care of people in wyoming for 25 years. i have great concerns about the spell or at least we know for sure is in it which is $500 million of that in medicare to our patients who depend on medicare and that the system we know has gone broke. and that's why there's a front-page story one of the wyoming papers, doctors shortage will worsen. it's going to be harder on perl communities and other communities around the country if this goes through because the folks who look at the parts of the bill that we have seen, they have said that one fifth of the hospitals in this country if they're able to keep their doors open will be operating in a significant loss ten years from now. that's not the best future for health health care in our country. but i had a telephone town hall meeting, people from all around the state of wyoming to call in and asking questions and they said what's in the bill? was coming to the senate? we don't know yet. we haven't seen that. and they said when you find out? to come home in a similar town meetings a

i would just ask the senator from wyoming -- mr. barrasso: may i respond to my colleague from texas, i think you're absolutely right. the more people learn about this bill and the details of the bill, the more the american people oppose this bill. and my colleague from texas made a wonderful yesterday and again today when she said, how do we know when they start the tax collecting right now, how do we know the money is even going to be there four years from now to start supplying the services? there was a story in today's "u.s.a. today" talking about employment an unemployment in this country, and the story says, public gain, -- public game, private gain. it says the federal government is adding jobs this year at a rate of nearly 10,000 per month. and we have read about all of the different bureaucracies that will be brought into play if this passes. over 70 new bureaucracies, 150,000 more federal employees, more washington bureaucrats to make rules and regulations that affect the people of america. talks about the 10% unemployment

a senator: isn't the senator from wyoming saying this? the troops that you spoke to and the troops that we are going to fund in the next day or so with this legislation want a strong country to come back to? mr. wicker: and they would be happy if we were standing firm today, this weekend to prevent ever-increasing deficits, to prevent this country from being burdened with -- with larger and larger debts, to protect the programs that they will come back to to make sure medicare is not cut even further? isn't the senator saying that these troops expect us to be standing for the financial strength of this country so that they can have the same america to come back to that they volunteered to fight for? mr. barrasso: mr. president, that is exactly what i'm saying. my colleague from mississippi is so right. that's what the men and women from wyoming who are serving right now in iraq and kuwait want. they want to come home to the same country that they left, the place where they have jobs, where they have opportunities for their children, where

also as a practicing doctor for 25 years taking care of families in wyoming, what i saw people in wyoming, the reason they liked this if they were on medicare, because it dealt with prevention and it helped coordinate care. one of the things that medicare doesn't do as well is really coordinate care and work with prevention. well, we know how important prevention is in helping people keep down the cost of their care, how long -- how good it is in terms of giving people opportunities to stay healthy. i means that why they call it prevention. well, the -- the bill in front of us, as i see, and i ask my senate colleague from wyoming, to me this is a bill that's going to cut $120 billion from medicare advantage, the program that the people in our state like. mr. enzi: mr. president, the senator from wyoming is absolutely correct. and we're getting a lot of calls, e-mails, and letters about that. another -- another thing that the president promised, of course, is that everybody would have catastrophic coverage. it kind of fascinates me that the wyoming people and the people across the country

in fact, the senator from wyoming had a very interesting letter from his home health care groups in wyoming which related what percentage of home health care agencies would actually close. it was a very high percentage under this proposal. now, there's no question but that medicare is in dire straits. it is headed towards insolvency. it goes into a negative cash flow in two years, and it has $35 trillion of obligations which we have no idea how w*er going to pay for them -- how we're going to pay for them. and so medicare reform is important and i've supported it, proposed it here. in fact, i've proposed it a number of times and it's always been voted against by those on the other side of the aisle. but any reform to medicare of this size -- $464 billion in the first ten years, $1 trillion in the first ten years of full implementation, $3 trillion over 20 years -- anything that is going to cut medicare by those numbers, those savings, if they're going to occur, those reductions should go to benefit making medicare more solvent. what happens under this bill? that's not what they're used for.

the people of wyoming know there's an advantage to being in this program. that's why they sign up. that's why citizens all around the country have signed up for medicare advantage because they realize there's value in prevention. and there's value in coordinated cavecare. there is value in having eye care, dental care, hearing care. there is -- there are advantages to want to stay healthy, to keep down the cost of their care. mr. mccain: even though it may cost more, the fact that you have a weller and fitter group of senior citizens, you in the long run reduce health care costs because they take advantage of the kind of care that over time would keep them from going into the hospital earlier or having to see a doctor more often. mr. barrasso: that's one of the reasons that medicare advantage was brought forth.

coburn from oklahoma, and doctor barrasso from wyoming. i wonder if they would bear with me for just a minute or two to reflect on something that the majority leader said and the -- what the minority leader said. the minority leader talked about a historic mistake. there's been a lot of talk around here about making history on health care. the problem is there's many different kinds of history as the republican leader -- leader has pointed out. it seems our friends on the other side are absolutely determined to pursue a political come cozkamakazee mission for td states. i did a little research on historic mistakes. we made them before in the united states congress and maybe we'd be wise to take governor schwarzenegger's advice and slow down and learn from our history rather than try to top our previous historic mistake, like

president, i agree with the senator from wyoming. of course under the procedure that we're following -- and i think it's important for the american people to know this -- the bill, the 400-page bill that was added to the underlying bill was brought up over the weekend and is being presented to us in a way that it can't be amended. and so something that affects a sixth of the economy, which you've had a day and a half to read, which is part of an overall bill that will raise taxes, cut medicare, send big bills to states, has many questions, could be improved with amendments, can't be amended. mr. barrasso: another amendment -- and i see my colleague from south dakota is here -- an amendment that i offered on the floor of the senate yesterday to protect individuals from skyrocketing insurance premiums. because you recall that the president of the united states said that premiums, families in wyoming and in other states, families across the country, health insurance premiums would go down $2,500 per family. yet, what i read and study an

the presiding officer: the senator from wyoming. mr. enzi: i ask unanimous consent that a, an article that was discussed earlier and had some objection to it, but that objection has been resolved from from factcheck .org be published in the record. the presiding officer: without objection. mr. enzi: i yield five minutes to the senator from maine. the presiding officer: the senator from maine. ms. collins: thank you, madam president. and i thank the kphaerpbg of the bill. madam president -- i thank the manager of the bill. madam president, i rise in support by the motion offered by my colleague from nebraska to recommit this bill in order to strike the more than $42 billion in cuts in the medicare home health benefit. madam president, you too come from a pretty rural state, so i know that you understand just how important home health care is to the seniors in our states. home health care has become an increasingly important part where -- of our health care system. the highly skilled services and compassionate care that our nation's home

it is going to affect people in all communities across america, not just in wyoming. i can't imagine anyone in a small community being for this. >> put more people in the hospital. senator? >> senator, i have been listening to this debate and it is seldom that debates on the floor have much impact on me, but i do think the lincoln amendment is a terrible amendment. we should not be voting on compensation. i wonder, senator, if we should offer a unanimous consent agreement to change the amendment to take into account our -- aarp and phrma and others. i wonder if you would be willing to take that under unanimous consent. >> not to mention the chief executives of the parm pharmaceutical companies. why wouldn't we want to bring them in? after all thers they are paying their lobbyists millions of dollars every year to cut the deals they talk about on the front of "the new york times." i hope the senator would be happy to look at these also. again i refer to the new york sometimes -- refer to the "new york times". >> the senator from arizona state thd case very well and it

crapo: my colleague from wyoming. there was a little pause there while we were comparing some of our notes here, but the next phrase in the motion -- or in the amendment says that -- it's referring to a procedural motion that would raise taxes on middle-class families. there is nobody bringing a motion here to raise taxes. the amendment says that it's referring the bill to the finance committee to take out the taxes on those who earn less than $200,000 or $250,000. i note that my colleague from kansas has arrived. did you care to jump in at this point? mr. roberts: i will tread with great care, i will say to my distinguished friend. and thank you for this colloquy. but you ask what it means that the senate should reject any procedural maneuver that, that's in quotes, and what does that really mean? well, it applies only to the senate procedural motions. by itself, it would have no effect on any subsidy provision. that is, the way that it is commonly understood under senate rules. it means if adopted that the amendment

the presiding officer: the senator from wyoming. mr. mr. enzi: the reason i wasn't on the floor a large part of yesterday is i was wading through the amendment and also the scores. then i had to have the experts interpret it. the american people are having to relying on the stuff heard here on the floor. i get calls from all over the country saying stop this bill any way you can. make them get it right. and i got to tell you, some of those are from other states, and they're saying my senator is not listening to me. i'm really counting on you. so i rise to speak on the issue of the health care reform. i rise with a great sense of disappointment as i reflect on the debate that might have been. from the very start of this debate i've said we need to reform our health care system. everyone agrees we need the real changes that will allow every american to purchase high-quality affordable health insurance. not a single one of my senate colleagues on either sao*eul supports the casino -- side of the aisle status quo the statuse understand the curr

i've seen what's going to happen in wyoming. the blue cross blue shield association came to similar conclusions. one is community rating which forces insurers to make rates regardless of health status or habit. cbo doesn't think this has much effect, but costs inevitably rise in insurers aren't allowed to price based on risk and we have 35 states that give an example on that. at the white house decided to shoot the messengers like well point to avoid rebutting their messages. but amanda at mit, william congdon of the brookings institution and market bring them young have found similar results in a $2 a paper peer-reviewed forum for health economics and policy. these economists on the a community rating lives raise premiums to the individual markets by 20.9%. i asked that the remainder of this editorial be published in the journal. >> without objection. >> i yield the floor. >> you can read the letter from senator gregg to republicans c-span health care hub. also there, the senate and house versions of the health care bill video

and so i would say to my friend from wyoming the piping you make is exactly right. we are doing all of this and the exercise of to be reducing cost. clearly that is not the case with this legislation. >> let me address the question to the friend from wyoming who is a medical doctor and outstanding senator. you know, we are being asked to believe from the folks on the other side and with the american people are struggling with and having a hard time believing is they are saying that even though they are cutting medicare by a total of 450 billion plus over this ten year period that medicare is actually the solvency of medicare is going to be extended. the expected the american people to believe that somehow when the fact of the matter is we've noeth from the information we received this spring from the bipartisan medicare commission unless something is done medicare is going to become insolvent in the year 2017. pure and simple. and what we are doing here is not taking the savings that they are proposing and why we don't agree with them, but irrespective of that, irre

in fact, the senator from wyoming had an interesting letter from his home health care groups from wyoming which related to have percentage of health care agencies would agency close. there was a very high percentage under this proposal. now there's no question, but that medicare was in dire straights. it is headed towards insolve yen si, it going into a negative cash flow in two years. we have no idea how we're going to pay for them. medicare reform is important. and i support it, i proposed it. it's always been voted against by the completes on the other side of the aisle. but any reform in medicare this size, $464 billion the first ten years, $3 trillion over 20 years. anything that's going to cut medicare by those numbers, those savings, those reductions is going to benefit making medicare more solvent. what happens under this bill? that's not what they are used for. they come out of the pocket for seniors and the people who provide seniors care, and the seniors ability to purchase insurance. those dollars go from the senior over to creating this new -- these new major programs, these

wyoming wyoming i -- mrs. lummis: the federal government is overleveraged. meaning we've taken on too much debt. both of the federal reserve, while they've been trying to help our banking system right itself, and we in congress by not recognizing that in this recession we, too, should be making sure that government isn't growing in an outsized way when it is in fact the private sector that creates wealth. we are joined by the gentleman from colorado who is on the small business committee and small businesses in our communities are really hurting, as are community banks. among the things that we have talked about with the federal reserve chairman is the issue of how community banks sometimes have loans that are performing, that every year the borrower is making the payments, principal and interest. but when bank regulators come in and look at those loans they're worried that the asset that is backing that borrower might be a little shaky. so they might require the bank to write down that loan even though its performing -- it's performing. i know that the fede

and of course i' if i'm talking about how much money for wyoming as opposed to new york, it wouldn't sound like a lot. another surprising thing that happened to it is it looked like nevada and new york were going to be hit real hard. and the next day we got numbers, and -- now we had the same c.b.o.-joint tax score. that didn't change. didn't change a bit. one set of numbers. but the evaluation the next day look add lot better for nevada and new york, but it didn't bring it down enough, so there was a special provision that's been put in the bill -- this wasn't done in the gang of six; this was done after the bill was written -- a special provision that made it much nicer for nevada and new york. we said, wait a minute. why are you doing that for nevada and new york? and some of the influential people around here from nevada and new york said, well, this economy is in a real downturn and we're being hit harder than anybody else. and i said, well, that's -- that's a nice gesture, but this bill -- this part of this bill isn't going to go into effect for four years. how do we know that

that would fund the state of wyoming for 320 years. it's a big number, and we're talking about cutting it. if we don't cut this, if we don't use this to pay for the other new entitlements, this is not deficit-neutral. and c.b.o. says that. everybody's entitled to their own opinions, but the facts are there. the facts say if -- if, if -- and we're not going to do those ifs. i won't dwell on that point even though i'm a little upsefplt and i would -- a senator: would the senator yield for just a quick question. the presiding officer: the senator from new hampshire. mr. gregg: the senator from idaho wants to speak. if i could ask the ranking member of the "help" committee a quick question? i heard the senator from montana, the senator from north dakota say that the amendment that i have pending would make it impossible for them, under this bill, to create a new entitlement programs because the medicare money which is going to be caken from medicare and used to create these new entitlement programs would not be available. my amendment says

now you're seeing it -- we're saying it in wyoming. "the washington post" said it on saturday, "medicare cuts could hurt hospitals, expert warns." we're seeing that affecting the quality of care. we're seeing it in terms of will we have a doctor shortage, will that worsen? we're going to deal with that at home. but people are seeing it all across the country because fundamentally this bill is flawed. it will not address the sort of concerns that we have, and we are trying to get costs under control. this will drive up costs. we're trying to help improve the quality of care. this will not improve the quality of care. we're hoping to improve access for patients. this will make it harder. this will make longer waiting lines, it will limit care in rural communities, as i know about those in wyoming. you are know about them in alabama. when we see and we read the report by the actuaries, the committee that overseas medicare, and they didn't rush to do this. they're talking about the tbhail now has been out -- they're talking about the bill

president, i'd yield our final minute to the senator from wyoming. the presiding officer: without objection. mr. barrasso: mr. president? the presiding officer: the senator from wyoming. mr. barrasso: thank you, mr. president. mr. president, my wife, bobbie, was diagnosed with breast cancer by a screening mammogram in her 40's. it's that screening mammogram that has saved her life. by the time of the mammogram, the tumor had spread and she's had three operations, two full bouts of chemotherapy. i do not want a government bureaucrat making a decision for the women of america if they should be allowed to have screening mammograms. it saves lives, 1 in 1,900 for women in their 40's. the reid bill empowers bureaucrats to decide what benefits will be allowed for the american women. the amendment from the senator from maryland does the same: bureaucrats, not the physicians who are in the -- who are doing the treating. and that's why i support the amendment from the senator from alaska, because that amendment says the federal government cannot use recommend

i assume it's going to happen in wyoming. the blue cross blue shield came to similar conclusions one is community rating which forces them to change rates regardless of health status or habits. cbo doesn't think this has much effect, but costs inevitably rise when insurers aren't allowed to price based on risk. and we have 35 states that give an example or not. at the white house decided to shoot the messengers like well point to avoid their messages. william congdon of the brookings institute and mark showalter at brigham young have found similar results in the 2008 papers in the peer-reviewed forum for health economics and possibly see. as economist on the estate community rating months raise premiums and the individual market by 20.9% -- >> the senator has consumed five minutes. >> iso 30 manger of this editorial be published in the journal. >> without objection. >> i yield the floor. >> and you can read senator greg's letter at c-span.org/health care. the u.s. senate voted to protect coverage of mammograms and preventive

i would just ask the senator from wyoming, dr. barrasso, in your experience, how is this going to affect the quality of health care? mr. barrasso: i'm very grateful for the senator from texas bringing this up. i had a town hall meeting last night, a telephone town hall meeting. and this specific amendment you're bringing here today came up with great praise for the people of wyoming, from the people of wyoming who said she's doing it right, leading the good fight. after i answer your question, i'm going to ask you how do we know the money's going to be there? that's the question that came up in the telephone town hall meeting. people in wyoming are concerned if this passes it's going to make health care harder for people in rural states like wyoming, like our sister state to the north -- montana. my colleague from montana is on the floor. doctor shortage will worsen. this is a headline news, front page of the washington tribune eagle. doctor shortage will worsen if this passes. a lot of folks concerned, communities where there's a

we made a -- in the s-chip in wyoming. we made a provision so they could go through the private market. when they don't go through the private market, the problem the kids have if a dad is working, they have insurance. if they are not working, they don't have insurance or it's the mom. under the wyoming one, when they go through the private market, they know they have it a year. that's the way it ought to be. of course you have to sign up for it. right now you don't have to sign up. you just go to the hospital, get your fix and we pay for it or the state pays their share. and we're dumping a huge liability on the states, so it's a huge problem. the states are very concerned. right now, they are having budget problems almost across the entire united states. and they're saying so what are you going to dump on us? well, our group of six asked that question and we got this overall c.b.o. score on how much it was going to cost the states as a whole, but we didn't want to know how much it was going to cost as a whole. every one

of wyoming's 23 counties, 16 do not have satellite access to wyoming-based stations. over half of all television households in wyoming do not have access to local television. for a rural state like wyoming, satellite sometimes represents the only viable option to receiving television programming. the inability to receive local stations restricts access to local content and severely limits the reach of emergency notifications. emergency situations, like the butane tank truck that recently overturned on an icy highway during a blizzard should serve as proof that the availability of local stations on satellite television is not just an entertainment issue. the d.m.a. system may make sense for the densely populated areas in the east, but it has created an absurdity in this -- in the sparsely populated areas in the west. i am grateful to determine what a local market is. but, madam speaker, people in wyoming do not need a study to tell them that when their network tv stations originate 400 miles away from a different state they are not receiving the local content they need

i would ask my friends from oklahoma and wyoming. it's going to be a lot harder for congress if they try to fix all of this health care system at once to come back and repeal it than it was t to repeal a bot tax. don't you think we should take the time to avoid another historic mistake? mr. coburn: i would answer my colleague from tennessee that as a practicing physician, what i see is the historic mistake is we're going to allow the federal government to decide what care you're going to get. we're going to divide the loyalty of your physician. no longer will they be a 100% advocate for you. they're going to be an advocate for the government and what the government says. this bill, even the one that's going to come, has three different programs that puts bureaucracy in charge of what you can and cannot have. it doesn't consider your personal health, what your past history is, what your family history is. they're going to say what you can and cannot do. that's called rationing. that's in the bill. that's coming. and that's a historic

this is from lingell, wiping wyoming, a community in my state. it talks about norma clark, 80. it says that she slipped on the ice near the horse coral and broke her hip. i'm an orthopedic surgeon. alone took her three hours -- alone it took her three hours to drag herself the 40 years back to the house in snow and mud after she tied her legs together with a rope to stablize the injury this is a person on medicare. and they're going to cu cut $464 billion from medicare. and they're going to use gimmicks that are going to harm our people. and i have a former governor, a chief of staff from a governor's office. you know in the rural parts of your community, governor, and now senator of nebraska, you have hard-working people who expect honesty from a government an they're not getting it in this bill which is going to tax for 10 years an only give services for six. mr. johanns: that is such a compelling story. and i want to add something to that. when you think that the policy could not get more crazy and insane, you hear about this idea that you're going to expand medicare, which

the presiding officer: the senator from wyoming. mr. enzi: mr. president, i want to thank the senator from south dakota for his enthusiasm and passion and ability to explain things. the passion that you've seen throughout the day from the republicans that have spoken is a reflection of the passion that we're hearing in our television calls and our e-mails and our letters. our volume is much higher than the 61% that the cnn poll says. of course, we wouldn't expect the cnn poll to necessarily reflect our constituents. but that enthusiasm across america, that passion, that concern subreflected in this chamber. i -- should be reflected this this chamber. i get a lot of mail and even phone calls from other states, and they say, "how come my senator isn't listening to city in how come he's not listening to all of my friends? thank you for what you're doing on health care." and what we're doing on health care, of course, is asking that it be done step by step so that we can get the confidence of the american people, not do something grandiose that can't

the senator from wyoming. mr. barrasso: we have an amendment read on the floor yesterday, that i worked my way through, along with my staff, 383 pages, and the minority -- the majority whip comes to the floor and says republicans haven't offered amendments. so i just tried to offer one unsuccessfully because it has been objected to. so i will at this time ask unanimous consent that the pending amendment be set aside and that i be allowed to call up amendment number 3153 to protect young, healthy persons from increased insurance premiums. mr. baucus: mr. president, mr. president, clearly this is a stunt. i object. the presiding officer: objection is heard. mr. barrasso: mr. president, i ask unanimous consent that the pending -- and these are not -- i just heard the comments. these are amendments that are aimed to keep the president's words that we will get insurance premiums under control, that people will notice their premiums go down, that we will make it better for people, easier for people. the democrats want t

i would ask my friends from oklahoma and wyoming. it's going to be a lot harder for congress if they try to fix all of this health care system at once to come back and repeal it than it was t to repeal a bot tax. don't you think we should take the time to avoid another historic mistake? mr. coburn: i would answer my colleague from tennessee that as a practicing physician, what i see is the historic mistake is we're going to allow the federal government to decide what care you're going to get. we're going to divide the loyalty of your physician. no longer will they be a 100% advocate for you. they're going to be an advocate for the government and what the government says. this bill, even the one that's going to come, has three different programs that puts bureaucracy in charge of what you can and cannot have. it doesn't consider your personal health, what your past history is, what your family history is. they're going to say what you can and cannot do. that's called rationing. that's in the bill. that's coming. and that's a historic

lander, wyoming, you are next. >> this is wyoming. caller: i used to work for homeland security with tea s.a. and the airports. -- with tsa and airports. some of your callers said we should beat up internal security and secure ourselves in the united states instead of sending many of our troops to other countries to fight the battle offshore. i was a vietnam veteran. i see both sides of it. host: specifically, what kind of work to do for tsa? caller: i was a screener at the gate in utah, a screening bags with x-ray. host: without breaking confidentiality, what kind of things do they tell you to look for that might tip you off that something bad will happen? caller: i cannot really say. i cite a piece of paper say i cannot divulge the things i learned on how we are supposed to profile people and see people as they come through. you looked inside the bag with x-ray and you could tell that normal things in a bag or a suitcase just do not belong. you can tell there is something different. host: is there something that says if this person

voter in wyoming is represented by 60 times more than a voter in california. far worse prevailed than when the senate was designed. even with the distortions built into the senate health care would pass the senate if it could pass by a simple majority. but we are in a slow-motion constitutional crisis, and the most immediate cause is a filibuster, filibuster isn't a way of the written constitution. in fact, it is almost certainly unconstitutional because the constitution specifies certain cases where supermajority is required then you can assume that the did not imagine that super majorities would be required for other purposes. and that sense it is to me quite clearly unconstitutional. now it won't be declared unconstitutional. there's no way to enforce on constitutionally because the supreme court would not interfere in the internal workings of the senate but i think it is quite obviously unconstitutional but that is the worst thing about it. the worst thing about it is it takes a rusted come up system that the best of times is on and responsive and shot thr

the presiding officer: the senator from wyoming. mr. enzi: mr. president, i'd yield ten minutes to the senator -- up to ten minutes to the senator from arizona. the presiding officer: the senator from arizona. mr. kyl: thank you, mr. president. mr. president, america's seniors have made clear that they value the medicare advantage program. they like their access to private plans, plan choices, the lower cost sharing, and all of the extra benefits not included in traditional medicare, such as vision, dental, hearing, and the wellness programs that help them to stay fit. before the medicare modernization act of 2003, seniors had been decrying their lack of choices. we made sure under the medicare modernization act that seniors would be assured health care choices just as all of us here in the congress enjoy. now that they have access to private coverage and enjoy more benefits and choices, seniors want us to make sure that medicare advantage stays viable. and they're not happy about the proposed cuts in the majority leader's bill. i have

the presiding officer: the senator from wyoming. mr. enzi: the senator from nevada. the presiding officer: the senator from nevada. mr. ensign: mr. president -- madam president, excuse me. it's a football day. i apologize. probably had that kind of male thinking going on. madam president, there's an urban myth that people like to talk about when they're discussing health care reform. it's like one of those rumors that runs rampant on the internet. nobody knows where it started but you're sure it must be true. the story about canadian health care. you know, everyone there is covered and they have a progressive health care system that we should somehow copy. well, it's time to bust this myth and tell the american people what a government-run health care system like canada would mean for us here in the united states. canada and great brit i object offer what is typically referred to as universal coverage. universal coverage, however, does not mean unlimited access to care or readily available care. let me tell you why. let's talk about spending first. the u.s. spends ab

>> i have people and wyoming know that there is an advantage to this program. that is why they sign up and citizens have signed up for medicare advantage because they realize there is value in prevention and coordinated care. there is value in having the eye care, dental, hearing care, dental, hearing, there are a advantages to want to stay healthy to keep down the cost. >> even though it may cost more, the fact they you have a more well and fit group of senior citizens, dot dot in the long line at reduce health care costs because they take a vantage of the kind of car that overt -- kind of care that over time will keep them from going to the hospital earlier or see the doctor more often? five that is the reason it was brought forth for i know a lot of senators from the rural states supported because it allows people in small communities to have the advantage to be in a program like battered doctors to go into those communities and the 11 million people who are on medicare advantage in this country know they are on medicare advantage. it is the fastest-growing

we spoke with wyoming. republican senator john barrasso. this is been a half hour. >> host: joining us from the rotundo buildings senator john barrasso republican of wyoming. put your doctor hat, former orthopedic surgeon. what is good in bill for doctors and what is bad for the for doctors? >> guest: thank you for having me. wish i could be in the studio. we're having three roll call votes on senate floor. they're in middle of third vote. i voted quickly. my name is on top of the alphabet and ran over here to be with you. it is interesting. i've practiced medicine 25 years, taking care of people from wyoming, and families across the state. what the doctors would tell you if you ask them what is wrong with the bill, there is no really, no dealing with lawsuit abuse. doctors would tell you that the number one place you could save money in health care in this country is with the overuse of tests, exams, things that don't actually help anybody be healthier or get well but are there just to cover the doctor in case something does go wrong with

wisconsin, 243,443, and wyoming, 3,942. these are people who benefit from medicare advantage that would not like to get off of it. well, this choice in coverage has made a difference in the lives of more than almost 11 million people. 11 million individuals nationwide, families that benefit from this. the extra benefits that i had mentioned earlier are being portrayed as gym memberships as opposed to lower premiums, copayments and deductibles. let me read you some letters from my constituents. these are real lives being affected by the cuts contemplated in this bill. i'm going to have to get my reading glasses on. and you should see some of the beautiful handwriting. some of it is very shaky but beautiful, to me, anyway. from cedar city, utah. "senator hatch: i'm writing to you to request your help in preserving our medicare advantage plans from being cut. my medicare advantage plan provides me with benefits and servings that traditional medicare did not provide. i like my plan very much. it allows me my choice of doctors,

senator barasso pointed out where the people in wyoming are on this bill. we also know where the american people are. i haven't seen a survey in months by anybody that indicates the american people are for this bill. it's not in doubt. we heard that president clinton came up to their lunch. the president may be coming back himself. you know the argument they are making on the other side? ignore the american people, make history. make history? what i hear the american people saying to us, vote for this bill, and you'll be history. this is not in the gray area. the american people are asking us to stop this bill and start over. they don't want a 2,074-page monstrosity of complexity and tax increases. they want us to stop and start over and get it right. >> could i ask the senator from new hampshire very quickly, is it your understanding that aarp does sell health insurance and wal-mart sells health insurance? >> that is correct. >> then wouldn't they be included in the amendment for excessive remune racial -- remuneration? >> the underlying proposal is a blat

. >> senator from wyoming. >> were going to have three republican and one democrat and the democrats wrote the bill. and the democrats are doing a side-by-side to their own amendments. it looks to me like they ought to get together and get some things figured out and they ought to be a little more fairness on the number of amendments. so i would object. >> objection is observed. >> mr. president,. >> senator from illinois. >> this is the second time we offered to call a mandatory vote. and the complaint from the other side is you're not calling amendment for a vote. how many times where to ask for permission untrimmed permission to call a vote, run into objections from the republican side and then hear the speech why aren't we voting on amendments? i am certain that in the vast expanse of time and space we can work out something fair in terms of the number of amendments on both sides. in fact, maybe the next round will have more republican amendments than democratic amendments. at omaha many republican amendments are democratic amendments would've voted on so far. can we get an offic

system that works and this is designed to make it work a little better, but make it like the senator in wyoming wants, based on quality. he didn't mention this, but i know he agrees, insurance market reform, so those patients that come to him don't have to wait until the year as they have in the past. but i want to make it very clear this is no -- quote -- "government takeover." that's a scare tactic. that's not accurate. let's just maintain the current system. i'd like to yield to the senator from vermont. the presiding officer: the senator from vermont is recognized. mr. sanders: i'm going to speak on something other than health care. all right. that's fine. i thank my friend from montana for yielding. and, mr. president, what i want to touch upon is my strong belief that ben bernanke should not be reappointed for a second term as chairman of the federal reserve. and in that regard i place a hold on his nomination. mr. president, everybody in this country understands that we're in the midst of the worst economic crisis since the great depression. we are looking at 17% of our people being eith

joining us now is a republican of wyoming. put your doctor hat on. what is good in this bill for doctors and what is bad? >> thanks for having me. i wish i could be in the studio with you. we are adding three roll-call votes. they are in the middle of the third. my name is at the top of the alphabet so i voted quickly and ran over here to be with you. i practiced medicine for 25 years, taking care of people in wyoming. the doctors will tell you that there is no dealing with a lawsuit abuse in this bill. the number one place you can save money in health care in this country is with the overuse of tests, exams, things that do not help anybody get healthier or be well. they are there to cover the doctorate in case something goes wrong with the patient. they want to make sure they can say that they did everything they could to order the mri or the cat scan. it is not just what the doctor's patients now practice insurance which is a business expense passed on to patients, but the additional tests and exams that are higher than what the doctors pay that co

the presiding officer: the senator from wyoming. mr. enzi: thank you, mr. president. i found the afternoon to be very interesting. we have actually two debates going on at the same time and sometimes they don't seem very related, but they are. one of the amendments that we're debate something the one from the senator from arkansas and it limits the deductible compensation for insurance executives to $400,000. and then we have the ensign amendment which suggests that we should do the same for lawyers with junk lawsuits, but doesn't go quite that unreasonable in that it only limits it as a portion of the -- of the -- of the lawsuit. of course, one of the reasons that the -- being given on the floor for supporting the arkansas amendment is that republicans are funded by insurance companies. i really have to object to that kind of wording. we could make a lot of insinuations about who junk lawsuits are being supported by and where the money from those folks goes to. and they said, well, the evidence is that the insurance companies are putting so much money into defeating

crapo: the senator from wyoming is exactly right. the wrong thing to do when our economy needs to be strengthen and restarted, if you will, is to apply a huge amount of new taxes. let's just take the example that we talked about earl yes. this young lady -- earlier. this young lady under the bill in the senate now, will not only see her health benefits go down, but the net value of her compensation will go down. she will get a little extra wages in order to offset the reduction of her health care benefits, but those will be taxed and her net compensation package will go down. and the point here is this, and it's a little bit ironic, that today the democrat caucus is going to be meeting with the president at the white house in, yet, one more closed-door meeting where they're going to be trying to redraft the bill in order to get around some of the problems which i hope they will let the american public see to debate before they try to vote on it again. but it's kind of ironic that as the democrats come out of that caucus, if they don'

the presiding officer: the senator from wyoming. mr. enzi: thank you, madam president. the majority has voted to cut off further amendments to this bill. senator reid has used a procedural tool that prevents republicans from offering amendments. several of my democrat colleagues have come to the floor to argue the republicans don't have any ideas on how to improve this bill. nothing could be further from the truth. republicans have filed over 200 separate amendments to this bill, yet the majority is refusing to allow us to vote on any of them. on a bill that will affect the health care of every american and 1/6 of our nation's economy, the majority has not allowed us to have more than ten votes to try to improve this bill. this bill needs to be fixed. we know this bill currently will cut medicare, raise taxes, and increase insurance premiums. if we had the chance to offer amendments, i believe we could make changes to fix those problems. i have filed nine amendments this bill, but i have not been allowed to offer any of them. i believe that any reform should reflect the

i've been joined by my colleague from wyoming, ms. cynthia lummis. mrs. lummis: i'd like to thank the gentlelady from ohio for bringing this issue to our attention this evening. many of us have anecdotal information about friends, relatives, colleagues who have experienced a diagnosis of breast cancer in their 40's because they went in to receive a routine mammogram. that was certainly the case with my sister-in-law who in her 40's went in for a routine mammogram, had none of the genetic or typical markers that reveal the need to have mammograms, but of course, since they were regularly recommended for women in their 30's and 40's, she went in for her annual mammogram and was diagnosed with a very aggressive form of breast cancer. she was diagnosed, had her mastectomy and began her chemotherapy all within a period of 30 days. without that routine mammogram, that aggressive breast cancer would have had an opportunity to spread in a way that would have caused or exacerbated the chance that that cancer would not have been treatable and would not have saved h

alexander: i see the senator from texas, the senator from idaho and the senator from wyoming have come to the floor in addition to the sponsor of the amendment, senator hatch. i'm sure they are prepared to reflect on who's hurt by these cuts. the only thing i would emphasize with what you have said is that disproportionately low-income americans in texas and in idaho and in tennessee and in wyoming and in utah are hurt. only a third of eligible white seniors who don't have medicaid or employer-based insurance are enrolled in medicare advantage. but the number increases to 40% for african-americans and 53% for hispanics. mr. mccain: could i ask the senator again, he described the benefits provided under the medicare advantage program that seniors can have if they want; right? are those same ability -- dental, vision, hearing and fitness care -- that available under regular medicare today? mr. alexander: my understanding is the answer is no to that. that's the reason 11 million americans choose medicare advantage is because these benefits are not available under the original medicare. mr

that leaves just two, utah and wyoming. check out cnn.com/stateoftheunion. until then, i'm john king in washington. up next, tom foreman and dr. sanjay gupta and the critical health care debate. >>> a late night senate showdown. we're just one hour away from a major vote on health care reform. democrats say it will pass. and if it does, it will be a huge step towards a massive overhaul of the nation's health care system. hello, i'm tom foreman reporting tonight from washington. >> and i'm dr. sanjay gupta in atlanta. this is special coverage of a crucial senate vote on held care reform. >> members of the best political team are joining us on the late night shift. dana bash is standing by at the capitol. dan lothian is here in washington and dana gergen and democratic strategist john brazil is on the phone as well. let's head straight to capitol hill first. they are kicking off ap brand new legislative date. dana bash is there. what a day it's been for you, dana. set the scene for us. i have a question about that. is there a risk that someone might not make i

the presiding officer: the senator from wyoming. mr. enzi: thank you, mr. president. after the -- after the speech by the senator from illinois, i feel compelled to make a few comments. one, he challenged us a little bit to do a bill in 2,000 pages or less. i'm 1 of those people who don't think -- i'm one of those people who don't think it could be done enough. i don't think there's enough pages there to solve the biggest problem in the united states for every american p people -- people are not comprehending how big health care is. the bill that we are doing will affect 100% of the people in america. i don't know if we had a bill before that affected 100% of the people. 100% of the people, 100% of professions, 100% of the businesses. this is big. everybody has a role in health care. and we're trying to condense it into 2,000 pages and make seem a lot simpler than it is. the reason that our side said that you need to take it a step at a time and get it right is because that gives up some of the right. there are over 200 references in the 2,000 pages that say that the

majority whip simpson, republican from wyoming and he tells a story that applies to all lawmakers and have to go back to states and speak before distinguished audiences like that and introduce highlights all that simpson has done for the great state of wyoming. and all he has done for the united states of america and lists the achievements. does president stop, all that he has done to promote world peace. at the end of the statement, he finally says well, now for the latest dope from washington, here's senator simpson. i'll give you my intellectual spin and we have roughly an hour or so and king henry viii said to his wives, i won't keep you long. i want to make a few general observations about the lobbying business and then i'll do what jim suggested and walk through the stages of a law making process and indicate where a lobbyist might be able to enter and try to influence the policy process and decisions that congress makes. any time you have a question, comment, story, joke, just yell out. i guess you have to raise your hand on c-span. i will be glad to take it there or else wait

it had already been tried in the states like wisconsin, wyoming, and cities. the person who drafted the bill said we are just riding the wave now. they gave a lot of flexibility to states for have the cat actually implemented. that is a good model -- how they can actually implement it. >> how does one best regulate big government without increasing the size of the bureaucracy? is that even possible? >> regulate the government? regulating government is one of our big problems to date. if you were one of the senior executives that i talked about, you are faced with so many rules and regulations and constraints on how to manage. when we did our survey, we ask, what is the biggest reason we are having problems today? they said partisanship and other areas. all the administrative rules and constraints and everything that make it impossible to actually do anything if you are in government. we have made that hill for sisyphus of lot steeper than it actually was. what we need to do is the regulate the government allots -- deregulate the government a lot. those of you

. >> host: kenneth from wyoming. good morning on the republican line. >> caller: good morning, gentleman. >> host: thanks, go ahead with your question. >> caller: yeah, i have a comment and a question. i was drafted into the military in the earl '70s. i was stationed on board a nuclear submarine. i kind of now we were working with the iranians then. i kind of know what the situation was. and it is now -- and i am in support of president obama in what he's doing. i have a reservation in some of the things. but my question is are we adequately supplied going into this war with afghanistan with the 30,000 that they are saying? or do we have to put in more troops to make sure that what our objective is is going to be met? >> well, i think that's up to general mcchrystal and others to address. but right now, for my understanding, there are hundred thousand troops there now, before you add the surge troops. so there are about 60,000 u.s. forces, 40,000 nato forces. and we're going to add anywhere from 30 to 34,000 u.s. and