. There were 12 there with faculty members. Some of them were able to get home. They were recovered and returned but alive. Now we know there are four students still missing and two faculty still missing. We remain hopeful that these young ladies and their two faculty members will make it back home to Florida. We have Christine Gianacaci, Stephanie Crispinelli, Courtney Hayes, and Britney Gengel, along with faculty members Patrick Hartwick and Richard Bruno. I have been talking with Dr. Ross, the president of Lynn University. My office, with other Members of Congress, is trying to assist in the efforts to find these students who were in the Hotel Montana, which fell shortly after the earthquake. Yesterday, I sent a letter to Secretary Clinton, Administrator Shah, and Secretary Gates. I ask unanimous consent to have printed in the Record a copy of this letter dated January 21, 2010, at the conclusion of my remarks.

Mr. LeMIEUX. Mr. President, in that letter we have asked that the search-and-rescue efforts continue. We saw the miraculous discovery of that young boy and young girl yesterday. There are people potentially alive still buried in the rubble. We must continue while there is some hope to look for survivors. But if there are no survivors, we request in this letter that their loved ones be brought home so they can be here in the United States. It is a request I think we all understand. We have been working with Secretary Clinton's office. We know they share the same view. I wanted to bring that to the attention of the Senate. As a parent of young children, I cannot imagine the loss and the feeling of loss of these parents from Lynn University and others who are still waiting for the potential recovery, as the days grow longer and the hours go by, of their family members, especially the loss it must be for these parents, the idea of losing a child. There is nothing more tragic one can think of. Our hearts go out to them. They are in our prayers. We look forward to the hopeful return of these students and faculty, but if not their return alive, then at least bringing them home so they can have rest and peace back in the United States of America. Mr. President, I yield the floor. Exhibit 1 U.S. Senate, Washington, DC, January 21, 2010. Re Locating and Returning Americans Missing in Haiti. Hon. Hillary Clinton, Secretary, U.S. Department of State, Washington, DC. Hon. Robert Gates, Secretary, U.S. Department of Defense, Washington, DC. Dr. Rajiv Shah, Administrator, U.S. Agency for International Development, Washington, DC. Dear Madam Secretary Clinton, Mr. Secretary Gates, and Administrator Shah: Over the past week, the immense scale of the tragedy in Haiti has been revealed. The outpouring of support from Americans for the Haitian people has been significant and heart-warming. Americans' commitment to the renewal of Haiti existed before last week's devastating earthquake. As a result, thousands of Americans were working, studying, and serving in Haiti when the quake struck. Many of them remain missing. Among the missing are a number of my fellow Floridians. Because these Americans remain unaccounted for, please urge all relevant U.S. officials to advocate for continuing search and rescue efforts until the possibility of survival no longer exists. Additionally, on behalf of the families of the missing. I request you to do everything within your power to ensure that every American known to be missing in Haiti is located and returned home. Thank you for your attention to this urgent matter. Sincerely, George S. LeMieux, United States Senator.

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