Craig Thomas

Mr. THOMAS

Mr. THOMAS. I thank the Chair. Madam President, I certainly agree with my friend from Kentucky that there is nothing more important than for us to ensure that our education system is accountable, is working well, and is fair to all students.

Mr. THOMAS

Mr. THOMAS. Mr. President, I would like to take the first 10 minutes of our 30 minutes and talk a little bit about the uninsured and talk a little bit about insurance, of course. I am pleased this is uninsured week, that we are focusing on that problem of uninsured folks. I think it is a great thing that we ought to be doing. There are some alternatives that we can pursue. I have been particularly involved in the rural health care aspect, being from Wyoming where, of course, almost all of our health care is rural health care. We have had good results in our Medicare bill that was passed last year. We have equity pay for the providers in that bill. We have assistance for those serving underserved areas. We have a number of things that are very necessary. I am pleased they are there. We have been focusing on Medicare, of course, because that is the Government's responsibility directly. We have made some good progress on that. Among other things, we seek to help seniors with pharmaceutical costs. We have a program out there. I am a little disappointed the minority leader is nothing but critical of it. It is out there and we ought to be trying to make it work now rather than trying to oppose it for political reasons. I think that is a mistake. There are opportunities out there for the elderly to enjoy a considerable amount of assistance, particularly low-income people, with the $600 assistance in addition to a 20-percent reduction. The fact that there are 70 cards out there--all you have to do is call 1-800- Medicare and get the advice that is necessary to do it. I wish we could support something instead of totally always being critical. In any event, we have worked on those, and I think it is time that we look, now, at the broader aspects of health care. That includes many other things. We have a great system. We have probably the best health care system in the world. However, if that system gets in the position where access is limited by the costs, then of course we are not making it possible for everyone to participate. That is really where we are. The costs of health care have increased substantially. There are lots of reasons for that. One of them is the new equipment that is being used, which everybody wants to take advantage of, of course, because it is the high-tech stuff. Another reason, obviously, is the liability problem we have tried to address on the floor a number of times, and we have not been able to move past the obstructionism on the other side. The liability problem not only results in the cost of the liability insurance going up, but it also results in having more testing, more specialists, more costly health care simply to avoid the opportunities that people might have to sue. So there are a lot of things. I had the opportunity not long ago to talk to the management of one of the largest hospitals we have in Wyoming. It was interesting when the financial officer broke down the situation with regard to the funding. First, he talked about the billing level, which, of course, is quite above the cost level because they need to bill some more than it costs to make up for those who do not pay. But the point was, they broke down the number of people who were there, the number there in Medicare, the number there on Medicaid, the number that had their own insurance, the number that were uninsured, and the emergency ones. Part of the problem is Medicare is not paying the full cost, Medicaid does not pay much of the cost at all, so then you get to the uninsured and, of course, many of them do not pay, are not able to pay at all, and you have the emergencies, so what happens? It goes to those of us who have insurance. As I go about my State talking to people, I hear more about the cost of health insurance than anything else that you talk about in a town meeting. It is largely because of some of those shifts there. As has been pointed out, we have over 40 million Americans who do not have health insurance, and that is unacceptable. We need to do something about that. The cost of health care--of course we ought not to forget that continues to grow almost unchecked. It has grown to $1.6 trillion in 2002, a 9.3-percent increase over the previous year. You cannot keep having a 10-percent increase in these costs and yet be able to deal with them. The health care cost portion of the gross national product in 2002 was nearly 15 percent, up from 14 percent the year before. This is part of it that we ought not forget--the cost of health care. We ought to look at the costs as well as who is going to pay. Unfortunately, that is about all we ever talk about--who is going to pay. There is more to it than that. These rates cannot continue to grow at that rate. We have had a considerable amount of planning in our State with respect to the uninsured. We had a group--I am glad there has been a task force here, and we have about 14 percent of our people in Wyoming who are uninsured. It is largely because of the cost. We have a number of things, however, that have been suggested which I think we ought to take a look at. There are some important special recommendations. We could expand public programs such as Medicaid and CHIP. The minority leader was just talking about the CHIP program and why it should be such a surprise since it has been there for a good long time. It is one that the States participate in funding. We need to do that. It needs to be funded at the full level by the States. We need to provide a buy-in option for public programs so people have an opportunity to buy into these programs that now exist. We need to increase the reimbursement for public programs. They are not paying their share. Therefore, private insurance goes up, and those people who can't afford it or even come close to affording it are even less likely because it has gone up more. We need to target tax credits and Federal subsidies. I think tax credits are valuable. That would allow people to take a higher crisis sort of a policy. Community health centers that deal with people who aren't able to have insurance and need help is an excellent way to deal with this. Of course, we need to do something to help participation of employer- sponsored programs. That is not the only answer because a lot of people are self-employed. Of course, we also need to push for personal responsibility for health. An interesting program has been talked about in Wyoming. It is a group called the ``Be Well Program.'' They would deal with employer groups that cover their employees. The employees would sign an agreement to keep up their own health, to exercise, and do some of the things that we all talk about and which not everyone does. That would be a condition of being insured. It is already in a couple of contracts. There are a lot of things to do, and the task force has a number of ideas. I think we need to move forward to try to do some things. Most of us I don't believe favor a socialist program where the Government runs all of the health care programs. That is evidently not the kind of thing we want to have because all of the Canadians would come here. But, nevertheless, there needs to be a program that gives an opportunity for people to fully participate. I am delighted that we are moving forward with it. I yield the floor.

Mr. THOMAS

Mr. THOMAS. Mr. President, we are dealing with an issue that is probably the most important that we have before us, in terms of jobs, in terms of meeting the needs in this country. We are dealing with an issue we have talked about for 2 years or more. We have finally come up with some solutions. This is an issue that has already been on the floor that passed with 58 positive votes. The Senator from Arizona indicated it hasn't been discussed or talked about or voted on. That is absolutely not the case. It has been, and that is where we are. There are two major issues involved. I am not going to get into the details. We are creating a policy for our future energy needs. As we look around at our families and our businesses and everything we do, there is nothing that affects our lives all day long more than energy. Whether it is lights, whether it is air-conditioning, whether it is heat, whether it is cars, whether it is receiving goods in your community, that all takes energy. So we are developing a policy, not necessarily for what is going to happen next week or next year, but down the road, where are we going to be? The second portion deals with some of the issues that are troublesome now: The price of fuel, and the idea we are going to run short on some of the kinds of fuel we are using. All those things are there. This was part of an energy bill. It is not all of it, but it is a good part of it that we have worked on for a very long time. It is backed up by the facts. Unfortunately, to say we talked about no facts, here that is not true. This is a broad policy, for one thing, that deals with alternative sources of energy. It deals with renewables, the cleanliness of coal, with pipelines. It deals with all those things that are so important to do this job. One thing that always strikes me, probably because we in Wyoming are the largest coal producer in the country, is that coal is the largest fossil fuel resource that we have available to us. At the same time, some other things have been easier. All the electric-generating plants over the last 15 years use natural gas. Natural gas can be used for many things where coal really is only available for this purpose, coal and nuclear. But we want to make coal energy clean so the air will be clean. This is what this bill does. It allows us to use that fuel most available to us and have it for the future. We have been taking a look at energy usage, and what strikes us is that consumption continues to go up at a rather fast rate. We are using more in our cars; we have bigger homes; we are doing things so that consumption of energy goes up. But the production level is going down. If that doesn't create some kind of crisis in the future, I don't know what possibly could. It was mentioned, and it should be mentioned again, that this is a jobs bill. That is really what we are trying to do. We can create more jobs in this particular provision, not only immediate jobs for the development of nuclear powerplants or power lines or coal mines or whatever, but the jobs created for other industries, of course, have to have energy available for them. The amendment proposed here certainly would do away with one of the most important things we have done for a good long time, something we have worked on for a good long time, something that not only deals immediately with problems but addresses the future of our families, yours and ours, and jobs. So we ought not pass this amendment. I urge my colleagues to vote against it. I yield the floor.

Mr. THOMAS

Mr. THOMAS. Madam President, I am pleased we have this resolution before us. I think all of us share the same thoughts about this whole Iraqi prisoner abuse issue. We are all very disappointed and very troubled about the events in the prison. We need to move forward to resolve this issue. We need to do what needs to be done as a followup. We do not need to make it into a political operation for the next week because we have other things to do in Iraq. But we must take care of this issue because we, as Americans, hold ourselves to a higher standard. These are appalling actions of those responsible for the treatment of the detainees in Iraq. It falls far short of any of those standards. Our credibility has been called into question in the eyes of those we are trying to help, as well as the rest of the world. These incidents of cruelty and mistreatment at the hands of American service men and women are inexcusable, and certainly it is a very small group of our service people. Unfortunately, the foolish actions of a few have cast a pall on thousands of our military. All of us know that is not the case, and all of us who have served in the military know these are not the kinds of activities we are ordered to do. There have been mistakes, and we need to determine how those happened and see they do not happen again so our folks can continue at the very hard job they have. These terrible events have dealt a blow to what we are seeking to do. I want to say again our task is to win in Iraq, and this is a deterrent from that, but we can overcome it and move on with the task. This also makes it more important that we win at home. With the media and the emphasis that has been put on this issue, it detracts from our job. We cannot let that happen. If we are really as strong in our feeling about our service people overseas, we ought to make sure we support what they are doing and continue to give them that support. We as a nation must deliberately correct the situation and ensure it does not happen again. All of us want to do that. Democracies hold themselves accountable. That is our task. We can do it, and we will do it. We acknowledge we have done wrong, and we will move to correct it. That is what this resolution is about. That is what the hearings are about. That is what holding people in authority responsible is about. We need to move on that initiative. We need to get the facts. We need to make the whole effort more transparent in the future, of course, as all Government activities should be transparent. The process needs to move swiftly and decisively. We need to do this job and get on with the rest of the job. For those who committed the acts and those who enabled them, we need to do all we can in determining if there is involvement in the chain of command. I do not think anyone denies that is what we need to do. These things that have happened are certainly fundamentally contradictory to American values. The eyes of the world are focused now on how we will react, and we have reacted. The President has reacted. The Secretary has reacted. The Congress will react. We need to ensure that it continues, but I do warn that we ought not divert all of our attention to this issue, taking it away from the overall issue that still exists. We need to be there. The stakes are simply too high to play politics with this issue, and unfortunately that might well happen. So we need to proceed. We need to make everyone understand that these are not the kinds of things that the United States will live with and let happen. We will do something about it. We need to bring those to justice who were involved. We will go forward and we will win in Iraq. First, we must win in the United States. Energy Policy Earlier, I listened to the assistant minority leader talk about energy and say that the things we are doing now have nothing to do with an energy bill. I think that is absolutely wrong. What we are talking about is an energy policy that will last somewhat over time but is designed to change some of the things that we are doing in energy and energy use that are causing us part of the problems today. Will they reflect some change in the next day or two? Of course not. But we need to be working forward at doing something about the long-term impact of energy. I will briefly talk about a few of the things that need to be done because it is just impossible to say they do not have an impact. Keep in mind that we have had an energy bill now last year and this year, and we tried to bring it up on the Senate floor. It passed here, went to conference, came back, and would not be accepted again. We have been obstructed and cannot move forward in doing something with the broad energy bill that has to do with energy efficiency. Again, it is going to take some time to do that, but it is very clear that consumption has gone up faster than has production. If we continue to do so, this will be the case. Even more importantly, our consumption will grow and our production--if we keep it as it is--will soon be overcome and will not grow. So we have to talk about issues like renewable energy. We have to talk about alternative energy. Those things are in the bill. That is what we are talking about doing, seeing if we can do some things differently than we have in the past. We also have some incentives to continue like in marginal wells. Marginal wells, even with the price as high as it is, if there is not some incentive for a well that only delivers two, three, or four barrels a day, we do not produce them, but in total they still have a large impact on what we are doing. We need to make some changes in the way we use energy. We are using oil, for example, to heat homes. We are using oil to do a lot of things other than make gasoline. We have other energy sources that could be used for that purpose. The same is true with natural gas. We are using natural gas for many things. For instance, the electric-generating plants that have been built in the last 10 or 15 years have all been natural gas plants. Natural gas is so much more flexible for other uses: we ought to be using coal; we ought to be using nuclear for the generation of electricity so we can use natural gas for other purposes. So to say this bill has nothing to do with our problems with energy is absolutely without merit. It does have a great deal to do with it. We talked about some things that would have a pretty immediate impact, such as doing something on the Indian reservations to promote production. They would like to do that, but we have not really been able to make it happen. We are talking about doing something with hydrogen, fairly short term, to make hydrogen part of automobile fuel, and use coal and make hydrogen for automobiles. We can talk about the price of gas next week. I would love to be able to do something about that, and hopefully maybe we can, but the real thoughtful question is, where are we going to be in 5, 10, or 15 years from now to meet the needs which will constantly be growing? We need to have a plan. We need to have a policy. This Congress has absolutely refused to move forward with the policy, along with many other things, and has strictly been obstructed from moving forward. So every week we are going through the same things because we cannot get them passed. Something needs to be done. I think we have some very important issues before us. First of all, we have this resolution. I favor the resolution, which says very clearly how we feel about what happened in the prisons in Iraq. It says very clearly what we ought to be doing about those responsible for those acts. It says very clearly that we ought to make sure that does not happen in the future and that we can go back to doing what we are supposed to be doing. I hope we do not make such an issue in terms of accomplishing things that we detract from the real purpose of our being in Iraq, and that is to win freedom for the Iraqi people, do something about terrorism, and be able to bring our men and women back to the United States after the victory. I yield the floor and I suggest the absence of a quorum.

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

Mr. THOMAS. I ask unanimous consent that the time in the quorum call be equally divided between the two sides.

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

Mr. THOMAS

Mr. THOMAS. Mr. President, I would like to announce for the information of the Senate and the public that the following hearing has been scheduled before the Subcommittee on National Parks of the Committee on Energy and Natural Resources: The hearing will be held on Thursday, May 20, 2004 at 2:30 p.m. in room SD-366 of the Dirksen Senate Office Building in Washington, DC. The purpose of the hearing is to receive testimony on the following bills: S. 1672, to expand the Timucuan Ecological and Historic Preserve, Florida; S. 1789 and H.R. 1616, to authorize the exchange of certain lands within the Martin Luther King, Junior, National Historic Site for lands owned by the City of Atlanta, GA, and for other purposes; S. 1808, to provide for the preservation and restoration of historic buildings at historically women's public colleges or universities; S. 2167, to establish the Lewis and Clark National Historic Park in the States of Washington and Oregon, and for other purposes; and S. 2173, to further the purposes of the Sand Creek Massacre National Historic Site Establishment Act of 2000. Because of the limited time available for the hearings, witnesses may testify by invitation only. However, those wishing to submit written testimony for the hearing record should send two copies of their testimony to the Committee on Energy and Natural Resources, United States Senate, SD-364 Dirksen Senate Office Building, Washington, DC 20510-6150. For further information, pleased contact Tom Lillie at (202) 224-5161 or Sarah Creachbaum at (202) 224-6293.

Mr. THOMAS

Mr. THOMAS. Mr. President, I come to the floor to support the chairman and senior ranking member on this legislation. I know they have talked about it in great detail and explained it thoroughly. My point is, it is time for us to move forward. We have been on the bill for a frustratingly long time. We have gone to the bill three times. But this isn't the only one. We seem to be having the same experience with many of the interesting bills, such as highway legislation, the budget, moving forward with jobs. It seems to me we ought to examine ourselves and see where we are in terms of doing the job we were assigned to do, and that is to move forward dealing with those issues that are pertinent to this country. I support passage of the JOBS bill. It is interesting that at a time when we are concerned about jobs, concerned about continued economic growth, having a deficit in the trade balance, concerned about manufacturing jobs, here we are with some reasons to do things that would impact all those issues, and we continue not to do it. It is time we come to the snubbing post and talk about what we have to do to get this job done. There are, of course, different views of what should be done, and I understand that. There are different ideas. The bottom line is, when you have a bill and it has a purpose, that is what we ought to be talking about, not about loading it up with everything that everyone intended at one point or another to include so that it becomes so controversial that the core values, the reason it is there, never happens. That is basically where we are. This is basically a bill that was brought to the committee. The Senators have at one time talked about giving 3 percent encouragement for people to send goods overseas. The World Trade Organization ruled against that and said it was unfair and said, If you don't do something about it, we are going to continue to add penalties to this area. We are now at 7 percent. Each week it can be added to be a higher percentage. That is what the basic bill is about. There are lots of things involving taxes and lots of things involving a million things you could do. But we ought not to forget what the purpose of it is, and we need to go back to that purpose and say: Wait a minute here; we need to get that finished. It is really interesting. At some point, this is broader than that, but I think we have to take a look at the role of the Federal Government and what we are doing. We ought to take a little time, and I am in the process of trying to find out all of the various agencies and activities that are funded by this Congress. I think we would be amazed. Every time we see a little problem, every time we see something here, every time a constituent wants something, suddenly we have a Federal program for it. And then it is amazing we say to ourselves: Where is all this money going? I can tell you where it is going. We are continuing to have more and more programs, and we need to take a look at putting those in some kind of a priority as to what the role really is of the Federal Government. Unfortunately, I am sure it is true, many of the things here are strictly political. They are simply things that a Senator wants to spell out his political situation by offering an amendment. Whether or not it ever passes, you can go home and tell the folks: I sure worked on that one, you know. Well, that is not what these things are for. That is not what they are for. Amendments should be perfecting the base, perfecting the purpose for the bill. Then if we want to do all these other things, let them stand on their own. I happen to be a big supporter of the Energy bill. We put together a total Energy bill. Frankly, if I had my way about it, we would keep it together because we are talking about the whole. It is a policy. You are talking about what you do about alternative sources. You are talking about what you do about conservation as to how you can use less energy. You are talking about the way you substitute and do research to develop new ideas. You are talking about domestic production--all those things. But when you start taking it apart, then it becomes very difficult to deal with all the issues that ought to be there. Nevertheless, this is the way it is. I support it because we do need to do something. But there are an awful lot of issues that aren't there that ought to be in the energy policy that are being left behind. It makes it less likely they will be passed. We have things like trade adjustment assistance to service workers. That is an issue that ought to be talked about, I suppose, but it should not be addressed in this bill. It costs $5 billion over 10 years. We have that one on there. We have overtime rules, trying to go back and change the rules that are put in by the administration. What does that have to do with doing something about WTO? Nothing. But it is one of the issues that is going to hold us up. This JOBS bill is designed to save hundreds of thousands of manufacturing jobs, alleviate the tax burden on businesses, and allow manufacturers to freely compete with their European counterparts. That is what it is for. As a result of a 2001 WTO ruling, which I have already mentioned, the European Union initiated a phase-in of punitive tariffs. That is in the process right now. It started at 5, it is at 7, and it is going to continue. So we need to focus on that issue and do something about it. The bill reported by the Finance Committee represents a strong, bipartisan effort to accomplish key objectives for manufacturers. It is one that enhances the ability of U.S.-based companies to compete in an international market; provides a lower tax rate on manufacturing goods; makes the tax burden of U.S. manufacturers closer to the international competition; enhances the financial strength of U.S. companies, creating incentives for them to invest in workers, facilities, and community. Our manufacturing sector, of course, has faced many challenges over the last number of years and will continue to. We are in a changing economic situation. Interestingly enough, many manufacturers produce more goods through efficiency. They actually have less workers and are producing more goods than before. That indicates we have to broaden our kinds of manufacturing and do more in different areas. We need to stay focused on this bill. I am becoming rather impatient with what is happening on the Senate floor, not only on this bill but on lots of bills where we continue to have endless numbers of these issues put on that do not belong there at all. We ought to come to an understanding that this is the issue that is being dealt with here. Let's do it. This one is important and we should do it. These amendments need to end. I yield the floor.

Mr. THOMAS

Mr. THOMAS. Madam President, are we now under the Republican time?

Mr. THOMAS

Mr. THOMAS. Madam President, I had come to the Senate floor to talk about an issue that is very important to all of us, particularly Medicare recipients in this country. But first I have to express some disappointment, frankly, and some surprise about the discussion that has gone on here in the first 30 minutes criticizing the President on everything that is happening overseas, acting as if we are not in support of what is happening there. I am very surprised and, frankly, disappointed. All they talk about is what the President has done. We voted here on this floor to do this job in the Middle East. That is what we are seeking to do, and that is what our great service people are doing for us over there. The idea behind conducting Operation Iraqi Freedom was to free 25 million Iraqis from the Saddam Hussein regime. That is why we are there: to defend the will of the international community, to remove the threat of terrorism that happened here on September 11, and to change the dynamics in the Middle East. That is what we are seeking to do, and that is what we are trying to carry on, and it is an admirable effort. Madam President, 211 Members of Congress have visited Iraq and witnessed firsthand some of the extraordinary efforts of the coalition forces and Iraqis. I have been to Iraq. I am impressed with what they are doing. For us to simply criticize everything that is happening there aimed at the election in 2004 is a great disappointment to me. Despite the terrorist attacks and the tough events that have happened, public opinion has found 56 percent of Iraqis believe things are better than they were; 71 percent believe a year from now they will be better than they are now. Again, having been there, I agree with that assessment. I have been there traveling around with the military, with all the little kids waving and saying hello. I have seen the schools and hospitals that have been fixed up. Of course, there is a real problem with terrorism, there is no question about it. The defeat of Saddam Hussein's regime is the second major victory in the war on terrorism. We need to continue. I hope we give the kind of support that is necessary.

Mr. THOMAS

Mr. THOMAS. Madam President, we also have issues at home about which we ought to be talking. One of them is health care, of course. We have great health care in this country, the best in the world. We have some limited access, however, because of the costs, and we need to address that issue. There are many reasons for the costs. One reason is liability and malpractice, which we do not seem to be able to deal with. Another reason, I suppose, is overutilization. There is a difference between health care and health. We have some responsibility to take care of ourselves as well. Modern equipment is the biggest cost increase. We all want the modern equipment. We have to find the system in which the costs can be reduced. In any event, what we are talking about today is the opportunity to make it much better for Medicare folks through a Medicare drug discount card in which seniors will soon be able to enroll. All Medicare beneficiaries, except those who have medication paid for by Medicaid, will be eligible. While seniors may enroll in only one Medicare- approved discount card, they can keep the other discount cards if they have them, if they like. There are going to be 40 official discount cards available. It is surprising there has been that much involvement. It shows we are moving in the right direction and doing what needs to be done. This is the first time in Medicare's history that seniors will have a discount for pharmaceutical drugs. Quite frankly, it is the first thing in about 30 years we have done to bring Medicare more into the modern world and give some options to seniors. I want to emphasize what is going to happen. In 2006, there are going to be options for seniors. They can stay with what they now have. It is also the first time that low-income seniors will receive additional assistance from the Federal Government for the cost of their medications. It is a great step forward for seniors to deal with the high cost of drugs. This is more of a temporary program. When we put this together in the Finance Committee, of which I am a member, we knew changes were going to be difficult. We knew it would take some time to prepare for those changes, not only on the part of seniors but on the part of people who have a program. This program will be implemented and in place until 2006, when there will be a broad system put into place. We need to take advantage of this card system as quickly as possible so we get the benefits from it. I commend the hard work of Secretary Tommy Thompson and CMS Administrator Mark McClellan. There has been an overwhelming response to this program. As I mentioned, 40 drug discount cards will be available from which seniors can choose. I believe there are an additional 33 that will be available on a regional basis. So there is a lot of interest for doing something in this area. Drug card sponsors are required to provide information to beneficiaries, the annual enrollment fee cannot be more than $30 per year, and the people who are putting out the cards will have to show what their discount prices will be. The transparency will give an opportunity for people to choose what will work best for them. We are trying to make this as simple as possible. Medicare's Web site will be the best opportunity for people to get an update on drug prices. The Web site is www.medicare.gov. The information will be there. In my home State of Wyoming, AARP is holding seminars to help people understand the benefits, what the options are, and how you can take advantage of them. It is very important for seniors in the next couple of weeks to take advantage of the informational efforts being put forth. The easiest one, of course, is for seniors to call 1-800- Medicare, and a live person in this country will answer and help them figure out the card that meets their needs the best. CMS has already received a lot of calls. They received 112,000 calls on Monday, as a matter of fact--isn't that amazing?--and 94,000 on Tuesday from seniors seeking information. It is the right thing to do to call that 1-800-Medicare number. The average wait is only a very short 22 seconds, I believe. This is a huge accomplishment for a Federal bureaucracy to be able to put this into place to deal with that many people in that short a time. By mid-May, seniors should make a decision so they can receive a card, and the benefits are to begin on June 1. I think it is great to take advantage of this information. Our own offices in Wyoming will have the information as to where people can go to get the information and find out the choices that are available. Contrary to what some people have said on the other side of the aisle, this discount card will provide for significant savings. There was a study that was done which shows there will be an approximate 17-, 18- to 25-percent reduction in the cost. The average beneficiary will probably spend $1,500. This is a significant amount of saving over where we are today. It is expected that the overall savings to seniors would be probably about a billion dollars over the next year, and that is very useful. The card provides immediate help to the most needy Medicare beneficiaries. Low-income seniors who do not currently have prescription drug coverage or do not qualify for Medicaid will be given additional help. Low-income beneficiaries will be helped by receiving $600 annually to help them buy the medicine right from the pharmaceutical companies. To qualify for that additional assistance, they must have an income of 135 percent of the Federal poverty level. That is about $12,000 per individual or $16,000 for couples. If they qualify for Medicaid, of course, they get their assistance there and will not get it from the card. Further, the Federal Government will pay the annual enrollment fees for low-income seniors. Major card companies have told HHS that they will continue to provide the drugs that are already given free or at a steeply discounted rate for those people who qualify for the $600 use. So low-income people will reap a great benefit from this. In Wyoming, of course, we know that our AARP chapter and the Senior Health Insurance Information Program have been working hard. I think that is the case in all States. So I guess the point we are trying to make today is, here is a program that has the potential to be beneficial to all Medicare recipients. It is a choice program. If they have other cards that are not in this official brand, they may keep those. They do not need to get into it if they choose not to, but it is beneficial, and they need to know what is required to get the information and then have an opportunity to make choices among several things that can indeed happen. So we want to urge everyone to take advantage of this potential new change and the opportunities available to reap some savings and to make pharmaceuticals even a stronger part of their health care program by making them less expensive through this program. I yield to my friend from Wyoming.

Mr. THOMAS

Mr. THOMAS. Mr. President, I am pleased to share my views about the environment on Earth Day. I know many Members in this body support efforts to clean up our environment. Earth Day 2004 is the ideal time to recognize just how much our environment has improved. Over the last 3 years, the focus has been on results--making our air, water, and land cleaner. To get to that point and to keep improving in the future, we need to employ the best science and data available for decision-making. Our policies should encourage innovation and the development of new, cleaner technologies. We should continue to build on America's ethic of stewardship and personal responsibility through education, volunteer opportunities, and in our daily lives. Opportunities for environmental improvements are not limited to Federal Government actions. States, tribes, local communities, and individuals must be included. Over the last 30 years, our Nation has made great progress in providing for a better environment and improving public health. In that time, our economy grew 164 percent, population grew 39 percent, and our energy consumption increased 42 percent. Yet air pollution from the six major pollutants decreased by 48 percent. In 2002, State data reported to EPA showed that approximately 251 million people, or 94 percent of the total population, were served by community water systems that met all health-based standards. This number is up from 79 percent in 1993. Others areas of the environment can also be improved. I have introduced legislation to clean up old abandoned mine sites. While we have done a good job in addressing this problem, we can do better. I have a very simple solution to deal with this problem that will make our communities safer. The United States is holding $1 billion of money due States and tribes to clean up abandoned sites, and deal with problems associated with coal mining activities. The money has already been collected and allocated, but not yet appropriated. There is no justification for Congress to continue to hold this money. States are pleading for help to fix abandoned mine problems that will make communities safer and healthier for their citizens. It is unfortunate their pleas are being disregarded. This is a specific issue where we can make a huge dent in the problem today, right now. I ask Members to listen to the pleas of communities and immediately appropriate the $1 billion due States and tribes. If my colleagues care about the environment and want to clean up these cities, join me and we will get that money released. Let's show the American public that statements made in support of the environment are not political rhetoric and truly reflect the positions and feelings of Members. We can get this done today, and I ask each of you my colleagues to join me in making this happen on Earth Day 2004. There is no doubt that environmental progress is continuing. The facts are unequivocal: Today the Nation's environment is cleaner and healthier than it was 3 years ago. We are getting results more quickly and more substantially by reforming outmoded, command-and-control mandates that hinder environmental progress. We have been able to accomplish this with innovative, market-based approaches that harness the power of technology to achieve maximum environmental benefits.

Mr. THOMAS

Mr. THOMAS. Mr. President, before I talk on the subject I came to talk about, I want to react a little to what has been said in terms of the economy. It is surprising, because the economy has grown substantially, that we find some complaining about it over there. It is not a surprise that the person who pays the most taxes gets a tax cut. That should not be a surprise. The idea is that encouraging business is how you create jobs. But I guess we have a different view of what it is. I think we have a political aspect to what is going on here. This place has become almost like a political rally, when what we ought to be doing is talking about issues. I hope we can do that.

Mr. THOMAS

Mr. THOMAS. Mr. President, this has little to do with the idea of establishing a venue search for various court actions. I would like to address an issue that is very important to all of us, particularly the Western States that have a good amount of public lands. First, there are many suits being filed. People are trying through suits, or the threat of suits, but even worse, if there is a suit, to be able to pick a venue they think is more sympathetic to their point of view than going to the venue in which the issue occurs. That is what I am talking about. That has particularly been the case with environmentalists who have sought to manage public lands and public facilities largely through suits rather than the issues. In recent years, we have been steamrolled quite a bit by Federal issues that go to judges completely out of the area rather than dealing with them in the circuit in which the issue occurs. Specifically, we have had some experience with suits involving issues with Yellowstone Park or Teton Park. We have a circuit court system. We are in the Tenth Circuit. I need to review what I am talking about. The Federal judiciary is set up on a system of circuit courts. It is set up with a number of circuits throughout the country and based on geography. The reason for that, of course, is so everyone has access to the legal system and it is fairly available to them. If you go to a circuit court and you appeal that decision, it goes to the appeals court and then to the Supreme Court. The fact is, the circuit court in Cheyenne, WY, is a Federal court, just as the circuit court in Washington, DC. It certainly is more appropriate to go to them. That is why those circuit courts are there. Our Constitution includes many checks and balances, and the authority for Congress to limit judicial jurisdiction is clearly needed. I have introduced a bill that would provide original jurisdiction to the appropriate court venue in the impacted area for matters involving Federal lands. I cannot continue to watch issues that happen in particular parts of the country--in this case in Wyoming and Montana-- to be taken to a Federal court in Washington, DC, when, in fact, there are Federal courts in our area. That is why they are there. My intent is nondiscriminatory. It simply underscores my strong belief that Federal judges in the area should have the first crack at cases that have a direct impact on that particular area. Certainly that is something on which we need to continue to work. It is a matter, of course, that affects a lot of Federal lands. Half of the State of Wyoming belongs to the Federal Government. It is similar in Arizona and other States in the West. The circuits we are in are the ones that should, in fact, deal with those Federal land issues when the issue is in that particular State. Of course, the appeals go on the same as anywhere else. When I introduced the bill, some folks were shocked and said it was a waste of time. I think it is more shocking to skirt the jurisdiction of judicial courts and venue shop and go somewhere they think will give a better result to the lawsuit that has been filed. The justices need to be fair. Everyone deserves their day in court. Certainly we have an issue now where the local court has been involved at one time, and they went around the local court and went to Washington, DC. We have two courts on the same level with two different points of view on the same issue. It has caused us a great deal of problems. I ask unanimous consent that an article written by Judge Robert Ranck, a retired judge, be printed in the Record.

Mr. THOMAS. Mr. President, I hope we can take a look at the idea of directing these various court activities to the circuit court in which it arises. It seems a reasonable approach. I have introduced a bill to do that, and I look forward to pursuing it. Mr. President, I yield the floor.

Mr. THOMAS

Mr. THOMAS. Mr. President, I would like to announce for the information of the Senate and the public that the following hearing has been scheduled before the Subcommittee on National Parks of the Committee on Energy and Natural Resources: The hearing will be held on Tuesday, April 27, 2004, at 2:30 PM in room SD-366 of the Dirksen Senate Office Building in Washington, DC. The purpose of the hearing is to receive testimony on the following bills: S. 1064, to establish a commission to commemorate the sesquicentennial of the American Civil War, and for other purposes; S. 1092, to authorize the establishment of a national database for purposes of identifying, locating, and cataloging the many memorials and permanent tributes to America's veterans; S. 1748, to establish a program to award grants to improve and maintain sites honoring Presidents of the United States; S. 2046, to authorize the exchange of certain land in Everglades National Park; S. 2052, to amend the National Trails System Act to designate El Camino Real de los Tejas as a National Historic Trail; and S. 2319, to authorize and facilitate hydroelectric power licensing of the Tapoco Project. Because of the limited time available for the hearings, witnesses may testify by invitation only. However, those wishing to submit written testimony for the hearing record should send two copies of their testimony to the Committee on Energy and Natural Resources, United States Senate, SD-364 Dirksen Senate Office Building, Washington, DC 20510-6150. For further information, please contact Tom Lillie at (202) 224-5161 or Sarah Creachbaum at (202) 224-6293.

Mr. THOMAS

Mr. THOMAS. Madam President, I rise today to express our Nation's deepest thanks and gratitude to a special young man and his family. During this past recess, I attended funeral services in Dubois, WY for Marine PFC Chance Phelps. On April 9, 2004, Private First Class Phelps died in the line of duty while serving his country in the war on terrorism. He was shot and killed while fighting insurgents in the town of Ramadi, Iraq, west of Baghdad. Private First Class Phelps was a member of the 3rd Battalion, 11th Marine Regiment, 1st Marine Division. He spent the early years of his life in Dubois, WY before moving to Colorado. He enjoyed the outdoors, hunting and fishing, and was an outstanding athlete. He was good natured, and loved his family and his country. Private First Class Chance had a profound sense of duty that led him to join the United States Marine Corps. He felt deeply compelled to serve and defend his country following the terrorist attacks of September 11. It is because of people like Chance Phelps that we continue to live safe and secure. America's men and women who answer the call of service and wear our Nation's uniform deserve respect and recognition for the enormous burden that they willingly bear. Our people put everything on the line everyday, and because of these folks, our Nation remains free and strong in the face of danger. The motto of the Marine Corps is ``Semper Fidelis.'' It means ``Always Faithful.'' Through his selfless and courageous sacrifice, PFC Chance Phelps lived up to these words with great honor. Private First Class Phelps is survived by his mother Gretchen, his father John, his sister Kelley, and his brothers of the United States Marine Corps. We say goodbye to a son, a brother, a Marine, and an American. Our Nation pays its deepest respect to PFC Chance Phelps for his courage, his love of country and his sacrifice, so that we may remain free. He was a hero in life and he remains a hero in death. All of Wyoming, and indeed the entire Nation are proud of him. So, one Marine to another, Private First Class Phelps, Semper Fi.

Mr. THOMAS

Mr. THOMAS. Mr. President, I rise to speak about where we are, where we are going, and some of the difficulties we are finding in getting there. I was listening earlier as the Senator from New York and the Senator from Illinois were discussing some of the issues they consider to be problems with this administration. They talked about the cost of energy. One of the reasons we are having some problems with the cost of energy is we have not been able to get an Energy bill passed that gives us any direction because it has been obstructed by the other side of the aisle, and it continues to be. So that is not a surprise. They talked a lot about the health care problems. One of the reasons we have health care problems is the obstruction on the other side that will not allow us to move forward with malpractice insurance. The same thing, of course, is true with Medicare. They were critical of doing something with Medicare. I remind my colleagues this is the first time in 30 years we have done something to help change Medicare, and it is going to be implemented over a period of time because there will need to be some changes in it. For the first time, people will be given an opportunity to get pharmaceuticals at less cost, and we will begin to have an opportunity to change Medicare from the way it was originally structured. It is very difficult to do that with the obstruction on the other side. It is frustrating to be in the Senate where we are supposed to be making decisions, supposed to be moving forward. We do not all agree, that is certainly true, but we do have a system that allows us to go forward. That is what votes are for, but we cannot take votes. We continue to sit here and only talk about things. I am particularly interested in the energy issue, of course. I think it is certainly one that we have talked about for a very long time. It now becomes more important because of the cost increases, because of the difficulties we are having with energy. It begins to be more apparent that we need to have an energy policy that has some plans for where we go over the next 5 or 10 years. We need to do that as soon as we can. One of the things the Bush administration, Vice President Cheney and the President, did was to seek to have an energy policy. All we have heard are complaints and criticisms and still there is obstruction to having an energy policy, when it is so clear that that is precisely what we need to have. We have higher gas prices at the pumps, partly because OPEC has backed off somewhat, but also because we have made it necessary for refiners to put into place about 18 different combinations of fuel. There have been unexpected disruptions from Venezuela and elsewhere. We are having higher home heating bills because of the stress on natural gas where the consumption is going up much faster than the production, and it is predicted to do that in the future for some time. So we are still talking about these issues. People are more aware of them because of the blackout, because of the cost, and because of the difficulties. So we need to make some changes, but we need a policy. We are not talking about all that we can do instantly. We are saying we need a general policy, and that is what this policy is. It has to do with alternative sources. It has to do with efficiency. It has to do with conservation. It has to do with more research so that, for instance, there can be more clean coal burned. Today, the Wall Street Journal said finally people are saying we are having trouble with natural gas because of the demand, but coal is the fuel that we have with the most fossil reserves in this country, and we can do it in a clean way. Particularly, western coal is low in Btu and low in C02. We need to be moving in that direction. We need a balanced bill, and there are things we can do to accomplish that. We are going to have to change the fuels over a period of time. Some, particularly on the other side of the aisle, say: Oh, well, we have to start using alternatives up to 40 percent in the next 5 years. Right now, of all of our energy production, 3 percent is produced by alternatives such as wind. We can do much more in the future, and we hope that we do, but we cannot turn that corner right away. It is a very difficult thing to do.

Mr. THOMAS. Mr. President, I certainly urge that we stop obstructing and move forward with an energy policy. I yield the floor.

Mr. THOMAS

Mr. THOMAS. Mr. President, I rise today to talk about the issue before the Senate. The previous comments this morning sounded like a political rally. We ought to talk about the issues before the Senate instead of spending all our time criticizing the President. We have before the Senate welfare reform, to extend what we have done in the past. Welfare reform has been a remarkable success story for millions of people. Welfare reform is working because former recipients are working. Families once dependent on welfare checks are now looking forward to the independence of a paycheck. That, of course, has been the purpose of the program. Through the years it has been very successful. This bill deals with the effort to provide meaningful work and more opportunity for welfare recipients to move off welfare, to promote healthy families, to provide opportunity for health and marriage programs, to give States the flexibility to continue to work on the programs they have had. We are very pleased this is now before the Senate. As a Finance Committee member who has worked on this for a very long time, it is something that we need to pass and make available to people in this country. The legislation before the Senate, H.R. 4, the Personal Responsibility and Individual Development for Everyone Act, makes the necessary changes in existing law to make it even more of a success. America began a war on poverty more than three decades ago. However, the good intentions of that policy produced conflicting results. Seniors were lifted out of poverty, poor families received basic health care, and disadvantaged children were given a head start in life. Many Americans were injured by that helping hand. The welfare system actually became an enemy of individual efforts and responsibility. As dependence passed from one generation to the next, the vicious welfare cycle began for some families. Between 1965 and 1995, Federal and State welfare spending increased from $40 billion to more than $350 billion per year. However, all this money produced virtually no progress in reducing child poverty. In August 1996, Congress passed a progressive welfare reform law that transferred welfare benefits into temporary help, not into a permanent way of life. The new system honors work by requiring all able-bodied recipients to work or go back to school to further their education. The goal of the 1996 welfare reform law was to give participants a strong, time-limited support system as they developed long-life skills that encourage independence. That is the purpose of this entire program. It has been successful. It provides childcare funding to help families meet the work requirements while limiting the benefits to 5 years. States must promote self-sufficiency. They are given the flexibility to reach that goal. The following results of the 1996 landmark welfare reform bill speak for themselves. From August 1996 to June 2003, the number of families on welfare fell from 4.4 million to 2 million, a 54-percent decline. In the same time period, the number of individuals fell from 12.2 million to less than 5 million, a decline of 60 percent. From 1996 to 2002, child poverty went from 20.5 percent to 16.7 percent. This represents a reduction of over 2.3 million poor children. Child poverty rates among African Americans and Hispanics were at or near record low levels. The percentage of never married working mothers increased from 49.3 in 1996 to 65 percent in 2002. Childcare funding has continued at record levels. Let me say that again: Childcare funding has continued at record levels. We are going to be faced with a resolution shortly to increase that. The fact is, we have had ample dollars in the past. We have fewer people now and all different kinds of programs going into that. I hope we do not add $6 billion to the cost of the program. State and Federal funding for childcare from the childcare development block grant, TANF, and social services block grant increased from $3.2 billion in 1996 to $11.8 billion in 2003. In 2003, an estimated 2.5 million children will receive subsidized childcare from these funding sources. From 1996 to 2003, child support collections increased from $12 billion to $21 billion. This demonstrates a pattern of success, moving people in the direction this was designed to move them. Wyoming, my home State, has had particularly good luck. In the wake of these changes, welfare reform has been phenomenal. In fact, the number of individuals receiving assistance has dropped approximately 90 percent since 1994. This was accomplished with total weekly hour requirements of work of 40 hours, which is above and beyond the current law. That is what is in the reauthorization bill before the Senate. Last year, Wyoming received a $19.9 million bonus for reducing the out-of-wedlock birth rate. Wyoming also has over $30 million in reserve funds they are able to use when this bill is passed. This increased flexibility will not only help my State keep folks off the welfare rolls, but provide assistance to childcare and other expenses while continuing on their path of self- sufficiency. I am very proud of my State's success. Our experience proves welfare reform is a strong and comprehensive policy to uplift and empower people to be able to earn for themselves. I am encouraged by the initial results of welfare reform, but there is still a lot of work to do. I support the chairman's bill because it does the following: It increases work hours to 34. This is better to prepare recipients for full-time employment. I would like to see that number of work hours be increased to 40. Wyoming has made that work well. This creates a partial credit system for States doing everything they can to make this even better. We have increased childcare spending by $1 billion over 5 years. It allows the States to use Federal money no longer used on cash assistance. Increased flexibility allows for more activities. I hope we move this out of committee. We have been deferring it by extending the old bill. We need to put the new bill into place. We need to stop the uncertainty for the States as to what we are doing. I thank Chairman Grassley for his leadership. I hope we can move this week to conference and keep our commitments to equip TANF recipients with the skills they need to take care of themselves and their families. I yield the floor.

Mr. THOMAS

Mr. THOMAS. Mr. President, I would like to announce for the information of the Senate and the public that the following hearing has been scheduled before the Subcommittee on National Parks of the Committee on Energy and Natural Resources: The hearing will be held on Tuesday, April 8, 2004, at 2:30 p.m., in room SD-366 of the Dirksen Senate Office Building in Washington, DC. The purpose of the hearing is to review the National Park Service concessions program, including implementation of the National Park Service Concessions Management Improvement Act of 1998. Because of the limited time available for the hearings, witnesses may testify by invitation only. However, those wishing to submit written testimony for the hearing record should send two copies of their testimony to the Committee on Energy and Natural Resources, U.S. Senate, SD-364 Dirksen Senate Office Building, Washington, DC 20510- 6150. For further information, please contact Tom Lillie at (202) 224-5161 or Sarah Creachbaum at (202) 224-6293.

Mr. THOMAS

Mr. THOMAS. Mr. President, I take a few minutes today to talk about an issue I am sure we are all concerned about and interested in. As I go about Wyoming and talk to people, particularly in town meetings, the issue that arises most often and with the most passion is the high cost of health insurance. The cost of health insurance is directly related to the cost of health care. What we hear the most about is from people who are in private business, farmers and ranchers, who provide all of their own health care costs, which have become increasingly prohibitive. It seems to me we are going to have to focus properly on Medicare, Medicaid, veterans, those government programs for which we are responsible. I suggest we need to focus now and begin to take a look at the broader picture of health care. We have a system that has available certainly some of the best health care in the world, but the key is to have access. If the cost limits access, we have a problem. We have some unique features in Wyoming. Because of a small population, we cannot have all the various professional services in every small town. There has to be a system. We have worked at that. There are several hospitals with the different kinds of specialties that help serve communities. We have had more and more critical access facilities which make it easier for small communities to work. I visited Dubois, WY, this week, a new clinic to a small town. I also met with a group of physicians and hospital operators in Cheyenne. We talked about some of these issues. Before it was over, these professionals, these providers, indicated they agree this system is broken and there needs to be some kind of change made in the future. I don't know the answer. I don't know that anyone yet knows the answer. I suggest to my fellow Members of the Senate and the House, we need to begin to take a look. If I can start out by saying I am not one who favors a Federal socialized medicine program, we need to find some ways to do something with what we have now. National health expenditures grew $1.6 trillion in 2002, a 9.3- percent increase over the previous year. The costs of health care generally have gone up 15 percent a year for several years. It is hard to sustain 15-percent growth, particularly when, increasingly, health care for families is a relatively large portion of expenditures. Health care as a share of GDP in 2002 was 14.9 percent, up from 14.1 percent in 2001. So we are seeing substantial increases. And over the years those increases have continued. So one has to ask, if the costs are going up 15 percent a year, how long can you sustain that? What do we need to do? Folks are seeing double-digit premium increases each year, including Federal employees. So it is quite obvious to me that we cannot continue to grow rates at that level. I indicated I had talked to some folks who certainly agree we need to deal with that. We face more challenges in the health care system than just reforming the public programs or addressing the nearly 42 million people--15 percent--who do not have health insurance. There are some things, of course, we need to consider. We need to improve the underlying health care infrastructure. Its rising costs affect all of us. I think we have to take some of the responsibility for fixing that system. We have a health care system today where, for instance, hospital charges do not reflect the actual costs because of public and private insurance reimbursements. I recently met with a hospital CEO in my hometown. At that hospital they had some very interesting topics they talked about. Their gross charges, for example, were $202 million; $80 million was written off; $120.7 million reflects actual costs; $1.4 million was income from insurance, and they had $3.3 million in other income. This is not a large profit margin. What does that mean? No. 1, Medicare does not pay to the level of actual costs. Now, you may say, well, we need to keep the cost of Medicare down. That is true. On the other hand, if their payment is not equal to the cost, then someone else has to bear the cost; Medicaid even more so. Medicaid pays even a smaller percentage of the actual cost than does Medicare. This is a combination, of course, of State and Federal programs. So we find that situation. Charity, for those who are uninsured, for those who come in and are not able to pay, we still take them, of course. Trauma care, sometimes, is reimbursed by the county or the State. But if someone has an accident and arrives at the hospital, they are given care, of course, whether they have the ability to pay, whether they have insurance. And guess who pays the principal cost of that. Those who have insurance. People who are insured represent about 35 percent of the people in a hospital, but they pay 98 percent of the cost. So what we are doing basically is taking the costs that are there, and those who have commercial insurance are paying a very large percentage of that cost. Therefore, we are shifting costs from the broad user base to a relatively small group who buy insurance, which causes the private insurance to be higher. So there are some weaknesses there. Certainly, we have to do something about it. Health providers must shift this cost to private insurance or they do not make it up. Emergency room costs, of course, are extremely expensive. They are used a great deal, particularly with Medicaid where there is no first- dollar payment by anyone. When anything goes wrong for someone who is under Medicaid, they can go to the emergency room because it does not cost anything. Of course, we pay the highest prices for prescription drugs and shoulder the research and development costs for much of the rest of the world. I think most of us are working on that issue. I think we are going to have a hearing next week in the Finance Committee to see if there is any relationship in terms of the trade aspect of it--with Canada, for example, where you can send goods from this country that cost a certain amount, and the Government up there says they will cost less. Is that part of a trade problem? I think it is something we ought to talk about. Also, of course, one of the things we have tried to fix--and I hope we continue to try to do something about it--is putting a limit on noneconomic damages for liability in health care. We have tried to pass that. We tried to pass it in the Wyoming Legislature. I think, hopefully, they will continue to do that. But what it has done in our State--and I think in a number of other States--is it certainly has raised the costs because the cost for malpractice insurance for practioners has gone up a great deal. It has also caused some practitioners, particularly OB/GYNs, to not serve any longer. Again, in a State such as ours, where there may be just one provider in a community, if that person does not provide services, then there is no one there and people have to go miles and miles to find care. So it has a great impact. Not only is it the impact of increased costs to the provider, which he or she passes on to his or her patients, but it also has caused practices to be quite different and to be overly general about care. A number of years ago, if you hurt your arm, you would go to a general practitioner, he would fix it, put a cast on it, and you would go home. Now you would go in and: Oh, my gosh, you hurt your arm? You better see an arm specialist. We need to take some tests. We need to have an MRI and a few other things--all of which make care more expensive than it used to be. Some of that cost is simply for protection against malpractice lawsuits. So that is one of the things we can do. We are seeing more and more small businesses being unable and unwilling to help provide health care for their employees. So there are all kinds of different problems that have arisen. I think people, also, are probably less responsible for their own health. This idea that we should take care of ourselves a little better to avoid sickness--everyone agrees with that idea, but not everyone participates in that. So, again, we have some things that could be changed. I met a gentleman who is promoting a new program, running a new program called Be-well. It is a program for employers who create health contracts with their employees under the proposition that the employer says to the employee: I am willing and able to cover your health care expense, your insurance expense. However, you must agree to do some things for your own health. You need to agree to exercise. You need to agree to do some things. You need to agree to this Be-Well program. Most everyone agrees with that idea, but often there is not any real incentive to do that. This program provides an incentive to people to be more responsible for themselves. So we face some real challenges. Physicians and providers are retiring earlier because of some of these pressures. Hospital vacancy rates for registered nurses, radiology technicians, and pharmacists have reached more than 10 percent. There are a number of hospitals that face rather severe shortages. We are also facing dental shortages. Again, in low population States, we are seeing the dental providers becoming an older group. Many are soon to retire. Frankly, there are not enough people standing in line waiting to replace them. We are working on trying to get a multistate dental training arrangement and also urging some assistance for underserved areas in this area as well. So what I am interested in seeing is if we can start a little dialog on the broader issues that affect health care and health care costs and the ability to have access to health care for people in this country. I will continue to work on this issue. We have been very involved in our office on rural health care. We are very pleased with some of the things that were done in the bill that we passed last year for Medicare. I was very pleased that we passed that bill. To be sure, it is not finalized, but it is a first step in 30-some years to begin making changes. So we have had changes taking place with people but not a lot of changes in terms of how we provide health care. Last year we had a forum on rural health care which is a little unique, but some of the problems are the same. We began to discuss those problems and to look to the future. That is what we have to ask, what is health care going to look like 5 or 10 years from now, if we can make that sort of projection, and then begin to look at what we can do to get where we want it to be rather than where we think it will be if we do nothing. There are some ideas out there. I don't suggest they are all the best, but some are being talked about--tax credits to have a medical setaside for payments that you could keep tax free and then use it. In many cases you could use it for the first dollar cost, and then all you have to buy is a higher level insurance, which is much cheaper, catastrophic insurance, rather than the first low dollar, which is much more expensive. We are going to be working on a better medical savings program. Association health plans have been talked about. The idea of insurance is to get enough people into the package so you can level out the cost between those who are less healthy and those who are more healthy. But if you do not have large numbers, that doesn't happen. There is some objection to that in terms of the States. I am not necessarily supporting all these ideas. But, for example, if you were a service station operator, you could be part of a national service station operators insurance program. Some have talked about the idea that everyone, even if they had to be helped, should have insurance. We require insurance on your car. We don't require it, but somebody else has to pay for it. So that is something we should talk about. Better education efforts for consumers to make healthier choices, certainly that is something we ought to take seriously. As I mentioned, medical malpractice reform is clearly something we ought to do. We, obviously, have been blocked in the Senate from doing that. There are a lot of issues we need to look at, and they deal with where we are going to be in a few years and where we are now. But we will be worse off in a few years unless we begin to deal with some of those issues. I appreciate the time and look forward to continuing to have the debate. I yield the floor.

Mr. THOMAS

Mr. THOMAS. Mr. President, I will make some comments in morning business. First of all, I had the privilege this morning of attending a meeting of Marines, which we have periodically, and I was very pleased to listen to a report from the commandant about the current situation in Iraq and Afghanistan. Certainly, he is very pleased with what is happening there with regard to our military, what they are able to do and accomplish there. We do not hear much about the good stuff that is going on. We hear, of course, the news on bad things. It was an excellent report. Certainly we are very proud of our Marines and all of our service personnel there.

Mr. THOMAS

Mr. THOMAS. Mr. President, I agree with the Senator from Alaska. Having worked for several years on this Energy bill, it seems to me there is nothing more timely than to move forward. This is a policy. We think it is for tomorrow, but it is looking forward. It is a balanced policy that has alternative fuels. It has clean air. It has conservation and efficiency, as well as domestic production. We need to do this. I hope we move forward.