tv U.S. Senate U.S. Senate CSPAN December 11, 2018 9:59am-12:31pm EST
and-- mentioned you. >> i've heard that. >> and you know, some day people are going to say-- >> exactly. >> hi. how are you? >> good. [inaudible conversations] [inaudible conversations] >> my team that i have now in washington and i think is generally the way we should look at things how do these help people. >> the u.s. senate is about to gavel in on this tuesday morning to continue debate on the nomination of the deputy treasury secretary. a vote on the nomination is
sunset, for your miracles are without number, and for your providence that sustains us. strengthen our lawmakers. empower them this day to mount up on wings like eagles, running without weariness, and walking without fainting. may their consistent communion with you be expressed in their thoughts, words, and actions. lord, make them one in the common cause of justice, righteousness, and truth. we pray in your loving name. amen.
please joig the pledge of allegiance i pledge allegiance to the flag of the united states of america, and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the presiding officer: the clerk will read a communication to the senate. the clerk: washington d.c, december 11, 2018. to the senate: under the provisions of rule 1, paragraph 3, of the standing rules of the senate, i hereby appoint the honorable cindy hyde-smith, a senator from the state of mississippi, to perform the duties of the chair. signed: orrin g. hatch, presidet pro tempore. mr. mcconnell: madam president. the presiding officer: majority leader. mr. mcconnell: i think it's time
the senate subjects itself to a bit of a reality check. today is december 11. here are just some of the things the senate needs to accomplish before this congress adjourns: we need to confirm more of the president's nominees for the judiciary and for the executive branch, such as the well-qualified nominee to be deputy secretary at the department of treasury whom we are currently considering. we need to reach an agreement to fund the remaining one-fourth of the federal government that was not covered by regular appropriations. we need to make a substantial new investment in the integrity of our borders and the security of american families. we need to take up and pass the conference report for the farm bill to honor our commitments to our nation's growers and producers. this week alone we need to dispense with the debate pertaining to the
situation in yemen and an attempt by some of our democratic colleagues to undo reforms that protect america's private personal information as they exercise their first amendment rights. in addition, at the request of the president and following improvements to the legislation that has been secured by several members, the senate will take up the recently revised criminal justice bill this month. i intend to turn to the new text as early as the end of this week. so as a result of this additional legislative business, members should now be prepared to work between christmas and new year's, if necessary, in order to complete our work. let me say that again. unless we approach all this work in a highly collaborative, productive way and take real advantage of unanimous consent to
expedite proceedings, it is virtually certain that the senate will need to be in session between christmas and new year's in order to complete this work. the senate is a consent-based institution. expediting this work would require an extraordinary degree of collaboration from everyone. so members should either prepare to cooperate and work together or prepare for a very, very long month. in just a few hours from now, madam president, we will receive an indication of whether that cooperation will begin to take shape. my friend, the democratic leader, and his counterpart in the house are scheduled to meet with president trump at the white house later today. for the nation's sake, i hope that my democratic friends are prepared to have a serious discussion and reach an accommodation with the president on funding for border security.
otherwise, circumstances are beginning to resemble a movie we've seen before. it was only this past january when democrats chose to manufacture a government funding lapse over the issue of illegal information. it didn't work out very well. the reality is that the president's request is entirely reasonable, and before today's partisan consideration set in, i bet it might have looked reasonable to a majority of the senate democrats who joined in support of a physical border security legislation back in 2006, some 12 years ago. senate republicans are working with the president and his homeland security team on a 5.02 billion dollar targeted funding to bolster security measures in specific places where the department of homeland security determines it is most needed.
and make no mistake, the need is great. in fiscal year it 2018, customs and border patrol reported a 30% increase in apprehensions at the u.s.-mexico border. looking further back, the monthly apprehension total this past october reached its highest level in four years. four years. the c.d.p. has observed over the past year a 50% increase in apprehensions of known gang members and a 115% increase in seizures of fentanyl narcotics. clearly delivering border security funding must be a priority. that's because the men and women of the border patrol deserve to be a priority. american communities deserve to be a priority as they face down the threat of gang violence. american families deserve to be a priority as the flow of lethal
drugs fuels an epidemic of addiction. this is the right investment in the right place at the right time. there's no reason why the democratic leader and the house democratic leader should put the demands of far-left special interests ahead of safety of american families. there's no reason for my democratic friends to end this year the way they began it: with a government shutdown. it would be truly bizarre for them to decide they'd prefer a partial government shutdown to reasonable funding for national security. it would signal that their party is more committed to political spite for the president than to the public interest. so i'll be watching eagerly this morning to see if the democratic leader approaches these negotiations with the productive and good-faith spirit that they deserve. now on another matter, as i mentioned a moment ago, one key piece of our unfinished business
is the farm bill. last night i used my very own hemp pen to sign the conference report, clearing the way for the house and senate to pass legislation and send it to the president's desk. i'm proud that the bill includes my provision to legalize the production of industrial hemp. it's a victory for farmers and consumers throughout our country. fighting for kentucky hemp has been a long struggle. my state was once the national leader in the growing and production of industrial hemp, but then for decades a federal ban halted that progress and shut american farmers out of the hemp field. don't get me wrong, hemp could still be found all over our country in all kinds of products. the problem is that it's just all being grown somewhere else and imported into america. it's time to let american growers get back in business with this vert till crop once -- with this versatile crop once
again. farmers, processers and manufacturers in my state and across the country are ready for the hemp to come back. it began in 2014 when i secured the establishment of a hemp pilot program with the help of then-agriculture commissioner jamie comber, states like kentucky got the opportunity to explore the potential and show us what hemp could do and the results have been nothing short of extraordinary. now american-grown hemp can be found in your food, clothes and your car dash board. the results mean growth, economic growth and new opportunity. last year alone hemp products contributed more than $16 million to kentucky's economy, and that was just from the pilot program. just from the pilot program. at a time when farm income is down and our growers are struggling, industrial hemp is a bright spot of agriculture's future. my provision in the farm bill will not only legalize domestic
hemp, but it will also allow state departments of agriculture to be responsible for its oversight. in kentucky, that means that commissioner ryan quarles, another champion of hemp, will be able to help farmers thrive. i know the occupant of the chair is familiar with commissioner quarles. when the senate votes on this legislation in the coming days, we'll also be voting to give farmers throughout the country the chance to tap into hemp's potential and take part in its future. i've been proud to work with my colleagues in congress like senator ron wyden and with hemp advocates in kentucky to get to this point. obviously i'll be proudly voting for this bill. on a final matter, the senate will soon vote on an attempt by some of our democratic colleagues to unwind an important privacy reform the treasury department enacted earlier this year. we need to stand up for privacy, stand up for the first
amendment, and reject the democrats' resolution. the question at hand is whether the i.r.s. should have special power to demand that certain nonprofit organizations hand over the list of their contributors. this raises the question, madam president, why? why should the i.r.s. have this private information? for accounting purposes? no. the regulation requires tax-exempt nonprofits to maintain books, but individual donations are not tax deductible, so there aren't accounting reasons why the i.r.s. would need to track donors. for transparency purposes? no. the personal information in question is not part of any public inspection requirement. in fact, the i.r.s. is required to redact this information when releasing a nonprofit's public tax dollars. the guidance does nothing to
affect the information that is publicly available. so why does the i.r.s. need to stockpile this information? for safe keeping? hardly. several years ago, the i.r.s. had to settle a lawsuit. a worker broke the law and leaked, leaked an unredacted copy of a group's confidential forms. of course, that information ended up in a left-wing organization on the opposite side of the issue. a few years before that, california, which had begun demanding its own copy of this private information, accidentally, accidentally published the private information of donors to over 1,000 nonprofits registered within that state. these aren't isolated incidents. they are part of a disturbingly hostile climate for certain kinds of political expression
and for the free exchange of ideas. we have seen angry activist mobs deal out personal harassment and professional sabotage to individuals with whom they have a disagreement. we have seen the last administration's i.r.s. focus hostile treatment on certain organizations whose political views ran afoul of the bureaucrats' own opinions. so this is the backdrop, madam president, which makes secretary mnuchin's pro-privacy decision so important. the democrats want to overrule secretary mnuchin's guidance. they want the i.r.s. to resume packing filing cabinets full of names of americans who support different causes, even though they can't say why. that's today. what about home? 45 senate democrats are already
signed onto a more sweeping piece of legislation known as the disclose act which would amplify and expand this chilling effect in numerous other ways. for one thing, this bill would cut out the middleman of the leaky i.r.s. and enable direct ideological harassment, increasing disclosure of this private information straight to the public. that's just one example. it would also give the f.e.c. more power to regulate america's speech about important issues and many public officials. so get ready to hear a lot of lofty rhetoric about restoring democracy from the democratic leader in the house and her allies here in the senate, but underneath the rhetoric, underneath the rhetoric, get ready for legislation that would do more to undermine our constitutional freedoms and
chill their exercise than any other bill i can think of in recent memory. so, madam president, let's not walk down this road. let's not chill americans' exercise of the first amendment. let's defend these freedoms today and stay vigilant tomorrow. the vote scheduled for 11:30 a.m. this morning occur at 11:00 this morning. the presiding officer: without objection. a senator: madam president. the presiding officer: under the previous order, the leadership time is reserved, morning business is closed. under the previous order, the senate will proceed to executive session and resume consideration of the following nomination, which the clerk will report. the clerk: nomination, department of the treasury, justin george muzinich of new york to be deputy secretary.
a senator: madam president. the presiding officer: the senator from tennessee. mr. alexander: thank you, madam president. i ask consent to speak for up to 30 minutes. the presiding officer: without objection. mr. alexander: madam president, today i'm asking experts at the american enterprise institute and the brookings institution, as well as other leading health care experts, for specific ideas about how congress and the president can work together to reduce the cost of health care in the united states. here is why. last july at the senate help committee's second in a series of five hearings on reducing health care costs, dr. brent james, a member of the national academy of medicine, testified that 30% and perhaps as much as 50% of all the money spent in this country on health care is unnecessary. that startled me, and i hope it startles you.
so i asked another witness, dr. david lanske from the pacific business group on health if he agreed with dr. james' estimate that 50% of all the money spent on health care is unnecessary. dr. lanske said yes. and then at our next hearing on reducing health care costs, not one witness on our distinguished panel disagreed with dr. james. that means we're spending as much as half of all we spend on health care on unnecessary treatment, tests, and administrative costs. as a country, we spend a huge amount on health care, $3.5 trillion in 2017, according to the centers for medicare and medicaid services. so when we used dr. james' estimates, that means we spend roughly $1 trillion to $1.8 trillion on unnecessary health care in 2017. that is more money than the
gross domestic product of every country in the world except nine. that is three times as much as the federal government spends on all of our national defense. 60 times as much as it spends on pell grants for college. and about 550 times as much as the federal government spends on national parks. for the last eight years, most of the debate about health care has not been about this extraordinary effect that we may be -- extraordinary fact that we may be spending up to half of what we spend on health care unnecessarily. instead, we have been arguing about health insurance. in fact, really, we have been arguing about 6% of the health insurance market, the individual insurance market. the truth is we'll never have lower cost health insurance until we have lower cost health care. so instead of continuing to argue over a small percentage of
the insurance market, what we should be discussing is the high cost of health care that affects virtually every american. and here is something we ought to be able to agree on. we're spending too much on health care and too much of what we spend is unnecessary, and the five hearings we held reminded us of something else we should be able to agree on. one major reason for the unnecessarily high cost of health care is that the health care system does not operate with the discipline and cost-saving benefits of a real market. too many barriers to innovation drive up costs, and most americans have no earthly idea of the true price of health care services they buy, which also drives up costs. let me repeat that. one major reason for the unnecessarily high cost of health care is that the health
care system does not operate with the discipline and the cost-saving benefits of a real market. too many barriers to innovation drive up costs, and most americans have no earthly idea of the price of the health care services they buy, so that also drives up costs. as a country, american families, american federal and state governments and private companies, we spend $3.5 trillion on health care in 2017, according to the c.m.s., almost as much as we spend on the entire federal government in 2017, according to the congressional budget office. high health care costs impact everyone. first, the taxpayer, because the federal government spends about one-third of all federal dollars on health care. according to the congressional budget office, of the
$3.98 trillion the government spent in 2017, $1.1 trillion of that was mandatory spending for medicare, medicaid, and other health care programs. this federal government runaway spending is the principal cause of the national debt. the cause of the national debt is not national defense, national parks, and the national institutes of health. the cause of the national debt is the runaway government spending on health care, which is squeezing the budget for national parks, national defense, and basic biomedical research. health care costs also impact states, all of which have to balance their budgets. when i was governor of tennessee a few years ago, medicaid was about 8% of our state budget. that was in the 1980's. today it is 30% of tennessee's state budget. that means states have less to spend on fixing roads, educating children, and granting -- and
helping adults and high school graduates get better job skills. second, health care spending adds to the cost of doing business in the united states. warren buffett has called the ballooning cost of health care a hungry tapeworm on the american economy. and third and most important, the rising cost of health care is squeezing the budget of american families. according to the gallup poll, 80% of registered voters before this midterm election rated health care as extremely or very important to their vote, a higher percentage than every other issue polled, including economy, including immigration, including taxes. i would imagine that every senator has heard stories from their constituents about struggling to stretch paychecks to afford a prescription or to cover a surprise medical bill. any one of us who has received a medical bill in the mail has wondered what am i actually paying for? here's a story i heard recently.
todd is a novel father who recently took his son to an emergency room after a bicycle accident. the son was treated. todd paid 150-dollar co-pay because the emergency room was, quote, in network for his health insurance, and they headed home. so todd was surprised when he received a bill in the mail for $1,800. because even though the emergency room was in network, the doctor who treated his son was not. so todd wrote his senator, me, trying to figure out why it's so hard to understand what health care prices really are. if i am expected to be a conscientious consumer of my own health care needs, he wrote, i need a little help. the issue of surprise billing is a widely recognized problem. it was highlighted in a report from the white house on health care costs just this last monday. we want americans like todd and
his son to be able to access quality care that they can afford, so earlier this year, our senate committee set out in a bipartisan way to see what we could find out about lowering health care costs. we held five hearings over six months. in june at our first hearing, we set out to better understand how much health care actually costs in the u.s., to see if we could get some agreement on the numbers. at our second hearing in july, we heard from dr. james who told us that up to half of what we spend on health care is unnecessary. at our third hearing later in july, we looked at administrative tasks imposed by the federal government and how those burdens lead to doctors spending more time on paperwork, less time on treating patients, and all this also increases costs. in september, we looked at why when you speck reviews and prices before buying everything from a coffee maker to a car, the cost or the price of your
health care has remained hidden in a black box. this is something even the federal government's top health care official knows personally. health and human services secretary alex azar recently told a story of how his doctor ordered him to have a routine echo echo cardio test, a stress test. he was sent down to the hospital where after a considerable effort on his part he learned the test would cost him $3,500. so after using a website that compiled typical prices for medical care, secretary azar learned the same test would have cost just $550 in a doctor's office. secretary azar said consumers are so in the dark, they often feel, quote, powerless. in an age where you can compare different prices and check a dozen reviews when you're buying a barbeque grill, you should be
able to more easily understand what you're paying for health care. and last month at our fifth hearing, we heard about steps the private sector is taking to disrupt the health care system and what kinds of federal barriers are preventing private companies from lowering costs. as we held our five hearings, two conclusions became clear. number one, we spend more on health care than any other country, but we don't spend it well. again, dr. james told us that 30, maybe as much as 50% of all the money we spent on health care is unnecessary. that's really stonishing. it being aos what dr. -- echos what dr. ashish who said this, quote, the popular belief has been the reason that we spend so much more on health care than other countries is that we just use too much health care. well, it turns out, dr. ashish
said, that when we look at data, we're not using more health care. why are we spending twice as much? there are two reasons, he said. one is administrative complexity, and, second, every time we use health care in america, we pay a lot more for it than any other country in the world. that was dr. ashish from the global health institute. while it would be convenient to have a moon shot to reduce health care costs, this would require people other than the federal government. the largest purchaser of health insurance, employers are really leading the way in this effort to reduce costs. for example, let's take international paper, which is based in memphis. it uses a service called best doctors. employees can use it for a second opinion on health care. best doctors review an employee's records and then they either affirm, reaffirm the treatment recommended by a doctor or recommend a different course, such as physical
therapy. the use of this voluntary program saved international paper over half a million dollars in 2017 by preventing unnecessary treatment. another way employers reduce health care costs is through wellness programs which encourage employees to lead healthier lives. there is probably no greater consensus in health care than that wellness, lifestyle changes like eating healthier, stopping smoking can prevent serious illness and reduce health care costs. it's harder to think of a better way to make a bigger impact on the health of americans than to reduce health costs to the health insurance that 180 million people get on the job. about 60% of us get our health insurance on the job. second, states are taking an active role in the cost of health care. the state of maine in 2017
required health insurers to split the cost of a patient if the patient shops around and is less than the price the insurer pays. in oregon, the state compiles data on insured residents and uses it to allow patients to compare the cost of procedures to different hospitals. and, third, private companies are creating innovative tools to reduce health care costs. for example, health care blue bird, a nashville company and witness at one of our hearings, is a tool to help patients find the best price for the highest quality care using their employer-sponsored insurance, which, as i said, 60% of us have. this is useful to lower costs because, for example, the amount a patient pays for cataract surgery in memphis can range from $2,000 to more than $8,000. fourth, hospitals, doctors, and
other health care providers have the potential to make ar large impact on the health care system. -- on the health care costs problem. on a smaller scale, one of our witnesses, dr. gross in florida, runs a practice that's called direct primary care model. dr. gross charges a flat membership rate of $60 in cash for adults under 605, -- 65. his practice doesn't bill anything to an insurance company for direct primary kir members, not to obamacare, not to medicaid, not to medicare. in return for this membership fee, members receive an annual wellness exam, 25 office visits per year, including same-day appointments, and some in-office testing and chronic disease management without paying anything additional out of
pocket. that gives the patient that defined level of health care at a predictable price. that price ranges about $1,000 to $1,200 a year. on a larger scale, h.g.h., who also testified, has 178 hospitals and 119 freestanding surgery centers in the united states and united kingdom is implementing new techniques to reduce the spread of mrsa that occurs in intensive care units. these new techniques have reduced cases of mrsa by 28% and have been so effective that the world health organization and the centers for disease control and prevention has added them to best practices. this reduction in mrsa infections saves $170,000 for
every 1,000 patients. that is saved among the hospitals, insurers, and patients. finally, information needs to be easily available so patients, consumers, can find out the price of their care and take an active role in choosing health care and planning for medical expenses whenever they can. there's also a role for the federal government to play. the federal government spends, as i said earlier, $1.1 trillion on medicare, medicaid, and other health care programs, that was in 2017. and about one-third of all health care spending in america is by the federal government. so how we spend those federal dollars will proivelly -- obviously make a big difference to the health care system. there may also be things washington can do, or is doing, that increases health care costs or prevents private companies from taking steps to lower health care costs. i want to find out what concrete specific steps the federal government can take to reduce
unnecessary health care spending or at least stop making the program work. for example, after our committee heard about gag clauses that prohibit a pharmacist from telling a patient their prescription would be cheaper if they paid with cash instead of their insurance, congress was able to act and ban those gag clauses earlier this year. in august, c.m.s. is beginning to require hospitals to post the amount they charge for services online and to keep that information up-to-date. these are the types of specific recommendations i'm looking for. now, i had some success working with experts to ask them for recommendations in priority order and then turning those recommendations into legislation. in 2005, i stopped by a meeting -- i was a member of the budget committee then, and i had become increasingly concerned about the rapid increase in the
federal debt and how it was squeezing out some of the essential programs that make our country competitive. so i stopped by a meeting of the national academy of sciences on american competitiveness and i said to them, most ideas fail in washington, d.c., for lack of the idea. i believe that if you, the academy, will give congress ten specific ideas in priority order to improve american competitiveness, i believe congress will enact those ideas. the academies got busy and recruited norm august is steen, put together a task force and came up with 20 ideas, not just ten. they were specific, such as doubling funding for basic science research, such as creating an energy agency model after the department of defense highly successful darpa agency that would invest in
high-potential, high-impact energy models. and congress used most of those ideas and put together a bill we called america competes. we passed it in 2007 and we authorized it in 2010. it was introduced by the majority and minority leader and had a large number of republican and democrat sponsors. that's an example of what can happen when experts give us specific recommendations toward an important public goal and give it to us in a way that we can actually implement them. that's what i'm looking for in the letter that i'm sending today to experts at the american enterprise institute and the brookings institution, specific relations, preferably in priority order, about what congress and the president can do to reduce the staggering health care cost problem in america that our witnesses from
the academy of medicine, and all across the board tell us we're spending nearly half of everything we spend on health care is unnecessary. i also want input from other leading policy experts including economists, nurses, patients, hospital administrators, legislators, governors, employers, insurance, health care innovative i'm asking for as many legislative or regulatory solutions or sub regulatory solutions as possible in writing by march 1, 2019. i'm especially interested in policies that bring to the health care system the discipline and lower cost benefits of a real functioning market. one way to do that is to remove barriers that discourage innovators from coming up with new ways to reduce health care costs. a second way is to make it easier for consumers of health
care to know the true price of what they are buying, and i would welcome suggestions of how those policy ideas could be implemented, what law to amend, what regulation to change, and any potential downsides to the policy recommendations. i will share these recommendations with senator patty murray, who is the ranking democratic member of the senate health committee, and with all of the members of our committee. i will share the recommendations with senator grassley and senator wyden, who are expected to be the chairman and ranking member of the finance committee. our health committee and the finance committee has shared jurisdiction over health care costs. sometimes that gets in the way of solutions. there's no reason it should. we should all be able to work together in a bipartisan way to address this startling phenomenon that the experts tell us is true, that we're wasting,
that we're spending nearly half the money we spend unnecessarily on health care. now we need for the experts to tell us exactly what to do about it. the federal government's not going to lower the cost of health care overnight, but i believe there are steps that we could take to make a real difference to american families. that might be two or three big steps or it might be a dozen smaller steps, but we shouldn't let this opportunity to make progress pass us by. madam president, i ask consent to include in the record following my remarks letters i have written in a mailing today to experts at the american enterprise institute and brookings institution as well as other leading health care experts. i thank the president and yield the floor. the presiding officer: without
a senator: madam president. the presiding officer: the senator from west virginia. mrs. capito: madam president, are we in a quorum call? the presiding officer: we are. mrs. capito: i ask to vitiate the quorum call, please. the presiding officer: cobra. mrs. capito: thank you, madam president. we are faced today with an escalating crisis on our southwest border. we'll all know it. we see news of it every day, and it's very real. as i am the chairman of the appropriation committee subcommittee on homeland
security, i'd like to present some facts to the senate that make the case for increased investment in our border security. in the fiscal year 2018, border patrol apprehensions at the southwest border were up more than 30% compared with fiscal year 2017. in real numbers, over 396,000 people were apprehended, but it's getting worse because if you look at october of 2018 as compared to october of 2017, apprehensions were up 88%. so the numbers are going up. but the facts i've laid out don't tell the entire story. border patrol estimates that it could be catching as little as half of the traffic that is illegally crossing our southwest border between the ports of entry, so we really don't know who we are catching and we don't know what they're carrying.
border patrol apprehensions of gang members is up 50% from fiscal year 2017 to fiscal year 2018. mexico is a primary source for narcotics entering the united states. this is extremely important to me as a representative from the state of west virginia. and fentanyl seizures by the border patrol were up 115% over the past year, from 2017 to 2018. we know that a significant portion of opioids enter our country through ports of entry, but we cannot ignore the fact that we are seeing opioids smuggling between the ports of entry increase at alarming rates as well. similarly, methamphetamines seizure by border patrol has increased 75% since the year 2015. in more populated areas along the border, aliens and smugglers are crossing the border unimpeded and quickly vanishing into our neighborhoods, into our commercial areas, and on to
highways, headed to places like mississippi and west virginia. a single load of fentanyl walked across our land border in an unassuming backpack could threaten the lives of several thousand americans. failure to better secure our border will have consequences for all american communities. and i'm very sad to say that my home state is an acutely affected area. in the year 2017, drug overdoses were responsible for more deaths per capita in west virginia than in any other state. listen to this. this is so sad. overdoses tragically took the life of one of every 1,700 west virginians and one of 4,600 americans in this country. we saw a 500% increase in meth overdose in west virginia from the years 2017 -- or 2013 to
2017. what i've learned in learning about this is we've gone from prescription drugs to heroin to heroin laced with fentanyl, and now it's synthetic meth that is the threat. this is occurring while we are seeing an uptick in meth that is mass produced in places like mexico trafficked throughout our border and distributed throughout the united states. these types of meth are being laced with a synthetic and dangerous opioid drug, fentanyl. in the current debate it is easy to forget that more than a decade ago congress on a bipartisan basis -- and i was over in the house of representatives at the time -- we were making significant investments in our border security infrastructure. what we see from these past investments is that physical barriers actually work at the border, and the statistics show that. in the 1990's and in the 2000's we built physical barriers in
the san diego sector. el paso sector, tucson sectors and the yuma sector. four sectors. in each of these places the number of apprehensions dropped by more than 90% after the infrastructure was installed. in these areas investment in border security has enhanced the safety and the security on both sides of the border. neighborhoods that were once overrun with illegal activity are vibrant. commercial areas that were once considered dangerous and unprofitable are now flourishing with economic development. nature preserves that were once trashed and trampled are again full of our native plants and animals. the cartels on the other side of the border profit in places where we haven't invested. and criminals aren't going to try to stop smuggling humans and narcotics into the united states because we've invested in certain key places. they simply change their routes and shift their tactics to areas where we haven't yet built
infrastructure. if we fail to better secure our border, we are inviting vulnerable migrant populations, many of whom may be fleeing danger in their own home communities, to subject themselves to dangerous journeys through rugged terrain. and they're often doing so under the thumb of cartelses who profit from the illegal human trafficking just as they profit from drug trafficking. we need to secure our borders and encourage these migrants to instead seek entry legally at the designated ports of entry. this past summer i traveled for several days to the southwest border both in california and in texas. i witnessed the needs that we have there firsthand. i saw the open pathways across the border and into our communities. i saw the gaps in our border security. i also saw communities that have become safer because we have
provided border security. but i didn't just see those things. i heard from the men and women who patrol our border each and every day. it's a tough job. it's a tough job. they expressed the need and the value in the investments i'm talking about here today. while the need for additional investment in border infrastructure may be obvious to some, congress has recognized that we need to be strategic in these investments. it was said on the senate floor last week that there is no plan for these investments. well, i'm here to tell you that's not the actual true story. in fact, the bipartisan fiscal year 2017 appropriations bill required customs and border protection to provide us with a comprehensive border security plan, an improvement plan to ensure that we get it right. this plan was developed sector by sector by agents in the field and weighed -- it was weighted by illegal activities occurring
in those sectors. it was written from the bottom up by career law enforcement professionals who walk the line every day, and sometimes on boats on the rio grande -- we did that too -- and know where new infrastructure is needed most. the plan was delivered in january of 2018 and provided us with a ten-year road map for border security investment based on operational requirements. and here's what we learned from this plan. as traffic slowed in san diego, in arizona, and el paso, we've seen it shift to south texas to the rio grande valley sector. this sector covers just 17% of the mileage of the entire border, but it now sees 40% of the illegal border traffic. this sector also accounts for an outsized number of narcotic seizures and a significant portion of the assaults on our border security agents, border patrol agents. through the f.y. 2018 appropriations bill enacted in
march, congress provided nearly $1.4 billion, a down payment towards this plan, towards this improvement plan. despite claims on the senate floor last week to the contrary, customs and border protection is executing this funding at an astounding rate. about a third of it is already under contract. another third will be in contract in the next several weeks. and the entirety of this funding will be under contract within a year of enactment of the legislation. they are spending it where it's needed most and as fast as we can get it to them. in june the appropriations committee, led by my subcommittee, produced a bill that recommended border security funding in line with this plan. specifically, the bill recommended significant funding for new physical barriers along the southwest border. this is a very good bill, but over the summer and over the fall this crisis at the southwest border has escalated. i believe we in congress must
demonstrate that we're flexible enough to respond when the situation calls for it. the statistics i cited certainly make a compelling case. providing additional resources in f.y. 2019 and f.y. 2020 for bored security infrastructure would be consistent with the border security improvement plan when viewed through the lens of an escalating crisis. this funding would go straight to the places in south texas where we're seeing the most illegal traffic. it is important to note, madam president, that providing an appropriate level of funding is possible without exceeding any of our budget caps, without shortchanging any of our other very important programs, as long as we get serious about finding a bipartisan way forward. we'll take a time-out here to realize that senator schumer and rising speaker pelosi are going to be meeting with the president on this very issue today, so i
urge them to reach a bipartisan way forward. i urge my colleagues here in the senate to take a long hard look at the undisputable facts that demonstrate the crisis on the border is escalating. our law enforcement personnel have provided us with a plan to work towards improving and solving that problem. so let's work together and get this done. i yield back my time.
the presiding officer: on this vote, the yeas are 5, the nays are 44. the nomination is confirmed. -- the yeas are 55, the nays are had 4 -- the nays are 44. the nomination is confirmed. the senator from missouri. mr. blunt: i ask unanimous consent that the motion to reconsider be considered made and laid on the table, and the president be immediately notified of the senate's action. i further ask the senate proceed to legislative session for a
period of morning business with senators permitted to speak for up to ten minutes each. further, that at 2:15, the senate vote on the kobes nomination as under the previous order. finally, if the nomination is confirmed, the motion to reconsider be considered made and laid upon the table, and the president be immediately notified of the senate's action. the presiding officer: is there objection? without objection, so ordered. mr. blunt: thank you, mr. president. i know that we've got a number of things scheduled here, including some farewell speeches from some of our colleagues. i was scheduled to speak, and i do want to speak, and i will try to not take too much advantage of the time, but i wanted to speak today and this week about the importance of treating mental health and the importance of the role that law enforcement plays in the way we treat mental health in this country.
for too long law enforcement and emergency room personnel have been, in fact, the de facto mental health system for the country. the national institutes of health says that one in five americans have a mental health or behavioral health issue and that one in nine adult americans has had a behavioral health issue that impacts how they live every single day. two congresses ago in the 115th congress senator stabenow and i worked to pass legislation, the excellence in mental health act. what that did was create eight state demonstration projects that would last for two years each to see what would happen if treated mental health like all other health, something that everybody knows, i believe, we should have been doing; something that in eight states we are doing. and, mr. president, the good news was that 24 states, a number that exceeded every
discussion that anybody had about how many states would step forward and say, we'd like to be the states that tray to do this first -- and try to do this first. i was proud that missouri was one of the eight states in the -- chosen to be in the demonstration project. we're about halfway through the two-year project, and in our state and in the seven other states, people have access to mental health services that they didn't have before. most missourians are within a relatively short drive of the facility that will treat their mental health problem like it was any other health problem. and as we begin to do that, i think we're going to see the kind of impact on law enforcement and the kind of help that law enforcement needs it as well. just a couple of years ago, i rode with both crisis intervention teams in kansas city and in my hometown in
springfield. in springfield, what i saw there was officers dealing with a 24/7 linkup to the berle mental health clinic, the regional mental health provider. 16 officers had in effect ipads that linked them up to a mental health professional. didn't take too long, and i think this would be indicative of what most law enforcement officials see almost every day. it didn't take too long before we came on someone huddled in the alcove of a building that was vacant who clearly had a behavioral health problem, wasn't at this point a drug problem or an alcohol problem. they were where they were because they had a mental health problem. the officer was able to skype back immediately with a mental
health professional. what i was most interested in, even with a well-trained officer who knew exactly what they were doing and how to do it, even with that officer there, as that officer linked the person up with someone, in effect, a telemedicine linkup with a mental health official, you could tell that person was more comfortable talking to the ipad and communicating that way than he was with the officer that was right there with him. it wasn't because the officer was in any way intimidating or unprofessional. but it was just because of what it was, a linkup with someone at another state, with someone -- with someone at another site, with someone who was clearly prepared to deal with those kinds of issues. so we're going to see that benefited shall the kind of things that the mental health community can do to provide more resources to the law enforcement community under excellence in
mental health is providing 0 a service, and i think producing real results. and i have i'd also say -- and i'd also say, as i conclude my remarks on this topic, what we hope to see is a significant number of people -- and, remember, i said n.i.h. said one out of five adult americans has a behavioral health issue. what happens when you deal with that behavioral health issue in terms of how you deal with all the other health issues that that individual or that community would be dealing with? what happens if somebody is feeling better about themselves, taking their medicine, eating better, sleeping better, showing up for the doctor's appointment, showing up for the dialysis appointment, doing what they ought to be doing? i believe what we're going to find and what's been found in earlier big-county studies of this kind is that actually doing the right thing winds up saving money, not costing money.
but also doing the right thing for police officers, for people in emergency rooms, for providing those -- the kinds of connections and alternatives needed make a big difference. and for all of the health care providers and the law enforcement individuals involved, i'm grateful for what they do, and i think we're seeing some real results from the bill that this body passed, president obama signed, now in law, and producing great results. and with that, mr. president, i would yield the floor. the presiding officer: the senator from washington. mrs. murray: thank you, mr. president. mr. president, i come to the floor to oppose john than kobes 's nomination. people across the country know how important it is that we fight back against extreme and extremely unqualified judicial nominees.
earlier this year during judge kavanaugh's confirmation, we saw just how far president trump and senate republicans are willing to go to jam through extreme judges who will work to strip away women's rights. but that wasn't always -- but that wasn't all we saw. we saw millions of men and women across the country inspired to fight back against his nomination. we saw people speak out and share their own personal stories about what was at stake, about sexual assault and how important that is we believe survivors, about the right to safe legal abortions and what it means for women and their families and about what kind of country we want to live in. and we saw, without question, that people across the country want us to stop president trump from swinging our courts far right by packing them with ideological judges. judges like mr. kobes who will continue the trump-pence agenda of rolling back women's rights and access to health care.
mr. president, making sure families know exactly what mr. kobempt s would mean for women if he is seeded is what i am here to do today. like many of president trump's nominees before him, mr. kobes lacks almost any real experience to qualify him for a seat on the eighth circuit court. he has little trial experience, little appellate experience, and no record of legal scholarship to speak of, and i'm not the only one concerned. the american bar association has rated him unqualified. that makes mr. kobes the sixth judicial nominee from president trump opposed by his professional colleagues. but the thin record he does have is disqualifying because it shows he will put extreme right-wing ideology ahead of women and science. mr. kobes is an outspoken advocate for fake women's health care centers, sometimes called
crisis pregnancy centers that seek out women looking for information about their health care needs and reproductive rights and then use misleading, blatantly false propaganda to scare and pressure them. mr. kobes even went out of his way to represent some of these fake clinics free of charge. he voluntarily defended a law requiring providers to give a lecture full of ideological propaganda and fearmongerring to women seeking safe legal abortions. the required lecture in this case actually went so far as to demand providers lie to women and claim abortions increase their risk of suicide. it does not. think about that. he argued for a law that directly interfered with the relationship between a patient and her health care provider. a law that said women making their own decisions about their own bodies and seeking health care that is their
constitutional right should be lied to, should be frightened out of a decision with fake information, including fake information about suicide. that is utterly wrong and disqualifying for any judicial nominee. and mr. kobes hasn't merely represented these fake clinics. he's served on the board of an organization which aimed to deceive and frighten women out of getting abortions. it is clear he wasn't chosen for his days in the legal field. he doesn't have them. mr. president, women and men across the country are paying attention. they know what is at stake. hours before the final vote on judge kavanaugh, i came here to speak about how angry i was when the senate failed anita hill in 1991 and confirmed justice thomas, how i decided to run for the senate then after that so i could fight to change things. and how i hoped everyone who is angry about judge kavanaugh would stay angry and keep fighting for change. and i also promised right here
that whatever happened, i was going to get up the next day and keep fighting, too, and i meant it. i'm going to keep standing up, speaking out, and making clear just how harmful president trump's ideological nominees are. i strongly oppose mr. kobes' nomination. i hope all of our colleagues will do the same. thank you, mr. president. i yield the floor. a senator: mr. president? the presiding officer: the senator from north dakota. a senator: mr. president, i first ask unanimous consent to speak for as much time as it takes me to finish this and i promise i won't keep you here until midnight. the presiding officer: is there objection? hearing no objection. a senator: i also ask that john wood, allison continuesley, both fellows in my office, dean williams, a detailee on my homeland security subcommittee be granted floor privileges. the presiding officer: without objection, so ordered. ms. heitkamp: in 2000 i was diagnosed with stage 3 breast
cancer. my oncologist told me you have a 28% chance of living more than ten years. think about that. so i knew right away that i had a chance to use what time god gave me for good and noble purposes. to try and do the things that i always thought needed to be done in this country. it's an important lesson for all of you. the greatest gift you have is not your bank account. your greatest gift that you have is the amount of time you have left on this earth and what you do with that time. and i chose for good or bad to come to the united states senate. i think when we have a world of options and we make this choice, it is so important that we come here with purpose, not just to be named a senator, not just for the trappings of office, but for purpose. so the truth is i'm not supposed to be here. i'm from matador, north dakota, a town of 90 people. when i was growing up, my family
was the one-tenth population. i just have to say. my dad was a world war ii veteran who loved education. read the paper every day, believed in this country, but he was never given a chance to go to high school. my family struggled to get by and when you look at it, you think about this. you think about a country where somebody from my background could actually become a united states senator. i'm a democrat from a very conservative state, but against all odds, in fact prediction was it was only 8%, i got elected to the senate. and the fact that i got to serve in the senate for six years is an incredible american story. people always ask me at what point did you kind of think wow, you came to the senate. i said i was so busy after i got elected because no one ever thought i would get elected so people wanted to see me who never wanted to see me during a campaign. so busy taking meetings, busy putting together the office. and i remember the day i came to
that chair and the pastor came and he gaveled in and then i turned around to say the pledge of allegiance. and i thought, here i am. north dakota, a girl, middle age, pudgy democrat from north dakota, and i'm standing in the well of the senate where not even 2000 people have come before. this is a great and great and good and noble country with great purpose, with great opportunity. and i want every child out there to understand it doesn't matter. we represent a cross-section of this great country. but we also aren't that special. we're not. sometimes i think the american public thinks if you took a hundred random people and put them in the chairs, they could do better than we could do. but the truth is you all came here with that same noble purpose. you all came here to change america, to do the right thing.
i don't care if you sit across there. i don't care if you sit here. you all came here for the right purpose. and so the fact i got to serve in the senate is part of a great american story. and that story only happens in this country. don't ever forget that. and if we lose that opportunity, we won't become diminished in who we are. so i want to today offer a few comments. i hope they're not too preachy. but i want everyone to understand, especially my colleagues, that this has been the opportunity of a lifetime. but think about what we did to get here. this process that we go through is brutal and quite honestly obscene. it's obscene what we do to get here. so having done all that work, having taken those steps and walked that gauntlet of a campaign, we have an opportunity to not just achieve the title
but to do great and good things for this country. my job here, the work that i've done has always been to remember who we're standing in this well for. throughout my life and the past six years, i've stood here for north dakota, for the incredible people that i serve. i've stood here for the families of disabled children who were terrified they would lose their health care. when i took that vote on the affordable care act, i saw in that vote, i remembered that ir-- their faces. i remembered their tears. i stood here for the men and women of our armed forces and our veterans in north dakota who believe that they did a great thing and deserve to be treated respectfully, honorably, and, yes, get the benefits that they've earned. and too often they're denied. a veteran should not have to come to a congressional office to get the benefits they've earned but yet too many have to. i stood here for retirees whose
pensions are threatened and i've asked a simple question. if we could spend billions bailing out the failed wall street bankers, can't we just pay attention to the working men and women who are struggling, who are in crisis, and literally the heartbreak of their stories if heard across this chamber, the reaction would be overwhelming. many of their -- many of them are veterans. many of them have worked hard and now are reason in the work that they've done. i've stood here for farmers and rural communities, and i've stood here for native people. and many times, as you know, have tried to do my best to educate all of you on the challenges of our first americans, our native americans. but mostly i think -- i hope i've stood here for the children of america because in spite of how we behave, they truly are our future. they are the people who make a difference for our future.
and if we do not start respecting that challenge that we have to create a better world, a better world of more opportunity, we will not fix the problems of america long term. so these are the people who drive me every day. they are who we serve, not a party, not an ideology. we serve americans. i've spent my time standing and fighting for them. and for me that work will never, never stop. so with all that said, i stand here proud of what we've accomplished. when you look at the time and the opportunity to rise above partisanship and rancor, i have found so much common ground with so many members of this body. and i am incredibly proud of what we've been able to accomplish. i've advocated for native american communities in my bill to stand up for native american children, which i did with lisa from the very beginning with senator murkowski.
the first bill i introduced. and it was symbolic for me because we have to do better. and i found great partnerships with lisa not just on this but on other issues. but i know her heart. and i know that she cares. and when you find people who care the way you care, you can do amazing things. my legislation to create an amber alert with our colleague john mccain in indian country became law. we're on our way to passing savannah's act which is going to recognize for the first time the challenge and the tragedy of missing and murdered indigenous women. all of this so, so important. bipartisan legislation to help crack down on human trafficking online. we shut down backpage. we shut down people who were in fact selling children for sex. you think about that. that's a noble act that we took and the challenge continues. congress passed my bill to give first responders more training and resources to keep our
communities strong and safe. i led a successful effort again with my colleague from alaska, lisa murkowski, to lift the age-old ban on exporting oil and pairing it with renewables that we did with my other colleagues on this side of the aisle when we looked at enhancing renewable energy. a flaming success on both sides. we are exporting literally millions of barrels of oil resulting in energy independence and helping our allies, but we also are growing our renewable energy industry because of that effort. it didn't happen without colleagues working together. i secured a vet center in grand forks and a cbach. huge to the veteran it is serves. i got needed funds for flood appreciation a-- protection across north dakota working with senator hoeven. i passed my bill to secure the northern border working with kelly ayotte who is no longer here but a great friend.
legislation i helped to provide relief to community banks. senator crapo, senator donnelly, senator tester, senator warner recognizing the challenges of small lenders and how we needed to address those challenges. no one thought we could get that done but we did because we believed we could. think about that. i worked with the republicans and democrats, probably the crowning achievement together in terms of bipartisanship to deal with war don -- carbon capture. the first major piece of carbon legislation that's been passed since i've been here. i can't speak to other pieces. how did that happen? it happened when senator barrasso and senator capito and i and senator sheldon whitehouse collaborated and said we can't agree on climate but we will degree on -- agree on development of technology that will change outcomes. this technology is absolutely essential to tackling the problems of carbon emissions in this country. so don't say it can't be done. if you can get sheldon
whitehouse and mitch mcconnell on a bill that involves carbon and the coal industry, that's a good day here. that's a really good day here. and so i want to -- i've worked to help to address detrimental impact exposure to trauma. this is an issue i hope you will all become better educated on. childhood trauma and the effect that it has on so many of our children. i worked with great colleagues dick durbin who actually let me take the ball and run with it for chi will always be grateful. worked with cory booker from new jersey doing incredible things for children. it is pivotal. if we're going to change outcomes for american families, that we begin to address why it is that we do everything that we've always done and we expect a different result. we have to think differently about these issues. i helped write and negotiate and pass two farm bills. thank you, pat. thank you, debbie for believing in bipartisanship and believing in rural america. i've worked with incredible
folks. i think john boozman from arkansas, a great story. little known fact in the farm bill that we're all going to pass is maybe the first piece of major legislation involving cuba. we've lifted the ban on using the usda programs to enhance export opportunities to the island of cuba. first time we've addressed cuba in any major piece of legislation. yes, i don't know if senator carper is here but i care about the post office. you ought to, too. we've ig noor -- ignored it way too long. i'm going to give a shout out and get people interested because i've not going to be your partner on the post office. those who care about politics, i want you to understand when i made a post fix my mail thinking i'd get 20, 30 hits. in the little state of north dakota i got over 500 complaints of what is happening with rural post delivery. if we can't run the post office,
how can we run the country? you all need to ask yourselves that question. i'm also incredibly proud of the stuff that i've done every day for north dakotans. in six years i've held over 3,400 meeting in north dakota, both in washington and with north dakotans in washington and north dakota. my office has provided responses to over 204,000 north dakotans who reached out to me on various issues. and my office has helped over 18,000 north dakotans with federal agencies getting their v.a. benefits, fixing issues with social security, helping resolve immigration and much, much more. people always ask me, what's your greatest achievement in the senate? and i -- you know, i can go through all of the things i just talked about. but i like to talk about one thing. it's a native american. he's from spirit lake nation, and he is a pipe maker, which is a very ceremonial and honorable position within their culture.
he's also a korean war vet, and he was one of the first people on the peninsula. he was captured -- injured, captured and literally saved lives during what was called the tiger death march . he ended up serving the entire korean war in a korean concentration camp. when he got out, no one knew who he was. there was no documentation of the fact that he was in the prison of war camp. notifies documentation that he'd been injured. -- there was no documentation that he had he'd been injured. senator dorgan was able to get him his p.o.w. award. but he also didn't get his purple heart. that bothered him because he had served and he had done incredible things in that service. so we were able to find, scouring the earth, and found him in texas, mr. president, somebody who would sign an affidavit who said, yes, he had been injured. and when we presented that purple heart to that veteran, 86
years old, he got out of his wheelchair, he saluted the chair during the flag song, and he hugged his medal. you all have the power to do that. you all have the power to make just one little difference. do that. do that and it is a great thing, even though it is not big legislation. so knowing that we are doing the work of the people and knowing that so many north dakotans have met with me and told me about incredible challenges that they have, incredible obstacles that they face and that you can make a difference -- you can help put food on their table. you can help them remain to be a family. you can help get them health care. you can do big things. but the little things matter, too. the little things that affect each one of their lives. so despite all the progress we've made during some difficult times, we aren't done. every day i come to the floor
fighting for rural america. you know, there is a huge gap in productivity, a huge gap in economic viability. there is a huge gap. and as we see the retreat of rural america, we become less in this country. as we see more and more wealth moving to urban areas, we have to address this issue. and there are big clouds i think on the horizon facing this country in rural america. if congress doesn't tackle them head oven, our children and grandchildren will suffer the consequences. and this is an urgency that takes center stage for me. i always said, the thing i wake up every morning thinking, what am i going to do about rural america today. you know why? because i am one of the few people here that does. that's because i represent a state that is still very rural, even if you live in fargo -- and i know it is not a big city to some of you, but it is a pretty big place to some of us in north dakota. you're just one generation from,
you know, hillsborough, you're one generation from coopersville. so i also want to say that we cannot sustain record debt and deficit. this is a bipartisan challenge. this is a challenge of historic proportions. we are the only generation in america and in our history who has inherited from the greatest generation, our parents, and we are borrowing are from our kids. shame on us. shame on what we are doing right now. the congressional budget office has said our country's debt is headed to the highest level since world war i or world war ii. these actions will have serious consequences, including increasing the chances of a fiscal crisis, which we can't ignore. i urge you to put fact before fantasy -- fact before fantasy. open your eyes. see this challenge. several months ago when i voted against the tax bill that had greatly contributed, i think, to
record deficits we now face, i ran into an older man after i'd give an speech at the veterans day service. and he came up to me -- it was actually before the vote. he came up to me and he said, senator heitkamp -- i said, yes, sir? he said, i want a tax break. i said, i hear that a lot. and he said, but not at the expense of my kids. he's still a patriot, that vietnam veteran. he still knows what it means to sacrifice for the next generation. so the federal government needs to be responsible in how they spend their money. i'm grateful that my friend james lankford is here because we toiled at way at government efficiency. we toiled away to try to make -- in spite of our ideological differences many times, in spite of how we view -- our world view on issues, we believe this government needs to be efficient, it needs to be effective, he needs to spend money the right way. we marveled that no one seemed to care about it except to show
up for an occasional meeting. that work can't stop and i hope you find an equal and willing partner in your work, senator lankford, but a i know for you that this is a moral impairive, to spend every dollar the right and most efficient way, to do things right. when we can tell the american public that we are spending their dollars responsibly, that we are making the right choices, we will have many, many more options and we will grow the reputation, not only of the united states government but of the united states senate. income disparity is at crisis with more individuals and families getting left behind. the top 1% of families in america make more than 25 times what families make in the bottom 99%. think about that. let me repeat that. 25 times what families in the bottom 99% make. and much of the recent economic prosperity we've seen in this country has been concentrated on
the coastment, leaving much of rural -- on the coast, leaving much of rural america behind. the administrative trade war, not something i have been shy talking about, is causing an emergency in rural america. but i think it is going to cascade into a challenge and it's going to domino into an economic peril for this country. i'm not saying that we don't need to address disparities, inequities in trade agreements. i am saying that you don't need a 17th century solution, which is called a tariff, to deal with a 21st century problem. think about this. think about the unilateral ability of the white house to impose a tax on the american people, and then, even more remarkably, to create a system over at the department of commerce to basically waive those taxes. how many of you would let the president decide who he's going to tax if it were income taxes and then who he's going to
waive? none of you would. take responsibility. congress needs to take back responsibility for tariffs before it's too late. and these markets took years to develop for agriculture. they are not going to come back at the snap of a finger. when you look at net farm income, it will be 13% lower in 2018, with no promise for an increase in net farm income in the future. this will cascade through rural america. i also with aens to sound the alarm -- and it goes to senator blunt did a wonderful job. being the worst of a familiar physician, who tells me every day that if he could only get his clients compliant with their hypertension and diabetes. and the single biggest factor is behavior. despair leads to a record rate of suicides. the economist magazine did a big
story on suicide. only one country is increasing -- and that's the united states of america and the developed nations. the rate of death by suicide jumped 58% in north dakota between 1999 and 2016. that's why we have made it a priority in my office to address those underpinning causes of death by suicide. and the challenges that we confront in various pockets of our population, whether it is our veterans, whether it is native americans, whether it is young people and now the growing rate of suicide among the elderly. congress has to take steps, and there is bipartisan support for addressing mental and behavioral health. and looking at comprehensive crisis of addict. and can we just -- as long as i got the soapbox and you're all listening to me, can we quit just talking about opioids? can we start talking about methamphetamine, alcohol, about a culture of addiction and not just focused on the opioid
addiction. it is the bright, shiny object that we always run to but it is a cover story for a much bigger problem that we are not addressing in this country. and so, please, please face the addiction challenge head-on. and in a broader context. i also would not be me if i didn't talk about indian country, facing dire challenges with poverty, abuse, and addiction. far too many americans fully understand the challenges in indian country or the importance of tribal sovereignty, treaty rights and cultural heritage. i have worked to educate many about those challenges, along with my colleague, lisa. i've also talked about the challenges of runaway and missing people with my colleague susan collins, who has been a great partner on so many things that i've done. and i think that when you find people of like heart and like commitment, we can do amazing and good things for the american
public. but we all need to understand that the first people, our first americans should not be the last americans. they should not be ignored. and when you have a unique -- a knew unique position here, given that your government, the united states government, signed treaty and sovereignty rights. so when you look at the disparities, you can't believe that we've done right by the treaties. finally, i want to talk about the crisis of childhood trauma, which i've already addressed, but just to give you some numbers. and they may be things that you wasn't thought about. according to a justice department study, 58% of all american children have witnessed or have been a crime victim in 2014. traumatic experiences like abuse, neglect,ens withing crimes, parental conflict can lead to ongoing severe mental and behavioral health
complications. for native children, she is are much more prevalent. so when we look at the challenges ahead, there are larger issues for congress to confront. members of congress can't just look for a quick win to talk about in their states without taking into account the long-term consequences of their actions. we need to look up and we need to look bigger. so that congress is creating a solid future for our children and our grandchildren. if we do nothing, that -- if we do nothing else in this chamber, that would be an important first step. everyone in congress makes their own decisions about how you want to use your time, and it can come down a few simple questions. do you want to solve problems or not? do you want to do right by your children and your grandchildren and that means all of our children and our grandchildren? do you want to win reelection at no matter what the cost? do you want to be able to look yourself in the mirror and say, i did good today?
i implore those still serving and those about to jo inthis chamber to seriously take up that's questions. for many of you, all of those priorities are the same. in fact i i thought we should do an experiment. one tuesday, i challenge you, you have the democratic caucus and their lunch give a list of the ten problems that america confronts that they want to solve and have the republican conference do the same thing. and i would just bet you that if you match those two lists, they would look pretty similar. they'd probably be identical. when the american public sees that, that you know the problem yet you can't find the will to solve the problem, then they become understandably discouraged. so my work isn't done. and i will continue to do this work from a different vantage point. so as you soon start work in the next congress with all of these challenges, please consider a few things.
the senate only works in we enable it to. that means each of us need to do our job and we may not always agree, but i know senators can work together, as i have, to get results. and i know that gridlock and partnership does not have -- and partisanship does not have to rule the day. i've seen it firsthand. a little ad-lib here. i also think that you as senators need to take power back from leadership. too often leadership determines the agenda. we should determine the agenda. so i've seen it firsthand. i've seen that we can come together and solve problems whether it's a climate change advocates along with climate deniers coming together on a carbon bill. if that is an indicator that congress can function, i don't know what is. but it took political courage on both sides, particularly with my colleague from rhode island. so i don't believe that this country or the caucus is as divided as it seems. all of us, those