National Defense Authorization Act for Fiscal Year 2013 - Continued
Floor Speech
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Mr. COBURN. Madam President, first, I wish to announce that I agree with the assessment of the Senator from New York in terms of the treatment that should be offered. I have no problems with that. I think she is right. There are a lot of other things in TRICARE that aren't right. And what the Senator from New York is doing is admirable, but there is a portion of it that is not.
With the modification to her amendment, she has now raised the total cost of this amendment over the next 10 years to $1.9 billion. And it is true that she has managed to insert with some excess funds that will be spent before the end of the year that won't be there by the time the money for this is used to pay for it. So she does meet that standard, but she doesn't meet the standard for the next 10 years.
So we are in the midst of this large discussion about how we are going to get out of this fiscal mess. I take her at her word that she really does want to reform TRICARE and fix it. But realize that TRICARE hasn't had a premium increase since 1995, and all it would take to pay for this is a $2-per-month increase in premiums for those on TRICARE. And it is just TRICARE Prime; it is not TRICARE Standard and TRICARE For Life. It is just $2. Madam President, $550 per year covers your whole family, with no deductibles and no copays right now. It hasn't been increased since 1995.
So one of the things we ought to do is we ought to work to bring TRICARE standards up to make sure they meet the needs of everybody. I don't disagree with that. But the other thing we ought to do is we ought to pay for it. Now, where is the money going to come from to pay for this, this very well-intentioned and proper thing? The way it is written now by the Senator from New York, this will come out of the operations and maintenance fund. So the very father of an autistic child will have less flight time, less drill time, less shooting time, less preparation time to go out and be a warfighter. And as we think about the 10-percent across-the-board cut that is coming or the $500 billion that is proposed to come out of the Defense Department, none of it is going to come out of TRICARE.
So what we ought to do is we ought to fix these things, but we ought to fix them without digging our hole deeper.
Before Secretary Gates left, he said the biggest thing that is eating the lunch in the Defense Department is the department of health within it that manages the health care because we have not done an appropriate job of having a slight rise in premiums to cover some of the tremendous benefits. Nobody else in the country gets the benefits we give with TRICARE--nobody--$550 a year per family, $275 if you are single, and no copay and no deductible. All it would take is $24 a year by our TRICARE Prime to pay to make sure that the people with disabilities and the people with autism have the appropriate therapies and they are covered under TRICARE.
So I would ask my colleague from New York if she would mind withdrawing her amendment, to be voted on later, that I might be able to offer a second-degree amendment and maybe in that way or another way pay for this out of things that we know are going on, that we could find $1.9 billion over the next 10 years to actually pay for the cost of this over the next 10 years. We didn't have time to do that beforehand. I don't know if she would be willing to do that. But there is no way you should justify taking another $1.9 billion out of the operation and maintenance program for our troops to health care. We ought to eliminate something that doesn't take away from their training time, flying time, shooting time, or sailing time. We ought to be taking it from somewhere else, but that is where this is going to come from.
I applaud what she is doing. She is right about fixing the problem. She is totally opposite of what we should be doing in terms of paying for it, and I would offer to work in good faith in the next hour to try to come up with a second-degree amendment that would be acceptable to my colleague and to the chairman and ranking member of this committee that would actually pay for it.
Madam President, I yield the floor and reserve the remainder of my time.
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Mr. COBURN. Madam President, might I ask through the Chair the Senator from New York if she would consider for a short period of time withdrawing her amendment and allowing me to develop a second-degree amendment that would actually pay for this so that we would accomplish her goal--and I think all of our goals--of making sure the proper treatment is there but won't handicap the armed services in terms of delayed training, less training, less flying time? Because it is going to come out of the operations and maintenance funds. I wonder if she would do that with the assurance of the chair and the assurance of the ranking member and chairman of the committee that the amendment would still be considered.
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Mr. COBURN. I think we ought to have a recorded vote on this since we are not paying for it and we are taking $1.9 billion out of the O&M budget of the Defense Department. I ask we have a recorded vote.
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Mr. COBURN. Mr. President, we have made remarkable progress in this country in terms of research into diseases. Since Francis Collins and his great work on the genome complex became successful, the way we research disease has totally changed. I have my favorite aunt who died of pancreatic cancer. I diagnosed it hundreds of times in my own practice of patients who were dear to me and whom I love. The problem with pancreatic cancer is it is diagnosed late. It is an adenocarcinoma of the pancreas, much like an adenocarcinoma of the colon. The reason we do so well on colon cancer is we do colonoscopies and we can treat the disease early. What is well-intended by this recalcitrant cancer bill will actually delay the cure for pancreatic cancer and other recalcitrant diseases.
Let me take a few minutes to explain why I am saying that.
We no longer look at diseases to cure them by looking at the base disease. There is translational and neurocommunicative and peptide and small markers of communication on an intracellular basis. Now, when we do research and we find that, what we find is we find cures for multiple diseases.
The other thing is we can take 100 people with a recalcitrant cancer, and every one of them, when we look at the genetics of cancer, will have to be treated differently. In other words, it is going to take a different approach, even though we might classify it as a neuroblastoma of the kidney or a pancreatic cancer--but looking at the genetics of the cancer, which is what we are doing now, is going to require totally different treatments.
This is very well intended. I understand. This is a big disease, and it is terrible that we diagnose it at a time where we cannot end up--less than 10 percent, around 5 percent survival rates, 5-year survival rates on this disease.
I would like to have printed in the Record a letter I received from Dr. Francis Collins. I ask unanimous consent to have that printed.
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Mr. COBURN. It is outlining NIH's and specifically the National Cancer Institute's concerns with this type of directive from us. I think they care about whether we solve these problems associated with these recalcitrant cancers. I think people who want to get it solved are true in their motives to try to solve it.
But there are some significant things in his letter that I would like to quote for my colleagues because I think it might just change your mind about us micromanaging what they are doing.
First, he says:
We have all the authorities to do whatever we need to do with the money that you have given us. We can do all these things you want us to do. If you tell us to do them, we will do them. But we already have the authority to go where we think we are going to get the best results in the quickest way.
NIH constantly examines scientific opportunities and conducts research evaluation and planning opportunities within its current statutory
In other words they are looking, trying to figure out how they change, where they go now
The national cancer institute recently organized a group to provide a ``horizon scan'' of pancreatic ductal adenocarcinoma ad carcinoma, building on previous planning
They just did all this. They have just been through a total review of pancreatic adenocarcinoma, and they have just shifted where they are spending funds to address this issue.
Basic research that may lack any overt connection to specific diseases is the foundation for disease-specific translational and clinical research.
We must preserve this translational research if in fact we will want to eventually apply it to specific diseases. So I would say this bill, ``pre'' the genomic age, would be a right thing for us to do. It is the wrong thing for us to do because what we are actually going to do is we are going to force the NIH to do things that are not going to benefit the results--the outcome of these diseases and waste money on what is being directed.
Do we have a time limit?
The PRESIDING OFFICER. Evidently; 10 minutes equally divided.
Mr. COBURN. I ask unanimous consent to continue until I finish my remarks.
The PRESIDING OFFICER. Is there objection?
Mr. LEVIN. I am distracted. What is the unanimous consent request?
Mr. COBURN. I wanted to finish my remarks.
Mr. LEVIN. I understand. Was it an additional 5 minutes?
Mr. COBURN. It will not be much longer than that. I am certainly not
Mr. LEVIN. I have no objection.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. COBURN. ``Advances in the biological sciences have changed the way we view disease. We now recognize the dysfunction of specific biochemical pathways''--not disease-specific pathways--``biochemical pathways that govern cell behavior that may be similar in superficially disparate diseases or quite different in patients with the same disease.
What they are saying to us, through this letter, is that, of course, they are going to do what we tell them to do. But the very intent of what we are wanting to accomplish is we are going to delay the outcome because we have not significantly, in the last 3 years, significantly increased NIH's budget. So limited dollars are going to be spent as directed through this recalcitrant bill that are not going to direct the translational research and biochemical pathway research they are in.
I would just tell my colleagues in the next 10 years we are going to see such phenomenal changes in our approach to disease, and the treatments for that, and the reason we are going to see it is because we stop looking at diseases and started looking at translational genomics and biochemical pathways.
I will be one of the few who vote against this. I am fine with a voice vote if no other colleagues object. I have no problems with that. But in the name of doing good I suggest that we are actually going to limit our ability to achieve, at a sooner time, the cures that everybody who is supporting this bill would like to see.
I yield.
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Mr. COBURN. Mr. President, reserving the right to object, I find it highly ironic that we just passed an amendment to protect the constitutional rights of Americans, and we have an objection to protecting the second amendment rights of the veterans of this country. How in the world can we say to people who fight and defend for us through a social worker deemed incompetent to carry a gun, that ought to be on the basis of a danger to themselves or to someone else, and it ought to be adjudicated, and we have Senators objecting to protecting the rights of the people who defend us?
On that basis, the contrary nature of that basis of what we just did, I will object to any further unanimous consents on this bill until we have a vote to protect the rights of the people who defend this country.
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Mr. COBURN. All we are asking for the veterans of this country is that if their rights are taken away that it be adjudicated by a judge or magistrate. That is all we are asking. Rather than a social worker at the VA--which is what happens today to veterans. We are not asking for anything big. We are just saying if you are going to take away the second amendment rights, which means all those who truly should lose their rights will lose them, but they ought to have it adjudicated rather than mandated by somebody who is unqualified to state that they should lose their rights.
I will announce today right now that I will not object if Senator Levin again offers the request that will put four amendments on the floor. I will not object to that. I want to cooperate in this body. But I think you ought to think about what we just voted on--which I voted for--which is to protect the Bill of Rights for people of this country. To protect the Bill of Rights for people of this country. There could be no one for whom we should want to protect the Bill of Rights more than somebody who served our country.
We can object. All I am saying is, let them at least have their day in court if you are going to take away a fundamental right given under the Constitution. I will say today, if the Senator from Michigan offers his unanimous consent again I will not object and we will move forward because I want us to move forward. I want us to finish this bill. I want the Defense Department to be able to have something they can count on for the next year. But ask yourself in your heart, how fair is it? We are worried about terrorists and their Bill of Rights but we are not worried about the people who defend our country and their Bill of Rights? Tell me how we got to that point.
I yield the floor.
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Mr. COBURN. Reserving the right to object, this bill came out of the Veterans' Committee 14 to 0. They had hearings on it. We have done the work. It has been done. It came unanimously out of the Veterans' Committee. There is no question about what is right to do in terms of protecting--this is not about allowing anybody with any mental disease to have a gun. This is about taking the rights of those who do not have a mental disease to have their rights restored.
The PRESIDING OFFICER. Does the Senator from Oklahoma object?
Mr. COBURN. I do not.
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