Congressional Budget for the United States Government for Fiscal Year 2010

Floor Speech

CONGRESSIONAL BUDGET FOR THE UNITED STATES GOVERNMENT FOR FISCAL YEAR 2010 -- (Senate - April 01, 2009)

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Mr. WHITEHOUSE. Mr. President, I thank the distinguished chairman very much for those very kind and gracious remarks, and I am indeed here to discuss the budget, and particularly the health care aspects of the budget.

This is the season. Here we go again, into the annual budget process, and as we have seen today on the Senate floor, our friends across the aisle are doing a great deal of complaining and not a great deal of contributing.

Are their complaints sincere? Well, perhaps. I am sure some are sincere. But in evaluating them, we should bear this in mind: Under George Bush, the difference between the budget projections he inherited from President Clinton and the budget performance he left for President Obama was a negative nearly $9 trillion--a massive, reckless landslide of fair-weather debt.

Mr. CONRAD. Mr. President, will the Senator yield? Again, I apologize for interrupting.

Mr. WHITEHOUSE. Of course, I will yield.

Mr. CONRAD. Just for a moment, for the purpose of a unanimous consent request.

Mr. President, I ask unanimous consent that after Senator Whitehouse is done, Senator Graham be recognized for 5 minutes and then Senator Enzi for 5 minutes.

The PRESIDING OFFICER. Without objection, it is so ordered.

Mr. CONRAD. I apologize for this interruption, but I have to go to another committee to introduce someone who is up for a nomination. So I needed to do it at this moment to make certain there is a good flow.

I thank the Senator very much.

Mr. WHITEHOUSE. I understand perfectly, and I appreciate the chairman's diligence in ensuring a smooth flow of this important legislation.

So we have this litany of complaints from the side that is responsible for the Bush debt of nearly $9 trillion. Now that President Obama has to dig out from under the Bush economic collapse, now that we are in a deep economic recession, now, in the one time when Government spending and borrowing is justified to get us through the economic trough we are going through, we are treated to lectures about debt from our free-borrowing friends. The party of ``deficits don't matter'' wakes up to this concern just in time, coincidently, to thwart our new President.

The grotesque folly of the Bush debt was that it addressed things such as lowering tax rates for America's billionaires, not the core American priorities we need to address, in a country that is failing to educate its children as well as international competitors do, a country whose energy policy hurts everyone except oil-producing nations and the oil and coal industry, and a country mired in a disastrous health care system. President Obama's budget addresses these priorities.

Indeed, one of the highest priorities in our budget proposal for fiscal year 2010 is a badly needed and long-overdue reform of that broken and dysfunctional health care system. I have spoken on this subject in the Chamber many times because unless something is done soon, health care's massive costs will overwhelm us. Already, the system costs well over $2 trillion a year, and as our population ages, we face $35 trillion in unfunded Medicare liabilities, with not a nickel set aside against those liabilities.

No one seriously now questions the need for fundamental health care reform, and it is time to come together to determine what that reform will look like and how we can get it done. That would be a productive thing to talk about with regard to this budget.

An event last Thursday marked an important step forward on health care reform. The American Cancer Society, the American Diabetes Association, the American Heart Association, and Consumers Union came together to issue a joint statement on the vital importance of including health care delivery system reform as part of any comprehensive health care legislation that Congress should move this year. I was proud to join them at their announcement, together with Senator Schumer and Senator Rockefeller.

These organizations represent tens of millions of Americans--Americans living with chronic illness, with cancer, with diabetes, with heart disease, and millions more who are consumers of health care in this country. These organizations and their members understand the failures and the tragedies of our health care system. Separate and together, their voices are powerful, and I would like to share some of what they said.

The number of uninsured Americans exceeds 45 million. Health care costs are rising faster than incomes. We spend at least twice as much per capita on health care as our major trading partners, and we rank 37th in the World Health Organization's evaluation of health systems worldwide. The major chronic diseases--cancer, diabetes, cardiovascular diseases, and stroke--account for three out of every four deaths in the United States, and the estimated total direct and indirect health care costs for these chronic diseases exceeds $700 billion each year. Much of America's chronic disease burden could be avoided through better coordination of care and by applying known best practices to prevent the onset and progression of these conditions at the primary, secondary, and tertiary levels.

While insurance coverage for all Americans is an important goal, we must give equal weight in the health care reform debate to changes that improve the quality of care, increase and improve the delivery of preventive services, and ensure that individuals always receive care that is safe, efficient, and without unnecessary interventions, tests, and treatment. To achieve these goals we must make structural changes: Improve our health information technology infrastructure; align financial incentives with evidence-based and cost-effective decision making; and develop a reliable process for assessing the health value of new technologies.

That is a part of the joint statement the American Cancer Society, the American Diabetes Association, the American Heart Association, and Consumers Union issued last Thursday.

Mr. President, I ask unanimous consent to have printed in the Record the full text of the joint statement I have just referred to.

The PRESIDING OFFICER. Without objection, it is so ordered.

(See exhibit 1.)

Mr. WHITEHOUSE. Also, on Thursday, Mr. President, Consumers Union presented new polling data about Americans' experiences with the health care delivery system that confirms the urgent need for delivery system reform. In the poll, 18 percent of respondents reported that either they or an immediate family member contracted an infection following a medical procedure, and more than 60 percent of those reported that the infection was severe or life-threatening. Mr. President, 13 percent of respondents have had their medical record misplaced, and 9 percent have received the wrong prescription from the pharmacist. Only half of adults--only half of adults--receive routine preventive medical tests, and for adults 35 years and younger, only 30 percent even visit a doctor for routine testing.

At our event last week, these organizations emphasized the importance of preventive care. As is so often the case in our health care system, no data or information is as compelling as a personal story, and we were fortunate on Thursday to hear an extraordinary one.

Gina Gavlak is a diabetes center and emergency department nurse and the vice chair of the American Diabetes Association's advocacy committee.

Gina was diagnosed with diabetes at age 10, and has been living with the disease for the last 29 years. She has worn an insulin pump 24 hours a day, 7 days a week, 365 days a year for the past 12 years. Before using the pump, Gina took over 21,000 insulin injections, an average of 6 times a day.

Gina has battled pre-existing condition rules and outrageously high insurance premiums, but her biggest battle has been the daily management of her disease. She has taken on this battle with extraordinary determination and diligence, and with exemplary results.

Through extremely careful monitoring and management, she has had only two hospitalizations and one emergency department visit due to diabetes. She has never missed a day of work because of diabetes. She has had two uncomplicated pregnancies resulting in the birth of her two healthy children.

Gina's story is both poignant and important. It shows the tremendous benefits that come from comprehensive management of chronic disease--both in quality of life and in reduced cost of care. But not everyone has Gina's unique drive and commitment. Many patients will need an interactive, organized, and prevention-focused health care system to effectively manage their care.

Unfortunately, this is not the health care system we have. The Cancer Society, the Diabetes Association, the Heart Association, and Consumers Union wrote:

The promise of ..... delivery system reform measures to lower costs is the most humane avenue to a financially sustainable health care system .....

Although coverage for all Americans is a vital component of this change--a simultaneous effort aimed at securing high-quality, cost-effective preventive care is equally important ..... the time for comprehensive health care reform has arrived and our organizations will work together to help create a health care system capable of consistently delivering the most effective, patient-centered care.

These efforts will improve the quality of life and health outcomes for millions of people who suffer from a chronic disease, and lead to more efficient use of our nation's health resources.

The time has indeed come, not only for coverage reforms that will bring all Americans the security and stability that health insurance provides, but also for a fundamental overhaul of the way our delivery system provides care. That is a necessary investment this budget makes.

We have to be smart about this. We know how bad the system is; we see its looming catastrophic costs; we must invest the time, the money and the effort to transition to a modern, safe, efficient and healing health care system.

That is why this President's budget matters. That is why President Obama's budget is worth passing; it looks beyond the sorry politics of today and addresses the real problems Americans have to cope with day to day, in their regular lives.

I ask unanimous consent that statements by Dr. Timothy J. Gardner and Dan Smith, and a Consumer's Union Release be printed in the Record.

There being no objection, the material was ordered to be printed in the RECORD, as follows:

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Mr. WHITEHOUSE. Mr. President, I want to respond very briefly before I yield to the distinguished chairman of the Environment and Public Works Committee on this question of reconciliation and climate change. One really has to have had their sense of irony surgically removed to keep a straight face on the Senate floor today as the party of reconciliation comes to the floor, over and over again, to complain about the use of reconciliation.

The party of reconciliation is the Republican Party. They have used it 13 times. They used it for George Bush's tax cuts for billionaires. If you have bloody hands from reconciliation, the Republican Party has blood above the elbows from reconciliation. Yet they come to the floor, as innocent as lambs, to say: Oh, my gosh, what a terrible thing it would be if we used reconciliation for something important like protecting the planet from climate change as opposed to just something like, say, our favorite: tax cuts for billionaires.

I think climate change is a little bit too serious for that quality of rhetoric and debate. If the Republican Party in the Senate is willing to stand and say that climate change is not real, then we can have that discussion. But the Senator from Wyoming and the Senator from Idaho and Senators across the other side of the aisle have all had their health directors from their home States come to the Environment and Public Works Committee to say that climate change is real, and it is dangerous for the health of their constituents. I think it is incumbent on us to do something about it. I don't think it is helpful to call it a bailout or to call it a tax. You could unwind the most vigorous rhetoric you like, but it doesn't change the point that we have to do something about climate change.

The fundamental fact that they are defending and the fundamental point that is lurking behind this rhetoric about bailout, rhetoric about a tax, is they want to continue to make it free for industry to pollute our atmosphere with carbon and greenhouse gases.

Behind it all, that is the proposition for which opposition to cap and trade stands. If you are opposed to cap and trade, then what you are saying is, it should be free, it should continue to be free for industry to pollute our atmosphere and warm our planet and compromise the quality of lives of our children. And we, as a party, the Republicans are going to stand and defend that proposition.

Well, of course, they cannot say that. So they instead talk about bailouts and taxes. But I very much hope we will look behind that screen, that we will treat this problem as a serious one, as it should be treated, and if we need to go to reconciliation to solve it, well, by gosh, this would be a far better use of it than the tax rates for billionaires that was the Republican's favorite use for reconciliation.

I yield the floor to my distinguished Chairman.

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AMENDMENT NO. 869

Mr. CONRAD. Mr. President, the next amendment that is in order is the Whitehouse-Boxer amendment.

Senator Whitehouse.

The PRESIDING OFFICER. The Senator from Rhode Island.

Mr. WHITEHOUSE. Thank you very much, Mr. President.

Mr. President, this amendment requires the Senate to balance, on the one hand, the newfound concern of our Republican colleagues about the reconciliation procedure they have used no less than 14 times for purposes such as raising the national debt to give America's suffering billionaires a tax cut against, on the other hand, jeopardy to the economy, to the public health or to the national security of the United States.

It allows the reconciliation procedure to be considered if the Senate finds that inaction on climate change will jeopardize the public health, the economy or the national security of the United States.

I urge my colleagues to vote in favor of the economy, the national security, and the public health of the United States.

I call up the amendment.

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