S10700 CONGRESSIONAL RECORD — SENATE November 20, 2008 

and such, if they are building roads, 

improving them, or building bridges or 

whatever, they have to incorporate in 

their planning bike paths and walking 

paths along with them. I am not saying 

they have to build those; I am just saying that at least they ought to have 

them in their plans. Again, thinking 

about kids going to school, they ought 

to have sidewalks along their streets 

going to school so they can walk to 

school. Many places don’t have sidewalks and bike paths and walking 

paths. 

My point is that there are a lot of 

things outside of the health care environment we normally think of that can 

be very helpful for prevention and 

wellness—workplaces, workplace wellness. There are some companies in this 

country doing a great job with this. 

They have set up wellness programs, 

nutrition guidance programs, 

antismoking programs for employees, 

and in every case I have ever looked at 

where you have the incentives and the 

company really goes to work at this, 

they find some amazing results. They 

find their absenteeism goes down, they 

find workers are much more productive 

than they had been in the past, and 

they find their health care costs going 

down. Now, we need to make this available to every business in this country— 

small businesses, people who employ 10 

people or more. There has to be something including a component of prevention in the workplace. 

So I mentioned schools, workplaces, 

communities. Communities have to be 

involved. We need to promote community wellness programs. 

The Trust for America’s Health earlier this year came out with a study 

they had done on community-based 

wellness programs and the return on 

investment. Most times when you talk 

with people about prevention and 

wellness, they say: Oh, that is all fine, 

but you don’t get a payback for 20 or 30 

years. The Trust for America’s Health 

did a study State by State and they 

showed that in these cases where the 

communities had community wellness 

programs, that actually, in the first 

year—in the first year—there was almost a 2-to-1 return. For every dollar 

they invested, they got $2 back the 

very next year, and it increased every 

year after that. So we have to think 

about how we promote communitybased wellness programs. 

The elderly. I can’t think of how 

many times I have been to senior citizens centers, congregate meal sites, 

some independent living centers, and 

those types of places where we see so 

many elderly on drugs. They are on so 

many drugs. They can’t keep track of 

the 15 pills they have to take every 

day. Well, there have been some very 

good studies done, on the fact that if 

you give the elderly better nutrition, 

better exercise, better social ability, 

you can get them off some of those 

drugs—maybe not all of them, but you 

can get them off of half of the drugs or 

more that they are taking. So there 

are a lot of things we can do just, as I 

say, outside. 

Within health care, there are a lot of 

things too. Students are going to medical school today, taking all of these 

courses on medicine and drugs and 

pharmacology year after year; very intensive, very hard studies. I think I 

would not be wrong in saying that 

most medical school students today, at 

most they might have one 3-hour credit 

course at the end of their study where 

they take something dealing with prevention. It is just not a factor in medical schools. It should be. It should be 

a factor in nursing schools. Any health 

care professional, any health care profession should have that component, 

including physicians assistants, nurse 

practitioners, and anyone involved in 

the health professions. So that is another part also. 

We need to be thinking about how we 

can beef up our public health service in 

this country. When I was a young kid 

going to public school, we had school 

nurses, and they came around and 

made sure we had our vaccinations and 

things such as that, and that we exercised. We don’t do that anymore. We 

have to restructure our public health 

service in this country, to think about 

how we better utilize the public health 

service. 

If you go to medical school now, 

Medicare is one of the biggest funders 

of medical schools now, or if you go 

into the military, the military will put 

you through medical school and then 

you pay it back in 8 to 10 years for 

your medical school training. But what 

if you wanted to be a public health 

service officer, you wanted to go to 

medical school and maybe take one of 

the courses in public health? Well, that 

would apply there too. Why not pay 

their way through college, and then 

they pay it back for working in the 

public health service for a number of 

years. 

We think about the several hundred 

community health centers we have in 

this country, doing a great job. Why 

aren’t they a part of the Public Health 

Service Corps in America, and utilize 

them for prevention and wellness, 

diagnostics? Quite frankly, people 

should not have to pay a copay or a 

cost share to get a colonoscopy, or 

breast cancer screening or a host of 

other things for diagnosis. Annual 

physical checkups; there shouldn’t be a 

copay or cost share for that. That is 

just keeping people from doing it. 

When you detect things early and you 

can intervene early, that is part of prevention also, earlier diagnostics. 

Again, this has to be a big part—I 

think the centerpiece—of health care 

reform because it is the only way we 

are going to actually save money. Well, 

you may save money in a bigger pool 

and better insurance, that type of 

thing, yes, but the big bucks we will 

save and will make our people more 

productive and healthy is to have prevention and wellness. 

Yesterday, I convened a meeting of 

the key groups that have been active in 

the wellness and prevention field, including the Trust for America’s Health, 

the Partnerships for Prevention, the 

Robert Wood Johnson Foundation, the 

American Diabetes Association, the 

American Heart Association, the 

American Cancer Society, the YMCA, 

the American Medical Association, and 

many others. This was yesterday. It 

was an excellent session, with a room 

full of people who all realize this is the 

time for bold thinking and real change. 

In addition, I intend to hold additional 

hearings in December. 

This working group that Senator 

KENNEDY asked me to chair will reach 

out broadly. We wish to capture the 

best ideas, the best practices. Our goal 

is nothing less than to transform 

America into a genuine ‘‘wellness society.’’ 

To borrow a phrase, that is change 

you can believe in. It is also change 

that is long overdue. 

To date, wellness and prevention 

have been the missing pieces in the national conversation about health care 

reform. It is time to make them the 

centerpiece of the conversation—not an 

asterisk or a footnote but centerpiece 

of our conversation on health care reform. 

As chair of the Prevention and Public 

Health Working Group, I look forward 

to working with my colleagues on both 

sides of the aisle to solicit ideas and 

input. Promoting wellness and preventing disease is not about party or 

ideology; it is about pragmatism and 

common sense. It is about what 

works—keeping people healthy and 

keeping costs down, making people 

more productive in their daily lives. 

We have a big job ahead of us, but I 

am confident the new President and 

the new Congress can deliver on health 

care reform, and we can do it in the 

next calendar year. Yes, we can greatly 

expand access to the health care system—or as I call it, the ‘‘sick care’’ 

system. At the same time, if that is all 

we do, we will have failed. We can and 

must transform America’s sick care 

system into a true health care system, 

one that makes preventing illness and 

staying well every bit as important as 

curing the illness later on. 

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

The PRESIDING OFFICER. The 

clerk will call the roll. 

The assistant legislative clerk proceeded to call the roll. 

Mr. REID. Mr. President, I ask unanimous consent that the order for the 

quorum call be rescinded. 

The PRESIDING OFFICER (Mr. NELSON of Nebraska). Without objection, it 

is so ordered. 

f 

UNANIMOUS-CONSENT 

AGREEMENT—H.R. 6867 

Mr. REID. Mr. President, I ask unanimous consent that at 3 p.m. today, the 

Senate proceed to vote on the motion 

to invoke cloture on the motion to proceed to H.R. 6867; that if cloture is invoked on the motion to proceed, then 


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November 20, 2008 CONGRESSIONAL RECORD — SENATE S10701 

all postcloture time be yielded back 

and the motion to proceed be agreed to; 

that after the bill is reported, it then 

be read a third time, and the Senate 

proceed to vote on passage of the bill, 

without further intervening action or 

debate; that if cloture is not invoked 

on the motion to proceed, then a motion to reconsider the failed cloture 

vote be considered as entered, and the 

Senate then proceed to a period of 

morning business, with Senators permitted to speak for up to 10 minutes 

each. 

The PRESIDING OFFICER. Is there 

objection? 

Mr. REID. If the Chair will withhold, 

I appreciate very much all Senators’ 

thoughtful consideration of what we 

are trying to accomplish. I especially 

extend my appreciation to the Republican leader for his stepping out of important meetings to take calls from me 

and being available to help us work our 

way through these difficult times. 

We are all trying to accomplish the 

same thing. We have an economy that 

is in peril, and we want to make sure 

we do everything we can within reason 

and keeping with our responsibilities 

to succeed. 

The PRESIDING OFFICER. Is there 

objection? 

Mr. ALEXANDER. No objection. 

The PRESIDING OFFICER. Without 

objection, it is so ordered. 

Mr. REID. This will be the last vote 

this week. 

f 

CONCLUSION OF MORNING 

BUSINESS 

The PRESIDING OFFICER. The hour 

of 3 p.m. having arrived, morning business is now closed. 

f 

UNEMPLOYMENT COMPENSATION 

EXTENSION ACT OF 2008—MOTION 

TO PROCEED 

The PRESIDING OFFICER. Under 

the previous order, the Senate will resume consideration of the motion to 

proceed to H.R. 6867, which the clerk 

will now report. 

The assistant legislative clerk read 

as follows: 

Motion to proceed to the consideration of 

Calendar No. 1123, H.R. 6867, an act to provide for additional emergency unemployment compensation. 

CLOTURE MOTION

The PRESIDING OFFICER. Under 

the previous order, pursuant to rule 

XXII, the Chair lays before the Senate 

the pending cloture motion, which the 

clerk will report. 

The assistant legislative clerk read 

as follows: 

CLOTURE MOTION

We, the undersigned Senators, in accordance with the provisions of rule XXII of the 

Standing Rules of the Senate, hereby move 

to bring to a close debate on the motion to 

proceed to Calendar No. 1123, H.R. 6867, the 

Unemployment Compensation Extension Act 

of 2008. 

Harry Reid, Max Baucus, Patrick J. 

Leahy, Bernard Sanders, Kent Conrad, 

E. Benjamin Nelson, John D. Rockefeller, IV, Dianne Feinstein, Robert P. 

Casey, Jr., Patty Murray, Richard Durbin, Sheldon Whitehouse, Barbara A. 

Mikulski, Barbara Boxer, Carl Levin, 

Daniel K. Akaka, Mark L. Pryor. 

The PRESIDING OFFICER. By unanimous consent, the mandatory quorum 

call has been waived. 

The question is, Is it the sense of the 

Senate that debate on the motion to 

proceed to H.R. 6867, an act to provide 

for additional emergency unemployment compensation, shall be brought 

to a close? 

The yeas and nays are mandatory 

under the rule. 

The clerk will call the roll. 

The assistant legislative clerk called 

the roll. 

Mr. DURBIN. I announce that the 

Senator from Delaware (Mr. BIDEN) and 

the Senator from Arkansas (Mrs. LINCOLN) are necessarily absent. 

Mr. KYL. The following Senators are 

necessarily absent: the Senator from 

Georgia (Mr. CHAMBLISS) and the Senator from New Hampshire (Mr. 

SUNUNU). 

The PRESIDING OFFICER (Ms. 

KLOBUCHAR). Are there any other Senators in the Chamber desiring to vote? 

The yeas and nays resulted—yeas 89, 

nays 6, as follows: 

[Rollcall Vote No. 214 Leg.] 

YEAS—89 

Akaka 

Alexander 

Allard 

Baucus 

Bayh 

Bennett 

Bingaman 

Bond 

Boxer 

Brown 

Brownback 

Bunning 

Burr 

Byrd 

Cantwell 

Cardin 

Carper 

Casey 

Clinton 

Cochran 

Coleman 

Collins 

Conrad 

Corker 

Cornyn 

Craig 

Crapo 

Dodd 

Dole 

Domenici 

Dorgan 

Durbin 

Ensign 

Feingold 

Feinstein 

Graham 

Grassley 

Gregg 

Hagel 

Harkin 

Hutchison 

Inouye 

Isakson 

Johnson 

Kennedy 

Kerry 

Klobuchar 

Kohl 

Kyl 

Landrieu 

Lautenberg 

Leahy 

Levin 

Lieberman 

Lugar 

Martinez 

McCain 

McCaskill 

McConnell 

Menendez 

Mikulski 

Murkowski 

Murray 

Nelson (FL) 

Nelson (NE) 

Pryor 

Reed 

Reid 

Roberts 

Rockefeller 

Salazar 

Sanders 

Schumer 

Sessions 

Shelby 

Smith 

Snowe 

Specter 

Stabenow 

Stevens 

Tester 

Thune 

Vitter 

Voinovich 

Warner 

Webb 

Whitehouse 

Wicker 

Wyden 

NAYS—6 

Barrasso 

Coburn 

DeMint 

Enzi 

Hatch 

Inhofe 

NOT VOTING—4 

Biden 

Chambliss 

Lincoln 

Sununu 

The PRESIDING OFFICER. On this 

vote, the yeas are 89, the nays are 6. 

Three-fifths of the Senators duly chosen and sworn having voted in the affirmative, the motion is agreed to. 

Under the previous order, all 

postcloture time is yielded back and 

the motion to proceed is agreed to. 

Mr. KENNEDY. Madam President, 

next week we will celebrate Thanksgiving—a holiday to be with family and 

to give thanks for the many blessings 

we enjoy. But this year, American families gathering around the Thanksgiving table are burdened with serious 

worries: Are we going to lose our 

home? Can we afford to retire when our 

savings have been wiped out? Will we 

have to choose between sending our 

children to college and paying our 

medical bills? 

One of the greatest hardships millions of Americans are facing is the 

loss of their jobs. The current job market is the worst in the past quarter 

century. Over 1 million people have 

lost their jobs this year—half a million 

in September and October alone. Last 

week, more workers filed for unemployment benefits than at any time 

since the tragedy of September 11, 2001. 

Economists predict the unemployment 

rate will continue to climb from its 

current 14-year high of 6.5 percent to 

well over 8 percent in the coming year. 

Earlier this year, Congress approved 

additional unemployment benefits for 

workers. That was an important step, 

but families need additional support. 

Unemployment benefits have expired 

for many workers, and finding a new 

job is far more difficult as the recession deepens. More than 2 million 

Americans have been unable to find 

work for more than 6 months. If Congress fails to extend benefits again this 

year, nearly 1.2 million Americans will 

have exhausted their benefits by the 

end of the year. 

That’s why this legislation is so essential. It provides 7 additional weeks 

of unemployment assistance to workers whose benefits have expired, and an 

additional 13 weeks for jobless workers 

in high-unemployment states. This bill 

has already passed the House overwhelmingly, with strong bipartisan 

support. By acting today, we will deliver immediate aid to many of the 

neediest Americans who are unable to 

find work. 

Not only does the extension of unemployment benefits provide a lifeline for 

struggling families, it also serves as a 

needed and immediate stimulus for the 

economy—each dollar of unemployment benefits generates $1.64 in economic growth. I urge my colleagues to 

join me in supporting this critical extension of unemployment assistance. 

Providing these additional unemployment benefits, however, is not the 

only step we must take to help working families meet the tough challenges 

that lie ahead. Jumpstarting our economy and restoring American prosperity 

will take bolder vision and more decisive action. We need to create good 

jobs for the millions of Americans who 

want to work. That means investing in 

our workers, investing in our infrastructure, and investing in technology 

for the future. It also means repairing 

the broken safety nets, so that more 

families who are being hurt by this 

downturn can get back on their feet. 

I wish we could have done more in 

this lame-duck, but at least we are 

taking an important step. I look forward to working with our new President and the new Congress in January 


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