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Nomination of Chai Rachel Feldblum to be a Member of the Equal Employment Opportunity Commission

Floor Speech

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Location: Washington, DC

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Mr. COBURN. Madam President, I enjoyed listening to my colleague for Texas. I will just comment to him, we are just beginning to see the series of untruths about what the President and his allies have said about this bill. I practiced medicine for 25 years, I delivered over 4,000 babies, I had a broad-ranging general practice, and I was belittled on this floor for the statements that are now coming true by the very colleagues who voted for the unaffordable care act.

Let me just outline for you four things that are going to be untrue.

You cannot keep your insurance. Whether you like it or not, you are not going to be able to keep your insurance. You cannot keep anything. I am going to read a story in a minute about a young man who could not afford his employer-based plan but went shopping, had a vasectomy so he could qualify for his insurance because it did not have maternal coverage. They did not want more children. His wife wanted to stop working. He had a wonderful plan. He cannot do it now. Now he cannot get insurance because he cannot afford it, and he makes about $500 too much to qualify for any subsidy.

So you cannot keep it.

The second thing is you cannot keep your doctor. I am experiencing that right now. MD Anderson in the Senator's own State is not covered by any of the plans. I have had a recurrence of cancer. My doctors now are at MD Anderson. I cannot use them under the unaffordable care act, unless I want to go and spend $70,000 or $80,000 on my next procedure out of my own pocket. I will have to go somewhere where the care is not what I would deem it.

The third untruth is every family is going to save $2,500. It is going to be about the opposite. Because everybody is going to be spending about $2,500 more.

Then, finally, what I was belittled on, that the quality of care is going to go down when they said the quality of care is going to go up. Access is going to be harder, not easier.

So when the American people really find out--the intention behind trying to fix health care was a good one. The system was broken. We do need to do things. But the untruths associated with this attempt to micromanage people's lives in a market--that was not perfect--I want to tell you, this is going to be so much worse than what we had in terms of real care and real outcomes. When it comes to individuals, most important is the relationship between the doctor and the patient. It is not just for the patient. The doctor having a relationship with the patient makes for much better judgments in terms of the quality of care they give and the insight into caring for the whole of that person. We are wrecking that. We are going to wreck that.

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Mr. COBURN. I have not researched it yet. I guarantee my colleague, I will research it, and I will find out. But the fact is, the leading cancer centers--Sloan-Kettering, the same thing--the leading cancer centers in this country probably could not reach an agreement at a price low enough that would pay for their costs for this advanced cancer care, so they did not offer them a contract because they would not cut their prices enough for the insurance.

So here is the main point. We promised to increase access. What you are really seeing is decreased access. I cannot go to Chris Logothetis. The No. 1 urologic oncological specialist in the United States--I cannot go see him under my insurance. I can. I am fortunate enough. I had a career before I was in the Senate. I will pay. But think about how many people are not going to be able to see Chris Logothetis and go to MD Anderson and have their life saved through the latest advances in pure biochemical and medical research put forward by a lot of people from Texas; some money from the NIH, there is no question; some from the Milken Institute, private money that has gone into research. We all seem to think that NIH is the only one who funds research around this country. There are a lot of entrepreneurs who fund tons of it.

So as to this idea of access, we can say you are going to have access. It is just like in Medicaid. Oklahoma chose not to expand Medicaid, and I agree with that. The reason is we are never going to send the States the money. It is an impossibility, if you look at our budget situation, for us to ever keep the promise that the unaffordable care act said we would do for the States.

But here is what is happening: People who are going to be signed up for Medicaid--and there is a whole other story about people who are put in Medicaid who are not eligible and will not be able to sign up who the whole system has kicked wrongly into Medicaid--you can sign up for Medicaid. Where is your doctor? Seventy-five percent of the doctors in California are not even going to sign up for the Affordable Care Act.

In Oklahoma, a recent survey said, of the doctors over age 52, 60 percent are retiring in next year. Age 52--our best doctors, the ones with the most experience, with the most gray hair. They have seen it all. They have the best differential diagnosis. They are hanging it up.

Now we have all these rules coming with the Affordable Care Act on what you have to do on electronic medical records. You have ICD-10--66,000 codes now versus 10,000 that the doctor is responsible for picking. What we have is a mess on our hands.

The final fifth lie is the denial of the problems that ObamaCare, the unaffordable care act, has caused and sticking our head in the ground and saying: Well, it is not causing any of those things.

It is going to be the most disruptive thing that has ever happened in this country to one-fifth of our economy.

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Mr. COBURN. Sure. One of those things is adverse selection, where sicker people raise the costs for everybody in the pool. But if, in fact, you looked at the Nation as a whole, and you had a law that said for any insurance company that is cherry-picking only healthy people, a portion of their profits will go into a pool at the end of the year for people with high-risk illnesses, that is what Switzerland does. It works wonderfully. What it does is it changes the behavior of the insurance company. They cover everybody.

So the whole idea behind insurance is to spread the risk. We did not have good risk rating. There is no question we need to address it. The Senator was on a bill with me, the Patients' Choice Act, which actually would not have created any of this mess and actually would have created a market with some of the parameters that would have spread the risk and had real indemnification in the country, but also would have had market forces driving it and still let you choose what you want.

The biggest problem with the unaffordable care act is it takes any discretion away from you about what is best for you and your family. It does it two ways. One is in terms of the details of what you can and cannot buy. I have 63-year-olds who have to buy maternity coverage.

But the final point I would make in that regard is that it takes away your ability to do what is your free and correct right to not buy health care if you do not want it. What is freedom about? You have to buy health care? We say: It does not really do it. It just charges you a tax, right? Even though we said it was not a tax, we somehow got it twisted around, and the Supreme Court says this is now a tax. I have not figured that one out yet. I hope the Senator has.

What does that have to do with freedom? If I choose to not buy a product--what if I choose not to buy high-definition cable? Is there a penalty for that? In other words, does Washington really know better? I think we have seen in the last 10 years, in my experience in the Senate, we are really the last ones to know, and the common sense of the American people is far greater than most of the ideas that were ever thought about coming out of here, other than some of the original founding documents that our Founders had.

So I would make one other comment on Medicaid. There is a recent study out of Oregon, which has done a good job of expanding its Medicaid. But when they went to look at what the difference was of expanded Medicaid, what they found out was that you were still, in Oregon, better off if you did not have Medicaid. You were better off if you had no insurance at all than if you had Medicaid. That is because we downward select through Medicaid, because of its pricing, to not the best of the health care system.

So when they looked at the control of diabetes, when they looked at high blood pressure, when they looked at the control of heart disease and congestive heart failure--when they looked at all those things--they found one thing that was better: the treatment of anxiety.

That was it. So in Oregon, when they actually looked at the study--and part of that is because, even though you say you got Medicaid, if you do not have a great doctor-patient relationship, where someone can get in your face who loves you and cares for you and cares about your health, and says: You have to do these things to change, you are going to change. So there is no impact.

So running it from Washington versus having real markets with a real safety net like the Patient Choice Act, which had a real safety net so that people are auto-enrolled who are irresponsible against catastrophic illnesses, is not a much better answer.

The other thing that is going to happen--I predict in April--is that you are going to see another uproar in this country. That is when the seniors in this country pay their taxes and they find out that the little meager interest income they got off their savings because of what the Federal Reserve is doing, or the few dividends they got, 3.5 percent of that is going to now come to ``pay for ObamaCare,'' because that is called investment income--3.5 percent.

So whatever your tax rate is, if you have any earnings on an investment, you are going to be paying that. You know, I will never forget Christmas Eve morning 2009--not having an opportunity to go over the Patient's Choice Act or have it voted on through the raw, brute political force of this body and ignoring the rights of the minority. We voted on the bill that many of us predicted--I am not worried about the exchanges. They will get that fixed. That is just the incompetency of management. They will get it fixed. It will eventually work and work well.

What will not work is the rest of it. It will not work. Just look at centralized management everywhere else in the Federal Government. It is inefficient, most of the time ineffective, oftentimes complicated by fraud or incompetence. We are going to do that to one-sixth of our economy. We are doing to it one-sixth of our economy.

The other thing that is going to happen in April of this year is people who have a health insurance policy through their employment, not buying through an exchange, are going to see their personal contributions through their employer rise significantly. That is because the insurance industry is going to have to pay for all of this. They are going to have adverse selection in what is being signed up on the exchanges.

The insurance companies that sell to the medium-size businesses and the smaller businesses who are not in a risk plan, they are going to be raising the costs for small businesses. So what is probably going to happen is that those small businesses are either going to markedly increase their employees' share or they are going to drop insurance all together and pay the fine--pay the tax or pay the fee, whatever it is. Pay the penalty. But the individuals, the people who we said we were helping, then will not be with the insurance that they had. They will be back to an exchange with a price, even with subsidies that are greater, 1. No. 2, with a copay that is greater--2. And, No. 3, with a massive deductible which is at 6,000 or 7,000 bucks, and all you really have is catastrophic coverage. Why did we not just do that? Why did we not just write catastrophic coverage for everyone in the country and let the market work on the rest of it?

That does not allow the elites in our society to make decisions for you. That is what we have done.

Let me share another story. This is from Tina Wilkerson. Tina called in. She has been a school cafeteria worker for a long time. For the last 14 years she has worked 40 hours a week for 10 months out of the year. She works for a food contractor company.

She has now been changed to a seasonal employee because of ObamaCare, so that her employer can avoid the ObamaCare mandates. It was costing her about $400 a month for a health care premium, which included medical, dental, vision, plus life insurance, plus a short-term disability policy. She went to the Web site, looked at plans. With her subsidy, she pays $645 a month premium, with a $12,000 deductible, does not have vision care, does not have dental care, does not have life insurance coverage, and does not have disability coverage.

That is middle income in Oklahoma. Here is someone who, because of what we have done, is now far worse off--far more exposed in her attempt to do good. I will give my colleagues credit. Their ambitions, their goals are worthy; they were worthy. But the results are a disaster and will become much worse of a disaster.

I want to spend a little bit of time talking about the fact of what is really going to happen in the medical world. I have four former partners. I go by there sometimes on Friday and visit. You cannot believe the morale in the medical community today--unbelievably negative. You talk about worried. Think about the average physician. They have an undergraduate degree. They spend 4 years in medical school. They then spend 3 or 4 years in specialty training. So they have 12 years at a minimum of higher education.

They come out all excited about actually doing good, real good, making a difference in individual people's lives--whether it is holding a hand when somebody is going through a rough time or diagnosing a very serious disease. The payment for being a physician is the relationship with a patient. It does not have anything to do with money. It has to do with helping your fellow man. I want to tell you, that is totally upside down right now. If you do not think that makes a difference when you have a doctor walk into a clinic setting, and you are sitting there on an exam table, and that doctor is focused on: How am I going to pay the overhead? How am I going to buy the next piece of equipment that I need to care for you the way I need to care? How am I going to buy insurance for my own employees? How am I going to pay for the necessary bills?

Oh, by the way, I have got the Independent Payment Advisory Board coming that is going to tell me what I can and cannot do as a physician, regardless of how I am trained, regardless of what I know, regardless of how much gray hair, regardless of how much experience I have in terms of really caring for folks, I am going to have a group of unelected, appointed bureaucrats decide what I can and cannot do for you.

Then on top of that, we have ICD-10. Most people do not know that. That is a diagnostic code manual that has just been expanded from some 10,000 diagnoses to over 66,000 with Federal penalties if you do not explicitly get

it down to the detail. It is not enough that you broke a metacarpal in your hand, you now have to label which hand, which finger, and describe in subsets the fracture. Your nurse cannot do that for you. You have got to do it. So now we are taking more time, and the penalties are going to be severe if you do not do it right.

As a matter of fact, they will not pay you for Medicare or Medicaid if you have not done that. There is no significant benefit to the health care community, but certainly a mandated bureaucratic cost on every physician practicing in this country that will offer no long-term benefit to the individual patient.

So now you have a doctor walking in. He may have been up all night the night before delivering a baby, carrying this added burden of all of this bureaucratic mess that the affordable/unaffordable care act placed on physicians in this country. Think that has any impact on diagnostic skills, on compassion, on empathy? Think it will impact care? It certainly will. It is going to have a devastating impact.

I want my physician focused on me. I do not want him worried about the Federal Government. I do not want him worried about IPAB. I do not want him worried about ICD-10. I do not want him worried about whether or not they have met the requirements of electronic medical records. I want him worried about me. I want him concentrating on me.

So we have put this big distraction out there because we know better than the market, than the trained professionals, and the arrogant assumption that we know better than the average American about what they need because we have already told them what they must buy. We have told them, if you do not buy what you must buy, here is the penalty. Thank goodness the young people of this country have figured that out.

Which brings us back to the integrity of the statements of the President. What did he say? We have seen all sorts of rationalization evidence: If you like your insurance now you have got, you can keep it. Is that right? Right now, for 5.8 million, and soon to be 15 million Americans that is not true. They knew it was not true when they said it. But it sounded good.

Second deceitful thing: If you like your doctor, you can keep your doctor, period. Oh, really? Can I if I did not have individual separate means to keep Chris Logothetis? No, no. You cannot keep your doctor. You can have a new doctor, based on what your insurance company--based on what the pricing mechanism has. You can have one of those doctors. But if your doctor is not on that list, you cannot keep him.

So somebody may have delivered all of your babies, taken care of your parents, delivered your babys' babies, cared for your husband's heart attack, knows everything about your family, knows your psychosocial profile, knows your emotional needs, someone who has really been your ally in life--that is gone for millions and millions and millions of Americans.

But oh, no: You like your doctor, you can keep your doctor. Every one of my colleagues voted against Mike Enzi's bill to allow you to keep your insurance under the grandfather clause. Every one. Mike Enzi knew what was going to happen. He put a bill on the floor. All of my colleagues said: No, we do not want you to be able to keep your insurance. It does not work that way. What about the deceit of this? Is it significant? Sure it is. It is a matter of trust.

Third thing. The promise of President Obama, who said, on average, that your health insurance costs will go down $2,500 a year. I do not know who told him that, whether it was Dr. Emanuel or who. I do not know what whiz-bang accountant or financial forecaster told him that. But it is just the opposite of that. Probably the average American is going to spend about $2,500 more trying to get equivalent care to what they had, not keeping their same insurance and not keeping their doctor.

Then, finally, the deceit that is assumed but not spoken, is that your doctor is going to make decisions for you and with you about your health care.

When the independent advisory board gets going, it will be not only about Medicare, it will be about everybody. If a group of unelected bureaucrats thinks I shouldn't run a non-stress test on a pregnant woman whom I am watching closely and they say I can't do that, I won't be able to do that.

We are going to be having a group of people practicing medicine in this country who don't know the patient, don't know the situation, don't have their hands on the patient, haven't ever touched the patient, making decisions about what kind of care that patient will get.

When we try to unwind the unaffordable care act, we have a routine chorus of noes. So the consequence is, who is going to be held accountable?

A total disruption of the indemnification market in this country is now occurring in terms of health care insurance. When the insurance companies look at what their ratios are in terms of young to old, in terms of higher risk patients who cost more versus younger patients who cost less, they will make a calculation this spring about what their fees will be for next year.

The ObamaCare administration did something else deceitful--intentionally deceitful. Before the election next fall, they don't want you to know how much the health care costs are going to rise, and so they changed the date on which you will make a selection for next year and on which those prices will go through until after the November elections next year because they know that if you know the significant increase in costs that are going to come next year--not just this year but next year--based on the adverse selection and the mix of all of the insurance companies in this country--they know that the rise in your insurance health cost is going to be significant. So what did they do? They passed a little rule, and they changed the day to make the knowledge available to you, the purchaser, come after the election. So you won't be a fully informed voter knowing that your insurance costs are going to rise 20 or 25 percent again next year under the unaffordable care act--the unaffordable care act.

We are in a mess in a lot of ways. We are going to continue to see significant disruptions in the health care in this country. We are going to see a continuous decline in the quality of health care in this country--just the opposite of what they promised--because we are disrupting the doctor-patient relationship. I know this, having practiced for 25 years. I know what it takes to really care for someone. I know what it means to be in a room and spend the time that it takes to listen, to find out what is really going on, to find out why the patient is really there. We are going to drive down all of that.

We have this payment system in Medicare which pays on the basis of procedure--which is a dumb system--instead of paying on the basis of time that is spent with a patient. What most people don't recognize is that all reimbursements in this country for physicians--unless a doctor is in concierge medicine, which is another thing I will talk about in a minute--force doctors to spend less time with their patients because as we crank down reimbursements, either through Medicaid or through the insurance or through Medicare, and a doctor has fixed overhead which has been markedly expanded under the mandates associated with the Affordable Care Act, less time means less quality care. Less time means less quality care.

There was an interesting study done recently about how long--after your doctor comes into the room and asks ``why are you here today?'' how long before you are interrupted because the doctor is in a hurry to get to the next patient. It is 6 1/2 seconds.

So our reimbursement mechanism, mandated by the Federal Government--another positive aspect of us meddling in the markets--is decreasing the time, the quality, and the quantity of health care that patients rightly deserve when they are sitting in your office.

What is the market doing about this? There is this growing expanse of what are called concierge doctors where, for a certain fee, that doctor is yours no matter how many times per year you want to go to him or them. No matter what your needs are, they are available to you 24 hours a day, 7 days a week, 365 days a year. How does it work? Well, most people can't afford concierge medicine. It is about $1,000 a year that you pay. Insurance doesn't reimburse you for it. You pay $1,000, and they are available. You get a comprehensive, thorough health care screening exam once a year. All of your tests are included in that as far as blood tests and laboratory tests at a physician's office. Then if you have a need at any time during that year, you have access to that physician.

What do we find? The first studies that have come out on that, where we take the time pressure off the doctors and let them actually practice medicine the way they were trained, show that they order 40 percent fewer tests. Isn't that interesting?

The axiom in medicine that every doctor is trained with is if you will listen to your patients, they will tell you what is wrong with them, whether it is cancer or diabetes or heart disease or anxiety or depression or hypertension. But it takes time, it takes interaction, and it takes a great differential diagnosis. The unaffordable care act is destroying that. This is why you are seeing this little blurb out in the market where you see concierge medicine because now the reason they are ordering fewer tests is they spend about five times as long with a patient because they are not in a hurry to get to the next patient because they are not making their money by filling out a code and filing it with an insurance company. There is a complete relationship between the physician and their patient.

I would like to return to this gentleman named Brian who is from Oklahoma. He and his wife have two children under 5 years of age. They believed what the President said when he told them they would keep their health insurance plan and their doctors if they liked them. Brian recently called my office and said: That isn't true. That was a lie to me. It was deceitful. It was untrue.

Brian works in Tulsa, and the company he works for, he felt the insurance cost was too much, so he didn't take insurance from his employer, and he went on the private market and bought, through Community Care in Tulsa, a plan he and his wife could afford. His wife decided to quit working, stay home, and raise their two kids. He was paying a $330 premium, but it didn't cover maternity care, and they didn't want any more children, so he underwent a vasectomy, which is an elective procedure, to make sure he wouldn't have more children.

On November 1, Brian received a letter in the mail stating that as of November 1 of this next year he would be terminated from his current plan and he would have to find a plan that satisfied the new mandates that the wisdom of Washington said had to be in there--maternity care. He spent hours on the ACA Web site, and what he found were plans that ranged in costs from $800 to $1,100 per month--four times what he was paying. He can't afford that. He didn't qualify for a subsidy, but he can't afford that.

So now what does he do? He had plan for $330 a month that met his needs and covered what he and his wife thought they needed covered. He is a young man. What is going to happen to Brian? Brian is going to get taxed, not because he doesn't want to buy health care, not because he can't afford the $330 or even $400 or $500 a month, but because he can't afford $800 or $1,100 a month. So now Brian is going to be without health care--I am going to say it again: without health care--and then we are going to fine him, we are going to tax him because we designed a system that took him out of the market. It didn't put him in the market; it took him out of the market.

What have we done? We had an opportunity to fix that with the Enzi amendment, to grandfather all of these plans in, and all of my colleagues on the other side of the aisle said no.

So here is Brian with a wife at home and two small children under 5, and he is stuck in no man's land. Do you think he thinks President Obama is truthful? No. Does he think those who touted the Affordable Care Act are truthful? No. He has lost confidence in his government.

That is really where we are in our country today. We are in a crisis of confidence with Washington. It was never meant to be. If you read the enumerated powers--as a matter of fact, we have an Enumerated Powers Act. It has 36 cosponsors. It says simply that if you bring a bill to the floor, you have to state what section of the Constitution gives you authority to legislate in that area based on what article I, section 8 of the Constitution has to say.

Disappointingly, there is not one of my colleagues on the other side of the aisle who is a cosponsor of that bill. It doesn't stop you from offering the bill, it just says please reference where in the Constitution you have the authority to legislate in this way. None of our colleagues believe the Constitution has any bearing on what we do by the fact they will not even cosponsor that bill.

The very thing our Founders emphasized was our authority to make or change law. That is fundamental, structural to this country. As we have ignored--as does the affordable-unaffordable care act--the enumerated powers, the consequences to our country are monstrous.

This book contains, through the middle of November, all the emails my office has gotten on the Affordable Care Act from a State of just 4 million people. We are just 4 million people. There is not much positive in here. As a matter of fact, there is not one positive story in here. They are all stories similar to Brian's and Tina's--identical. Had care; don't have care now. Had an affordable plan; don't have an affordable plan now. Had a doctor; don't have that doctor now.

As a matter of fact, one of the stories in here is from somebody who had their doctor for 35 years and can't have that doctor anymore. It is not because the doctor doesn't want the patient, and it is not because the patient doesn't want the doctor. It is because the unaffordable care act has decided that will not work in our system anymore.

We have heard through the press that we didn't have any ideas on health care. My colleagues know that isn't true. Senator Baucus stood right over there on December 8, when we tried to bring up the Patients' Choice Act. That did everything in terms of the goals which the Affordable Care Act did, without raising taxes, without disrupting the indemnification market in this country, creating a true safety net for those who could not afford health care, and created auto-enrollment for the irresponsible. We were never allowed to vote on that.

It was very similar to what we are seeing now with the Defense authorization bill. We have to pass one, but you can't have your say. My 4 million people don't count when it comes to the Defense authorization bill because they do not like the amendments I might offer.

Under the Constitution, it is illegal for the Pentagon not to give a report of how it is spending its money. It is a violation of the Constitution. We have an Audit the Pentagon Act. It has real teeth in it. There is somewhere between $50 billion and $100 billion worth of waste a year in the Pentagon. We will never manage the Pentagon if we can't measure what they are doing. Yet we don't get an opportunity to offer that. It is a smart good government amendment. But it is not in there, and it is not ever going to get offered. Why? Because the majority leader in this body has decided he will decide what amendments are offered and what amendments will not be.

This is no longer the greatest deliberative body. This is a mimic of the House of Representatives--the exact opposite of what our Founders intended the Senate to be. Their genius was they created a House of Representatives to be responsive to the populace demands of our country. That is why elections are every 2 years for the House of Representatives.

When the Senate was first formed, it was an appointed body by the State legislature and it was for a 6-year term. Jefferson wrote the rules--the first rules under which the Senate would operate--and the Senate was designed to make sure there could never be a tyranny of the majority, as we see today; that the minority rights of those in opposition would never be limited. For the first 130 years, it took absolute unanimous consent to do anything in this body. The rules were always changed--when the rules changes were made--with a two-thirds vote of those duly sworn and present, until November of this year.

Are things raw in the Senate right now? You bet. And they are going to stay that way because the very genius behind our Founders was to force consensus and compromise in the Senate, something the majority leader doesn't believe in. We saw the raw, brute political power with the unaffordable care act. Not a single Republican voted for that bill. It was forced through with a 60-vote margin in December 2009 on Christmas Eve morning.

Now we see more raw, brute political force, not because it had to be that way but because leadership is lacking, an understanding of the traditions and history of the Senate. Carl Levin explained why he didn't agree with that. We didn't listen to one of

the senior Members who has been here a long time, who understands the history of the Senate, and so consequently we find ourselves in a situation where consensus is not derived, the mechanism to force consensus has been diminished, long-term thought goes out the window, and bipartisanship will as well.

I wish to spend another minute or two talking about the Defense Authorization Act and the waste in the Pentagon. A little over 1 year ago I put out a report on the Pentagon. In the Pentagon's budget is $67 billion a year which the Pentagon spends on items that have nothing to do with defending this country. I put out that report in the hopes the Senate Armed Services Committee would look at that report and say: We ought to take all this out of the Defense Department.

Do my colleagues realize the Defense Department has 112 science, technology, engineering, and math programs--110 separate programs. That doesn't have anything to do with defending the country. They have 138 green energy programs, spending billions of dollars every year on them. That should be at the Department of Energy, not in the Pentagon. It costs $50,000 a year to educate a child on a military base in this country--four and a half times what it costs to educate anybody anywhere else in this country. That doesn't have anything to do with defending the country either. Why?

So we have $67 billion that not one aspect of was acted on in the Defense Authorization bill. That was not taken out. Let's have the military defend this country and not do all these other things that don't have anything to do with defending the country.

Oh, by the way, if we moved that $67 billion out, it is estimated we could save about $15 billion in overhead absorption by moving medical research to the NIH, where it belongs, instead of the billions of dollars we send to the Pentagon for medical research that doesn't have anything to do with extraneous diseases that our combat forces might encounter in odd places around the world.

So $67 billion, and we could have saved $15 billion. That $15 billion is three-quarters of what the new ``agreement'' between the House and the Senate on the budget for the next 2 years is. We could have saved that. That is $15 billion that would have paid for training; $15 billion that would have bought more ships; $15 billion that would have worked on missile defense, now that we are going to need it since Iran is going to eventually be armed with a missile-based nuclear weapon. But we didn't do it.

We have the Government Accountability Office that in the last 3 years has identified duplication throughout the Federal Government coming close to the tune of $250 billion. One committee in the House has actually acted on their report. Of that $250 billion, perhaps $50 billion or $40 billion could be saved by eliminating some duplication. Yet not one committee in the Senate acted on the recommendations of the Government Accountability Office to eliminate duplication--not one. Not one bill came to the floor.

We have tried to insert a lot of it, but we can't offer amendments anymore. We don't have the opportunity--the 4 million people in Oklahoma--to have a say on what happens. They see what is not happening, and they wonder why we don't fix these things.

Let me create a scenario for a minute. What do my colleagues think would happen in the country if we actually did the things the Government Accountability Office recommends we do? What would the people think if we eliminated the duplication, if we eliminated the fraud, if we eliminated the waste? The confidence of the American people in this Congress would rise because we are actually addressing the problems. We are actually addressing the key components that put us in deficit every year.

It is true--my colleagues all tell me--the biggest problem is our entitlements. That is true. But it doesn't mean we don't worry about the smaller problems. As a matter of fact, I am reminded--as I see the Presiding Officer in the Chair--that I owe Senator King some information on some programs I forgot to give him that he asked me for in November. But if in fact we did all those things, if our committees were charged, through the leadership of this body, to eliminate the duplication, consolidate the programs, and save the money because we need the money right now, we need to not be charging it to our children, what would happen to the confidence in this country? It would rise. We would actually be doing what the people expect us to do. Nobody in the real world gets to do what we do--ignore the real problems, don't act on the real problems and say: It is too hard. It is too difficult.

I yearn for bipartisanship, for consensus. I yearn for a system that forces us into consensus--not all my way, not all somebody else's way but somewhere in the middle. That requires using the rules of the Senate and a long-term vision of where our country needs to be going and not caring about what a political career looks like but caring about what our country looks like.

We have lost focus on what is important. It is not my career, it is not the career of the distinguished Senator from Iowa, it is what happens to our country. We have our eye on the wrong ball. I do too. I admit it. We degenerate to the easiest thing to be critical about.

I am human. I admit to that as well. It doesn't have to be that way.

Mr. President, I see that the majority leader and several others are on the floor. I yield the floor in anticipation of our vote.

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