Sheldon Whitehouse

Mr. WHITEHOUSE

Mr. WHITEHOUSE. May I have an additional 5 minutes?

Mr. WHITEHOUSE. Very well. Mr. President, I have had the chance to sit yesterday where the Presiding Officer is sitting today and hear several hours of Republican criticism of the health care bill, much of it focusing on the recent report from the CMS Office of the Actuary and the concern about cost. I wish to say a few words about that. Clearly, the problem of cost is a very real and dramatic one. This is the curve of our national health care spending, starting back in 1955, the year I was born, at $12 billion and increasing at an accelerating rate until in 2009 we were at $2.5 trillion every single year. Of course, if we look at the curve, we are not going to level out next year at that level; it is going to keep rocketing upward to the point where in my home State of Rhode Island, if we don't do anything, by 2016--which is just over the horizon; it is not too far to look forward to, even in this building--$26,000 is what it will cost the average family of four for their health insurance. So the problem of cost is a very real one and the numbers involved are staggering. However, if you are going to look at the CMS report, I would suggest there is not just one number to look at, there are several numbers. Then there is an alternative consideration that I think we need to consider. The Republicans have focused on page 4 of the CMS report where the Actuary estimates that total national health expenditures under this bill would increase by an estimated total of $234 billion, or 0.7 percent during the calendar years 2010 to 2019, over those 10 years. That is an important number, I will grant them that, but I think there is another number that is equally important--indeed, more important, and that is on the page before. On page 3 the CMS Actuary says that: ``Under this legislation, an additional 33 million people would become insured by 2019.'' An additional 33 million Americans would become insured by 2019. Think about that. We have over and over again come to the floor and told of stories from our home States, heard our colleagues tell us stories from their home States about the terrible toll and tragedy that befalls families when they are uninsured or underinsured. Just 30 years ago when we were about here on the chart, only 8 percent of American families filing for bankruptcy protection did so as a result of medical bills. Now it is 60 percent. Sixty percent of family bankruptcies relate back to medical emergencies, unforeseen diagnoses, medical bills that have broken the family. Thirty-three million people with adequate health insurance so they don't face that trauma and that catastrophe, that is something real. It has been estimated that because of a lack of insurance, 40,000 people a year die prematurely. Forty thousand Americans dead as a consequence of lack of insurance. So this bill would cover 33 million people and lift that burden of worry, of anxiety, of financial catastrophe, of illness, even of death, off of all of those families. That is not something to shrug off. Yet, not once did I hear that number mentioned by the other side. Not once did they even mention that this bill would cover 33 million Americans who would otherwise be without health insurance. They must hear the same stories at home. It is not that in Republican States there are no bankruptcies and no deaths because people are uninsured and no misery, no tragedy. They just come to this floor and don't bother to count that side of the equation. Another number out of the report is that if you took just the savings side, the net savings from the Medicare-Medicaid growth trend and class proposals in the bill are estimated to total about $564 billion--net savings totaling $564 billion, before you get to those 33 million. When you cover them, that is how it gets to that $224 billion. If you do rough math, and if you have 33 million Americans and they start getting coverage, say, 5 years out--so that there is 5 years of coverage in this for them--divide by $234 billion, it is about $1,500 per person per year to have those 33 million people insured. Anybody who thinks for 1 minute about the human side of our health care tragedy cannot help but think that that would be a wise investment--for $1,500, to give somebody the security of health insurance. Of course, that assumes that this bill actually does, when it is implemented, raise costs by $234 billion. As somebody used to say on the radio, that is not the end of the story. The end of the story takes a little bit of development. I note that the Actuary himself said that the actual future impacts of this act on health expenditures, insured status, and individual decisions, and employee behavior are ``very uncertain.'' Why? Because few precedents exist for use and estimation. Consequently, ``the estimates presented here are subject to a substantially greater degree of uncertainty than is usually the case with more routine health care proposals.'' In the conclusion, the CMS Chief Actuary reiterates that, saying: These findings are subject to much greater uncertainty than normal. Many of the provisions are unprecedented or have been implemented only on a smaller scale. Consequently, little historical experience is available with which to estimate the potential impact. Where does that affect the bill? It doesn't affect it in new coverage. We know how much it costs to cover people. It doesn't affect it with expanding access to health care. We know how much that costs. Where it affects it is on the savings side. It is not just the CMS Actuary who says that. As I will get to in a moment, that is also the conclusion of the Congressional Budget Office. They agree on this. If we are going to get something done about this health care increase, we are going to have to do something about reforming the delivery system, about taking out waste and excess costs. Those things are, by definition, hard to predict. They don't lend themselves to the actuarial prediction that the CMS Actuary does and that CBO does. But there is a big target out there. Here is President Obama's Council of Economic Advisers. They had a report out in July: Efficiency improvements in the U.S. health care system potentially could free up resources equal to 5 percent of

Mr. WHITEHOUSE. Mr. President, I ask unanimous consent that the distinguished Senator from Iowa be recognized for 20 minutes, and that I be recognized at the conclusion of his remarks for up to 20 minutes.

Mr. WHITEHOUSE. Dr. Gawande continues: Pick up the Senate health-care bill--yes, all 2,074 pages-- and leaf through it. Almost half of it is devoted to programs that would test various ways to curb costs and increase quality. Just like Professor Gruber said: . . . I can't think of a thing to try that they didn't try. They really make the best effort anyone has ever made. Everything is in here. . . . I can't think of anything I'd do that they are not doing in the bill. You couldn't have done better than they are doing. Dr. Gawande continues: The bill is a hodgepodge. And it should be. Which of these programs will work? We can't know. That's why the Congressional Budget Office doesn't credit any of them with substantial savings. . . . But we should not lose faith. He concludes: . . . there's no piece of legislation that will have all the answers. . . . But if we're willing to accept an arduous, messy, and continuous process we can come to grips with a problem even of this immensity. We've done it before. So when the other side comes to the table and argues that this bill is a cost disaster, a nightmare, and all the things they are saying, I urge people to consider two things. First is that they have been pretty clear that they do not want a bill at all, ever, any bill, none. Their desire to deny our new President this victory is an ulterior goal they have declared. Senators have said they want it to be his Waterloo. They have said: It is our goal to break him, to break his momentum. So when they say start over, it is a little hard to believe it. If they were candid, they would say: No, stop dead and leave things just the way they are. Obviously, they could not say that because America would not get behind that. So they have come up in the last few days with this ``start over'' theory. When you look at what their political purpose is, to break President Obama, to break his momentum, to stop any health care bill from happening, it is worth considering their protestations on the floor in that light. The other light in considering them is in this one: If we are going to save significant money by making the delivery system more efficient, all experts agree you cannot cost it out in advance. The actuaries cannot figure it out. But the tools we need to make it happen, the intent of the Obama administration to make it happen is in there. The savings target is between $700 billion and over $1 trillion a year. When we achieve those savings, we are improving the quality of health care. It is less duplicative, it is less wasteful, it is less paperwork, and the quality goes up. A perfect example is the famous Keystone Project in Michigan where they practically eliminated hospital-acquired infections in intensive care units in a number of hospitals in Michigan. In 15 months, they saved 1,500 lives and $150 million. When they started that project, could an actuary have predicted that would happen? No, never. Never. And at the beginning of the agricultural revolution, when agricultural extension agents first went out and we modernized the American agricultural center, could they have predicted what Dr. Gawande reported? No, they could not. You cannot predict it, but this President can direct it. He can make it happen. We will give him the tools. For those who are concerned about cost, there is very significant grounds for optimism about what happens in this bill. If we don't do it this way with those delivery system reforms, we are going to be left with a bloody toolbox, cutting people off, throwing them off, chopping the benefits, paying providers less. It will be to health care reform what a Civil War surgeon's toolbox was to modern medicine--saws, knives, cauterizing irons, and the patients screaming. It does not have to be that way. There is a better way, and it is in the bill. I thank the distinguished Senator for yielding me the extra time. I yield the floor.

Mr. WHITEHOUSE

Mr. WHITEHOUSE. I think those were the Republican amendments that were accepted into the HELP Committee bill. In fact, I think there were 161, if I remember correctly from my time sitting on the committee. We took Republican amendment after Republican amendment after Republican amendment trying to reach out to them.

Mr. WHITEHOUSE. Mr. President, I would love to interject a question to the distinguished Senator from Michigan. We are in a situation in which the other side is repeatedly coming to the Senate floor to ask us to delay, to stop, to slow down, to start over. I am curious, as somebody who has watched this debate very closely, what the Senator from Michigan thinks about where we would be if we acceded to that wish? Bearing in mind that one of the sort of ideological firebrands who seems to be leading a measure of the debate on the other side has indicated this is not about health care and people; this is about giving President Obama a Waterloo; this is about creating a political defeat for the President of the United States on their side; it has nothing to do with health care; it is entirely about creating a defeat for this new President; when, in the face of all the obstruction the distinguished Senator from Michigan described so eloquently, this recordbreaking, ``unprecedented in the history of the Senate'' obstruction we are seeing, the person whom I think right now seems to characterize the leadership of the radicalized rightwing and is running the Republican Party, Rush Limbaugh, is telling the other side they have not been obstructive enough. So if we were to go back, start all over, and reach out our hands again to our friends on the Republican side, is there any reason to believe that we would not be just as rebuffed going forward as we have been in the long arduous process of negotiation and hearing and public meeting and all of the work that has taken us to this point right now?

Mr. WHITEHOUSE. If we were to wait, does the Senator think there is any likelihood people on the other side would suddenly want to cooperate with President Obama and not hand him a defeat? If Rush Limbaugh would say: OK, Republicans in the Senate, go ahead, work with the Democrats now; don't just be the party of obstruction and delay but try to work cooperatively for the American people, does the Senator think there is any likelihood of that happening?

Mr. WHITEHOUSE. I share the disappointment of the Senator from Michigan; that the promise and the outreached hands have been rejected and rebuffed; that this place has become so bitterly partisan. This is my first time in the Senate with a Democratic President, and I have been surprised at the tone of the debate, at the lack of truth of a great many of the arguments, of the very apparent motivation. I have spoken to members of our caucus who I think are probably viewed as some of the most moderate when it comes to seeking bipartisanship, who are calm and respected Members of the Senate and who have been here a long time, and I have asked them how this compares to their long years of experience in the Senate. One of them said he has literally never seen anything like it in all the years he has been in the Senate. He has never seen anything like it. They are always on message, he said, but I have never seen them so off truth. I think it is regrettable, but if your mission is to destroy a strong and important piece of legislation, not because it is bad legislation but because you can't stand having this new President win a political victory, are you going to go out and disclose that is your motivation? No, you are going to come up with a bunch of other cockamamie arguments to paper that over. You will talk about death panels and you will go through all the nonsense we have seen and it is regrettable.

Mr. WHITEHOUSE

Mr. WHITEHOUSE. Mr. President, I rise today to introduce the Commercial Advertisement Loudness Mitigation Act of 2009--the CALM Act. I want to thank my original cosponsor Senator Schumer for his support of this straightforward and commonsense legislation, which would require the Federal Communications Commission, FCC, to limit the volume of television advertisements to a level no louder than the average volume level of the programs during which the advertisements appear. This time for this Act is overdue. All too often over the years, Americans, sitting down after a long workday or workweek to enjoy their favorite television shows, have been assaulted by commercials at volumes that are degrees of magnitude louder than the shows themselves. The FCC first received enough complaints from viewers to look into the problem in the 1960s--when television was in its earliest stages--but technology did not exist to fix the problem. Each decade, as consumer complaints piled up, the FCC had to reexamine the loudness issue. Unfortunately, it took no action even with the technology improved. The complaints continue to this day; in the 25 quarterly reports on consumer complaints released by the FCC since 2002, 21 have listed as a top complaint the loudness of television commercials. But now, with the digital transition complete and new broadcast technology available, we can finally take this long-overdue action. We now have a common digital platform used by all broadcasters, which presents a terrific opportunity to standardize the loudness of the ads broadcast into our living rooms. As Consumers Union, the nonprofit organization that publishes Consumers Report has stated, in testimony before the House of Representatives, ``the CALM Act provides an elegant and commonsense solution to finally ending a forty-five year consumer complaint in the United States.'' The House has already begun its consideration of companion legislation, and I applaud the leadership of Representative Eshoo on this issue. The television industry has been deeply involved in the drafting of this legislation, and the standards it adopts are practicable, affordable, and effective. I hope my Senate colleagues will act quickly to pass the CALM Act and finally put an end to this longstanding irritation.

Mr. WHITEHOUSE

Mr. WHITEHOUSE. Mr. President, I will speak for just a moment because I know the Senator from Pennsylvania wishes to speak. When he comes to the floor, I will quickly yield to him. While there is a moment in between, I want to speak to some of the arguments we have heard. There is always the question of the substance of an argument. There is also the question of the credibility of an argument. I think as people watch this debate and discuss the credibility of the concern expressed by our friends on the other side of the aisle about the deficit impact of the CLASS Act, it is worth considering a few facts just to evaluate that. First is that the CLASS Act is required to be actuarially self- sustaining. People pay into it and, from those funds, under the insurance principle, funds come back out. It is required to be self- sustaining that way. Second, it is voluntary. Nobody has to contribute. If you want to contribute, then you can become eligible for the benefit once you have vested. But nobody is forced into this; it is entirely voluntary. The CBO, on which we rely in a nonpartisan fashion, has said this is solvent for 75 years. Finally, because we think--at least on this side--this matters. It will help the disabled and elderly at that critical point of decision, when their ability to stay home, their ability to stay independent, or their ability to stay at work depends on just a little bit of help to accommodate their age or disability, it is then that this will make a difference. What a difference it will make in human lives. I know the Senator from Connecticut wishes to use an example. I will yield to him on his signal. We have seen this before. We saw this not long ago on the public option, which would compete with insurers head to head on a fair and level playing field. It was completely voluntary, and it had to be actuarially self-sustaining. It had to meet the solvency laws of the State in which it operated. In both cases, our colleagues on the other side have rushed to the floor to talk about deficits and how these will contribute to the deficit. These are both actuarially self-sustaining programs required to stay solvent. Yet here they come to raise the specter of deficits. But this is the same party that pays for 14-percent subsidies to private insurers to compete with Medicare. As my son would say, duh, if you are getting 14 percent extra, it is pretty easy to compete. When they asked for that deal, they promised they would drive costs down. In fact, they have driven costs up, and they put it in their pockets. It is not fair to the insurers that are not in the program. It is greedy on their part. All we want to do is hold them to their promises. Do we hear any concerns about the deficit problem on the 14-percent subsidy for the Medicare Advantage Program? No, dead silence--guess what--because it helps the insurance industry. When the Part D program came in, our friends on the other side forced through a provision--a unique provision--that gave the pharmaceutical industry a special privilege that the U.S. Government could not negotiate with it over price--could not negotiate with it. Lord knows how much that has added to our deficit. But have they ever come to complain? No, because the beneficiary is the pharmaceutical industry. But when things help regular people, when things help competition in the insurance market, even where they are required to be actuarially self-sustaining and solvent, then suddenly they turn up. They can detect the threat of deficit in parts per billion when it helps somebody. But a patent, actual living, breathing, deficit-enhancing subsidy that is on the books right now, they don't care about if it helps the pharmaceutical industry or the insurance industry. As we have this discussion, that is a point worth bearing in mind because it is not just the substance of the amendment, it is the credibility of the argument that counts. I said I would yield to the distinguished Senator from Pennsylvania when he arrived, and he has arrived. Without further ado, I yield the floor.

Mr. WHITEHOUSE. Mr. President, those of us who have been privileged to hear our friends on the other side debate the public option have seen a relentless insistence on the public option operating on a level playing field with the private insurance industry. I can't tell the number of times we have heard that. Indeed, even when we designed the public option so that it did operate on a level playing field with the private insurance industry, they still complained. But now we have a situation in which we have private industry operating at a 14-percent advantage and subsidy against Medicare. Suddenly, the other side's interest in a level playing field has evaporated. Suddenly their interest is in doing what is, once again--in the astonishing coincidence that characterizes debate--in the interest of the insurance industry. I have yet to see an argument made from the other side of the aisle that doesn't happen to coincide with the interests of the insurance industry. It could not be more stark on this point. If it is a public option, they want it to compete on a level playing field. And even then they are against it. If it is privately subsidized coverage, getting an advantage against the public system, then they are for it. I urge consistency and support of the effort to bring some discipline to Medicare Advantage, as the private insurance industry promised. We are doing no more than holding them to their word.

Mr. WHITEHOUSE

Mr. WHITEHOUSE. Mr. President, I yield the floor to the distinguished assistant majority leader.

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

Mr. WHITEHOUSE. Mr. President, I see the distinguished Senator from Iowa as well as the distinguished Senator from Pennsylvania. Whichever one of them would like to proceed, I am prepared to yield. It looks as if it will be the distinguished Senator from Iowa. I had the very great honor of serving on the HELP Committee during the time that the HELP Committee section of this bill was prepared. One of the most vital and important elements of this bill is its new focus on wellness and prevention to help Americans stay healthy so that it truly is health care and not just sick care, so that the medical establishment is not incented to add more and more tests and procedures because that is what they get paid for but won't have an e-mail contact or won't have a phone call to help talk a patient through something because they can't get reimbursed. The potential value of wellness and prevention in this country is astonishing. It has been underinvested in because the people who are responsible for making those choices really don't get the benefit of them under our present perverse system. The Senator from Iowa has shown great leadership. He is now chairman of the HELP Committee, but he certainly chaired, through the committee deliberations, the health and wellness portions. It was my honor to watch him in action and see the astonishing results he achieved. I yield the floor to him and ask unanimous consent that at the conclusion of the remarks of the distinguished Senator from Iowa, the Senator from Pennsylvania, Mr. Casey, be recognized.

Mr. WHITEHOUSE. Mr. President, I now call up amendment No. 2870, an amendment to protect the Social Security surplus and CLASS program savings in this act and ask for the amendment's immediate consideration.

Mr. WHITEHOUSE. Madam President, I intend shortly to call up an amendment once the procedural posture is clarified and has been cleared on the Republican side, an amendment to protect the Social Security surplus and the CLASS program savings in this act. When I do, I will then ask for its immediate consideration, but at the moment, that is still being worked out from a parliamentary standpoint, so my words will come in advance of that. I wish to describe the amendment for my colleagues. It is a sense-of- the-Senate resolution that demonstrates the Senate's commitment to meaningful deficit reduction in this legislation while also protecting both the Social Security surpluses generated by the legislation and savings generated from a significant element of the bill, the long-term voluntary insurance program created by the Community Living Assistance Services and Supports Act, what we call the CLASS Act. The amendment expresses the sense of the Senate that surpluses generated by this bill for the Social Security trust fund be reserved for Social Security and that the savings for the long-term insurance program created by the CLASS Act be reserved for the CLASS program. The CBO has estimated that this bill will save $130 billion over the first 10 years and roughly $650 billion over the next 10 years. This amendment stands for the proposition that these impressive savings will be protected vis-a-vis the CLASS Act and the Social Security trust fund. I wish to speak in particular today about the CLASS Act. This act creates a voluntary insurance program for seniors and individuals with disabilities. This program will enable them to afford long-term care even after they have exhausted coverage offered by Medicare or their private insurer. Let me make clear that this is not a mandatory program. It does not increase taxes on anyone. It is a completely voluntary program that offers an additional insurance option for the disabled. Without such insurance, disabled people often cannot afford the massive costs of long-term care. Under current law, they are often forced to sell their homes or otherwise what is called ``spend down'' their assets until they meet a poverty threshold before they can begin receiving the help they need. Certain colleagues on the other side of the aisle have argued that the CLASS plan would lead to a financially unstable entitlement program and would rapidly increase the Federal deficit. That is simply not accurate. The CLASS plan is fully self-sustaining and actuarially sound, funded by the premiums paid by those individuals who voluntarily opt into this insurance plan. There are no taxpayer dollars involved. After individuals pay premiums for 5 years, they become eligible to receive a cash benefit of no less than $50 per day to assist with the various costs associated with the onset of a disability or long-term health condition. These benefits could be used to pay for transportation to work, for instance, or the construction of a wheelchair ramp or the hiring of a personal aide--the sorts of things that so often make the difference between somebody remaining an independent and productive member of society and requiring the support of assisted living or nursing home care. I think we can all agree that it is in everyone's best interest to try to provide this kind of assistance to people when an unexpected disability begins to affect their lives, to allow them the support they need to continue as best they can in their homes, in their apartments, with their families, at their jobs, and remain, as I said, both independent and productive. The Congressional Budget Office has concluded that this plan is fiscally solvent. In fact, it projected that the program would be solvent for at least 75 years. There was a helpful amendment offered in the HELP Committee when we considered and debated and passed that piece of legislation. The amendment was offered by the distinguished Senator from New Hampshire, your colleague, Senator Gregg, the ranking member on the Budget Committee. It passed unanimously, and it ensures and requires that the program be actuarially sound for 75 years. CBO has projected that, in fact, it would be solvent for at least 75 years. CBO further estimated that the program would reduce the deficit by $72 billion over 10 years, saving $1.6 billion for Medicaid during the first 4 years of the program. So it has a substantial fiscal upside. I am surprised that our colleagues on the other side are criticizing this element of the bill. It seems to run contrary to the findings that have been made by the nonpartisan Congressional Budget Office. It is certainly a stark contrast to their tolerance for their own Medicare Part D Program, the pharmaceutical program the other side touted so proudly, which is different from the CLASS Act in many respects: It was vastly expensive; it was completely unpaid for; it was a massive handout to the pharmaceutical industry, containing within it the, to me, appalling proposition that the government was forbidden by law, forbidden by a previous Congress, to negotiate with the pharmaceutical industry over the price of drugs and had to take it or leave it, whatever the pharmaceutical industry charged. Frankly, it is irresponsible to put the government into that situation. It is fiscally irresponsible, and it is irresponsible from a management point of view. It is irresponsible in more ways than I can name. Yet they happily went that way, the path of fiscal irresponsibility, when it suited the pharmaceutical industry. Of course, in order to do so, they had to leave a hole in the Part D pharmaceutical program for seniors to fall into, what the Presiding Officer knows well and what my colleagues know well as the dreaded doughnut hole that has caused so many unsuspecting seniors so much surprise, chagrin, fear, anxiety, and misery. Now, having been the architects of that program, they criticize the CLASS Act even though the CBO has found it to be fiscally sound. It seems there is an enormous double standard between programs designed for the benefit of, say, the pharmaceutical industry, or perhaps the insurance industry, and the standards they would apply to programs that benefit people who suffer from the onset of a disability--regular Americans, regular families. This is something that happens to people across this country all the time. That is really the most important effect of the CLASS Act. As good as it is on deficits, as much as the CBO has confirmed that it is to our fiscal advantage to proceed with the CLASS Act, the most important effect is not on deficits, it is on people. It is on families. This insurance program will allow disabled people, young and old, to live more financially secure and productive lives, free from the fear that medical expenses will impoverish or bankrupt them, able to make those investments in their own adaptation to their disability so they can maintain the lifestyle, the job, and the home they are accustomed to and comfortable with. Studies show that less than a quarter of private long-term care insurance policies provide a lifetime of benefits. The CLASS Act fills an important void that has been left by the public sector for people who seek this protection and this insurance on a paid-for basis. The CLASS plan is a win-win for reducing costs in our health care system and protecting Americans who require long-term care. Our current system plain fails to protect those who aren't healthy or wealthy enough for private market coverage. It fails to create an opportunity for individuals to plan and save for their future lifetime care needs. It fails to provide a sustainable safety net for individuals who require long-term services and supports to keep the familiar aspects of their life around them--job, family, home, hearth. I will shortly ask that my colleagues support the amendment when it is called up. It will put the Senate on record as protecting Social Security. It will put the Senate on record as protecting the CLASS Act savings scored by CBO. It will put the Senate on record as supporting the impressive deficit reduction in the bill. I look forward to favorable consideration when we have a parliamentary agreement on calling it up. I yield the floor.

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

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

Mr. WHITEHOUSE. Mr. President, I thank the chairman of the committee.

Mr. WHITEHOUSE. Of course. How long would the Senator wish?

Mr. WHITEHOUSE. I had the opportunity to be on the floor yesterday, and the time was all under agreement. My time was concluded, and I was leaving the floor. The Senator from Utah had the occasion to offer some very kind words about me. Because of the procedural posture we were in, I did not have the chance to reply or respond at that time. This is the first time we have been on the floor together since then, when I have had the chance to have the floor, and I do want to let him know how much I value what he had to say. I know there are very well-established standards of protocol here in which we say nice things about each other, but I felt that what he had to say was not just protocol but was sincere and heartfelt, and it really does mean a lot to me and is reciprocated on my part. I think Senator Hatch brings enormous, as I said earlier, dignity, erudition, principle, collegiality--many good characteristics to the floor. He is a force for good in this body, and I am delighted to have him count me a friend. I yield him the next 5 minutes.

Mr. WHITEHOUSE. I yield 5 minutes to the distinguished Senator from Utah right now.

Mr. WHITEHOUSE. Would the Senator yield back for one moment?

Mr. WHITEHOUSE. I am delighted to yield.

Mr. WHITEHOUSE. Mr. President, if I could ask the Senator to yield for a question, it would appear, then, that not only is there this subsidy that goes to the private insurance industry, funded by a tax on all other Medicare recipients, but those private insurance companies are actually doing their level best to try to pick out a disproportionately healthy Medicare-eligible population, so what we end up doing is not only paying more for Medicare Advantage but also for a healthier population. So it is a double subsidy.