Arlen Specter

Mr. SPECTER

Mr. SPECTER. Mr. President, I ask unanimous consent that I may speak up to 20 minutes.

Mr. SPECTER. Mr. President, I have sought recognition to comment about the Patient Protection and Affordable Care Act. It has been an extraordinary legislative process with a good bit of the calendar year 2009 taken up with very intensive work to try to pass health care reform. At the moment, there is still some doubt as to what will happen with the bill. The Congressional Budget Office has not yet submitted a report on the so-called managers' package. There are still some concerns being expressed by some Senators. I can understand the frustration that some have had as we have moved away from a public option. I have been an advocate of a robust public option and think it ought to be part of the legislation. The public option is what it says. It is an option. There have been efforts made to demagog the issue by saying it is a takeover by the Federal Government. It is not. The private insurance industry remains in the field, and this is one option. As President Obama has put it, it is an option to try to keep the private insurance companies honest. We have seen, in the past several months, very large increases in premiums for small business. The reports have been that those increases in premiums have come from Wall Street pressure on the insurance companies to try to increase their profits before there is legislation. The public option would be a forceful factor dealing there. When the objections were raised to the public option and in an effort to find 60 votes--it is difficult when you have no help at all from the Republican side of the aisle, illustrated by the performance just put on with their prepared colloquy--it is not easy to find everyone in agreement. Then there was an effort to move to expand Medicare. I think that is a fallback position that would have been very helpful. There are some who are contending that people who are disappointed with the lack of a public option and disappointed from the retreat of expanding Medicare say we ought to start over and begin again. I can understand that frustration. My own view, after thinking it through very carefully, is we ought to proceed and do as much as we can this year, realizing that some of the tough legislative achievements take a period of time to accomplish. But the Civil Rights Act of 1957 was necessary, although it did not go as far as people would have liked then, to get the Civil Rights Act of 1964. Again, it did not go as far as people would have liked, but we did find the Voting Rights Act of 1965. We have to find times when we have to build incrementally on these matters. I have been in the Senate following the elections of 1980, and I have seen matters take a very substantial period of time. While it is not on the subject, we were trying to provide more than 100,000 jobs in Pennsylvania by deepening the channel. The authorization came in 1983. It took until 1992 to get the Corps of Engineers to agree on funding. Now it has $77 million. We are still in court, but it is going to move forward. I do not expect health care legislation to take that kind of a long term, but it is a matter which does take some time. It is my hope we will yet improve this bill. It is my hope that when the bill goes to conference, we will find a way, perhaps, even to bring back the public option in a refined sense. The public option is in the House bill. One Republican Senator has stated opposition on the ground that there has not been time enough to review the bill. It is complicated. I think there has been time enough to review the bill. But I respect the view of the Senator on the other side of the aisle. When the bill goes to conference, that Senator will have an opportunity to review the bill further. That Senator has shown some inclination to support the bill, having voted it out of the Finance Committee. Another Republican Senator has commented that the bill has been very greatly improved, not sufficiently for the taste of that Senator, but perhaps we will find a way to improve the bill. We still do have a bicameral legislature. We do have the House of Representatives which has the public option. Comments were made about the fall of the expansion of Medicare on the ground it was considered in too brief a period of time, not enough time to digest it, not enough time to think through. We will have, in the month of January, some time to consider that further, and in conference we may well find we are able to improve the bill. We cannot get to conference unless we pass the bill out of the Senate. I was asked yesterday how will I respond to my constituents if we have the bill which has had so much taken from it. I said: A more relevant question or an equally relevant question is how will I respond to my 12 million constituents in Pennsylvania if we go home with nothing. If we have 80 percent accomplished, then that is a starting achievement. It may well be it will take the campaign in 2010. If this Congress will not pass a bill with a robust public option, it could well be a campaign issue. I believe my colleagues on the other side of the aisle may well be misreading the American people. I believe the American people do want health reform. It does take time for the American people to understand the ramifications of it. But this may well be a campaign issue in 2010. The 112th Congress may have a different view as to how we ought to proceed. During the month of August, when I was making the rounds of town meetings in Pennsylvania, in accordance with my habit to cover almost every county almost every year, when I got to the first town meeting, the second Tuesday in August, the first week we were in recess, I found instead of the customary 85 or 100 people, more than 1,000 people and 3 national television sound trucks--CNN, MSNBC, and FOX. There were a lot of vituperative statements. One man approached me apoplectic and said the Lord was going to stand before me. I think he got mixed up. I think he meant to say I was going to stand before the Lord. Senators are reputed to have power but not quite that much power. I think the public tenor is considerably more favorable to health care insurance today than it was then. After the 2010 election, it may be substantially more favorable. We have to move ahead with building blocks, and we do have a chance to improve the bill in conference. I point to the provisions of the bill as to what we have. We have very significant insurance reforms. We have eliminating discrimination based on preexisting conditions. We have new health insurance exchanges. We have an elimination of a cap. We cover many of the uninsured, expanding to some 33 million additional people. We have substantial more small business assistance, preventive care, increased health workforce. We have improvements in the health delivery system. We have fiscal responsibility that this bill will not add to the deficit but will, in fact, reduce the deficit in the first decade by some $120 billion and in the second decade by some $650 billion. We have a provision I have pressed in earlier legislation, S. 914, to provide for transformational medicine. During my tenure as chairman of the Appropriations Subcommittee on Health and Human Services, I took the lead, with the concurrence of Senator Harkin, who was then in the minority, to increase NIH funding from $12 billion to $30 billion and then in the stimulus package to add $10 billion more. There has been a gap on what we call transformational medicine, going from the so-called bench in the laboratory to the bedside. While I have not seen the final version of the managers' packet, I am informed that provision will be a part of the bill. We have very important measures for preventive care, for annual exams, which will cut off many chronic illnesses which are so debilitating and so expensive. I have pressed an amendment, which is pending, to have mandatory jail sentences for at least 6 months for someone convicted of $100,000 or more of Medicare or Medicaid fraud. Jail sentences are a real deterrent. The experience I had as Philadelphia's DA showed me that when you have a fine, that is added onto the cost of doing business and is passed on to the consumers. I ask unanimous consent to have printed in the Record a statement of the provisions which I briefly summarized which are very favorable in this bill and a statement of testimony at a Criminal Justice Subcommittee to show the value of deterrence.

Mr. SPECTER. I thank the Chair. Mr. President, there is another very important aspect, in my opinion, of the Senate enacting legislation on this bill; that is, we were sent to Washington to govern. What we have seen in the recent past has been staggering partisan politics. Partisan politics became a blood sport in Washington, DC. It is a blood sport on the floor of the Senate. It pervades the entire town. The point from the Republican side of the aisle has been very clear; that is, to make this President Obama's Waterloo, to make this ``break President Obama.'' I saw the ramifications when we took up the stimulus package earlier this year. There were only three Republicans--Senator Snowe, Senator Collins, and myself--who would even talk to the Democrats. There was a determination to look ahead to the 2012 elections on the Presidency even before the ink was dry on the oath of office taken by President Obama on January 20. This was the second week of February, the week of February 6, as I recall, just a couple weeks, and already the plans were for the next election. As I reviewed the matter, it seemed to me we were on the brink of going into a 1929 Depression. The 1929 Depression was very hard on the Specter family, living in Wichita, KS, at the time. Both of my parents were immigrants. In the mid-1930s, the family moved from Wichita to Philadelphia to live with my father's sister. That is what happened in the Depression--you moved in with relatives because there were no jobs. I sided with supporting the stimulus package and played a key role in having that enacted. And the political consequences on a personal level are not something to be discussed on this floor at this time, but the conduct of partisanship on the stimulus package is directly relevant to what we are doing here today, and that is that we are being stonewalled. I think it is harder for a Republican to stand up on health care reform and join the Democrats today than it was in January and in February when three of us did so. And if I were on the other side of the aisle today, I would be supporting health care reform. I would be supporting, and perhaps, if I were on the other side of the aisle today, I could bring somebody with me. I don't know. That is entirely speculative. Without revealing any more of the confidence which went on inside of the Republican caucus, when I talk about a Republican Senator's statement that this should be the Waterloo of President Obama and this should break him, those are matters in the public record. But the pressure over there in the Republican caucus is absolutely intense, and we were sent here to govern. In the Democratic caucus--and the Presiding Officer, the distinguished Senator from Colorado, was there on Monday evening--when my turn came to speak, I said: I have two sentences. And may the record show a smile on the face of the Presiding Officer. I said: I have two sentences. One sentence is, the bill is a great deal better than the current system, and the second sentence is, we should not let obstructionism prevent us from governing. And that is why I crossed the aisle to make the 60th vote. I was very surprised to see in the public record--been in the newspapers--that everybody stood up and applauded, and I read in one of the Hill newspapers today that you could hear the applause down the corridor. So they knew what was going on. Well, that is the role, it seems to me, of a Senator. We are facing a situation where, if defeated, it will have a significant impact on the tenure of President Obama. We had a meeting on Tuesday--2 days ago--in the Executive Office Building, and it was a rather remarkable setting. There was a large rectangular table, and in the center on each side--one side was President Obama, the other side was Vice President Biden, and almost all of the 60 Senators were present. I think Senator Byrd couldn't be there because of his ailment, but I believe everybody else was present. During the course of that session, the President expressed himself--and this has also been publicized--that if action was not taken now, it would discourage anyone from the foreseeable future--any President-- from undertaking health care reform if now, with both Houses and 60 Members of the Democratic Party, you can't get it through the Senate and get it conferenced and get it enacted. Some of those who were most vocal in favor of the public option urged those in the caucus who disagreed to reconsider their position, and I would renew that request that they reconsider their position. The people who would classify themselves as most progressive in the Democratic caucus have swallowed hard and have announced publicly that they would support this bill even though it doesn't have a robust public option, doesn't have the Medicare expansion. And that may shift yet. It is fair and accurate to say there are more pressing problems confronting the United States today than at any time in our history, and we have to finish health care next year to move ahead to jobs. We have the issues of global warming and climate control, and we have the problems with the Mideast peace process and the difficulties in Iran and North Korea and Afghanistan. We need a strong President, and we need a Congress which has the courage to act and the tenacity and willingness to confront tough problems. We need to show the American people that it is not all gridlock here, that it is not all desperate, desolate partisan politics. So my vote will be in favor of the bill. Although I am, frankly, disappointed and I share the frustration expressed by many people who say go back and start again, this is a significant step forward. We have a great chance to improve it in conference, and beyond that there will be another Congress. And with the analogy of civil rights legislation, we can get the public option and get greater public involvement for the benefit of the American people. I thank the Chair, and I yield the floor. Mr. President, in the absence of any other Senator seeking recognition, I ask unanimous consent to speak up to 3 minutes on another subject.

Mr. SPECTER. Mr. President, there has been wide publicity given to three young Americans who were taken into custody by Iran and the recent reports that they are going to be tried in an Iranian court. Senator Casey and I, in the Senate, introduced a resolution urging the Iranians to release those three young Americans--Congresswoman Allyson Schwartz, on the House side, did so in the past--and it is my hope Iran will change its view. I was talking to the Syrian Ambassador yesterday, who advised me that when the five British citizens were taken into custody by Iran, the Government of Great Britain made a request of the Syrian Government to use their good offices to secure the release of the five British citizens. That request was made via Syria, and they were released. I have written to and contacted the State Department since that meeting yesterday afternoon to find out what is the status of U.S. activity because if we have not asked the Syrians for help, my view is that we should. It would be my hope that with the very difficult problems facing the United States in Iran, that Iran would relinquish the custody of those three young Americans and release them to their family and friends, especially at this time of the year. I have been an advocate of dialog with Iran for years. I have tried to go to Iran since 1989, when the Iran-Iraq war ended. Senator Shelby and I got to Iraq and met Saddam Hussein, but as yet we have not had an interparliamentary exchange, which I have sought for a long time with the Iranians. It would be my hope that Iran, for humanitarian reasons, would release these people and that we would exercise our best efforts--the U.S. Government working through Syria or whatever other channel we can find--to secure their release. Mr. President, I yield the floor, and I suggest the absence of a quorum.

Mr. SPECTER

Mr. SPECTER. Madam President, will the Senator from Utah be willing to yield for a question?

Mr. SPECTER. My question relates to the provisions of the pending bill, section 1303(2)(A), which specifies that the plan will not allow for any payments of abortion, and where there is, as provided under section 1303(2)(B), there will be a segregation of funds. So that under the existing statute, there is no Federal funding used for abortion. But a woman has the right to pay for her own abortion coverage. And with the status of Medicaid, where the prohibition applies to any Federal funds being used to pay for an abortion, there are 23 States which allow for payment for abortion coverage coming out of State funds. So aren't the provisions of this statute, which enable a woman to pay for an abortion on her own, exactly the same as what is now covered under Medicaid, without violating the provisions of the Hyde amendment?

Mr. SPECTER. If the Senator will yield further.

Mr. SPECTER. Would the Senator from Utah respond to my question? How can you disagree with the provisions of section 1303(2)(A) of the bill which is pending which specifies that if a qualified health plan provides services for abortion--this is the essence of it--if a qualified health plan provides coverage for services for abortion, the issuer of the plan should not use any amount of the Federal funds for abortion? So there is a flatout prohibition for use of Federal funds. And under section 1303(2)(B), there is a segregation of funds which is identical to Medicaid. So however you may want to characterize it, how do you respond to the flat language of the statute which accomplishes the purpose of the Hyde amendment and allows for a payment by collateral funds, just as Medicaid pays for abortions without Federal funds?

Mr. SPECTER. The Senator from Utah has not yet answered the question.

Mr. SPECTER

Mr. SPECTER. Madam President, I have sought recognition to join Senator Boxer, Senator Mikulski, and Senator Gillibrand in opposing the Stupak amendment. The controversy set forth on this issue has been debated in this body and in the House since the Hyde amendment was enacted in 1977. What is attempted by the pending amendment in the Senate and the Stupak amendment in the House is to alter that to the disadvantage of a woman's right to choose. The decision in Roe v. Wade in 1973 was admittedly and obviously viewed as a landmark decision which recognizes the constitutional right of a woman to choose. There have been some limitations drafted as we have moved through the process. We have had many debates on this floor on the Mexico City policy, and many aspects have been subject to challenge. But the provision which is in the bill presented by the distinguished majority leader, Senator Reid, the pending bill, maintains careful delineation which has been worked out up until this time; that is, there would not be any Federal funds used for abortion, but there would be no limitation on the ability of a woman to have abortion coverage if she chooses to so long as she paid for it herself. The provisions in the statute are very plain. Section 1302(2)(a) provides for the prohibition on the use of Federal funds. I am inserting the meaning of the language where it has references to many subsections. But the prohibition on the use of Federal funds states, in effect, that if a qualified health plan provides coverage of services for abortion, the issuer of the plan shall not use any of the Federal funds for abortion. Then there is a provision on segregation of funds, section 1303(2)(b), which provides, in effect, in the case of a plan which covers abortions, the issuer of the plan shall segregate an amount equal to the cost of services for medical services other than abortion from the cost of medical services for abortions. That sets it out about as plainly as you can. The precedent on Medicaid coverage, which involves Federal funding, where some 23 States have chosen to add abortion coverage where the States are putting up their own money, so that there are no Federal funds involved but the Medicaid services do cover abortions, but they are with funds other than Federal funds--State funds--it is just the same analogy as no Federal funds under this bill but with moneys provided by the woman who wants the coverage for herself. The precedent from Medicaid, it seems to me, is totally dispositive of the matters of public policy. Also, it ought to be noted that there is some 87 percent of insurance in the private market which covers abortions. Insurance in the private market provided by employers has the feature of deductibility. So while there is not a direct payment by the Federal Government on policies which do cover abortions, there is an indirect factor here because there is a tax break. The Federal Government does not get taxes on items which the employer deducts on the cost of the insurance coverage. There is also a consideration on an underlying issue of discriminatory practices as to women on the limitation of what is reasonable medical coverage. There is an analogy--none of the analogies are really compelling, but the argument has been made that where you have a pharmaceutical coverage on Viagra, for example, which deals with reproductive capacity, nobody would think of saying the pharmaceutical coverage ought to be limited. Similarly, where there is the right to an abortion, if a woman wants to have it, which she pays for herself, it has all of the ring of discrimination. A principal concern which I have is that if this issue results in a stalemate, the entire bill will be defeated because of this issue. There are two remaining matters to be resolved which have some significant import which could lead to the defeat of the bill. One is on the issue of the public option. It is my argument, contention that we still ought to have a robust public option. There is a vast misunderstanding that the public option does not mean that the Federal Government is taking over on insurance coverage. That is single payer. That is not the public option, which is what it says, an option, one alternative. There are efforts being made to find an accommodation. I hope we stick with a robust public option. The other issue which could lead to defeat of this bill, bring it down, is this controversy on abortion. It is still unclear how the Stupak amendment emerged in the House bill. There are lots of objections to it. Why the dichotomy of Hyde with no Federal funds being used and people could pay for their own was not followed in the House bill I do not know. I do not ascribe any inappropriate motives to any of my colleagues. I would not do that. But I think a consequence of this controversy--and I think there may be some who do want to kill the bill. Certainly, the delaying tactics on the other side of the aisle make it plain that there are those who would use whatever procedures are available, whatever arguments are available to defeat the bill. That would be very regrettable in terms of the long struggle. We have discussed this on the floor again and again, what has happened since Theodore Roosevelt, FDR, and the efforts made to have coverage of health care for the uninsured. If we stalemate on this issue, that could be the consequence. There is no reason to stalemate when there is such a clear-cut path. The bill explicitly provides that no Federal funds may be used for abortion, that any Federal funds would be segregated. That is the precise precedent of Medicaid. So I urge my colleagues to defeat the pending amendment so we can proceed to move for final enactment of this important legislation. I thank the Chair and I yield the floor.

Mr. SPECTER

Mr. SPECTER. Mr. President, the schedulers have allocated 15 minutes to me, so I ask unanimous consent at this time that I may speak for up to 15 minutes.

Mr. SPECTER. Mr. President, I have sought recognition to speak in opposition to the Ensign amendment. The authoritative statement on attorney's fees has come from the National Association of Insurance Commissioners in a 2008 document entitled ``Countrywide Summary of Medical Malpractice Insurance.'' These are authoritative figures on how much the defense lawyers have taken and how much the plaintiffs' lawyers have taken. It shows that the plaintiffs' lawyers, on this state of the record, are underpaid--paid less than defense lawyers--hardly the cause for an amendment to lower attorney's fees even more for plaintiffs' lawyers. These are the statistics by the National Association of Insurance Commissioners as to the attorney's fees. The attorney's fees for defendants were $2.110 billion. The total recovery by plaintiffs was $4.09 billion. Calculating attorney's fees at one-third would mean that the attorney's fees were, for the plaintiffs' attorneys, $1.340 billion, substantially under the $2.110 billion for defense attorneys. Attorneys who take on cases on a contingent fee do so because, unlike insurance companies which have the funds to retain lawyers on an hourly basis, most plaintiffs are unable to pay attorney's fees, do not have the capital to do so. The arrangement is worked out that the fee will be paid by a share of the recovery. If there is no recovery, there is no fee. Beyond the absence of the fee, the plaintiffs characteristically cannot afford the costs of litigation. When depositions are taken or filings are made or various other costs arise, it is up to the plaintiff's lawyer to pay those fees and those are not reimbursed. An effort is being made now to have those deductions on an annual basis. The plaintiff's attorney cannot even take them in the year when they are paid. So if you see a situation where, in absolute dollars plaintiffs' lawyers on contingent fees are paid less than defense lawyers, and you have added to that the risk factor that the plaintiff's lawyers may get nothing, there should even be a greater compensation for plaintiffs' lawyers than defense lawyers. As these statistics show, it is less. Most of my experience in the courtroom has been as a prosecuting attorney, but some experience--I worked for a big law firm, Barnes, Dechert, Price, Myers and Rhoads, representing the Pennsylvania railroads, defendants, representing insurance companies. In the firm practice in that kind of representation, there is frequently a senior lawyer, junior lawyer, associate, paralegal, and multiple tiers running up the costs. Most plaintiffs' lawyers do not have large firms. Many are single practitioners. To postulate a situation where the fees be cut even further is just not reasonable or not realistic. When the contention has been made--it was just made by the Republican leader, repeated earlier contentions--that there are Senators who voted in favor of the Kennedy bill on liability reform, it is not so as represented. First of all, Senator Kennedy's bill in 1995 was a much different bill. Second, it was a tabling motion. Those who voted against tabling were willing to consider the issue, not that they agreed with what was in the bill. Procedurally, when there is a motion to table, if it is passed the bill is off the floor. If a motion to table is defeated, then the bill remains on the floor for consideration. But it does not mean that people who want to consider the bill are in agreement the bill ought to be enacted. The issue of attorney's fees and the issue of malpractice litigation ought to be left to the States in our Federal system. Pennsylvania, my State, is illustrative of the way State governments can handle the issue and deal with it to avoid excesses. In Pennsylvania there was a rule change made to require that before a malpractice suit could be brought, there had to be a certification from a doctor that the case fell below applicable standards of care. A second major change was made which required that the medical malpractice action be brought only in the county where the cause of action took place. That was a move aimed at eliminating so-called venue shopping, to go to a venue where there is likely to be a better result. As a consequence of these two rule changes, the number of filings in Pennsylvania dropped dramatically. With the comparison of the years 2000 to 2002, it was noted that the rates dropped by more than 37 percent in 2003, continued to decline in every succeeding year, and in 2008 had dropped 41.4 percent. The improvement in the picture was further illustrated by the fact that the reforms resulted in the reduction of premiums on malpractice insurance. These reductions are in sharp contrast to 2002, when one leading carrier increased its rates an average of 40 percent and a second leading carrier increased its rates by 45 percent. Then the rates have been decreased consistently and in ensuing years. Other indications in the success of Pennsylvania was the renewed interest of companies that want to sell medical malpractice insurance in Pennsylvania--57 newly licensed entities are now writing medical malpractice coverage since April, 2002. This is illustrative of the way the States can deal with this issue. It ought to be left to the States. Interestingly, the Senator from Nevada, who has proposed this amendment, has filed legislation this year, S. 45, and in S. 45 he has a different approach. He allocates for some recoveries up to 40 percent. Why there is a difference now, cutting it back to 33 percent, and then down to 25 percent, is unexplained. But when an amendment of this sort is offered on a bill for comprehensive health care reform, it is not germane to the issues before the Senate. The standard of being germane means whether there is any provision in the bill now which relates to this matter. Had this really been a serious effort to get legislation, the process or recourse to be followed would have been considerably different. The way to get legislation enacted is not merely to come before some bill and offer it without hearings before the committee of jurisdiction, without the consideration of witnesses. There have been no hearings on the amendment offered by the Senator from Nevada. Had there been hearings we would have been in a position to make a determination as to what are the real facts. Are the fees collected by plaintiffs' attorneys on a contingent basis excessive? What is the reality for the justification, in terms of the time it takes and the expenses involved? But no request was made, to my knowledge, for a hearing before the Judiciary Committee. I do know that no hearing was held. So we do not have a factual basis for making an evaluation of this amendment at this time. It is my hope that we will move from this amendment and take up the issues which are in dispute. We need to eliminate and reject the false rumors which have been advanced. The contention has been made that there would be death panels as a result of this bill. That has been thoroughly debunked. There has been a context that there would be cuts in Medicare. We argued an amendment a few days ago on the contention that there would be very substantial cuts in Medicare. The AARP opposed that amendment because it was fallacious. It was untrue. AARP is an outstanding guardian of the interests and rights of senior citizens, and AARP opposed that amendment. The contention has been made that there will be a government takeover of medical care which has also been disputed and pretty well disproved. When the government option is offered, it is just that. I believe America would be well served by having a robust public option. But the option is nothing more or less than what it says. It is one alternative. Private insurers would still be in the picture. There have been repeated contentions that there will be an increase in the deficit. President Obama is pledged not to sign a bill which will add to the deficit. I am pledged not to vote for a bill which will add to the deficit. When you take a look at what this bill will accomplish, there are very substantial savings in the current cost of medical care, which is $2.4 trillion. I will be specific in what they are. With annual examinations available and incentives for people to take annual examinations, they will be catching what could turn out to be chronic ailments, very disabling, very expensive. Catching a problem with a cardiac issue, with a heart problem, or catching breast cancer at an early stage or catching Hodgkin's at an early stage--I speak with some experience about this issue--will cut down medical expenses tremendously. When there are advance directives, there will also be additional savings. This bill provides for counseling for people who want to know about advance directives. No one should tell anyone else what they ought to do about end-of-life medical care, but it is fair to say consider it, make a decision, have a living will, do not leave it to the last minute when someone is rushed to the hospital and the burden then falls on family members. Estimates range as high as 27 percent of Medicare costs in the last few days, few weeks of a person's life. There are also very substantial savings available for changes in lifestyle. Safeway has demonstrated lower insurance premiums for people who stop smoking, lower insurance premiums for people who have lower cholesterol. That is another major area of savings. An additional area of savings would be to change the current approach of having fines imposed for Medicare. I ask unanimous consent for 30 additional seconds.

Mr. SPECTER. Currently the criminal justice system results most of the time in fines for health care fraud. That is totally ineffective. But if there were jail sentences imposed, that would be a deterrent to others, something I learned years ago as a prosecuting attorney. We can also come to terms on the abortion issue, allowing women to pay for abortion coverage in their medical care. There is no reason they should be denied in maintaining the principles of the Hyde amendment with no federal payment for abortion services. I thank the Chair and yield the floor.

Mr. SPECTER

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

Mr. SPECTER

Mr. SPECTER. Mr. President, I have sought recognition to comment briefly on the Patient Protection and Affordable Care Act, which was disclosed late yesterday by our distinguished majority leader, Senator Reid, to whom we all owe a debt of gratitude for the extraordinary work in putting together this very complex legislative proposal. Also, compliments are due to Senator Baucus, who chairs the Finance Committee, and Senator Dodd, who carried on the work of Senator Kennedy on the Health, Education, Labor, and Pensions bill. The bill provides for gross spending of $979 billion over a 10-year period, under the $1 trillion dollar mark. The coverage allocation is $848 billion. There are gross savings of $1,109 billion, and the deficit impact is to have a reduction of some $130 billion over the 10-year period. In the second 10-year period, the projection for savings is substantially greater. There will be millions of Americans covered who do not now have health coverage, so over 94 percent of all legal residents of all ages will be covered. We are now digesting this very complex piece of legislation. The majority leader has scheduled a cloture vote for Saturday at 8 p.m. It is my hope and, candidly, my expectation that we will have the 60 votes to proceed for the consideration of this bill. It is my view that inaction is not an option; that there are too many people not covered by health insurance or who are underinsured. The cost of health coverage is escalating at such a tremendous rate. It is having a great impact especially on small businesses. A recent prominent publication noted that rates for small business were being dramatically increased. Senator Harkin scheduled a hearing in the Health, Education, Labor, and Pensions Committee. One of my constituents from Lancaster came in to testify that his premiums were rising by 128 percent. So I believe that inaction is not an option. We have had many declarations of positions, and in the Senate, where you need 60 votes to move ahead, every one of those votes is indispensable. Only one Republican, Senator Snowe in the Finance Committee, supported the Finance Committee bill, so there was no margin for error. It would be my hope that my colleagues will not draw any lines in the sand, realizing that no legislative proposal is going to meet the expectations and the desires of every individual Senator. There are 100 of us. There are 435 Members of the House of Representatives. If there is an art to politics, it is an art of listening, of being flexible, and accommodation or compromise. So we are undertaking a major historic event. Efforts have been made since the days of Theodore Roosevelt to have this kind of health coverage legislation. It is too important for us to fail. (The remarks of Senator Specter pertaining to the introduction of S. 2805 are printed in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

Mr. SPECTER

Mr. SPECTER. Mr. President, while I have the floor, I wish to briefly address one other subject. I know my colleague is on the floor waiting for an opportunity to speak. This relates to a plan which is being carried on in the city of Philadelphia to stop foreclosures. We have seen a tremendous problem across America with the housing bubble, with so many people being in houses they could not afford and so many foreclosures. The Philadelphia program received front-page attention in the New York Times just yesterday as a model program. I call the Philadelphia program to the attention of my colleagues and to anyone who may be watching C-SPAN2, a program which is a model and which ought to be followed in other jurisdictions. In March of 2008, the Philadelphia City Council passed a resolution called the Residential Mortgage Foreclosure Diversion Pilot Program. Following the council resolution, Philadelphia's civil court adopted rules that no owner-occupied house could be foreclosed on or sold at sheriff's sale before a mandatory conciliation conference between the borrower and lender aimed at finding a workable compromise. This Philadelphia program has emerged as a model, enabling hundreds of troubled home buyers to retain their homes. In October of last year, a little more than a year ago, Senator Casey and I held field hearings in Philadelphia and Pittsburgh to explore ways to keep borrowers in their homes using the successful Philadelphia program model. I ask unanimous consent that at the conclusion of these remarks, a copy of the New York Times article be printed in full in the Record which details the Philadelphia program and is a suggestion for other cities as to how to follow that.

Mr. SPECTER. I thank the Chair and yield the floor.

Mr. SPECTER

Mr. SPECTER. Mr. President, I seek recognition to introduce legislation to deal with the pressing problem of hunger in the United States. The report of the Economic Research Service of the Department of Agriculture on Monday, November 16--3 days ago--disclosed some startling facts about hunger in America. The report showed there are 49 million Americans who experienced hunger last year. Among that number, 17 million were children, and 500,000 of those children were under the age of 6, which is a critical stage in childhood development. The hunger problem hit disproportionately higher for Hispanics at 27 percent higher and African Americans at 26 percent higher. It is hard to find a sufficiently tough word to describe it--scandalous, outrageous, criminal, repugnant--that in this land of plenty, we should find Americans who are hungry. It is unacceptable to have people hungry anywhere in the world, but right here in our own backyard for this situation to exist is beyond the pale. Having read the article on the 16th, I contacted the Secretary of Agriculture, Tom Vilsack, discussed the issue with him, and I am now introducing legislation which will add $250 million to the food banks to try to deal with this issue on an emergency basis. It would be my hope that this is the kind of legislation which could be passed very promptly--hopefully, before Christmas of this year during our current session--to take some immediate action to replenish the food banks so people in America are not hungry. Mr. President, I ask unanimous consent that my full statement be printed in the Record.

Mr. SPECTER

Mr. SPECTER. Mr. President, I seek recognition to introduce legislation to deal with the pressing problem of hunger in the United States. The report of the Economic Research Service of the Department of Agriculture on Monday, November 16--3 days ago--disclosed some startling facts about hunger in America. The report showed there are 49 million Americans who experienced hunger last year. Among that number, 17 million were children, and 500,000 of those children were under the age of 6, which is a critical stage in childhood development. The hunger problem hit disproportionately higher for Hispanics at 27 percent higher and African Americans at 26 percent higher. It is hard to find a sufficiently tough word to describe it--scandalous, outrageous, criminal, repugnant--that in this land of plenty, we should find Americans who are hungry. It is unacceptable to have people hungry anywhere in the world, but right here in our own backyard for this situation to exist is beyond the pale. Having read the article on the 16th, I contacted the Secretary of Agriculture, Tom Vilsack, discussed the issue with him, and I am now introducing legislation which will add $250 million to the food banks to try to deal with this issue on an emergency basis. It would be my hope that this is the kind of legislation which could be passed very promptly--hopefully, before Christmas of this year during our current session--to take some immediate action to replenish the food banks so people in America are not hungry. Mr. President, I ask unanimous consent that my full statement be printed in the Record.

Mr. SPECTER

Mr. SPECTER. I thank the Chair. (The remarks of Mr. Specter pertaining to the submission of S. Res. 339 are printed in today's Record under ``Submission of Concurrent and Senate Resolutions.'')

Mr. SPECTER. I thank the Chair, and I yield the floor.

Mr. SPECTER

Mr. SPECTER. Mr. President, I have sought recognition to introduce a sense-of-the-Senate resolution urging the Supreme Court to permit live television coverage of its open proceedings. This is different from previous legislation which I have introduced which would require the Court to permit live television coverage. I offer this resolution on behalf of Senator Cornyn, Senator Kaufman, Senator Feingold, Senator Durbin, Senator Klobuchar, Senator Whitehouse, and Senator Schumer. The previous bills, which would have required the Supreme Court to open its proceedings to live television coverage, were voted out of the Judiciary Committee in the 109th Congress by a vote of 12 to 6 and the 110th Congress by a vote of 11 to 8. The basis for the legislative action is on the recognized authority of Congress to establish administrative matters for the Court. For example, the Congress determines how many Justices there will be--nine; the Congress determines how many Justices are required for a quorum-- six; the Congress determines that the Court will begin its operation on the first day of October; the Congress has set time limits. The shift in the resolution for urging the Court is to take a milder approach to avoid a confrontation and to avoid a possible constitutional clash on the separation of powers. There is no doubt that the Court would have the last word if the Congress required live television coverage. And, as I say, there are analogous administrative matters which the Congress does control. But as a first step, today the resolution urges the Court to open its proceedings for live television coverage. The thrust of this resolution is that the Court should be televised, just as the Senate is televised, just as the House is televised, to familiarize the American people with what the Court does. The average person knows very little about what the Court does. The Supreme Court itself has held that newspapers have a right to be in a courtroom. In an electronic age, television and radio ought to have the same standing. The importance of the Court is seen in the scope of the cases which they decide and the kinds of cases which they do not decide. For example, the Court makes a determination on life, a woman's right to choose, makes a determination on the application of the death penalty, a determination on civil rights, on Guantanamo, on wireless wiretapping, on congressional authority, on Executive authority. The Court is the final word since 1803, in the case of Marbury v. Madison, when the Court decided the Court would be the final word. That was the statement of Chief Justice Marshall, and it has stood for the life of our country. I believe it is a sound judgment for the Supreme Court to have the final word. But if the Framers were to rewrite the Constitution, I think the Court would now be article I instead of the Congress being article I, and the executive branch--the President-- being article II. It is also important to note what the Court does not decide. The Court declined to hear the terrorist surveillance program. That warrantless wiretap program was found unconstitutional by the Federal court in Detroit. It was reversed by the Sixth Circuit Court of Appeals on standing ground, with a very vigorous and better reasoned dissent. Standing is a very flexible doctrine and usually made when the Court simply doesn't want to take up the issue. But the terrorist surveillance program presented the sharpest conflict--perhaps the sharpest conflict between congressional authority, under article I, with the Foreign Intelligence Surveillance Act establishing the exclusive way to conduct wiretaps and the President's article II powers as Commander in Chief to conduct warrantless wiretaps. The Supreme Court denied hearing the case of the survivors of victims of 9/11 against Saudi Arabia, even though congressional mandate is clear that sovereign immunity does not apply to foreign government officials. Just in the past few years, the Supreme Court has decided cases of enormous importance. A few illustrate the proposition: The Court did decide cutting-edge issues on whether local school districts may fulfill the promise of Brown v. Board of Education by taking voluntary remedial steps to maintain integrated schools; whether public universities may consider race when evaluating applicants for admission in order to ensure diversity within their student bodies; whether citizens have a constitutional right to own guns; whether States may exercise the power of eminent domain to take a personal residence in order to make room for commercial development. The Court has also declined to hear cases involving splits--that is, differences of judgment--between different courts of appeals. It is not an effective administration of the judicial system if the case may be decided differently depending on whether a person litigates in the First Circuit or in the Eleventh Circuit and then the district courts, where the circuit has not ruled, speculate as to what the court of appeals would have decided. We had a confirmation hearing yesterday with Judge Vanaskie of the Middle District of Pennsylvania. I asked him if he had seen situations where there were circuit splits, but your circuit hasn't decided, and how do you handle that case. Judge Vanaskie pointed out that was very problematic. There are major matters where the Supreme Court has left these circuit splits standing. For example, whether jurors may consult the Bible during their deliberations in a criminal case, whether a civil lawsuit must be dismissed predicated on state secret, whether the spouse of a U.S. citizen remains eligible for an immigration visa after the citizen dies, whether an employee who alleges that he or she was unlawfully discriminated against for claiming benefits or exercising other rights under an employer-sponsored health care or pension plan, or when does a collective bargaining agreement confer on retirees the right to lifetime health care benefits? may a Federal court toll the statute of limitations in a suit brought under the Federal Tort Claims Act? These are illustrative of very important decisions which the Supreme Court does not decide. Congress can't tell the Supreme Court what to decide, but Congress may mandate the Court's jurisdiction. If this were in the public view, if the Court were accountable for not handling such cases, I think the Court might well take a different view. It is not as if the Court is too busy to hear these cases. Take a brief survey of the Court's docket. In 1886, there were 1,396 cases on the Supreme Court docket. It decided 451. In 1926, there were 223 signed opinions. So it was down from 451 in 1886 to 223 in 1926. Then by 1987, it was down to 146. In 2007, the Court heard argument in only 75 cases and issued only 67 signed opinions. So it is perfectly clear that the Court's docket, with the four clerks--which each one of the Supreme Court Justices has--could well accommodate a more vigorous workload. In the written statement that I will include when I finish these extemporaneous remarks, I have cited several recent cases where the Court has not followed well-established precedent. Well, they have the authority to overrule their own precedents, but it is something the public ought to have an idea on and an understanding of. I think this is a particularly good time for the Court to consider televising itself under the resolution urging them to be televised since Justice Souter recently left the Court. Justice Souter made the famous statement that if the Supreme Court were to be televised, the cameras would roll in over his dead body. The members of the Supreme Court are very concerned about what their fellows think, and it may well have been that in light of a strenuous objection by Justice Souter, when he was on the Court, that would have tipped the scales. But listen to what the Justices have had to say on the issue of televising the Supreme Court. I have made it a practice to question the nominees for the Supreme Court to get their views on television. Justice Paul Stevens said: Literally hundreds of people have stood in line for hours in order to hear oral argument only to be denied admission because the courtroom was filled. The practice is, if you can get in at all, you stay for 3 minutes and then you are ushered out to let other people in because it is a small chamber. Justice John Paul Stevens said: Television in the Court is worth a try. Justice Ruth Bader Ginsburg said: I don't see any problem with having proceedings televised. I think it would be good for the public. Justice Breyer said--at a time when he was chief judge of the First Circuit--I voted in the judicial conference in favor of experimenting with television in the courtroom. The judicial conference made an analysis of television--made a favorable recommendation--and some circuit courts and some lower courts have been televised. Justice Sotomayor, in her recent confirmation hearing, said, referring to her experience with cameras in the courtroom, that the experience has ``generally been positive, and I would certainly recount that,'' referring to her colleagues on the Supreme Court. Justice Alito said, in the Third Circuit, there was a debate and he argued we should do it; that is, televise it. He said: I would keep an open mind on the subject with respect to the Supreme Court. The fact is the Justices frequently appear on television on their own. For example, Chief Justice Roberts and Justice Stevens appeared on interviews on ABC's ``Prime Time.'' Justice Ginsburg has appeared on CBS News. Justice Breyer has been on ``FOX News Sunday.'' Justices Scalia and Thomas have appeared on CBS's ``60 Minutes.'' All the Justices appeared for interviews that C-SPAN recently aired during its ``Supreme Court Week.'' Public opinion polls are strongly in favor of having the Supreme Court televised. There have been numerous editorials in support, and recently the Supreme Court of the United Kingdom opened its proceedings for television. That is a very brief statement of a more expansive statement, which I have prepared, and I think the reasons for opening the Court are overwhelming. In a Democratic society, there should be transparency at all levels of government. The judicial independence of the Supreme Court is of vital importance to be maintained, and they have life tenure, but there is no reason why the American people should not understand what they are doing. The American people should understand that when they take a case such as Bush v. Gore, where there is a challenge on the counting of the votes in Florida and where Justice Scalia says there would be irreparable harm in allowing the votes in Florida to be counted because it might undermine the legitimacy of the new administration, the American people ought to have maximum access to understand what the Court is doing. The American people ought to have maximum access to know that the Supreme Court of the United States declined to hear a decision on whether the President had authority to conduct warrantless wiretaps. The American people ought to know that all these circuit splits remain unresolved at a time when the workload and the agenda and the docket of the Supreme Court has declined enormously. Mr. President, I ask unanimous consent to have printed in the Record at this point a ``Dear Colleague'' letter signed by Senator Cornyn and myself.

Mr. SPECTER. Mr. President, I ask unanimous consent to have printed in the Record an extensive floor statement and that the Congressional Record contain my introduction of the floor statement. Frequently, when the floor statement occurs right after the oral extemporaneous comments, the reader may wonder why the speaker is repeating himself on so many of the same points. So, I would like to have the full text as to what I am saying now appear in the Congressional Record so that it is understandable why the long text appears after so much of what has already been said.

Mr. SPECTER

Mr. SPECTER. Mr. President, today I seek recognition to introduce legislation entitled the Cotton Shirt Industry Tariff Relief and Promotion Act. This legislation will strengthen our domestic dress shirt manufacturers and the pima cotton growers. My bill extends a technical correction that levels the playing field by correcting an anomaly from previous trade agreements that has unfairly advantaged foreign producers and sent hundreds of jobs offshore. This legislation extends the reduction of duties levied on cotton shirting fabric that is not made in the United States. U.S. law recognizes this lack of fabric availability and has granted special favorable trade concessions to manufacturers in Canada, Mexico, the Caribbean, the Andean region, and Africa. The U.S. allowed shirts to enter this country duty-free from many other countries, while failing to reduce tariffs on those manufacturers that stayed in the U.S. and were forced to compete on these uneven terms. My bill extends the correction of this inequity. This legislation also recognizes the need to promote the U.S. shirting manufacturing and textiles sectors, and does so through the extension of a Cotton Competitiveness grant program, which is funded through a portion of previously collected duties. Our country has experienced an enormous loss of jobs in the manufacturing sector. It is critical that our domestic manufacturers are able to compete on a level playing field. My legislation is a concrete step that this Congress can take to reduce the hemorrhaging of U.S. manufacturing jobs. One group of beneficiaries of this legislation is a Gitman Brothers factory in Ashland, PA. The Ashland Shirt and Pajama factory was built in 1948 and employs 132 workers. This factory in the Lehigh Valley turns out world class shirts with such labels as Saks Fifth Avenue that are shipped across the U.S. Their shirts are made of pima cotton that is grown in the Southwestern U.S., but spun into fabric only by special mills in Western Europe. Gitman must compete against Canadian shirt companies that import the same fabric tariff-free and who can then ship their shirts into the U.S. tariff-free under NAFTA. These workers and their families deserve trade laws that do not chase their jobs offshore. This legislation enjoys the support of the domestic shirting industry, UNITE, and the Pima cotton association. I offer this legislation on behalf of the men and women of the Gitman factory in Ashland, the domestic dress shirting industry, and the pima cotton growers, so that for them, free trade will indeed be fair trade as well.

Mr. SPECTER

Mr. SPECTER. Mr. President, today I seek recognition to introduce legislation entitled the Cotton Shirt Industry Tariff Relief and Promotion Act. This legislation will strengthen our domestic dress shirt manufacturers and the pima cotton growers. My bill extends a technical correction that levels the playing field by correcting an anomaly from previous trade agreements that has unfairly advantaged foreign producers and sent hundreds of jobs offshore. This legislation extends the reduction of duties levied on cotton shirting fabric that is not made in the United States. U.S. law recognizes this lack of fabric availability and has granted special favorable trade concessions to manufacturers in Canada, Mexico, the Caribbean, the Andean region, and Africa. The U.S. allowed shirts to enter this country duty-free from many other countries, while failing to reduce tariffs on those manufacturers that stayed in the U.S. and were forced to compete on these uneven terms. My bill extends the correction of this inequity. This legislation also recognizes the need to promote the U.S. shirting manufacturing and textiles sectors, and does so through the extension of a Cotton Competitiveness grant program, which is funded through a portion of previously collected duties. Our country has experienced an enormous loss of jobs in the manufacturing sector. It is critical that our domestic manufacturers are able to compete on a level playing field. My legislation is a concrete step that this Congress can take to reduce the hemorrhaging of U.S. manufacturing jobs. One group of beneficiaries of this legislation is a Gitman Brothers factory in Ashland, PA. The Ashland Shirt and Pajama factory was built in 1948 and employs 132 workers. This factory in the Lehigh Valley turns out world class shirts with such labels as Saks Fifth Avenue that are shipped across the U.S. Their shirts are made of pima cotton that is grown in the Southwestern U.S., but spun into fabric only by special mills in Western Europe. Gitman must compete against Canadian shirt companies that import the same fabric tariff-free and who can then ship their shirts into the U.S. tariff-free under NAFTA. These workers and their families deserve trade laws that do not chase their jobs offshore. This legislation enjoys the support of the domestic shirting industry, UNITE, and the Pima cotton association. I offer this legislation on behalf of the men and women of the Gitman factory in Ashland, the domestic dress shirting industry, and the pima cotton growers, so that for them, free trade will indeed be fair trade as well.