Mark Warner

Mr. WARNER

Mr. WARNER. Mr. President, I ask unanimous consent to speak in morning business for up to 6 minutes.

Mr. WARNER

Mr. WARNER. Mr. President, I rise to talk about an amendment I hope ultimately will be given a chance for consideration on this very important legislation we are working on right now. I commend the chair of the Finance Committee for his good work on trying to focus this next round of job-creation activities that will be created, I believe, as we move forward on extending some of the tax provisions that expired last year. Some of these tax provisions were part of our stimulus bill that, about a year ago, we passed to help jump-start job activities; a stimulus bill I sometimes think the American public--perhaps we never explained. In fact, close to one-third of that bill was tax cuts, another third was direct assistance to States and localities, and the final third was a series of new initiatives, many of which are just now starting to come to pass. I can recall, about a year ago, I came to the Senate floor as we were debating the stimulus, the American Recovery and Reinvestment Act, to talk about fiscal accountability; to talk about our long-term outlook; and to make some recommendations on how we might better track the performance and outcome of the American Recovery and Reinvestment Act, what most folks commonly refer to as the stimulus. Here we are 1 year later and unfortunately it appears critical Recovery Act reports and plans have gone missing or have been long ignored or were never fully developed in the first place. As we debate this important piece of legislation that extends a number of the tax provisions, I think we ought to take this moment as well to correct some of the deficiencies in reporting on the fiscal responsibility I think all of us on both sides of the aisle would like to see in the overall Recovery Act activities. We have this chance, at this point, to correct course and to ensure we can account for every dollar. Now it is time to correct management and transparency gaps that still exist. Today, I would like simply to very briefly go through a couple things my amendment would do. Hopefully, the chair of the Finance Committee and folks on the other side will agree to have these amendments incorporated. My amendment will, in three very important ways, correct the management and transparency gaps that still exist in the Recovery Act. First, it will require agencies to update the implementation plans they have developed last year for high-risk programs. High risk has this connotation that somehow it is a bad area or bad idea. No, the high-risk areas I am defining are those programs that are over $2 billion that saw a funding increase of over 150 percent more than their fiscal year 2008 funding or are brandnew programs. These programs will be required to update their plan by July 1, 2010. Let me take a moment and describe what kind of programs I am talking about. As I mentioned a few moments ago, the stimulus broke into tax cuts, assistance to the States, and then, finally, an agreement that we ought to take up a series of areas that have for years been talked about in this country but, candidly, we have never done much about-- broadband technology, high-speed rail, smart grid, health care information technology. These are all areas that, again, had broad support on both sides of the aisle, that we talked about, and only in the case of the stimulus were there actually funds put behind these initiatives. The challenge was, a year ago many of these areas had very little funding or had no programmatic prior experience so the administration appropriately took some time to gear up these programs. We are just starting to see some of the disbursement on high-speed rail and disbursement on the President's Race to the Top education grants. But for these new programmatic areas, we need to make sure there is a plan in place, that there are metrics in place, and that we know how these dollars are being spent out. So the first part of my amendment will require these programs in high-risk areas to update their plans by July 1 of this year. Second, my amendment will require these high-risk programs to report back to Congress and the public quarterly, beginning September 30, 2010. These reports must include performance and financial data to let us know whether these programs are working and meeting the goals they defined in their initial business plan that they would lay out to us in July of this year. I think this is terribly important. These are areas that, because they are new--I think they have enormous popular support, but because they are new, we need to make sure that at the front end of these program implementations, we have that business plan in place, we have the metrics, and we have a reporting mechanism. The second part of my amendment is an area that we have been working with the inspector general around the Recovery Act, Mr. Devaney, and others. I think many of us in this Chamber would be disturbed to find out that the recent quarterly report showed that over 1,000 recipients of stimulus funding--1,000 agencies, departments, grantees--had failed to report back the legally required data on how these dollars have been distributed, what kind of tracking is in place. Consequently, when we hear critiques, particularly from the other side, about the stimulus, about the job creation and efficiency, well, an appropriate rebuttal requires facts being in place. Over 1,000 of the recipients that have received stimulus funds have basically ignored the law and failed to report back. So my amendment proposes financial penalties of up to $250,000 for recipients of the stimulus funds who knowingly fail to comply with the existing quarterly reporting requirements. We have to ensure that our agencies, Congress, and the public are getting the information they need to know if these important investments are working. The amendment requires agencies to notify recipients if they miss a deadline. They will provide an opportunity for the recipient to report and offer technical assistance if they need that assistance to get back on track. But if recipients knowingly do not file the required reports or if they ignore these agency requests for this information, agencies may impose a penalty to hold these recipients accountable. The amendment provides sufficient discretion for agencies to set penalties, such as consideration of whether the recipient is a nonprofit, government, or small business entity. We don't want to add on a new burden, but we simply want those who are receiving financial assistance from the stimulus fund to actually fulfill their obligation and make sure they report back to us and the public on how those dollars are being spent. I repeat, it is not too late to correct the gaps in program management and transparency in the American Recovery and Reinvestment Act. So much of the Recovery Act funding is still in the pipeline. As a matter of fact, at the end of last fiscal year, last October, only 18 percent of our recovery dollars had been spent out. Even at the end of this fiscal year, at the end of September 2010, only about 54 percent of the dollars will be spent out. We still have literally hundreds of billions of dollars to be spent out from this program. We have to make sure--we owe it to ourselves, we owe it to the public--that we have in place both the appropriate metrics on these high-risk programs and that those other organizations that are receiving dollars do what is their legal requirement to report back on this terribly important data. I hope we can get this amendment adopted. I look forward to working with my colleagues on both sides of the aisle to bring this added transparency and this added management oversight to this very important activity. I yield the floor, and I suggest the absence of a quorum.

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

Mr. WARNER

Mr. WARNER. Madam President, I rise today to commend the efforts of Virginia Task Forces One and Two on their recent deployment to Haiti. Their combined efforts in the immediate aftermath of the devastating earthquake resulted in the successful rescue of 19 men, women, and children. These teams are made up of over 150 firefighters, physicians, and structural engineers from Fairfax and Virginia Beach, VA. Both teams were manned and ready within 24 hours of the call for help. That included preparing and staging over 100 tons of cargo and gear for airlift to Haiti. One of the rescues involved Jens Christensen, a United Nations worker from Denmark who was trapped in the United Nations compound. The teams worked for over 8 hours to free him, and kept him alive by inserting a feeding tube through the rubble to provide him water during the rescue. Acting on a tip from local residents, the team also rescued two children, ``Kiki and Sabrina,'' almost a full week after the earthquake. These two Haitian girls were still alive in a building no one had previously searched. Another woman was rescued from the rubble of a collapsed market, and the team was able to provide paramedics and physicians to treat her on site and stabilize the woman for transport to a local hospital. These teams leveraged their countless hours of training to hit the ground running at full speed. They have extensive international and domestic disaster response experience, and are recognized throughout the United States and the world as leaders in readiness, response and recovery techniques. This is an important capability--and just yesterday I understand the teams were put on ready alert to potentially deploy again, this time to Chile to help with search and rescue efforts. Please join me in commending the heroic and humanitarian efforts of Virginia Task Force One and Virginia Task Force Two. I offer sincere thanks to all the team members, support personnel, and the families of these brave men and women.

Mr. WARNER

Mr. WARNER. Mr. President, in the summer of 2009, Senator Webb and I had the honor of interviewing several potential candidates to serve on the U.S. Court of Appeals for the Fourth Circuit. We were enormously impressed by the quality of all the candidates being considered. But one candidate rose to the top of the list for her extensive experience, judicial temperament, and commitment to the law. This candidate was Justice Barbara Keenan. President Obama nominated Justice Keenan on September 14, 2009. The Senate Judiciary Committee held a hearing on the nomination where members of the committee were given the opportunity to engage Justice Keenan in a question-and-answer session. On October 29, 2009, the members of the committee reported the nomination by unanimous consent. Justice Keenan's nomination has been on the Senate Calendar for 4 months now. I believe it is time for this Chamber to consider the nomination and give Justice Keenan an up-or-down vote. Justice Keenan has strong academic credentials. She graduated from Cornell University in 1971 and received her law degree from the George Washington University Law School in 1974. She also earned a master of laws degree from the University of Virginia School of Law in 1992. Justice Keenan has served with distinction at every level of State court in Virginia. She has served as a justice on the Virginia Supreme Court since 1991. She also served on the Fairfax County General District Court, the Circuit Court of Fairfax County, and the Court of Appeals of Virginia. Earlier in her career, Justice Keenan worked as an assistant prosecutor in Fairfax and briefly worked as an attorney in private practice. The Virginia State Bar Judicial Nominations Committee ranked Justice Keenan as ``highly qualified.'' She was one of the few candidates to receive a unanimous vote. The committee noted in the summary of her evaluation that ``. . . it would be a shame to lose Justice Keenan's skills on the Supreme Court of Virginia, but Senators Webb and Warner could do no better than her appointment to the Fourth Circuit . . .'' The committee also found that Justice Keenan has exhibited excellent judicial temperament, has the highest integrity, and concluded that she has superior intellect and legal skills for the position. In addition to the Virginia State Bar, Justice Keenan was considered ``highly recommended'' or ``highly qualified'' by the Virginia Women Attorney's Association, the Old Dominion Bar Association, the Virginia Trial Lawyers Association, and the Asian Pacific American Bar Association. I must also mention that Justice Keenan is the first woman appointed to the bench in Virginia and one of the initial 10 appointees to the Virginia Court of Appeals following its creation in 1985. Six weeks ago Justice Keenan was the first woman to administer the oath of office to a Virginia Governor, Gov. Bob McDonnell. In May, Virginia Lawyers Weekly named Justice Keenan as the ``influential woman of the year'' for ``a litany of first and years of service.'' I look forward to casting my vote in support of Justice Barbara Keenan's nomination and encourage my colleagues on both sides of the aisle to do the same.

Mr. WARNER

Mr. WARNER. Thank you, Mr. President. I thank my colleague, the Senator from Delaware, for his comments and for his leadership on this issue. I also thank all of the freshmen. This is, I think, the seventh time the freshmen have come to the floor on this very important issue. Our colleagues have had to now endure 65 speeches from the freshmen on the subject of health care. Before I get into my remarks, I want to personally thank Senator Baucus, Senator Dodd, the majority leader, and their staffs, for working with the 11 freshmen Members who have come together today to unveil a package of health care amendments focused on the issue of cost containment. We have been working on this now for close to 3 months. Let me say at the outset, I am proud of the enormous broad-based support we are receiving for this package of amendments. The Business Roundtable has endorsed the amendments. Companies such as Walmart, Intel, Target and Quad/Graphics endorse this package. Groups such as the AARP and the AFL, and important think tanks such as the New America Foundation have endorsed this package. We also have support from Mark McClellan, who was the head of CMS under President Bush. While the merged bill starts to move us in the right direction in addressing health care spending in this country, this package strengthens that movement. Our package further moves us away from a current system that makes no financial sense--one that rewards volume over quality and one that reimburses hospitals for higher, rather than lower, readmission rates. We are taking the payment reform aspects of the health care bill-- sections that increase accountability, and focus on data mining and administrative simplification--and accelerating them. We are giving the Secretary, as we move forward, the ability to take pilot programs and broaden their approach and appeal. And if it works, we'll bring that reform to our whole system. While we anticipate a very good score from CBO in terms of lowering health care costs overall, another thing we focused on with this package is not just health care reform in the context of government- related programs, such as Medicare and Medicaid, but also how we partner with those in the private sector. One of the reasons the Business Roundtable is so supportive is the fact that our package recognizes that well over half of the American public still receives their health care through private insurance or in conjunction with their employers. With these amendments, we look at how we take the best of the private sector, and the lessons we've learned from them, and bring those into health care reform. My friend, the Senator from Delaware, has raised this point. There are still issues to be resolved in this bill. I still have some concerns, particularly with the public option portion. But I know that with a good-faith effort, we are going to get those issues resolved. One thing that needs to be reaffirmed, time and time again, is what happens if we don't enact health care reform. Not acting is a policy choice; it is every bit as much of a policy choice as moving forward on this bill. What many don't realize is that the largest driver of our Federal deficit is not education funding, transportation funding, and not even TARP funds or the stimulus. The largest driver of our Federal deficit is health care spending. If we fail to act now, Medicare, which provides health care to millions of senior citizens, will go bankrupt in the next 8 years. If we fail to act now, an average Virginia family will see their health care costs eat up 40 percent of their disposable income in the next decade. One of the reasons we are seeing so much broad-based business support for our amendment package is business understands that if we can't drive down overall health care costs, the ability of the United States to come out of this recession and remain competitive in a global marketplace will be seriously undermined. As long as American business has to pay twice as much per person--as much as $3,000 to $4,000 more per employee--for their health care costs than any of our industrial competitors around the world, regardless of how productive the American workforce is, American businesses will be at a serious disadvantage. Our amendment package is complex. It is a bit dense. There are some 30-odd different provisions that take very good parts of the merged bill and move them faster. It increases price transparency in health care pricing, and increases our ability to take programs and pilots that work and roll them out on a wider basis. My good friend, the Senator from Colorado, has been working hard on the administrative reform portion. This is a good package of amendments. I was asked yesterday by somebody in the press how I would describe the package. I guess I would sum it up--because some of this stuff gets fairly dense--with two things that this package of amendments is trying to do. I think we all remember, years back, in the travel industry, when you called up and tried to get an airline reservation and depending on whom you called and what time you called, you might get a totally different price on your airline ticket. Well, this package of amendments is trying to do for health care what Travelocity did for the airline business. And that is bring some true pricing transparency to the health care system. Our package of amendments will move us--it will not get us all the way there--but it will move us further down the field. I say this modestly, again, to the originators of the bill--it is a very good bill, a very good framework. But humbly I might say, as some know, I was lucky enough in the old days to fall into the cell phone industry. I managed to eke out a small living in that industry. I like to think about the cell phone industry as a metaphor for this package of amendments. If we think of the original bill as creating the cell phone of the 20th century, our package of amendments is basically the iPhone version to your Motorola flip phone original version. We literally provide dozens of new applications on a good, basic framework that has been provided by this merged bill. And we take these applications a little bit further into the 21st century. I am very proud of the work all these freshmen Senators and their staffs have done over the last 3 or 4 months. Again, I thank the chairman of the Finance Committee, the chairman of the HELP Committee, the majority leader and their staffs for helping us work through this package, and I look forward to its adoption. With that, I yield the floor, and I believe the junior Senator from Colorado will speak next.

Mr. WARNER. Madam President, I know our time is about to expire. I wish to close by thanking all my freshman colleagues and their staffs for the great work they have done on this legislation. I see a number of my colleagues from the other side of the aisle. This is an amendment package that brings greater transparency, greater accountability, greater efficiency, and greater innovation, and is supported by the Business Roundtable, small businesses and health care systems around the country. I ask for their consideration. I again thank the Chair, Senator Dodd, for allowing us to lay out this package of amendments. I think it will add an important component to this bill in trying to rein in costs not just on the government side but systemwide. I yield the floor.

Mr. WARNER

Mr. WARNER. Mr. President, today I wish to recognize the 225th anniversary of the birth of MG Zachary Taylor, a Virginia native son and the 12th President of the United States of America. Best remembered as a distinguished military hero, Zachary Taylor was known as a resourceful, steadfast, modest and compassionate commander who fought many successful battles, earning from his soldiers and countrymen the affectionate nickname ``Old Rough and Ready.'' Zachary Taylor's personal popularity increased as his national prominence spread. General Taylor defeated Henry Clay, Winfield Scott and Daniel Webster for the Whig Party Presidential nomination. Although he had not sought office, Zachary Taylor was elected the 12th President of the United States. Slavery was the driving issue of the campaign and the primary challenge of Zachary Taylor's brief Presidency. In his inaugural address, Zachary Taylor promised that the preservation of the Union would be his first obligation. He was determined to find a solution to end slavery even though he was a southerner and a slave holder. Zachary Taylor urged settlers in New Mexico and California to bypass the territorial stage and draft constitutions for statehood. As Southern Democrats called for a secession convention, Zachary Taylor reacted with a bristling statement that he would hang anyone who tried to disrupt the Union by force or by conspiracy, setting the stage for the Compromise of 1850. During his 15 months in office, Zachary Taylor also created the Department of the Interior and signed a treaty with Great Britain guaranteeing a neutral canal connecting North and South America. After laying the cornerstone of the Washington Monument on July 4, 1850, Zachary Taylor fell ill and passed away. An unprecedented 100,000 people lined the funeral route to see the hero laid at rest. On November 24, 2009, representatives of local, State and Federal Government will gather to honor one of Orange County's most famous native sons. First Day Issue Zachary Taylor Dollar coins will be given to county schoolchildren. Please join me in commemorating the life of Zachary Taylor and the courage and efforts during his term of office to bring a peaceful end to slavery in the United States.

Mr. WARNER

Mr. WARNER. Mr. President, let me commend my colleague, the Senator from Massachusetts, for his comments about Senator Byrd. I also want to join in recognizing and celebrating Senator Byrd's service to West Virginia and to our country. As a new Member to this body, I did not have the occasion to work as closely with Senator Byrd as others. However, as a resident of the Commonwealth of Virginia, not only did I follow the enormous respect Senator Byrd has engendered here in the Senate, but I have also watched with awe Senator Byrd's ability to bring jobs back to West Virginia. He was able to relocate many Federal agencies and activities, oftentimes that may have previously resided in Virginia, to the State of West Virginia. I join my colleagues in commending Senator Byrd, not only for his enormous service to this body and to our country, but as someone who has been a tireless advocate for his home State of West Virginia.

Mr. WARNER

Mr. WARNER. Mr. President, I rise today to once again join my colleagues in addressing the need for comprehensive health care reform. The Senator from New Hampshire, Mrs. Shaheen, earlier spoke on health care reform and its effect on small business. I know my colleague, Senator Udall from Colorado, is going to be speaking soon. And I know we are going to be joined, as well, a little bit later by Senator Landrieu, who takes a leadership role on the issues affecting small businesses, as chair of the Small Business Committee. I rise today to stress how important health care reform is to the small business community. Currently, there are small businesses across America that have been hit very hard by the effects of the recession. Small businesses are struggling as they try to keep their doors open, with the enormous constriction of credit that is taking place. Small businesses are struggling to have the finances to expand; even healthy small businesses, as we have seen. Banks continue to draw back in capital and try to build up their own balance sheets. The people who have taken the hardest hit by the restriction on capital and the restriction on lending have been small businesses across this country. So we have the enormous challenges small businesses have felt by the recession that has been exacerbated by the constriction of lending, and then we add on top of that the enormous challenges that small businesses face in the health care market. The only people who pay retail--who pay full price for their health care benefits in America today--are small businesses and those who purchase health care on the individual-based market. There is no group that will more benefit, or have more to gain from meaningful health care reform, than small businesses. Small businesses currently lack the bargaining power of large firms and pay as much as 18 percent more for the same health insurance as larger companies. If you work in a large company you get the benefit of the larger pool, and you are better able to bargain for your health insurance rates. If you are poor and cannot afford health insurance, you get access to Medicaid. If you are a senior, you get access to Medicare. Small businesses are the group that falls through the cracks. They don't have access to this purchasing power, and consequently pay, on average, about 18 percent more for health insurance than larger companies. As health insurance costs continue to rise, more and more small businesses can no longer even afford to offer health insurance to their employees. And if they do, their employees can't afford the co-payments to purchase health insurance. In fact, nearly one-quarter of the uninsured in our country works for small businesses. Between 2000 and 2009, the percentage of firms with less than 10 employees--the heart of small businesses--offering insurance coverage fell from 57 percent to 46 percent. Among people with employer-based coverage in January of 2006, one-sixth lost their coverage by 2008. Nearly three-quarters of small businesses that do not offer coverage to their employees cite high premiums as the reason. Small businesses want to offer health benefits to their employees, but are priced out of the market and cannot afford it. Many small business employees are left uninsured and, in turn, rely on the health care system to pick up the costs when they get sick. It is these people who show up at emergency rooms and access the most inefficient part of our health care system. They are oftentimes not people who are unemployed, but employees of small businesses. Enacting market reforms such as creating insurance exchanges will finally give small businesses affordable options. Their employees will have a place to purchase insurance at large pool rates and, by insuring more people, reform will help drive down the cost of health insurance for all Americans. Insurance exchanges will also significantly reduce administrative costs for small businesses by enabling them to easily and simply compare the prices, benefits, and performance of health care plans. I know a number of us are working on a series of amendments for when the health care bill gets to the Senate floor to try to make sure we add further disclosure requirements and more transparency to our health care system. Right now we don't have a free market in our health care system because nobody knows what the providers actually pay, and what the doctors and hospitals actually charge. Small businesses will benefit by trying to bring transparency to these health insurance exchanges. Additionally, reform will enact consumer protections such as prohibiting insurance companies from denying coverage based on preexisting conditions and dropping people when they are sick. This is particularly a challenge to small businesses. If you only have a small group of employees and a few have preexisting conditions, those preexisting conditions drive up the cost of providing insurance for this smaller pool. Oftentimes this results in pricing small businesses out of the market. Reforms such as eliminating preexisting conditions will dramatically help small businesses and their employees obtain affordable health insurance. These protections are vital for small business employees because they help level the playing field in the small group market. They guarantee the option of large pool rates, lower costs, and prohibit insurance companies from arbitrarily penalizing small businesses when one of their employees becomes seriously ill. Lowering health care costs for employers is also key to our ability to compete in the global economy. If American business is going to come out of this recession and we can compete with countries around the world, we have to take on the cost of health insurance. American workers are more productive than any other workers in the world. But even with that increased productivity, if American businesses have to pay $3,000 to $4,000 more per employee because of higher health insurance costs than our competitors that puts American businesses at a dramatic disadvantage. As health care costs continue to rise, other business investments are sacrificed. Forty percent of businesses say health care costs have a negative impact on other parts of their business. As I mentioned, with the great reduction of credit availability to small businesses and in this challenging economic climate, American businesses cannot afford to be at such a disadvantage. With health care reform, more of our Nation's dollars will go toward investments in our economy. Health care costs also stifle productivity. Too many Americans end up staying in jobs simply because the employer provides health insurance. They aren't able to move around, or move into entrepreneurial startup firms where innovation and real growth potential takes place. Startup firms and, again, small businesses are often not able to offer health insurance. Consequently, we have good workers who are not able to move into these firms and help spur job growth because they are caught in dead-end jobs. They are constrained by the security of health insurance offered at their old jobs or perhaps because they have a preexisting condition and can't move to a new situation. Again, if we do health insurance reform right, it will put in place reforms such as the elimination of preexisting conditions requirements that will allow more freedom of movement within the job workforce. So, once again, I join my colleagues in making this case. We have made it time and again. Health care reform is necessary to make sure American businesses remain competitive. Health care reform is necessary because health care costs are the single largest driver of our Federal deficit. Health care reform is necessary because if we don't address rising costs, Medicare will be insolvent by 2017. If we don't reform the system, costs will also rise for families; an average Virginia family, for example, within the next decade, will be paying nearly 40 percent of their disposable income to meet their health insurance premiums. I will close my comments with where I started. Small businesses are the only players in our market who still pay retail for their health care costs and are increasingly being priced out of the market. Reform is imperative for the small business community. I know my friend, the Senator from Colorado, is about to speak, and our leader on small business issues, the Senator from Louisiana, who has been so diligent on leading these efforts and making sure that small businesses are protected in health care. We must get this right. We must get this bill to the floor. And we must provide needed relief to the small businesses that will generate the economic recovery that we're all hoping for. Thank you, Mr. President. I yield the floor.

Mr. WARNER

Mr. WARNER. Yes.

Mr. WARNER

Mr. WARNER. I thank the Senator from North Dakota for his comments, and I look forward to working with him. I think this is clearly an area where we will find common cause with our colleagues on the other side of the aisle. Never again should the American taxpayer have to pick up the burden from institutions that have been financially irresponsible and then from those financial irresponsibilities that pose a systemic risk where we the taxpayers are left basically holding the bag. So I thank the Senator for his comments, and I look forward to working with him on this very important issue.

Mr. WARNER. I am very familiar with what happened in the UK, with the situation with the Bank of Scotland, which had received governmental assistance--somewhat similar to the banks that had received our TARP financing. They came in and said: We are going to start to break up this institution. Former Fed Chair Paul Volcker has suggested that certain banks should perhaps be prohibited from taking on excessive risk activities, in a sense going back almost to a Glass-Steagall approach. Those are both areas that I believe warrant further consideration. Our approach here has been to say that while it is hard, in this interconnected financial system we have where institutions crisscross all across the world, to put an arbitrary size cap on it, what we can do, by putting this type of Systemic Risk Council in place, we can put barriers and a price of getting too large by having added capital requirements; by having this designation that you have to show us a dissolution plan and that the Systemic Risk Council would weigh in; by assuring that if you take on too much risk activities on your own trading desk, there is a higher price to pay for that. There are these other examples, as you mentioned, that we will be debating through this whole process. I know the Senator has raised this issue at times on the floor as well, and I will solicit his advice and comments. And perhaps we need to go even beyond that in looking at, as I think you appropriately pointed out, at the end of the day, does too big to fail mean just too big? It is a hard place to draw a line. But I thank the Senator for his question, and I yield my time.

Mr. WARNER. I would yield for a question.

Mr. WARNER. Mr. President, I rise to address an issue I know this body will be dealing with in much greater detail in the coming weeks and months; that is, financial reregulation. On Monday, I am introducing legislation to establish a systemic risk council. I have worked with Chairman Dodd on this issue and his staff, and I am very grateful that his discussion draft--although I have not seen the specific language--is expected to include a strong systemic oversight council which I have been advocating. I appreciate Chairman Dodd's leadership on this issue and look forward to working with him and the administration on making it a reality. As I have articulated previously on the floor and in an opinion piece published in the Washington Post, we need to establish a framework for addressing systemic risk in our financial system. Systemic risk is not the only area we need to address but is an area where the current system has unequivocally failed. Systemic risk is actually a number of risks united by the possibility that, if left uncontrolled, they could have consequences for the entire markets or the entire economy. We saw examples of that a year ago. Most often, systemic risk comes from the failure of an important financial institution. But because that is not the only source, we should not expect to control systemic risks with a rigid, one-size- fits-all approach. In order to do this, we need a body that can look across our financial system at all sources of risk, that can spot gaps or opportunities for firms to avoid regulation, and that will not be consumed by other day-to-day responsibilities or protecting its own regulatory turf. Some have proposed that the Federal Reserve serve as the systemic risk regulator. But its monetary policy responsibilities present potential conflicts, and it has proven incapable of properly regulating large institutions. The Federal Reserve claims to be the systemic risk regulator at the moment, but it has obviously failed to take on that task, and we need to be careful in balancing its responsibilities and authorities in the coming years. That is why, if we want to ensure that monetary policy and systemic risk are each managed in the best possible manner, we must recognize that institutional structures and responsibilities do matter. Doubling down on a structure of the past that has not performed well outside of its core function is not how we should confront the challenges of the future. Our Founding Fathers opposed concentrations of power and favored a system of checks and balances. We have resisted creating an all- powerful central bank, and a council would allow for such a system of checks and balances. The Federal Reserve is, of course, not the only agency that has not performed well in the crisis over the last year or so. The current system has failed to provide proper checks and balances and has replaced healthy competition where efficient and innovative firms flourish with a system where a handful of firms are too large to fail, can threaten the safety of the entire system, and enjoy an implicit--or maybe even more explicit now--government guarantee that destroys any notion of market competition. This failure points to another task we must take on in financial regulatory modernization. We must end the notion of too big to fail. That is why I believe we should establish a strong systemic risk oversight council, and I will be introducing legislation, as I mentioned, to do that. A systemic risk council is not a silver bullet but avoids the pitfalls of entrusting systemic risk responsibility with one single agency that has other missions, and those other missions could serve as a source of conflict of interest. A council could see across the horizon and have all the information and expertise flow up into it. It addresses our stovepipe problems and avoids the conflicts that come from also conducting monetary policy and helps to stave off regulatory capture. The systemic risk oversight council I propose would consist of the Treasury Secretary, of course, the Chairman of the Federal Reserve-- they would play a valuable role--and the heads of the major financial regulatory agencies, two independent members, including the chair of the council. This chair of the council would be independently appointed by the President. It would be charged with the responsibility for working to improve our understanding and control of systemic risks. This builds on the model of the President's working group on financial markets. An independent chair, appointed by the President and approved by Congress and supported by a permanent staff, has proven to be relatively effective and ends up resembling the National Transportation Safety Board or the National Security Council. Critics of this approach have said you cannot convene a committee to put out a fire. But we do convene committees to prepare for and respond to large-scale crises time and again across our whole system. Experience has taught us boards and councils can work in a wide range of contexts, provided they have the right responsibilities, powers, and membership. Even the Federal Reserve and the Federal Deposit Insurance Corporation are run by boards. In addition, I believe we should leave the real emergency powers with the regulators. The Federal Reserve should retain its 13(3) authority, though it should be tightened up. Bank regulators should retain prompt and corrective action authority, and the FDIC should retain its resolution powers. As a matter of fact, Senator Corker and I have introduced legislation already that expands the FDIC's resolution powers to include bank holding companies. In a crisis, however, the council should coordinate all of these regulators and their actions, as police, fire, and emergency response all coordinate in local emergencies. But the systemic risk council cannot just be a debating society, and so it would have real resources and power. First, in addition to gathering and analyzing data, the council could help to determine how to regulate new products and markets in order to minimize regulatory gaps. Those regulatory gaps often end up with regulatory arbitrage, as we have seen recently. It would first identify gaps in the system and then have the appropriate regulators work together to fill these gaps. With these tools, we will eliminate the huge blind spots our regulators had last fall when new and unregulated markets tail-spun out of control. We will eliminate the ability of firms to avoid regulation or find the weakest regulator by ensuring consistent treatment of activities across the financial markets. Second, in order to address the too-big-to-fail issue, the council will work to prevent firms from becoming too large to fail. It would do this in three specific ways. First, it would have the authority to identify large firms that could pose systemic risk if they failed but did not currently have an end-to- end prudential regulator and would assign them a Federal regulator. This could include hedge funds, insurance companies or other nonbank financial companies. Making sure those companies that have no regulatory oversight, if they fall into this category of too big to fail, have some kind of oversight is terribly important. Second, the council would establish systemwide prudential standards for large firms, including counterparty exposure limits, increased capital requirements, reduced leverage and strengthened risk management requirements, all to make sure that while we would not set arbitrary caps on size, we would make sure, as a firm gets too large or takes on too much excessive risk, that there are additional requirements, such as additional capital and others I outlined. Finally, it would work with the council to ensure that any firm could fail safely--we saw in the past that there was no plan on how we would unwind a Lehman or an AIG--by working with the financial regulators, the day-to-day prudential regulators, to develop clear, written plans for the unwinding or failure of a financial company. In a sense, we would be asking some of these too-big-to-fail institutions to preapprove or put forward their own funeral plans or dissolution plans so we would know how we go through this process, should that unfortunate event take place. These plans would be made in advance of trouble and could not rely on the type of government intervention we were forced into last fall. As I have said, the systemic risk council is not a silver bullet. Many systemic risks already lie squarely within the responsibility of our day-to-day financial regulators. We need to make sure our current regulators have clear missions, including managing risks within their institutions and regulated markets, and we must ensure these regulators do their job. But that is only half of the answer because other systemic risks lay outside of the day-to-day prudential regulators' job description, in between the cracks of our existing regulatory system. The Systemic Risk Council's responsibilities would be clear and focused. Systemic risk would be its only job, and it would help fill in the cracks and prevent problems from becoming unmanageably large or complex. What I am proposing today boils down to a simple, consistent, and I believe common sense idea: If we want to do something constructive about systemic risk, we should create a mechanism that can ensure our regulators do their jobs, avoid conflicts of interest, and fully leverage our existing regulatory resources to promote the proactive identification and control of systemic risks. By having this council, made up of the heads of the day-to-day prudential regulators--the Fed, the Treasury, independent members, and this independent chair appointed by the President--I believe we create this mechanism. We need to make sure we never again put the American taxpayer into the kind of financial duress we had take place last year. I believe the Systemic Risk Council approach, working as one piece of an overall financial modernization and reregulation, will lead us in that direction.

Mr. WARNER

Mr. WARNER. Mr. President, I thank my colleague from North Carolina for organizing the freshmen one more time to talk about our vision for health care reform. We invite our colleagues not only on our side of the aisle but our colleagues across the aisle to join us in this conversation about how to get health care reform right. I also commend my colleague from New Hampshire, Senator Shaheen, on her comments about how we can fix financial incentives in our current health care system. I think reforming our delivery system ought to be, clearly, part of any overall health care reform we take on. I want to pick up, actually, where Senator Shaheen left off and talk about how we can readjust our financial incentives system in health care. We have them all wrong. We have a health care system right now that rewards bad practices. We have a health care system that rewards hospitals for multiple readmissions rather than a low readmission rate. We have a health care system that rewards volume of care rather than quality of care. Reforming the financial incentives in our delivery system has to be a key component of any health care reform going forward. I join my colleagues in citing examples of delivery system reforms that are happening now in my own state. I have three examples here from the Commonwealth of Virginia. In 2000, VCU Health System in Richmond, our capital, developed a system called Virginia Coordinated Care to manage health care services for the uninsured. The uninsured often rely on emergency rooms to be treated for their illnesses and then go back home until they get sick again. There is no continuity of care and oftentimes that uninsured person will end up back on an emergency room doorstep because, outside of being treated for the episodic incident, there was no management of that patient's care during that period. What VCU developed was a program that assigned a primary care physician to oversee each uninsured patient's health. The goal was to increase coordination between doctors and hospitals and, as a result, increase accountability, improve quality of care, and lower costs. The Virginia Coordinated Care program started with a few participants in 2000; by 2009, there were over 20,000 members. One of the most important outcomes of the program was a significant drop in emergency room visits by enrolled patients. By increasing continuity of care, emergency room visits dropped 14 percent between 2000 and 2005. Costs were reduced for Richmond area hospitals, as well as surrounding Virginia hospitals as fewer patients showed up at other emergency rooms. By treating the patient earlier in their illness the program achieved better quality of care, and better results for the health care system as a whole. Another example of delivery system reform took place at another end of our State, at Sentara Healthcare, located in Norfolk, VA. In 1999, Sentara studies found that intensive care units that were monitored by a doctor full time had lower mortality rates and shorter length of stays than those that were not. In order to improve quality of care, Sentara worked with a company called VISICU to install Web-based television cameras in each patient's room. With this technology, a single physician in a central location can follow patients in multiple rooms at the same time. Again, this kind of logical approach produced more efficient care at a lower cost. Sentara saw a 25-percent reduction in mortality among these patients, a 17-percent reduction in their length of stay, and a 150-percent return on investment in the program. Perhaps the best example is now being modeled by the Carilion Clinic in Roanoke, VA. Carilion Clinic is a multispecialty health care organization, with more than 600 doctors and 8 health care organizations. In 2010, next year, Carilion Clinic will join with Engelberg Center for Health Care Reform at Brookings and the Dartmouth Institute for Health Policy and Clinical Practice to implement a new and innovative health care model that rewards providers for improving patient outcomes while also lowering costs. This Accountable Care Organization will encourage physicians, hospitals, insurance companies, and the government to work together to coordinate care, improve quality, and reduce costs. Under this model, providers will assume greater responsibility not only for treating the patient's illness but for the overall quality and cost of care to be delivered. They will actually be incentivized to take steps to keep patients healthy, while avoiding costly medications and procedures. Additionally, this model will encourage, and make it affordable, for doctors to finally practice preventive care. Carilion Clinic is doing the right thing: moving away from the current, and very flawed, fee-for-service system. As long as our health care system--one-sixth of our economy-- continues to reward providers simply based on quantity rather than quality of care, we are never going to get health care reform right. By increasing coordination of care, and putting in place smarter financial incentives, we can have higher quality care at lower costs. We can focus on the health of patients, rather than the number of procedures. Changing our payment mechanisms and restructuring financial incentives are a key part of health care reform. I know my freshmen colleagues stand ready to work with our colleagues on this side of the aisle, and I again invite our colleagues on the other side of the aisle to join us in this effort. Getting it right will lead to improved quality of care, lower costs, and a healthier America. I thank our leader today, the Senator from North Carolina, for granting me this time. I look forward to working with Senator Hagan and all my colleagues as we move forward. I yield the floor.

Mr. WARNER

Mr. WARNER. Mr. President, I thank my colleague, the Senator from New Hampshire, for leading the freshmen Senators here this morning as we once again take the floor to talk about health care reform. I also commend my friend, the junior Senator from Florida, for his comments today. I share his views about the necessity of bringing our Federal deficit in line. In the Commonwealth of Virginia, we have a balanced budget requirement and we meet our budget every year. I am proud of the fact that Virginia has been named the best managed State in America. So I do have to take issue with some of the comments made by my colleagues, who I think understand States' needs. The fastest growing costs in my State, as well as the State of Colorado, New Hampshire, and I would assume the State of Florida, are health care costs. Medicaid is going to bankrupt virtually every State in the Nation by 2025 if we do not act. I hope for, and welcome, my colleagues' efforts to try to reach a bipartisan consensus on health care reform. I will again make the point I have made repeatedly over the last few weeks: What happens if we don't act? What happens if we simply kick the can down the road another 10 years? That is the appeal I make to my colleagues on the other side. Join us. Particularly join the freshmen Senators, who don't come to the Senate with the same background of the last 20 years and experience of past battles. Join a group who does, however, come to this body wanting to do the people's business. That means driving down health care costs, expanding coverage, and making sure our health care system is financially sustainable. If we don't act, not only will States' increasing Medicaid costs go unmet, State budgets will not be balanced. If we don't act, the Federal deficit will explode. The largest driver of the deficit is not the TARP spending or stimulus spending; it is health care spending. If we don't act, the current Medicare Program, which seniors depend on, will go bankrupt by 2017. That is not a political statement; that is a fact. If we don't act, American companies will not be competitive in the global economy. We have the most productive workforce in the world. But no American company can compete when they have built in health care costs of $3,000 to $4,000 more per worker than any other competitor in the world. If we don't act, for the 65 percent of us who get our health care coverage through the private insurance market, an average Virginia family will be paying 40 percent of their disposable income on health insurance premiums within the next decade. I ask my colleague from Florida and others on the other side of the aisle to join us in this bipartisan effort to reform health care. This morning we will lay out how we think health care reform can both expand coverage and drive down costs. We will look at some of the models currently being used by large employers who have had the flexibility to design their own benefit plans. These models have successfully driven down costs by putting in place prevention and wellness activities, negotiating better prices with providers, and restructuring a financial incentive system which currently rewards hospitals based on higher readmission rates, rather than quality care. I thank the Senator from New Hampshire for organizing the freshmen one more time. As a former Governor, I know she has been a leader on issues like Medicaid and health care costs. I call on my colleagues on the other side of the aisle to actually join in this effort to make sure we do achieve bipartisan health care reform. I yield the floor.

Mr. WARNER

Mr. WARNER. Mr. President, first of all, I thank my colleague, the Senator from Colorado, for organizing this effort today and leading freshmen Senators this week as we, once again, come down to the floor, as some of the folks who are newest to the Senate, most recently hired in most cases, to talk about the need for health care reform. I particularly thank my colleague, the Senator from Colorado, for raising the very important issue of the cost of health care to small businesses. The remarkable thing about small businesses is they are basically the only people who pay retail for their health care costs in America today. Those who have Medicare, those who have Medicaid, large employers--they all can leverage their purchasing power. But small businesses are the folks who take it on the chin, and I am grateful for my colleague's comments today, describing how health care reform can benefit small businesses. My colleagues, the Senator from Alaska and the Senator from Oregon, have also pointed out some other myths, as the Senator from Colorado indicated. The one I am going to take on today, because we hear a lot from our friends on the other side of the aisle about the problems with reform, and sometimes they do actually dispel some of these myths--but one of the myths I have dealt with for 18 years, as somebody who founded the Virginia Health Care Foundation in the early 1990s, is, how do we deal with the uninsured? Yes, part of our health care reform is about extending coverage to the uninsured. There will be some additional cost to do that, but I think it is very important to recognize that under our current system, right now we pay for the uninsured. We pay for the uninsured through uncompensated care, as my colleague from Colorado mentioned. We pay for the uninsured in higher health insurance premiums for all of us who buy private insurance. We pay for the uninsured, candidly, in higher costs to our Medicare and Medicaid system. Our uninsured end up on the emergency room doorsteps, oftentimes receiving care in the most inefficient way possible and oftentimes without good quality care. We have seen, on average, 8 percent of families' 2009 health care premiums--about $1,000 a year for all of us who purchase private health insurance--we pay in effect a $1,000-a-year tax to compensate and pay for the cost of the uninsured. As my colleague mentioned, and I know from my experience in Virginia 18 years ago, we started this Virginia Health Care Foundation to deal with how we could provide health care coverage for the uninsured. We saw folks ending up, as I mentioned, on hospital doorsteps. We saw folks waiting too long before they could access the health care system. Oftentimes, if they had a chronic disease and then waited to get that health care coverage, the cost of covering that person was not only much higher-- obviously, the person has to deal with a much more serious illness--but they too ended up in the emergency room, which is an inefficient delivery mechanism. If we are going to truly start to bring down the cost of insurance, if we are going to do the right thing in giving the uninsured in this country a chance to receive a medical home and make sure they access health care through a more affordable and more long term, healthier way, we must pass health care reform this year. A lot of numbers have been bandied about concerning what kind of extended coverage we are talking about in this health care reform. There have been arguments that we are talking about covering 30 million additional people. I believe the Senate Finance bill covers 25, 26 million. One of the things that is often absent from this debate is that while these are the numbers we are trying to deal with right now, literally triple that number, about 87 million Americans during a year, at one point or another, through either being unemployed for a while or moving off one plan to another, go through some period of being uninsured and uncovered. On top of that 87 million, we also have the problem of literally tens of millions of people who are stuck in dead-end jobs, who want to change jobs, who want to become more productive, but they are afraid to make that change because of concerns over losing their health care coverage. If we can provide the kind of health care reform we are talking about, if we can provide the kind of coverage we are talking about, those kinds of problems will go away. We will become a more effective and cost-effective society. I know we have other colleagues who want to speak, and I want to come back to where we started, at least the freshmen did a few weeks back, and why some of our colleagues on the other side who seem to be this ``caucus of no,'' who seem to say: Let's take more time, let's put it off, let's wait a little bit longer before we take on health care reform--why that policy choice is so wrong. If we do nothing, if we choose not to act this year, our current health care system is financially unsustainable. If we do nothing, Medicare, under the current projections, will go bankrupt in 2017. Many of us on this side of the aisle share the concerns of some of our colleagues on the other side of the aisle about the exploding deficit our Nation faces. The largest single driver of our Federal deficit is not the stimulus program, it is not the TARP program, it is not some of the other things we debate back and forth, it is the rising cost of health care that we pay for with Federal dollars in Medicare, Medicaid, and the VA. If we do nothing, our deficit and those health care costs will continue to explode, undermining the dollar, undermining our ability for economic recovery. If we do nothing, an average family in Virginia--and I would argue probably an average family in the State of Colorado--will see literally 40 percent of their disposable income go to paying their health insurance premiums within the next decade. Those costs are unaffordable and unsustainable. Finally, as a former business guy and somebody who believes, as my colleague from Denver does, that the heart of what keeps our economy growing is the business community, and particularly the small business community, if we can't lower our health care costs, then American business will not be competitive in the global economy. No matter how productive American workers are, America builds into our cost structure, for almost every business, about $3,000 to $4,000 more per employee because we have so much higher health care costs than any of our competitors around the rest of the world. We cannot maintain that competitive disadvantage in a global economy. The time is now. There are ways we can continue to improve these bills. We are looking forward to the melding of the Finance bill and HELP bill, and I know myself and some of my fellow freshmen colleagues will have some ideas about how we can improve programs even in that package. I thank my colleague from Colorado for his leadership on this issue, and I look forward to working with not only my freshmen colleagues but all colleagues on this side of the aisle, and hopefully those on the other side, to make sure we do get health care reform this year. I yield my time.

Mr. WARNER

Mr. WARNER. Madam President, I thank my colleague, the Senator from Oregon, for helping organize this morning. I thank all other colleagues for once again coming together and speaking with different voices but with similar themes. I also thank our newest colleague, the new Senator from Massachusetts, for being here. I know he will take time in another moment to give his maiden speech. Being here and giving us moral support is helpful. One of the things we all get to do as freshmen Senators is sit in that chair and preside over the Senate at various times. Consequently, we often get, perhaps more than other colleagues, a chance to hear the folks on the other side and their talking points. Monday afternoons, I get to hear it for uninterrupted hours. What I hear time and again from our colleagues on the other side is complaints about the various proposals this side--and, hopefully, some on the other side will join us on--has put forward. What I do not hear from the other side is what happens if we take their approach, which is doing nothing. What I do not hear from the other side is a simple recognition not of the moral challenges of covering close to 30 million additional Americans, but the fiscal challenges of not acting, a fact that we all brought forward last week when we pointed out, if we fail to act, we will see Medicare go bankrupt by 2017; if we fail to act, our deficit numbers will continue to explode; if we fail to act, an average Virginia family, and an average Colorado family as well, will be spending close to 40 percent of their disposable incomes within the next decade paying for health care. Senator Merkley and Senator Begich have mentioned if we fail, American business cannot compete when we have to pay $3,000 to $4,000 more per employee than our competitors across the world in terms of increased health care costs. Some may say that the simple reason for these increasing health care costs is because we have an aging population. We do. But an aging population is not the only reason for rising health care costs. Our rising health care costs are increasingly driven by an inefficient delivery system, by a system that does not reward value, by a system that does not compensate based upon any rational basis. That is where so many of the reforms are focused through the Senate Finance Committee and the HELP Committee bills--and others we will be putting forward in later weeks, perhaps even on the floor, that will bring these reforms to the overall delivery system. Again, some of my colleagues have already mentioned wellness. Senator Shaheen mentioned the enormous differential between states in terms of Medicaid reimbursements. We can and must do a better job. For example, if as we see here, we can put health care reform in place and drive system reform, we could potentially save $3 trillion over the next 10 years across the entire system. If we fail to act, we leave those costs in a system that does not provide good quality health care and, with 70 percent of the cost going for chronic diseases, does not provide better coverage, either. On this last chart, in terms of what we are talking about in expanded savings, if we fail, if we simply expand the current system--this is based upon Lewin Group studies, the Commonwealth Fund that has been cited many times on the other side--if we simply put in place expanded coverage without reform, we will continue to explode the deficit. But if we put in place the kinds of reforms we are talking about, which is wellness, and increased transparency--and I strongly believe in a free market system--but we have no transparency in our system in terms of what costs are and what people actually pay. If we take advantage of some of the best examples in the private sector, where health reform is taking place right now, we can bring about not only reform but bring about reform with lower costs, higher value, and truly make sure Americans all across the country get the coverage they need and that does not break the deficit.

Mr. WARNER

Mr. WARNER. I thank my colleague from Delaware for pointing out the enormous cost of inaction both to our Federal deficit and to families who are struggling with these costs. Now I yield 4 minutes of our time to the distinguished Senator from Alaska.

Mr. WARNER. Mr. President, I know our time allotment is drawing to a close and we still have more Senators who wish to speak. I yield 3 minutes to my distinguished colleague, the Senator from Illinois.

Mr. WARNER. Mr. President, I thank my colleague from North Carolina and all these freshmen Senators who have talked today about the very real costs of inaction. I would like to now call on our final colleague, my friend, the junior Senator from Colorado.

Mr. WARNER. I now yield 4 minutes to the Senator from North Carolina, my friend.

Mr. WARNER. Mr. President, I thank the Senator from Illinois. I also thank my distinguished colleague from Tennessee for granting our group 4 additional minutes.

Mr. WARNER. I thank my friend from Oregon for pointing out, in vivid terms, the challenges the status quo presents to so many American families. I yield 4 minutes to my friend, the distinguished Senator from Colorado.