Mark Pryor

Mr. PRYOR

Mr. PRYOR. Mr. President, Holmes had Watson, Mat Dillon had Chester, even Andy had Barney; for the past 20 years, I have had Bob Russell. Bob has long been a trusted friend, and for the past 7 years he has been my great chief of staff, providing valuable counsel, know-how, and humor. Bob is headed to the private sector, but I could not let him leave without thanking him for his public service in the Arkansas attorney general's office and in the Senate. Bob was instrumental in assembling an exceptional team of talented aides, many of whom are in the gallery today. Over the last 7 years, he led that team as we steered a number of legislative initiatives to success, including legislation to improve children's safety, help military families, and strengthen Arkansas communities. None of these accomplishments would have been possible without Bob's hard work, integrity, and deliberation. Bob believes in the ``do right'' rule. He came to the Senate to get these done for Arkansas, and when he realized that partisanship was getting in the way, he took action. Along with Tom Ingram, former chief of staff to Lamar Alexander, he formed the bipartisan chiefs of staff group. This informal group meets regularly to facilitate working relationships across the aisle. These friendships translate into solutions instead of barriers. The so-called Gang of 14 is a prime example, where Bob and Tom recognized early on that common ground on Federal judges was more favorable than Senate gridlock. Just a few weeks later, 14 Senators, including myself, struck a deal that enabled the Senate to move forward with the judicial nominations and conduct regular business. That is the type of unseen influence Bob Russell has had on this place for the last 7 years. I love Bob and I trust him. He is a good family man and he is a good Southern Baptist. On many Mondays, we would come in and say: Tell me about your sermon on Sunday. I will miss his presence and his insights. He has been a good mentor and adviser to me and to many on my staff and has made many lifelong friendships here in Washington. He is more than a chief of staff, he is my friend. Frank Broyles is an Arkansas hero, well-loved for coaching the Razorbacks to a national championship and famous for developing assistant coaches. One of his players was Jimmy Johnson, who would later coach as an assistant at Arkansas under Broyles. It is tough to let an assistant coach go, but when he is that good, he deserves to go out and do great things on his own. I feel the same way about Bob, especially since I know that Ecclesiastes says: For everything there is a season, and a time for every matter under Heaven. Johnson went on to win a national championship and two Super Bowls. I know Bob will go on to a highly successful career in his own right.

Mr. PRYOR

Mr. PRYOR. Mr. President, I rise today with Senator Cardin to introduce the Nanotechnology Safety Act of 2010 which will authorize a program of scientific investigation by the Food and Drug Administration on nanotechnology-based medical and health products. Nanotechnology holds great promise to revolutionize the development of new medicines, drug delivery, and orthopedic implants while holding down the cost of health care. However, Congress and the FDA must assure the public that nanotechnology-based products are both safe and efficacious. The Nanotechnology Safety Act of 2010 will enable the FDA to properly study how nanomaterials are absorbed by the human body, how nanomaterials designed to carry cancer fighting drugs target and kill tumors, and how nanoscale texturing of bone implants can make a stronger joint and reduce the threat of infection. Nanotechnology, or the manipulation of material at dimensions between 1 and 100 nanometers, is a challenging scientific area. To put this size scale in perspective, a human hair is 80,000 nanometers thick. Nanomaterials have different chemical, physical, electrical and biological characteristics than when used as larger, bulk materials. For example, nanoscale silver has exhibited unique antibacterial properties for treating infections and wounds. Nanomaterials have a much larger ratio of surface area to mass than ordinary materials do. It is at the surface of materials that biological and chemical reactions take place, and so we would expect nanomaterials to be more reactive than bulk materials. The novel characteristics of nanomaterials mean that risk assessments developed for ordinary materials may be of limited use in determining the health and public safety of products based on nanotechnology. The FDA needs the tools and resources to assure the public that nanotechnology-based medical and health products are safe and effective. The development of a regulatory framework for the use of nanomaterials in drugs, medical devices, and food additives must be based on scientific knowledge and data about each specific technology and product. Without a robust scientific framework there is no way to know what data to collect. More than a dozen material characteristics have been suggested even for relatively simple nanomaterials. Without better scientific knowledge of nanomaterials and their behavior in the human body, we do not know what data to collect and examine. In 2007, the FDA Nanotechnology Task Force published a report analyzing the FDA's scientific program and regulatory authority for addressing nanotechnology in drugs, medical devices, biologics, and food supplements. A general finding of the report is that nanoscale materials present regulatory challenges similar to those posed by products using other emerging technologies. However, these challenges may be magnified because nanotechnology can be used to make almost any FDA-regulated product. Also, at the nanoscale, the properties of a material relevant to the safety and effectiveness of the FDA-regulated products might change. The Task Force recommended that the FDA focus on improving its scientific knowledge of nanotechnology to help ensure the agency's regulatory effectiveness, particularly with regard to products not subject to premarket authorization requirements. The FDA has already reviewed and approved some nanotechnology-based products. In the coming years, they expect a significant increase in the use of nanoscale materials in drugs, devices, biologics, cosmetics, and food. This will require the FDA to devote more of its regulatory attention to nanotechnology based products. Let me talk for a few minutes about two areas where nanotechnology is already being applied to health care. The early detection of cancer and multifunctional therapeutics. The early detection of cancer can result in significant improvement in human health care and reduction in cost. Nanotechnology offers important new tools for detection where existing and more conventional technologies may be reaching their limits. The present obstacle to early detection of cancer lies in the inability of existing tools to detect these molecular level changes directly during early phases in the genesis of a cancer. Nanotechnology can provide smart contrast agents and tools for real time imaging of a single cell and tissues at the nanoscale. Nanotechnology promises a host of minimally-invasive diagnostic techniques and much research is aimed at ultra-sensitive labeling and detection technologies. In the in vitro area, nanotechnology can help define cancers by molecular signatures denoting processes that reflect fundamental changes in cells and tissues that lead to cancer. Already, investigators have developed novel nanoscale in vitro techniques that can analyze genomic variations across different tumor types and distinguish normal from malignant cells. In the in vivo area, one of the most pressing needs in clinical oncology is for imaging agents that can identify tumors that are far smaller than is possible with today's technology. Achieving this level of sensitivity requires better targeting of imaging agents and generation of a larger imaging signal, both of which nanoscale devices are capable of accomplishing. Perhaps the greatest near-term impact of multifunctional therapeutic compounds will come in the area of tumor targeting and cancer therapies. Nanotechnology can be used to develop new methods of drug delivery that better target selected tissues and cells, and to improve on the efficiency of drug activity in the cytoplasm or nucleus. Drug delivery applications will provide a solution to solubility problems, as well as offer intracellular delivery possibilities. The introduction of nanotechnology to multifunctional therapeutics is at an early stage of development. The delivery of nanoscale multifunctional therapeutics could permit very precise site specific targeting of cancer cells. More sophisticated ``smart'' systems for drug delivery still have to be developed that sense and respond to specific chemical agents and are tailored to each patient. Multifunctional therapeutic devices need to be developed that simultaneously detect, diagnose, treat and monitor response to the therapy. For example, various nanomaterials can be made to link with a drug, a targeting molecule and an imaging agent to seek out cancers and release their payload when required. The FDA has already begun to devote some resources to the understanding of the human health effects and safety of nanotechnology. It has established a Nanotechnology Core Facility at the FDA's Jefferson Arkansas Laboratories. Combining the expertise of the National Center for Toxicological Research and the Arkansas Research Laboratory, which is part of the FDA Office of Regulatory Affairs, this new Nanotechnology Core Facility will support nanotechnology toxicity studies, develop analytical tools to quantify nanomaterials in complex matrices, and develop procedures for characterizing nanomaterials in FDA-regulated products. In conclusion, the Nanotechnology Safety Act of 2010 will provide the FDA the authority necessary to scientifically study the safety and effectiveness of nanotechnology-based drugs, delivery systems, medical devices, orthopedic implants, cosmetics, and food additives regulated by the agency. This bill is a sound investment on the promise of nanotechnology to improve human health and reduce costs in the 21st Century. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. PRYOR

Mr. PRYOR. Mr. President, I rise today with Senator Cardin to introduce the Nanotechnology Safety Act of 2010 which will authorize a program of scientific investigation by the Food and Drug Administration on nanotechnology-based medical and health products. Nanotechnology holds great promise to revolutionize the development of new medicines, drug delivery, and orthopedic implants while holding down the cost of health care. However, Congress and the FDA must assure the public that nanotechnology-based products are both safe and efficacious. The Nanotechnology Safety Act of 2010 will enable the FDA to properly study how nanomaterials are absorbed by the human body, how nanomaterials designed to carry cancer fighting drugs target and kill tumors, and how nanoscale texturing of bone implants can make a stronger joint and reduce the threat of infection. Nanotechnology, or the manipulation of material at dimensions between 1 and 100 nanometers, is a challenging scientific area. To put this size scale in perspective, a human hair is 80,000 nanometers thick. Nanomaterials have different chemical, physical, electrical and biological characteristics than when used as larger, bulk materials. For example, nanoscale silver has exhibited unique antibacterial properties for treating infections and wounds. Nanomaterials have a much larger ratio of surface area to mass than ordinary materials do. It is at the surface of materials that biological and chemical reactions take place, and so we would expect nanomaterials to be more reactive than bulk materials. The novel characteristics of nanomaterials mean that risk assessments developed for ordinary materials may be of limited use in determining the health and public safety of products based on nanotechnology. The FDA needs the tools and resources to assure the public that nanotechnology-based medical and health products are safe and effective. The development of a regulatory framework for the use of nanomaterials in drugs, medical devices, and food additives must be based on scientific knowledge and data about each specific technology and product. Without a robust scientific framework there is no way to know what data to collect. More than a dozen material characteristics have been suggested even for relatively simple nanomaterials. Without better scientific knowledge of nanomaterials and their behavior in the human body, we do not know what data to collect and examine. In 2007, the FDA Nanotechnology Task Force published a report analyzing the FDA's scientific program and regulatory authority for addressing nanotechnology in drugs, medical devices, biologics, and food supplements. A general finding of the report is that nanoscale materials present regulatory challenges similar to those posed by products using other emerging technologies. However, these challenges may be magnified because nanotechnology can be used to make almost any FDA-regulated product. Also, at the nanoscale, the properties of a material relevant to the safety and effectiveness of the FDA-regulated products might change. The Task Force recommended that the FDA focus on improving its scientific knowledge of nanotechnology to help ensure the agency's regulatory effectiveness, particularly with regard to products not subject to premarket authorization requirements. The FDA has already reviewed and approved some nanotechnology-based products. In the coming years, they expect a significant increase in the use of nanoscale materials in drugs, devices, biologics, cosmetics, and food. This will require the FDA to devote more of its regulatory attention to nanotechnology based products. Let me talk for a few minutes about two areas where nanotechnology is already being applied to health care. The early detection of cancer and multifunctional therapeutics. The early detection of cancer can result in significant improvement in human health care and reduction in cost. Nanotechnology offers important new tools for detection where existing and more conventional technologies may be reaching their limits. The present obstacle to early detection of cancer lies in the inability of existing tools to detect these molecular level changes directly during early phases in the genesis of a cancer. Nanotechnology can provide smart contrast agents and tools for real time imaging of a single cell and tissues at the nanoscale. Nanotechnology promises a host of minimally-invasive diagnostic techniques and much research is aimed at ultra-sensitive labeling and detection technologies. In the in vitro area, nanotechnology can help define cancers by molecular signatures denoting processes that reflect fundamental changes in cells and tissues that lead to cancer. Already, investigators have developed novel nanoscale in vitro techniques that can analyze genomic variations across different tumor types and distinguish normal from malignant cells. In the in vivo area, one of the most pressing needs in clinical oncology is for imaging agents that can identify tumors that are far smaller than is possible with today's technology. Achieving this level of sensitivity requires better targeting of imaging agents and generation of a larger imaging signal, both of which nanoscale devices are capable of accomplishing. Perhaps the greatest near-term impact of multifunctional therapeutic compounds will come in the area of tumor targeting and cancer therapies. Nanotechnology can be used to develop new methods of drug delivery that better target selected tissues and cells, and to improve on the efficiency of drug activity in the cytoplasm or nucleus. Drug delivery applications will provide a solution to solubility problems, as well as offer intracellular delivery possibilities. The introduction of nanotechnology to multifunctional therapeutics is at an early stage of development. The delivery of nanoscale multifunctional therapeutics could permit very precise site specific targeting of cancer cells. More sophisticated ``smart'' systems for drug delivery still have to be developed that sense and respond to specific chemical agents and are tailored to each patient. Multifunctional therapeutic devices need to be developed that simultaneously detect, diagnose, treat and monitor response to the therapy. For example, various nanomaterials can be made to link with a drug, a targeting molecule and an imaging agent to seek out cancers and release their payload when required. The FDA has already begun to devote some resources to the understanding of the human health effects and safety of nanotechnology. It has established a Nanotechnology Core Facility at the FDA's Jefferson Arkansas Laboratories. Combining the expertise of the National Center for Toxicological Research and the Arkansas Research Laboratory, which is part of the FDA Office of Regulatory Affairs, this new Nanotechnology Core Facility will support nanotechnology toxicity studies, develop analytical tools to quantify nanomaterials in complex matrices, and develop procedures for characterizing nanomaterials in FDA-regulated products. In conclusion, the Nanotechnology Safety Act of 2010 will provide the FDA the authority necessary to scientifically study the safety and effectiveness of nanotechnology-based drugs, delivery systems, medical devices, orthopedic implants, cosmetics, and food additives regulated by the agency. This bill is a sound investment on the promise of nanotechnology to improve human health and reduce costs in the 21st Century. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. PRYOR

Mr. PRYOR. Mr. President, I ask unanimous consent that the majority leader be authorized to sign any duly enrolled bill and joint resolution today, December 15.

Mr. PRYOR. I suggest the absence of a quorum.

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

Mr. PRYOR

Mr. PRYOR. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of H.R. 4154 just received from the House and at the desk; that the Baucus substitute amendment be considered and agreed to; the bill, as amended, be read three times, passed, and the motion to reconsider be laid upon the table; that any statements relating to the measure be printed in the Record, without further intervening action or debate. Mr. President, I understand the Republican leader will object, so I will withdraw this request.

Mr. PRYOR

Mr. PRYOR. Mr. President, I ask unanimous consent that when the Senate completes its business today, it adjourn until 10 a.m. Wednesday, December 16; that following the prayer and pledge, the Journal of proceedings be approved to date, the morning hour be deemed expired, the time for the two leaders be reserved for their use later in the day, and the Senate resume consideration of H.R. 3590, the health care reform legislation, with the first hour equally divided and controlled between the leaders or their designees, with the majority leader controlling the first half and the Republicans controlling the second half.

Mr. PRYOR

Mr. PRYOR. Mr. President, we expect votes tomorrow in relation to the Hutchison motion to commit regarding taxes and implementation and the Sanders amendment regarding a national single-payer system. Senators will be notified when any votes are scheduled.

Mr. PRYOR

Mr. PRYOR. Mr. President, I ask unanimous consent the Senate proceed to a period of morning business with Senators permitted to speak for up to 10 minutes each.

Mr. PRYOR

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

Mr. PRYOR

Mr. PRYOR. Mr. President, I rise today to introduce two pieces of legislation to address gaps in our preparedness and ability to respond to widespread infectious disease outbreaks and biological attacks. The H1N1 outbreak demonstrated to us how investments in pandemic preparedness activities, such as the creation of pandemic influenza strategies, can lessen the effects of a pandemic and improve our response. However, we have learned from the H1N1 pandemic that we still have gaps in our ability to prepare for and respond to these types of events and that state and local entities are uncertain in their abilities to respond to a more severe event. Apart from shortcomings in government coordination and planning, there is also a glaring deficiency in an important statute that underpins our nation's response to disasters. When a natural disaster such as flooding in Arkansas occurs, local and State government resources can be quickly overextended. When that occurs a governor can request and the President can issue a major disaster declaration, which triggers the maximum amount of resources from the Federal disaster response system. Sometimes the system works well and other times not as well, but we know for certain that without a disaster declaration and effective Federal intervention a natural disaster can have devastating effects on life, property, and our economy. Unfortunately, due to a lack of clarification of the definition of a major disaster in the Stafford Act, there is no precedent for the President to issue a major disaster declaration when local medical resources are overwhelmed by the exponential spread of life-threatening diseases, or alternatively, a deliberate biological attack by terrorists. The bills that I am introducing today will help to address preparedness shortcomings as well as the deficiency in law. My first bill, S. 2863, entitled The Emergency Response Act, addresses this shortcoming in law. It will ensure the Federal Government can provide the maximum amount of support to State and local governments by allowing pandemics, acts of terrorism or other man-made disasters to be considered a major disaster under the Stafford Act. This clarification in law will permit the President to issue a major disaster declaration and allow Federal agencies to coordinate their efforts, give technical assistance, give advisory assistance, and work with local authorities and people in the private sector for events such as pandemics, biological attacks or chemical releases. The second bill, S. 2864, entitled The Defense Against Infectious Disease Act, requires the Federal government to periodically update the National Strategy for Pandemic Influenza and the National Pandemic Implementation plan with the assistance of State, Local and Tribal stakeholders in order to ensure our preparedness plans are up to date and incorporate the latest technologies, medical developments and logistical challenges. This bill addresses concerns raised by the U.S. Government Accountability Office about both the completeness of these emergency plans and the need for them to be updated. Most Americans may not even know that these emergency plans exist, but they do understand that strong planning is the foundation for effective action. An out-of-date plan is not a plan, and after watching the spread of H1N1 and the missteps in our government's response, Americans can easily imagine what it would be like in the event of an even more serious disease outbreak, and the importance of planning for such an emergency. This bill will also help address the situation I described previously in which a severe infectious disease outbreak can overwhelm our local medical facilities, many of which have limited resources to handle even their every day needs. To address situations which will over extend local resources, my bill also requires the Federal Government to identify alternative medical care facilities and other resources such as medical equipment, daily supplies and personnel to ensure we know what assets we have to help State and local communities. The idea here is preparation. We should make the best of the H1N1 outbreak and learn from this experience. That is why I introduced the Emergency Response Act and the Defense Against Infectious Diseases Act. I ask that my colleagues support these bills to ensure that we are prepared for the next pandemic. Mr. President, I ask unanimous consent that a bill summary be printed in the Record.

Mr. PRYOR

Mr. PRYOR. Mr. President, I rise today to introduce two pieces of legislation to address gaps in our preparedness and ability to respond to widespread infectious disease outbreaks and biological attacks. The H1N1 outbreak demonstrated to us how investments in pandemic preparedness activities, such as the creation of pandemic influenza strategies, can lessen the effects of a pandemic and improve our response. However, we have learned from the H1N1 pandemic that we still have gaps in our ability to prepare for and respond to these types of events and that state and local entities are uncertain in their abilities to respond to a more severe event. Apart from shortcomings in government coordination and planning, there is also a glaring deficiency in an important statute that underpins our nation's response to disasters. When a natural disaster such as flooding in Arkansas occurs, local and State government resources can be quickly overextended. When that occurs a governor can request and the President can issue a major disaster declaration, which triggers the maximum amount of resources from the Federal disaster response system. Sometimes the system works well and other times not as well, but we know for certain that without a disaster declaration and effective Federal intervention a natural disaster can have devastating effects on life, property, and our economy. Unfortunately, due to a lack of clarification of the definition of a major disaster in the Stafford Act, there is no precedent for the President to issue a major disaster declaration when local medical resources are overwhelmed by the exponential spread of life-threatening diseases, or alternatively, a deliberate biological attack by terrorists. The bills that I am introducing today will help to address preparedness shortcomings as well as the deficiency in law. My first bill, S. 2863, entitled The Emergency Response Act, addresses this shortcoming in law. It will ensure the Federal Government can provide the maximum amount of support to State and local governments by allowing pandemics, acts of terrorism or other man-made disasters to be considered a major disaster under the Stafford Act. This clarification in law will permit the President to issue a major disaster declaration and allow Federal agencies to coordinate their efforts, give technical assistance, give advisory assistance, and work with local authorities and people in the private sector for events such as pandemics, biological attacks or chemical releases. The second bill, S. 2864, entitled The Defense Against Infectious Disease Act, requires the Federal government to periodically update the National Strategy for Pandemic Influenza and the National Pandemic Implementation plan with the assistance of State, Local and Tribal stakeholders in order to ensure our preparedness plans are up to date and incorporate the latest technologies, medical developments and logistical challenges. This bill addresses concerns raised by the U.S. Government Accountability Office about both the completeness of these emergency plans and the need for them to be updated. Most Americans may not even know that these emergency plans exist, but they do understand that strong planning is the foundation for effective action. An out-of-date plan is not a plan, and after watching the spread of H1N1 and the missteps in our government's response, Americans can easily imagine what it would be like in the event of an even more serious disease outbreak, and the importance of planning for such an emergency. This bill will also help address the situation I described previously in which a severe infectious disease outbreak can overwhelm our local medical facilities, many of which have limited resources to handle even their every day needs. To address situations which will over extend local resources, my bill also requires the Federal Government to identify alternative medical care facilities and other resources such as medical equipment, daily supplies and personnel to ensure we know what assets we have to help State and local communities. The idea here is preparation. We should make the best of the H1N1 outbreak and learn from this experience. That is why I introduced the Emergency Response Act and the Defense Against Infectious Diseases Act. I ask that my colleagues support these bills to ensure that we are prepared for the next pandemic. Mr. President, I ask unanimous consent that a bill summary be printed in the Record.

Mr. PRYOR

Mr. PRYOR. Mr. President, today I pay tribute to the professional career and community achievements of Terry Sherwood of Magnolia, AR. Terry Sherwood, a graduate of Michigan State University, began working as an employee of Southwest Arkansas Planning and Development District, Inc. in 1969. His hard work and dedication showed as he became the executive director in January 1992. He has provided the people of Arkansas with many accomplishments that are spread throughout the State. He has served on several boards in several leadership roles such as past president and board member of the National Association of Development Organizations, NADO, vice president and member of the executive board of the I-69 Mid-Continent Highway Coalition, chairman of the Arkansas I-69 Association, vice-president of Arkansas Good Roads, board member of the Council of Peers Southeast Regional Executive Directors Institute, board member of the Southwest Regional Economic Development Association, chair of the Association of Delta Development Districts Delta Regional Authority, member of the Public Participation Committee Arkansas Highway and Transportation Department, and member of Arkansas Association of Development Organizations. Terry has brought great leadership and outstanding integrity to the south Arkansas community. His leadership is unique and has inspired many other people in the area to get involved in their local neighborhoods and towns. Mr. President, I ask that my colleagues join me in recognizing the great contributions Terry Sherwood has made to Arkansas and the United States of America.

Mr. PRYOR

Mr. PRYOR. Mr. President, I would like to speak on my amendment for just 1 minute.

Mr. PRYOR. Mr. President, I would ask my colleagues to look at this amendment very closely. It is a good consumer-oriented amendment that will allow people to make smart decisions on their health insurance. We need more of this type of information to allow the premium payers to make good decisions for themselves, for their families, and for their businesses. So I would ask my colleagues on both sides of the aisle to consider voting for this amendment. Mr. President, I ask for the yeas and nays.

Mr. PRYOR. Mr. President, I ask unanimous consent that the time during the quorum call be charged equally between the two sides.

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

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

Mr. PRYOR. Mr. President, I am here to speak on my amendment, which is a simple and straightforward amendment to create an enrollee satisfaction survey for the qualified health plans offered through the exchange established in the Senate health care reform bill. Let me show you how this will work. This is taken from the Federal Employees Health Benefits Program Web page that is administered by the Office of Personnel Management, OPM. They lay out on the Web page how the survey works. The first question is: How would you rate your overall experience with your health plan? Other questions are: When you needed care right away, how often did you get care as soon as you thought you needed it? How often did your personal doctor listen carefully to you, show respect for what you had to say, and spend enough time with you? This is all collected and put into a form and used when people make health care decisions on what plan to choose. One of the real measures of the quality of a health care plan is how satisfied people are with that plan. It is a little bit hard to measure. We send out these surveys to Federal employees. They come back and the information is available to the public. People can click on this and know, when they are about to sign up for a plan, how the plan rates in satisfaction. This is not a new idea. It has been around for a long time. It helps people make good health care decisions. It allows them to compare one company to another. It allows them to look at what the people who have that health care plan right now, how they perceive the performance of the plan. It is a win-win for the whole system. The idea is to make this part of the new law, and if you are on the exchange, you would have access to filling out one of these surveys; but, more importantly, you would also have access to reading the surveys and knowing, when you are making your health care choice, how your company rates. Here are a few examples. Again, this is from the Web page right now under the Federal health care plan. The first question was about overall plan satisfaction. The FEHBP national average is 80 percent. People are 80 percent satisfied with that. There is one insurance company that only has 54.5 percent. Another one has 88.7 percent. So you can understand the range. Again, that is not to say nobody is happy with that one at 54.5 percent, but it allows the people who are purchasing the health care to make an informed decision before they enter into a contract with the company. One of these categories is ``getting care quickly.'' The average is 91.6 percent. It is not a big spread, but one company is at 88 percent, a little below average. The highest company is at 93.5 percent, a little above average. That is not a very big spread, but if getting care quickly is your most important thing, you may want to go to the one where the people who use that insurance company right now say you get care the quickest. Another issue is the claims processing. That is one of the questions here: How does a company do in processing your claims? In our office, we have hundreds of complaints from people around Arkansas who have had problems with insurance companies processing their claims. Again, the average here is 92 percent. That is what the FEHBP average is. There is a company that has a 77-percent rating as a result of the survey. There, again, that is not saying people would not choose that company; they may choose it for other reasons. But if the claims processing part of their business is important, they may not choose that company, or at least they know what they are getting into. The highest one I saw in the claims processing was 96.8 percent. You understand this is something that already exists, something I cannot imagine anybody having a problem with because it puts the tool in the hands of the people making decisions on the health care provider that they are going to choose. It puts the tool in their hands, before they choose them, to know what they are getting into. Lastly, basically, this doesn't cost any money--and if it does, it is just a tiny amount. This is a very consumer-friendly tool. It simplifies the process for people. It takes a lot of anxiety out of the process for people. It is also a very good commonsense, grassroots way to hold insurance companies accountable. If they don't do well in these customer surveys, chances are they will not get a lot of business in the coming year. It puts a quality control there--a satisfaction-based quality control there. I think it is a great tool for keeping people happy. I can guarantee you that, when they look at the survey from this company that only had 55 percent respond in a positive way, they are going to talk to their folks and say: We have to get that number up. What is going on in this company? Again, this is something people talk about. I have heard many people in Arkansas and around the country say they want the same deal we have in Congress. This isn't all the same deal, but this is part of it. What we are able to do is, when we make health care choices, we are able to have this knowledge before we make a decision. Accountability and performance go hand in hand. This is a great example of how we can do that and have a very inexpensive way and a way that is meaningful to the people making the decision. This is there at the point of decision. I ask that all my colleagues join in this amendment. We will vote on this, I understand, around 4 o'clock. With that, I yield the floor and suggest the absence of a quorum.

Mr. PRYOR

Mr. PRYOR. Mr. President, I ask unanimous consent that no further amendments or motions be in order today.

Mr. PRYOR. Mr. President, I call up amendment No. 2939.

Mr. PRYOR. I believe the sequence was that I would go first.

Mr. PRYOR. I ask unanimous consent that further reading of the amendment be dispensed with.

Mr. PRYOR

Mr. PRYOR. Madam President, I ask unanimous consent that the Senate proceed to a period for the transaction of morning business, with Senators permitted to speak therein for up to 10 minutes each.