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Richard D.
Democrat IL

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  • Contrasting Budgets

    by Senator Richard J. Durbin

    Posted on 2013-03-12

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    DURBIN. Mr. President, this is a historic week because we will see congressional presentations of the congressional budgets, and I believe we will see stark contrasts.

    [[Page S1673]] Congressman Ryan of Wisconsin--nearby my home State of Illinois--is going to prepare and present to the Republicans in the House of Representatives a budget that he says will bring our overall Federal budget into balance over 10 years. It is a daunting task, and I commend him for his effort. I also have to say that we have been there before. We have heard this budget before. We know what it contains. There are several elements in the Ryan budget--as some have announced in advance--that repeat the mistakes of his earlier budgets, and some of them are grievous.

    We understand we need entitlement reform to make sure important programs such as Social Security, Medicare, and Medicaid continue for years to come. We understand there will be some hard choices associated with efforts to make these programs more solvent.

    The Ryan approach continues to have something called premium support. What it boils down to is this: In the outyears, Congressman Ryan and the House Republicans want to offer seniors across America less money to pay for their Medicare insurance. They want to privatize the Medicare insurance system.

    Our side of the aisle--both in the House and the Senate--is dedicated to some basic principles. One of the first is to make sure men and women across America who are from working families have a fighting chance, to make sure the Tax Code is responsive to their needs, to make sure the programs they count on will be there when they need them.

    Every hour of every day most American workers in States such as Massachusetts and Illinois pay into our Social Security and Medicare system with the belief that when the time comes for retirement, Social Security and Medicare will be there. Unfortunately, what Congressman Ryan is proposing is to really break that promise and to say to seniors across America: You can pay into it for a lifetime, but when the time comes and you really need Medicare and health insurance during your retirement, you probably won't be able to afford it. You won't be able to come up with the premiums.

    What good is a Medicare system that a worker has paid into for a lifetime if it cannot provide the basic protections they will need during retirement? They can balance the books--at the cost of coverage and the cost of the Medicare promise that has been made for generations.

    Therein lies the real crux of the difference between Democrats and Republicans when we look at these entitlement programs. We know that reform is necessary, but reform should be based on best medical practices, on reducing the obvious waste in the Medicaid Program, and not on penalizing seniors who are on a fixed income who cannot afford increasingly high Medicare premiums. That is the Paul Ryan approach-- privatizing Medicare. It is not a good approach for America. That is the real difference.

    Of course, there is this dedication on the part of Congressman Ryan to reduce the tax rates for the wealthiest people in America. Those rates, after the fiscal cliff negotiation, go as high as 39 percent on the highest income. Paul Ryan's budget wants to bring them down to 25 percent, which is a dramatic decline in the income tax rate for the wealthiest Americans. How will he achieve this? He says he will achieve it by changing the Tax Code to bring the rate down to 25 percent. I sat through the negotiations in the Bowles-Simpson Commission and other places, and the math does not work. If they are going to try to bring down the income tax rate for the wealthiest to 25 percent, sadly, they will eliminate the most basic income tax deductions for working and middle-income families across America. That is the reality; otherwise, they cannot reach that number.

    We have to look at this. If the Paul Ryan budget means the wealthiest Americans get a tax cut while working families see a tax increase and if the Paul Ryan budget means Medicare will be fiscally solvent but unaffordable for most working Americans, this is a budget we need to reject out of hand.

    We will see that budget in its entirety today, and by tomorrow the Democratic alternative here in the Senate, which has been worked on and prepared by Senator Patty Murray of Washington and her colleagues in the Senate Budget Committee, will be presented as well, and it will be a stark contrast. What Senator Murray and the Senate Budget Committee will produce is a balanced approach that says: Yes, there will be deficit reduction, but it will be the right way. We need to make sure we have revenues coming from those who can afford to pay in the highest income categories. Yes, we need spending cuts, and they will continue. We need entitlement reform that is thoughtful and sensitive. We need reform that really makes sure these programs are here for generations to come.

    I think America will applaud the efforts on the Senate side. I think they will have many questions to ask on the House side, and then the debate begins. Those of us on the Appropriations Committee wait for this to be completed because the budget resolution is basically our blueprint for what we can achieve during the remainder of the year and for the next budget year that starts October 1.

    There are a couple of things that are part of the budget process that I will address very quickly.

    Sequestration I am very concerned about the impact of sequestration on health care. Reporters in Illinois asked me over the weekend: What is the big deal? Sequestration came and life didn't end. It seems as though we are going on in a normal way.

    Unfortunately, they overlooked some obvious impacts. For example, community health centers are the frontline for primary health care across America. I visit them and always leave with a sense of hope and a positive feeling. The community health centers in Chicago and across Illinois are quality medical institutions. They serve people with limited insurance or no insurance, and they serve them in the most professional way. I have said with confidence that if I happen to get sick someday or someone in my family did, I would feel confident walking into these community health centers--they are that good.

    Some 22 million people in more than 9,000 locations across America rely on them. As the point of care for uninsured and low-income people, community health centers provide preventive services that help avoid expensive procedures and emergency room visits.

    At a time when 30 million new Americans are about to get health insurance so they can afford to get care, these across-the-board cuts are taking $115 million out of community health centers this year alone. Nationally, almost 900,000 patients will lose access. Community health center funding in Illinois will be cut by $6.2 million. Erie Family Health Center in Chicago is one of the best. They will do their best to protect clinical care, but the wraparound services that make Erie so effective, not to mention cost-effective, will be reduced.

    Now is not the time to cut community health center funding. Instead, we should expand the centers so hard-working and low-income families get the care they need.

    Regardless of where someone lives or where they go to see the doctor, the $1.6 billion cut to the National Institutes of Health threatens all of us. And that is what these cuts are going to do to medical research--cutting $1.6 billion from the National Institutes of Health. I have always said that I will take this issue to any corner of America, any group--liberal or conservative, young or old--and make my case that investment in health care research is one of the most important investments our government makes. When we shortchange medical research, we shortchange our future.

    Great medical care is only as good as the science behind it. Drugs and devices work only as well as our understanding of the medical conditions they are treating. Our country is rich with promising research. We lead the world and should be proud of it. We have the bright minds, the curious scientists, and the innovative labs. Today countless people are engaged in work that will lead to better treatments for arthritis, Alzheimer's, AIDS, diabetes, cancer, and the list goes on.

    Biomedical research supported by the NIH has established America as the leader in the world, and we are right on the verge of making life- changing discoveries through this research. But sequestration--which is now in place-- [[Page S1674]] will have a ripple effect that could curb medical discoveries and weaken the economies across the country.

    Dr. Francis Collins, Director of the NIH, says there is no question that sequestration will slow the development of an influenza vaccine and cancer research.

    Eli Zerhouni, head of NIH under President George W. Bush, said: We are going to maim our innovation capabilities if we do these abrupt deep cuts at NIH. It will impact science for generations to come.

    Right now, when so much good research is moving us forward, we should be doubling down on medical education, innovation, and infrastructure. Cutting back on NIH and biomedical research is so shortsighted. Medical research saves lives, keeps America's place as a leader in science and medicine, and it generates economic growth. Frankly, these cuts shake the confidence of people in this field. Trying to decide whether they should dedicate their lives to medical research with the uncertainty of sequestration and budget cuts is unfair.

    For over a century, NIH-supported scientists have led the way for important breakthroughs to improve health and save lives through the discovery of things such as the MRI, extending the life expectancy for people with cystic fibrosis, revolutionizing our thinking about cancer, improving our understanding of stroke and heart disease, and creating new vaccines that save lives.

    President Obama has called on congressional leaders to come together to create an alternative to the sequestration. A balanced mix of smarter spending cuts and revenue from closing loopholes that benefit higher income individuals will mean we can keep our commitment to medical research.

    This week we are going to start the debate on the continuing resolution. One of the early amendments that is likely to be offered will be by Senator Harkin, who chairs the Labor, Health and Human Services Subcommittee in Appropriations. I have spoken to Senator Harkin. He is determined to do everything he can to give the Senate the opportunity to continue to cut the deficit but to do it in a way that will not make dramatic negative cuts in medical research.

    I hope we can get a bipartisan consensus. Diseases and the threats of ill health strike all of us regardless of party affiliation. We should come together on a bipartisan basis to support increasing medical research and maintaining America's lead in the world.

    I yield the floor and suggest the absence of a quorum.

    The ACTING PRESIDENT pro tempore. The clerk will call the roll.

    The legislative clerk proceeded to call the roll.

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