John McCain

Mr. McCAIN

Mr. McCAIN. I would say to my friend, the Republican leader, that I have seen a lot of processes around here and a lot of negotiations and a lot of discussions, but I must admit I have not seen one quite like this one, nor do I believe my leader has. I was on the floor in a colloquy with the assistant Democratic leader a couple days ago, and I said: What is in the bill? He said: None of us know. Talk about being kept in the dark. I would say to my friend from Kentucky, we have to put this into the context of what the President of the United States said in his campaign because the whole campaign, as I well know better than anyone, was all based on change. On the issue specifically surrounding health care reform, I quote then-Candidate Obama on October 18, 2009: I am going to have all the negotiations around a big table televised on C-SPAN so that people can see who is making arguments on behalf of their constituents and who is making arguments on behalf of the drug companies or the insurance companies. He went on to say that a couple more times. I would ask my friend: Hasn't it been several days that we basically have been gridlocked over one amendment, which is the amendment by the Senator from North Dakota that would allow drug reimportation from Canada and other countries? So then, guess what the reports are today: PhRMA renegotiating its deal? Inside Health Policy's Baker, Pecquet, Lotven and Coughlin report: `The pharmaceutical industry is negotiating with the White House and lawmakers on a revised health care deal under which the industry would ante up cuts beyond the $80 billion it agreed to this summer, possibly by agreeing to policies that would further shrink the . . . doughnut hole. . . .' I will not go into all the details of that. Just a few minutes ago on the floor, guess what. They announced there would be some change made, an amendment that would be included in the managers' package. I would ask my friend, is it maybe the case that the majority leader, who is having a meeting, as we speak, of all the Democratic Senators behind closed doors, without C-SPAN, has cut another deal along with the White House with--guess who--the pharmaceutical companies that have raised prices some 9 percent on prescription drugs this year? This is a process the American people don't deserve, so I would ask my friend from Kentucky.

Mr. McCAIN. So we were hung up--or should I say gridlocked--for 2 or 3 days, over the entire weekend. The Republican leader even agreed to a unanimous consent agreement that would allow a Democratic side-by-side amendment, and that was not agreed to--until over at the White House, according to this report, PhRMA renegotiated its deal and apparently they now have sufficient votes to defeat the Dorgan amendment which, as of last summer, according to the New York Times, said the last deal shortly after striking that agreement, the trade group--the Pharmaceutical Research Manufacturers of America, or PhRMA--also set aside $150 million for advertising to support the health care legislation. I ask my friend, is this changing the climate in Washington or is it not only business as usual but, in my opinion, I haven't seen anything quite like this one.

Mr. McCAIN. Hadn't there been charge after charge that Republicans are ``filibustering'' and Republicans have been blocking passage of this legislation? I would ask my friend, hasn't the Republican leader offered a series of amendments we could get locked into and have votes on?

Mr. McCAIN. As I understand it, there is a meeting going on behind closed doors, again, where there are no C-SPAN cameras. According to the Washington Post this morning, it says: The Senate will resume debate Monday afternoon on a popular proposal to allow U.S. citizens to buy cheaper drugs from foreign countries which led to a last-minute lobbying push by drug makers last week and bogged down negotiations over a health care reform bill. It goes on to say: The fight over the imported drugs proposal poses a particularly difficult political challenge for President Obama who cosponsored a similar bill when he was in Congress and who included funding for the idea in his first budget. But the pharmaceutical industry, which has been a key supporter of health care reform after reaching agreement with the White House earlier this year, has responded with a fierce lobbying campaign aimed at killing the proposal, focusing on Democratic Senators from States with large drug and research sectors. So it will be interesting to watch the vote. I would also point out to my friend, it is clear that if we allow drug reimportation, we will save $100 billion, according to CBO, and the deal that was cut--the first deal that was cut with the White House was they would reduce it by $80 billion, so they had a $20 billion cushion. Now it will be very interesting to see what the latest deal is and how the vote goes. But, again, I wish to ask my Republican leader, we get a little cynical around here from time to time and we see sometimes deals cut and things done behind closed doors. I am past the point of frustration; I am getting a little bit sad about this. Because I think we know we are now bumping up against Christmas. Sometime we are going to break for Christmas. So the pressures now are going to be even more intense because I think it is well known and reported that if they don't get a deal before we go out for Christmas, then it will be very much like a fish sitting out in the sun. After awhile, it doesn't smell very good, when people see a 2,000-page bill which has all kinds of provisions in it. So I understand, without C-SPAN cameras, that all the 60 Democratic Members of this body are going to go down to the White House for another meeting tomorrow, and we will see what happens then.

Mr. McCAIN. Well, my understanding is, if you go out and buy a car today from any car dealer, you don't have to make payments for a year. You can get that kind of a deal if you want it. This deal is exactly upside down. You get to make the payments early, and then you get to drive the car after 4 years.

Mr. McCAIN. I would also like to say, there is a history we should not ignore; that is, that every major reform ever enacted in the modern history of this country has been bipartisan, whether it be Medicare, whether it be Social Security, whether it be welfare reform, as we remember under President Clinton. Every major reform has been accomplished by Democrats and Republicans sitting down together and saying: OK, what is it we have to do? What kind of an agreement do we have to make? Some of us have been around here long enough to remember that in 1983, Ronald Reagan and Tip O'Neill, a liberal Democrat from Massachusetts and the conservative Republican from California, sat down with their aides across the table and key Members of Congress when Social Security was about to go broke. Why can't we, since there must be areas we agree on, now say to our Democratic friends and the President, rather than trying to ram 60 votes through the Senate, why can't we now sit down and proceed in a fashion--we will give things up. We are willing to make concessions to save a system of Medicare that is about to go broke in 6 years. We will make some concessions but get us in on the takeoff and don't expect us to be in on the landing when already the bill is written and the fix is in, as the fix apparently is in on the Dorgan amendment.

Mr. McCAIN. Madam President, it is a remarkable process we are going through. I see that my friend from Tennessee is here. I know he, being the head of our policy committee and a major contributor to keeping us all informed and up to date, would also like to say something. First, I will say something I had not planned on saying; that is, this has been a vigorous debate. I think we have been able to act in an effective way, which has been reflected in the polls of the American people who are largely opposed to this measure and greatly supportive of a process where we can all sit down together--with the American people in the room, to be honest--when we are talking about one-sixth of the GDP. The Republican leader's job has been compared by one of his predecessors to herding cats--I agree with that--or keeping frogs in a wheelbarrow. I have not seen the Republican Members on this side of the aisle as much together and as cohesive and working in the most cooperative and supportive fashion of each other since I have been in the Senate. For that, I congratulate the Republican leader.

Mr. McCAIN. I will mention, also, on the issue of PhRMA, again, here we are in the direst of economic times, with a Consumer Price Index that has declined by 1.3 percent this year, and they have orchestrated a 9-percent increase in the cost of prescription drugs--that is remarkable--laying on an additional burden, which naturally falls more on seniors than anybody else since they are the greatest users of pharmaceutical drugs. I don't blame them for fighting for their industry. But the point is, what they are doing is harming millions and millions of Americans. Again, about contributing to the cynicism of the American people, whether you are for or against the issue of drug reimportation, to cut a deal behind closed doors and then, apparently, because of support of an amendment by Senator Dorgan, go down and negotiate another deal--how do you describe a process like that?

Mr. McCAIN. The original deal was published in every newspaper, and it was that they would close the so-called doughnut hole by some $80 billion. CBO said their profits would be reduced by some $100 billion if we allow reimportation. They had a $20 billion cushion.

Mr. McCAIN. But then, incredibly, they counted the votes. The votes were there to pass the Dorgan amendment. According to published reports, the pharmaceutical industry is negotiating with the White House and lawmakers on a revised health care deal under which the industry would ante up cuts beyond the $80 billion it agreed to this summer. In other words, because that wasn't sufficient to get votes to kill the Dorgan amendment that would allow reimportation of drugs, they went down and renegotiated. What is that called?

Mr. McCAIN. Can I also give you this to illustrate it graphically? In this news report, several lobbyists told Inside Health Policy--that is the organization that is reporting this--they have heard that the Pharmaceutical Research and Manufacturers of America may have already reached a deal with the White House and AARP to close the Senate bill's coverage gap by 75 percent versus the 50 percent under the current bill. PhRMA declined to confirm the reports that it may be agreeable to reforms that would further close the doughnut hole but signaled discussions were underway, and AARP said no agreement has been reached. We haven't seen a deal. Here are our old friends at AARP at it again. They are at it again.

Mr. McCAIN. Yes.

Mr. McCAIN. When you lose Medicare Advantage, as Dr. Barrasso will fully attest, then you are almost forced into the so-called Medigap policies, which then cover the things that are no longer covered under Medicare Advantage, such as dental, vision, fitness, and other aspects of Medicare Advantage. So if you destroy Medicare Advantage, then people will be forced into the Medigap policies. Who makes their money off Medigap policies? AARP.

Mr. McCAIN. I agree with the Senator. Again, I would like to ask Dr. Barrasso because he has treated patients who are under Medicare Advantage. Before I do, I want to say again that the whole process has been wrong. The process of going behind closed doors; the process where, after nearly a year of addressing this issue, the distinguished--and he is a fine person, a fine Senator from Illinois-- the No. 2 leader in the majority, in a colloquy I had with him just 2 days ago, said no one knows what is in the bill. He said no one knows what is in the bill. This is after a year. It is wrong. What it does is--this issue is vital, but it destroys the confidence of the American people to be truly represented here to have their interests overridden by the special interests, of which PhRMA and this deal that is going on right now is a classic example. I ask Senator Barrasso.

Mr. McCAIN. May I interrupt? I ask unanimous consent that the Senator from Tennessee take over this colloquy.

Mr. McCAIN. Go ahead. I am sorry.

Mr. McCAIN. The point I want to make is this process has turned into something, again, like I have never seen before. I was just handed this FOX News, just-reported breaking news that Harkin said--I guess referring to the Senator from Iowa--Harkin said that Medicare buy-in and public option are now dead. I don't know what to say except it seems to me they are just throwing everything against the wall and seeing what sticks and what doesn't stick. This is really, again, one of the most astounding kinds of situations I have observed in the years I have been in the Senate. Medicare buy-in is dead, public option is now dead. What I would like to see is that Harkin would report that now Republicans and Democrats will sit down together and try to work out something of which the American people would heartily approve.

Mr. McCAIN. If I can speak for just about 10 seconds.

Mr. McCAIN. Very briefly, I say to my friends, apparently, if the news reports are right, the public option and Medicare is out. That is an interesting twist, and again, I think affirmation that they are just throwing things against the wall to see if anything sticks. But it doesn't change the core of the bill, which the Senator from South Dakota has been so eloquent about, and that is the $\1/2\ trillion in cuts from Medicare and increases in taxes. So you can take the public option out or leave it in, and it still doesn't change the fundamental fact that it is going to restructure health care in America and do nothing to reduce the cost and nothing to improve the quality. I just wanted to make that comment and ask for comment from the Senator from South Dakota. By the way, could I just mention, I haven't quite seen anything on the floor of the Senate as I saw when the Senator from South Dakota was challenged earlier today. I was watching the proceedings on the floor, and I wonder if the Senator from South Dakota would like to maybe respond to accusations of misleading information, I guess is the kindest way I could describe it.

Mr. McCAIN. I would respond by saying whether the public option is in or out or whether expansion of Medicare is in or out, the core of this legislation will do nothing to reduce or eliminate the problem of health care in America, which is the cost of health care not the quality of health care. In fact, it will, in many ways, impact directly the quality of health care, increase the cost, as we all know, by some $2.5 trillion, according to the chairman of the Finance Committee. But I also want to point out the back and forth of this--is it in there, is it out? Well, let's try this. Who, up until a week ago, ever heard we were going to expand Medicare? Now it is out, now it is in. We used to have hearings around here, proposals, witnesses, and then we would shape legislation, which would be amended in the committee, and then brought to the floor and amended on the Senate floor. Here we have to get news flashes to know whether the public option is in or out, whether Medicare expansion is in or out. Again, this is kind of a bizarre process. But my friend is right; it doesn't affect the core problem with this legislation, which is that it does not reduce cost, and it increases the size and scope of government and the tax burden that Americans will bear for a long period of time, including, by the way--and, again, I don't mean to sound parochial, but there are 337,000 of my citizens in the Medicare Advantage Program. The other side has admitted that the Medicare Advantage Program will go by the wayside. That is affecting a whole lot of people's lives, I would say, and that is in the core of the bill. That will not be changed by expansion of Medicare or with a public option or with no public option.

Mr. McCAIN. If I could just mention this. Over the weekend, obviously people watched football games. I was obviously pleased to see my alma mater prevail over those great cadets at West Point. We have a tendency to divert our attention--even seeing, for a change, the Redskins winning a football game--but what we talked about late last week is vitally important. The Centers for Medicare and Medicaid Services had some devastating comments to make. This is the organization that is tasked to provide us with the best estimates of the consequences of legislation--specifically Medicare and Medicaid. The CMS, referring to this bill, said: . . . we estimate that total national health expenditures under this bill would increase by an estimated total of $234 billion during calendar years 2010 to 2019. It goes on and on and talks about the devastating effects of this legislation, whether the public option is in or out, whether we expand Medicare or not. It is remarkable information that is in this study, a study being ignored by the other side. Clearly, what is happening on the other side is only one Senator is throwing proposals back and forth to the CBO until they get something that perhaps looks like it might be sellable. But the CMS has already made their judgment on this legislation.

Mr. McCAIN. If I could, before my friend from Alabama, I wonder also, when we are talking about dropping expansion of Medicare as is reported by news reports--I don't know; we have not been informed--could it possibly have anything to do with the fact that the AMA came out in opposition to it? Could it have anything to do with the fact that the American Hospital Association came out in opposition to it? Of course, that the PhRMA situation is a parliamentary procedure that is awaiting action on the floor speaks for itself.

Mr. McCAIN

Mr. McCAIN. How much time remains on both sides?

Mr. McCAIN. I yield 3 minutes to the Senator from Florida.

Mr. McCAIN. Mr. President, I understand there will be debate until 2 o'clock, and then a vote on the consolidated--consolidated-- appropriations conference report. What does ``consolidated appropriations conference report'' mean? It means there are six bills, three which were never considered on the floor of the Senate. That is what the Senate means by ``consolidated,'' my friends. So for three of the bills, we were never allowed to debate, to amend, or accept, or reject. They are now spending $450 billion, loaded up with 4,752 earmarks, totaling $3.7 billion, 1,350 pages long, and of that 409 pages are dedicated to listing congressional porkbarrel spending. I know most Americans are watching NFL football today and they probably do not pay much attention to what we do on a Sunday afternoon here on the floor of the Senate. But if they knew--if they knew what we are about to pass: a bill that has increased spending by 14 percent over last year's level, with the exception, of course, for our veterans care, which is only increased by 5 percent. Here we are with a $1.4 trillion--now a $1.5 trillion debt this year, an aggregate of over $12 trillion, unemployment at 10 percent, and 900,000 families who lost their homes in 2008, and the numbers for 2009 will be greater. So what do we do here? We spend and spend and earmark and earmark. The Consumer Price Index went down 1.3 percent, so we are going to increase spending by 5 percent. What could the American people do with the $3.7 billion in earmarks that are in this bill? Let me tell you a few of them, and you will not believe it, and I am not making it up: $2.7 million to support surgical operations in outer space at the University of Nebraska. I know Trekkies all over America will approve of that. I know Dr. Leonard McCoy--``Bones''--and even Dr. Spock and Captain Kirk will call them all to the bridge and be happy to know that $2.7 million is going to go to Dr. Leonard McCoy and his friends to support surgical operations in outer space, while thousands of Americans are losing their homes. Another one I have been unable to describe adequately without violating the rules of the Senate: $655,000 for Cedars-Sinai Medical Center, Los Angeles, CA, for equipment and supplies for the Institute for Irritable Bowel Syndrome Research. The only thing I can say is, that problem will not be reduced when people read this legislation, so there may be a need for it. So here we are. The list goes on and on. It is crazy stuff: $200,000 for a visitors center in Bastrop, TX, population 5,340; $292,200 for elimination of slum and blight in Scranton, PA--the cast of ``The Office'' is rejoicing--$200,000 for ``design and construction of the Garapan Public Market'' in the Northern Mariana Islands. The Woodstock Film Festival Youth Initiative is going to get $30,000. It is beyond imagination when you put it into the context that Americans are suffering more than they have at anytime in their lives. Thanks to the greed and avarice of Wall Street, Main Street is under tremendous duress. This is shameful. I want to remind my colleagues, last March--not that long ago--the President of the United States signed another pork-laden omnibus bill. The President of the United States said: I am signing an imperfect omnibus bill because it is necessary for the ongoing functions of government. But I also view this as a departure point for more far-reaching change. He also said: The future demands that we operate in a different way than we have in the past. So let there be no doubt: this piece of legislation-- The one he was signing last March loaded with pork-- this piece of legislation must mark an end to the old way of doing business, and the beginning of a new era of responsibility and accountability that the American people have every right to expect and to demand. If the President of the United States is going to carry out those words, he will veto this bill. He will veto this bill and send it back and tell them to get rid of this pork, tell them to get rid of it. So what is going to happen? In a few minutes--we all know what is going to happen in a few minutes--by a very large vote, the Senate of the United States is going to vote in favor of this bill. There will be, on this side of the aisle--the party of fiscal conservatives that lost the last two elections--one major reason being because we let spending get out of control--there will be Members on this side of the aisle who will vote for this porkbarrel bill. On the other side of the aisle, a majority over there--an overwhelming majority; all but maybe one or two--will also vote for the bill. Then they will go home--if we ever get out of here--they will go home, and they will say: I am a fiscal conservative, and I am all for a commission to cut spending. Let's appoint a commission. Let's not take any responsibilities ourselves. Let's appoint a commission, and that commission will recommend how we can reduce spending. If you want to reduce spending and eliminate unnecessary and wasteful spending, vote against this bill that increases spending over last year by some 14 percent. If you want to vote for it, fine, but isn't it a little hard, with a straight face, to go back and tell your constituents you are for the elimination of this wasteful and porkbarrel and corrupting spending? It corrupts, my friends. It is a gateway drug to corruption. We have former Members of Congress in Federal prison because of this. First, since it is going to be passed, I urge the President of the United States--I do not urge--I demand the President of the United States to keep his word when he signed another porkbarrel-laden bill last March, to veto this bill. I urge my colleagues--I urge my colleagues--let's stand up against this for once: a bill that has $3.7 billion in earmarks. Immediately, colleagues remind us: Well, this is a legitimate earmark. This is important; that is important. The problem with it is, nobody ever saw it before. It never competed. Maybe we need to support surgical operations in outer space. Do we need it at the University of Nebraska? No. It is earmarked for the University of Nebraska. By the way, I do not think, except for Trekkies, many Americans think we need to spend $2.7 million to support surgical operations in outer space. All I can say is: Do not be surprised when the American people, less than a year from now, next November, rise up and reject this kind of behavior and practice of irresponsible spending, while they are hurting more than they have ever been in their lives. They deserve better than what we are getting out of this legislative process, and they have every right to demand something different. Let's show some courage and vote against this bill, send it back to the President, get rid of the porkbarrel spending, and send it back, and let us vote for it. We could do it immediately. I urge my colleagues, look at this bill and vote against it. Mr. President, I reserve the remainder of my time.