Ron Wyden

Mr. WYDEN

Mr. WYDEN. Mr. President, parliamentary inquiry: I believe I have time reserved at this point. I was going to speak for a little over 20 minutes or so. I would like to inquire through the Chair of my colleagues if they wish to finish their remarks before I go to mine.

Mr. WYDEN

Mr. WYDEN. Mr. President, I rise today to bring to light an important issue which threatens our national security and begs the attention of Congress. The legislation I propose today seeks to end the Iranian government's acquisition of sensitive military equipment by blocking the Pentagon's sale of F-14 fighter jet parts. It is the sensitive job of the Department of Defense to demilitarize and auction off surplus military equipment. However, recent investigations and reports have uncovered a frightening trend regarding the sale of F-14 ``Tomcat'' aircraft parts. U.S. customs agents have discovered F-14 parts being illegally shipped to Iran by brokers who bought F-14 surplus equipment from Department of Defense auctions. Other than the United States, Iran is the only Nation to fly the F- 14. The U.S. allowed Iran to buy 79 F-14s before its revolution in 1979. Fortunately, most of Iran's F-14s are currently grounded for lack of parts. We know that Iran is pursuing a nuclear weapons capability. We know that the Department of State has identified Iran as the most active state sponsor of terrorism. We know that the sale of spare parts for F- 14s could make it more difficult to confront the nuclear weapons capability of Iran. And yet F-14 parts are still being sold by the DoD. Iran's F-14s, especially with the parts to get more of them airborne, greatly strengthen its ground war potential, harming our national and global security. Our country should be doing everything possible to deny the brutal regime in Tehran access to spare parts for their F-14 fleet. The Department of Defense will tell you that it is already taking action to control the sale of F-14 parts. A few times a year they change the restriction on the sale of F-14 parts. But history has shown us that these rules are not enough. The Department has been caught still selling F-14 parts, even when its rules forbid it. It has sold F- 14 parts to companies that have turned out to be fronts for the Iranians. More recently, the DoD sold sensitive technology, including classified F-14 parts to undercover GAO investigators. My intention with this bill is to make it crystal clear to the Department of Defense that it may not sell any F-14 parts to anyone for any reason. There should be no chance for the parts to make their way to the Iranians. Additionally, my bill would prohibit the export of any F-14 parts that have already been sold. This prevents the parts from ending up in Iran through even the most roundabout route. I am not trying to reform the entire military surplus sales process. I am confident that the Armed Services Committee will continue its investigations and propose some much needed changes. My bill would simply fix a very specific, but very important, problem: the sale of F- 14 components that end up in the hands of Iran. I urge the members of the Senate to support this bill. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, I rise today to bring to light an important issue which threatens our national security and begs the attention of Congress. The legislation I propose today seeks to end the Iranian government's acquisition of sensitive military equipment by blocking the Pentagon's sale of F-14 fighter jet parts. It is the sensitive job of the Department of Defense to demilitarize and auction off surplus military equipment. However, recent investigations and reports have uncovered a frightening trend regarding the sale of F-14 ``Tomcat'' aircraft parts. U.S. customs agents have discovered F-14 parts being illegally shipped to Iran by brokers who bought F-14 surplus equipment from Department of Defense auctions. Other than the United States, Iran is the only Nation to fly the F- 14. The U.S. allowed Iran to buy 79 F-14s before its revolution in 1979. Fortunately, most of Iran's F-14s are currently grounded for lack of parts. We know that Iran is pursuing a nuclear weapons capability. We know that the Department of State has identified Iran as the most active state sponsor of terrorism. We know that the sale of spare parts for F- 14s could make it more difficult to confront the nuclear weapons capability of Iran. And yet F-14 parts are still being sold by the DoD. Iran's F-14s, especially with the parts to get more of them airborne, greatly strengthen its ground war potential, harming our national and global security. Our country should be doing everything possible to deny the brutal regime in Tehran access to spare parts for their F-14 fleet. The Department of Defense will tell you that it is already taking action to control the sale of F-14 parts. A few times a year they change the restriction on the sale of F-14 parts. But history has shown us that these rules are not enough. The Department has been caught still selling F-14 parts, even when its rules forbid it. It has sold F- 14 parts to companies that have turned out to be fronts for the Iranians. More recently, the DoD sold sensitive technology, including classified F-14 parts to undercover GAO investigators. My intention with this bill is to make it crystal clear to the Department of Defense that it may not sell any F-14 parts to anyone for any reason. There should be no chance for the parts to make their way to the Iranians. Additionally, my bill would prohibit the export of any F-14 parts that have already been sold. This prevents the parts from ending up in Iran through even the most roundabout route. I am not trying to reform the entire military surplus sales process. I am confident that the Armed Services Committee will continue its investigations and propose some much needed changes. My bill would simply fix a very specific, but very important, problem: the sale of F- 14 components that end up in the hands of Iran. I urge the members of the Senate to support this bill. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. To wrap up briefly, Senator Smith has stated it well. I am very honored to represent Oregon in the Senate. I have been able to get into a host of issues that I think are important, particularly as a member of the Finance Committee, to fix health care and fix the out-of- whack American tax system. I serve on the Intelligence Committee. But Senator Smith and I have said this is our most important issue for our State for this session because, without this funding, there is a real question about whether these local communities can hang on. They simply have no other options. You are not going to be able to go to a small resource-dependent community in eastern Oregon and set up a biotechnology company in the next few weeks. It is not going to happen. I support those kinds of industries and economic development, as does my colleague. It has been a big part of our bipartisan agenda. But we are talking about survival for these rural communities. This will be our top priority for this session. This has also made a great contribution in terms of bringing together people of differing views on natural resources. As part of the legislation that I authored with Senator Craig a number of years ago-- as Senator Smith has noted--we set up resource advisory committees so that you now have folks in the timber industry talking to environmentalists who in the past were, for the most part, spending their days in the courthouses suing each other. Now they are working together to cooperate through the legislation that we have put in place. This has been recognized as a wildly successful natural resources law, bringing about cooperation that, prior to this law going into effect, was seen virtually nowhere. It is a stable, consistent source of funding for communities that have nowhere else to turn, affecting communities in 39 States, but it is also a program that has brought together a unique kind of cooperation between people in the natural resources area who in the past would spend an awful lot of time running what I call a lawyers full employment program, essentially suing each other in the Federal courthouse. We are going to be back on the floor for whatever number of times it takes to get this program reauthorized and take these rural communities off this roller coaster. They ought to be able to know that they can survive, and they can survive as they have over many years through a program that was tied to the unique consideration that the Federal Government owns most of our land. That is what this is all about. This is different than how people may pay for schools and roads and essential services in parts of the eastern United States where there is little Federal ownership. We ask that the Senate not ignore the plight of rural America, particularly the rural West, as we continue forward with the legislative calendar. Amendment No. 104 Withdrawn I ask unanimous consent that this bipartisan amendment be withdrawn. We will be back another day. But I ask unanimous consent that the amendment I have offered be withdrawn.

Mr. WYDEN. I thank my colleague for his comments and his thoughtfulness. Before I make my concluding remarks on our amendment, I ask unanimous consent for Senator Jack Reed to speak after I have concluded.

Mr. WYDEN. Madam President, in much of our country that is dependent on natural resources, there is a world of hurt today. There are tremendous concerns in many of our rural communities about how we are going to finance their schools and roads. In my State, more than 50 percent of the land is owned by the Federal Government. So we are not in a position to pay for schools and roads and essential services the way much of the rest of the country does because there, through transactions that occur on private property, they are able to generate the funds they need to pay for essential services. When Senator Smith and I go home, we are faced with a very different situation. Because a law I wrote a number of years ago with Mr. Craig, the distinguished Senator from Idaho, expired at the end of the year, we are seeing a number of our local communities face Draconian cuts in essential services. The layoff announcements are going on right now as local districts and local communities come together and wrestle with how they are going to make the difficult choices with respect to funding essential services. Cuts in excess of 70 percent of discretionary funding are going to cripple one of our counties in rural Oregon, southern Oregon, Douglas County, which currently receives about 43 percent of its annual budget from the law I authored with Senator Craig. Another of our counties, Jackson County, again in southern Oregon, is prepared to shut down all of its libraries. That will be coming up very shortly. In Curry County, they are looking at the prospect of laying off all nonessential workers, including patrol officers, some of whom would be left to perform only the mandated corrections duties. By June, 20 percent of the county workforce in Curry County will have been cut. So it is not clear with these cuts whether the county will even be able to continue to be a county, as it will not be able to provide a minimum level of services. Road department levels are going to be reduced in areas such as Josephine County and Linn County. I am going to be having community meetings this weekend on the Oregon coast. Tillamook County is looking at layoffs in the sheriff's department and cuts to its road maintenance, jeopardizing roads that are critical to getting sawlogs to the mills and having family-wage jobs for workers in my State. Senator Feinstein and Senator Boxer join me in this. There are stories like this from across the country. Over 700 counties in 39 States have received critical funding from the county payments program. The fact is, in a State such as ours, where the Federal Government owns more than 50 percent of the land in many of these small communities with tiny populations, they are not going to be able to make it without these funds that are a lifeline in terms of law enforcement and schools and essential road and transportation services. This is my top priority--my top priority--for my State in this session, to try to make sure these funds are reauthorized. In this particular amendment, Senator Smith and Senator Boxer and Senator Feinstein and I want to reauthorize the program for 1 year. But I am also introducing legislation for a long-term reauthorization because I think we ought to get these counties off the roller coaster once and for all. This is based on an approach that was adopted many years ago with States that had widespread Federal ownership getting funds that related to timber receipts. As a result of the environmental laws, those receipts went down, and we needed this law to ensure that those counties would survive. So the county payments legislation is supported by a diverse coalition, including the National Association of Counties and a number of labor organizations. If Senators, particularly in rural communities, look now--as I have been in townhall meetings and other kinds of gatherings--at how we are going to support schools and roads and basic local government, I would only say that without this program, this will hit local communities like a wrecking ball. It is something that should not be abided by this Senate. I see my colleague from Oregon, my partner in this and many other issues, standing, and I would like to yield at this time. After Senator Smith has completed his remarks, I will wrap up very briefly. I would also note that Senator Reed was here earlier, and I was not aware that he was in the queue as well, and I want him to be able to speak soon in a way that is convenient for him. So I yield the floor.

Mr. WYDEN. Madam President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. WYDEN. Madam President, if the distinguished Senator from Colorado is finished, I ask unanimous consent to set aside his amendment and call up an amendment I offer with Senator Smith and Senator Feinstein and Senator Boxer and ask for its immediate consideration.

Mr. WYDEN. Madam President, I ask unanimous consent to be able, after Senator Smith and Senator Allard have offered their amendments, and also Senator Reed, who was here earlier than I, to be able to offer a bipartisan amendment on a matter of critical importance to all from timber-producing States that deals with funding for schools and roads. I ask unanimous consent to be able to offer that bipartisan amendment after Senator Smith has offered his amendment, after Senator Allard has offered his amendment and after Senator Reed has had an opportunity to speak.

Mr. WYDEN

Mr. WYDEN. Mr. President, it has been more than a decade since the U.S. Senate last addressed fixing health care. I do not think it is morally right for the Senate to duck on health care any longer and that is why I am proposing legislation today to provide affordable, guaranteed, private health coverage for all Americans. The legislation, called the Healthy Americans Act, ensures care for the 46 million Americans who now live without health insurance, frees business owners from the skyrocketing costs of insuring their workers, and promises every American health care coverage that can never be taken away. My proposal is fully paid for, holds down health care cost growth in the future and provides coverage just like Members of Congress can get now. America spent $2.2 trillion on health care last year. PriceWaterhouseCoopers expects premiums will increase 11 percent this year alone and I believe the American health care system as we know it is not sustainable. Our current employer-sponsored health insurance system is a historic accident. In the 1940s, employers needed a way to attract workers as wage and price controls continued. Our country needs a uniquely American solution that works for an economy that is competing not just with the company across town but the company across the world. Americans need a health care system that works for individuals and families, and encourages people to stay healthy instead of only seeking care after they are sick. The Healthy Americans Act does this and more. It doesn't take long to explain how the Healthy Americans Act works. From the first day individuals, families and businesses win. The Healthy Americans Act cuts the link between health insurance and employment altogether. Under the Healthy Americans Act, businesses paying for employee health premiums are required to increase their workers' paychecks by the amount they spent last year on their health coverage. Federal tax law is changed to hold the worker harmless for the extra compensation, and the worker is required to purchase private coverage through an exchange in their State that forces insurance companies to offer simplified, standardized coverage, with benefits like a Member of Congress gets, and prohibits insurers from engaging in price discrimination. Requiring employers to cash out their health premiums, as I propose in the Healthy Americans Act, is good for both employers and workers. With health premiums going up 11 percent this year, employers are going to be glad to be exempt from these increases. With the extra money in their paycheck, workers have a new incentive to shop for their health care and hold down their cost. If a worker can save a few hundred dollars on their health care purchase, they can use that money for something else they need. In addition, the Healthy Americans Act is easy to administer and guarantees lifetime health security. Once you have signed up with a plan through an exchange in the State in which you live, that is it; you have completed the administrative process. Even if you lose your job or you go bankrupt, you can never have your coverage taken away. Sign up, and the premium you pay for the plan and all of the administrative activities are handled through the tax system. For those who cannot afford private coverage, the Healthy Americans Act subsidizes their purchases. Businesses that have not been able to afford health coverage for their workers, under the new approach, will pay a fee--one that is tiered to their size and revenue, with some paying as little as 2 percent of the national average premium amount per worker for that basic benefit package. It will be easy to administer, locally controlled, with guaranteed coverage as good as your Member of Congress gets. The Lewin Group has costed out my proposal and reports that it is fully paid for and in addition to expanding coverage for millions of people, guaranteeing health benefits as good as their Member of Congress gets, it also saves $4.5 billion in health spending in the first year. Money is saved by reducing the administrative costs of insurance, reducing cost shifting, and preventing those needless hospital emergency room visits. Also, there are substantial incentives that come about because insurance companies would have to compete for the business of consumers, who would have a new incentive to hold down health costs. There are other parts of the Healthy Americans Act I wish to describe briefly. As the name of the legislation suggests, I believe strongly that fixing American health care requires a new ethic of health care prevention, a sharp new focus in keeping our citizens well, and trying to keep them from falling victim to skyrocketing rates of increase in diabetes, heart attack, and strokes. Spending on these chronic illnesses is soaring, and it is especially sad to see so many children and seniors fall victim to these diseases. Yet many Government programs and private insurance devote most of their attention to treating Americans after they are ill and give short shrift to wellness. Under the Healthy Americans Act, there will be for the first time significant new incentives for all Americans to stay healthy. They are voluntary incentives, but ones that I think will make a real difference in building a national new ethic of wellness and health care prevention. Parents who enroll children in wellness programs will be eligible for discounts in their own premiums. Instead of mandating that parents take youngsters to various health programs--and maybe they do and maybe they don't--the Healthy Americans Act says when a parent takes a child to one of those wellness programs, the parent would be eligible to get a discount on the parent's health premiums. Under the Healthy Americans Act, employers who financially support health care prevention for their workers get incentives for doing that as well. Medicare is authorized to reduce outpatient Part B premiums so as to reward seniors trying to reduce their cholesterol, lose weight, or decrease the risk of stroke. It has never been done before. For example, Part B of Medicare, the outpatient part, doesn't offer any incentives for older Americans to change their behavior. Everybody pays the same Medicare Part B premium right now. The Healthy Americans Act proposes we change that and ensures that if a senior from Virginia or Oregon or elsewhere is involved in a wellness program, in health care prevention efforts, like smoking cessation, they could get a lower Part B premium for doing that. The preventive health efforts I have described are promoted through new voluntary incentives under the Healthy Americans Act, not heavy- handed mandates. What this legislation says is--let's make it more attractive for people to stay healthy and change their behaviors to promote the kind of wellness practices we all know we should do but need an incentive to follow. Finally, and most importantly, the Healthy Americans Act does not harm those who have coverage in order to help those who have nothing. The legislation makes clear that all Americans retain the right to purchase as much health care coverage as they want. All Americans will enjoy true health security with the Healthy Americans Act, a lifetime guarantee of coverage at least as good as their Member of Congress receives. A recent ``Health Affairs'' article pointed out that more than half of the Nation's uninsured are ineligible for public programs such as Medicaid, but do not have the money to purchase coverage for themselves. At present, for most poor people to receive health benefits, they have to go out and try to squeeze themselves into one of the categories that entitles them to care. Under the Healthy Americans Act, low-income people will receive private health coverage, coverage that is as good as a Member of Congress gets, automatically. Like everyone else, they will sign up through the exchange in their State. When they are working, the premiums they owe are withheld from their paycheck. If they lose their job, there is an automatic adjustment in their withholding. In addition, under the Healthy Americans Act, it will be more attractive for doctors and other health care providers to care for the poor. Those who are now in underfunded programs, such as Medicaid, are going to be able to have private insurance that pays doctors and other providers commercial rates which are traditionally higher than Medicaid reimbursement rates. Because low-income children and the disabled are so vulnerable, if Medicaid provides benefits that are not included in the kind of package Members of Congress get, then those low-income folks would be entitled to get the additional benefits from the Medicaid Program in their State. The Healthy Americans Act also makes changes in Medicare. As the largest Federal health program, Medicare's financial status is far more fragile than Social Security. Two-thirds of Medicare spending is now devoted to about 5 percent of the elderly population. Those are the seniors with chronic illness and the seniors who need compassionate end-of-life health care. The Healthy Americans Act strengthens Medicare for both seniors and taxpayers in both of these areas. In addition to reducing Medicare's outpatient premiums for seniors who adopt healthy lifestyles and reduce the prospect of chronic illness, primary care reimbursements for doctors and other providers get a boost under the Healthy Americans Act. Good primary care for seniors also reduces the likelihood of chronic illness that goes unmanaged. This reimbursement boost is sure to increase access to care for seniors--and I see them all over, in Oregon and elsewhere--who are having difficulty finding doctors who will treat them. To better meet the needs of seniors suffering from multiple chronic illnesses, the Healthy Americans Act promotes better coordination of their care by allowing a special management fee to providers who better assist seniors with these especially important services. Hospice law is changed so that seniors who are terminally ill do not have to give up care that allows them to treat their illness in order to get the Medicare hospice benefit. In addition, the Healthy Americans Act empowers all our citizens wishing to make their own end-of-life care decisions. The legislation requires hospitals and other facilities to give patients the choice of stating in writing how they would want their doctor and other health care providers to handle various end-of- life care decisions. When I announced the Healthy Americans Act last December, I stood with an unprecedented coalition of labor and business. Andy Stern, president of SEIU said ``It is time for fundamental, not incremental change and Senator Wyden has a plan that is practical and principle, and sets down a moral test'' 'Why doesn't every American have the right to the same health care as the President, the Vice President, 535 members of Congress and 3 million Federal workers?' '' Steve Burd, the CEO of Safeway, a Fortune 50 company that has focused on prevention and wellness, called the Healthy Americans Act ``an innovative proposal that lays a foundation to begin a serious discussion on health care reform in this country.'' Ron Pollack of Families USA, listed the principles embodied in the Healthy Americans Act that he believes are important: universality; subsides to make the coverage affordable; community rating rules so the sicker and older are not priced out of the market; and benefits like a Member of Congress has today. Also at my press conference was Mike Roach, of Portland, OR, a 30- year member of National Federation of Independent Businesses. He owns a clothing store in Portland and employs eight people. He believes the Healthy Americans Act will help him attract good employees. And Bob Beal, president of Oregon Iron Works, an Oregon-based company that competes internationally, believes that we must also address the skyrocketing health care costs that make it harder for companies like his in the international market place. Like me, the people who stood by me when I announced the Healthy Americans Act believe we need to move the health care debate forward and cannot afford to let more time to go by. The last time Congress took a serious look at reforming health care, there wasn't anything resembling this kind of coalition of labor, business, low-income and end-of-life advocates standing together to call for action. In tackling one-seventh of the economy, invariably technical issues arise. I want to thank many people who have assisted along the way. Len Nichols of the New America Foundation sent me e-mails at 2 in the morning that helped refine provisions. John Sheils, Randy Haught and Evelyn Murphy of the Lewin Group assisted in telling us our numbers worked or didn't. The Congressional Research Service staff followed up on questions from the common to the obscure. That group included: Bob Lyke, Jeanne Hearne, April Grady, Julie Whitaker, Christine Scott, Chris Peterson, Richard Rimkunas, Karen Trintz, Julie Stone and Andrew Sommers. The Senate Legislative Counsel staff translated the ideas and concepts into legislative language. They devoted an enormous amount of time in getting the ideas and the language right. I'd like to thank Mark Mathiesen, Mark McGunagle, Bill Baird, John Goetcheus, Stacy Kern- Sheerer, Kelly Malone and Ruth Ernest for their patience and extraordinary effort. On my staff, Joshua Sheinkman, my legislative director and Jeff Michaels, my administrative assistant, were instrumental in completing the tax and business sections of the bill. Emily Katz who started in my office as a legislative fellow and became a permanent part of the Wyden health team made sure we had credible facts and statistics. Last but not least, I would like to thank Stephanie Kennan, my Senior Health Policy Adviser for the last 9 years who played devil's advocate, worked through the conflicting and evolving ideas, and kept the many threads of the bill working together. The full text of the Healthy Americans Act and the Lewin analysis are available on my Web site. In closing, I believe that without your health, you don't get to the starting line of life. For too long, the Congress has dodged the debate and chosen to slice off parts of the issue. And as worthy as those past efforts have been to help certain segments of our citizens, all Americans deserve guaranteed coverage like their Member of Congress, and no one should go to bed at night worrying about losing their health care. It is time for Congress to provide 21st century solutions to one of the most important issues our country must address. The Healthy Americans Act starts that debate. I ask unanimous consent, that the Healthy Americans Act section-by- section summary, and examples of how the legislation would affect individuals and families and employers be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, it has been more than a decade since the U.S. Senate last addressed fixing health care. I do not think it is morally right for the Senate to duck on health care any longer and that is why I am proposing legislation today to provide affordable, guaranteed, private health coverage for all Americans. The legislation, called the Healthy Americans Act, ensures care for the 46 million Americans who now live without health insurance, frees business owners from the skyrocketing costs of insuring their workers, and promises every American health care coverage that can never be taken away. My proposal is fully paid for, holds down health care cost growth in the future and provides coverage just like Members of Congress can get now. America spent $2.2 trillion on health care last year. PriceWaterhouseCoopers expects premiums will increase 11 percent this year alone and I believe the American health care system as we know it is not sustainable. Our current employer-sponsored health insurance system is a historic accident. In the 1940s, employers needed a way to attract workers as wage and price controls continued. Our country needs a uniquely American solution that works for an economy that is competing not just with the company across town but the company across the world. Americans need a health care system that works for individuals and families, and encourages people to stay healthy instead of only seeking care after they are sick. The Healthy Americans Act does this and more. It doesn't take long to explain how the Healthy Americans Act works. From the first day individuals, families and businesses win. The Healthy Americans Act cuts the link between health insurance and employment altogether. Under the Healthy Americans Act, businesses paying for employee health premiums are required to increase their workers' paychecks by the amount they spent last year on their health coverage. Federal tax law is changed to hold the worker harmless for the extra compensation, and the worker is required to purchase private coverage through an exchange in their State that forces insurance companies to offer simplified, standardized coverage, with benefits like a Member of Congress gets, and prohibits insurers from engaging in price discrimination. Requiring employers to cash out their health premiums, as I propose in the Healthy Americans Act, is good for both employers and workers. With health premiums going up 11 percent this year, employers are going to be glad to be exempt from these increases. With the extra money in their paycheck, workers have a new incentive to shop for their health care and hold down their cost. If a worker can save a few hundred dollars on their health care purchase, they can use that money for something else they need. In addition, the Healthy Americans Act is easy to administer and guarantees lifetime health security. Once you have signed up with a plan through an exchange in the State in which you live, that is it; you have completed the administrative process. Even if you lose your job or you go bankrupt, you can never have your coverage taken away. Sign up, and the premium you pay for the plan and all of the administrative activities are handled through the tax system. For those who cannot afford private coverage, the Healthy Americans Act subsidizes their purchases. Businesses that have not been able to afford health coverage for their workers, under the new approach, will pay a fee--one that is tiered to their size and revenue, with some paying as little as 2 percent of the national average premium amount per worker for that basic benefit package. It will be easy to administer, locally controlled, with guaranteed coverage as good as your Member of Congress gets. The Lewin Group has costed out my proposal and reports that it is fully paid for and in addition to expanding coverage for millions of people, guaranteeing health benefits as good as their Member of Congress gets, it also saves $4.5 billion in health spending in the first year. Money is saved by reducing the administrative costs of insurance, reducing cost shifting, and preventing those needless hospital emergency room visits. Also, there are substantial incentives that come about because insurance companies would have to compete for the business of consumers, who would have a new incentive to hold down health costs. There are other parts of the Healthy Americans Act I wish to describe briefly. As the name of the legislation suggests, I believe strongly that fixing American health care requires a new ethic of health care prevention, a sharp new focus in keeping our citizens well, and trying to keep them from falling victim to skyrocketing rates of increase in diabetes, heart attack, and strokes. Spending on these chronic illnesses is soaring, and it is especially sad to see so many children and seniors fall victim to these diseases. Yet many Government programs and private insurance devote most of their attention to treating Americans after they are ill and give short shrift to wellness. Under the Healthy Americans Act, there will be for the first time significant new incentives for all Americans to stay healthy. They are voluntary incentives, but ones that I think will make a real difference in building a national new ethic of wellness and health care prevention. Parents who enroll children in wellness programs will be eligible for discounts in their own premiums. Instead of mandating that parents take youngsters to various health programs--and maybe they do and maybe they don't--the Healthy Americans Act says when a parent takes a child to one of those wellness programs, the parent would be eligible to get a discount on the parent's health premiums. Under the Healthy Americans Act, employers who financially support health care prevention for their workers get incentives for doing that as well. Medicare is authorized to reduce outpatient Part B premiums so as to reward seniors trying to reduce their cholesterol, lose weight, or decrease the risk of stroke. It has never been done before. For example, Part B of Medicare, the outpatient part, doesn't offer any incentives for older Americans to change their behavior. Everybody pays the same Medicare Part B premium right now. The Healthy Americans Act proposes we change that and ensures that if a senior from Virginia or Oregon or elsewhere is involved in a wellness program, in health care prevention efforts, like smoking cessation, they could get a lower Part B premium for doing that. The preventive health efforts I have described are promoted through new voluntary incentives under the Healthy Americans Act, not heavy- handed mandates. What this legislation says is--let's make it more attractive for people to stay healthy and change their behaviors to promote the kind of wellness practices we all know we should do but need an incentive to follow. Finally, and most importantly, the Healthy Americans Act does not harm those who have coverage in order to help those who have nothing. The legislation makes clear that all Americans retain the right to purchase as much health care coverage as they want. All Americans will enjoy true health security with the Healthy Americans Act, a lifetime guarantee of coverage at least as good as their Member of Congress receives. A recent ``Health Affairs'' article pointed out that more than half of the Nation's uninsured are ineligible for public programs such as Medicaid, but do not have the money to purchase coverage for themselves. At present, for most poor people to receive health benefits, they have to go out and try to squeeze themselves into one of the categories that entitles them to care. Under the Healthy Americans Act, low-income people will receive private health coverage, coverage that is as good as a Member of Congress gets, automatically. Like everyone else, they will sign up through the exchange in their State. When they are working, the premiums they owe are withheld from their paycheck. If they lose their job, there is an automatic adjustment in their withholding. In addition, under the Healthy Americans Act, it will be more attractive for doctors and other health care providers to care for the poor. Those who are now in underfunded programs, such as Medicaid, are going to be able to have private insurance that pays doctors and other providers commercial rates which are traditionally higher than Medicaid reimbursement rates. Because low-income children and the disabled are so vulnerable, if Medicaid provides benefits that are not included in the kind of package Members of Congress get, then those low-income folks would be entitled to get the additional benefits from the Medicaid Program in their State. The Healthy Americans Act also makes changes in Medicare. As the largest Federal health program, Medicare's financial status is far more fragile than Social Security. Two-thirds of Medicare spending is now devoted to about 5 percent of the elderly population. Those are the seniors with chronic illness and the seniors who need compassionate end-of-life health care. The Healthy Americans Act strengthens Medicare for both seniors and taxpayers in both of these areas. In addition to reducing Medicare's outpatient premiums for seniors who adopt healthy lifestyles and reduce the prospect of chronic illness, primary care reimbursements for doctors and other providers get a boost under the Healthy Americans Act. Good primary care for seniors also reduces the likelihood of chronic illness that goes unmanaged. This reimbursement boost is sure to increase access to care for seniors--and I see them all over, in Oregon and elsewhere--who are having difficulty finding doctors who will treat them. To better meet the needs of seniors suffering from multiple chronic illnesses, the Healthy Americans Act promotes better coordination of their care by allowing a special management fee to providers who better assist seniors with these especially important services. Hospice law is changed so that seniors who are terminally ill do not have to give up care that allows them to treat their illness in order to get the Medicare hospice benefit. In addition, the Healthy Americans Act empowers all our citizens wishing to make their own end-of-life care decisions. The legislation requires hospitals and other facilities to give patients the choice of stating in writing how they would want their doctor and other health care providers to handle various end-of- life care decisions. When I announced the Healthy Americans Act last December, I stood with an unprecedented coalition of labor and business. Andy Stern, president of SEIU said ``It is time for fundamental, not incremental change and Senator Wyden has a plan that is practical and principle, and sets down a moral test'' 'Why doesn't every American have the right to the same health care as the President, the Vice President, 535 members of Congress and 3 million Federal workers?' '' Steve Burd, the CEO of Safeway, a Fortune 50 company that has focused on prevention and wellness, called the Healthy Americans Act ``an innovative proposal that lays a foundation to begin a serious discussion on health care reform in this country.'' Ron Pollack of Families USA, listed the principles embodied in the Healthy Americans Act that he believes are important: universality; subsides to make the coverage affordable; community rating rules so the sicker and older are not priced out of the market; and benefits like a Member of Congress has today. Also at my press conference was Mike Roach, of Portland, OR, a 30- year member of National Federation of Independent Businesses. He owns a clothing store in Portland and employs eight people. He believes the Healthy Americans Act will help him attract good employees. And Bob Beal, president of Oregon Iron Works, an Oregon-based company that competes internationally, believes that we must also address the skyrocketing health care costs that make it harder for companies like his in the international market place. Like me, the people who stood by me when I announced the Healthy Americans Act believe we need to move the health care debate forward and cannot afford to let more time to go by. The last time Congress took a serious look at reforming health care, there wasn't anything resembling this kind of coalition of labor, business, low-income and end-of-life advocates standing together to call for action. In tackling one-seventh of the economy, invariably technical issues arise. I want to thank many people who have assisted along the way. Len Nichols of the New America Foundation sent me e-mails at 2 in the morning that helped refine provisions. John Sheils, Randy Haught and Evelyn Murphy of the Lewin Group assisted in telling us our numbers worked or didn't. The Congressional Research Service staff followed up on questions from the common to the obscure. That group included: Bob Lyke, Jeanne Hearne, April Grady, Julie Whitaker, Christine Scott, Chris Peterson, Richard Rimkunas, Karen Trintz, Julie Stone and Andrew Sommers. The Senate Legislative Counsel staff translated the ideas and concepts into legislative language. They devoted an enormous amount of time in getting the ideas and the language right. I'd like to thank Mark Mathiesen, Mark McGunagle, Bill Baird, John Goetcheus, Stacy Kern- Sheerer, Kelly Malone and Ruth Ernest for their patience and extraordinary effort. On my staff, Joshua Sheinkman, my legislative director and Jeff Michaels, my administrative assistant, were instrumental in completing the tax and business sections of the bill. Emily Katz who started in my office as a legislative fellow and became a permanent part of the Wyden health team made sure we had credible facts and statistics. Last but not least, I would like to thank Stephanie Kennan, my Senior Health Policy Adviser for the last 9 years who played devil's advocate, worked through the conflicting and evolving ideas, and kept the many threads of the bill working together. The full text of the Healthy Americans Act and the Lewin analysis are available on my Web site. In closing, I believe that without your health, you don't get to the starting line of life. For too long, the Congress has dodged the debate and chosen to slice off parts of the issue. And as worthy as those past efforts have been to help certain segments of our citizens, all Americans deserve guaranteed coverage like their Member of Congress, and no one should go to bed at night worrying about losing their health care. It is time for Congress to provide 21st century solutions to one of the most important issues our country must address. The Healthy Americans Act starts that debate. I ask unanimous consent, that the Healthy Americans Act section-by- section summary, and examples of how the legislation would affect individuals and families and employers be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, we all understand there has been an awful lot of heated rhetoric about this issue of Medicare and negotiating drug prices and how much savings will come about for the consumer. I and the distinguished senior Senator from Maine have been working for well over 3 years, in a bipartisan way, on this issue. I and Senator Snowe have been able to come up with an approach for dealing with this issue, helping the seniors of this country, helping the taxpayers of this country, and lowering the temperature of the debate about prescription drugs by showing how Medicare can be a smart shopper without setting up some kind of big Government price control regime. Throughout this discussion over the last 3 years, Senator Snowe and I have repeatedly put into the legislation that we have brought to the Senate a strict prohibition on establishing any kind of price control regime or any kind of uniform formulary, which is essentially a list of drugs that restricts the choices for those involved--seniors or anyone else. What Senator Snowe and I have tried to do is lower the temperature on this issue, to try to zero in, in a bipartisan way, on the areas where it is important for the Secretary of Health and Human Services to be in a position of trying to have some negotiations to get a break for the seniors and for the taxpayers. I will use those words specifically. We are talking about what could be a negotiation--not going in with some arbitrary price and throwing around figures of $1.20 a pill or something like that. We are talking about the opportunity for our Government to be a smart shopper, while steering clear of any price control regime. By the way, I know this was an important issue for the Presiding Officer as he campaigned to come here. Senator Snowe and I voted for the Medicare prescription drug program. I still have the welts on my back to show for it. But what Senator Snowe and I said from the very outset, from the very time of the original Senate debate, is we were going to go to work on a bipartisan basis to try to fix those areas, such as the one identified by the Presiding Officer, the distinguished Senator from Rhode Island. We have set out to do just that. And in 2004, the Congressional Budget Office sent us a letter saying we were heading in the right direction. Senator Snowe and I said from the beginning we have to make sure that seniors and taxpayers get a good deal when we have what are called single-source drugs, monopoly drugs. These are drugs where there isn't any ability to have the kind of leverage and clout we would like to have in the marketplace. In 2004, the Congressional Budget Office sent me a letter that there could be savings if negotiations were permitted on single-source drugs for which there is no therapeutic equivalent. It is common sense, it seems to me, when the Congressional Budget Office says there could be savings in one kind of area, we would want to add that. The distinguished chairman of the Committee on Finance, Senator Baucus, puts it pretty well. Senator Baucus says: Why don't you add that to your cost containment tool box? Senator Baucus has said what we need is a variety of ways to hold down the cost--he calls it, in my view correctly, a kind of tool-box approach to making sure seniors and taxpayers get a good deal. What Senator Snowe and I have said is let's make sure that tool box that Senator Baucus has been talking about zero in on this question of single-source drugs, where we do need some bargaining power. There are some who have said the only possible way to have negotiations is if you set up some kind of one-size-fits-all national formulary. They say: The VA has one. Gosh, you all in the Senate would not want to limit the drugs available to our country's seniors. Let me make it clear what Senator Snowe and I are doing rejects that approach. We are not talking about a nationwide formulary or some kind of list of drugs that restricts seniors' choices. By the way, when the former Secretary of Health and Human Services, Tommy Thompson, felt it was important to do the kind of thing Senator Snowe and I are talking about on the drug Cipro, Secretary Thompson did not go out and set up a nationwide formulary. He didn't say: We are going to say the price of the pill is $1.27. He did not set up some kind of arbitrary price-control regime. Secretary Thompson, in his last meeting with the press when he was leaving the Department, said he wished he had the power to bargain under Medicare. Secretary Thompson did exactly the kind of thing that I and Senator Snowe have been talking about. He said we have to make sure that the consumer and the taxpayers get a good deal for Cipro. Secretary Thompson did not set up a nationwide formulary. Secretary Thompson did not set up some price-control regime. Secretary Thompson did not say: It is going to be $1.27 per pill. He said: Let's negotiate, let's talk, let's go back and forth as everyone does in the marketplace in Rhode Island, Oregon and everywhere else across the country. Let's ask: What are we going to do to make sure that everyone gets a fair shake? That situation, of course, was an emergency, because we had anthrax. But as the Senator from Rhode Island has pointed out a number of times over the last few months, for a lot of seniors, trying to afford prescription medicine is kind of like having a new emergency every day. Secretary Thompson said: Yes, we have a big emergency on this anthrax situation. I think the Senator from Rhode Island knows exactly what I see when I am home in Coos Bay, John Day, Pendleton, or Gresham, Oregon, and everywhere else. For a lot of seniors in this country, every day is an emergency with respect to being able to afford their medicine. Those seniors ought to know that their Government, in the case of the single-source drug, for example, where there is monopoly power, can bargain in those kind of instances without price controls, without a nationwide formulary. That is what Senator Snowe and I and others, on a bipartisan basis, wish to stand up for--to help those seniors and those taxpayers. Now, some have argued that as seniors get a better deal for Medicare, that means higher prices for everyone else. They, also, argue that negotiations would not do anything. I don't know how one can make both arguments at the same time and make sense. Those two do not connect. What Senator Snowe and I wish to do is have a Medicare program that is a smart, savvy shopper. By being a better shopper, seniors and taxpayers are going to save. We know that no one goes to Costco and buys toilet paper one roll at a time. They shop smart. We ought to do that with Medicare. I was pleased with last week's Committee on Finance hearing. Chairman Baucus and others said it is valuable to have additional information to know whether markets for drugs are achieving the best price possible. I and Senator Snowe have been interested in that approach as well. We know there are a variety of pharmacies out there that can offer cheaper medicines to seniors without limiting the drugs available, and we find it hard to believe that Medicare cannot do exactly the same thing. Let us give Medicare the opportunity to do exactly the same thing that people do in New Hampshire, Texas, and Rhode Island; that is, to shop smart, look for a bargain, and don't set up nationwide price controls and don't set up a nationwide formulary that restricts the kind of drugs our seniors can get. If we work in a bipartisan way, which is what Senator Snowe and I have been trying to do on this issue for 3\1/2\ years, we can draw a line that promotes smart shopping in Medicare without going over the line to price controls and restrictive formularies. Let us try to lower the temperature on this particular debate by looking at ways to shop smart without price controls. In 2004, the Congressional Budget Office said it would make a difference in at least one key area I have been talking about today. I believe it would make a difference in other key areas. I am looking forward, as a member of the Senate Committee on Finance, to working under the leadership of Chairman Baucus, on a bipartisan basis, to get this issue resolved because, as the Presiding Officer of the Senate has noted over these many months, this is not an abstract issue for the people most involved. Those are seniors walking on an economic tightrope. We don't know what will happen to medical costs this year, but we can make sure we use every possible opportunity without price controls to make the Medicare Program a smart shopper. I yield the floor.

Mr. WYDEN

Mr. WYDEN. I ask unanimous consent to speak as if in morning business for up to 15 minutes.

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

Mr. WYDEN

Mr. WYDEN. I move to reconsider the vote.

Mr. WYDEN

Mr. WYDEN. Mr. President, I note the absence of a quorum.

Mr. WYDEN. Mr. President, I ask unanimous consent that the majority leader be recognized at 12:30 p.m. today.

Mr. WYDEN. Mr. President, I ask unanimous consent that the time today from 4:30 to 5:30 be equally divided and controlled between the two leaders or their designees, and that 10 minutes of the majority's time be allocated to Senator Feingold.

Mr. WYDEN

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

Mr. WYDEN. Mr. President, for almost 13 years, it has been considered politically dangerous to come to the floor of the Senate and describe a fresh approach to fixing health care in America. I am going to do that this morning because I do not believe it is morally right for the Senate to duck on health care any longer. During the Senate's long absence, the skyrocketing costs of health care have hit American communities like a wrecking ball. PricewaterhouseCoopers estimates that health care premiums will rise 11 percent this year, several times the rate of inflation. In America, with the world's best doctors, nurses, hospitals, and other providers, many with health coverage believe they are just one more rate hike away from losing the coverage they have, and more than 40 million Americans have little or no coverage at all. Just about all of us are baffled about how to purchase the health care that is best for us. In fact, it is easier to get information about the cost and quality of washing machines than it is to get information about health care that can mean life or death. I believe the combination of cost hikes, increases in chronic illness, our aging society, and the disadvantage American employers face in global markets, where their competitors spend little or nothing for health, means our current health system cannot be sustained. Since health care has been poked and prodded for so many years, I believe it is time for diagnosis and treatment. As usual, it makes sense to start with a look at the financial bottom line. Go there, and it sure looks as if we Americans are spending enough money on medical care. Last year, according to the Center for Medicare and Medicaid Services, Americans spent $2.2 trillion on health care. There are about 300 million of us. You divide 300 million into $2.2 trillion, and it would be possible to send every man, woman, and child in America a check for more than $7,000. Here is another way to look at it: For the money Americans spent on health care last year, we could have hired a group of skilled physicians, paid each one of them $200,000 to care for seven families, and all Americans would have quality, affordable health care. Whenever I mention those figures to a physicians group, it takes about 30 seconds before a doctor stands up and says: Ron, where do I go to get my seven families? My conclusion, after reviewing the numbers and expenditures for health care: America is spending enough money on medical services; it is just not spending the money in the right places. While the Senate has taken a pass on fixing health care and redirecting misspent health dollars, several State leaders have stepped forward. In my view, Arnold Schwarzenegger and Mitt Romney deserve substantial credit just for trying to lead on health care. I will discuss in a minute why I do not agree with their decision to continue the link between health insurance and employment, but Governors Schwarzenegger and Romney deserve America's thanks for making it clear that they will not sit quietly by while Washington, DC, slow-walks health care. As a member of the Senate Finance Committee, I intend to help State officials obtain the special waivers in Federal health programs they need to make Federal dollars in their States stretch further for health care. Having already stated that I believe enough money is being spent on medical services, I am especially interested in helping the States make better use of their existing funds. As a result of the new initiatives in California, Massachusetts, and other States, some in the Congress believe the next few years should be spent watching how the States fare in their efforts. Meaning well, these Congress people believe our role in the Congress should primarily be to ship more Federal money to the States for their reforms and then pretty much call it a day. Respectfully, I disagree. I believe there is no possible way the States can fix health care because the States did not create the major problems in American health care. Who did? The Federal Government, the big spender of health dollars in America, the architect of the policies now driving American health care toward implosion. Here is how it happened. More than 60 years ago, with wage and price controls in effect, our employers found that they could get good workers by giving them health care benefits. Employer-based health coverage was born and generously greased by the adoption of Federal tax policies that make employer-based health coverage a deductible expense for employers and a tax-free benefit for workers. Soon most workers came to get their health coverage through their employer. It became the norm for talented workers to quickly ask prospective employers: Say, tell me about your health package. Today, these Federal tax breaks total more than $200 billion annually. The cost, however, involves more than dollars. These tax breaks go disproportionately to the wealthiest in America and subsidize inefficiency to boot. A high-flying CEO at a major corporation can write off the cost of Cadillac health coverage or even getting a designer smile for his face, while the folks at the corner hardware store lack company health coverage and get nothing. With employer- sponsored health coverage, an individual worker is largely in the dark about whether they have been overcharged for health care, and the Tax Code allows for a writeoff for wasteful spending. These Federal tax policies that reward regressive practices and inefficient health spending are taking a large and growing toll. For example, an increasing number of the uninsured work at small businesses, like the hardware store that fares so poorly under the Federal Tax Code. Because these small businesses cannot afford health care for their workers, these workers often ignore their illnesses until they can bear it no longer. Their next stop--the hospital emergency room, where the medical bills generated by the uninsured are often passed on to the insured and to taxpayers. My next picture shows where we are headed with the employer-based health coverage. In an era where such cost shifting is widespread and some companies spend almost as much on health care as they make in profit, employer-based health coverage is melting away similar to this popsicle on the summer sidewalk in August. If PricewaterhouseCoopers is right and health premiums rise another 11 percent this year, those with employer-based coverage will face another round of big copayments for their health care, more deductibles, and additional benefit reduction this year. Their choice is likely to be worse coverage or no coverage. Recently, a woman in her fifties came to one of my town hall meetings in Oregon and said: I just hope my employer can keep offering health benefits and I can hang in there until I get Medicare. I believe this Senate ought to act when hard-working Americans go to bed at night worried about the prospect of losing their health coverage when they get up in the morning. Now, you could argue that 60 years ago employer-based health coverage made sense. That was before U.S. employers faced determined global competition, U.S. workers changed jobs seven or eight times by the age of 35, and American society became more mobile. It surely doesn't make sense today. I believe you cannot fix American health care without changing our system of employer-based health coverage and the Federal tax breaks that lubricate it. I believe you cannot fix American health care without changing the incentives that drive our choices and our behavior. Not a State in the Union has the power to bring this about. We in the Senate do. In a few days, after some additional consultation with colleagues, I will introduce legislation that offers a fresh and different approach to fixing health care in America. I call the legislation the Healthy Americans Act, and it is based on four judgments about health care I have made. First, Democrats have been correct in saying that to fix health care everybody must be covered. This concept, of course, is known as universal coverage. Republicans, in my view, have been correct in saying there must be more personal responsibility and personal involvement in making health care choices than there is today. Second, there is a model for fixing health care that every single Senator--every Member of Congress--knows something about. It is the system that serves Members of Congress and their families, offering the Members of this body high-quality, affordable, private health coverage with lots of choice. Third, America doesn't have health care at all; it has sick care. For example, Medicare Part A will write checks for thousands of dollars so that a senior can be treated in the hospital after they have had a heart attack or a stroke. Medicare Part B--the part of the program that covers outpatient services--provides no incentives for changing the behavior that led to the chronic illness and landed the senior citizen in the hospital. Certainly, it is clear that preventing disease, not just treating disease, must be a bigger part of America's health care future. Fourth, in my view, you cannot fix American health care if you hurt the middle class who have coverage in order to help those who do not. To fix American health care, you must prove that all Americans have the opportunity to get ahead, starting with their first paycheck under a new health care plan--the Healthy Americans Act that I have drafted and has been posed at my Web site at wyden.senate.gov. Included at this site is a written evaluation of the legislation, done by the Lewin Group. The Lewin Group has been called the gold standard of health care actuarial data. Their evaluation is clear. Under the Healthy Americans Act, all Americans can be guaranteed a lifetime of private health coverage, at least as good as their Member of Congress receives, for no more than our country spends on health care today. In addition, fixing American health care can be done more quickly than imagined--within 2 years after a reform law is passed--and produce more than $4 billion in savings in the first year, while expanding coverage. The next chart is especially important because it shows that the Healthy Americans Act will slow the rate of growth in health care spending by almost $1.5 trillion over the next 10 years. The distinguished Presiding Officer is an expert in foreign affairs and our policy with Iraq. I am sure that as he looks at the chart, he can see that, according to the Lewin Group, the amount of money that would be saved in slowing the rate of growth in health care spending is several times--threefold--the amount of money our country has spent on the war in Iraq. Mr. President, it doesn't take long to explain how the Healthy Americans Act works. It starts by going where Arnold Schwarzenegger and Mitt Romney would not. It cuts the link between health insurance and employment altogether. Under the Healthy Americans Act, businesses paying for employee health premiums are required to increase their workers' paychecks by the amount they spent last year on their health coverage. Federal tax law is changed to hold the worker harmless for the extra compensation, and the worker is required to purchase private coverage through an exchange in their State that forces insurance companies to offer simplified, standardized coverage, and prohibits them from engaging in price discrimination. Now, requiring employers to cash out their health premiums, as I propose in the Healthy Americans Act, is good for both employers and workers. With health premiums going up 11 percent this year, employers are going to be glad to be exempt from these increases. With the extra money in their paycheck, workers have a new incentive to shop for their health care and hold down their cost. If a worker in Virginia can save a few hundred dollars on their health care purchase, they can use that money so that one of the constituents of the Presiding Officer can be on their way to Oregon to get in some sensational fishing. In addition, the Healthy Americans Act is easy to administer and guarantees lifetime health security. Once you have signed up with a plan through an exchange in the State in which you live, that is it; you have completed the administrative process. Even if you lose your job or you go bankrupt, you can never have your coverage taken away. Sign up, and the premium you pay for the plan and all of the administrative activities are handled through the tax system. For those who cannot afford private coverage, the Healthy Americans Act subsidizes their purchases. Businesses that have not been able to afford health coverage for their workers, under the new approach, will pay a fee--one that is tiered to their size and revenue, with some paying as little as 2 percent of the national average premium amount per worker for that basic benefit package. Mike Roach, the owner of the 8-person Paloma clothing firm in Portland, OR, is a 30-year member of the National Federation of Independent Businesses, and he was instrumental in ensuring that this legislation was small business friendly every step of the way. Mr. President, that is pretty much it, in terms of how the Healthy Americans Act actually works. It will be easy to administer, locally controlled, with guaranteed coverage as good as your Member of Congress gets; and on top of it, there is a model for delivering it that the distinguished Presiding Officer and everybody else in this body knows about. Page 12 of the Lewin report on my Web site shows how the Healthy Americans Act expands coverage for millions of people, guaranteeing health benefits as good as their Member of Congress gets, while saving $4.5 billion in health spending in the first year. Money is saved by reducing the administrative costs of insurance, reducing cost shifting, and preventing those needless hospital emergency room visits. Also, there are substantial incentives that come about because insurance companies would have to compete for the business of consumers, who would have a new incentive to hold down health costs, which I have already described as the Virginian's opportunity to go fishing in Oregon. There are other parts of the Healthy Americans Act I wish to describe briefly. As the name of the legislation suggests, I believe strongly that fixing American health care requires a new ethic of health care prevention, a sharp new focus in keeping our citizens well, and trying to keep them from falling victim to skyrocketing rates of increase in diabetes, heart attack, and strokes. Spending on these chronic illnesses is soaring, and it is especially sad to see so many children and seniors fall victim to these diseases. Yet, many Government programs and private insurance devote most of their attention to treating Americans after they are ill and give short shrift to wellness. Under the Healthy Americans Act, there will be for the first time significant new incentives for all Americans to stay healthy. They are voluntary incentives, but ones that I think will make a real difference in building a national new ethic of wellness and health care prevention. Parents who enroll children in wellness programs will be eligible for discounts in their own premiums. Instead of mandating that parents take youngsters to various health programs--and maybe they do and maybe they don't--the Healthy Americans Act says when a parent takes a child to one of those wellness programs, the parent would be eligible to get a discount on the parent's health premiums. Under the Healthy Americans Act, employers who financially support health care prevention for their workers get incentives for doing that as well. Medicare is authorized to reduce outpatient Part B premiums so as to reward seniors trying to reduce their cholesterol, lose weight, or decrease the risk of stroke. It has never been done before. For example, Part B of Medicare, the outpatient part, doesn't offer any incentives for older Americans to change their behavior. Everybody pays the same Medicare Part B premium right now. The Healthy Americans Act proposes we change that and ensures that if a senior from Virginia or Oregon or elsewhere is involved in a wellness program, in health care prevention efforts, like smoking cessation, they could get a lower Part B premium for doing that. The preventive health efforts I have described are promoted through new voluntary incentives under the Healthy Americans Act, not heavy-handed mandates. Under the Healthy Americans Act, there is no national nanny established under the legislation to watch who is hitting the snack food bowl. What this legislation says is--let's make it more attractive for people to stay healthy, to change their behaviors, to promote the kind of wellness practices we all know about but somehow don't seem to find time to actually get done in our hectic schedules. Finally, and most importantly, the Healthy Americans Act does not harm those who have coverage in order to help those who do nothing. The legislation makes clear that all Americans retain the right to purchase as much health care coverage as they want. All Americans will enjoy true health security with the Healthy Americans Act, a lifetime guarantee of coverage at least as good as their Member of Congress receives. Most American families will obtain this coverage with either their premiums reduced from what they pay today or for less than a dollar a day more. That can all be seen in the Lewin chart as No. 10 at my Web site. In addition, all Americans benefit from the reduced administrative costs the legislation produces, the insurance reforms, and, of course, the new focus on prevention. I am now going to explain briefly how care for the poor is handled under the Healthy Americans Act and why this is good for both low- income people and taxpayers. This is especially important in light of a recent article in the health policy journal, ``Health Affairs.'' This article points out that more than half of the Nation's uninsured are ineligible for public programs such as Medicaid, but do not have the money to purchase coverage for themselves. At present, for most poor people to receive health benefits, they have to go out and try to squeeze themselves into one of the categories that entitles them to care. So what we have, Mr. President, in Virginia, in Oregon, and elsewhere, is citizens trying to crunch themselves into one of these boxes, one of these categories that might make them eligible for health care in Virginia or Oregon. As former Oregon Gov. John Kitzhaber has noted, there are more than 20 different categories of Medicaid. Administrating all of this takes funds, in my view, that ought to be spent caring for poor folks in America. Under the Healthy Americans Act, low-income people will receive private health coverage, coverage that is as good as a Member of Congress gets, automatically. Like everyone else, they will sign up through the exchange in their State. When they are working, the premiums they owe are withheld from their paycheck. If they lose their job, there is an automatic adjustment in their withholding. In addition, under the Healthy Americans Act, it will be more attractive for doctors and other health care providers to care for the poor. Those who are now in underfunded programs, such as Medicaid, are going to be able to have private insurance that pays doctors and other providers commercial rates which are traditionally higher than Medicaid reimbursement rates. Because low-income children and the disabled are so vulnerable, if Medicaid provides benefits that are not included in the kind of package Members of Congress get, then those low-income folks would be entitled to get the additional benefits from the Medicaid program in their State. I am now going to explain how Medicare is strengthened by the Healthy Americans Act. As the largest Federal health program, Medicare's financial status is far more fragile than Social Security. Two-thirds of Medicare spending is now devoted to about 5 percent of the elderly population. Those are the seniors with chronic illness and the seniors who need compassionate end-of-life health care. The Healthy Americans Act strengthens Medicare for both seniors and taxpayers in both of these areas. In addition to reducing Medicare's outpatient premiums for seniors who adopt healthy lifestyles and reduce the prospect of chronic illness, primary care reimbursements for doctors and other providers get a boost under the Healthy Americans Act. Good primary care for seniors also reduces the likelihood of chronic illness that goes unmanaged. This reimbursement boost is sure to increase access to care for seniors--and I see them all over, in Oregon and elsewhere--who are having difficulty finding doctors who will treat them. To better meet the needs of seniors suffering from multiple chronic illnesses, the Healthy Americans Act promotes better coordination of their care by allowing a special management fee to providers who better assist seniors with these especially important services. Hospice law is changed so that seniors who are terminally ill do not have to give up care that allows them to treat their illness in order to get hospice. In addition, the Healthy Americans Act empowers all our citizens wishing to make their own end-of-life care decisions. The legislation requires hospitals and other facilities to give patients the choice of stating in writing how they would want their doctor and other health care providers to handle various end-of-life care decisions. The tragic case of the late Terri Schiavo came before the Senate before the distinguished Presiding Officer of the Senate had joined this body, but I was particularly struck during that debate and afterwards how strongly the American people feel about making sure that the patient and not Government gets to drive all of the decisions surrounding their end-of-life care. Under the Healthy Americans Act, that would be the norm rather than the exception. In writing this legislation, I spent a lot of time looking back-- looking back literally over 60 years--since Harry Truman tried to fix health care in the 81st Congress in 1945. I tried to make sure, particularly, that the lessons of 1994 were ones the Senate would pick up on and make sure that the same mistakes were not committed again. For example, in 1994, the last time this Senate considered fixing health care, the principal piece of legislation before the Senate was 1,369 pages long. The Healthy Americans Act posted at my Web site saves a lot of Oregon trees by coming in about 1,200 pages shorter. In 1994, getting to universal coverage was, in effect, put before securing the savings to responsibly finance an expansion of coverage. The Healthy Americans Act, as noted in the Lewin report, generates billions of dollars in savings in the first year as the legislation is implemented. In 1994, the principal method of financing universal coverage was an employer mandate. The Healthy Americans Act requires no such employer mandate, provides financial relief for employers competing in tough global markets, and still ensures that every business takes some measure for financing health care in a way that is going to allow those businesses to be competitive in tough global markets. In 1994, there was never a coalition of employers, union leaders, and patient advocates behind a specific piece of legislation. Now, Andy Stern, president of the 1.8 million-worker Service Employees International Union; Steve Burd, CEO of Safeway with more than 200,000 workers, patient advocates representing various points of view, and employers of all sizes have joined behind the Healthy Americans Act. There is also a moral question I would like the Senate to consider. Given what I have just outlined, how can this Senate justify denying all Americans health care coverage as good as Members of Congress receive? The Lewin report proves it can be done--proves it can be done without spending more money than the country spends now and, in fact, can be done saving more than $4 billion in the very first year. There is a model for putting reforms in place: the system enjoyed by all the Senators serving in this body today. Fixing health care under the Healthy Americans Act will reduce administrative hassle and expense and allow all our citizens finally--finally--to go to bed at night without fear of losing essential medical care. I want 2007 to be the year when the Senate, as well as the various State governments, step up on health care. The States deserve our support, but they cannot possibly remedy the health problems created by Federal leaders in this city more than 60 years ago. The Senate can provide this remedy. Here on this floor, the Senate can acknowledge that the employer-based system of health coverage that worked back in 1945 no longer makes sense for 2007. We can acknowledge, as I have done today, that I think Democrats are right about making sure that everybody gets covered and Republicans are right about promoting personal responsibility and more personal involvement in making health care choices. We can end 13 years of ducking on health care, 13 years of slapping Band-Aids on health care, and roll up our sleeves and go to work. A lot of it--and I know the distinguished President of the Senate has been to many community meetings in his home State of Virginia--simply means following up on what constituents say at home. Every time health care comes up when I have community meetings somebody usually says, ``Well, I guess we ought to go to what is called a single payer system. You know, one where the Government essentially runs it and you don't have these private insurance companies.'' After somebody at a town meeting says we ought to have a single payer system, somebody else says, ``No, we already voted on that.'' In fact, Oregonians did. They voted against a single payer system by more than 3 to 1 just a few years ago. But the other speakers say, ``We don't want all that Government. We don't want the Government to make all the decisions.'' So after a bit, somebody raises their hand at one of my townhall meetings and says, ``Ron, what we want is what you Members of Congress have. We want health care coverage like you have.'' Then everybody in the room shakes their head in agreement. So much of what I propose in the Healthy Americans Act comes from those townhall meetings that I hold in all of Oregon's 36 counties. I have an approach that guarantees benefits like Members of Congress have; that is delivered in the same way; and that can actually be implemented with the very first paycheck that a worker gets under the new system. Part of the reason I have written this legislation as I have has been to ensure that the Congress and the Federal Government could pick up some lost credibility on health care. My sense is that after the debate of 1994 on health care in America a lot of Americans said: The United States Congress can't figure out how to put together a two-car parade let alone a reform that involves one-seventh of the American economy. That is why I have written this legislation so it can be understood and the effects can be seen from the time the very first paychecks go out under the legislation. The legislation works in a way that will be attractive to both workers and employers. So I have spent a lot of time listening to my constituents as I brought together the various principles that are contained in the Healthy Americans Act. I know colleagues in this body have other ideas. I would like to wrap up by simply saying I think health care has been studied enough. It has been commissioned. It has been blue-ribboned. It has been the subject of white papers, blue papers, pink papers, papers of every possible description. It is time for the Senate to act. The Senate has ducked on health care for almost 13 years. Health care and Iraq are the driving issues that our citizens care about most. It is time to fix health care, and I think with the Healthy Americans Act, this body can get the job done. Mr. President, I yield the floor, and I note the absence of a quorum.

Mr. WYDEN

Mr. WYDEN. Mr. President, Senator Snowe and I said we would work to improve the Medicare Part D benefit ever since we voted for its passage. Senator Snowe and I think one of the most egregious errors in the Medicare drug benefit was to write into law that the Secretary cannot have bargaining power under any circumstances. That is why today we are introducing the Medicare Enhancements for Needed Drugs Act of 2007. This legislation lifts the prohibition on bargaining power and requires the Secretary to negotiate on behalf of seniors. We believed that one of the most important things missing from the Part D benefit was cost containment--and allowing Medicare to negotiate for drug prices would be an important cost containment measure. Our legislation clearly prohibits price setting or the creation of a uniform formulary. What our legislation allows Medicare to do is to be a smart shopper--just as any consumer would be--by allowing Medicare to go in the market and use its clout just like any other big purchaser. Under our proposal, the Secretary could negotiate in any circumstance, but must negotiate in several instances: for single source drugs for which there is no therapeutic equivalent; drugs for which taxpayer funding was substantial in its research and development; and for any fallback plan the Secretary must provide. In addition, our legislation requires the Secretary to provide a fallback plan if there is not comprehensive coverage, including coverage for the so-called donut hole, available in a region. The Congressional Budget Office has stated there might be savings achieved if the Secretary could negotiate for single source drugs for which there is no therapeutic equivalent. To be good stewards of taxpayer dollars, to be able to strengthen the program and to help seniors truly save, we must look toward using every logical tool to lower costs. Not to try to achieve lower prices in areas identified as potentially saving the program, taxpayers and seniors would be foolish. I don't know of a single private entity, whether it's a timber company in my home State of Oregon, or a big auto company, who when they're buying something in bulk doesn't say, hey pal, how about a discount? So why shouldn't Medicare, if it needs to negotiate, have that authority just in case? Why wouldn't we want to assure that Medicare can be a smart shopper? I look forward to working with my colleagues as the Senate Finance Committee works on this issue.

Mr. WYDEN

Mr. WYDEN. Mr. President, today I introduce legislation to authorize the Secretary of the Interior to enter into cooperative agreements to protect National Parks through collaborative efforts on lands inside and outside of National Park System units. My bill passed the Senate in the 109th Congress, but unfortunately did not have an opportunity to pass in the House before the end of the Congress. Today, I reintroduce the bill hoping that it can expeditiously pass again in the Senate and continue on to pass in the House. This legislation is based on very successful watershed protection legislation enacted for the Forest Service and the Bureau of Land Management, now commonly referred to as the Wyden amendment. The Wyden amendment, first enacted in 1998 for Fiscal Year 1999, has resulted in countless Forest Service and Bureau of Land Management cooperative agreements with neighboring state and local land owners to accomplish high priority restoration, protection and enhancement work on public and private lands. It has not required additional funding, but has allowed the agencies to leverage their scarce restoration dollars thereby allowing the Federal dollars to stretch farther. The legislation I introduce today will allow the Park Service to use a similar authority to attack natural threats to National Parks, such as invasive weeds, before they cross onto Parks' land. The National Park Service tells me that if they have to wait until the weeds hit the Parks before treating them the costs for treatment rise exponentially and the probability of beating the weeds back drops exponentially. Examples of projects the National Park Service would pursue with this authority, as well as the groups with which they would partner, are attached. I am pleased that Senator Akaka is joining me as an original co-sponsor of this legislation and I hope my other colleagues will join me as co-sponsors of this legislation and in ensuring its swift passage. I ask unanimous consent that the text of the bill and a list of projects be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, Senator Snowe and I said we would work to improve the Medicare Part D benefit ever since we voted for its passage. Senator Snowe and I think one of the most egregious errors in the Medicare drug benefit was to write into law that the Secretary cannot have bargaining power under any circumstances. That is why today we are introducing the Medicare Enhancements for Needed Drugs Act of 2007. This legislation lifts the prohibition on bargaining power and requires the Secretary to negotiate on behalf of seniors. We believed that one of the most important things missing from the Part D benefit was cost containment--and allowing Medicare to negotiate for drug prices would be an important cost containment measure. Our legislation clearly prohibits price setting or the creation of a uniform formulary. What our legislation allows Medicare to do is to be a smart shopper--just as any consumer would be--by allowing Medicare to go in the market and use its clout just like any other big purchaser. Under our proposal, the Secretary could negotiate in any circumstance, but must negotiate in several instances: for single source drugs for which there is no therapeutic equivalent; drugs for which taxpayer funding was substantial in its research and development; and for any fallback plan the Secretary must provide. In addition, our legislation requires the Secretary to provide a fallback plan if there is not comprehensive coverage, including coverage for the so-called donut hole, available in a region. The Congressional Budget Office has stated there might be savings achieved if the Secretary could negotiate for single source drugs for which there is no therapeutic equivalent. To be good stewards of taxpayer dollars, to be able to strengthen the program and to help seniors truly save, we must look toward using every logical tool to lower costs. Not to try to achieve lower prices in areas identified as potentially saving the program, taxpayers and seniors would be foolish. I don't know of a single private entity, whether it's a timber company in my home State of Oregon, or a big auto company, who when they're buying something in bulk doesn't say, hey pal, how about a discount? So why shouldn't Medicare, if it needs to negotiate, have that authority just in case? Why wouldn't we want to assure that Medicare can be a smart shopper? I look forward to working with my colleagues as the Senate Finance Committee works on this issue.

Mr. WYDEN. Mr. President, today I introduce legislation to authorize the Secretary of the Interior to enter into cooperative agreements to protect National Parks through collaborative efforts on lands inside and outside of National Park System units. My bill passed the Senate in the 109th Congress, but unfortunately did not have an opportunity to pass in the House before the end of the Congress. Today, I reintroduce the bill hoping that it can expeditiously pass again in the Senate and continue on to pass in the House. This legislation is based on very successful watershed protection legislation enacted for the Forest Service and the Bureau of Land Management, now commonly referred to as the Wyden amendment. The Wyden amendment, first enacted in 1998 for Fiscal Year 1999, has resulted in countless Forest Service and Bureau of Land Management cooperative agreements with neighboring state and local land owners to accomplish high priority restoration, protection and enhancement work on public and private lands. It has not required additional funding, but has allowed the agencies to leverage their scarce restoration dollars thereby allowing the Federal dollars to stretch farther. The legislation I introduce today will allow the Park Service to use a similar authority to attack natural threats to National Parks, such as invasive weeds, before they cross onto Parks' land. The National Park Service tells me that if they have to wait until the weeds hit the Parks before treating them the costs for treatment rise exponentially and the probability of beating the weeds back drops exponentially. Examples of projects the National Park Service would pursue with this authority, as well as the groups with which they would partner, are attached. I am pleased that Senator Akaka is joining me as an original co-sponsor of this legislation and I hope my other colleagues will join me as co-sponsors of this legislation and in ensuring its swift passage. I ask unanimous consent that the text of the bill and a list of projects be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, the legislation I introduce today reauthorizes a very successful cooperative watershed restoration program that I originally sponsored, and that was originally enacted for the Forest Service, in the Fiscal Year 1999 Interior Appropriations bill. The original legislation lasted through Fiscal Year 2001 after which it was reauthorized by the Appropriations Committees, at my request, through Fiscal Year 2005 and then again through Fiscal Year 2011. My bill passed the Senate in the 109th Congress, but unfortunately did not pass in the House before the end of the Congress. Today, I reintroduce the bill hoping that it can speedily pass both chambers. The bill making what is commonly referred to as the Wyden amendment permanent authorizes the Secretary of Agriculture to use appropriated Forest Service funds for watershed restoration and enhancement agreements that benefit the ecological health of National Forest System lands and watersheds. The Wyden amendment does not require additional funding, but allows the Forest Service to leverage scarce restoration dollars thereby allowing the federal dollars to stretch farther. During the eight years the program has existed, the Forest Service has leveraged three dollars for every Forest Service dollar spent on these agreements. The Wyden amendment has resulted in countless Forest Service cooperative agreements with neighboring state and local land owners to accomplish high priority restoration, protection and enhancement work on public and private watersheds. The projects authorized by these agreements have improved watershed health and fish habitat through the control of invasive species, culvert replacement, and other riparian zone improvement projects. In addition to ecological restoration, use of the Wyden amendment has improved cooperative relationships between the Forest Service, private land owners, state agencies and other federal agencies. I am hopeful that my colleagues on the Energy and Natural Resources Committee will again pass this bill out of the Committee and that thereafter this legislation can again pass the Senate expeditiously. I ask unanimous consent that the text of the bill be printed in the Record.