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Mr. COBURN. Madam President, I rise to address my colleagues regarding the importance of improving access to health care in our rural communities. Rural America accounts for about 20 percent of the Nation's population, yet only 9 percent of the country's physicians. It should, therefore, come as no surprise that nearly 70 percent of the primary care health professional shortage areas are in rural communities.
The disparity in access to quality health care has a substantial and tangible impact on the quality of care and the quality of life for rural Americans, who are typically older, poorer, and sicker than the population at large. That also has an impact on the economic vitality of those regions.
I do not believe that the stimulus legislation is the right vehicle for the majority of the spending it contains. Of the spending it contains, I note that the bill spends a substantial amount of money for health care in rural communities. This spending is directed toward health care access points, health information technology, workforce training development, and broadband deployment. At this point, it is likely some version of this package will move forward. As Congress spends this money, I would encourage my colleagues to give appropriate focus to preventive care and approaches that integrate these various components of health care across an entire region.
Improving health outcomes for a community requires going beyond building hospitals and clinics. A regional ``systems'' approach to improving health may provide effective opportunities to improve the health outcomes of individuals and communities in a cost-effective manner. Such an approach could integrate health coverage initiatives with prevention programs, primary care clinics, advanced specialty outpatient care programs, hospital-based care, and a regional health information network.
I plan to work with my colleagues to shape policies this Congress that will improve health care across America, including rural communities. Individuals, communities, private foundations, and the Government must work together if we are to be successful.
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Mr. COBURN. Madam President, I hear the word ``legacy.'' The legacy that is going to be left from this bill is demonstrated to us by history. Here is what we did the last time we found ourselves in this shape. The Federal Government as a percentage of GDP went from 2 1/2 percent to 20 percent in all the New Deal programs.
There is a wonderful book, and people ought to read it. It is called ``The Forgotten Man,'' Roosevelt's ``Forgotten Man'' series. This is an analysis of what we did, how we did it, what worked, and what didn't. Quite frankly, what you can see from this chart is that Government never got small again. Never. And what is going to happen is, if you look outside of this chart to what we are doing now, you are going to see Government grow again. So the total State and Federal take from GDP will be above 38 percent from now on. Now, what does that mean to you? What is the legacy of that? The legacy of that is lost opportunity--not for us; we will be pushing up daisies. Our children and our grandchildren, though, will suffer from a massive decline in their standard of living.
That is not to say we shouldn't do a stimulus bill. The stimulus bill we should do should be very targeted--this one is not--it should be timely--this one is not--and it should be temporary--this one absolutely is not because we are going to see this same thing happen. Even our own budget chairman, the honorable Senator from North Dakota, says, at a minimum, $124 billion a year increase in the baseline, additional spending that will never go away--never go away.
So what does it mean when we say we have a legacy? Here is the legacy of this bill: The cost this year, not including interest, for every family in this country is going to be $11,000. That is what we are going to borrow against your future earnings. We will increase the baseline budget this year $350 billion. That is just this year. The increase in the annual deficit will be somewhere between $50 billion and $185 billion, before interest. And we are going to pay $438 billion in interest on this borrowed money over the next 10 years. Everybody knows that if you save before you spend, it costs you about half. But what we are doing is spending and costing the future of our children.
What is the Congressional Budget Office's best guess? That we will create somewhere between 1.3 and 2.9 million new jobs. But also their best guess is that in about 10 years, this ``stimulus'' will have a negative effect on the economy. We are going to spend $15 billion to renovate offices for Federal employees. What percentage of this $800-plus billion bill will really stimulate? About 12 percent.
The other thing that is wrong with the bill is that there are no brakes on it. What happens when we have two or three quarters of growth? Do you think this body will come back and take this money away? No. Politicians are averse to ever taking anything away because they care more about getting reelected than they care about what is in the long-term best interest of the country. So here we have a stimulus bill that will forever raise the baseline and the interference of Government.
Now, what does this really mean if it goes to 35 percent? What it means is that you lose liberty. You lose freedom. If you think the Government is involved in the decisions you make now, just grow it another 10 percent total and see what happens. Your liberty and your freedom. It doesn't mean we shouldn't do a stimulus bill. We should. But we ought to do one that will really make a difference.
The other moral hazard with this bill is that we didn't hear today what the plans are for the mortgage problems, the housing problems, or the bank problems. Now, the reason we didn't hear about that is because we have to get past this vote because when you get ready to swallow the near trillion dollars they are going to come and ask for on those two problems, this is going to seem small. But if you have to talk about both at the same time, $1.8 trillion, now we are at $25,000 per family.
The fact is, what was done in this country from 1929 to 1938 didn't work. We are not even doing as good a job as they did in terms of directing the money. Yet, because of the basis of fear, we are going to pass a bill saying we have to do something. We do have to do something, but it doesn't have to be done today. It needs to be done in a very meticulous manner to make sure we get it right.
There is a legacy with this bill. I will spend the last few minutes talking about the fact that there are no earmarks in this bill. That is an out and outright untruth. There are tons of earmarks in this bill, from electric golf carts, to power generations for specific lobbyists who spent well over $1 million getting it in there, to a new building for the State Department to train its security personnel. They spend $12 million a year now. They are going to spend $275 million now and still spend $12 million a year, but we get a building in West Virginia because the Senators from West Virginia want that building there.
The competitiveness clause we put in, which the Senate voted unanimously on to put all contracts competitive, it will be blown out of the water, it will never come out of conference----
The PRESIDING OFFICER. The Senator's time has expired.
Mr. COBURN. Because we don't want to do what is best for the children of this country; we want to do what is best for the politicians.
I yield the floor.
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