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tv   Key Capitol Hill Hearings  CSPAN  May 13, 2015 2:00am-4:01am EDT

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overty. so instead of how to push a trade bill we ought to be raising the minimum wage. we should make college more affordable. to have social security that still pay off student loans. that is a shame upon america. . . about how to bring a trade bill to this floor why don't we fix the student loan problem? why don't we raise the minimum wage? why don't we pass a highway bill that is funded to help middle-class people? it's all a matter of perspective, my friends. we still haven't done equal pay for equal work, so women are not making what they should. and that hurts our women when they retire. they've lost more than $400,000
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in income. so instead of standing in the corner and figuring out how to bring a trade bill to the floor they ought to be fixing equal pay for equal work, they ought to be fixing student loans for our students, they ought to be passing a highway bill, they ought to be increasing the minimum wage, and they ought to deal with currency fairness because our trading partners, they play with their currency in order to push forward their products. but oh, no ... that is not on the agenda. we could have an agenda for a vibrant middle class but instead of that, we are moving toward a trade bill. now, i know there are some who disagree with me, who come down this floor and say we're going to create jobs with this trade bill it's going to be great. well let them explain how we're not going to see some of the 12
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million jobs that are manufacturing jobs in america not move to countries who pay 56 cents an hour. another country $1.19 an hour. i know they'll disagree with me. they're making all of these promises. and, you know, the more i hear it the more i hear the echos of the nafta debate. now, that was a long time ago and i was here then. in 1988, i voted for fast-track authority to allow the administration to negotiate the north american free trade agreement. then five years later i saw the deal. it was a bad deal, and i voted no. but it was too late because when i saw the deal, i knew i couldn't fix it because that's what fast-track is.
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and what this majority here today is saying to us is, vote for fast-track and give up your right, senator boxer from amending this trade agreement. so they say well, it's very transparent. go down and look at it. well let me tell you what you have to do to read this agreement. follow this: you can only take a few of your staffers who happen to have to have a security clearance -- because god knows why, this is secure; this is classified. it has nothing to do with defense. it has nothing to do with going after isis. it has nothing to do with any of that. but it is classified. so i go down with my staff that i could get to go with me, and as soon as i get there the guard says to me, hand over your electronics. okay give over my electronics. then the guard says, you can't
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take notes. i said, i can't take notes? well, you can take notes but you have to give them back to me and i'll put them in a file. so i said, wait a minute. i'm going to take notes and then you're going to take my notes away from me and then you're going to have them in a file, and you can read my notes? not on your life. so instead of standing in a corner trying to figure out a way to bring a trade bill to the floor that doesn't do anything for the middle class, that is held so secretively that you need to go down there and hand over your electronics and give up your right to take notes and bring them back to your office, they ought to come over here and figure out how to help the middle class how to extend the highway bill, how to raise the minimum wage how to move toward clean energy, how to fix our
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currency manipulation that we see abroad. so anyway, take you back to 1988. i vote for fast-track, for nafta. instead of the million new jobs that were promised, by 2010, the united states had lost 700,000 jobs. so instead of standing in a corner figuring out how we're going to lose more jobs, we ought to do something that works for the middle class. let me tell you what happened with nafta. instead of improved pay for our workers, which was promised, nafta pushed down american wages. it empowered employers to sty their workers either -- to say to their workers either accept lower wages and benefits or we are moving to mexico. instead of strengthening our economy, it increased our trade deficit to mexico, which know
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this year hit $50 billion. before nafta we had a trade surplus with mexico. now we have a trade deficit. so instead of standing in the corner and figuring out how we can have more trade deficits with countries we ought to do something to help the middle class. i want to talk about something that happened in california in santa ana right after nafta. the city had worked hard to keep a mitsubishi plant that assembled big-screen tv's securing tax credits to help the plant stay competitive. even after nafta passed, company officials promised they would keep the plant in santa ana. but guess what, folks? three years later mitsubishi closed the plant. company officials said they had to cut costs especially labor costs, so they were moving their operations to mexico. we lost 400 good-paying
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middle-class jobs, even though everyone promised nafta would never do that, this is going to be wonderful and i got suckered into voting "yes" on fast-track. and i fear we see this pattern again. the definition of "insanity" is doing the same thing over and over and expecting a different outcome. so we have 12.3 million manufacturing jobs in this country, and we are looking at a trans-pacific partnership deal, the largest trade deal in history covering 40% of the world's economy. tell me, what chance do our people who work in manufacturing have against countries that pay less than a dollar an hour? in one case, i think it's 56 cents -- 57 cents -- say it again ... 70 cents an hour. i stand corrected.
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of the 12 countries in the t.p.p. three have minimum wages that are higher than ours -- australia, new zealand and canada. but most of the countries have far lower wages including chile with a wage of $2.14 per sioux withdrew a minimum -- purr rue with $1.38 vietnam with a minimum wage of 70 cents. singapore doesn't even have a minimum wage. they don't have a minimum wage. so i think i have laid out the argument as to why all these promises about better wages more jobs false flate on its face when you look at that -- false flat on its face when you look at that last trade deal and this one is with more countries. and then there is the investor state dispute settlement or isds, which will allow polluters to sue for unlimited money
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damages. for exam -- for example they could use it to try to undo the incredible work done in california on climate change by claiming they were put at a disadvantage by having to live with california's laws. polluters could seek to undermine the president's clean power plant or the toxic mercury pollution under the mercury and air toxic standard, or they could sue because they had to use -- spend a little money to make sure that they didn't dump toxins into our waterways drinking water. now, we've seen this happen before. s.d. meyers did it. they sued. long pine resources sued. the rencco group sued. they notified peru in 2010 and intended to launch an $800 million investor state claim against the government because they said the fair trade agreement was violated because it said that they didn't really have to install all these
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antipollution devices. and yet peru forced them to do it and what happened was polluter pay turned into polluters get paid. so you have a trade agreement that threatens 12 million manufacturing jobs. you have a trade agreement that is pushing off the floor all the things we need to do for our middle class. you have a trade agreement that sets up this extra judicial board that can overcome america's laws. as former labor secretary robert reich has warned, the consequences could be disastrous. he calls the t.p.p. a trojan horse in a global race to the bottom giving big corporations a way to eliminate any and all laws and regulations that get in the way of their profits. so we should set this aside not go to this today work together,
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as democrats and republicans for a true middle-class agenda for a robust investment in our roads, bridges and highways, to fix our immigration system. i see senator leahy's on the floor. he put together a comprehensive immigration reform bill that was amazing but it got stopped and it got stuck and it never happened. and you've got workers in the dark. they're afraid to come out into the sunlight and that puts downward pressure on wages. let's pass that. let's make college more affordable ensure equal pay for equal work and currency fairness. and we can do it. and, mr. president, i'm going to take about three minutes to talk about my last issue today and that is the toxic reform bill that passed out of the environment and public works committee. and i'd ask unanimous consent to put my full statement in the
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record. the presiding officer: without objection. mrs. boxer: well, i have some great news on the front of the toxic bill. the original vitter-udall bill was slain and is gone and in its place is a better bill. that's the great news. the bad news is, it's still not a really good bill. we have to do better and we can do better. what we did in this bill is understand that we had to negotiate certain things out of it and one of the things we had to negotiate was how far the bill went, the original bill in preempting state laws. and we have addressed that. credit goes to want 450 organizations who while they still oppose this bill pushed hard for those changes.
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and credit goes to senators whitehouse and merkley and booker who told me they wanted to try to negotiate some changes and i blessed them and they went and did it. and for that i have to thank a senator who no longer is with us ted kennedy who once taught me, he said, as a chairman you need to understand sometimes that you have to turn to your colleagues and let them move forward. and i was happy to do that. and so the changes that came back were partway fix on preemption, a full fix on preempting air laws and water laws when it comes to toxics coenforcement has been fixed. so we're very, very pleased. what is not really fixed however, is we want to make sure that states have even more latitude to move if they see a danger. we want to make sure that if there's a cancer cluster among
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kids or adults around this country that we can see the federal government move to help them. we want to make sure that asbestos is addressed directly in this bill because 10,000 people a year die because of asbestos exposure. we want to make sure if there's a chemical stored near a drinking water supply that in fact that will receive priority attention. what chemical is in there? we saw it happen in west virginia and senator manchin wrote a really good bill with me. we should address that. and i was happy to see that we got some bipartisan votes on those last two fixes. so we have to fix this bill. and anyone who comes to the floor and says it's perfect i just don't agree with them, but that's not important what i think, it's what 450 groups think. they think the bill has to be fixed.
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so let's be clear. the people who say we have to fix the bill with perfecting amendments include the american public health association the public health nursing section the asbestos disease awareness organization the consumers' union, the institute for agriculture and trade policy the national disease clusters alliance the national hispanic medical association the birth defects research for children physicians for social responsibility the maryland nurses association, the massachusetts nurses association the national association of hispanic nurses, the association of women's health obstetric and neonatal nersz, the bladder cancer advocacy group the breast cancer the breast cancer fund huntington breast cancer action coalition, kids versus cancer lung cancer alliance. it goes on and on. i ask unanimous consent to put
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the full list of these groups into the record. the presiding officer: without objection. mrs. boxer: so i say to my colleagues the vitter-udall bill is much better than it was when it was introduced. and these 450 groups did everything in their power to help us fix the bill. we're halfway there. and i hope we can negotiate some more fixes and maybe we can do that. if we can pass four or five of these amendments we're on our way. but if we can't fix the bill and it does come here, there will be a lot of talking about how to fix it. a lot of talking a lot of standing on feet a lot of rallies with 450 groups. so that's the choice the senate faces. and in the end, in the end we'll deal with this. but i just took to the floor today to thank my colleagues who helped negotiate this from a bill that was a disaster to a
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better bill and i also want to make sure that these 450 organizations -- just extraordinary what they did standing up for safer chemicals healthy families, nrdc -- these groups were so fantastic. they never allowed people to talk them down to bully them out of the room. and i stand with them 100%. asbestos disease awareness, you were incredible. so we have some hope here and all we have to do is keep on fixing this bill and it could come to a good place. mr. president, i so appreciate the patience of my colleagues. i've talked long about two bills , very important. i hope we will not get on this trade bill. i hope we will move to an agenda for the middle class. thank you very much. a senator: mr. president? the presiding officer: the senator from delaware.
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mr. carper: mr. president, i want to hearken back about six months, if i could to the election of last november. for me there were at least three takeaways from that election. one of those is the voters of this country want us to work together across party lines. number two, they want us to get things done. and the among the things they want us to get done are find ways to strengthen the economic recovery that's been underway now for several years. senator boxer has referred to a couple of things that would be on that to-do list. a robust six-year transportation bill that rebuilds our roads highways bridges transit systems, puts a lot of people to work helps to strengthen our economic recovery by making some more efficient effective transportation network to move products and goods all over this country and outside of this country. we need to strengthen our cybersecurity. we need to address data
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breaches. all the attacks that are going on to -- throughout this country, businesses, colleges, universities you name it. we need tax reform that actually provides some predictability in the tax system and makes our tax code at least on the business side more competitive with the rest of the world. and we also need to acknowledge as the president has done that 95% of the -- the world's market lies outside of our borders. 95%. the fastest-growing part of that market around the world is asia. the president has suggested supported strongly a trade agreement that would involve 12 nations, including about a half dozen here in this hemisphere and the other half over in asia that altogether encompass about 40% of the world trade market. and the president is not suggesting that we just open up
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our markets so that other countries can sell more of their stuff here. they already do that, for the most part. the -- the goal of this trade agreement is to open up these other markets in other countries so we can sell our goods our products and our services there. this is a top priority for this administration and this should be a top priority for democrats and republicans and a priority that's hammered out and compromises that are hammered out that are fair to workers and middle-class families. the majority leader has come here today to suggest a path forward. i hope we'll not reject it. what he suggested is we allow through a vote, a cloture motion, to move to the floor and begin debate on four different pieces of legislation that are part of the transportation agreement.
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we've seen this movie before. in fact, we've seen it any number of times before because we've given trade promotion authority to every prince since world -- president since world war ii since richard nixon. and the reason why is it's impossible for 435 people of congress to negotiate a trade deal whether it's three nations or 11 nations. it's pretty much impossible. that's what you have trade promotion authority. the majority leader suggested this, let's move to the -- these four bills. let's begin the debate. we should realize as democrats we've already realized a great victory here. in the past, the republicans have rejected our efforts almost every time to include trade assistance adjustment. when folks are displaced from their jobs, that they actually get some help on their health care and job training and have an opportunity to put their lives back together. in this case, we actually
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have -- with this legislation today the trade promotion authority, which actually expresses our views as a congress to our trading partners and negotiating partners overseas, but the -- in return for doing that, and i think that's in our interest, but the other thing we get out of moving t.p.a. with t.a.a. together is that we get upfront the assurance that we're going to look after workers that are displaced. it's the best trade adjustment assistance we've ever had at least in the terms it treats workers and displaced workers. even those who are maybe not even affected by this agreement but are affected by other calamities in our economy. not just in the manufacturing sector but also in the service sector as well. so i suggest this to my colleagues. let's spend the time between now and 2:30 this foong -- this afternoon trying to figure out how we can establish some confidence and faith and trust
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here that if we move to this bill it will not be just to consider trade promotion authority and trade adjustment assistance. we'll have an opportunity to consider the other two pieces of legislation as well. there's a lot riding on this. a lot riding on this. the economic recovery of our country does rise or fall simply on the passage of this -- of this legislation and the conclusion of the negotiations but it sure would help. it would sure help bolster a stronger economic recovery. just as would the passage of a six-year transportation bill. just as would cybersecurity legislation, data breach legislation and on and on and on. so i'll close with this thought. the debates we've had here in recent months with respect to the negotiations between the five permanent members of the security council the germans and the iranians on the -- our efforts to make sure the iranians don't have -- don't
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develop a nuclear weapon. we have said again and again and again, we have reworked the old reagan slogan trust but verify. except with the iranians, we have not said trust but verify, we have said mistrust but verify mistrust but verify. i would suggest to my colleagues especially on this side of the aisle let's take that approach here. maybe we don't trust the republicans that they're going to do what they say they're going to do, but we have an opportunity to verify, and the verify comes with a vote later on. we go to the bill, we vote for -- actually move to the bill debate the amendments and so forth. at the end of the day we're not happy with what's happened. we feel like we have been given a raw deal. that workers in this country middle-class families have been given a raw deal, we have a chance to verify and we vote not to move the bill off the floor. we would not provide cloture to end debate. that's where we have our final vote our final. i would hope we would keep that in mind.
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with that, mr. preside mr. thune: mr. president later today the senate will vote on whether or not to proceed to a bill that was reported out of the senate finance committee on which i serve the trade promotion authority legislation. and what's sort of remarkable about this is that we are on the cusp here in the united states senate of passing a major piece of legislation bipartisan legislation in which a republican majority in the united states senate is working with a democrat president to give him trade promotion authority -- something that would be very good for our economy. and if the democrats here in the senate don't blow it, this could be a major hallmark achievement of this congress. but my understanding is there's an effort on the other side now to prevent us from even getting on the bill to debate it, and i hope that as democrats
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contemplate that move that they'll think long and hard about what they will be doing. because not only will they be undermining their own president who is very much for this they will be hurting the american economy. because every president literally back to f.d.r. has had trade promotion authority in which he has the ability to negotiate trade agreements with other trading partners in a way that congress ultimately has to approve but in a way that expedites and gives maximum amount of leverage to get the best trade agreement possible. so we're taking up that legislation hopefully later today, but it's all going to depend on senate democrats and whether or not they want to proceed to this bill or not. and i certainly hope, as i said, that they will come to the conclusion that it's in the best interests of our country of our economy and certainly i think in the best interests of creating a bipartisan achievement here in which they're working with their own president and with republicans here in the united states senate.
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mr. president, with 96% of the world's consumers outside the borders of the united states trade is essential to growing our economy and opening new markets for products marked "made in the u.s.a." over the past few years exports have been a bright spot in our economy supporting an increasing number of american jobs each and every year. in fact, in 2014 exports supported 11.7 million u.s. jobs and made up 13% of our nation's economy. my home state of south dakota alone, exports support more than 15,000 jobs in industries that range from farming and ranching to machinery and electronics. we need to continue to open markets around the globe to american goods and services. and the best way to do that, mr. president is through new trade agreements. countries with which we have free and fair trade agreements purchase substantially more from
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us than other countries. in fact, in 2013 free trade agreement countries purchased 3412 times more goods and services per capita from the united states than non-free trade agreement countries. let me restate that, mr. president. in 2013, those countries with whom we have a free trade agreement purchased 12 times more goods per capita from the united states than those countries with whom we do not have a free trade agreement. and it's not just american farmers and ranchers and manufacturing -- and manufacturers who benefit from trade agreements. american consumers benefit as well. trade agreements give american families access to a greater variety of goods at lower prices the u.s. chamber of commerce estimates that trade increases american families' purchasing power by $10,000 annually. for american workers increased trade means more opportunity and
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increased access to high-paying jobs. manufacturing jobs tied to exports pay on average 13% to 18% more than wages in other areas of our economy. unfortunately while trade agreements are proliferated around the globe over the past several years the united states hasn't signed a new trade agreement in five years. altogether the united states has just 14 trade agreements currently in effect. mr. president, that's a lot of lost opportunity for american workers and businesses since trade agreements have proved to be the best way to increase demand for american products and services. a big reason for the lack of trade agreements in recent years is the fact that trade promotion authority expired in 2007. as i said earlier since 1934 you have to go back to the administration of f.d.r., almost all of the united states free trade agreements have been negotiated using trade promotion
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authority or a similar streamlined process. trade promotion authority is designed to put the united states in the strongest possible position when it comes to negotiating trade agreements. under t.p.a., congress sets guidelines for trade negotiations and outlines the priorities the administration has to follow. in return, congress promises a simple up-and-down vote on the resulting trade agreement instead of a long amendment process that could leave the final deal looking nothing like what was originally negotiated. that simple up-and-down vote is the key. it lets our negotiating partners know that congress and trade negotiators are on the same page which gives other countries the confidence they need to put their best offers on the table. and that in turn allows for a successful and timely conclusion to negotiations. currently the administration is negotiating two major trade agreements that have the potential to vastly expand the
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market for american goods and services in the european union and in the pacific. the trade promotion authority is being negotiated with a -- the trans-pacific partnership is being negotiated with new zealand, and vietnam. if this agreement is done right, it could have huge benefits for american agriculture among other industries. currently american agricultural products face high tariffs. poultry tariffs poultry tariffs in t.p.p. countries for example can reach a staggering 240%. reducing the barriers to american agriculture -- agricultural products face in these countries would have enormous benefits for american farmers and ranchers. agricultural producers in my state of south dakota have contacted me to tell me how trade benefits their industries and urge support for trade promotion authority as the most effective way to secure trade agreements that will benefit
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south dakota farmers and ranchers. a leader of the south dakota dairy association wrote about the benefits for south dakota dairy farmers and urged me to vote in favor of trade promotion authority. the trans-pacific partnership he said -- and i quote -- "have the potential to be positive for our dairy industry but only if the united states insists on settling for nothing less than a balanced deal that delivers net trade benefits for the dairy industry passing t.p.a. is a key part of getting there" -- end quote. it's have a dairy producer in my state of south dakota. mr. president, passing t.p.a. is a key part of getting there. neither the trans-pacific partnership nor the u.s.-e.u. trade agreement is likely to be completed in a timely fashion without trade promotion authority. if we want to make sure that trade negotiations achieve the
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goals of american farmers and manufacturers, trade promotion authority is essential. the bipartisan bill that we're considering on the senate floor this week reauthorizes trade promotion authority and includes updates like provisions to strengthen the transparency of the negotiating process and ensure that the american people stay informed. it also contains provisions that i pushed for to require negotiators to ensure that trade agreements promote digital trade as well as trade in physical goods and services. given the increasing importance of digitally enabled commerce in the 21st century economy, it is essential that our trade agreements include new rules that keep digital trade free from unnecessary government interference. mr. president, this trade promotion authority bill will help ensure any trade deals the united states enters into will be favorable to american farmers
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and ranchers and manufacturers and hold other countries accountable for their unfair practices. passing this bill is essential to prevent american workers and businesses from being left behind in the global economy. since republicans took control of the senate in january democrats and republicans have come together on a number of issues to pass legislation to address challenges that are facing our country. i hope that this bill will be our next bipartisan achievement. the president has made it clear that he supports this bill and key democrat senators are working to make sure that it passes. i hope, mr. president that the rest of the democrat party here in the united states senate will come together with the president and republicans to get this done. as president obama said the other day -- and i quote -- "we have to make sure that america writes the rules of the global economy because if we don't write the rules for trade around the world, guess what -- china
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will and they'll write those rules in a way that gives chinese workers and chinese businesses the upper hand and locks american-made goods out" -- end quote. that from president obama. put another way mr. president if america fails to lead on trade, other nations will step in to fill the void and not have the best interests of american workers and american families in mind. it is time to pass trade promotion authority so that we can secure favorable new trade deals and ensure that american goods and services can compete on a level playing field around the globe and american workers and american consumers can see the benefits that come along with that. i hope that will be the outcome of the vote today mr. president. and i hope that, again it will be a major achievement for this senate a bipartisan achievement in which both sides worked together for the good of our economy for the good of jobs, for the good of higher wage levels for american workers
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and for the good of a more competitive economy in which our consumers benefit. mr. president, i yield the floor. a senator: mr. president? the presiding officer: the senator from vermont. mr. sanders: thank you mr. president. mr. president, at 2:30 this afternoon the senate will be voting on a motion to proceed to the fast track bill that the finance committee recently opposed approved. i will be stronglily opposing that legislation. here's why -- in a nutshell here is the reality of the american economy today. while we are certainly better off than we were six and a half years ago the truth is for the last 40 years the american middle class has been disappearing. the truth is that today we have some 45 million americans living in povertyth almost the highest rate in the modern history of america.
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and while the middle class continues to shrink, we are seeing more income and wealth inequality than at any time in our country since 1929, and it is worse in america than any other major country on earth. today, 99% of all new income is going to the top 1%. today, the top .1% owns almost -- almost as much wealth as the bottom 90%. in the last two years mr. president, the 14 wealthiest people in this country have seen an increase in their wealth of $157 billion. that $157 billion is more wealth than is owned by the bottom 130 million americans.
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how is that happening? why is that happening? we have seen a huge increase in technology productivity is way up and the reality is that most working people should be seeing an increase in their income and yet median family income has gone down by almost $5,000 since 1999. how does it happen? why is it happening that in the richest country in the history of the world almost all of the new wealth is now in the hands of the few while the vast majority of the american people are working longer hours for lower wages? how does it happen? well, there are a lot of factors but let me tell you that our disastrous trade agreements -- nafta cafta permanent normal trade relations with china -- are certainly one of the major reasons why the middle class is in decline and why more and more income and wealth goes to a
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handful of people on the top. president, mr. president the -- mr. president, the sad truth of the matter is many of the new jobs created in this country today are part time and low-paying jobs. 30 or 40 years ago working people who maybe had a harm degree could go out and get a job in a factory. they never got rich, it wasn't a glamorous job but you know what they had enough wages and benefits to make it into the middle class. but since 2001, we have lost almost 60 thigh factories -- 60,000 factories in america. and today when young people graduate high school they don't have the opportunity to work in a factory and have a union job and make middle-class beiges wages. their options are wal-mart, mcdonald's low wages minimal benefits, companies that are vehemently antiunion.
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mr. president, the sad truth of the matter is that we are in a race to the bottom. and not only have our trade agreements cost us millions of decent-paying jobs but they have depressed wages in this country because companies and virtually every major multinational corporation in this country has outsourced jobs shed millions of american jobs, what they say to workers is not if you don't like the cuts in health care, you teen like the cuts in wages we're going to go to china and we can hire people there for a buck an hour. sadly, mr. president the trans-pacific partnership agreement follows in the footsteps of these other disastrous free trade agreements that have forced american workers to compete against desperate and low-wage workers
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around the world. mr. president, over and over again -- and i have heard this so many times -- i heard it just on the floor this morning -- supporters of fast track have told us that unfettered free trade will increase american jobs and wages and will be just a wonderful thing for the american economy. sadly, however these folks have been proven wrong and wrong and wrong time after time after time. i hear the same language and every time what they say just proves not to be true. let me just mention to you some quotes from the supporters of nafta. this is what people were telling us about how great the free trade agreement or the nafta free trade agreement would be. on september 19, 1993, president bill clinton said the following -- he was, of
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course president pushing nafta in the same way that president obama is today pushing the t.p.p. this is what clinton said -- and i quote -- "i believe that nafta will create 200,000 american jobs in the first two years of its effect. i believe that nafta will create a million jobs in the first five years of its impact" -- end of quote. in 1993, it's not just liberals like bill clinton here's the very conservative heritage foundation in 1993. this is what thieved -- and i quote -- "virtually all economists agree that nafta will produce a net increase of u.s. jobs over the next decade" -- end of quote. 1993 the distinguished senator from kentucky, our majority leader mitch mcconnell said -- and i quote -- "american firms will not move to mexico just for lower wages" -- end of quote by mitch mcmcconnell. is what president clinton is what the heritage foundation, is that what mitch mcconnell said turn out to be correct?
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of course, it did not. what happened was exactly the opposite of what they said. according to the economists at the economic policy institute navy has led to the loss of more than 680,000 jobs. in 1993 the year before nafta was implemented, the united states had a trade surplus with mexico of more than $1.6 billion. last year the trade deficit with mexico was $53 billion. so all of the verbiage that we heard about nafta being so good for american workers turned out to be dead wrong. what about china? we were told my god the chinese market will be open, billions of people, what a opportunity to create good pic jobs in america. this is what the proponents of permanent normal trade relations with china had to say. president clinton again in 1999, bill clinton -- quote -- "in opening the economy of chain
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the agreement will create unprecedented opportunities for american farmers workers and companies to compete successfully in china's market. this is a 100-0 deal for america when it comes to the economic consequences" -- end quote. conservative economists at the cato institute inth 1999 this is what they said, the silliest argument against pntr is chinese imports would overwhelm u.s. industry. in fact, american workers are far more productive than their chinese counterparts, pntr would create n.r.a. more export opportunities for america than for the chinese" -- end of quote. wow, were they wrong. the economic policy institute has stated that pntr with china has led to the net loss of 2.7 million american jobs. go to any tent store in america, walk in the door, where are the products made? china, china china
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vietnam, other low-wage countries. in fact, it is harder and harder to buy a product not made in china. so all those people who told us what a great deal pntr with china would be turned out to be wrong, dead wrong. in fact, our trade agreement with china has cost us almost three million jobs. in 2001, the trade deficit with china was $83 billion. today it is $342 billion. in 2011 -- on another trade agreement -- u.s. chamber of commerce, big proponents of unfettered free trade strongly supporting t.p.p. chamber of commerce told us we had to pass a free trade agreement with south korea because it would create some 280,000 jobs in america. 280,000 jobs, a lot of jobs. turns out wrong again. in reality economic policy
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institute recently found that the korean free trade agreement has led to the loss of some 75,000 jobs. and now mr. president the obama administration says trust us. forget what they said about nafta. forget what they said about korea. forget what they said about china. this one is different. really really. cross our fingers hope to die. this one is really, really different. yes, it may be true that every corporation in america corporations that have shut down factories in this country moved to china they're supporting this agreement. yeah it's true that wall street whose greed and recklessness have almost destroyed the american economy they're supporting this agreement. yes, it is true that the pharmaceutical industry who charges us the highest prices in the world for prescription drugs, they're supporting this agreement. but not to worry, we should trust these guys. they really are thinking of the
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american middle class and working families. trust us. when they tell us a trade agreement will be good for working people, yes, we should really trust them. meanwhile every trade union in america, the vast majority of environmental groups in this country, they are saying be careful about t.p.p. vote "no" on fast track. mr. president, here is the reality of the american economy. since 2001, we have lost 60,000 factories in this country and we've lost over 4.7 million manufacturing jobs. in 1970, 25% of all of the jobs of this country were in manufacturing. today that figure is down to 9%. and the point here is that by and large especially if there were unions, those manufacturing jobs paid working people a
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living wage, not a wal-mart wage not a mcdonald's wage. our demand must be to corporate america who tell us every night on tv to buy this product to buy this pair of sneakers, to buy this television, to buy whatever it is, that maybe just maybe they might want to start manufacturing those products here in the united states of america, pay our workers a decent wage rather than look all over the world for the lowest possible wages at which they can exploit workers who are desperate. mr. president, i was very disappointed that president obama chose the headquarters of nike to tout the so-called benefits of the t.p.p. nike epitomizes why disastrous unfettered free trade policies during the past four decades have failed american workers. nike does not employ a single
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manufacturing worker who makes shoes in the united states of america. not one worker. 100% of the shoes that are sold b'nai key are -- that are sold by nike are made overseas in low-wage countries. when nike was founded and this is the transformation of the american country when nike was founded in 1964, just 4% of u.s. foot wear was imported. in other words we manufactured the vast majority of the shoes and the sneakers that we wore. today nearly all of the shoes that are bought in the united states are manufactured overseas. today over 330,000 workers manufacture nike's products in vietnam, where the minimum wage is 56 cents an hour. and i hear president obama and other proponents of t.p.p. talking about a level playing field. we have to compete on a level playing field.
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does anybody think competing against people, desperate people who make 56 cents an hour is a level playing field is fair to american workers? of course we want the poor people all over the world to see an increase in their standard of living and we've got to play an important role in that. but you don't have to destroy the american middle class to help low-income workers around the world. in vietnam not only is the minimum wage 56 cents an hour, nonpartisan -- independent labor unions are banned and people are thrown in jail for expressing their political beliefs. is that the level playing field that president obama and other proponents of unfettered free trade are talking about? back in 1988, phil knight -- phil knight is the founder and owner of nike -- he said that nike had become synonymous with slave wages forced overtime and
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arbitrary abuse. phil knight was right. in fact, factories in vietnam where nike shoes are manufactured have been cited by the workers rights consortium for excessive overtime, wage theft and physical mistreatment of workers. today mr. knight is one of the wealthiest people on this planet worth more than $22 billion. while mr. knight's net worth has more than tripled since 1999, the average vietnamese worker who makes nike shoes earns pennies an hour. that is pretty much synonymous with what unfettered free trade is all about. a handful of people like phil knight become multi multibillionaires and poor people all over the world are exploited and paid pennies an hour. mr. president, it is not just nike and it is not just vietnam. another country that is part of
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the trans-pacific partnership is malaysia. today there are nearly 200,000 electronics factories in malaysia where high-tech products from apple dell, intel, motorola instruments are manufactured and brought back to the united states. if the t.p.p. is approved, that number will go up substantially. well what's wrong with that? it turns out that many of the workers at the electronics plants in malaysia are being forced to work there under horrible working conditions. according to veritay which conducted a two-year investigation into labor abuses in malaysia, an investigation which was commissioned by the u.s. department of labor 32% of the industry's nearly 200,000 migrant workers in malaysia were employed in forced situations because their passports had been taken away because they were straining to pay back illegally high recruitment fees. in other words american workers are going to be forced to compete against people in
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malaysia immigrant workers there whose passports have been taken away, who can't leave the country, who are working under forced labor situations. so mr. president let me conclude by saying this. all of us understand that trade is good. it is a good thing. but i think most of us now have caught on to the fact that the trade agreements pushed by corporate america pushed by wall street, pushed by the pharmaceutical industry are very very good if you are the c.e.o. of a major corporation but they are a disaster if you are an american worker. so it is my view that we have got to rebuild manufacturing in america. it is my view that we have got to create millions of decent-paying jobs in america. it is my view that we need to fundamentally rewrite our trade agreements so that our largest
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export does not become decent-paying american jobs. so i would urge my colleagues to vote "no" on the fast-track agreement. let us sit down and work on trade agreements that work for the american middle class that work for our working people and not just for the c.e.o.'s of the largest corporations in this country. and with that, mr. president, i would yield the floor and i
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officials, veterans advocates, and healthcare providers.
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>> we have a vote on the floor which should be over in the next ten minutes. i will talk a little bit and tell you what i want you to know. i will start with testimony from sloan gibson. make the note that his staff said that was okay. i want to take extra time because this is an important hearing. last year culminating with the passage of the veterans choice bill problems in raleigh, denver come orlando
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and answers that were in completed for understandable reasons. just left about a year early. gone as well. there was a transition. there is no excuse for the plethora of problems, and the transition should have been much better, but was not. va demonstrated that they were finally listening. all i was hearing was nothing but stonewall until finally sloan walked into the hearing, pulled out a new rule to make the number of miles driven which i think everyone in this committee appreciates and agrees with. i believe we are satisfactorily working toward the care you need.
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it will happen in the near future. i no some of you do not like the veterans choice bill because they fear it will be a replacement for the veterans administration. administration. you will not replace the veterans administration, you can empower it and the veteran by saying they have access to world-class care in close proximity to where they live, and affordable and manageable amount. the va has demonstrated it cannot build a hospital without running over several hundred percent. every time we can provide healthcare without having to build a hospital what we
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need is a partnership between the private sector and veterans administration to deliver the ultimate goal which is to see to it that veterans get world-class healthcare in a timely way. we have had some bumps. i met with private contractors. with va is cooperating in ways it may not have been before the see to it that the two are working seamlessly. private contractors have to understand it is contingent upon there willingness to cooperate with the va. there are some who do not like the non- va healthcare
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provisions anyway but they will have to get used to it because we will make this work. we will make this work for veterans. the hearing is important. understanding that as we talk the 1st person we are here to serve as our veterans. we can expect no less of ourselves to see to it they get the best world-class healthcare. with that said, i turned to the ranking member. >> thank you, mr. chairman. thank you for having this hearing. we went through a terrible tragedy and debacle not long ago that prompted the veterans access choice and accountability act which sought to relieve some of the problems and underlying issues including deceit and
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fraud that caused delays and misreporting within the va system. the discussion today is centered on the remaining flaws and failings in the va healthcare program particularly the veterans choice program. and as much as this program was established to deal with the immediate crisis of access to care in the short term with an investment of 10 billion to 10 billion to provide direct care services in the community and $5 billion to provide a choice program, there is still a lot to be done the program was just a down payment, just a 1st step. i believe that it has to be improved even further. there remains underutilization of the
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choice program. the underutilization may well be the result of the failure to sufficiently publicize or make aware veterans. it may it may be the result of other more fundamental issues within the program and i share the chairman's view that changing the 40-mile rule was certainly a welcome step. the most important fact that brings us here today that we cannot lose sight of is we still have not solved the crisis that led to this program veterans still way too long for appointments healthcare delayed in effect is healthcare denied for veterans who suffer from
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healthcare conditions that require immediate treatment. the va most recent data as of may 1 1st indicates weightless numbers have increased significantly since the same time last month. as of april 2 300,000 veterans 2nd 300,000 veterans had appointment scheduled more than 30 days from the preferred date. as of the may 1 release that number jumped to nearly 434,000. anyone believes this crisis has resolved is living in an alternate universe. it is not the universe that our veterans and have it. real-life consequences that cannot be tolerated. too many veterans are waiting too long for appointments command i am glad that the va is finally
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going out to facilities with long wait times trying to determine why exactly they are not utilizing non- va care options. i notice a lot of the testimony today talked about further changes to geographic criteria. every time there is an additional change more of the 10 billion allocated will be devoted to paying for access but this money is due to our veterans because better healthcare is due to them. i we will i will close on this note: we still do not have accountability. the inspector general has not completed his work. we have no reports on disciplinary action for delays that or intolerable and still are unacceptable.
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accountability is absolutely necessary and i believe the inspector general needs more resources to effectively implement accountability. i will continue to press reports and for action by the inspector general that will send a message to the healthcare apparatus and professionals that we mean what we say when accountability is our launch word. thank you, mr. chairman. >> thank you, senator blumenthal. our 1st panel is made up of the following individuals. sloan gibson. i want to thank him for his willingness to take on tough situations.
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i appreciate the fact he is approaching it in a positive way. i hope you will maintain that attitude. to reiterate secretary mcdonald and undersecretary gibson invited the ranking member and myself for what they call a standup which we did in february and have been invited to come back in june. as many members as want to come i will make sure they are invited. benchmark itself against itself to try to find better ways to do things to flesh out problems in advance and get themselves earlier. we have big problems to solve. we appreciate you being here to assist. i am sure that everyone
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appreciate you being here. providers, mr. mcintyre, i enjoyed our meeting earlier this week. i appreciate your being here today. >> thank you, mr. chairman. chairman, ranking member members of the community we are committed to making the program work and provide veterans timely and geographically accessible quality care using care in the community whenever necessary. i we will talk i will talk shortly about what we're doing and the help we need to make it happen. first i want to talk about access to care. most mornings at 9:00 a.m. for the last year's senior leaders from across the department gather to focus on improving veterans access to care. we concentrate on we concentrate on key drivers of access including increasing medical center
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staffing by 11,000 adding space, boosting care during extended hours and weekends and increasing staff productivity. the result, 2.5 million more completed appointments inside the va this year than last. of relative value units to make common measure of care used to measure care delivered across the industry is also up 9 percent. another another focus area and improving access has been increasingly use of care in the committee. va issued 2.1 million which resulted in more than 16 million appointments completed. here today authorizations are up 44 percent which will result in millions of additional appointments for community care. veterans are responding to this improved access. among those enrolled more
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are using va for care and those using va are increasing their reliance. this is especially the case where we have been investing most heavily. in phoenix we have invested hundreds of additional staff i should note that we have increased care in the committee 127 percent in phoenix over the last year largely due to the extraordinary effort of tri- west in a particular community. wait times are not down. the surge and in addition to five the surgeon additional veterans coming in those there asking for more care. in las vegas we have a 17 percent increase in veterans receiving care.
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in denver we have opened outpatient clinics and that it more than 500 additional staff. veterans are using va for care there up 9 percent. in north carolina were wait times continue to be a problem we have increased appointments 13 percent to my relative value units up 19 percent command veterans using va for care up 10 percent. in all these locations we have had dramatic increases in care for the committee. the primary reason for increasing demand increases in the number of medical conditions and a rise in the degree of disability and improving access to care. community care is critical for improving access. we use it and have for years and programs other than choice. we spent approximately 7.9 billion on committee care other than choice.
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in 2014 that row state and a half billion command reestimate at the current rate of growth va will spend $9.9 billion. at the same time we have had a large increase. it has not worked as intended. here are some things we are doing to fix it. we changed the measure using the fastest route. roughly doubles the number of veterans eligible. there is much more to do. follow on mailing will go out. we just launched a major change to make choice the default option for care. additional additional staff training and communication to make sense of provider communication improvement
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improvement to the website and ramped up social networking, knew mechanisms to gather feedback from veterans as well as frontline staff. these are all in place or are about to launch. in the long-term we must rationalize community care into a single channel. the different programs with different rules and reimbursement rates methods of payment and funding routes are too complicated too complicated for veterans providers, and for employees who coordinate care. we will need your help. let me touch on the other issue. we have completed and that -- in-depth analysis to provide choice to all veterans more than 40 miles from where they can get the care that they need. we have sure that analysis.
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it confirms the extraordinary costs that have been estimated previously. we have briefed the staff on a broad range of other options and believe there are one or more worthy of discussion and careful consideration. while we are working together on an intermediate term solution we are requesting greater flexibility to expand hardship criteria and choice beyond geographic barriers. this would allow us to mitigate the impact of distance and hardship. we request greater flexibility around requirements that preclude us from using choice for services such as obstetrics dentistry command long-term care. as described above, we accelerated access to care in the committee anticipating that a substantial portion would be funded through choice. for various reasons for various reasons most touched on previously we will be
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unable to sustain that pace without greater program flexibility and flexibility to utilize at least some portion of program funds to cover the cost of care in the committee. we are requesting some measure of funding flexibility to support this care. on may 1 the va sent a legislative proposal. we request your support. lastly, we are requesting flexibility in one other area hepatitis c treatment. you are familiar with the miraculous impact of this new generation of drugs veterans that have been have see positive for years now have a cure within reach with minimal side effects. there is no funding provided in our 2015 budget request or appropriation. remove 688 billion from care in the community
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anticipating the shift in cost to choice to fund treatment for veterans with these new drugs. was the right thing to do but it was not enough. we are requesting flexibility to use a limited amount of dollars to make this available to veterans between now and the end of the fiscal year. so we are improving access to care. now a standing airport of great times the we still have work to do but we are improving access to care. we're committed to making choice work. we need help especially additional flexibility to allow us to make the healthcare needs of our veterans met. we look forward to your questions. >> mr. chairman, ranking member, members of the community i am grateful for
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the opportunity to appear before you on behalf of our company's employees and its nonprofit owners to discuss the work which we are privileged to do in support of the department of veterans affairs. i would like to focus my testimony on three topics the reality of this program's implementation process of identifying and resolving gaps and those which remain to be solved and what i believe to be the art of the possible. as you know and as secretary gibson has said purchasing care in the community has been a lot of practice. in fact, in september of 2013 after two years of planning va sought to change that. that that contract was designed to have a
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consolidated, integrated delivery system built in the committee to undergird the facilities across the 28 states. make sure at the end of the day they were not there to replace the va but supplement. it worked as intended. when the furnace went off in our hometown 6300 providers under contract going forward at the side of the medical center to assist them in eliminating the backlog. by august 14000 veterans moved through that process. around the same time we are modification that we had primary care. we now have over a hundred thousand providers across 28 states under contract along with 4500 facilities. the reason why is we need to
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make sure networks are tailored to match demand that exists in a particular market that is not able to be met by the facility itself. that was a complicated program to set up done in short order, but it was training for what was to come next. on november 5 after 30 days of work we were to stand up and support of va choice program partner to receive a list of eligible veterans, design and produce a card and put it out with a personalized letter from the secretary and stand up a contact center to handle the calls coming in. after two weeks of design and hiring and training of 850 people. no one went into three-hour waits. phones were answered, but the work and only begun. we have been on a pathway sense to try to secure the operation. there is additional refinements that may well be
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needed and desired command if so we stand prepared to support what they might look like. there are there are other changes that may well be needed to the program as we go forward. secondly, we need to aggressively identify and resolve gaps and fix operational performance command we are in the process of doing that together .-dot modernizing it systems after a 247 build a new system that will serve all facilities and our own staff as we seek to move the veteran information back and forth between facilities as care is rendered and we are in the process of tailoring networks to match the demand that exists in each market across our area. the program is up operational command there are refinements needed. i believe that because of the collaborative work that
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has been underway between all of us engaged in this we are refining the pieces that need to be refined identifying policy gaps and those things, as the secretary said, are getting attended to. there are a there are a couple of policy issues that remain the jurisdiction of this particular committee. i encourage a relook at the 60 day authorization limitation that has been applied. secondly,. secondly, i respectively submit that there needs to be harmonization between the two programs and between all of the facets of how the va buys its care currently as well as how the va operates itself in engagement with us at the end of the day i believe the art of the possible is truly within our grasp. i would like to.to dallas texas a couple of weeks ago
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we sat with the director and entire staff and looked at the full demand that exists for veterans in that market. we then we then took out and looked at the network constructed to stand aside. if there is not a network provider you can set up in engagement with an individual provider to deliver services under choice and then designed a network map and over the next 90 days from behavioral health to primary care to specialty care we will rack and stacked the network to meet the demands that otherwise cannot be met by the va medical center in dallas. that is being repeated across our entire 28 state
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area and the pacific as we seek to do our part to mature the operations of choice. it is a privilege to serve in support of those who serve this country, an honor to serve the veterans from the states represented by half the members of this committee, and i would forward to taking questions after my colleague is finished with the remarks. >> thank you. >> i appreciate the opportunity to testify on the administration of the veterans choice program. one of the longest-serving administrators. dedicated dedicated to ensuring nations veterans have prompt access to needed healthcare services and believe there is great potential to help va deliver timely, coordinated, and
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quality care. awarded care. awarded a contract for three to six regions. we implemented pc three. at the beginning of april 2014. in october after congress passed and the president signed the veterans access choice and accountability act we amended our contract includes several components. with less than a month we literally hit the deck running and have not slowed down sense. to meet the required start date we work closely to develop an aggressive implementation schedule and timeline. the ambitious schedule required us to hire and
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train staff quickly and to reconfigure our systems. despite this aggressive implementation schedule for veterans started to receive their choice and were able to follow in -- calling to speak directly with a customer service representative about the questions or to request an appointment for services. having said that there are challenges that have resulted in veteran frustration as well as on the part of va and our own staff including call centers with such an aggressive schedule there is little time to finalize process loads and make system changes. we we literally had less than one week from the date we signed to the actual go live date. the collaboration has been good but there is still considerable work that must be done. the program is operating smoothly and the veteran
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experiences consistent and gratifying. we appreciate the opportunity to offer our thoughts. it is a knew program. there are a number of policy and process decisions and issues that are either unresolved for undocumented. if it is to succeed, these items must be addressed quickly. we have been working closely to address these issues. many items simply could not have been anticipated. others should have been addressed before the program started but the implementation timeline did not provide adequate time to do so. the identification policy and operational issues and concerns as a result we are to keep up with development and adequately train our staff. the situation is not ideal.
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based upon these dynamics we have one overall recommendation. we recommend a comprehensive coordinated operation strategy that clearly defines program requirements. the strategy should provide a clear roadmap for all of us to follow one that is communicated. va leadership medical leadership and staff contractors, congress, and veterans. the strategy needs to identify key initiatives and timelines and needs to contain flexibility to address issues as they arise and make necessary course corrections. the strategy must improve process issues development of policy and operational guides mandated across the program, comprehensive training using consistent
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process loads operational guides command scripting. a clear and responsive process. i would like to thank the committee for its leadership we believe there is great potential for the program to help va deliver care to veterans and are committed to cooperating to ensure the program succeeds working together where confident. thank you and i look forward to your questions. >> thank you very much. i had all of these preplanned questions. it was quick, so i want to make sure i got it. you are encouraging the authorization of what?
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>> the limitation on 60 days for authorized care. it puts people who have cancer in a position where we need to move them back and forth. it takes a person who might be with us under choice and does the same command i do not think that was intended. i think it was intentional that there were parameters drafted, but the notion that certain types of care would have to move back and forth is not -- neither efficient or effective. >> i don't want to spend too much time on this but this is important i think. tell me -- you want to expand that to a longer timeframe. >> i would leave it to the clinicians. i got it. what i would do is evaluate which types of care either
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needed authorization is that would last more than 60 days >> in other words -- what you are saying is the limitation causes things for that patient to have to go back and forth because of the limitation. >> the administrative process requires us to go back and forth in support of that veteran when it is probably unnecessary is what i would submit. [inaudible] >> yes, sir. >> is there any reason we cannot fix that? >> we will work on it and come back with a proposal. >> just listening it seems like it would be more cost effective to fix it rather than go back and forth. there has got to be money involved every time. >> there is a fee a fee for each authorization, but the bigger concern is the potential disruption.
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>> always less expensive and that is more efficient. i efficient. i appreciate you raising that in your testimony. >> you are welcome. >> do you have any credit cards? [laughter] i don't want them. i just want to know if you have them. you have the right to remain silent. >> am trying to think. >> do you get the annual mailing out the required notification of security about four pages long and the print is so small. >> it goes right in the recycling bin. >> in your testimony i heard a clear statement that we need to simplify and coordinate the instructions rules, and processes. >> that's right, mr. chairman. i think as i said everything has been moving quickly. as a result there are number of things that maybe of not been addressed as completely
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as ideally we would all like to see and it makes it difficult. it is hard for us. you are talking about call center representatives "trying to and clerks trying to keep up with the development and somehow we have to find a way to make it easy for not us that the people working closely with veterans to make the program work. they need to understand it. >> a little bit further. the veteran needs to understand. all of the stuff i did as a businessman we serve people with college degrees but wrote everything that an 8th grade level. that is the way you communicate to the majority of the american people. some of these things i read.
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[laughter] you read all of these things your not supposed to do. so long and cumbersome. i do not do the right thing sometimes. that can be our veterans as well. i hope you would work together to find ways to simplify the communication mechanism to the beneficiary, which is the veteran and the provider, which is the local provider. i no it is complicated. sometimes out of fear we cover so much that we do not accomplish the goal. i appreciate you raising that testimony in my last question will be of sloan. you talking about you wanted more flexibility. >> yes, sir. >> put some meat on that poem. >> at the top of the list is
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flexibility around the determination of hardship for veterans to be able to have access to choice care. the way the law is written it is restricted to geographic barriers i believe is the language that is in the bill. we want to open that aperture giving us more flexibility to extend care. >> open that to be a type of illness. >> a type of illness distance. there could be an instance where veteran delivers -- lives within 40 miles of the center that does not deliver the care. >> i will interrupt you, and i apologize. you want the ability to exercise judgment. >> yes, sir. >> the chance to exercise judgment in terms of the 60 day authorization. >> yes, sir. >> there ought to be ways we can accomplish those things. >> yes, sir. >> excited about that answer whatever the case.
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i recognize your flexibility sounds to be more cost effective and less expensive it probably raises cost questions but in the end we're got to remember the person we want to serve as the veteran. >> yes, sir. >> thank you, mr. chairman. let me say that you will be asked shortly by senator sanders urging that he uses authority to break patents on hepatitis c medication for the treatment of veterans. i strongly urge you consider using your authority to take
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that action that will make this medication more widely available to veterans who need and deserve especially the research that undertook this initiative and successfully reach the result. i want to focus for the moment on the va proposal to fund construction cost at the denver facility specifically the one billion-dollar cost overrun out of the choice program provision for long deferred maintenance and facility capacity issues. these funds were specifically designated and intended by congress to improve veterans health care veterans in my state who are
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aware of this proposal are absolutely outraged that their healthcare specifically the primary care upgrade would be indefinitely deferred because of one billion-dollar cost overruns and aurora colorado. i suspect the same reaction will be felt equally deeply by veterans at the more than 220 other facilities whose healthcare will be compromised as a result of the proposed redesignation. i would like assurance from you since we are talking about choice program funds
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that you are considering alternatives to that action. >> senator we sent a letter earlier today to this committee, to the house committee command the appropriations committee requesting the increase in authorization to complete that facility as well as requesting the use of 700 $30 million of those 5 billion to be used to complete the denver facility >> i want to interrupt you because -- and i apologize. for me that alternative is a nonstarter. it is just unacceptable command i expressed that i expressed that view to appropriate administration officials. i realize you're doing a hand you're dealt. i am urging you to consider alternatives. there are alternatives
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responsible and available alternatives that do not involve deferring healthcare improvement through construction at those facilities across the country whether in connecticut or georgia montana or louisiana of vermont and all the other states represented on this committee as well as many you're not. >> sen., senator, in years past i would tell you it is likely that fda had gone looking for that type of money there is a good chance we could have found it. because of the work we have been doing over the past year to make hepatitis c care available to veterans under the circumstances we don't have $700 million sitting on the sidelines. there are no easy answers. >> i am not asking you to find a billion dollars but this nation is capable of doing better for its
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veterans. a supplemental appropriation for example might be an alternative. i am asking you to go back to the drawing board and use different pencils not necessarily sharpened pencil, but different alternatives to compensate for the absolutely unacceptable cost overruns and delays in aurora. the project should be completed but not at the sacrifice of healthcare for other veterans around the country. what i say to you today is not personal to you were secretary mcdonald command we have talked at great length about this issue. we have visited that facility together along with the chairman command i have seen that vast halting
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shell of the campus that is a mockery of government contracts. we need to address this situation to complete the project but it cannot be done at the sacrifice of other veterans. my time has expired. i apologize for interrupting you and i think the witnesses for being here today. >> i i would not ordinarily do this, but in light of the question raised and for the benefit of us to know i think we all have an obligation to ourselves to make suggestions on what we do, the cost overruns. everyone on the committee command i have taken a couple of actions. a meeting tomorrow. democrats and republican leaders come together. i hope the i hope the va
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people are back in their office saying what are we going to do. i have ordered gal to do a study of surplus property to try to raise money to go to veterans choice. you are dealing with a situation where you have until about may the 20th. we need to get at least until july 15. we have a way to do that. it only gives us time to determine how close it is we need. there are going to have to have interim bridges which i am working on but if everyone on the committee would think outside the box if it was your problem and you inherited a $700 million shortfall where would you go looking?
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i once loan to revisit the two places i mentioned because it seems like if we will take you out of the construction business, that we will happen to a major extent. there will be savings. and also and also look at the 77 ftes you are asking for an increase. maybe they are not as necessary is helping to build that hospital in denver. if everyone is making a contribution despite that movie the american president we need to get the yellow pad out and work on solutions and find a way to do it. it is a nonstarter. i agree that it is not the right way and i apologize for injecting that. >> and i want to thank the chairman. he and i have worked together. i am not speaking for the chairman obviously but i have alternative suggestions as well. i have no pride of authorship in meeting the
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needs of completing the facility but doing it without sacrificing other projects and i will have specific ideas and puzzles. >> my apologies to the members of the community and i turn to senator murray and. >> thank you. your comments and connecting this hearing. i hope to ask a series of questions. i want to start with a story i have told before about a vietnam veteran named larry. he lived in florida and indicates that he is a vietnam veteran, a navy veteran indicates violent florida he received excellent care moved to rural kansas, became my constituent, lives about 25 miles from sealock and three hours from a hospital.
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i started the story or the story began in july of 2014 when larry, this vietnam veteran needed a cortisone shot. the va instructions were come to wichita. we raised this topic with secretary mcdonald hearing on september the 9th. larry contacted us and said i don't care how it comes. we raised this topic with the secretary in september of last year. shortly thereafter the director in kansas city took this issue to heart and has solved the problem temporarily. in december he was granted an appointment. i should say it does not offer cortisone shots, but he got care and the private
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sector. the dr. who treated him then asked to treat him again and to follow up. the va denied that request and send them back to wichita. they denied the request because he was not eligible for choice. so he is back to wichita. ultimately he then needed a colonoscopy same series of events. the outpatient public does not provide colonoscopies command he is trapped in the system of no one telling him what he can do. he has gone to wichita but recently last week he received a letter from the va approving and for choice. he then calls try west.
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try west says, you are not eligible. but i got this letter. he indicates he talked to four different operators come all who gave him a different answer than the three others. he called the 866 number and was told he was not eligible to my got the four different answers and now we're back to the question what happens to larry. even from the beginning if he was not eligible and even if he is not eligible because the sealock is there why is someone not at try west or the va telling him we have these other authorities that would work for you as compared to just leaving them hanging.
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i doubt very is the only veteran experiencing this circumstance. >> i doubt that the problem is unique. i suspect there are other veterans with similar experiences. as i described in my opening statement, we are asking for additional flexibility which would give us more authority to be able to handle that kind of situation. we handle we actually handle many situations through other va care in the committee routinely which is why we have incurred so much expense on a year-to-date basis, but we find ourselves running out of resources in order to be able to sustain that. so we wind up making sub optimal decisions. given two great examples the chairman asked whether
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or not we would be using judgment. the answer is yes but for someone with a routine requirement there is no reason the travel hundred and 50 miles. that is something that ought to be done locally. for the veteran that has to get a colonoscopy, i'm not going to drive hundred and 50 miles to get a colonoscopy. that is something else that must be provided. if a veteran needed a knee replacement i might say, okay, under the circumstances make the trip, but for therapy that must follow up, i do not want the veteran traveling 150 miles each time for physical therapy. the challenge we have is 40 miles from where you get the care. we keep running the numbers command the tab is renders. we have got to find a way to manage this in such a way that we are doing the right thing for veterans and at
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the same time being the best stewards we can of the taxpayer dollars. >> we had a number of conversations on this topic. i would argue i would argue given the chance, but i want today about whether or not how the 40 miles should be interpreted. the uncertainty and the burden lying in the wrong place. it ought to lie with the live with the va or try west. my 2nd.is that if you have other authorities, whether or not he qualifies ought not matter in the answer he gets. >> i agree completely. >> thank you. >> senator kindly yielding to me. >> the gentleman that has to run out the door. >> thank you. and thank you for the work you have been doing and maintaining the bipartisan spirit of this committee.
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i want to make two points. i want to thank sloan gibson for the impressive work that they are doing. i understand how easy it is to beat up on the va. 151 medical centers, 900 see box, problem everyday but in a nation with a dysfunctional healthcare system the private sector also has one or two problems we should recognize that when you talk to the major veterans organizations american legion you know what they say? and you have heard this this, when people walk in the quality of care that they get is pretty good. i want to thank you for trying to improve that care. i will fight vigorously those want to privatize. our goal is to strengthen
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be creative in terms of using the knew program that we have developed so that people can get care locally. i will oppose efforts to privatize the va. i wanted to get to another issue. the senator touched upon it. i wrote a i wrote a letter to secretary mcdonald about an issue that has concerned me for a while the high cost of the drug's of all the which is a very -- a miracle drug so to speak treating the veterans of our country who have high rates of habitat is see. mr. chairman, to me it is an outrage that you have a company's profits have soared revenues have doubled. they have come up with the drug charging the general public a thousand dollars a pill, charging the va
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something like $540. no. no comment. but that is because the va negotiate strike prices. but you are but you are running out of money and we have several hundred thousand veterans suffering with hepatitis c which can be fatal without money to treat them. frankly, it is time to talk to the manufacturer and basically ask them if they are currently being generous in providing these drugs hepatitis c drugs for free. very generous. but maybe at a time when profits are soaring they might want to respect veterans of this country who might die or become sick because they do not have access to this wonderful product. as the senator mentioned if
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they are not prepared to come to the table, and i no you think you have done well i am not impressed. so i would -- you sit down again and tell them you up. to utilize federal law to break the patents on these drugs unless they are prepared to come down significantly lower than they are now. it is not a question of taking money. maybe that is is a good idea, but it is a better idea to have them treat veterans with respect and charge a reasonable price rather than ripping off the va. [inaudible conversations] >> turn that clock on when they start talking. >> thank you, mr. chairman.
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i appreciate your work and the ranking member's work. i agree that it should not come out of the choice program. mr. gibson, i was looking back at the notes i have taken. you gave encouraging notes with regard to statistics about the areas of the country with regard to additional care being provided which is encouraging. do you believe they are consistent across the country? are you finding evidence? >> actually, i always worry when people quote averages to me. what you find is wide disparity across the country in terms of the length of wait times and therefore in terms of the specific areas where we are making the most intensive investments. what i would tell you is
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where we have been making consequential investment you consistently see a material improvement in access measured by completed appointments, growth and relative value units, but what we are not seeing consistently is material improvement in wait time. you look behind that and realize what is happening is as we improve access to care are more veterans are coming or veterans that are already there are making additional utilization of va care. ..
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>> it sounds like the va should be making the decision about whether or not they are delivering the care or whether veterans should he making that decision. it sounds to me like maybe we should take the other approach and say if we gave that toys to the veterans i would suspect that a number of them who have very great care of being
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delivered might very well might want to continue that out. but there are others that would suspect that would say i don't expect you to build a new hospital near me. you have looked at asking for the ability to have flexibility to make that choice. what happened if we took it as an alternative and once again we are talking about dollars and cents. what if we let them decide for themselves whether they want to have cured through a va facility or utilizing the choice program more fully and skip all of the extra stuff that you have talked about or whether or not they have already had care and now they have to go back in after 60 days. it is still the va making the decision. i'm sure that this is not a new

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