Arlen Specter

Mr. SPECTER

Mr. SPECTER. I will work with Senator Harkin to provide as much funding as possible for this program when we get to conference with the House. lifespan respite care appropriations

Mr. SPECTER. The Lifespan Respite Care Act is a worthwhile piece of legislation that will impact almost all American families. I will work with the chairman to provide funding for these activities.

Mr. SPECTER. Mr. President, like my colleague from Georgia, I am supportive of the Health Information Technology Development program, and I was happy to support the chairman's effort to increase funding for it. I believe that the goals of the Department of Health and Human Services through its Office of the National Coordinator of Health Information Technology may be well-served by the sort of program that Senator Isakson described a moment ago.

Mr. SPECTER

Mr. SPECTER. Further, Judge Southwick has voted in favor of the so- called underdogs. The suggestion that he is biased against women and homosexuals is contradicted by a number of cases: Curtis v. Curtis, Kmart Corp. v. Lee, Hughey v. State of Mississippi. Again, I ask unanimous consent that a description of these cases be printed in the Record.

Mr. SPECTER

Mr. SPECTER. Mr. President, with Senator Grassley, I introduce a bill that will help control Medicare spending and will increase transparency in our health care system. Medicare spending is a huge component of the Federal budget. In 2006, Medicare benefit payments totaled $374 billion and accounted for 12 percent of the Federal budget. Over the past several months I have received many letters from hospitals, consumer groups, employers, health and welfare funds, and health care journalists about the secrecy that the medical device industry is trying to impose around pricing for implantable medical devices, pacemakers, hip and knee replacements, which hospitals purchase. Hospitals are being told they can't share pricing information with any ``third parties,'' that would include patients, physicians, auditors, and consultants. The hospitals are not the ultimate payers. The payers are patients and those who provide health insurance coverage, which includes small businesses, large employers, and local, State, and Federal Government programs. But the hospitals are the ones who have the role of negotiating fair pricing on behalf of the patients and other payers. A New York hospital stated in a letter to me that many hospitals, patients, communities and Federal agencies are ``prevented from participating in an open and fair marketplace--culminating in inflated pricing and less than optimal cost effective health care.'' This hospital said that it has an annual health care supplies spend of approximately $300 million, and although the implantable items such as cardiac pacemakers and orthopedic implants represent only 3 percent of the total items the hospital buys, the expenditures are close to 40 percent of the total spend. Moreover, these devices are characterized by annual cost increases of from 8 percent to 15 percent. Since national sales of implant able devices are approximately $65 billion annually, with an expected growth in utilization of close to 20 percent, the potential of adding 8 to 15 percent annual price increases to the expenditures clearly demands attention. A smaller health system in Jackson, MS, reports savings in 2006 of more than $10 million because it was able to get detailed objective and measurable information that neutralized the arguments from the vendors who were telling them that they were getting the best price. The National Partnership for Women and Families told me that consumers can learn more about the quality and price of a car than they can about these medical devices that are implanted in the body. The Pacific Business Group on Health, a collection of 50 of the Nation's largest purchasers of health care who spend billions of dollars annually to provide health care coverage to more than 3 million employees, retirees and dependents, also wrote to me that the critical strategy for improving the quality of our Nation's health care system is increasing its transparency. The Transparency in Medical Device Pricing Act of 2007 would require medical device manufacturers, as a condition of receiving direct or indirect payments under Medicare, Medicaid, and SCHIP, to submit to the Secretary of Health and Human Services, on a quarterly basis, data on average and median sales prices for all implantable medical devices used in inpatient and outpatient procedures. Manufacturers would be subject to civil monetary penalties from $10,000 to $100,000 for failure to report or for misrepresentation of price data. The data would be available to the public on the website of the centers for Medicare and Medicaid Services. Senator Grassley and I believe this bill will improve the overall quality and efficiency of our health care system and will help ensure that health care programs administered or sponsored by the Federal Government, in particular, promote quality and efficient delivery of health care through 1. the use of health information technology; 2. transparency regarding health care quality and price; and 3. better incentives for those involved in these programs--physicians, hospitals, and beneficiaries. By making important information available in a readily useable manner and in collaboration with similar initiatives in the private sector and nonfederal public sector, we can help control government spending on health care. The rising cost of health care and health insurance is a problem for consumers, small business owners, large employers and union health and welfare funds. This bill says that if you want to do business with the Federal Government, you have got to show us your prices.

Mr. SPECTER

Mr. SPECTER. Mr. President, with Senator Grassley, I introduce a bill that will help control Medicare spending and will increase transparency in our health care system. Medicare spending is a huge component of the Federal budget. In 2006, Medicare benefit payments totaled $374 billion and accounted for 12 percent of the Federal budget. Over the past several months I have received many letters from hospitals, consumer groups, employers, health and welfare funds, and health care journalists about the secrecy that the medical device industry is trying to impose around pricing for implantable medical devices, pacemakers, hip and knee replacements, which hospitals purchase. Hospitals are being told they can't share pricing information with any ``third parties,'' that would include patients, physicians, auditors, and consultants. The hospitals are not the ultimate payers. The payers are patients and those who provide health insurance coverage, which includes small businesses, large employers, and local, State, and Federal Government programs. But the hospitals are the ones who have the role of negotiating fair pricing on behalf of the patients and other payers. A New York hospital stated in a letter to me that many hospitals, patients, communities and Federal agencies are ``prevented from participating in an open and fair marketplace--culminating in inflated pricing and less than optimal cost effective health care.'' This hospital said that it has an annual health care supplies spend of approximately $300 million, and although the implantable items such as cardiac pacemakers and orthopedic implants represent only 3 percent of the total items the hospital buys, the expenditures are close to 40 percent of the total spend. Moreover, these devices are characterized by annual cost increases of from 8 percent to 15 percent. Since national sales of implant able devices are approximately $65 billion annually, with an expected growth in utilization of close to 20 percent, the potential of adding 8 to 15 percent annual price increases to the expenditures clearly demands attention. A smaller health system in Jackson, MS, reports savings in 2006 of more than $10 million because it was able to get detailed objective and measurable information that neutralized the arguments from the vendors who were telling them that they were getting the best price. The National Partnership for Women and Families told me that consumers can learn more about the quality and price of a car than they can about these medical devices that are implanted in the body. The Pacific Business Group on Health, a collection of 50 of the Nation's largest purchasers of health care who spend billions of dollars annually to provide health care coverage to more than 3 million employees, retirees and dependents, also wrote to me that the critical strategy for improving the quality of our Nation's health care system is increasing its transparency. The Transparency in Medical Device Pricing Act of 2007 would require medical device manufacturers, as a condition of receiving direct or indirect payments under Medicare, Medicaid, and SCHIP, to submit to the Secretary of Health and Human Services, on a quarterly basis, data on average and median sales prices for all implantable medical devices used in inpatient and outpatient procedures. Manufacturers would be subject to civil monetary penalties from $10,000 to $100,000 for failure to report or for misrepresentation of price data. The data would be available to the public on the website of the centers for Medicare and Medicaid Services. Senator Grassley and I believe this bill will improve the overall quality and efficiency of our health care system and will help ensure that health care programs administered or sponsored by the Federal Government, in particular, promote quality and efficient delivery of health care through 1. the use of health information technology; 2. transparency regarding health care quality and price; and 3. better incentives for those involved in these programs--physicians, hospitals, and beneficiaries. By making important information available in a readily useable manner and in collaboration with similar initiatives in the private sector and nonfederal public sector, we can help control government spending on health care. The rising cost of health care and health insurance is a problem for consumers, small business owners, large employers and union health and welfare funds. This bill says that if you want to do business with the Federal Government, you have got to show us your prices.

Mr. SPECTER

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

Mr. SPECTER. I agree with the comments made by my distinguished colleague, Chairman Harkin.

Mr. SPECTER. I appreciate Senator Lincoln and Senator Crapo for continuing to advocate on this important issue. I too will work with Chairman Harkin to ensure CDC is responsive to this issue and begins developing a national plan to address COPD. low income home energy assistance

Mr. SPECTER. Mr. President, the LIHEAP program benefits many families and seniors in Pennsylvania. It provides a vital safety net for these households so they do not have to make the choice between prescription drugs and heat, or paying a grocery bill or energy bill. I look forward to working with Chairman Harkin and Senator Reed on increasing funding for this program in conference. GME Program

Mr. SPECTER. Mr. President, I thank the distinguished chairman for the work he has done, and our staffs, bringing the bill to this posture. We are within striking distance of concluding it. As Senator Harkin has outlined, there is a commitment to finish by noon tomorrow. The managers have been on the floor since shortly after 3, when under previous arrangement this bill was called up, and there are no other Senators present now. I know Senator Harkin would join me in urging Senators to come to the floor. Anybody who wants to debate an amendment ought to come to the floor promptly. We will find as the hour of 5:30 approaches, Senators will come in when we are about ready to vote, when there is not any time to debate change. Senators will want to find time. Now is the time for Senators to come to the floor who want to debate. I also supplement what Senator Harkin said to this effect: There are a number of amendments, as the chairman has stated, that have been cleared. Some Senators have raised objections. It is their right to raise objections, but as frequently happens, once there is discussion, arrangements can be worked out to clear them. It is our view, Senator Harkin's and mine, buttressed by staff negotiations, that these matters can be cleared. But they will take some time. We do not want to get into a situation where at 5:50 tonight after the first vote, there is lengthy consideration as to what we are going to be doing at that time. The practice has been to have a single vote on Monday evenings at 5:30. We have two votes lined up, and we know many Senators will have other commitments, which is customary for Monday evening. But they cannot be fulfilled unless we conclude the business of the Senate, at least moving along so that we have within striking distance the prospect of concluding the bill by noon tomorrow. Senators who have any debate or who have lodged objections to any pending amendments should come to the floor now so they can be heard. If they don't, we won't be in a position to consider their objections at a later time and still move the bill through to completion by noon tomorrow.

Mr. SPECTER. May the record show that the only two Senators on the floor are the two managers. Again, we renew our request, anybody who has any debate they want to offer, amendments they want to offer, or objections they want to raise to any pending amendments ought to come to the floor promptly. In the absence of any other Senator seeking recognition, I suggest the absence of a quorum.

Mr. SPECTER. Mr. President, a little over an hour ago, Senator Harkin, the distinguished chairman of the subcommittee, and I urged Senators who wanted to debate amendments to come to the floor or Senators who had objections to pending amendments to come to the floor to utilize the time before the 5:30 vote. The managers, Senator Harkin and I, have been on the floor continuously since shortly after 3 p.m., when the bill was called back to the floor for consideration, and we know from practice, regrettably, that when the vote starts at 5 p.m. or 6 p.m. or about 5:45 or 10 minutes to 6, people will want floor time and have a great deal to say, and then we will be unable to accommodate all of the Senators who want to act on the bill. Senator Harkin outlined at the outset the two votes which will begin at 5:30 and said that there was the prospect of substantial additional voting tonight, if we were unable to clarify where we stand, because of our target to conclude this bill by noon tomorrow, which is the target established by the leaders and by the managers of this bill. So at this point, at 4:50, I would renew the request that Senators who want to debate, who want to take up any action on the bill, or want to discuss any of the pending amendments where objections have been lodged, come to the floor now while we have the time to transact that business. Mr. President, in the absence of any other Senator on the floor seeking recognition--in fact, in the absence of any other Senator on the floor--Senator Harkin is in the cloakroom ready to come to the floor to transact business if any Senator wants to do so, but in the absence of any such Senator, I suggest the absence of a quorum.

Mr. SPECTER. I agree with the senior Senator from California.

Mr. SPECTER. I agree.

Mr. SPECTER. I thank Senator Bond, Senator Hutchison, and Senator Voinovich. As I said in committee, I am committed to providing an increased level of funding for Children's Hospitals GME in conference. The children's hospitals in Pennsylvania exemplify everything they have said. They have been both regional and national leaders in centers of excellence in pediatric care and pediatric research--while meeting the needs of vulnerable and low income children across our State. Their teaching programs are an integral part of all they do--in providing services and making sure that children have the doctors they need. My colleagues may not realize the continuing shortages in pediatric specialty care--which is centered in these institutions--or the waiting periods that all children and families face for nonemergency specialty care. CHGME has provided a cost effective and valuable program in providing enormous assistance to these children's hospitals and their ability to continue services and teaching. Most importantly, it directly benefits children's health care.

Mr. SPECTER. I also strongly support efforts to increase the number of organ donors and will work to maintain this funding in conference.

Mr. SPECTER. Mr. President, as you know, the rate of obesity, particularly in children, has reached epidemic proportions across our country. According to the Centers for Disease Control and Prevention, more than 60 percent of children between the ages of 9 and 13 do not participate in any organized physical activity outside of school hours.

Mr. SPECTER. The Centers for Disease Control and Prevention is doing significant work in this area, and I urge the Director to increase awareness in the area of obesity and work cooperatively with organizations that are researching, testing and developing innovative approaches to get children more physically active.

Mr. SPECTER. I thank my colleagues for raising this issue, and agree to try to help support teacher preparation, using methods that are shown to be effective. We all recognize the importance of teacher quality, and I will continue to work with my colleagues on this issue.

Mr. SPECTER

Mr. SPECTER. Yes, I will support that effort.

Mr. SPECTER. There are over 300 deafblind children in Pennsylvania, so this is an issue that also affects a number of families in my State. I thank Senator Cornyn for calling this issue to our attention. I will do what I can when we go to conference to try to keep the funding for deafblind services at the higher level. 1945 Trinity Test

Mr. SPECTER

Mr. SPECTER. Mr. President, I believe this is a very worthwhile amendment for a very important cause for mine safety. I urge my colleagues to support it.

Mr. SPECTER. I agree and will work with the chairman.

Mr. SPECTER. Madam President, I appreciate the Senator from Alabama yielding. I am due in the Judiciary Committee, where I am ranking, and we are proceeding with the confirmation as to Judge Mukasey. I wish to speak briefly in opposition to the amendment. The figures which have been provided to me show that there has been an increase in the funding for the Office of Labor Management Standards up to $47,753,000--it does show a slight decrease on this year. But overall, since fiscal year 2001, the figure has risen from $30,492,000 to a figure of $47,753,000 for last year. This year it is, both the Senate and House figures, $45,737,000. There has been a very substantial increase in the number of workers, and there is a concern about the complexity of the new form LM-2 which runs to more than 100 pages. The Department of Labor has issued some 88 answers to frequently asked questions to try to address this new rule. Having taken a look at it, it is not in line with the policy to try to reduce regulatory burdens because this new form is extremely burdensome. The principal argument is going to be made by Senator Harkin. I have asked him to take the lead, to go ahead because I am due at a Judiciary Committee hearing on Judge Mukasey for Attorney General. I yield the floor.