E PL UR UM IB N U U S Congressional Record United States of America PROCEEDINGS AND DEBATES OF THE 107th CONGRESS, FIRST SESSION

Vol. 147 WASHINGTON, TUESDAY, JUNE 19, 2001 No. 85 Senate The Senate met at 10 a.m. and was U.S. SENATE, RESERVATION OF LEADER TIME called to order by the Honorable PRESIDENT PRO TEMPORE, The ACTING PRESIDENT pro tem- Washington, DC, June 19, 2001. THOMAS R. CARPER, a Senator from the pore. Under the previous order, the State of Delaware. To the Senate: Under the provisions of rule I, paragraph 3, leadership time is reserved. of the Standing Rules of the Senate, I hereby f PRAYER appoint the Honorable THOMAS R. CARPER, a MORNING BUSINESS The Chaplain, Dr. Lloyd John Senator from the State of Delaware, to per- Ogilvie, offered the following prayer: form the duties of the Chair. The ACTING PRESIDENT pro tem- Gracious Father, You have called us ROBERT C. BYRD, pore. Under the previous order, there to be creative thinkers. We begin this President pro tempore. will now be a period for the transaction day by yielding our thinking brains to Mr. CARPER thereupon assumed the of morning business not to extend be- Your magnificent creativity. You know chair as Acting President pro tempore. yond the hour of 11:30 a.m., with Sen- ators permitted to speak therein for up everything; You also know what is best f for us and the Nation You have en- to 10 minutes each. trusted to the care of this Senate. We RECOGNITION OF THE ACTING Under the previous order, the time are grateful that You not only are om- MAJORITY LEADER until 10:30 a.m. shall be under the con- niscient but also omnipresent. You are trol of the Senator from Arizona, Mr. The ACTING PRESIDENT pro tem- KYL. here in this Chamber and will be with pore. The Senator from Nevada. the Senators and their staffs wherever f this day’s responsibilities take them. f PRESIDENT BUSH’S EUROPEAN We take seriously the admonition of SCHEDULE TRIP Proverbs 16:3: ‘‘Commit your works to Mr. KYL. Mr. President, President the Lord, and your thoughts will be es- Mr. REID. Mr. President, we will be in a period for morning business until Bush has just returned from his trip to tablished.’’ Europe, and the newspapers are full of 11:30 this morning. By virtue of a pre- Thank You for this secret of success glowing accounts. Some of the head- vious unanimous-consent agreement, in Your Word. In response we look to lines include the following: ‘‘Europe Senators KYL and BROWNBACK will be what is ahead this day and thank you sees Bush’s Trip Exceeding Expecta- in control of the time until 10:45 a.m. in advance for supernatural intel- tions.’’ That from the New York Times and Senator DURBIN will be in control ligence to maximize our thinking. You on June 18. The International Herald of the time from 10:45 a.m. to 11:30 a.m. are our Lord and Saviour. Amen. Tribune: ‘‘President Climbs in Euro- At 11:30 this morning, Majority Lead- pean Esteem.’’ f er DASCHLE will be in the Chamber to Similarly, other headlines and sto- move to begin consideration of the Pa- ries noted the fact that the President PLEDGE OF ALLEGIANCE tients’ Bill of Rights. As Members was successful in communicating his know, this legislation has been around views on a wide variety of subjects, in- The Honorable THOMAS R. CARPER led for years, and the leader is going to an- the Pledge of Allegiance, as follows: cluding most especially our view of na- nounce at 11:30 a.m. today his move- tional security issues and specifically I pledge allegiance to the Flag of the ment toward consideration of that bill. the question of missile defense. United States of America, and to the Repub- We expect to be able to move to it. We I want to spend a few minutes talk- lic for which it stands, one nation under God, hope the minority will not have any indivisible, with liberty and justice for all. ing about the President’s successful problems with our going to that bill. trip, his vision for the future in a new Majority Leader DASCHLE will an- f post-cold-war era, and the acceptance nounce at 11:30 a.m. that we are going of those views by most of our allies and to finish that bill before the July 4 re- even, to some extent, by those whom APPOINTMENT OF ACTING cess. That means if there are problems he characterizes as friends, countries PRESIDENT PRO TEMPORE moving to the bill and cloture has to be that could, indeed, someday perhaps be The PRESIDING OFFICER. The filed, we will work this weekend and allies, countries such as Russia, fol- clerk will please read a communication perhaps the next weekend to complete lowing especially his visit with Presi- to the Senate from the President pro this legislation. dent Putin during the course of this tempore (Mr. BYRD). The Senate will be in recess from trip. The assistant legislative clerk read 12:30 p.m. to 2:15 p.m. today for our I think the pundits had a good time the following letter: weekly party conferences. as the President was preparing for his

∑ This ‘‘bullet’’ symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor.

S6387

.

VerDate 19-JUN-2001 00:56 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00001 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.000 pfrm03 PsN: S19PT1 S6388 CONGRESSIONAL RECORD — SENATE June 19, 2001 trip, speculating about whether this At the conclusion of my remarks, I come along and help us find the right President, who had not extensively am going to ask unanimous consent to way to do that. In that spirit, he vis- traveled abroad and did not have a print in the RECORD two very fine ited with these European leaders. great deal of international experience, pieces by one of the finest columnists We all know the President is very would be able to impress these savvy and political writers of our time, convincing. I realize the situation international leaders. Charles Krauthammer. One of them ap- there is a little different. In politics, it What they found—and it was inter- peared in the Weekly Standard in the is not the typical kind of diplomacy esting—on the Sunday morning talk June 4 issue. It is entitled ‘‘The Bush coming out of the State Department or shows they were all doing a little bit of Doctrine, ABM, Kyoto, and the New other areas of diplomatic expertise, in a retreat, which pleased me because I American Unilateralism.’’ The other is our country and in others, where sub- had seen the same kind of questioning an op-ed the Washington Post carried tlety and the spoken word are so very of the President when he was beginning on June 18 in which he makes a similar important. President Bush is a man his run for the Presidency as Governor point that the type of unilateralism who means and says what he means of Texas. President Bush took to Europe and is very plainly. There is a certain advan- There were those who said: He is a intent on pursuing with respect to tage to that when you are dealing with very congenial fellow, but does he real- United States interests throughout the foreign leaders who do not know you so ly have what it takes? I think we all world is not a unilateralism that says well. It quickly becomes apparent to saw, and even my Democratic col- the United States is going to do what them that what you are telling them is leagues who supported Vice President we want to do no matter what anybody exactly what you believe, exactly what Gore at the time concluded, that this is else thinks and basically ignores their the United States intends to do, and a man who not only has great charm points of view at all, but, rather, as that there is no guile, there is no hid- but also significant substance and a Charles Krauthammer carefully points den agenda. view of the world which is in keeping out, this new Bush doctrine is a subtle I think it has an effect of disarming with the times as we commence our change from the past in this regard. some leaders who might be looking for journey into this 21st century. It says we are going to identify what hidden agendas or games that some- He proved that during the campaign. we believe is in the best interests of times people in the political world like He proved it in domestic affairs, the United States of America and in to play. President Bush is not like achieving a milestone of success with the interests of the rest of the family that. He has been very straightforward. the tax cuts we passed and he signed of nations of the world. He has been very clear about his vision. into law a little over a week ago, and We are going to pursue a course that He has not wavered from that, which then this foreign trip, which was the achieves the goals that sustain those first major trip, the trip to Europe, to is, of course, tempting to do when vis- interests, and we are not going to be iting with other world leaders who do visit with our NATO allies and other deterred by naysayers, by countries leaders in the region. We heard the not totally share your world view. that, frankly, do not have the same The net result of that diplomacy and same kind of questions: Was the Presi- goals in mind or by any kind of inter- dent prepared to meet these leaders? the new American vision of national national view that everything has to be There is a problem here, Mr. Presi- security for the family of nations of dent, as you know, and that is that done by international accord or it can- the world has been an acceptance by most of the countries of Western Eu- not be done at all. We are not going to many of the European leaders, ex- rope—the majority, I should say—are have our national security interests ve- pressed very overtly. As the headlines governed by left-of-center political toed by any other country of the world. noted, a view among even those who do leaders. They are, obviously, not of the So we will pursue our national inter- not necessarily totally share the Presi- same political viewpoint as President ests, and we are not going to allow dent’s view is that there is room to Bush, but our alliance with our NATO other countries of the world that do work with this President on these com- allies has gone through a series of not share those goals to dictate the re- mon goals. changes where we have had generally sults. Our NATO allies, countries such as conservative leadership, more left-of- However, that does not mean we are Spain and Italy, the Czech Republic, center leadership, and then a combina- simply going to try to impose our will Vaclav Havel, made some very elo- tion of the two. on others or that we are going to go quent statements in support of the We have always been able to accom- our own way and to heck with the rest President. The Polish Government, modate our differences politically be- of the world. Not at all. As Mr. even some statements from leaders of cause of the common goal of providing Krauthammer points out, President the British Government, Hungary, and a defense for the members of the NATO Bush has very carefully conducted an other countries in Europe, have in one alliance and in working together in na- overarching strategy, and then the tac- way or another expressly supported the tional security matters that go beyond tics of achieving that strategy include President’s plans for missile defense to just the question of the NATO alliance, a very heavy dose of consultation, es- protect the United States, our troops especially during the cold war as we pecially with our allies and particu- deployed abroad, and our allies. Vaclav were dealing with the then-Soviet larly with our NATO allies. It also in- Havel said: Union and subsequent to that time volves consultation with other friends The new world we are entering cannot be dealing with other challenges, includ- of the United States, countries such as based on mutually assured destruction. An ing the Balkans and, of course, in deal- Russia and India, and other countries increasingly important role should be played ing with the evolution of the changes such as China, with which we have had by defense systems. that have been occurring in the coun- some difficulties in recent times. There are many similar quotations in try of Russia itself. But the point of these consultations these various news stories that were That was the state of play when the is not to tell other leaders what we are filed by the reporters covering the President made this journey. Yet what going to do come heck or high water President’s trip. we found was, notwithstanding the po- but, rather, to say: Look, this is what While there were many European litical differences of these leaders, we believe is in our best interests and leaders who overtly expressed support there still is more that binds us than your best interests. Let’s work to- for what the President was trying to divides us. President Bush is one of gether to try to find a way to achieve do, as I said, there were others who those innate leaders who has the capac- these goals. There is some room for dis- were not specific in their endorsement ity to bring people together because of cussion. We have not finalized every- but who made it very clear they be- the force of his personality, which is thing we plan to do, so there is an op- lieved President Bush was somebody one of reaching out, of showing that he portunity for everybody to help shape with whom they could sit down, talk is willing to listen, that he is willing to the future of the world as we begin this these things over with, and reach some accommodate, but also making it very next century. But there are certain kind of mutual conclusion. clear he has some very firm principles goals and objectives we are going to at- I was especially pleased this morning upon which U.S. policy is going to be tempt to achieve. If you want to be to find President Putin being quoted based. with us we would like to have you over and over again, in the lead story

VerDate 19-JUN-2001 00:06 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00002 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.005 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6389 in the Washington Post saying he be- One of the questions raised by some dent—that the single biggest loss of lieved there was room for the United of our European friends was, Is the life of U.S. servicemen in the gulf war States and Russia to talk about these technology really there? occurred when 28 American soldiers issues. By the way, I am somewhat amused were killed by one Scud missile. He was talking about something that by the twin arguments of opponents. It is a very lethal weapon if you don’t has been very fundamental, from the ‘‘This thing will be so effective that it have a defense against it. So what Sec- Russian point of view, to the relation- will start another arms race.’’ That is retary Rumsfeld and President Bush ship between Russia and the United argument No. 1. Argument No. 2: ‘‘It have decided to do is to take what we States, the ABM Treaty. There is a will never be effective.’’ It is going to have—such as the Patriot missile of suggestion it is no longer absolutely be effective or it is not going to be ef- the gulf war time—get it into the field necessary that that treaty remain in fective. I think it will be effective. I and begin working with it, all the existence as the cornerstone of the also do not think it will start another while continuing to test more and strategic relationship between Russia arms race. more advanced systems. In this way, and the United States, as he has char- But what about the state of tech- we will actually have a rudimentary acterized it. President Bush has said it nology? defense to begin with, and we can con- no longer is the cornerstone. That was The Bush administration has decided tinue to build on that as the tech- a treaty developed during the height of that, because of the immediacy of the nology evolves. the cold war when the Soviet Union threat identified in the Rumsfeld Com- I will give you an analogy. We build and the United States totally mis- mission report 3 years ago, we need to ships in classes. We will start the Los trusted each other. Whether or not it get on with this now; that we cannot Angeles class of attack submarines, for helped keep the peace during that time test forever to try to develop the per- example. The first of the Los Angeles is totally irrelevant to the cir- fect system. There will never be a per- class submarines that came out of the cumstances of today, where the threat fect system, at least for the amount of dock was a good submarine, but it was of mutually assured destruction simply money we are willing to spend, and not nearly as good as the last Los Ange- cannot be the basis for the relation- right now we do not need a perfect sys- les class submarine that came out ship, the strategic relationship be- tem. The threat is from an accidental many years later. Throughout the time tween the Russian people and the launch or rogue nation, and those are that basic class of submarines was American people. not the most robust threats to have to built, changes were being made and It has even been put into the context defeat. embodied in that submarine, so that So I think what Secretary Rumsfeld of a moral statement. Dr. Henry Kis- the last one that came off the dock, in and the President have in mind doing singer was one of the architects of the many respects, was not much like the ABM Treaty. He was there at the cre- is fielding, as soon as possible, what- ever technology we have, under- very first one; it was much, much im- ation. He has testified to Congress, and proved and, frankly, was the basis for he has told many of us, that it is time standing that it is not necessarily the best and it may not work in all cir- the evolution to the next generation of to scrap this treaty. He knew why it attack submarines. was put into place in 1972. He knew the cumstances. Now, is that an indictment of what And so it is with missile defenses. I function it might perform at that time. believe what the Secretary and the But he now fully appreciates that it no they intend to do? I do not think so. It is an honest acknowledgement of the President have in mind is fielding a longer serves that function and, more combination of air and space and land importantly, leaves us nude, unpro- fact that there is no such thing as a perfect shield, and that we are in the systems, combined with the satellite tected, vulnerable to attack by coun- and radar that is necessary to detect a tries that were not parties to that trea- beginning stages of actually fielding launch, and continue to follow a rogue ty and never would be. Here is what he this equipment. missile, and then provide information said during testimony in 1999: We have done a lot of research, to be sure. But, frankly, for political rea- at the very end of its flight for inter- The circumstances that existed when the cept and shootdown. treaty was agreed to were notably different sons, a lot of that research has been from the situation today. The threat to the wasted because the systems that could That combination might include the United States from missile proliferation is take advantage of that research have airborne laser, something with great growing and is, today, coming from a num- been stopped from development and promise. It might include standard ber of hostile Third World countries. The eventual deployment. So we have had a missiles aboard the so-called Aegis United States has to recognize that the ABM lot of starts and stops, but we have cruisers, cruisers with very good radar, Treaty constrains the nation’s missile de- never gone the next step, which is to and a missile which today is, obvi- fense programs to an intolerable degree in actually put it out in the field and see ously, not capable against the most ro- the day and age when ballistic missiles are bust of intercontinental ballistic mis- attractive to so many countries because how it works. there are currently no defenses against What Secretary Rumsfeld has said is siles but at least has some capability if them. This treaty may have worked in a go back to the gulf war. That was an especially you are able to sail the two-power nuclear world, although even that emergency. We knew the Iraqis had cruisers close enough to the launching is questionable. But in a multinuclear world Scud missiles. In fact, they were begin- point of the missile. it is reckless. ning to shoot them toward Israel. We As those missiles are made bigger, He was even more blunt during a did not have a missile defense. But Sec- and another stage is added to them, press conference with then-Governor retary of Defense CHENEY at that time and a more sophisticated seeker is put Bush on May 23, 2000, when he said: said: Don’t we have anything that we on top of that missile, it will become Deliberate vulnerability when the tech- might employ here? And the answer more and more robust, to the point nologies are available to avoid it cannot be a from the Pentagon was: Yes, we have that at some point it will have the ca- strategic objective, cannot be a political ob- the Patriot. It is an anti-aircraft sys- pability of stopping just about any jective, and cannot be a moral objective of tem, but it is very good at that, and it missile that might be launched against any American President. might be able to shoot down some Scud us. We also have the potential for land- He is correct. For any President of missiles. based systems. the United States or Congress to delib- So they tinkered with it. They took The point is this: The President has erately leave the United States vulner- the Patriot batteries that we had—I in mind moving forward, getting off able to attack when we understand think some of them were even test bat- the dime. Almost no one, any longer, that there is a growing threat of that teries—and put them into the field. denies the threat. Even President attack, and to leave in place any kind And those Patriots did a remarkably Putin has pointed that out. of legal regimes that would inhibit us good job. I think that the end result So the question is: Do you test for- from developing the means of pro- was somewhere in the neighborhood of ever, until you are absolutely certain, tecting ourselves, is intolerable; it is about one-third of the Scud missiles or do you move forward? morally indefensible, especially, as Dr. were brought down by the Patriot. I saw my little nephew over the Kissinger says, when the technology is That is important when you recog- weekend. He is just now trying to there to provide a defense. nize—and you will recall, Mr. Presi- crawl and walk; and he is falling down

VerDate 19-JUN-2001 00:56 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00003 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.008 pfrm03 PsN: S19PT1 S6390 CONGRESSIONAL RECORD — SENATE June 19, 2001 more than he is walking, but he is try- lenge that we have to meet. But the I applaud the President. I congratu- ing. And the next time I see him, I sus- mere fact that we have other kinds of late him for a successful trip. I hope we pect he is going to be walking. You challenges as well does not mean that will have more opportunities to discuss don’t quit just because you fell down we ignore the one that is first and fore- this important issue in the future. the first time. And we don’t stop just most on the minds of these rogue lead- Mr. President, I ask unanimous con- because we had a couple tests that ers. Why else would they be spending sent that two articles by Charles were not totally successful. the billions of dollars they are spend- Krauthammer be printed in the The point is, we will continue to test; ing to develop or buy the technology RECORD. we will continue to develop; we will de- for these missiles and the weapons of There being no objection, the mate- ploy what we have as we get it ready to mass destruction that they put on top rial was ordered to be printed in the deploy, and we will continue to evolve of the missiles? Why? RECORD, as follows: those systems until we are satisfied This kind of weapon offers them a [From the Weekly Standard, June 4, 2001] blackmail potential. In the wrong that we have a system that can work. THE BUSH DOCTRINE hands, with this kind of weapon a To those critics who say we don’t ABM, Kyoto, and the New American have the technology or we won’t have country can essentially say to the rest Unilateralism of the world—at the time they intend it, I say, give us a chance. Let’s try. (By Charles Krauthammer) to attack someone else, or want to get Let’s see. Don’t say, you can’t do it, I. THE WORLD AS IT IS and we never start and we never try. something from the rest of the world— look, you know we can launch this mis- Between 1989 and 1991 the world changed so The consequences are simply too great. radically so suddenly that even today the As Dr. Kissinger said, it would be lit- sile against you. We have done it in the implications have not adequately been erally reckless and immoral for us not past. We will do it again. So you better grasped. The great ideological wars of the to try when the technology is there. give us what we want, or you better twentieth century, which began in the ’30s Another question in this respect that stay out of our way, or you better do and lasted six decades, came to an end over- the allies asked is, What would the re- whatever we want you to do. It is that night. And the Soviet Union died in its sleep, action from Russia be? It is a fair ques- blackmail component that worries so and with it the last great existential threat to America, the West, and the liberal idea. tion. Russia has some concerns. But many of our leaders the most. Go back to the Persian Gulf war So fantastic was the change that, at first, Russia should not have concerns. Does most analysts and political thinkers refused anybody believe that the United States again. If Saddam Hussein had had the weapons that could put a missile on to recognize the new unipolarity. In the intends to attack Russia? Even the early ’90s, conventional wisdom held that we Russians have to acknowledge that is London or Paris or Berlin or Rome or were in a quick transition from a bipolar to no longer the relationship between our any other country in that area of the a multipolar world: Japan was rising, Europe world, do you think we would have had two countries. And we don’t believe was uniting, China was emerging, sleeping the same quality of allied contingent giants like India were stirring, and America they intend to attack us. Why would to face him down in that Persian Gulf was in decline. It seems absurd today, but they? war? Do you think other countries this belief in American decline was all the So these large inventories of nuclear rage. weapons that both sides have, frankly, would have been as willing to join the United States? And if, in fact, those Ten years later, the fog has cleared. No one are going to come down. We are not is saying that Japan will overtake the weapons could have killed a lot more going to maintain that level of war- United States economically, or Europe will Americans, would the United States head, and we do not think the Russians overtake the United States diplomatically, have been as anxious to kick him out are either. In fact, they have made it or that some new anti-American coalition of of Kuwait? clear they cannot afford to do so. powers will rise to replace the Communist The argument would have been: Ku- block militarily. Today, the United States Frankly, we would rather not have to wait is of no interest to us, especially remains the preeminent economic, military, spend the money on all those weapons when he can rain so much destruction diplomatic, and cultural power on a scale not so both sides can draw down their nu- down upon us. So you need the kinds of seen since the fall of the Roman Empire. clear weapons. defenses that prevent these rogue na- Oddly enough, the uniqueness of this struc- ture is only dimly understood in the United For anybody to suggest that our tions from carrying out their aggres- building the rudimentary defense is States. It is the rest of the world that sees sive intentions. it—undoubtedly, because it feels it—acutely. going to cause the Russians to begin That is why—just getting back to the spending billions more to build new Russia and China never fail in their summits President’s visit in Europe this week— to denounce explicitly the ‘‘unipolarity’’ of weapons, when they cannot afford to I am so heartened by not only the way the current world structure and to pledge to keep the ones they have, is, I think, lu- he has laid this vision out but the way do everything to abolish it. The French—ele- dicrous. It is not going to happen. It is he has stuck to his guns, all the while gant, caustic, and as ever the intellectual a misplaced fear. being very open in his discussions with leader in things anti-American—have coined I acknowledge the concern that these allied leaders, as well as the Russians. the term ‘‘hyperpower’’ to describe Amer- people express, but I ask them to think I must say, I was also heartened by ica’s new condition. about the facts. Even Russian leaders the descriptions of the policy, and the And a new condition it is. It is not, as we have acknowledged they would not be in America tend to imagine, just the super- steadiness with which Secretary of powerdom of the Cold War writ large. It is able to maintain more than about 1,500 State Colin Powell and National Sec- something never seen before in the modern warheads—down from about 6,000 or retary Adviser Condoleezza Rice pre- world. Yet during the first decade of more that they have today. sented this case again Sunday on the unipolarity, the United States acted much as So I do not think it makes sense to talk shows. Dr. Rice, despite, I would it had during the preceding half-century. argue that we should not prepare to de- say, bating by the questioner, was very In part, this was because many in the po- fend ourselves just because the Rus- calm and very firm in articulating that litical and foreign policy elite refused to rec- sians might be fearful somehow and, the United States will do what it takes ognize the new reality. But more important, therefore, might decide to spend bil- it was because those in power who did recog- to protect the citizens of the United nize it were deeply distrustful of American lions more that they do not have in de- States and the interests of other free- power. They saw their mission as seeking a veloping new weapons. Nor do I think dom-loving people around the world new world harmony by constraining this that argument applies to anyone else. but that we will do so in a way in overwhelming American power within a web What we are talking about is build- which we engage these other leaders. of international obligations—rather than ing a defense that rogue nations will We will listen to what they have to maintaining, augmenting, and exploiting the understand, making it unprofitable for say, and to the extent we are able to do American predominance they had inherited. them to develop and deploy the tech- so, within the confines of what is nec- This wish to maintain, augment, and ex- nology of missile defenses. essary for the United States, we will ploit that predominance is what distin- Are there other threats out there guishes the new foreign policy of the Bush find ways to accommodate their needs administration. If successful, it would do from these countries such as the so- as well. what Teddy Roosevelt did exactly a century called suitcase bomb? Yes, we are One of these would be to actually ago: adapt America’s foreign policy and mili- spending a lot to try to deal with that, provide that kind of missile defense tary posture to its new position in the world. too. The cruise missile is another chal- protection for them as well. At the dawn of the 20th century, that meant

VerDate 19-JUN-2001 00:56 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00004 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.011 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6391 entry into the club of Great Powers. Roo- century what airpower was to the 20th. In Its goal was to make the treaty more endur- sevelt both urged and assured such entry 1901, there was not an airplane in the world. ing, at a time when it had already become with a Big Stick foreign policy that built the Most people did not think a heavier-than-air obsolete. In fact, in one agreement, nego- Panama Canal and sent a blue water navy machine could in theory ever fly. Yet 38 tiated in New York in 1997, the Clinton ad- around the world to formally announce our years later, the world experienced the great- ministration amended the ABM treaty to in- arrival. est war in history, whose outcome was cru- clude as signatories Kazakhstan, Ukraine, At the dawn of the 21st century, the task cially affected by air power and air defenses and Belarus, thus making any future of the new administration is to develop a in a bewildering proliferation of new tech- changes in the treaty require five signatures military and foreign policy appropriate to nologies: bombers, fighters, transports, glid- rather than only two. It is as if Britain and our position of overwhelming dominance. In ers, carriers, radar. Germany had spent the 1930s regulating the its first four months in office, the Bush ad- It is inconceivable that 38 years from now, levels of their horse cavalries. ministration has begun the task: reversing we will not be living in a world where missile That era is over. the premises of Clinton foreign policy and technology is equally routine, and thus rou- III. KYOTO: ESCAPE FROM MULTILATERALISM adopting policies that recognize the new tinely in the hands of bad guys. It was expected that a Republican adminis- unipolarity and the unilateralism necessary It is therefore inexplicable why the United tration would abrogate the ABM treaty. It to maintain it. States should not use its unique technology was not expected that a Republican adminis- to build the necessary defense against the II. ABM: BURYING BIPOLARITY tration would even more decisively discard next inevitable threat. In May 2000, while still a presidential can- the Kyoto treaty on greenhouse gases. Yet Yet for eight years, the U.S. government this step may be even more far-reaching. didate, George W. Bush gave a speech at the did nothing on the grounds that true safety National Press Club pledging to build a na- To be sure, Bush had good political and lay in a doctrine (mutually assured destruc- economic reasons to discard Kyoto. The Sen- tional missile defense for the United States. tion) and a treaty (the antiballistic missile A year later, as president, he repeated that ate had expressed its rejection of what Clin- treaty) that codifies it. The logic of MAD is ton had negotiated 95–0. The treaty had no in a speech at the National Defense Univer- simple: If either side can ever launch a first. sity. This set off the usual reflexive reaction domestic constituency of any significance. And because missile defenses cast doubt on Its substance bordered on the comic: It ex- of longtime missile defense opponents. What the efficacy of a second strike capacity, they empted China, India, and the other mas- was missed both times, however, was that make the nuclear balance more unstable. sively industrializing polluters in the Third Bush was proposing far more than a revival This argument against missile defense was World from CO restrictions. The cost for the of the missile defense idea that had been put 2 plausible during the Cold War. True, it United States was staggering, while the en- on hold during the Clinton years. Bush also hinged on the very implausible notion of a vironmental benefit was negligible. The ex- declared that he would make unilateral cuts first strike. But at the time, the United empted 1.3 billion Chinese and billion Indi- in American offensive nuclear arms. Taken States and the Soviet Union were mortal ide- ans alone would have been pumping out CO together, what he proposed was a radical new 2 ological enemies. We came close enough in emissions equal to those the United States nuclear doctrine: the end of arms control. Berlin and Cuba to know that war was plau- was cutting. In reality, Kyoto was a huge Henceforth, the United States would build sible. But even then the idea of a first strike transfer of resources from the United States nuclear weapons, both offensive and defen- remained quite fantastic because it meant to the Third World, under the guise of envi- sive, to suit its needs—regardless of what initiating the most destructive war in ronmental protection. others, particularly the Russians, thought. human history. All very good reasons. Nonetheless, the Sure, there would be consultation—no need Today, the idea of Russia or America alacrity and almost casualness with which to be impolite. Humble unilateralism, the launching a bolt from the blue is merely ab- Bush withdrew from Kyoto sent a message oxymoron that best describes this approach, surd. Russia does not define itself as our ex- that the United States would no longer ac- requires it: Be nice, be understanding. But, istential adversary. It no longer sees its mis- quiesce in multilateral nonsense just be- in the end, be undeterred. sion as the abolition of our very way of life. cause it had pages of signatories and bore Liberal critics argue that a missile defense We no longer are nose-to-nose in flashpoints the sheen of international comity. Nonsense would launch a new arms race, with the Rus- like Berlin. Ask yourself: Did you ever in the was nonsense, and would be treated as such. sians building new warheads to ensure that darkest days of the Cold War lie awake at That alarmed the usual suspects. They they could overcome our defenses. The re- night wondering whether Britain or France were further alarmed when word leaked that sponse of the Bush administration is: So or Israel had enough of a second strike ca- the administration rejected the protocol ne- what? If the Russians want to waste what pacity to deter an American first strike gotiated by the Clinton administration for little remains of their economy on such against them? Of course not. Nuclear weap- enforcing the biological weapons treaty of weapons, let them. These nukes are of no ons are not in themselves threats. They be- 1972. The reason here is even more obvious. use. Whether or not Russia builds new mis- come so in conditions of extreme hostility. It The protocol does nothing of the sort. Bio- siles, no American defense will stop a mas- all depends on the intent of the political au- logical weapons are inherently unverifiable. sive Russian first strike anyway. And if Rus- thorities who control them. A Russian or an You can make biological weapons in a lab- sia decides to enlarge its already massive American first strike? We are no longer con- oratory, in a bunker, in a closet. In a police second strike capacity, in a world in which tending over the fate of the earth, over the state, these are unfindable. And police states the very idea of a first strike between us and future of Korea and Germany and Europe. are what we worry about. The countries ef- the Russians is preposterous, then fine Our worst confrontation in the last decade fectively restricted would be open societies again. was over the Pristina airport! with a free press—precisely the countries The premises underlying the new Bush nu- What about China? The fallback for some that we do not worry about. Even worse, the clear doctrine are simple: (1) There is no So- missile defense opponents is that China will protocol would have a perverse effect. It viet Union. (2) Russia—no longer either a su- feel the need to develop a second strike ca- would allow extensive inspection of Amer- perpower or an enemy, and therefore neither pacity to overcome our defenses. But this ican anti-biological-warfare facilities—where a plausibly viable nor an ideological threat— too is absurd. China does not have a second we develop vaccines, protective gear, and the does not count. (3) Therefore, the entire strike capacity. If it has never had one in the like—and thus give information to potential structure of bilateral arms control, both of- absence of an American missile defense, why enemies on how to make their biological fensive and defensive, which was an Amer- should the construction of an American mis- agents more effective against us. ican obsession during the last quarter-cen- sile defense create a crisis of strategic insta- Given the storm over Kyoto, the adminis- tury of the Cold War, is a useless relic. In- bility between us? tration is looking for a delicate way to get deed, it is seriously damaging to American But the new Bush nuclear doctrine does out of this one. There is nothing wrong with security. not just bury MAD. It buries the ABM treaty delicacy. But the thrust of the administra- Henceforth, America will build the best and the very idea of bilateral nuclear coordi- tion—to free itself from the thrall of inter- weaponry it can to meet its needs. And those nation with another superpower. Those national treaty-signing that has character- needs are new. The coming threat is not agreements, on both offensive and defensive ized U.S. foreign policy for nearly a decade— from Russia, but from the inevitable pro- nuclear weapons, are a relic of the bipolar is refreshing. liferation of missiles into the hands of here- world. In the absence of bipolarity, there is One can only marvel at the enthusiasm tofore insignificant enemies. no need to tailor our weapons to the needs or with which the Clinton administration pur- Critics can downplay and discount one threat or wishes of a rival superpower. sued not just Kyoto and the biological pro- such threat or another. North Korea, they Yet the Clinton administration for eight tocol but multilateral treaties on everything say, is incapable of building an interconti- years carried on as if it did. It spent enor- from chemical weapons to nuclear testing. nental ballistic missile. (They were saying mous amounts of energy trying to get the Treaty-signing was portrayed as a way to that right up to the time when it launched a START treaties refined and passed in Russia. build a new structure of legality and regu- three-stage rocket over Japan in 1998). Or It went to great lengths to constrain and larity in the world, to establish new moral they will protest that Iraq cannot possibly dumb down the testing of high-tech weap- norms that would in and of themselves re- build an effective nuclear capacity clandes- onry (particularly on missile defense) to be strain bad behavior. But the very idea of a tinely. They are wrong on the details, but, ‘‘treaty compliant.’’ It spent even more en- Saddam Hussein being morally constrained even more important, they are wrong in ergy negotiating baroque extensions, elabo- by, say, a treaty on chemical weapons is sim- principle: Missile technology is to the 21st rations, and amendments to the ABM treaty. ply silly.

VerDate 19-JUN-2001 00:06 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00005 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.001 pfrm03 PsN: S19PT1 S6392 CONGRESSIONAL RECORD — SENATE June 19, 2001 This reality could not have escaped the lib- Britain was the balancer of power in Europe tering source of armed conflict, terror, and eral internationalists who spent the ’90s pur- for over two centuries, always joining the instability. suing such toothless agreements. Why then weaker coalition against the stronger to cre- The ‘‘realist’’ school is more skeptical that did they do it? The deeper reason is that ate equilibrium. Our unique reach around these goals can be achieved at the point of a these treaties offered an opportunity for the world allows us to be—indeed dictates bayonet. True, democracy can be imposed by those who distrusted American power (and that we be—the ultimate balancer in every force, as both Germany and Japan can at- have ever since the Vietnam era) to con- region. We balanced Iraq by supporting its test. But those occurred in the highly un- strain it—and constrain it in ways that give weaker neighbors in the Gulf War. We bal- usual circumstance of total military occupa- the appearance of altruism and good inter- ance China by supporting the ring of smaller tion following a war for unconditional sur- national citizenship. states at her periphery (from South Korea to render. Unless we are willing to wage such Moreover, it was clear that the constraints Taiwan, even to Vietnam). One can argue wars and follow up with the kind of trustee- on American power imposed by U.S.-Soviet whether we should have gone there, but our ship we enjoyed over Germany and Japan, we bipolarity and the agreements it spawned role in the Balkans was essentially to create will find that our interventions on behalf of would soon and inevitably come to an end. a micro-balance: to support the weaker Bos- democracy will leave little mark, as we Even the ABM treaty, the last of these rel- nia Muslims against their more dominant learned with some chagrin in Haiti and Bos- ics, would have to expire of its own obsoles- ethnic neighbors, and subsequently to sup- nia. cent dead weight. In the absence of port the (at the time) weaker Kosovo Alba- Nonetheless, although they disagree on the bipolarity, what was there to hold America nians against the dominant Serbs. stringency of criteria for unleashing Amer- back—from, say, building ‘‘Star Wars’’ weap- (2) To maintain the peace by acting as the ican power, both schools share the premise onry or raping the global environment or world’s foremost anti-proliferator. Weapons that overwhelming American power is good otherwise indulging in the arrogance of of mass destruction and missiles to deliver not just for the United States but for the power? Hence the mania during the last dec- them are the greatest threat of the 21st cen- world. The Bush administration is the first ade for the multilateral treaties that would tury. Non-proliferation is not enough. Pas- administration of the post-Cold War era to impose a new structure of constraint on sive steps to deny rogue states the tech- share that premise and act accordingly. It American freedom of action. nology for deadly missiles and weapons of welcomes the U.S. role of, well, hyperpower. Kyoto and the biological weapons protocol mass destruction is, of course, necessary. In its first few months, its policies have re- are the models for the new structure of But it is insufficient. Ultimately the stuff flected a comfort with the unipolarity of the ‘‘strategic stability’’ that would succeed the gets through. world today, a desire to maintain and en- ABM treaty and its relatives. By summarily What to do when it does? It may become hance it, and a willingness to act unilater- rejecting Kyoto, the Bush administration necessary in the future actually to preempt ally to do so. It is a vision of America’s role radically redefines the direction of American rogue states’ weapons of mass destruction, very different from that elaborated in the foreign policy: rejecting the multilateral as Israel did in 1981 by destroying the Osirak first post-Cold War decade—and far more straitjacket, disenthralling the United nuclear reactor in Iraq. Premption is, of radical than has generally been noted. The States from the notion there is real safety or course, very difficult. Which is why we must French, though, should be onto it very soon. benefit from internationally endorsed parch- begin thinking of moving to a higher plat- ment barriers, and asserting a new American form. Space is the ultimate high ground. For [From the Weekly Standard, June 4, 2001] unilateralism. 30 years, we have been reluctant even to BIG ROTTEN APPLE IV. THE PURPOSES OF UNILATERALISM think about placing weapons in space, but it NEW YORK CITY AFTER GIULIANI This is a posture that fits the unipolarity is inevitable that space will become milita- (By James Higgins) of the 21st century world. Its aim is to re- rized. The only question is: Who will get store American freedom of action. But as yet there first and how will they use it? Liberalism, or paleoliberalism to some, is it is defined only negatively. The question The demilitarization of space is a fine idea what New Yorkers are told will return to remains: freedom of action to do what? and utterly utopian. Space will be an avenue City Hall when term limits force mayor Ru- First and foremost, to maintain our pre- for projection of national power as were the dolph Giuliani to depart in 2002. Four Demo- eminence. Not just because we enjoy our own oceans 500 years ago. The Great Powers that crats are vying to succeed him. power (‘‘It’s good to be the king’’—Mel emerged in the modern world were those But the potential return of Brooks), but because it is more likely to that, above all, mastered control of the high unreconstructed liberalism is not the most keep the peace. It is hard to understand the seas. The only reason space has not yet been menacing aspect of this fall’s election. The enthusiasm of so many for a diminished militarized is that none but a handful of greater threat is the potential return of America and a world reverted to multi- countries are yet able to do so. And none is unreconstructed crime. Not the kind in the polarity. Multipolar international structures remotely as technologically and industrially streets, but the kind in the suites—the suites are inherently less stable, as the cata- and economically prepared to do so as is the of city government and the Democratic strophic collapse of the delicate alliance sys- United States. party. tem of 1914 definitively demonstrated. This is not as radical an idea as one might Everyone old enough to have watched TV Multipolarity, yes, when there is no alter- think. When President Kennedy committed in the 1980s and early 1990s knows that New native. But not when there is. Not when we the United States to a breakneck program of York City before Giuliani was where foreign have the unique imbalance of power that we manned space flight, he understood full well tourists came to pay the world’s highest enjoy today—and that has given the inter- the symbiosis between civilian and military hotel taxes while waiting to be robbed and national system a stability and essential space power. It is inevitable that within a shot. But the depth and breadth of corrup- tranquility it had not known for at least a generation the United States will have an tion in the city’s Democratic establishment century. Army, Navy, Marines, Air Force, and Space during the pre-Giuliani years may be dif- The international environment is far more Force. Space is already used militarily for ficult for non-New Yorkers to grasp. The likely to enjoy peace under a single spying, sensing, and targeting. It could be problem was not just a few rotten apples at hegemon. Moreover, we are not just any uniquely useful, among other things, for the top. Under a series of Democratic may- hegemon. We run a uniquely benign impe- finding and destroying rogue-state missile ors—Abraham Beame, Edward Koch, and rium. This is not mere self-congratulation; it forces. David Dinkins—the whole tree was rotten. It is a fact manifest in the way others welcome (3) To extend the peace by spreading de- was corruption that the New York City our power. It is the reason, for example, the mocracy and free institutions. This is an un- Democrats stood for even more than lib- Pacific Rim countries are loath to see our assailable goal and probably the most endur- eralism, and it was corruption at least as military presence diminished. ing method of promoting peace. The libera- much as liberalism that brought Giuliani to Unlike other hegemons and would-be tion of the Warsaw Pact states, for example, office. It was as if, having jailed much of the hegemons, we do not entertain a grand vi- relieved us of the enormous burden of phys- leadership of New York’s ‘‘Five Families’’ of sion of a new world. No Thousand Year ically manning the ramparts of Western Eu- crime while he was U.S. attorney for the Reich. No New Soviet Man. By position and rope with huge land armies. The zone of de- Southern District of New York, Giuliani had nature, we are essentially a status quo mocracy is almost invariably a zone of to become mayor to flush out this Sixth power. We have no particular desire to re- peace. Family. make human nature, to conquer for the ex- There is a significant disagreement, how- To appreciate the significance of the up- traction of natural resources, or to rule for ever, as to how far to go and how much blood coming election, it’s essential to know this the simple pleasure of dominion. We could and treasure to expend in pursuit of this background. The chief reason the rot was not not wait to get out of Haiti, and we would goal. The ‘‘globalist’’ school favors vigorous always visible to outsiders is the canniness get out of Kosovo and Bosnia today if we intervention and use of force to promote the of Dems in the Big Apple. Unlike their coun- could. Our principal aim is to maintain the spread of our values where they are threat- terpart New Jersey crew, the New York City stability and relative tranquility of the cur- ened or where they need protection to bur- Democratic leadership has refrained from rent international system by enforcing, geon. Globalists supported the U.S. interven- putting into the highest offices sticky-fin- maintaining, and extending the current tion in the Balkans not just on humani- gered characters like U.S. senators Harrison peace. Our goals include: tarian grounds, but on the grounds that ulti- Williams and Robert Torricelli. The New (1) To enforce the peace by acting, unique- mately we might widen the zone of democ- York Democrats could have been working ly, as the balancer of last resort everywhere. racy in Europe and thus eliminate a fes- from the template of the mobsters who once

VerDate 19-JUN-2001 01:04 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00006 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.006 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6393 controlled Las Vegas: They’ve always chosen lar (ABM) or multipolar (Kyoto), in the Rumsfield, read Deputy Secretary Wolfowitz clean front men. There was never a hint of name of good international citizenship. known Vice President Cheney or listened to personal corruption on the part of Beame, The word now, however, is that Bush has President Bush would be wise to place his Koch, or Dinkins. Their administrations gone soft. He sends Secretary of State Colin bet at the ‘‘no wobble’’ window. were another story. Consider: Powell to Europe to try to get agreement on The ACTING PRESIDENT pro tem- missile defenses. He tries, reports the New Under Ed Koch, the entire city department pore. Under the previous order, the charged with inspecting restaurants had to York Times in high scoop mode, to cook an be closed because there was almost no one ABM deal with the Russians—shades of the time until 10:45 a.m. shall be under the left to do the job after investigators arrested old days. He then concedes there is global control of the Senator from Kansas, the inspectors who were taking bribes. Not warming and promises action. ‘‘When Presi- Mr. BROWNBACK. long afterwards, the department that in- dent Bush announces . . . that he will seek Mr. BROWNBACK. Thank you, Mr. spected taxicabs had to be closed for exactly millions of dollars for new research into the President. the same reason. causes of global warming,’’ reported the f Over an extended period of the ’80s and Times just one week ago, ‘‘. . . it will mark early ’90s, the felony rate among Democratic yet another example of how global and do- EMBRYONIC STEM CELL borough leaders in New York City ap- mestic politics have forced him to back away RESEARCH proached 50 percent. Criminal defense law- from the hairline pronouncements of his first yers tell me that if senior managers of a pri- five months in the White House.’’ Mr. BROWNBACK. Mr. President, I vate business used their jobs to commit The Bush administration, explained News- rise today to address the issue of em- crimes at this rate, the entire enterprise week, began by ‘‘playing the bully.’’ But bryonic stem cell research and cloning. would be inviting a RICO indictment. then ‘‘the Bushies began to see that they The two issues are inexplicably tied to- The Beame, Koch, and Dinkins administra- could not simply impose their agenda on a gether. I want to discuss this in the tions approved a contract with school balky and complex world.’’ The alleged cave has been greeted with narrow context of Federal funding for custodians that was close to being criminal embryonic stem cell research and on its face: The custodians were required smug satisfaction from those on the left who only to maintain schools to ‘‘minimum see Bush returning, after a brief flirtation cloning. The two are tied together in standards,’’ and the contract precluded any with the mad-dog ideological right, to the what is currently being discussed. They basic soundness of post-Cold War foreign pol- effective enforcement mechanism. The lucky take an embryo, raise it to a certain icy as established by the Clinton administra- custodians then personally got to keep what- age, kill the embryo, take the stem tion. ever money in their budgets they didn’t Dream on. cell out of the embryo—the young stem spend doing their jobs. This type of contract Has Bush gone wobbly? Not at all. cells inside that are reproducing on a came to an end only after a 1992 60 Minutes Ask yourself: If you really wanted to re- rapid basis—and use those in research, segment showed the custodians spending less assert American unilateralism, to get rid of or use those for human development time at the filthy schools they were osten- the cobwebs of the bipolar era and the myr- sibly maintaining than attending to the and in the capacity of making other or- iad Clinton-era treaty strings trying Gul- gans in the future. yachts they acquired—and did maintain—at liver down, what would you do? No need for taxpayer expense. in-your-face arrogance. No need to humili- The next step will be to take the Pre- As pre-Giuliani taxi and limousine com- ate. No need to proclaim that you will ignore siding Officer’s DNA material, my DNA missioner Herb Ryan described the system nattering allies and nervous enemies. material, the Official Reporter’s DNA after he was caught taking bribes, ‘‘Every- Journalists can talk like that because the material, or the DNA material of some body else has their own thing. I just wanted trust is clarifying. Governments cannot talk of the new interns, take it out, and put to get my own thing.’’ The literal trans- like that because the truth is scary. The it into an embryo that has been lation of ‘‘Our Thing’’ is, of course, La Cosa trick to unilateralism—doing what you Nostra. think is right, regardless of what others denuclized, take that DNA material, This is just a small sample of what the think—is to pretend you are not acting uni- put it into the embryo, and start the Sixth Family Democrats and their ap- laterally at all. Thus if you really want to growth that is again taking place so pointees did—indeed, just a small sample of junk the ABM Treaty, and the Europeans you will have a cloned individual. what they were caught doing. That predicate and Russians and Chinese start screaming That is an individual who has exactly criminal activity is a major part of what in bloody murder, the trick is to send Colin the same DNA as somebody else. Sci- 1989 lured political rising star and crime- Powell to smooth and sooth and schmooze entists grow it to a certain age, kill fighter Rudy Giuliani to run for mayor, a job every foreign leader in sight, have the embryo, and take those stem cells that for more than a century had been a po- Condoleezza Rica talk about how much we litical dead end. value allied input, have President Bush in from that embryo to be used to make Europe stress how missile defense will help an organ, or make brain cells, or make [From the Washington Post, June 18, 2001] the security of everybody. And then go ahead something else. ... FROM A NO-WOBBLE BUSH and junk the ABM Treaty regardless. Make These two topics are tied together. It (By Charles Krauthammer) nice, then carry on. is a gate which shouldn’t open. Or, say you want to kill the Kyoto protocol ‘‘Remember George, this is no time to go Initially, I think we need to talk (which the Senate rejected 95–0 and which about Federal funding in Congress. We wobbly.’’ So said Margaret Thatcher to the not a single EU country has ratified) and the first President Bush just days after Saddam Eueopeans hypocritically complain. The need to discuss the issue raised regard- Hussein attacked Kuwait. Bush did not go trick is to have the president go to Europe to ing Federal funding of destructive em- wobbly. He invaded. stress, both sincerely and correctly, that the bryonic research. My position is that A decade later, the second George Bush United States wants to be in the forefront of federally funded human embryonic came into office and immediately began a using science and technology to attack the stem cell research is illegal, it is im- radical reorientation of U.S. foreign policy. problem—but make absolutely clear that moral, and it is unnecessary for where Now, however the conventional wisdom is you’ll accept no mandatory cuts and tolerate that in the face of criticism from domestic we are and what we know today. We no treaty that penalizes the United States have other solutions that are legal, opponents and foreign allies, Bush is backing and lets China, India and the Third World off down. the hook. ethical, moral, and superior to where Has W. gone wobbly? In his first days, he Be nice, but be undeterred. The best we are going with these Federal funds offered a new American nuclear policy that unlateralism is velvet-glove unilateralism. today regarding embryonic stem cell scraps the 1972 anti-Ballistic Missile Treaty, At the end of the day, for all the rhetorical research and cloning. builds defenses against ballistic missile at- bows to Russia, European and liberal sen- The issue of destructive embryo re- tack and unilaterally cuts U.S. offensive nu- sibilities, look at how Bush returns from Eu- search has come into better focus over clear forces without wrangling with the Rus- rope: Kyoto is dead. The ABM Treaty is his- sians over arms control, the way of the past tory, Missile defense is on. NATO expansion the past few weeks as the new adminis- 30 years. He then summarily rejected the is relaunched. And just to italicize the new tration prepares to take definitive ac- Kyoto protocol on climate control, which turn in American foreign policy, the number tion on the Clinton-era guidelines would have forced the United States to un- of those annual, vaporous U.S.-EU summits which call the destruction of human dertake a ruinous 30 percent cut in CO2 emis- has been cut from two to one. embryos for the purposes of subsequent sions while permitting China, India and most Might the administration yet bend to the federal funding for the cells that have of humanity to pollute at will. critics and abandon the new unilateralism? been derived through the process of Bush’s assertion of American freedom of Perhaps. But the crowing of the Washington embryo destruction. action outraged those—U.S. Democrats, Eu- foreign policy establishment that this has al- ropeans, Russians—who prefer to see the ready occurred is wishful thinking. Currently, we say, OK. You can’t de- world’s only superpower bound and re- Will he wobble? Everything is possible. But stroy the embryo, but you can use strained by treaty constraints, whether bipo- anyone who has watched Defense Secretary what is taken from the destruction of

VerDate 19-JUN-2001 00:08 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00007 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.011 pfrm03 PsN: S19PT1 S6394 CONGRESSIONAL RECORD — SENATE June 19, 2001 that embryo. It would be like saying of DON NICKLES, JOHN MCCAIN, MICHAEL This bill even violates current Fed- the Presiding Officer, you can’t kill DEWINE, and JOHN ASHCROFT. eral policy on fetal tissue, which allows him, but you can take his heart, you I ask unanimous consent that this harvesting of tissue only after an abor- can take his lungs and brain, and his letter be printed in the RECORD. tion was performed for other reasons eyes out. And, if you get those, even There being no objection, the letter and the unborn child is already dead. though somebody kills him, that is OK. was ordered to be printed in the Under this bill, the Federal Govern- Well, that doesn’t seem to be right to RECORD, as follows: ment will use tax dollars to kill live most of us. It certainly doesn’t seem to WASHINGTON, DC, embryos for the immediate and direct be right to me, nor the Presiding Offi- February 4, 2000. purpose of using their parts for re- cer. Yet that is what is being proposed, STEM CELL GUIDELINES, search. Is that something that we want and currently taking what applies NIH Office of Science Policy, to do? I don’t think so. under the Clinton-era guidelines which Bethesda, MD. TO WHOM IT MAY CONCERN: Since 1996 Con- Taxpayer funding of this research is call for the destruction of human em- problematic for a variety of reasons. bryos for the purpose of subsequent gress has banned federal funding for ‘‘re- search in which a human embryo or embryos First among those concerns is that if Federal funding for the cells that have are destroyed.’’ We believe the draft guide- Congress were to approve this bill, it been derived from the process of em- lines published December 2 by the National would officially declare for the first bryo destruction. Institutes of Health for ‘‘human pluripotent time in our Nation’s history that Gov- During the Presidential campaign, stem cell research’’ do not comply with this ernment may exploit and destroy then Governor Bush stated, in response law, which we support and which remains in human life for its own, or somebody to a questionnaire, ‘‘I oppose using effect. else’s purposes. We don’t want to go Federal funds to perform fetal tissue Despite their title, the NIH guidelines do not regulate stem cell research. Rather, they there. research from induced abortions. Tax- Human embryonic stem cell research payer funds should not underwrite re- regulate the means by which researchers may obtain and destroy live human embryos is also unnecessary. search that involves the destruction of in order to receive federal funds for subse- I think there is a point that is lost to live human embryos.’’ quent stem cell research. Clearly, the de- many in the broader debate about when Later, after assuming the Presi- struction of human embryos is an integral human life begins. Where should we dency, his spokesman, Ari Fleischer, part of the contemplated research, in viola- protect it, and how do we protect? But stated that the President, ‘‘would op- tion of the law. the point is that human embryonic pose federally funded research for ex- Because Congress never intended for the stem cell research, and, thus, cloning, perimentation on embryonic stem cells Executive Branch to facilitate destructive that require live human embryos to be embryo research, we urge the National Insti- is also unnecessary. tutes of Health to withdraw these guidelines There are legitimate areas of re- discarded or destroyed.’’ as contrary to the law and Congressional in- I would like to applaud the President search which are showing more prom- tent. ise than embryonic stem cell research, for his bold and principled stand in de- Sam Brownback, Pete V. Domenici, Don fense of the most innocent human life. areas which do not create moral and Nickles, George V. Voinovich, Trent ethical difficulties. It has never been, and it will never be, Lott, John Ashcroft, Chuck Hagel, acceptable to kill one person for the Rick Santorum, Kit Bond, Bob Smith, In the past, Congress has increased benefit of another—no matter how big, Rod Grams, John Kyl, Jeff Sessions, funding for NIH. New advances in adult or how promising the purported ben- Michael B. Enzi, Mike DeWine, Jesse stem cell research, being reported al- efit. Helms, Tom Harkin, Conrad Burns, most weekly, show more promise than Few issues make this point as clearly Jim Bunning, John McCain. destructive embryo research, and I be- as the issue of destructive embryo re- Mr. BROWNBACK. Mr. President, in lieve should receive a significant in- search. order to provide the justification for crease in funding. As my colleagues are well aware, the NIH guidelines, the Department of The Presiding Officer, myself, and ev- Congress outlawed federal funding for Health and Human Services wrote a eryone else in the room have stem cells harmful embryo research in 1996 and legal opinion reviewing the ban just within us. has maintained that prohibition ever mentioned above and whether or not It has been a discovery within the since. The ban is broad-based and spe- Federal money could be used to con- past couple of years. These stem cells cific; funds cannot be used for ‘‘re- duct research on so-called human reproduce other cells within our body. search in which a human embryo or pluripotent stem cells that had been We have them in our fat tissue, our embryos are destroyed, discarded or derived from an embryo. My conclu- bones, and our brain. These are cells knowingly subjected to risk of injury sion—and that of many of my col- that can now be taken out, grown, and or death.’’ The intent of Congress is leagues—is that this research is illegal. they have multiple actions of other clear—if a research project requires the it is illegal for this reason: the delib- material, other tissue they can replace. destruction of human embryos no fed- erate killing of a human embryo is an It is very exciting and very promising. eral funds should be used for that essential component of the con- It does not have the ethical problems project. templated research; and without the of killing another life and does not The NIH, during the Clinton adminis- destruction of the embryo the proposed have the immune rejection problems tration, published guidelines that research would be impossible, which like taking DNA material from another sought to circumvent this language. At brings us to a discussion of the moral- life and putting it into someone else. It the time, several of my colleagues, and ity of this research. is our own DNA. It is our own material, myself, sent a letter to the NIH stating Recently there was a bill introduced, and it is showing great promise. I want our opposition to the guidelines. the Stem Cell Research Act of 2001, to read some of the significant ad- It read, in part, seemingly based on the NBAC rec- vances that have taken place in recent Despite their title, the NIH guidelines do ommendations, which seeks to allow times in adult stem cell research, not regulate stem cell research. Rather, they Federal funding for researchers to kill which I strongly support, and I support regulate the means by which researchers living human embryos. our increasing funding in a substantial may obtain and destroy live human embryos Under this bill federal researchers way for adult stem cell research. in order to receive Federal funds for subse- quent stem cell research. Clearly, the de- would be allowed to obtain their own Research has shown the pluripotent struction of human embryos is an integral supply of living human embryos, which nature of adult stem cells. In other part of the contemplated research, in viola- they would then be allowed to kill for words, they can have a multitude of op- tion of the law. research purposes. tions. Research shows the ability of a That is simply because to get embry- The very act of harvesting cells from single adult bone marrow stem cell to onic stem cells you have to kill the live human embryos results in the repopulate the bone marrow, forming embryo. You kill an embryo to ‘‘har- death of the embryo. Therefore, if en- functional marrow and blood cells, and vest’’ stem cells and use them. This is acted, this bill would result in the de- also differentiating into functional destructive human embryonic research. liberate destruction of human em- cells of liver, lung, gastrointestinal The letter that I cited was signed by, bryos—human life in its most infant tract—esophagus, stomach, intestine, among others, Senators TRENT LOTT, stage. colon—and skin, with indications it

VerDate 19-JUN-2001 00:08 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00008 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.015 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6395 could also form functional heart and In the future, people are going to say I thank the Chair. I yield the floor. skeletal muscle. The evidence shows they want embryonic stem cells, but The ACTING PRESIDENT pro tem- the stem cells home to sites of tissue what they really want is to be able to pore. The time of the Senator from damage. clone you, to clone another individual, Kansas has expired. In other words, these stem cells can take that DNA material from you, Under previous order, the time until go to the place where the damage is from me, from somebody in this room, 11:30 a.m. is under the control of the and start to reproduce and build up the destroy a young human embryo, put Senator from Illinois, Mr. DURBIN, or damaged material. the DNA material in there, start this his designee. The Senator from South This was a May 4, 2001, study that to reproducing for a while, kill that Carolina, Mr. HOLLINGS, controls 10 was just released on this pluripotent embryo, take the stem cells out, and minutes of that time. nature of adult stem cells. Adult stem work with those because they are exact f cells can repair cardiac damage. copies of the DNA from us. We do not Researchers at Baylor College of want to open this door of going the BETTER EDUCATION FOR Medicine found adult bone marrow route of cloning, and that is where this STUDENTS AND TEACHERS ACT stem cells could form functional heart is leading. AMENDMENT NO. 805 muscle and blood vessels in mice which Mr. President, that is why today I Mr. DURBIN. Mr. President, I ask had heart damage. They note their re- have spoken out on this topic. We unanimous consent, notwithstanding sults demonstrate the potential of should not be going this route. We do passage of H.R. 1, that amendment No. adult bone marrow stem cells for heart not need to go this route. It is illegal 805, a Torricelli amendment, be agreed repair and suggest a therapeutic strat- for us currently to go this route. I ask to and the motion to reconsider be laid egy that eventually could benefit pa- that we stop. This is a view that I be- upon the table. tients with heart attacks. The results lieve the President shares. In fact, in a The ACTING PRESIDENT pro tem- also suggest that circulating stem cells letter written to the Culture of Life pore. Without objection, it is so or- may naturally contribute to repair of Foundation, President Bush states: dered. tissues. I oppose Federal funding for stem-cell re- The amendment (No. 805) was agreed Also, scientists at Duke University search that involves destroying living to, as follows: human embryos. Medical Center showed that adult stem (Purpose: To require local educational agen- cells from a liver could transform into I ask unanimous consent that the cies and schools to implement school pest heart tissue when injected into mice. President’s letter be printed in the management plans and to provide parents, They say, ‘‘Recent evidence suggests RECORD. guardians, and staff members with notice that adult-derived stem cells, like There being no objection, the letter of the use of pesticides in schools) their embryonic counterparts, are was ordered to be printed in the At the appropriate place insert the fol- pluripotent....’’ They have a mul- RECORD, as follows: lowing: titude of options of this stem cell con- THE WHITE HOUSE, SEC. 9ll. PEST MANAGEMENT IN SCHOOLS. forming into bone, heart, and other Washington, DC, May 18, 2001. (a) SHORT TITLE.—This section may be types of tissue, and ‘‘these results dem- Mr. ROBERT A. BEST, cited as the ‘‘School Environment Protec- onstrate adult liver-derived stem cells President, The Culture of Life Foundation, Inc., tion Act of 2001’’. Washington, DC. (b) PEST MANAGEMENT.—The Federal Insec- respond to the tissue microenviron- DEAR MR. BEST: Thank you for your letter ticide, Fungicide, and Rodenticide Act is ment....’’ about the important issue of stem cell re- amended— In other words, what is the environ- search. (1) by redesignating sections 33 and 34 (7 ment that the tissue is placed into, and I share your concern and believe that we U.S.C. 136x, 136y) as sections 34 and 35, re- that is what it is responding to and de- can and must do more to find the causes and spectively; and veloping. cures of diseases that affect the lives of too (2) by inserting after section 32 (7 U.S.C. Researchers at New York Medical many Americans. 136w–7) the following: That’s why I have proposed to double fund- ‘‘SEC. 33. PEST MANAGEMENT IN SCHOOLS. College report results that show regen- ing for National institutes of Health medical eration of heart muscle is possible research on important diseases that affect so ‘‘(a) DEFINITIONS.—In this section: after heart attack, possibly from heart many American families, such as breast can- ‘‘(1) BAIT.—The term ‘bait’ means a pes- adult stem cell. cer. My proposal represents the largest fund- ticide that contains an ingredient that I have several others I want to read, ing increase in the Institutes’ history, I also serves as a feeding stimulant, odor, pheromone, or other attractant for a target but one in particular I think is inter- have called for an extension of the Research and Development tax credit to help encour- pest. esting is that scientists have found ‘‘(2) CONTACT PERSON.—The term ‘contact stem cells in our fat. So now we can age companies to continue research into life- saving treatments. person’ means an individual who is— take fat stem cells, of which we do not I oppose Federal funding for stem-cell re- ‘‘(A) knowledgeable about school pest man- have a shortage in America, and those search that involves destroying living agement plans; and adult stem cells can be derived and human embryos. I support innovative med- ‘‘(B) designated by a local educational made into other types of cells and ical research on life-threatening and debili- agency to carry out implementation of the grown. tating diseases, including promising research school pest management plan of a school. on stem cells from adult tissue. ‘‘(3) EMERGENCY.—The term ‘emergency’ A new report shows umbilical cord means an urgent need to mitigate or elimi- blood can provide effective treatment We have the technology to find these cures, and I want to make sure that the re- nate a pest that threatens the health or safe- of various blood disorders in adults. It sources are available as well. Only through a ty of a student or staff member. had previously been assumed that greater understanding through research will ‘‘(4) LOCAL EDUCATIONAL AGENCY.—The there were too few stem cells in cord we be able to find cures that will bring new term ‘local educational agency’ has the blood to treat adults and only children hope and health to millions of Americans. meaning given the term in section 3 of the were treated. Sincerely, Elementary and Secondary Education Act of The results of this study show that GEORGE W. BUSH. 1965. ‘‘(5) SCHOOL.— cord blood stem cells can proliferate Mr. BROWNBACK. Mr. President, I ‘‘(A) IN GENERAL.—The term ‘school’ means extensively and provide sufficient num- fully anticipate that President Bush a public— bers of cells for adult treatments. will settle the issue of Federal funding ‘‘(i) elementary school (as defined in sec- My point is we do not have to destroy of embryonic stem cell research within tion 3 of the Elementary and Secondary Edu- another life to have the great success the context of the existing embryo re- cation Act of 1965); of stem cell work. We can take it out of search ban in the very near future, and ‘‘(ii) secondary school (as defined in sec- our own bodies. We can take it out of I hope we take up the issue of cloning tion 3 of the Act); our own fat and be able to grow these and ban it. It is a place we should not ‘‘(iii) kindergarten or nursery school that things, and we do not need to go down and do not need to go. I applaud the is part of an elementary school or secondary school; or the route of what is called therapeutic President in advance for his defense, ‘‘(iv) tribally-funded school. cloning, to which destructive embry- for his clear statement on cloning, as ‘‘(B) INCLUSIONS.—The term ‘school’ in- onic stem-cell research is going to well, and his defense of the most inno- cludes any school building, and any area out- lead. cent human life. side of a school building (including a lawn,

VerDate 19-JUN-2001 00:08 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00009 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.018 pfrm03 PsN: S19PT1 S6396 CONGRESSIONAL RECORD — SENATE June 19, 2001 playground, sports field, and any other prop- ‘‘(iv) establish guidelines that are con- room is occupied or in use by students or erty or facility), that is controlled, managed, sistent with the definition of a school pest staff members (except students and staff par- or owned by the school or school district. management plan under subsection (a); ticipating in regular or vocational agricul- ‘‘(6) SCHOOL PEST MANAGEMENT PLAN.—The ‘‘(v) require that each local educational tural instruction involving the use of pes- term ‘school pest management plan’ means a agency use a certified applicator or a person ticides); and pest management plan developed under sub- authorized by the State agency to imple- ‘‘(ii) the use by students or staff members section (b). ment the school pest management plans; of an area or room treated with a pesticide ‘‘(7) STAFF MEMBER.— ‘‘(vi) be consistent with the State coopera- by broadcast spraying, baseboard spraying, ‘‘(A) IN GENERAL.—The term ‘staff member’ tive agreement under section 23; and tenting, or fogging during— means a person employed at a school or local ‘‘(vii) require the posting of signs in ac- ‘‘(I) the period specified on the label of the educational agency. cordance with paragraph (4)(G). pesticide during which a treated area or ‘‘(B) EXCLUSIONS.—The term ‘staff member’ ‘‘(D) APPROVAL BY ADMINISTRATOR.—Not room should remain unoccupied; or does not include— later than 90 days after receiving a school ‘‘(II) if there is no period specified on the ‘‘(i) a person hired by a school, local edu- pest management plan submitted by a State label, the 24-hour period beginning at the end cational agency, or State to apply a pes- agency under subparagraph (B), the Adminis- of the treatment. ticide; or trator shall— ‘‘(3) CONTACT PERSON.— ‘‘(ii) a person assisting in the application ‘‘(i) determine whether the school pest ‘‘(A) IN GENERAL.—Each local educational of a pesticide. management plan, at a minimum, meets the agency shall designate a contact person to ‘‘(8) STATE AGENCY.—The term ‘State agen- requirements of subparagraph (C); and carry out a school pest management plan in cy’ means the an agency of a State, or an ‘‘(ii)(I) if the Administrator determines schools under the jurisdiction of the local agency of an Indian tribe or tribal organiza- that the school pest management plan meets educational agency. tion (as those terms are defined in section 4 the requirements, approve the school pest ‘‘(B) DUTIES.—The contact person of a local of the Indian Self-Determination and Edu- management plan as part of the State coop- educational agency shall— cation Assistance Act (25 U.S.C. 450b)), that erative agreement; or ‘‘(i) maintain information about the sched- exercises primary jurisdiction over matters ‘‘(II) if the Administrator determines that uling of pesticide applications in each school relating to pesticide regulation. the school pest management plan does not under the jurisdiction of the local edu- ‘‘(9) UNIVERSAL NOTIFICATION.—The term meet the requirements— cational agency; ‘universal notification’ means notice pro- ‘‘(aa) disapprove the school pest manage- ‘‘(ii) act as a contact for inquiries, and dis- vided by a local educational agency or school ment plan; seminate information requested by parents to— ‘‘(bb) provide the State agency with rec- or guardians, about the school pest manage- ‘‘(A) parents, legal guardians, or other per- ommendations for and assistance in revising ment plan; sons with legal standing as parents of each the school pest management plan to meet ‘‘(iii) maintain and make available to par- child attending the school; and the requirements; and ents, legal guardians, or other persons with ‘‘(B) staff members of the school. ‘‘(cc) provide a 90-day deadline by which legal standing as parents of each child at- the State agency shall resubmit the revised ‘‘(b) SCHOOL PEST MANAGEMENT PLANS.— tending the school, before and during the no- school pest management plan to obtain ap- tice period and after application— ‘‘(1) STATE PLANS.— proval of the plan, in accordance with the ‘‘(I) copies of material safety data sheet for ‘‘(A) GUIDANCE.—As soon as practicable State cooperative agreement. pesticides applied at the school, or copies of (but not later than 180 days) after the date of ‘‘(E) DISTRIBUTION OF STATE PLAN TO material safety data sheets for end-use dilu- enactment of the School Environment Pro- SCHOOLS.—On approval of the school pest tions of pesticides applied at the school, if tection Act of 2001, the Administrator shall management plan of a State agency, the data sheets are available; develop, in accordance with this section— State agency shall make the school pest ‘‘(II) labels and fact sheets approved by the ‘‘(i) guidance for a school pest management management plan available to each local Administrator for all pesticides that may be plan; and educational agency in the State. used by the local educational agency; and ‘‘(ii) a sample school pest management ‘‘(F) EXCEPTION FOR EXISTING STATE ‘‘(III) any final official information related plan. PLANS.—If, on the date of enactment of the ‘‘(B) PLAN.—As soon as practicable (but School Environment Protection Act of 2001, to the pesticide, as provided to the local edu- not later than 1 year) after the date of enact- a State has implemented a school pest man- cational agency by the State agency; and ment of the School Environment Protection agement plan that, at a minimum, meets the ‘‘(iv) for each school, maintain all pes- Act of 2001, each State agency shall develop requirements under subparagraph (C) (as de- ticide use data for each pesticide used at the and submit to the Administrator for ap- termined by the Administrator), the State school (other than antimicrobial pesticides proval, as part of the State cooperative agency may maintain the school pest man- (as defined in clauses (i) and (ii) of section agreement under section 23, a school pest agement plan and shall not be required to de- 2(mm)(1)(A))) for at least 3 years after the management plan for local educational agen- velop a new school pest management plan date on which the pesticide is applied; and cies in the State. under subparagraph (B). ‘‘(v) make that data available for inspec- ‘‘(C) COMPONENTS.—A school pest manage- ‘‘(2) IMPLEMENTATION BY LOCAL EDU- tion on request by any person. ment plan developed under subparagraph (B) CATIONAL AGENCIES.— ‘‘(4) NOTIFICATION.— shall, at a minimum— ‘‘(A) IN GENERAL.—Not later than 1 year ‘‘(A) UNIVERSAL NOTIFICATION.—At the be- ‘‘(i) implement a system that— after the date on which a local educational ginning of each school year, at the midpoint ‘‘(I) eliminates or mitigates health risks, agency receives a copy of a school pest man- of each school year, and at the beginning of or economic or aesthetic damage, caused by agement plan of a State agency under para- any summer session (as determined by the pests; graph (1)(E), the local educational agency school), a local educational agency or school ‘‘(II) employs— shall develop and implement in each of the shall provide to staff members of a school, ‘‘(aa) integrated methods; schools under the jurisdiction of the local and to parents, legal guardians, and other ‘‘(bb) site or pest inspection; educational agency a school pest manage- persons with legal standing as parents of stu- ‘‘(cc) pest population monitoring; and ment plan that meets the standards and re- dents enrolled at the school, a notice de- ‘‘(dd) an evaluation of the need for pest quirements under the school pest manage- scribing the school pest management plan management; and ment plan of the State agency, as deter- that includes— ‘‘(III) is developed taking into consider- mined by the Administrator. ‘‘(i) a summary of the requirements and ation pest management alternatives (includ- ‘‘(B) EXCEPTION FOR EXISTING PLANS.—If, on procedures under the school pest manage- ing sanitation, structural repair, and me- the date of enactment of the School Environ- ment plan; chanical, biological, cultural, and pesticide ment Protection Act of 2001, a State main- ‘‘(ii) a description of any potential pest strategies) that minimize health and envi- tains a school pest management plan that, at problems that the school may experience (in- ronmental risks; a minimum, meets the standards and criteria cluding a description of the procedures that ‘‘(ii) require, for pesticide applications at established under this section (as determined may be used to address those problems); the school, universal notification to be pro- by the Administrator), and a local edu- ‘‘(iii) the address, telephone number, and vided— cational agency in the State has imple- website address of the Office of Pesticide ‘‘(I) at the beginning of the school year; mented the State school pest management Programs of the Environmental Protection ‘‘(II) at the midpoint of the school year; plan, the local educational agency may Agency; and and maintain the school pest management plan ‘‘(iv) the following statement (including ‘‘(III) at the beginning of any summer ses- and shall not be required to develop and im- information to be supplied by the school as sion, as determined by the school; plement a new school pest management plan indicated in brackets): ‘‘(iii) establish a registry of staff members under subparagraph (A). ‘As part of a school pest management plan, of a school, and of parents, legal guardians, ‘‘(C) APPLICATION OF PESTICIDES AT [ ] may use pesticides to control pests. or other persons with legal standing as par- SCHOOLS.—A school pest management plan The Environmental Protection Agency ents of each child attending the school, that shall prohibit— (EPA) and [ ] registers pesticides for have requested to be notified in advance of ‘‘(i) the application of a pesticide to any that use. EPA continues to examine reg- any pesticide application at the school; area or room at a school while the area or istered pesticides to determine that use of

VerDate 19-JUN-2001 00:08 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00010 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.020 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6397 the pesticides in accordance with instruc- and provided to the local educational agency ‘‘(dd) the name and telephone number of tions printed on the label does not pose un- by the State agency; the designated contact person; and reasonable risks to human health and the en- ‘‘(V) a description of the purpose of the ap- ‘‘(ee) the statement contained in subpara- vironment. Nevertheless, EPA cannot guar- plication of the pesticide; graph (A)(iv). antee that registered pesticides do not pose ‘‘(VI) the address, telephone number, and ‘‘(iv) OUTDOOR PESTICIDE APPLICATIONS.— risks, and unnecessary exposure to pesticides website address of the Office of Pesticide ‘‘(I) IN GENERAL.—In the case of an outdoor should be avoided. Based in part on rec- Programs of the Environmental Protection pesticide application at a school, each sign ommendations of a 1993 study by the Na- Agency; and shall include at least 3 dates, in chrono- tional Academy of Sciences that reviewed ‘‘(VII) the statement described in subpara- logical order, on which the outdoor pesticide registered pesticides and their potential to graph (A)(iv) (other than the ninth sentence application may take place if the preceding cause unreasonable adverse effects on human of that statement). date is canceled. health, particularly on the health of preg- ‘‘(C) NOTIFICATION AND POSTING EXEMP- nant women, infants, and children, Congress ‘‘(II) DURATION OF POSTING.—A sign de- TION.—A notice or posting of a sign under enacted the Food Quality Protection Act of scribed in subclause (I) shall be posted after subparagraph (A), (B), or (G) shall not be re- 1996. That law requires EPA to reevaluate all an outdoor pesticide application in accord- quired for the application at a school of— registered pesticides and new pesticides to ance with clauses (ii) and (iii). measure their safety, taking into account ‘‘(i) an antimicrobial pesticide; ‘‘(5) EMERGENCIES.— the unique exposures and sensitivity that ‘‘(ii) a bait, gel, or paste that is placed— ‘‘(A) IN GENERAL.—A school may apply a pregnant women, infants, and children may ‘‘(I) out of reach of children or in an area pesticide at the school without complying have to pesticides. EPA review under that that is not accessible to children; or with this part in an emergency, subject to law is ongoing. You may request to be noti- ‘‘(II) in a tamper-resistant or child-resist- subparagraph (B). fied at least 24 hours in advance of pesticide ant container or station; and ‘‘(B) SUBSEQUENT NOTIFICATION OF PARENTS, applications to be made and receive informa- ‘‘(iii) any pesticide that, as of the date of GUARDIANS, AND STAFF MEMBERS.—Not later tion about the applications by registering enactment of the School Environment Pro- than the earlier of the time that is 24 hours with the school. Certain pesticides used by tection Act of 2001, is exempt from the re- after a school applies a pesticide under this the school (including baits, pastes, and gels) quirements of this Act under section 25(b) paragraph or on the morning of the next are exempt from notification requirements. (including regulations promulgated at sec- business day, the school shall provide to If you would like more information con- tion 152 of title 40, Code of Federal Regula- each parent or guardian of a student listed cerning any pesticide application or any tions (or any successor regulation)). on the registry, a staff member listed on the product used at the school, contact ‘‘(D) NEW STAFF MEMBERS AND STUDENTS.— registry, and the designated contact person, []’. After the beginning of each school year, a notice of the application of the pesticide in ‘‘(B) NOTIFICATION TO PERSONS ON REG- local educational agency or school within a an emergency that includes— ISTRY.— local educational agency shall provide each ‘‘(i) the information required for a notice ‘‘(i) IN GENERAL.—Except as provided in notice required under subparagraph (A) to— under paragraph (4)(G); and clause (ii) and paragraph (5)— ‘‘(i) each new staff member who is em- ‘‘(ii) a description of the problem and the ‘‘(I) notice of an upcoming pesticide appli- ployed during the school year; and factors that required the application of the cation at a school shall be provided to each ‘‘(ii) the parent or guardian of each new pesticide to avoid a threat to the health or person on the registry of the school not later student enrolled during the school year. safety of a student or staff member. than 24 hours before the end of the last busi- ‘‘(E) METHOD OF NOTIFICATION.—A local ‘‘(C) METHOD OF NOTIFICATION.—The school ness day during which the school is in ses- educational agency or school may provide a may provide the notice required by para- sion that precedes the day on which the ap- notice under this subsection, using informa- graph (B) by any method of notification de- plication is to be made; and tion described in paragraph (4), in the form scribed in paragraph (4)(E). ‘‘(II) the application of a pesticide for of— ‘‘(D) POSTING OF SIGNS.—Immediately after which a notice is given under subclause (I) ‘‘(i) a written notice sent home with the the application of a pesticide under this shall not commence before the end of the students and provided to staff members; paragraph, a school shall post a sign warning business day. ‘‘(ii) a telephone call; of the pesticide application in accordance ‘‘(ii) NOTIFICATION CONCERNING PESTICIDES ‘‘(iii) direct contact; with clauses (ii) through (iv) of paragraph USED IN CURRICULA.—If pesticides are used as ‘‘(iv) a written notice mailed at least 1 (4)(B). part of a regular vocational agricultural cur- week before the application; or riculum of the school, a notice containing ‘‘(v) a notice delivered electronically (such ‘‘(c) RELATIONSHIP TO STATE AND LOCAL RE- the information described in subclauses (I), as through electronic mail or facsimile). QUIREMENTS.—Nothing in this section (in- (IV), (VI), and (VII) of clause (iii) for all pes- ‘‘(F) REISSUANCE.—If the date of the appli- cluding regulations promulgated under this ticides that may be used as a part of that cation of the pesticide needs to be extended section)— curriculum shall be provided to persons on beyond the period required for notice under ‘‘(1) precludes a State or political subdivi- the registry only once at the beginning of this paragraph, the school shall issue a no- sion of a State from imposing on local edu- each academic term of the school. tice containing only the new date and loca- cational agencies and schools any require- ‘‘(iii) CONTENTS OF NOTICE.—A notice under tion of application. ment under State or local law (including reg- clause (i) shall contain— ‘‘(G) POSTING OF SIGNS.— ulations) that is more stringent than the re- ‘‘(I) the trade name, common name (if ap- ‘‘(i) IN GENERAL.—Except as provided in quirements imposed under this section; or plicable), and Environmental Protection paragraph (5)— ‘‘(2) establishes any exception under, or af- Agency registration number of each pes- ‘‘(I) a school shall post a sign not later fects in any other way, section 24(b). ticide to be applied; than the last business day during which ‘‘(II) a description of each location at the school is in session preceding the date of ap- ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.— school at which a pesticide is to be applied; plication of a pesticide at the school; and There are authorized to be appropriated such ‘‘(III) a description of the date and time of ‘‘(II) the application for which a sign is sums as are necessary to carry out this sec- application, except that, in the case of an posted under subclause (I) shall not com- tion.’’. outdoor pesticide application, a notice shall mence before the time that is 24 hours after (c) CONFORMING AMENDMENT.—The table of include at least 3 dates, in chronological the end of the business day on which the sign contents in section 1(b) of the Federal Insec- order, on which the outdoor pesticide appli- is posted. cation may take place if the preceding date ‘‘(ii) LOCATION.—A sign shall be posted ticide, Fungicide, and Rodenticide Act (7 is canceled; under clause (i)— U.S.C. prec. 121) is amended by striking the ‘‘(IV) all information supplied to the local ‘‘(I) at a central location noticeable to in- items relating to sections 30 through 32 and educational agency by the State agency, in- dividuals entering the building; and inserting the following: cluding a description of potentially acute ‘‘(II) at the proposed site of application. ‘‘Sec. 30. Minimum requirements for training and chronic effects that may result from ex- ‘‘(iii) ADMINISTRATION.—A sign required to posure to each pesticide to be applied based be posted under clause (i) shall— of maintenance applicators and on— ‘‘(I) remain posted for at least 24 hours service technicians. ‘‘(aa) a description of potentially acute and after the end of the application; ‘‘Sec. 31. Environmental Protection Agency chronic effects that may result from expo- ‘‘(II) be— minor use program. 1 sure to each pesticide to be applied, as stated ‘‘(aa) at least 8 ⁄2 inches by 11 inches for ‘‘Sec. 32. Department of Agriculture minor on the label of the pesticide approved by the signs posted inside the school; and use program. Administrator; ‘‘(bb) at least 4 inches by 5 inches for signs ‘‘(bb) information derived from the mate- posted outside the school; and ‘‘(a) In general. rial safety data sheet for the end-use dilu- ‘‘(III) contain— ‘‘(b)(1) Minor use pesticide data. tion of the pesticide to be applied (if avail- ‘‘(aa) information about the pest problem able) or the material safety data sheets; and for which the application is necessary; ‘‘(2) Minor Use Pesticide Data ‘‘(cc) final, official information related to ‘‘(bb) the name of each pesticide to be used; Revolving Fund. the pesticide prepared by the Administrator ‘‘(cc) the date of application; ‘‘Sec. 33. Pest management in schools.

VerDate 19-JUN-2001 01:04 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00011 Fmt 0624 Sfmt 0655 E:\CR\FM\A19JN6.020 pfrm03 PsN: S19PT1 S6398 CONGRESSIONAL RECORD — SENATE June 19, 2001 ‘‘(a) Definitions. school pest management plan, a state- this country. What could that issue ‘‘(1) Bait. ment about pesticides, information on possibly be? Health care. It is about ‘‘(2) Contact person. how to sign up to be notified prior to whether or not our health insurance ‘‘(3) Emergency. ‘‘(4) Local educational agen- all pesticide applications, notice of pes- will be there when we need it. cy. ticides that are exempt from notifica- Yesterday in Springfield, IL, my ‘‘(5) School. tion requirements, and information on hometown, I had a press conference. I ‘‘(6) Staff member. who to contact for additional informa- invited three local doctors and two ‘‘(7) State agency. tion regarding pesticide applications at local nurses to talk about health care ‘‘(8) Universal notification. the school. The amendment also gives today. They came and told stories ‘‘(b) School pest management parents the option of being notified at which were chilling, stories of their ef- plans. forts to provide quality medical care to ‘‘(1) State plans. least 24 hours in advance of every pes- ‘‘(2) Implementation by local ticide application. Between universal the people of my hometown and how educational agencies. notification and this additional notice time and again they ran into road- ‘‘(3) Contact person. option, parents will be armed with the blocks, obstacles, and barriers from ‘‘(4) Notification. knowledge they need to protect their HMOs, and other health insurance com- ‘‘(5) Emergencies. children from potentially harmful pes- panies, which tried to overrule medical ‘‘(c) Relationship to State and decisions. local requirements. ticides when they send them to school. It is an enormous and hard fought vic- A cardiologist who came forward ‘‘(d) Authorization of appro- said: I brought a person into my office priations. tory for the health of our children. ‘‘Sec. 34. Severability. I would like to thank my colleagues, who was complaining of pain, thinking ‘‘Sec. 35. Authorization of appropriations.’’. Senators BOXER and REID for joining he suffered a heart attack. I was pre- (d) EFFECTIVE DATE.—This section and the me in introducing this important pared to provide emergency care and I amendments made by this section take ef- amendment. Their strong support for did, only to learn that his health insur- fect on October 1, 2001. the protection of our children against ance company would not pay me be- Mr. TORRICELLI. Mr. President, I exposure to pesticides was critical to cause I did not happen to be in their rise today to announce a landmark the passage of this amendment. They network. This person who showed up at agreement regarding the use of pes- have both been leaders on this issue for my office, afraid he was going to die, ticides in our Nation’s schools. This years, and I look forward to their con- was supposed to read his health insur- agreement marks the first time that tinued advocacy on behalf of our Na- ance policy, look for the appropriate doctor, and make an appointment. the Federal Government will institute tion’s children. That is the reality of dealing with regulations on pesticides and school- I extend my thanks to the majority HMOs and health insurance companies children. The Senate unanimously ac- leader, Senator DASCHLE, for working today. cepted my amendment to the Elemen- to address the concerns of all sides. I tary and Secondary Education Act, A lady who is an OB/GYN in my appreciate the willingness of the man- hometown talked about women under which passed in the Senate late last agers of the bill, Chairman KENNEDY week. For the first time, parents in all her care preparing to deliver a baby and Senator GREGG, to have this im- who, because the employer of that fifty States will be notified when pes- portant issue considered in the context ticides are used in schools. woman changed health insurance com- of the ESEA bill. In addition, I wish to panies, were told in the closing days of This agreement was reached after thank the many groups whose support seven weeks of negotiations between the pregnancy that she could no longer this amendment enjoys, including: Be- be treated by her obstetrician, but had my staff, environmental health groups, yond Pesticides/National Coalition a broad coalition of pesticide, agri- to go to a new doctor, an approved doc- Against the Misuse of Pesticides, the tor, someone who had never seen her culture, and education groups. It was National Pest Management Associa- developed with these various groups to during the course of her pregnancy tion, Responsible Industry for a Sound simply because this health insurance achieve a balance between the need to Environment, American Crop Protec- company thought it could save a dollar protect children from pests and ad- tion Association, Consumer Specialty by referring this care to a different ob- dressing the concerns about the safety Products Association, Chemical Pro- stetrician. of pesticide applications. ducers and Distributors Association, The cases went on and on and on. A recent study by the General Ac- and the International Sanitary Supply Frankly, it should not come as a sur- counting Office found that no credible Association. I also appreciate the sup- prise. We have known for years that statistics exist regarding the amount port of the New Jersey Pest Manage- HMOs, health maintenance organiza- of pesticides used in public schools and ment Association, and the New Jersey tions, are really cost containment or- no information exists about students’ Environmental Federation. Finally, ganizations. Their job is to reduce the exposure to pesticides or their health this amendment would not have been cost of health care. What is secondary impacts. We can and must do a better possible without the work of Joe in their consideration is really quality job of providing accurate information Fiordaliso of my staff. medical care that all of us count on to parents and staff at our Nation’s I look forward to working with mem- when we go to a doctor or a hospital or schools regarding pesticide use and the bers of the conference on ESEA to en- rely on a nurse’s advice. That has been potential effects on our children. sure that this amendment is included the casualty in this debate. This amendment requires local edu- in the final bill, which is presented to Yesterday, in Springfield, IL, these cational agencies and schools to imple- President Bush. health professionals came forward. ment a school pest management plan. f They joined ranks with 500 organiza- This plan must incorporate pest con- tions which have endorsed a bill we HEALTH CARE trol methods that minimize health and will begin debating today on the floor environmental risks in school and Mr. DURBIN. Mr. President, I want of the Senate. Let me add just a post- around schools. This amendment does to address in morning business an script to that—I hope we will begin de- not ban any pesticide. It simply states issue, which will be the focus of debate bating it today. Yesterday we tried to that the area of the pesticide applica- in the Senate for the next 2 weeks. take up this bill, to talk about a Pa- tion must remain unoccupied during Many times our debates in this Cham- tients’ Bill of Rights. There was an ob- the treatment, and for some pesticides, ber are about issues that a lot of people jection from the Republican side of the the area must remain unoccupied for across America wonder what can this aisle. They wanted more time. up to 24 hours after the treatment. possibly mean to me, my family, or my I suggest to those who are following Perhaps the most important compo- future. This debate, believe me, will af- this debate, this particular issue has nent of this amendment is the require- fect every single one of us. been debated for a long time. In 1973, ment for schools to provide universal What we do—whether we pass a law the Health Maintenance Organization notification to parents three times or fail to pass a law—can have a direct Act became law, allowing employers to throughout the year. The universal no- impact on everyone witnessing this de- offer managed care insurance options. tice must include a summary of the bate and virtually everyone living in That was 28 years ago.

VerDate 19-JUN-2001 00:08 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00012 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.020 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6399 In 1995, our current President, then States can be held accountable for tree in the backyard and breaks his Governor George Bush, vetoed a Texas their conduct in a court of law? Frank- arm while you are visiting somebody, bill providing protection for HMO pa- ly, all of us—every individual, every and you race to the nearest hospital tients. family, every business—with only two only to learn they cannot treat you be- By 1996, the first Federal law regu- exceptions. There are two special class- cause you don’t happen to be on the ap- lating private insurance, this one al- es in the United States who cannot be proved list for your health insurance. lowing workers to keep coverage when brought into court and held account- Who in the world is going to carry changing their jobs, opened the door to able for their wrongdoing: their health insurance policy around in patients’ rights. The battle went on One, diplomats. You have heard of the glove compartment of their car to from there. those cases. Diplomats who come to find out which is the hospital that the We have known for years that we the United States, get involved in traf- HMO will allow you to go to? When it need to provide patients and their fam- fic accidents, and race away to their comes to emergency care, people ilies and people working for businesses home country, never having to face a should not be second-guessed. You go across America the protection of a Pa- court of law. That happens to be part where you need to go when you are in tients’ Bill of Rights. What we have be- of a treaty. We are stuck with it. an emergency situation. You should fore us today, what we will be debating What is the second special and privi- not have to face some insurance com- this week, is a bipartisan Patients’ Bill leged class in America that cannot be pany clerk who is second-guessing of Rights. Senator JOHN MCCAIN, a held accountable for its wrongdoing? that. leading Republican, is one of the lead- HMOs, health insurance companies. Direct access to OB/GYN providers— ing sponsors of this bill; Senators That is right. If they make a decision I mentioned the illustration in Spring- ARLEN SPECTER and LINCOLN CHAFEE denying you coverage and you suffer field. also Republicans support the bill as bodily injury or die as a result of it, Access to doctor-prescribed drugs. Do well; and virtually every Democratic the HMO or the health insurance com- you know what the HMOs do? They put Senator. On the House side the same pany cannot be sued. That is why they down a list of drugs for which they will can be said. Republican leaders, as well oppose the Patients’ Bill of Rights. pay. They pick and choose the ones as Democrats, and some 60 Republicans They want to maintain their special where they get the deepest discounts voted for this bill when it came up. from the pharmaceutical companies. So this is a bill that has been here for status. The HMOs think they are royalty in So you come in with a problem and a long time. It is a bill that now has this country, that they should be above your doctor takes a look and says: This strong bipartisan support, and it has is the drug. You need it. Is a break- been subjected to a lot of give and take the law. I disagree with that com- pletely. This bipartisan Patient Pro- through drug, and it is available, and I and compromise to come up with a rea- think I can get it for you. I say: Doc- sonable approach. Yet still we run into tection Act protects all patients across America. It doesn’t pick and choose tor, is it expensive? And he says it is the obstacles that are being presented because it is new, but it is just what by its opponents, the major opponents, like the Republican alternative. It says that you should have access to special- you need. Then he says: Will your com- of course, the health maintenance or- pany cover this? Is it on their approved ganizations. ists. If your doctor says your son or daughter has cancer and that a pedi- list, their formulary? Why are they opposed to this bill? Sadly, a lot of HMOs have picked a atric oncologist is the right person for Why don’t they want to create a Pa- list that doesn’t include all the good your child, that should be the final tients’ Bill of Rights? Frankly, they drugs a doctor can prescribe. The Pa- word. You should not leave it to some think it is going to cost them in terms tients’ Bill of Rights says the doctor of their profits. They don’t want to bean counter, some accountant, some has the last word. If this is the right give up the rights they have to make clerk in an insurance company 100 drug that can cure your disease and life-and-death decisions and overrule miles away. give you a good life, you should not It says you should be able to go out doctors and nurses to save a buck. That have to get into a debate or an appeals of network for a specialist. In other is what this debate comes down to. process with an HMO or a health insur- If you happen to visit Washington, words, if the HMO does not have that ance company over it. DC, and turn on television, you are doctor on the list, that should not be Finally, access to point-of-service likely to see their television adver- the deciding factor when determining plans. We have to make certain that tising. These HMOs are going to dump who is the best doctor for your wife or people across America, when they need millions of dollars into advertising, your husband when they are facing a access to good health care, have it. The trying to tell the people across Amer- serious illness. HMOs and health insurance companies ica that giving you the right to have Care coordination, standing refer- that put up these obstacles should not your doctor make a medical decision is rals—all of these mean that you can have the final word. not in your best interests, that they get good health. This is the debate we are about to are the ones who should be entrusted Coverage for clinical trials. Clinical have for the next 2 weeks. This is what with our health care, they are the ones trials are efforts a lot of people get the Senate will focus on. Is there any- who should make the call in life-or- into when they receive a diagnosis of a thing more important than our health? death decisions when it comes to med- condition or disease that might other- What would you give up for your ical treatment, when it comes to pre- wise be incurable. They take a drug health? I don’t think anyone would scription drugs that are necessary to that is being tested by the Food and give up anything for their health. That sustain your life. They say, frankly, we Drug Administration to see how it is the most important thing in your don’t need a Patients’ Bill of Rights. might apply to your cancer, your heart life. Now we face an onslaught of oppo- That is understandable, because do disease, your special problem. A lot of sition from the HMOs and the health you know what is at issue here? What insurance companies say: We will not insurance companies that say no to the is at issue here is accountability. We pay for clinical trials, you are on your Patients’ Bill of Rights. just finished 7 weeks of debate about own. Well, who can pay for it? Who in I salute Senator TOM DASCHLE, the education. The key word in that debate their right mind can say an average majority leader, because he said this at was ‘‘accountability.’’ People should be person in an average family in America a rally that we just held on the steps of held accountable, students by tests, can pay the tens of thousands of dol- the U.S. Capitol. He said the Senate teachers by the results of those tests, lars necessary for life-or-death treat- will stay in session until we pass a Pa- principals—everyone to be held ac- ment in a clinical trial? tients’ Bill of Rights. He has given no- countable. But when it comes to health That is what is at issue here; that is tice to all of us in the Senate: Put on care, the HMOs do not want to be held what is behind this bill. The Patients’ hold your Fourth of July parades and accountable. They believe they should Bill of Rights say these insurance com- your picnics back at the ranch. We are take their profits and not be account- panies must cover the clinical trials all talking about staying here and get- able. that are necessary to save your life. ting the job done. Let’s take a step back and look at What about coverage for emergency There are going to be fireworks on the big picture. Who in the United care? Imagine your son falls out of a The Mall, if you want to stick around

VerDate 19-JUN-2001 00:08 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00013 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.022 pfrm03 PsN: S19PT1 S6400 CONGRESSIONAL RECORD — SENATE June 19, 2001 here and you don’t want to pass a Pa- me—I think every medical doctor in the floor of the Senate. We can talk tients’ Bill of Rights. We can look out the House of Representatives now sup- about politics and law and all the rest the back window here, skip the parades ports the Democratic approach, the bi- of it. Let me introduce you to a little and picnics, and stay at work until we partisan approach we are offering on fellow I met a year or so ago named pass a Patients’ Bill of Rights. I guar- the floor. Roberto Cortes from Elk Grove Village, antee, you may or may not see fire- Mr. REID. The reason I asked the IL. This wonderful little kid is fighting works on The Mall, but we will see fire- Senator this question is that the Sen- for his life every single day on a res- works on the floor of the Senate be- ator in his chart said it is a bipartisan pirator. cause the HMOs and health insurance bill. MCCAIN a Republican, EDWARDS a His mom and dad are real-life Amer- companies are not going to give up eas- Democrat from the South, KENNEDY a ican heroes. They get up every morning ily. They are going to fight us every Senator from Massachusetts, they are and try to make a life for themselves step of the way. the chief sponsors of this legislation. and their family. They dedicate every Who are on the different sides in this This is bipartisan legislation. We have waking moment so this little boy stays debate? On one side are 550 health orga- some courageous people who have said alive. This is a fight that goes on every nizations and consumer organizations, we have had enough of this. minute of every day. If you can imag- standing for families and individuals This legislation, I have heard the ine, if his respirator stopped he would across America—doctors and nurses Senator say, is supported by every con- die, and they know this. They have him and consumer groups. sumer group in America plus every at home, and they watch him con- Who is on the other side, opposing medical group in America, subspecialty stantly. This is a fight they are willing our bill? One group, and one group group, specialty group, the American to take on. They didn’t know when only, the HMOs, the health insurance Medical Association, and even the law- they were fighting for Roberto’s life companies. They know what is at stake yers support this. I don’t know of a that they would also have to fight the here. What is at stake is their profit, time in the past where you have the insurance companies. His problem is and they are going to fight us tooth American Medical Association and the spinal muscular atrophy, a leading ge- and nail to try to stop this bill. trial lawyers together. Does the Sen- netic cause of death in kids under the I can guarantee this. We are going to ator know another occasion? age of 2. fight for a real Patients’ Bill of Rights, Mr. DURBIN. I certainly don’t. Usu- Last year, they sent me an e-mail to not a bill of goods. We are not going to ally they fight like cats and dogs. talk about the battles they have had pass some phony law and say to Amer- When it comes to this bill, both sides with their health insurance company. ica we have solved your problem. We believe the HMOs and the health insur- He needs a drug called Synagus to pro- are going to fight and stay here for this ance companies should not be above tect him against respiratory infection. fight until we pass it. For everyone the law. They should not be a special Do you know what the insurance com- who witnesses this debate, I cannot class. They should be held accountable pany said? No. No. His doctor said, this think of a more important topic for us like every other American and every little boy needs this drug to protect to face. other business for their wrongdoing. him against an infection when he is on Mr. REID. Will the Senator yield for They should, in being held accountable, a respirator, and the health insurance a question? understand when they make life-or- company said no. Imagine that for a minute. Imagine Mr. DURBIN. I am happy to yield to death decisions and they are wrong, that you are battling every single day my colleague from Nevada. they may face a jury of a dozen Ameri- to save this beautiful little boy, and Mr. REID. I have been here this cans who will decide whether or not it meanwhile you have a health insurance morning listening to the Senator’s was fair. company denying you access to a drug statement, and of course it is very good Mr. REID. The Senator made ref- that his doctor says he needs to stay and beautiful. But I would like to ask erence to the advertisements being paid for by the HMOs. They are run- alive. Can it get any worse than that? the Senator a couple of questions. That is what this debate is all about. We have been working on this bill for ning in Washington and all over Amer- Forget all of us in suits and ties and years. I have been impressed with a ica. What they are focusing on is this is fancy dresses in the Senate and remem- couple of people who have stood out in a bill that the lawyers want. Would the ber Roberto Cortes of Elk Grove Vil- recent weeks. They are Republicans— Senator agree with me that those man- lage, IL. Remember his mom and dad. one by the name of JOHN MCCAIN and aged care entities that oppose this leg- That is what the debate is all about. the other by the name of CHARLIE NOR- islation are trying to divert attention We can’t match the health insurance WOOD. They are both Republicans. One away from the consumer protections in industry when it comes to all the tele- is a dentist from Georgia, the other is this bill and making it a lawyer-versus- vision advertising they are buying but, a Senator from the State of Arizona the-rest-of-us piece of legislation? believe me, if I could tell Roberto’s who, among other things, spent 5 or 6 Mr. DURBIN. There is no question story to moms and dads across Amer- years in a prisoner-of-war camp, most about it. I often try to reflect on ica, I know what would happen when of that time in solitary confinement. whether or not the Congress of the this bill finally comes up for final pas- The Senator from Illinois and I came United States could have enacted So- sage. I thank my colleague from Ne- with Senator MCCAIN to the House of cial Security or Medicare or the Amer- vada for joining me. Representatives in 1982. We have long icans with Disabilities Act if some of Mr. REID. If I may ask the Senator acknowledged his courage; have we the most well-financed special interest one more question, I hope Roberto is not? groups in America decided they wanted doing OK. Senator DORGAN and I held a Mr. DURBIN. Absolutely. to buy large amounts of TV airtime on hearing in Las Vegas, NV, where a Mr. REID. I have been impressed television of America. That is what is mother’s testimony was not as opti- with the courage of CHARLIE NORWOOD happening. They have done it before. mistic. It was sad. She had had deal- from Georgia. Is the Senator from Illi- They are trying to do it now. They are ings with an HMO, and her son is now nois also impressed? trying to twist and distort this debate dead. That was her testimony. Senator Mr. DURBIN. The fact that he has to try to undermine the public’s senti- DORGAN and I will talk about that stood up and announced last Friday ment for real change and real protec- more as the debate goes on. The Sen- that he has tried to work with the tion for patients. ator from Illinois is right; the HMOs HMOs, tried to work with the Repub- They are going to lose because the deal with people’s health: Roberto, the lican leadership and with the White people of America know stories in their boy in Las Vegas, parents, mothers, House and has virtually given up be- own family and their neighbor’s fam- brothers and sisters. There is nothing cause they, frankly, will not support a ily. I will share for a moment—I see that is more devastating than having real Patients’ Bill of Rights. Congress- two of my colleagues coming to the someone sick and you can’t get what man NORWOOD, a Republican, has said floor—with my colleague from the you know needs to be done. That is he will openly support the Democrats. State of Nevada one of the things I what the debate is all about. If I am not mistaken—perhaps I am— think really tells the whole story. You It is about accountability. Are people the Senator from Nevada can correct can listen to Senators come and go on going to be held to a standard that is

VerDate 19-JUN-2001 00:08 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00014 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.024 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6401 fair? We are not asking for a standard The legislative clerk proceeded to remember what this is all about. You that is unfair or unreasonable or that call the roll. are either for protecting patients or has not been in place in the past. We Mr. NELSON of Florida. Mr. Presi- you are for the status quo, which pro- are asking to have the standard where dent, I ask unanimous consent that the tects HMOs. Current law states that an a doctor makes a decision as to the order for the quorum call be rescinded. HMO cannot be sued for any grievous care their patient receives and it is not The PRESIDING OFFICER (Mr. DAY- wrongs, whereas a physician, a nurse, a made by some clerk in a room in Balti- TON). Without objection, it is so or- hospital, or any other health care pro- more or San Jose; it is made by that dered. vider who commits a grievous wrong doctor who is taking care of that pa- Mr. NELSON of Florida. Mr. Presi- against a patient can be held account- tient. Will the Senator agree? dent, I rise on this first day of consid- able. Mr. DURBIN. I agree, and I thank the eration of the Patients’ Bill of Rights So it is a stark choice: Do you want Senator from Nevada for joining me. I to say that this is a glorious day, that to protect the patients, or do you want see the Senator from Minnesota is here finally, after a 5-year wait, the Senate to protect HMOs? You will get all the seeking recognition. can take up this important legislation. other arguments about whether or not Let me say, this is one of the most It is my hope that our colleagues on this is going to increase the cost to pa- important debates of the year. Until the other side of the aisle will not tients. There will be some increase, but the Senate leadership changed 2 weeks block this legislation, as has been ru- often as we consider the formulation of ago, this bill was buried in committee. mored all over the Capitol today. We law, we have to consider the tradeoffs. The health insurance companies had us have heard that there will be all kinds Is this protection of a patient’s right right where they wanted us. They of efforts to delay and distract. worth the tradeoff of a small—a very stuck this bill in committee and said: This issue is way too important for small—increase in the cost? Eighty You will not hear a national debate this country to withstand such poten- percent of the American people clearly about the Patients’ Bill of Rights. It is tially dilatory tactics. Indeed, the peo- say they want the rights of a patient a new day in the Senate. There is new ple of this country embrace patient protected. leadership, and there is a new agenda. protection and they embrace it in a bi- I am glad that we finally have this I am proud of the fact that my party partisan and, indeed, a nonpartisan issue before us. has brought forward as the first bill fashion. One of the greatest experiences in my that we will debate a Patients’ Bill of What does this bill do? It simply ad- professional life and a great honor for Rights. I am proud of it because I be- dresses a grievous wrong under Amer- me was having served for the last 6 lieve that is what we are all about. ican law. Currently, health care pro- years as the elected insurance commis- Frankly, on a bipartisan basis with viders are held accountable for their sioner of the State of Florida. In that Senator MCCAIN and Congressman NOR- mistakes and their malpractice, save capacity, I dealt weekly with insurance WOOD and others, we are making this a for one type of health care provider— companies, health insurance rates, and strong bipartisan fight. It isn’t a fight an insurance entity known as a health what it took to keep those insurance so that at the end of the day we can maintenance organization. companies and HMOs financially via- say our party won; this politician won. An HMO is exempt under the law. So ble, while at the same time being able It is a fight so that at the end of the this Patients’ Bill of Rights brings to to protect patients’ rights. day Roberto Cortes has a chance, and the floor of this Senate the oppor- I see this discussion of a Patients’ his mom and dad can focus on this lit- tunity to change the law so that HMOs Bill of Rights as the tip of an iceberg in tle boy’s life and that daily struggle, are held accountable for their grievous a discussion of the overall reform of the entire health care delivery system. not a struggle with the health insur- mistakes. This is just common sense Ultimately, this will become a discus- ance companies. and clearly, a standard of fairness. This sion of the reform of the Medicare sys- I yield the floor. is why we are seeing wide acceptance of tem in this country. I hope and have The PRESIDING OFFICER (Mr. NEL- the principles of this legislation re- SON of Florida). The Senator from Min- clearly had assurances from our great flected in the polls all over this coun- nesota. assistant majority leader, the Senator try. Mr. DAYTON. Mr. President, if I from Nevada, and our great leader, the Now let’s not be deceived. Those who might add a refrain to what my distin- Senator from South Dakota, that we want to torpedo this legislation say guished colleagues have been talking are going to take up Medicare reform that they support a Patients’ Bill of about, last year I helped set up a later this year. health care hot line in Minnesota. I Rights, and then they get all mired in We have a great opportunity for tak- started getting a flood of calls, just as the discussion of the technical details. ing the first steps addressing the com- the Senator from Illinois described, But it is clear cut: Either you are for prehensive question of health care re- from parents who are fighting those the patient or for the HMO when it form and health insurance reform that same kinds of battles. I don’t have pic- comes down to the question of account- will ultimately address the fact that 44 tures here, but I can see them in my ability for grievous mistakes. million people in this country do not Now there has, in the course of this mind’s eye, the young boys and girls have health insurance, 21⁄2 million of and the grieving families, fighting fam- discussion, arisen a very legitimate these people are in my own State of ilies who are trying to deal with the concern. HMOs are a major provider of Florida. Clearly, they get health care. tragedy of their lives and have heaped insurance for employers. Therefore, an They often get it at the most expensive on them the further tragedy of HMOs employer is quite concerned that they place, which is the emergency room, or insurance companies not providing might have some liability because they and at the most expensive time when or not paying for the care. Suddenly engage the particular HMO as their in- the sniffles have turned into pneu- they are incurring tens of thousands of surance company. So, quite naturally, monia. But that is a discussion for an- dollars of debt, in addition to God- an employer does not want to have other day. awful personal losses. joint liability with an HMO that has The discussion, however, starts today So I certainly rise in support of the perpetrated some grievous malpractice. along the long, tortuous road of health legislation. I agree with the Senator In this bipartisan legislation offered care reform with a most important from Illinois that the change in the by Senators MCCAIN, EDWARDS, and first step; that is, enacting a Patients’ leadership of this body—the now-ma- KENNEDY, there is protection for the Bill of Rights. jority leader and assistant majority employer, and the employer would only I am proud to come to the floor and leader are making the difference in be liable if the employer had partici- be able to address this. I intend to this legislation coming to the Senate pated in that grievous malpractice. speak out on this important issue floor. I hope we can commence debate So as that issue arises, particularly again and again over the course of the on it today. among the business community, which next several days, and the next couple Mr. President, I suggest the absence legitimately ought to be concerned of weeks, until we pass this important of a quorum. with that issue, don’t be deceived, be- piece of legislation. The PRESIDING OFFICER. The cause you are protected. As we get into Thank you, Mr. President. I yield the clerk will call the roll. the discussion of this legislation, let’s floor.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00015 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.026 pfrm03 PsN: S19PT1 S6402 CONGRESSIONAL RECORD — SENATE June 19, 2001 The PRESIDING OFFICER. The Sen- As her mother said, when Jessica’s erybody will be able to celebrate that ator from Michigan. family should have been spending pre- we have created the important patient f cious time—she used to like to sit on protections that our families in this the porch and read books and blow bub- country need. PATIENTS’ BILL OF RIGHTS bles—with Jessica in her final year of I yield back, Mr. President. Ms. STABENOW. Mr. President, life, they were forced to spend count- The PRESIDING OFFICER (Mr. NEL- today, the Senate will begin serious less hours fighting with the HMO bu- SON of Florida). The Senator from Ne- consideration of one of the most impor- reaucrats about her care. vada. tant issues for every family in Amer- Jessica’s insurance plan was changed f ica—genuine protections for patients in just days before she was admitted to CONCLUSION OF MORNING managed care plans. As many of my the hospital for surgery. After months BUSINESS colleagues know, this issue has been of trying to figure out what to do about Mr. REID. My understanding is that one of my top priorities for a very long her seizures—she had 60 seizures in a the hour of morning business is now time and I am very pleased that real row—her family worked with the doc- debate has begun on the McCain, Ed- terminated; is that right? tor who had been treating her. This is The PRESIDING OFFICER. The Sen- wards, Kennedy bill—a bipartisan com- prior to the change. They said she ator is correct. promise for a meaningful Patients’ Bill needed an operation. It was scheduled Mr. REID. I suggest the absence of a of Rights. for May 12 of 1999. Unfortunately, her quorum. It is important to note that there has insurance changed to the HMO on May The PRESIDING OFFICER. The been a tremendous amount of work 1 without their knowledge. She had the clerk will call the roll. done to get to this point. This truly is operation on May 12. The legislative clerk proceeded to a compromise. It is truly bipartisan. I On May 17, they got a notice that the call the roll. congratulate my colleagues for work- insurance had changed and they Mr. DASCHLE. Mr. President, I ask ing so hard. I am very proud to be one wouldn’t cover it because she didn’t unanimous consent the order for the of the cosponsors of this bill. have preauthorization. quorum call be rescinded. I strongly believe that every person This is not a new story. We hear The PRESIDING OFFICER. Without has a right to affordable quality health story after story about people who find objection, it is so ordered. care. Whether we are talking about ac- themselves in situations where they Mr. DASCHLE. Mr. President, this is cess to nursing homes, prescription didn’t have preauthorization for things an important day—and one that has drugs for seniors, or the Patients’ Bill that were beyond their knowledge at been a long, long time coming. of Rights, I have fought to improve the time. It has been nearly 5 years since health care for every American. Unfortunately, to this day, that sur- President Clinton, at the time, ap- As we start this debate, I remind all gery was not paid for, and the Lukers pointed an independent panel of health of my colleagues that this debate is are paying for that themselves, while care experts and asked them to come about real people and their real experi- at the same time after they found out up with a Patients’ Bill of Rights. ences with HMOs. that she had the HMO, they would not It has been more than 4 years since We have not made this up. This is allow her doctor of 14 years to treat President Clinton urged Congress to about real people who have come to us her—and in her final year of life. pass a Patients’ Bill of Rights reflect- who have expressed concerns. They Jessica’s story demonstrates why we ing the panel’s recommendations. paid for health care. They assumed need patient protections. We must It has been more than 3 years since that their families would have it when make sure when our families have in- the first bipartisan Patients’ Bill of they needed it. Too many people find surance and believe the health care Rights was introduced in the House. And, it has been nearly 2 years since out that when it is time for that care will be there when their families need the last time we debated a real Pa- to be given, whether it is in an emer- it that they can count on that to hap- tients’ Bill of Rights here in the Sen- gency room, whether it is a doctor rec- pen; that they are not fighting about ate. ommending a form of treatment, they what day they got a notice about a We have talked long enough. There is are not able to receive it for their fam- change in the insurance; or they are only one thing left to do. We need to ily. It is not right. That is why we are not fighting about their doctor who has pass a real, enforceable Patients’ Bill here. been treating a family member for of Rights now. I want to share one story today about years not being able to continue be- The reason we are debating this bill a young woman named Jessica and her cause they do not fit into the list of is because so many people—inside and family in Royal Oak, MI. Jessica’s the HMO. outside of Congress—refused to give up. story is one example of many of why This is just one example. I have I especially want to thank the Senate we need to pass these important pa- heard stories throughout Michigan. sponsors: my colleague, Senator KEN- tient protections. But today we have an opportunity to NEDY, who has spent his entire adult I am proud to have worked with this begin the process to change it. life—nearly 40 years—working to im- family, speaking on behalf of families When I came to Washington as a prove health care for all Americans; all over this country. United States Senator from Michigan, my colleague, Senator JOHN EDWARDS, Jessica was born in 1975 with a rare I brought a picture of Jessica. The pic- who has played an indispensable role in metabolic disorder that required vigi- ture is sitting on my desk in my office finding an honest, honorable middle lant medical care. Unfortunately, her in the Hart Building. That picture is ground on the difficult question of li- disorder was not curable and she passed going to remain there until we pass ability; and my colleague, Senator away September 10, 1999. this bill. This bill is for Jessica and JOHN MCCAIN, for having the courage— During the last year of her life, every person who has ever needed care once again—to disregard party labels Jessica’s health insurance changed. and been denied it by an HMO. and challenge the special interests in Her family doctor, who had been treat- This picture I want to be able to take order to change what needs to be ing her all of her life, was not covered down pretty soon. It has been there changed. by the new HMO that she was forced long enough. Families have had to This bill matters—deeply matters— into, and Jessica had to seek treatment fight long enough. I am looking for- to America’s families. More than 70 through another physician. Her dis- ward to the day when I can give that percent of all Americans with insur- ease, however, was so complex that she picture back to Mr. and Mrs. Luker and ance and 80 percent of all Americans and her family could not find a new say: We did it. who get their insurance on the job—are doctor with the HMO. Today we can begin that process. now in some kind of managed care pro- Mrs. Luker talks about going name Let’s not fight about all the various gram. To them, this isn’t a political by name, page by page, and book by wranglings of the internal politics of issue; it can be a life-or-death issue. book through all of the physicians in this body. Let’s keep our focus on the This bill ensures that doctors, not in- the HMO, and none of them were will- Jessicas and on the families of this surance companies, make medical deci- ing to treat Jessica. country. If we do the right thing, ev- sions. It guarantees patients the right

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00016 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.030 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6403 to hear all of their treatment options— licans, CHARLIE NORWOOD and GREG President will decide to join us once he not just the cheapest ones. It says you GANSKE. Outside of Congress, 85 per- hears the debate and sees what our bill have the right to go to the nearest cent of all people surveyed—and 79 per- actually does. emergency room when you need emer- cent of Republicans—support the pro- In the second Presidential debate, gency care. It guarantees you the right tections in this plan, and so do more then-Governor Bush said: to see a specialist if you need one. It than 500 major health care, consumer It’s time for our nation to come together gives women the right to see an OB– and patient-advocate groups all across and do what’s right for people.... It’s time GYN without having to see another the country. to pass a national Patients’ Bill of Rights. doctor first to get permission. And it There has been one other significant We agree. The American people have guarantees that parents can choose a change since the first time we debated been waiting too long. Working to- pediatrician as their child’s primary a Patients’ Bill of Rights. Before, we gether in good faith we can end this care provider, if they need one. could only guess what would happen if wait and pass a real Patients’ Bill of But rights without remedies are no people were able to hold HMOs ac- Rights. rights at all. That is why our bill guar- countable. Now we know. Texas and I announce to all of my colleagues antees people the right to appeal deci- California have both passed Patients’ that it is my intention to stay on this sions by their HMO to an independent Bills of Rights. bill for whatever length of time it review board, and to get a timely re- Texas passed its law in 1997. In nearly takes. Obviously, we have this week sponse. Finally, if the HMO ignores the 4 years, 17 lawsuits have been filed— and next week that are full weeks for review board, our bill allows people to about five a year. In the last 6 months consideration of the bill. My expecta- hold HMOs accountable—the same way since California passed its law, 200 dis- tion is that if we finish the bill a week doctors and employers, and everyone putes have gone through the inde- from this Thursday night, there would else in America is held accountable for pendent appeals process. None—not not be a session on Friday preceding their actions. The 85 million Americans one—has gone to court. And two-thirds the recess. enrolled in Medicare, Medicaid and of the disputes were resolved in favor If we are not finished Thursday other Federal health programs already of the HMO. Experience from the two night, we will then debate the bill and have each of the protections in our bill. largest States—the two best labora- continue to work on it Friday, Satur- So does every Member of this Senate. tories—show that the scare tactics day, Sunday. We will not have a ses- Our bill extends them to all privately used by opponents of this bill are sim- sion on the Fourth of July, but we will insured Americans—no matter what ply that: scare tactics. pick up again on July 5 and go on as State they live in, or what insurance There are some important things long as it takes. We will finish this bill. plan their employers choose. that have not changed in the years It is also my expectation that if we fin- Opponents claim that guaranteeing since we started this debate. Ameri- ish this bill in time, I would be inclined these rights will cost too much. They cans are still being hurt by our inac- to bring up the supplemental appro- say people will lose their insurance be- tion. Every day that we delay passing a priations bill following the completion cause insurance premiums will go real Patients’ Bill of Rights, 35,000 of the Patients’ Bill of Rights. through the roof. But the facts show Americans are denied access to spe- Those two pieces of legislation are otherwise. According to the non- cialty care—and 10,000 doctors; see pa- bills I have already indicated to the partisan Congressional Budget Office, tients who have been harmed because Republican leader would be my hope our bill would increase employee pre- an insurer refused to pay for a diag- that we could complete before the July miums an average of about $1.20 a nostic test. 4th recess. In fact, it is my expectation month for real rights that can be en- Despite the growing support inside and absolute determination to finish at forced—$1.20 a month. and outside of Congress, we still face least in regard to the Patients’ Bill of Many things have changed since the formidable opposition from the special Rights. We will see what happens with first time this Senate passed a Pa- interests. regard to the supplemental in the tients’ Bill of Rights. The bill itself has HMOs and their allies reportedly are House and here in the committee. changed. We started with a bipartisan spending $15 million on ads to try to f compromise: the Norwood-Dingell Pa- kill this bill this week. We welcome an BIPARTISAN PATIENT PROTEC- tients’ Bill of Rights. This bill is a bi- honest and open debate on the issues. TION ACT—MOTION TO PROCEED partisan compromise on a bipartisan We hope opponents will resist the compromise. temptation to kill this bill by loading Mr. DASCHLE. Mr. President, I ask One of the most important com- it up with amendments that make pas- unanimous consent that the Senate promises concerns liability. This bill sage difficult. now proceed to the consideration of says very clearly that employers can- Our hope is that this debate will be Calendar No. 75, S. 1052, the Patients’ not be held liable unless they partici- like the one we had not long ago on an- Bill of Rights. pate directly in a decision to deny other important reform—campaign fi- The PRESIDING OFFICER. Is there health care. The only employers who nance reform. In fact, I have personally objection? Mr. THOMAS. Mr. President, I ob- can be held liable are the small frac- suggested to Senator LOTT that we take up this bill under the exact same ject. tion of companies that are large The PRESIDING OFFICER. Objec- understanding that we took up cam- enough to run their own health care tion is heard. plans—less than 5 percent of all Amer- paign finance reform; that we have a Mr. DASCHLE. Mr. President, I now ican businesses. Small businesses never good debate on amendments; that we move to proceed to S. 1052. make treatment decisions, so they offer the motion to table, if that would The PRESIDING OFFICER. The mo- would never be sued. be offered; if it is not tabled, that it be tion is debatable. We have also compromised on where subject to second degrees. I think it The Majority Leader. people can seek justice. Instead of al- worked as well on the campaign fi- Mr. DASCHLE. Mr. President, I re- lowing all disputes to be heard in State nance reform as any bill I have re- gret we are not in a position to begin courts, this bill says disputes about ad- cently had the opportunity to consider, consideration of this important legisla- ministrative questions should be heard and I hope we can do the same thing tion at this time. I remain hopeful that in Federal courts. Only cases involving for the Patients’ Bill of Rights. I am by the end of the day we will be able to medical decisions should go to State hopeful our Republican colleagues will do so. In the event that the Senate can- courts—just like doctors who make agree to that this afternoon. not proceed to the bill today, it is my medical decisions. There is one more important change intention to file cloture on the motion. Support for a Patients’ Bill of Rights that has occurred since the first time Under the rules, this cloture vote has grown—inside and outside of Con- we debated a Patients’ Bill of Rights. would occur on Thursday morning 1 gress. In the Senate, we have Senators We now have a new President. Members hour after the Senate convenes. MCCAIN, EDWARDS, and KENNEDY. In the of his staff have said President Bush I yield the floor. House, we have Congressman JOHN DIN- will veto our bill if this bill makes it to The PRESIDING OFFICER. The Sen- GELL and two conservative Repub- his desk. We remain hopeful that the ator from Arizona.

VerDate 19-JUN-2001 01:18 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00017 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.035 pfrm03 PsN: S19PT1 S6404 CONGRESSIONAL RECORD — SENATE June 19, 2001 Mr. MCCAIN. Mr. President, I reit- are required to and do commit their the nurses and the doctors of America, erate my support for the majority lead- lives to taking care of the health of our in particular—who have committed er’s unanimous-consent request. I be- citizens. themselves to addressing this issue so lieve it is fair and also crucial for al- I have been asked many times why is that all Americans can receive the lowing us to finally engage in a real it that I am involved in this issue, why health care they deserve. and meaningful debate that will get is it that I have worked very hard to I ask unanimous consent that a list Americans the protections they need try to fashion a bipartisan agreement of organizations supporting the bill be and want. that we could use as a base for amend- printed in the RECORD. This unanimous-consent request is ing and perfecting a bill that we can There being no objection, the list was exactly along the lines of that which have signed by the President. In my ordered to be printed in the RECORD, as governed the campaign finance reform Presidential campaign, in hundreds of follows: debate. Most Americans, no matter town hall meetings attended by thou- PROFESSIONAL GROUPS AND GRASSROOTS OR- how they felt on that issue, believed sands and thousands of Americans, GANIZATIONS SUPPORTING THE MCCAIN-ED- that it was a fair, open, and honest de- time after time after time after time, WARDS-KENNEDY BILL—THE BIPARTISAN PA- TIENT PROTECTION ACT bate in which the issues were venti- average citizens stood up and talked Abbott House of Irvington, NY; Abbott lated and the majority of the Senate about the fact that they have been de- House, Inc. in South Dakota; AIDS Action; worked its will. That is how most nied reasonable and fair health care Alliance for Children and Families; Alliance Americans think we should function and attention they believe they deserve for Lung Cancer Advocacy, Support and Edu- and, unfortunately, all too often we do and need. cation; Alpha 1; Alternative Services, Inc; not. This is an issue of importance to Amalgamated Transit Union; American Under this unanimous-consent agree- some 170 million Americans who would Academy of Child and Adolescent Psychi- ment, unlimited amendments can be be covered by this legislation. This is atry; American Academy of Dermatology As- offered, and each one will be provided a an issue to average Americans who are sociation; American Academy of Emergency Medicine; American Academy of Facial Plas- significant period of time, 2 hours, and members of health maintenance orga- tic and Reconstructive Surgery. after debate the amendment would be nizations. This is a challenge and a American Academy of Family Physicians; voted on by the full Senate. problem. American Academy of Mental Retardation; I am struggling to understand why These Americans want the decisions American Academy of Neurology; American we can’t agree that this is not only a made by a doctor and not an account- Academy of Ophthalmology; American Acad- fair proposal but truly it affords each ant. These Americans want and need emy of Otolaryngology—Head and Neck Sur- and every one of us with an oppor- and deserve a review process that is gery; American Academy of Pain Medicine; American Academy of Pediatrics; American tunity for engaging in a free and spir- fair. These Americans are not receiving Academy of Physical Medicine and Rehabili- ited debate. This format embodies the the fundamental health care they de- tation; American Association for Geriatric full spirit of the traditional Senate and serve as members of health mainte- Psychiatry; American Association for Mar- should not be ignored or misconstrued nance organizations and, frankly, that riage and Family Therapy; American Asso- as anything but a reasonable and hon- is available to other Americans who ciation for Psychosocial Rehabilitation; est proposal. have larger incomes. American Association for the Study of Liver I think Americans are watching us to Mr. President, this is not something Diseases. American Association of Children’s Resi- see if we can come together on an issue we should delay any longer. This is an dential Center; American Association of of great importance to everyone across issue we should take up and address, Neurological Surgeons; American Associa- our Nation. I don’t think delay is war- amend, debate, and then come to a rea- tion of Nurse Anesthetists; American Asso- ranted. We should not obstruct. sonable conclusion. I want to repeat ciation of Oral and Maxillofacial Surgeons; I am confident that engaging in a my commitment to working with the American Association of Pastoral Coun- truly open debate on this issue, with- White House, to working with all oppo- selors; American Association of People with out stringent time restraints or limits nents of the legislation in its present Disabilities; American Association of Pri- on amendments, will result in the pas- vate Practice Psychiatrists; American Asso- form. For us to do nothing, as has been ciation of University Affiliated Programs for sage of a strong bipartisan patients’ the case over the last several years, as Persons with Developmental Disabilities; protection bill that can be signed into time after time this issue has been American Association of University Women; law by President Bush. brought up and blocked through par- American Association on Health and Dis- I want to reiterate, it is my sincere liamentary procedures, is not fair. It is ability; American Association on Mental Re- and profound commitment to see that not fair and honest to the American tardation; American Bar Association. we enact a bill that the President of people to refuse to address the issue. American Board of Examiners in Clinical the United States can sign. It would As I said with campaign finance re- Social Work; American Cancer Society; American Children’s Home in Lexington, NC; serve no one’s purpose to go through form, if the result of the debates and American Chiropractic Association; Amer- the debate and amending process in the amendments is not to my liking and I ican College of Cardiology; American College Senate and in the other body and con- don’t agree with the result, I will re- of Gastroenterology; American College of ference and then have a bill the Presi- spectfully vote against it. But I will Legal Medicine; American College of Nurse dent will not sign. not try to block it. I hope Members on Midwives; American College of Nurse Practi- I will make a couple of additional both sides of the aisle will make that tioners; American College of Obstetricians comments. There has been some debate commitment as well because of the im- and Gynecologists; American College of Os- teopathic Emergency Physicians; American as to who supports and who does not portance of the issue to the American College of Osteopathic Family Physicians. support this legislation. I have a list of people. It deserves a full and complete American College of Osteopathic Pediatri- over 300 organizations that are in sup- debate and vote. cians; American college of Osteopathic Sur- port of this legislation—not only the I want to work together with my col- geons; American College of Physicians— nurses and doctors of America but tra- leagues on both sides of the aisle. We American Society of Internal Medicine; ditional consumer advocacy groups, in- have had meaningful negotiations. We American College of Surgeons; American cluding health groups such as the have had good discussions. As a result Congress of Community Supports and Em- ployment Services—ACCSES; American American Cancer Society, the Amer- of amendments, we will have further Council on the Blind; American Counseling ican Dental Association, the American discussions. I hope that over time we Association; American Dental Association; Nurses Association, a long list of orga- will be able to reach an agreement. I American Family Foundation; Federation of nizations that have traditionally advo- again express my support for the unan- Teachers; American Foundation for the cated for the health of Americans ei- imous consent request the majority Blind; American Gastroenterological Asso- ther in a specialized or general way. leader propounded because I think it is ciation. We have a clear division here be- a fair and honest way, providing no ad- American Group Psychotherapy Associa- tween the health maintenance organi- tion; American Headache Society; American vantage to either side on this debate. Health Quality Association; American Heart zations, which according to a CNN USA Again, I thank my colleagues for Association; American Lung Association; Today poll enjoy the approval of some their commitment and involvement in American Medical Association; American 15 percent of the American people, and this issue, but most of all I want to Medical Rehabilitation Providers Associa- the nurses and doctors and those who thank these 300-some organizations— tion; American Medical Student Association;

VerDate 19-JUN-2001 01:28 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00018 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.038 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6405 American Medical Women’s Association, Child Welfare League of America; Children Georgia, Inc.; Family Counseling Center of Inc.; American Mental Health Counselors As- & Families First; Children & Family Serv- Sarasota, FL; Family Counseling of Greater sociation; American Music Therapy Associa- ices Association; Children and Adults with New Haven, CT; Family Counseling Service tion; American Network of Community Op- Attention Deficit/Hyperactivity Disorder; in Texas. tions and Resources. Children’s Aid and Family Service in Family Counseling Service of Greater American Nurses Association; American Paramus, NJ; Children’s Aid Society of Mer- Miami; Family Counseling Service of Lex- Occupational Therapy Association; Amer- cer, PA; Children’s Alliance; Children’s ington; Family Counseling Service of North- ican Optometric Association; American Board of Hillsborough; Children’s Choice, ern Nevada; Family Counseling Service, Inc. Orthopsychiatric Association; American Os- Inc. in Philadelphia, PA; Children’s Defense in Lexington, KY; Family Guidance Center teopathic Association; American Pain Soci- Fund; Children’s Home & Aid Society of Chi- in Hickory, NC; Family Guidance Center of ety; American Pharmaceutical Association; cago, IL; Children’s Home Association of Illi- Alabama; Family Resources, Inc. in IA; Fam- American Physical Therapy Association; nois. ily Service Agency of Arizona; Family Serv- American Podiatric Medical Association; Children’s Home of Cromwell; Children’s ice Agency of Arkansas; Family Service American Psychiatric Association; American Home of Easton in Easton, PA; Children’s Agency of Central Coast; Family Service Psychiatric Nurses Association; American Home of Northern Kentucky; Children’s Agency of Clark and Champaign Counties in Psychoanalytic Association. Home of Poughkeepsie, NY; Children’s Home OH; Family Service Agency of Davie in CA. American Psychological Association; of Reading, PA; Children’s Home of Wyoming Family Service Agency of Genesee, MI; American Public Health Association; Amer- Conference; Children’s Village, Inc.; Family Service Agency of Monterey in CA; ican Small Business Association; American ChildServ; Christian Home Association- Family Service Agency of San Bernardino in Society for Clinical Laboratory Science; Child; Clinical Social Work Federation; Coa- CA; Family Service Agency of San Mateo in American Society for Therapeutic Radiology lition of National Cancer Cooperative Group; CA; Family Service Agency of Santa Barbara and Oncology; American Society of Cataract Colon Cancer Alliance. in CA; Family Service Agency of Santa Cruz and Refractive Surgery; American Society of Colorectal Cancer Network; Committee of in CA; Family Service Agency of Youngs- Clinical Oncology; American Society of Clin- Ten Thousand; Community Agencies Cor- town, OH; Family Service and Children’s Al- ical Pathologists; American Society of Gas- poration of New Jersey; Community Coun- liance of Jackson, MI; Family Service Asso- trointestinal Endoscopy; American Society seling Center in Portland, ME; Community ciation Greater Boston; Family Service As- of General Surgeons; American Society of In- Service Society of New York; Community sociation in Egg Harbor, NJ; Family Service ternal Medicine; American Society of Nu- Services of Stark County in OH; Community Association of Beloit, WA; Family Service clear Cardiology. Solutions Association of Warren, OH; Com- Association of Bucks County in PA. American Speech-Language-Hearing Asso- pass of Carolina in SC; Congress of Neuro- Family Service Association of Central In- ciation; American Therapeutic Recreation logical Surgeons; Connecticut Council of diana; Family Service Association of Day- Association; American Thorasic Society; Family Service; Consortium for Citizens ton, OH; Family Service Association of American Urogynecologic Association; with Disabilities; Consuelo Foundation. Greater Tampa; Family Service Association American Urological Association; American Consumers Union; Cornerstones of Care in of Greater Tampa, FL; Family Service Asso- Urological Society; American for Demo- Kansas City, MO; Corporation for the Ad- ciation of Howard County, Inc., IN; Family cratic Action; Anxiety Disorders Association vancement of Psychiatry; Council of Family Service Association of New Jersey; Family of America; Arc of the United States; Asso- and Child Caring Agencies in NY; Counseling Service Association of San Antonio, TX; ciation for Ambulatory Behavioral and Family Services of Peoria, IL; Court Family Service Association of Wabash Val- Healthcare; Association for Education and House, Inc. in Englewood, CO; Covenant Chil- ley, IN; Family Service Association of Wyo- Rehabilitation of the Blind and Visually Im- dren’s Home and Families; Crittenton Fam- ming Valley in PA; Family Service Aurora, paired; Association for the Advancement of ily Services in Columbus, OH; Crossroads of WI; Family Service Center in SC; Family Psychology. Youth; Cure for Lymphoma Foundation; Cys- Service Center in TX. Association of Academic Physiatrists; As- tic Fibrosis Foundation; Daniel, Inc. Family Service Center of Port Arthur, TX; sociation of Academic Psychiatrists; Asso- Denver Childrens Home; DePelchin Chil- Family Service Centers of Pinellas County, ciation of American Cancer Institutes; Asso- dren’s Center in TX; Digestive Disease Na- Inc. in Clearwater, FL; Family Service Coun- ciation of Community Cancer Centers; Asso- tional Coalition; Dystonia Medical Research cil of California; Family Service Council of ciation of Persons in Supported Employment Foundation; Easter Seals; Edgar County Indiana; Family Service Council of OH; Fam- Association of Women’s Health, Obstetric Children’s Home; El Pueblo Boys and Girls ily Service in Lancaster, PA; Family Service and Neonatal Nurses; Assurance Home in Ranch; Elon Homes for Children in Elon Col- in Lincoln, NE; Family Service in Omaha, Roswell, NM; Auberle or McKeesport, PA; lege, NC; Epilepsy Foundation of America; NE; Family Service in WI; Family Service Baker Victory Services In Lackawanna, NY; Ettie Lee Youth and Family Services in Inc. in St. Paul, MN; Family Service of Bur- Baptist Children’s Home of NC; Barium Baldwin Park, CA; Excelsior Youth Center in lington County in Mount Holly, NJ; Family Springs Home for Children in Barium Spring, WA; Eye Bank Association of America. Service of Central Connecticut. NC; Bazelon Center for Mental Health Law. Facing Our Risk of Cancer Empowered; Family Service of Chester County in PA; Berea Children’s Home and Family in OH; Families First, Inc.; Families USA; Family Family Service of El Paso, TX; Family Serv- Bethany for Children and Families; Bethesda & Children’s Center Council; Family & Chil- ice of Gaston County in Gastonia, NC; Fam- Children’s Home/Luthera of Meadsville, PA; dren’s Center in WI; Family & Counseling ily Service of Greater Baton Rouge, LA; Board of Child Care in Baltimore, MD; Boys Service of Allentown, PA; Family Advocacy Family Service of Greater Boston, MA; Fam- & Girls Country of Houston Inc., TX; Boys & Services of Baltimore; Family and Child ily Service of Greater New Orleans, LA; Girls Homes of North Carolina; Boys and Services of Washington; Family and Chil- Family Service of Lackawanna County, PA; Girls Harbor, Inc. in TX; Boys and Girls dren’s Service in VA; Family and Children’s Family Service of Morris County in Morris- Home and Family Services in Sioux City, IA; Services and Tulsa, OK; Family and Chil- town, NJ; Family Service of Norfolk County, Boys’ Village, Inc. of Smithville, OH; dren’s Services of San Jose; Family and Chil- MA; Family Service of Northwest, OH; Fam- Boysville of Michigan, Inc.; Brain Injury As- dren’s Agency Inc. in Norwalk, CT. ily Service of Racine, WI; Family Service of sociation; Brazoria County Youth Homes in Family and Children’s Association of Min- Roanoke Valley in VA. TX. eola, NY; Family and Children’s Center of Family Service of the Cincinnati, OH; Brighter Horizons Behavioral Health in Mishawaka, IN; Family and Children’s Coun- Family Service of the Piedmont in High Edinboro, PA; Buckner Children and Family seling of Louisville, KY; Family and Chil- Point, NC; Family Service of Waukesha Service in TX; Butterfield Youth Services in dren’s Service in Minneapolis, MN; Family County, WI; Family Service of Westchester, Marshall, MO; Cal Farley’s Boys Ranch and and Children’s Service in TN; Family and NY; Family Service of York in PA; Family Affiliates; California Access to Speciality Children’s Service of Harrisburg, PA; Family Service Spokane in WA; Family Service, Inc. Care Coalition; Cancer Care, Inc.; Cancer and Children’s Service of Niagara Falls, NY; in SD; Family Service, Inc. in TX; Family Leadership Council; Cancer Research Foun- Family and Children’s Services in Elizabeth, Service, Inc. of Detroit, MI; Family Service, dation of America; Catholic Family Center NJ; Family and Children’s Services of Cen- Inc. of Lawrence, MA; Family Services Asso- of Rochester, NY; Catholic Family Coun- tral, NJ; Family and Children’s Services of ciation, Inc. in Elkton, MD; Family Services seling in St. Louis, MO; Catholic Social Chattanooga, Inc. in TN; Family and Chil- Center in Huntsville, AL. Services of Wayne County, in IN; Center for dren’s Services of Fort Wayne; Family and Family Services in Canton, OH; Family Child and Family Services in VA. Children’s Services of Indiana. Services Cedar Rapids; Family Services of Center for Families and Children in OH; Family and Community Service of Dela- Central Massachusetts; Family Services of Center for Family Services, Inc. in Camden, ware County, PA; Family and Social Service Davidson County in Lexington, NC; Family NJ; Center for Patient Advocacy; Center on Federation of Hackensack, NJ; Family and Services of Delaware County; Family Serv- Disability and Health; Chaddock; Charity Youth Counseling Agency of Lake Charles, ices of Elkhart County, IN; Family Services Works, Inc.; Child and Family Guidance Cen- LA; Family Centers, Inc. in Greenich, CT; of King County in WA; Family Services of ter in TX; Child and Family Service of Ha- Family Connections in Orange, NJ; Family Montgomery County, PA; Family Services of waii; Child and Family Services in TN; Child Counseling & Shelter Service in Monroe, MI; Northeast Wisconsin; Family Services of and Family Services of Buffalo, NY; Child Family Counseling Agency; Family Coun- Northwestern in Erie, PA; Family Services and Family Services, Inc. in VA; Child Care seling and Children’s and Children’s Serv- of Southeast Texas; Family Services of Sum- Association of Illinois. ices; Family Counseling Center of Central mit County in Akron, OH.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00019 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.029 pfrm03 PsN: S19PT1 S6406 CONGRESSIONAL RECORD — SENATE June 19, 2001 Family Services of the Lower Cape Fear in Natchez Children’s Home in Natchez, MS; Inc. in St. Louis, MO; Rehabilitation Engi- NC; Family Services of the Mid-South in TN; National Association of Public Hospitals and neering and Assistive Technology Society of Family Services of Tidewater, Inc. in VA; Health Systems; National Alliance for the North America; Religious Action Center of Family Services of Western PA; Family Mentally Ill; National Alliance of Breast Reform Judaism; Research Institute for Services Woodfield; Family Services, Inc. in Cancer Organizations; National Association Independent Living; RESOLVE; Riverbend SC; Family Services, Inc. of Layfette; Fam- for Medical Direction of Respiratory Care; Head Start & Family Service; Salem Chil- ily Services, Inc. of Wintson-Salem, NC; National Association for Rural Mental dren’s Home; Salvation Army Family Serv- Family Solutions of Cuyahoga Falls, OH; Health; National Association for the Ad- ices; San Mar, Inc. of Boonsboro, MD; Family Support Services in TX; Family Tree vancement of Orthotics and Prosthetics; Na- Scarsdale Edgemont Family Counsel in NY. Information, Education & Counseling in LA; tional Association of Children’s Hospitals; School Social Work Association of Amer- Family Violence Prevention Fund. National Association of County Behavioral ica; Seattle Children’s Home in WA; Seedco/ FamilyMeans in Stillwater, MN; Federa- Health Directors; National Association of Non-Profit Assistance,; Service Net. Inc. in tion of Behavioral, Psychological & Cog- Developmental Disabilities Councils; Na- PA; Sheriffs Youth Programs of Minneapolis; nitive Sciences; Federation of Families for tional Association of People with AIDS; Na- Sipe’s Orchard Home in Conover, NC; Childrens Mental Health; FEI Behavioral tional Association of Physicians Who Care. Sjogren’s Syndrome Foundation; Society for Health in WI; Florida Families First; Florida National Association of Private Schools Excellence in Eye care; Society for Mater- Sheriffs Youth Ranches; Friends Committee for Exceptional Children; National Associa- nal-Fetal Medicine; Society of Cardio- on National Legislation; Gateway in Bir- tion of Private Special Education Centers; vascular & Interventional Radiology; Soci- mingham, AL; Gateways for Youth and Fam- National Assoicaiton of Protection and Ad- ety of Gastroenterology Nurses and Associ- ilies in WA; George Junior Republic in Indi- vocacy Systems; National Association of ates, Inc.; Society of Gynecologic ana; Gibault; Girls and Boys Town in NE. School Psychologists; National Association Oncologist; Goodwill-Hinckley Homes for Boys; of Social Workers; National Black Womens Southmountain Children’s Homes in Nebo, Greenbrier Childrens Center in Savannah, Health Project, Inc.; National Breast Cancer NC; Spina Bifida Association of America; St. GA; Growing Home in St. Paul, MN; Coalition; National Catholic Social Justice Anne Institute of Albany, NY; St. Colman’s Haddasah; Heart of America Family Services Lobby; National Coalition for Cancer Survi- Home in Watervliet, NY; St. Joseph Chilren’s in Kansas City, KS; Hemochromatosis Foun- vorship; National College of Osteopathic Home; St. Joseph’s Indian School in SD; St. dation; Hereditary Colon Cancer Association; Emergency Physicians; National Committee Mary’s Home Home of Beaverton, OR; St. Highfields, Inc. in Onondage, MI; Holy Fam- to Preserve Social Security and Medicare; Vincent’s Services, Inc. of Brooklyn, NY; ily Institute of Pittsburgh, PA; Home on the National Community Pharmacists Associa- Starr Commonwealth; Sunbeam Family Range in Sentinel Butte in Sentinel Butte, tion. Services of Oklahoma City, OK; Sunny Ridge ND; Hubert H. Humphrey, III—Former Min- National Consumers League; National Family Center; Susan G. Komen Breast Can- nesota Attorney General; Human Services, Council for Community Behavioral Health; cer Foundation. Inc. in Denver, CO. National Depressive and Manic-Depressive Tabor Children’s Services, Inc. of Huntington’s Disease Society of America; Association; National Down Syndrome Con- Doylestown, PA; Teen Ranch, Inc. Marlette, IARCCA An Association of Children; Idaho gress; National Family Planning and Repro- MI; Tennessee Citizen Action; Texas Associa- Youth Ranch; Indiana United Methodist ductive Health Association; National Health tion of Leaders in Children & Family; Texas Children; Infectious Disease Society of Council; National Hemophilia Foundation; Medical Association; The Arc of the United America; International Association of Psy- National Marfan Foundation; National Men- States; The Bradley Center in PA; The Cen- chosocial Rehabilitation Services; Jackson- tal Health Association; National Multiple ter for Families, Inc.—Shreveport, LA; The Field Homes in VA; Jane Addams Hull House Sclerosis Society; National Organization for Children’s Home in Catonsville, MD; The En- Association in Chicago, IL; Jeffrey Modell Rare Disorders; National Organization of docrine Society; The Family Center; The Foundation; Jewish Board of Family & Chil- Physicians Who Care. Hutton Settlement in WA. dren in New York, NY; Jewish Community National Organization of State Association The Learning Disabilities of America; The Services of South Florida; Jewish Family & for Children in MD; National Parent Net- Mechanicsburg Children’s Home of Mechan- Career Services in Atlanta, GA. work on Disabilities; National Partnership icsburg, PA; The Omaha Home for Boys in Jewish Family & Children’s Service in TX; for Women and Families; National Patient NE; The Organization of Specialists in Emer- Jewish Family and Children’s Service in Advocate Foundation; National Psoriasis gency Medicine; The Paget Foundation for Minnetonka, MN; Jewish Family and Com- Foundation; National Rehabilitation Asso- Pagets’s Diseases of Bone and Related Dis- munity Service in Chicago, IL; Jewish Fam- ciation; National Therapeutic Recreation orders; The Pressley Ridge Schools in PA; ily Service in Providence, RI; Jewish Family Society; National Transplant Action Com- The Village Family Service Center in Fargo, Service in Teaneck, NJ; Jewish Family Serv- mittee; National Women’s Health Network; ND; The Woodlands in Newark, OH; Third ice in TX; Jewish Family Service of Akron, National Women’s Law Center; Nation’s Way Center; Thornwell Home and School for OH; Jewish Family Services of Los Angeles; Voice on Mental Illness; Nazareth Children’s Children in SC; Title II Community AIDS Julia Dyckman Andrus Memorial Children’s Home in Rockwell, NC. National Network; Tourette Syndrome Asso- Center in NY; June Burnett Institute; NETWORK; Neurofibromatotis, Inc.; New ciation. Kemmerer Village; Kentucky United Meth- Community Corporation in Newark, NJ; Treatment Access Expansion Project; Tri- odist Homes. Newark Emergency Services for Families in angle Family Services in Raleigh, NC; Tulsa Kidney Cancer Association; KidsPeace Na- New Jersey; NISH; Norris Adolescent Center Boys’ Home in Tulsa, OK; Turning Point tional Centers, Inc. in PA; Lakeside, Kala- in WI; North American Brain Cancer Coali- Center; Uhlich Children’s Home; United Auto mazoo, MI; LaSalle School, Inc. in Albany, tion; Northeast Parent & Child Society in Workers; United Cerebral Palsy Association; NY; League of Women Voters; Leake and New York; Northern Virginia Family Serv- United Community & Family Service; United Watts Services, Inc. in Yonkers, NY; Learn- ice; Northwest Chapter of Paralyzed Vet- Family Services in Charlotte, NC; United ing Disabilities of America; Lee and Beulah erans of America; Northwest Childrens Methodists Childrens Home; United Ostomy Moor Children’s Home in TX; Leukemia and Home, Inc.; Northwood Children’s Services in Association; United States Public Interest Lymphoma Society; Lupus Foundation of Duluth, MN. America, Inc.; Lutheran Child & Family Oak Grove Institute Foundation; Oakland Research Group (U.S. Pirg). US TOO International, Inc.; USAction; Service in Bay City, MI; Lutheran Child & Family Services; Olive Crest Treatment Cen- Vera Lloyd Presbyterian Home & Family Family Services in River Forest, IL. ters; Omaha Home for Boys in Nebraska; On- Services in AR; Verdugo Mental Health Cen- Lutheran Social Services of Wisconsin; cology Nursing Society; Organization of Spe- ter; Village for Families & Children; Virginia Manisses Communications Group in RI; cialist in Emergency Medicine; Outcomes, Home for Boys; Webster-Cantrell Hall; Maple Shade Youth & Family Services; Inc. in Albuquerque, NM; Ovarian Cancer Na- Wellness Community; Whaley Children’s Maryhurst, Inc.; Maryland Association of tional Alliance; PA Alliance for Children and Center; Wisconsin Association of Family and Resources for Families & Youth; Massachu- Families in Hummelstown, PA; Pacific setts Council of Family; MediCo Unlimited, Lodge Youth Services; Paget Foundation; Children; Wisconsin Paralyzed Veterans of LLC; Mental Fitness Center; Mental Health Pain Care Coalition. America; Woodland Hills in Duluth, MN; Yel- America, Inc.; Mental Health Liaison Group; Palmer Home for Children in Columbus, lowstone Boys and Girls Ranch in Billings, Methodist Children’s Home in TX; Metro- MS; Pancreatic Cancer Action Network; Par- MT; Youth Haven, Inc. in Naples, FL; Youth politan Family Service of Portland, OR. alyzed Veterans of America; Patient Access Service Bureau in Portland, IN; YWCA of Metropolitan Family Services of Chicago; Coalition; Patient Access to Responsible Northeast Louisana. Michigan Federation of Private Child & Care Alliance; Patients Who Care, Inc.; Pedi- Mr. MCCAIN. Mr. President, I yield Family Agencies; Michigan State Medical atric Orthopaedic Society of North America; the floor. Society; Mid-South Chapter of the Paralyzed Pennsylvania Council of Children in Harris- The PRESIDING OFFICER. The Sen- Veterans of America; Milton Hershey School burg, PA; Perkins School for the Blind; Per- ator from North Carolina is recognized. in Hershey, PA; Missouri Baptist Children’s sonal & Family Counseling Service of New Mr. EDWARDS. Mr. President, I ask Home; Missouri Coalition of Children’s Agen- Philadelphia, OH; Philadelphia Health Man- unanimous consent that at the conclu- cies; Missouri Girls Town; Mooseheart Child agement Corporation in PA; Planned Parent- City and School in IL; Morning Star Boys’ hood Federation of America; sion of my remarks I be followed by Ranch in WA; Mountain Community Re- Presbyterian Home for Children; Pressley Senator KENNEDY, who is also a spon- sources; Namaqua Center in CO. Ridge Schools in PA; Provident Counseling, sor of this legislation.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00020 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.031 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6407 The PRESIDING OFFICER. Without verse it; and you can’t take them to thing, which is what this legislation is objection, it is so ordered. court. So somebody such as Steve, who about—having the HMO do the right Mr. EDWARDS. Mr. President, I has a terrible time trying to pay for thing from the beginning and having thank my friend from Arizona, who this oxygen himself, is stuck—even the patient, if they don’t, be able to do worked with me over a period of many though they have paid premiums and something about it. months to help put together this legis- paid for coverage, and any reasonable What we do is set up a system that is lation—after work had been done for physician in America knows he needs designed to avoid lawsuits. We have, many years by a number of Members of this care. first, an internal review process so that the Senate, led by Senator KENNEDY. That is what this act is about. The if the HMO says they are not going to The law for many years in this coun- Bipartisan Patient Protection Act cover a particular kind of care or treat- try has been on the side of big HMOs changes that. We are going to change ment, the patient can go through an and insurance companies. They have the law so that finally patients, nurses, internal review at the HMO. Second, if been treated like no other person in doctors, and health care providers who that process is unsuccessful, the pa- America is treated, like no other busi- know how to make these medical deci- tient can then go to an independent ex- ness, small or large; they are privileged sions and families who are involved and ternal review. This is a panel of doc- citizens. The American people want to whose children are being affected by tors, health care providers, who aren’t take away that privileged status from these decisions will have some power of connected to the HMO, aren’t con- HMOs and insurance companies. They the law on their side. nected to the patient or the treating are the only group in America that can Let me talk briefly about some spe- doctor, who can make a fair and objec- say to a family: Your child is not going cifics of our legislation. We provide and tive decision about whether this treat- to get the medical care your doctor guarantee access by women to OB/ ment is necessary. So the patient now thinks they need. GYNs as their primary care provider. has two different ways to get the They can overrule the decision of a They don’t have to get permission from HMO’s decision reversed. medical doctor that has been made anybody. They can do that. If a child If that is unsuccessful, if for what- after many years of training and expe- needs to see a specialist, a pediatri- ever reason the appeals process does rience, even though they may have no cian—a child with cancer who may not work, as a last resort, if the pa- experience or training whatsoever. need to be seen by a pediatric tient has been unsuccessful after doing Some young clerk sitting behind a desk oncologist—that child has an absolute all of that and if the patient has been somewhere can overrule a medical ex- right to go see that specialist if they injured as a result of what the HMO pert, and if they do it, there is abso- need it for their life-sustaining care. did, then as a matter of last resort the lutely nothing that can be done about Emergency room care. If a patient or patient can go to court. a family experiences an emergency and it. Now, first of all, with respect to em- The HMOs, the insurance companies, they need to get to the doctor, to the ployers, we specifically provide that are accountable to no one. Their judg- hospital, to the emergency room, they employers cannot be held responsible. ment can’t be questioned; their deci- don’t have to call a 1–800 number; they They cannot be sued; they cannot be sion can’t be reversed; and they can’t don’t have to call the HMO; they don’t liable. Employers are specifically pro- be challenged anyplace, including in have to get written permission. What tected under our bill. The only excep- court. any family will do when under an tion to that is if the employer actually That is what this bill is about. What emergency situation such as that and makes a medical decision—if they step we are about—Senator MCCAIN, Sen- they need care quickly, quality care, into the shoes of the HMO and do what ator KENNEDY, I, and all of the sponsors they can go straight to the nearest no small or medium-sized employer in of this legislation—is changing the law. emergency room without worrying America would do if they actually We want to move the law from the side about whether the HMO will cover. make a medical judgment. of big insurance companies and HMOs Under our law, they are covered, pe- By the way, this provision that em- and finally put the law on the side of riod. patients, nurses, and doctors. Scope. Our bill specifically provides ployers can only be held responsible if Every one of us, in traveling around that every American who has health they make a medical decision and oth- our home States, has heard horror insurance or HMO coverage is covered erwise they are protected is identical story after horror story of families and by our bill, period. They have at least to President Bush’s principle on this patients being run over by big HMOs. the protections provided in this bipar- issue. His principle provides that em- Let me recount one I heard in North tisan legislation. If a State has better ployers may only be held responsible if Carolina. protections for the patient, better pro- they make medical decisions. That is A young man, Steve Grissom, con- tections for the doctor, those protec- precisely what our bill does. tracted leukemia. In the course of his tions stay in place. But our bill pro- On this issue, the protection of em- treatment, he had to get a blood trans- vides a floor below which no State can ployers, the President’s principles and fusion. As part of the blood trans- go. our bill are exactly the same. fusion, he got AIDS. He got sicker and So the basic protections provided in If it becomes necessary after a pa- sicker and sicker. He was being seen by our bill—access to specialists, women tient has gone through the appeals a heart specialist at Duke University being able to go see an OB/GYN, going process—internal and external review— Hospital. That doctor prescribed 24- to the nearest emergency room, access and a patient has been injured for the hour-a-day oxygen for Steve because he to clinical trials, which is critical to case to go to court, we start with a needed it. This was a doctor with many many Americans—they will have under very simple principle. That principle is years of training at one of the leading this legislation an absolute right to this: We want to treat HMOs and insur- medical institutions in the country. those protections. ance companies just as the other Steve’s wife’s employer changed HMOs. Finally, accountability. Mr. Presi- health care providers. They are making Some clerk sitting behind a desk some- dent, these rights mean nothing if they health care decisions. They have de- where, without medical training, hav- are not enforceable. If they are not en- cided to overrule a doctor who decided ing never seen Steve Grissom, knowing forceable, this is not a Patients’ Bill of a patient needed a particular kind of nothing about it, decided they weren’t ‘‘Rights;’’ it is a patients’ bill of ‘‘sug- care. When they decide to overrule the going to pay for this oxygen anymore. gestions.’’ But because we have ac- doctor and step into the shoes of the They literally cut off his oxygen. countability and we have enforce- doctor, we think they ought to be Steve had nowhere to go. Why? Be- ability, these are substantive rights treated like the doctor, just like the cause under the law of the land, as we that in fact can be enforced. Finally, hospitals, just like the nurses. stand here today, HMOs can do exactly HMOs are going to be treated as every- What we provide is they can be taken what they did to Steve Grissom, and no body else in America. They are going to State court, just like the doctors, one can do a single thing about it. You to be held accountable, held respon- just like the hospitals, and they are can’t question their decision; you can’t sible, which means at the outset that subject to whatever limitations exist question their judgment; you can’t re- they have an incentive to do the right under State law by way of recovery.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00021 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.041 pfrm03 PsN: S19PT1 S6408 CONGRESSIONAL RECORD — SENATE June 19, 2001 The majority of the States in this courthouse. There is almost always a lobby are spending millions of dollars country have caps or limits on recov- State courthouse close by, but Federal to defeat our bill. It is not an accident ery, limits on noneconomic damages, courthouses, especially in rural Amer- that the HMOs like the Frist-Breaux in some cases, what is called pain and ica, are hundreds of miles away in bill and do not like our bill. suffering, limits on punitive damages, many cases. As we go through this debate, it will and some States provide you cannot re- We have a system that works. It has become clear that on every single dif- cover punitive damages. been outlined by the U.S. Supreme ference, between the legislation we The bottom line is this: Whatever the Court. It is what legal experts say have offered and the competing legisla- State law is, that law applies to the should be done. Most importantly, it is tion, whether it is coverage and wheth- HMO, just exactly as it applies to the fair. It treats the HMOs the same as ev- er States can opt out, whether it is ac- doctor, to the nurse, to the hospital, to erybody else, which is the goal of this cess to specialists outside the plan, everybody else in the State. We start legislation. whether it is a truly independent re- with the basic idea that HMOs are not Finally, we do require, in order for a view that the HMO can have no control privileged citizens; that they are just case to be brought to court, that, first, over, whether it is going to court and the same as the rest of us and ought to all appeals be exhausted. That is, the which court you go to, in every single be treated the same as the rest of us. patient must first go to the internal re- difference we protect the patients, they That is what our bill does: It treats the view and, second, to the external re- protect the HMOs. HMOs the same as the other health view. What we have learned from the Their bill, as Dr. NORWOOD, a Repub- care providers when they, in fact, over- two States that have served as models lican House Member from Georgia who rule a doctor and make a health care for this legislation—Texas and Cali- has fought on this issue for years, has decision. fornia—is almost all cases are resolved described it, is an HMO protection act. That structure—sending those cases by that process. The reason is we struc- It is not an accident that all the health to State court—is what has been rec- tured the bill to avoid lawsuits. It has, care groups in America and the Amer- ommended by the Judicial Conference in fact, worked in the two States that ican Medical Association support our of the United States headed by Chief have followed our model—California bill. Justice Rehnquist. It is what is rec- and Texas, two of the biggest States in These are people who deal with these ommended by the American Bar Asso- the country, two of the States where issues every single day, and they know ciation. It is what is recommended by there has been historically the largest that on all these important issues—ac- the State attorneys general. amount of litigation in the country. cess to specialists, who is covered, People who understand the court sys- There have been 16, 17 lawsuits since emergency room, access to a true inde- tem but are objective, not on one side those bills have been enacted in those pendent review process—our bill pro- or the other of this debate, have de- two States. The vast majority of cases tects the patients; their bill protects cided this is the place these cases have been resolved exactly as our bill the HMOs. should go for a variety of reasons. No. provides. They have been resolved All of us have worked long and hard 1, it treats the HMOs the same as doc- through the process of the appeal. on this issue for a substantial period of tors and hospitals are treated. No. 2, There has been some argument made time. Some have worked on it, includ- they are courts accustomed to han- about health care costs going up and ing Senator KENNEDY, for many years. dling these types of cases. It makes it people losing their insurance. The ma- It is time to quit talking about doing more likely the patient can get their jority leader spoke to this earlier. Our something about HMOs and HMO re- case heard more quickly. bill, according to the Congressional form and actually do something about It is fair. It is equitable. It is sup- Budget Office, raises insurance pre- it. The American people are not inter- ported by every group of objective ex- miums about 4 percent over 5 years. ested in the politics—Republicans, perts—Judicial Conference, the ABA, Not 4 percent annually, 4 percent over Democrats, Independents—and their the State attorneys general—and, by 5 years. positions politicizing this issue. What the way, follows exactly the outline set The competing bill, the Frist-Breaux they care about is that when their forth by the U.S. Supreme Court in the provision, raises insurance premiums child needs to see a specialist, they Pegram decision. about 3 percent over 5 years. So there want to be sure that child can see that This idea of sending these cases to is very little difference between the specialist. When they need to go to the State court is an idea that is supported two bills. emergency room, they need to know by the big legal organizations across In addition to that, of the 4 percent they can go to the emergency room the country and as outlined by the U.S. increase in our bill, the vast majority without having to worry if the HMO is Supreme Court in the Pegram case. of that has to do with better health going to pay for it. If the HMO does The basic principle is we treat HMOs care. It has nothing to do with law- something wrong and runs over them exactly the same way we treat doctors suits, nothing to do with litigation. and runs over their family and over- and hospitals if they are going to be in Mr. President, .8 percent, less than 1 rules a doctor’s medical decision, they the business of making medical deci- percent, has to do with litigation. The want to be able to do something about sions. remainder, over 3 percent, has to do that. They want the HMOs to be treat- The only cases that would go to Fed- with better access to the clinical trials, ed just as all the rest of us. eral court under this bill are the cases better access to specialists, better ac- Ultimately that is what this bill is that have, since 1974, been decided in cess to emergency rooms. about. The bottom line question is, Federal court. Those are the cases in- It specifically provides better care. with whom do we stand? Do we stand volving pure language of the contract. When people get better care, it costs a with the big HMOs and the big HMO For example, whether a particular pro- little bit more, and they will get a bet- lobbies or do we stand with the doc- vision has been met or whether the 90- ter product. tors, nurses, and families of America? day waiting period has been met. Those On balance, both bills increase costs I yield the floor. cases go to Federal court. They have slightly—3 percent in 1 case over 5 The PRESIDING OFFICER. Under always been in Federal court. We leave years; 4 percent in our case over 5 the previous order, the Senator from them exactly where they are. years. But as a direct result of this leg- Massachusetts is recognized. What we do not do is what has been islation being passed, people will have Mr. KENNEDY. Mr. President, before proposed by some, which is to send better quality care, and the cost has the Senator leaves, I wonder if he every case against an HMO to Federal very little to do with the fact the might respond to a question or two as court. The Federal courts are back- HMOs can now be held accountable and one of the principal sponsors. logged so that is a way to bury the be taken to court. First of all, I wonder if he shares cases and assure they never get heard. It is not an accident that the Amer- with me a certain degree of disappoint- It is more difficult to get attorneys be- ican Medical Association and over 300 ment that we are not going to have the cause many attorneys do not practice health care and consumer groups in opportunity to debate these protec- in Federal court, and many people are America support our bill. It is not an tions that are so important for Amer- a long way from the nearest Federal accident that the big HMOs and their ican families. Every day that we fail to

VerDate 19-JUN-2001 01:45 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00022 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.047 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6409 take action, families are being hurt. In the fourth change, regarding pro- Mr. KENNEDY. Let me speak to this Without this legislation, more than tecting the State cause of action, we point. I am confused as to why there is 50,000 of our fellow citizens today are added clarifying language to protect an attempt by the Republican leader- going to suffer further injury or pain. existing State court jurisdiction from ship to misrepresent what is in the em- This is the result of failing to take ac- inadvertent preemption under our bill. ployer provisions of the bill on page tion. A rather extraneous example or two 144. I think all of us who have been I want to make some general com- were given that might have created around here find language is misrepre- ments along the lines of those that the some confusion. As I understand it, sented and subsequently individuals Senator made. I first say that that was that was the fourth piece of clarifying disagree with the misrepresentation. It an outstanding presentation with re- language. appears that is what is happening. gard to the substance. It is difficult for Finally, the IRS enforcement lan- The Senator has stated my under- me to understand the opposition to guage was dropped, including an addi- standing. Then if we look at page 144, this, other than, as the Senator point- tional enforcement provision that we regarding the responsibility of the em- ed out, the special interests of the understand has a revenue impact and a ployer in the plans, it says: HMO industry do not want it. I have blue-slip problem. To avoid the blue- Causes of action against employers. . . . not heard the administration or the slip issue, we dropped the provision. Then it says: Those are the totality of the changes. Senators who are in opposition, indi- Subject to subparagraph (B), paragraph cate what protections in this legisla- Evidently they are being used to some- (1)(A) does not authorize a cause of action tion they would not want to give to the how represent that there were major against an employer or other plan sponsor American people. kinds of alterations or changes to the maintaining the plan (or against an em- We were informed by the Republican bill which are difficult to understand. ployee of such an employer or sponsor acting leadership that because this bill has Therefore, the other side refuses to per- within the scope of employment). been changed so many times, we need mit us to begin the debate on the bill. That is extremely clear. In the Presi- to hold further hearings to find out If the Senator would be good enough dent’s language, which he sent to the what is in it. There have been no hear- to indicate to me whether it is his un- Congress, and I have here, the Presi- ings since March of 1999. derstanding that these were the areas dent lists his requirement in his bill of One of the leaders pointed to para- in which adjustments were made and particulars, which says: graph (C) in the legislation, where em- whether the representations that were Only employers who retain the responsi- ployers can be held accountable. Then made, in terms of the clarifications? bility for and make final medical decisions they talked about the rising costs of 20 Was that his understanding as well? should be subject to the suit. percent a year and talked further Mr. EDWARDS. Will the Senator That is what President Bush said is about employer liability. yield for me to reply to the question? the principle. It is my understanding Mr. KENNEDY. I am glad to yield. As I understand, the changes that that that exact point is stated in the Mr. EDWARDS. In response to the had been made over the weekend were legislation on page 145, line 8: question, the areas that were changed basically in response to some of the ob- were all changes in the direction of the . . . to the extent there was direct partici- pation by the employer. . . . servations that were made about the objections of our opponents. In other underlying legislation. One question words, they raised concerns and we That talks about when they would be was about whether you could be sued in made changes to clarify so there would open to the responsibility. But as I understand it, and I welcome Federal or State court. The opposition be no question but that we intended ex- claims our bill allows them to be sued actly what they intended. the comments of the Senator, that in Federal and State courts at the For example, the first one the Sen- completely conforms with what Presi- same time. This was never the inten- ator mentions: exhaustion, which dent Bush himself has established. Is tion. I understand there was an at- means you have to go through the ap- that correct? tempt to explicitly clarify that pro- peals before you can take somebody to Mr. EDWARDS. The Senator is cor- ceeding so there would not be two fo- court, both sides intended that that be rect. The President specifically pro- rums. I understand that was one of the required because we want cases to be vided he does not want employers to be clarifications made. It was never in- decided by the appeal without having sued unless they make medical deci- tended to permit forum shopping and to go to court, to avoid unnecessary sions. Our legislation does exactly that was clarified. lawsuits. We made it clear in this clari- that. The language completely con- I might mention the rest, since there fication that there is no question about forms, in almost identical language, to were only four of them, and then get that. We intend for that to be true. the President’s principle. We do not the reaction of the Senator since he That was the purpose of the clarifica- want employers to be sued unless was very much involved in this. tion. somehow they step in the shoes of the No. 2 was the question about the ex- Second is the cases being brought in HMOs and make a medical decision. haustion of appeals before going to State and Federal court. The purpose That is exactly what the President is court. The opposition claims our bill for the change was to make it clear we suggesting. The Senator is correct, to made it too easy to go to court, argu- want nobody to be sued in both State the extent our opponents—who, by the ing that patients can bypass the ap- and Federal court; to clarify the lan- way, are trying to prevent this bill peals process simply by alleging harm. guage so there was no doubt in any- from ever being considered at this Since it was not our intent to make it body’s mind about which cases go to point in this Chamber—to the extent easy to bypass appeals, we resolved State court and which cases go to Fed- our opponents suggest under our legis- this matter by eliminating the word eral court. lation lawsuits against employers are ‘‘alleged.’’ Third, they complain that under our allowed, they need to read the Presi- The third was about making it easier bill some physicians, perhaps, could be dent’s principles because, in fact, our to sue doctors. The other side has been subject to lawsuits to which they oth- legislation is identical to the Presi- claiming our bill makes doctors liable erwise would not be subject. So we dent’s principle on this issue. for plan administration. This is a rath- made a change to eliminate that possi- Mr. EDWARDS. Mr. President, if the er technical issue, being sued in State bility. Senator will allow me one final com- court and now in Federal court again. Our bill, as the Senator well knows, ment, the Senator well knows, having That wasn’t the intent. We clarify that is intended to empower doctors, to em- fought on this issue for many years and the positions are protected. We also in- power nurses, to make the health care having led the fight, as Senator cluded language to extend civil protec- decisions that only they have the med- DASCHLE, our majority leader pointed tions to hospitals and insurance ical training and experience to make, out in his earlier comments, the Amer- agents. There was some question about that they have the qualifications to ican people can get a lesson from what the application of the language. The make, not some bureaucrat sitting be- is happening at this moment. We made change was specifically included to hind a desk at some HMO somewhere. it clear we intended to bring bipartisan clarify that, to demonstrate the pro- That is the purpose of this clarifying patient protection to the floor of the tections for those groups. language. Senate, a bill supported by Republican

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00023 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.049 pfrm03 PsN: S19PT1 S6410 CONGRESSIONAL RECORD — SENATE June 19, 2001 Senators in this Chamber and also in and will lead to employers giving up I have been going to the conferences the House. their insurance. with those who are opposed to it. They What has been the response by our I would be interested in the Senator’s say, oh, no, that is not what it does. opponents? Has the response been to definition and explanation of why, It is a favorite whipping provision in debate this issue in an open way before when the bill says in part (B) on page this language. They keep saying that the American people and to make their 144 that cause of action may arise isn’t what it does. That is what we in- case to support the HMOs’ position on against an employer or other plan tend to do. That is what we have done the floor of the Senate? No. Their re- sponsor, the language means some- in this language. We will have more of sponse is to try to prevent an issue thing other than cause of action aris- an opportunity to debate that later. that affects millions and millions of ing against the employer or other plan Mr. GREGG. Will the Senator yield Americans every year from even being sponsor. for a question? heard on the floor of the Senate. Mr. KENNEDY. I am glad to respond. Mr. KENNEDY. I only have about 5 I think it becomes clear who wants I hope we can do this briefly because or 6 minutes to be able to make some to provide real and meaningful patient we are going to recess. I will let the presentation on this. I look forward to protection and who wants to keep this Senator from North Carolina respond that time. I will be glad to yield. Could issue from ever getting to the floor of to that, if I may. I ask that we defer the recess time the Senate so HMOs maintain their Mr. EDWARDS. Mr. President, I re- from 12:30 until 12:35? privileged status. spond to the Senator’s question by say- Mr. GREGG. Mr. President, I ask Mr. KENNEDY. Mr. President, I ing, first of all, I suggest that he read unanimous consent that at the expira- thank the Senator. the principles because the language of tion of the discussion of the Senator In the press conference of the Repub- this legislation comes directly from from Massachusetts I be given 10 min- lican leadership, it was represented the President’s principles. utes. that there were complicated changes Mr. GREGG. If the Senator will Mr. KENNEDY. We are about to re- and alterations to the bill. The Senator yield, I am not asking the President. cess. responded to questions raised as to Mr. EDWARDS. Excuse me. Do I have Mr. GREGG. I am asking that the what these changes and clarifications the floor? Excuse me. time for the recess be extended beyond The PRESIDING OFFICER. The Sen- are. This is a result of the White House the Senator’s period for 10 additional ator from Massachusetts has the floor. minutes and that I be recognized. asking the principals to work out some Mr. KENNEDY. Mr. President, I The PRESIDING OFFICER. Without clarification in these areas and to ac- think we only have 2 or 3 more min- objection, it is so ordered. commodate these kinds of requests. utes. I wanted to give the opportunity Those changes were made. Now they The Senator from Massachusetts. for a response. I think the answer, as are being used as an excuse for failing Mr. KENNEDY. Fine. the Senator pointed out, is read from to bring this matter up. Mr. President, so how much time re- President Bush’s own words. Only em- Mr. GREGG. Mr. President, will the mains? It is now 12:30. ployers who retain responsibility for or Senator yield? The PRESIDING OFFICER. The Sen- Mr. KENNEDY. Yes; briefly. make final medical decisions should be ator from Massachusetts has another 5 Mr. GREGG. I know that the Senator subject to suit. It is that language and minutes by the previous unanimous from Massachusetts and the Senator that principle that has been included in consent agreement. Then the Senator from North Carolina said the employer the language. from New Hampshire will have 10 min- If the Senator from New Hampshire is not subject to liability under this utes, and then we will recess until 2:15. thinks that is in some way ambiguous, bill. The Senator cited section 5 on Mr. KENNEDY. Fine. or doesn’t achieve that objective, that page 144, subparagraph (A). The Sen- Mr. President, this whole debate is the objective that we had. That is ator didn’t cite subparagraph (B), should remain focused on what it is the language that was drafted in the which says, notwithstanding subpara- really about. What this debate is really Senate to carry that purpose forward. graph (A), the cause of action may all about is that doctors, nurses and But we are open. families are going to make decisions. arise against an employer, or other Does he agree with that principle? I And those decisions ought to be carried plan sponsor—it goes down the list—as ask the Senator. Does the Senator out. They should not be overturned by directed participation in the employ- agree with that fundamental principle bean counters and accountants work- er’s plan, and the decisions of the plan or differ with the President on it? under section 102. Mr. GREGG. No. I actually agree ing for HMOs thousands of miles away. So, very clearly, an employer is sub- with the principle. I think the Presi- These accountants do not have the ject to liability under that section, and dent’s point was that employers gen- training, do not know the patient, and that ‘‘directed participation’’ is an ex- erally should not be subjected and do not know the complete medical cir- tremely ambiguous phrase, I believe. I opened up to massive liability. And cumstances surrounding the patient’s would be happy to discuss that. this bill does that. That is why I asked case. That is what this legislation is Then, if we go to page 141, where a the Senator to explain the section. really all about. new Federal cause of action against Mr. KENNEDY. I will have to reclaim We have taken the kinds of protec- employers is created, subsection (ii) on the floor. tions which have been outlined now by that page says, ‘‘otherwise fails to ex- Mr. GREGG. The Senator asked me a the Senator from Arizona and the Sen- ercise ordinary care in the performance question. Doesn’t he want me to re- ator from North Carolina and indicate of a duty under the terms and condi- spond? what those protections are. There are tions of the plan with respect to a par- Mr. KENNEDY. I asked specifically 26 different protections which have ticipant’’ in the plan. That action cre- whether the Senator agreed with the been included. We have yet to hear ates a new cause of action, which is a President’s principles. The Senator from the other side, as we have had new cause of action against the plan’s said yes, he did. these debates now for 2 or 3 years, re- sponsor, and, by the terms of ERISA, He went on to say that the language garding which protections they do not section 3 definition, plan sponsor is de- in the legislation opens up massive op- agree with. Is it the emergency room? fined as—lo and behold—the employer. portunity for suing employers, which is Is it the clinical trials, specialty care, I believe it is very clear under this different. He answered my question. I or the OB/GYN protections? Is it the bill that employers are subject to the am reclaiming my time since I only gag rules? We have not heard what par- right to be sued. They are subject to have about a minute and a half left. ticular guarantees and protections that the right to be sued for what I expect I wish we had the opportunity to de- are there for the American families to are going to be multiple opportunities bate this because it is very clear what which they object. for a creative attorney. In fact, the has been done with the drafting of this They talk a good deal about the cost Congressional Budget Office has basi- legislation. The employers, outside of of this legislation. They want to do the cally rated this as a lawsuit against those who are actually going to be bidding, I guess, of the HMOs, and have employers and has in fact rated the making medical decisions affecting pa- them be the one industry in this coun- costs in this bill, which is significant tients, are excluded. try not held accountable for actions

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00024 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.051 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6411 they take that can harm, kill, or maim need a pediatric oncologist. They with lawyers running around them in children and workers in our country. shouldn’t go to a general practitioner circles, suing them like crazy, shooting What we are basically saying is, if to make the recommendation for the arrows at them, trying to recover from HMOs make decisions which put indi- kind of treatment that resulted in the them because then we will drive the viduals at risk, then they ought to be saving of my son’s life. We are talking employers out of the insurance market, held accountable. The HMOs should be about access to those kinds of special- and more people will be uninsured. held accountable. If there is an em- ists. We see there is a difference be- That is why it is projected that this ployer making a similar decision which tween the bill we have before us and bill will increase the number of unin- is going to result in the same kind of that which the opposition favors. sured by over 1.2 million people. pain and affliction to that individual, The PRESIDING OFFICER. The Sen- I am a little surprised that some of they ought to be held accountable. ator’s additional 5 minutes have ex- the sponsors of this bill want to expand Otherwise, employers that just go out pired. the number of uninsured in this coun- and make the contracts should not be. The Senator from New Hampshire is try. I think some supporters of this bill If there is a question of clarification of recognized for 10 minutes. may want to because there is, I believe, language, we would work that out. Mr. GREGG. Mr. President, I had not a belief that nationalization of the Over the period of time, one of the intended to speak right now, but I do health care system is a good idea, and attacks that has been made on this leg- think some of the things that have one way to energize support for nation- islation is its potential cost. I want to been said in this Chamber do need to be alization is to have a lot of uninsured. say that is an old red herring. I was responded to because it is very obvious But I am hopeful some of the other here not long ago when we passed the there is a significant disagreement, and folks who look at this bill and are sup- Family and Medical Leave Act. We had it is a disagreement which is core to portive will say: Hold it. That was not the Chamber of Commerce stating the this issue. our intent. We didn’t want to drive em- cost of the Family and Medical Leave First off, let’s begin with the ques- ployers out of the business of insuring Act was going to be $27 billion a year tion of how this bill is coming forward. and cause more people to be uninsured. on American industry. It is not. It has You have to remember, this bill has We wanted to do just the opposite. been an enormous success, and compa- not had a hearing since March of 1999. So this language is extremely broad, nies have welcomed it. And there is We have not had any hearings on this extremely pervasive, and will attack going to be the opportunity to expand particular bill. And this is one heck of the employers of America—small em- it. a complicated bill. The bill on Wednes- ployers, employers with 10 employees, I was here when we debated the port- day was not the bill we got on Thurs- with 5 employees, with 25 employees, ability of health care for those individ- day. with 50 employees. There is no exemp- uals with disabilities, the Kassebaum- So when the other side says we are tion in this bill. Then there is other Kennedy bill. We heard at the time delaying, I think that is a little bit of language in this bill. This bill creates a that it was going to increase premiums a straw man debate primarily because, whole new cause of action against em- by billions and billions of dollars. It as a matter of responsibility, we have ployers that has never been seen be- has not. It is working, and there is no to at least read the bill. And then we fore, a whole new Federal cause of ac- one here to suggest that we should not have to figure out what is in it. tion. And it is a biggy. This is one have gone ahead on it. One of the big issues in relation to where lawyers can really have a good I was here when we heard the ques- what is in it is what effect this will time because, under this bill, it makes tion: Should we increase the minimum have on employers. I think the lan- the employers responsible for the per- wage? There were those who said it was guage is unequivocal on that point. formance of the duties under the terms going to mean hundreds of thousands The language in section (B), as I cited and conditions of the plan. This is a of people were going to lose their jobs, before, 144, says: A cause of action may brand new concept under Federal law. and that it was going to add inevitably arise against an employer. Sure they It defines the people responsible, as I to the problems of inflation. It has not. have the nice title, ‘‘Exclusion of Em- said earlier, as plan sponsors. Plan We know the scare tactics that were ployers,’’ but they wipe out that lan- sponsors, under ERISA, are defined as being used in terms of the cost in the guage with the language which says: employers. It brings in the employers. past, and they are the same kinds of Notwithstanding anything in subpara- We went through the different obliga- scare tactics that are being used at the graph (A)—that is the one with the tions under a plan that an insurance present time. nice title on it, ‘‘Exclusion of Employ- company has that offers that plan and The CBO, as the Senator from North ers’’—a cause of action may arise which are enforceable, not today by the Carolina has pointed out, indicates against an employer or other plan individual but by a variety of different that last year premiums went up 10 sponsor—and then it lists why. processes. We calculate that there are percent, and the top four or five HMOs One of the standards here is if the potentially 200 new opportunities for had $10 billion in profits in our coun- employer had direct participation. And private causes of action against em- try. They estimate that 20 percent of ‘‘direct participation’’ has become a ployers as a result of this language. every premium dollar paid goes to ad- word of art that is incredibly broad. There are a lot of lawsuits because vertising, administrative expenses, and ‘‘Direct participation’’ just means an there are a lot of lawyers who can take large salaries for these individuals. It employer had to maybe wink at his em- those 200 opportunities and multiply went up 10 percent last year. It went up ployee, as he headed off to his doctor’s them. That is one of those factors 8 percent the year before. office, and say: Hope you get better. which has an infinity symbol beside it As the CBO estimates, under the As a practical matter, today direct as to the number of potential lawsuits, Breaux-Frist bill, it will go up 2.9 per- participation essentially brings in that little circle you learned in eighth cent over 5 years; and under the every employer in this country that grade when you took physics, a little McCain-Edwards bill, 4.2 percent—a 1.3- has a plan. That is why a lot of em- infinity circle connecting the lawyers percent difference. As the Senator from ployers are going to drop their plans. to lawsuits as a result of this language. North Carolina pointed out, if you look That is why no employer group sup- I would rename this bill ‘‘the lawyers at those figures, the difference is in the ports the McCain bill—none—because who want to be a millionaire act’’ be- additional kinds of expanded opportu- it is an attack on employers, as versus cause that is essentially what it is. nities for patients, such as for clinical a legitimate effort to try to get at mal- This representation that employers are trials. For example, women need those feasance, misfeasance negligence in the not subject to liability is absolutely in- clinical trials in relation to breast can- areas of HMOs. accurate. Under the clear terms of the cer. We need to make sure they are We all want to make sure that people bill itself, it is absolutely inaccurate. going to be able to have those trials. who are poorly treated by their HMO What is the practical effect of this We have to have greater access to have a right for recovery. We put to- bill? This issue is not about, as the specialists. If a child has, as my child gether proposals which accomplish Senator from Massachusetts outlined, had, an osteosarcoma—which only 1,200 that. But let’s not draw all the employ- a whole series of coverages that people children in this country have—they ers into the process and stick them need. This is not about that. We give

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00025 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.053 pfrm03 PsN: S19PT1 S6412 CONGRESSIONAL RECORD — SENATE June 19, 2001 those coverages in our State. Most harm and then everything else gets to our health care system without this States have those coverages as a re- the table. No more appeals process of very egregious, very intrusive, very li- quirement in their States. It is not any nature. The concept of trying to tigious piece of law being passed. about that. It is not about whether or reduce the amount of litigation by hav- To reiterate, this is not a debate not a patient has access to a specialist, ing a reasonable appeal process is to- about whether patients should have and it is not about whether or not a tally undermined by this bill. rights. woman has access to an OB/GYN. All of It should also be noted that the eco- This is not a debate about whether that is available and should be avail- nomic impact of this bill has been patients should be able to go the near- able. Those are being thrown up as red scored not by me, not by some political est emergency room without being pe- herrings to try to develop support. organization, but by CBO. This bill nalized. That issue is not even on the table be- costs 4.2 percent. That is not over 5 or This is not a debate whether a pa- cause there is hardly a State in the 10 years, as was represented here ear- tient should be able to access a spe- country that does not give those types lier. That is an annual cost on top of cialist with appropriate expertise and of coverages and require those types of the health care costs which are inflat- training; prescription drugs that are coverages of their HMOs. ing fairly rapidly right now. A 4.2 per- medically necessary and appropriate; It is not about whether a patient cent increase translates into a very or comprehensive information about should have a timely right to appeals, significant increase, as has been men- their health plan. This is not a debate about whether a both internal and external, because all tioned earlier, in the uninsured because female patient should be able to di- the laws, all the proposals that have employers will have to drop their in- rectly access OB/GYN without prior au- come forward have done that. It is not surance because they can’t afford it. thorization, nor is it a debate whether about that. That should not be our goal here. the parents of a child should be able to It is not about whether a patient What should our goal be? should be compensated if they get The PRESIDING OFFICER. The Sen- designate a pediatrician as their child’s harmed by their doctor or their HMO. ator from New Hampshire has used his primary care provider. This is not a debate about whether a All of the bills that have come forward, 10 minutes. pregnant, sick, or terminally ill pa- all the proposals that have come for- Mr. GREGG. I ask unanimous con- tient is able to continue receiving care sent for 2 more minutes. ward have had that as part of their lan- from her physician through the entire Mr. REID. Mr. President, reserving guage. All these bills share those same course of treatment—even if the plan the right to object, I have no objection goals. terminates her physician from the net- This is about a dramatic expansion in to my friend using 2 extra minutes. work. the opportunity to sue. That is what Following that, I would like to be rec- This is not a debate about whether the bill is about, as it is brought for- ognized and then the Senator from physicians are able to tell their pa- ward; specifically, to sue employers, North Carolina would be recognized for tients about all treatment options with the practical effect being that 5 minutes and then we will go to our without being gagged by the health more people will be uninsured in our party conferences. plan. country today because more employers The PRESIDING OFFICER. Without This is not a debate about whether will drop their insurance. The number objection, it is so ordered. there should be procedures to ensure of new opportunities in this bill for The Senator from New Hampshire that health plans make timely deci- lawyers to create havoc is significant. now has 2 minutes, to be followed by a sions and patients have the right to You have the fact that you can basi- statement from the Senator from Ne- both an internal appeal to the plan and cally forum shop between States and vada, and then 5 minutes to the Sen- an independent external review when a Federal law. You have States stepping ator from North Carolina. plan denies coverage. And this is not a into the area of ERISA. ERISA is an Mr. GREGG. Mr. President, the goal debate about whether the external re- incredibly complex piece of legislation here should be this: When you go to see view is independent from the plan and on which Federal courts have spent a a doctor and you go to your HMO, if the reviewer makes a decision based on lot of time developing expertise. There that is who covers you, you should ex- the best medical evidence and highest has been over 10,000 cases on ERISA de- pect to get good treatment. If you standard of care. cisions. Suddenly Federal and State don’t get good treatment, you should This is not a debate about whether courts are going to take on this issue. have relief. And you should expect to all Americans should enjoy these types Not only are they going to get to take have a certain amount of flexibility as of rights. it on, but they are going to get to take to who you see and especially with This is not a debate about whether it on without any liability caps. Essen- some very common events such as OB/ patient rights should be enforceable or tially, there are no liability caps GYN and areas such as that, where you even whether a patient should be fairly against health plans. There may be should have the capacity as the patient compensated when harmed or killed by caps against doctors in some States, to make some choices: your primary the decision of his or her health plan or but take California; they don’t have care provider, things such as that. HMO. caps against health plans. That is all accomplishable. In fact, We agree on all these issues. Both There are no liability caps. the bills that have been brought for- sides share these goals. Democrats and You are going to have punitive dam- ward from our side of the aisle—some Republicans. ages, economic damages without caps. of them in a bipartisan way, such as The real debate is about how we can The implication of what that means is the Breaux-Frist-Jeffords bill, last best achieve these common goals. It’s that you are going to have forum shop- year’s, the Nickles amendment, which about putting patients first—ahead of ping from State to State, depending on did not have any Democratic support— special interests. It’s about accom- which State makes the most sense for have accomplished that. In the process plishing these goals without driving up a person, which structure makes the of accomplishing that, we should not health care costs, giving employers most sense for a lawyer to pursue. fundamentally undermine the interests more reasons to drop health coverage, Then you are going to have them pro- of employers to participate in health adding millions more Americans to ceeding in that structure. And you are insurance for their employees, which is join the ranks of the uninsured, or dis- going to have the employer brought in. what, unfortunately, the McCain bill mantling our private, employer-based Plus this concept that you have to go does. And we should not do unneces- health care system. through an appeals process before you sary and significant damage to States The bill we are about to debate—the get to bring a lawsuit is also totally rights which is, unfortunately, what Bipartisan Patient Protection Act subjugated in this bill. The way this the McCain bill does. That is a whole sponsored by Senators MCCAIN, ED- bill is structured, all you have to do is other discussion. There are a variety of WARDS, and KENNEDY—fails on all these show harm and you are out of the ap- other problems. counts. peal process—or alleged harm. Origi- The goal can be accomplished, which I believe we can accomplish our com- nally it was ‘‘alleged’’ harm. Basically, is better health care and better protec- mon goals without inviting these unin- you get into court and claim you show tion of our patients and people who use tended consequences. Unfortunately,

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00026 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.061 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6413 there appears to be no interest from predict the legality of proposed actions cessity which may be used to deter- the majority in addressing these con- without the necessity of reference to mine whether a plan covers a benefit. cerns. Senator DASCHLE said recently varying state laws.’’ In effect, this allows the medical re- that he sees no reason to compromise Proponents of the McCain-Edwards viewer to ignore contract definitions of or address these concerns. I think that bill would have you believe that they medical necessity and substitute their is very unfortunate for consumers and have compromised by adding a $5 mil- own definitions or opinions as a basis for patients. lion cap on punitive damages for the for overturning a health plan’s deci- I would like to highlight the very Federal cause of action. But this cap is sion. real problems in this bill, S. 1052 which merely illusory. This provision would lead to routine was just introduced on June 14. The bill has no caps on Federal or reversals of health plan decisions and The McCain bill creates two opportu- State economic or non-economic dam- generate increased litigation. Employ- nities to take a bite at the apple. First, ages. ers and health plans would have no pre- it allows unlimited lawsuits against Plus, there are no caps on damages dictability in administering their plans health plans and employers under state specified for the numerous lawsuits or estimating their exposure to liabil- law. Second, it creates an expansive that would fall under State jurisdic- ity. Alternatively, this may cause new remedy with very large damages tion. And there is no evidence to sug- plans to routinely approve all coverage under federal law. gest that State law caps would be ap- thereby driving up premiums astro- The dual Federal-State scheme under plied to these various causes of action. nomically and raising quality and safe- the McCain bill will encourage dual In fact, most State medical mal- ty concerns for the patient. Employers claims and forum shopping. Plaintiff’s practice law damage caps only apply to may reconsider their commitment to lawyers will shop around for the forum physicians and other health profes- offer and administer health benefits if with the highest limits on damages. sionals—not health plans. California is the McCain bill becomes law. And there is nothing in the bill that one such example. would prohibit suits based on the same Excessive damage awards only harm Health plans and employers that or a similar set of facts from being physicians and patients. According to a honor their contractual obligations filed simultaneously or consecutively study by Tillinghast-Towers Perrin, could be on the losing end of a lawsuit in both State and Federal court. health plan liability will increase phy- when an external medical reviewer de- This dual Federal-State scheme will sician medical malpractice liability cides to disregard a term in the health raise complicated and costly jurisdic- premiums by 8 to 20 percent because plan contract. Even plans that adhere tional questions and will ensure that plaintiffs will target all possible de- carefully to the terms of their con- plan benefits and administration will fendants, including physicians. These tracts, no matter how generous those vary from State to State. This will costs will be passed on to patients in terms are, could be held liable if the re- only serve to confuse patients who are the form of higher premiums or re- viewer decides to apply a different already faced with the task of navi- duced coverage. standard. gating a complex health care system. Health plans will also pass on the in- Contrary to continued assertions by This scheme will also impose need- creased costs of being exposed to large its proponents, the McCain bill does less and excessive costs that will dis- damage awards to employers who will not protect employers from open-ended courage employers from sponsoring in turn pass the costs on to employees liability. In fact, the bill specifically health plans. It will ultimately in- or reduce or terminate coverage. authorizes certain types of lawsuits to crease the ranks of the uninsured. The McCain bill allows patients to go be brought against employers in Fed- Federal courts have been routinely straight to court—for the purpose of eral court for failing to perform a duty hearing cases involving complicated collecting monetary damages—without under the terms and conditions of the employee benefit cases. The McCain exhausting administrative remedies plan. bill would essentially remove all cov- first. Because employers are required to erage and claims decisions from Fed- The independent medical review carry out a broad range of administra- eral court and place them under State process is the best, most efficient rem- tive duties under ERISA’s statutory jurisdiction, even though States have edy for the majority of patients. It en- scheme, the McCain bill will leave no experience with ERISA and em- sures that patients get the medical them wide open to new Federal per- ployer-sponsored benefits. care when they need it. In contrast, sonal injury suits. Employers will be Federal courts have honed their ex- tort damages are only available to pa- sued for all types of alleged errors such pertise in resolving complicated em- tients after they are injured. as issuing notices required by the ployee benefits issues since they were The ‘‘go straight to court provision’’ Health Insurance Portability and Ac- given exclusive jurisdiction over such creates a perverse incentive for pa- countability Act, HIPAA, and the cases in the Employee Retirement In- tients, encouraged by their attorneys, COBRA, regardless of whether such er- come and Security Act of 1974, ERISA. to bypass the review process in order to rors result in a denial of a covered ben- Approximately 10,000 ERISA cases are seek the big damages awards in court. efit. filed each year in Federal court. Proponents of the exhaustion loop- In order to provide high quality and hole argue that external review is ‘‘not The McCain bill would impose poten- affordable benefits to employees, em- enough.’’ They would have you believe tially huge new compensatory and pu- ployers that sponsor health plans that an exhaustion requirement some- nitive damages remedies for violations across State lines must be able to ad- how precludes the ability of an injured of COBRA, HIPAA, and ERISA’s disclo- minister their benefits in a uniform, patient to seek recourse in court. But sure requirements. Moreover, under the consistent and equitable manner. The this is not the case. The external re- statute’s own requirements, the em- McCain bill will produce multiple and view process is merely a required and ployer is specifically required to carry conflicting State laws, regulations and beneficial step before going to court. out COBRA and disclosure require- court interpretations, making it dif- The high standards that the medical ments. The employer is almost always ficult for employers to administer reviewer is required to follow will help the administrator. Thus, McCain-Ken- their health plans. inform the court’s decisions in deter- nedy imposes a huge new liability on Congress’ rationale for giving Fed- mining whether the plan decision was employers that employers cannot eral courts exclusive jurisdiction with the right one. Just as a medical expert avoid; despite the fact that when Con- respect to remedies is as applicable is not versed in the specifics of the law, gress adopted COBRA and HIPAA with today as it was in 1974. From ERISA’s the court is not well versed in medicine large bipartisan majorities no discus- legislative history: ‘‘It is evident that and will benefit from the finding of the sion was given to the need for punitive the operations of employee benefit independent, external review—as will damages to enforce the new require- plans are increasingly interstate. The the patient. ments. uniformity of decision which the Act is The McCain bill allows the medical The ‘‘direct participation’’ provision designed to foster will help administra- reviewer to consider but ‘‘not be bound in the McCain bill provides little com- tors, fiduciaries and participants to by’’ a plan’s definition of medical ne- fort to employers who will still be

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00027 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.024 pfrm03 PsN: S19PT1 S6414 CONGRESSIONAL RECORD — SENATE June 19, 2001 dragged into court on every case. Em- hundreds and hundreds of groups. First of all, President Bush has ployers who do not ‘‘directly partici- Every consumer group in America sup- issued a set of principles that are spe- pate’’ in such decisions are not pro- ports our legislation. We have the phy- cific to this issue. His principles say, tected from being sued; they are only sician organizations, specialties and ‘‘Only employers who retain responsi- provided with a defense to raise in subspecialties, that support this legis- bility for and make final medical deci- court. lation. We have the American Medical sions should be subject to suit.’’ So the The PRESIDING OFFICER. The Sen- Association that supports this legisla- President himself, in his principles, has ator from Nevada. tion. said employers that are making med- Mr. REID. Mr. President, I disagree You know, for the first time that I ical decisions about individual cases with what my friend from New Hamp- can ever remember, we have the doc- are subject to sue and should be subject shire has said about the content and tors and the lawyers thinking this is to sue. the direction of the McCain-Edwards good legislation. So I say to my friend My colleague from New Hampshire legislation. Why don’t we decide if he is from New Hampshire, who is going to cited language on page 141 of the bill right or I am right. And how you do be the manager for the Republicans on referring to, ‘‘otherwise, calls of action that is you come to the Senate and you this legislation—I believe he should lis- created by failing to exercise ordinary debate the issue. ten to what he said if he believes this— care in the performance of a duty.’’ We are being prevented from doing and I know he does—let’s debate it, as Two pages later in the bill, which un- that today. The Republicans have ob- my dad would say, ‘‘like men,’’ and fortunately my colleague didn’t talk jected to our going forward to consider now women because they are a vital about, there is language at the bottom this bill. So this will necessitate our part of the Senate. Let’s debate this of the page, subsection (A), that says: going through the procedure of filing a issue as grownups, not hiding behind ‘‘This section does not authorize a motion to invoke cloture which we will procedural matters. If they think our cause of action against an employer.’’ vote on Thursday. I believe rather than legislation is so bad, let them prove it What I suggest to my colleague is wasting that time, we should be here out here. that he read the entirety of the section debating the principles enunciated by I am willing to take my chances on to which he refers. the Senator from New Hampshire and an up-or-down vote on the Senate floor. The language of what constitutes what we have been saying on this side That is how we should decide issues. making a medical decision in a specific all day. We should not be hiding behind some case is very clear in our legislation. It That seems to be the fair way to do procedural prohibition that prevents us includes none of the general things it, rather than talking about all the from moving this legislation forward. that the Senator from New Hampshire scary points of this bill from their per- One last thing. The majority leader talked about. What has to happen spective and the positive points from said today, right here at 11:30, that this under the specific language of our bill, our perspective. Let’s debate the legislation, the Patients’ Bill of and as set forth by the President of the issues. This bill has been around for 5 Rights, is going to be completed before United States, is that the employer has years in one version or another. We be- we leave for the recess—if we have a to actually override and make the deci- lieve that we have refined this legisla- Fourth of July recess. That is what he sion as an HMO would in a particular tion. Because of the courageous actions said. He is not playing games. He is case. Otherwise, under the language of of the Senator from Arizona and the majority leader of the Senate. He said our bill, and under the President’s brilliant input of the Senator from today that if we don’t finish this bill principle, the employer is protected, North Carolina, we now have a piece of by next Thursday night—if we do, we period. legislation that is extremely good. It is are off Friday. We have the Fourth of We want to protect employers. That better than the ones that have come July recess. If we don’t finish this bill is the whole purpose of this language. before us before. It is so good that on by next Thursday evening, we are It is why Senator MCCAIN and Senator our side we are going to offer very few, going to work Friday, Saturday, Sun- KENNEDY and I have worked for months if any, amendments because we believe day, and we are going to work Mon- and months in crafting this language. this legislation is so good. day—every day except the Fourth of The second argument my colleague This legislation deals with account- July. Then we will come back on the made is that there would be forum ability. We spent 8 weeks in this body fifth. We are going to be here until we shopping between State and Federal talking about education. What were we finish this legislation. So all staff court. The language is clear. If an HMO trying to establish? We wanted stu- members here in Washington and peo- makes a medical decision, that case dents and teachers and administrators ple watching this on C–SPAN should goes to State court. If the question is to be accountable and to make sure we understand that we, the Senators, may on the specific provisions of the plan had good education in our public not be home for our Fourth of July the employee is covered by, that case schools. break. We may be here doing the peo- goes to Federal court, period. It is Accountability: That same argument ple’s work, trying to work our way where the cases have always been. The should be and will be carried over into through this legislation, through all reason the other cases—the medical de- this legislation dealing with the Pa- the obstacles being thrown up proce- cision cases—go to State court is be- tients’ Bill of Rights. durally by the money interests of this cause when they make a medical judg- I have a lot of other things to say and country—the HMOs who think they ment and overrule a doctor, we want I will not say them now. I showed to own the medical care of this country. them to be treated just as the doctors the Presiding Officer in the Senate They don’t. It is owned by the people— and the health care providers. that we have only a partial list of the patients, nurses, and doctors. Third, he argues that ERISA is a those organizations that support this The PRESIDING OFFICER. The Sen- very complicated law that will be dif- legislation. These are business groups, ator from North Carolina is recognized. ficult for State courts to apply. Well, nurses groups, physician groups, start- Mr. EDWARDS. Mr. President, the the State courts won’t be applying ing with the Abbott House, Inc.—Ab- great thing about debate on the floor of ERISA. What the State courts would bott House in Irvington, NY. That is the Senate—particularly extended de- be doing is applying their own State No. 1 on the list. At the end of this list bate—is that we get past the high- law because what our bill provides is we have the YWCA of northeast Lou- pitched rhetoric and actually get to that when a medical judgment is made isiana. Of the 300-plus groups we have the facts. I want to respond briefly to by an HMO and some child is hurt as a listed here, we have groups that should some of the comments of my friend and result, and they take their case to know the difference between good and colleague from New Hampshire. State court, that State’s law applies, bad medical care. For example, there is He argues that under our bill employ- so that if there are recovery limits— the Wisconsin Paralyzed Veterans of ers can be held responsible—citing a and there are, I think, 30-some-odd America. They believe what we want to particular page of the legislation—if States in the country. And the argu- do is right. they make a comment to an employee ment was made that there are no caps It is not often that you find legisla- going out the door on the way to their in our legislation; there will be an out- tion in the Senate that is supported by doctor saying, ‘‘hope you feel better’’. rageous explosion of litigation.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00028 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.026 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6415 First of all, it ignores the fact that last week with some junior high school in with a purpose. Medical costs were State law applies, and the vast major- students—and they said he was doing climbing out of control. Something had ity of States have limits on recoveries. just fine. She had told him I was call- to be brought in to help. But the pen- Second, the evidence shows that in ing, and he gave the thumbs up. They dulum has clearly swung too far, away California and Texas—the two States expect him to be off the ventilator from the decision based on health made that use legislation similar to ours— today. by the doctor in the hospital, and the virtually no cases have ever gone to They do not know the cause of the nurse, towards a decision made on cost, court. The cases get resolved in the ap- infection. They are still working on made by an actuary, an insurance com- peals process. It is the way our legisla- that. It is an unusual thing. I have had pany, an HMO. tion is designed. Cases go to court only a couple people ask me about Senator So we believe we must pass a Pa- as a matter of absolute last resort. Bryan today. He is doing just fine. tients’ Bill of Rights to provide real Finally, he suggests there will be f protection for patients, one that allows forum shopping from State to State, for the doctor to decide; one that al- where a patient will choose to go to an- BIPARTISAN PATIENT PROTEC- lows the insurance company, the actu- other State to file a case because some- TION ACT—MOTION TO PRO- aries’ decision to be challenged on a how that is more beneficial to them. CEED—Continued health-related basis. We must end the Well, unfortunately, that has nothing The PRESIDING OFFICER. The Sen- practice of health plans putting the to do with the real world. Patients will ator from New York is recognized. bottom line before the Hippocratic be required to file their case in the Mr. SCHUMER. I thank the Chair. oath. We must restore balance when State where they live, which is exactly Before I get into the substance of my every one of us is faced with the awful where you would expect them to file. It remarks on the Patients’ Bill of choice of what medical decision to is where they got their care, where Rights, I wish to salute my colleagues, make for ourselves or for a loved one. they were hurt by the HMO. That is the Senator from Massachusetts, the As this debate gets underway, I hope where their case would be filed. Senator from North Carolina, and the to bring up the cases of some families So what we have done, ultimately, is Senator from Arizona, for working so I come across as I travel the State of set up a system whereby HMOs are long and hard on a bipartisan com- New York. These are not unique cases. treated the same as everybody else, as promise provision, one that I am proud These are not isolated cases. They hap- all the rest of us. That is its purpose. to support. pen, unfortunately, every day. We want to take away the privileged Mr. President, we hear a lot about Let me talk about Tracey Shea, from status that HMOs have enjoyed for so this Patients’ Bill of Rights, and there Long Island, in my State. Tracey com- long, while protecting employers, giv- are many discussions about legal plained to her doctor about chronic ing patients substantive rights, access issues, medical issues, et cetera, but headaches. The tests discovered a to specialists, access to emergency what hits home with most of us is when tumor in her brain. It was unclear what rooms, access to clinical trials, and we travel our States and we hear sto- that tumor was and her doctors ordered having those rights be enforceable. It is ries about what has happened under further tests. But the HMO refused to so important that these rights we cre- present law. pay for them, arguing that the tumor ate in this bill have teeth in them, and When there is a conflict, which con- was not malignant and further tests the only way they have teeth in them stantly arises in these days of HMOs, were unnecessary. Four months later, is if the force of law is behind them and between what a doctor believes is best Tracey died. She was 28. She was en- those rights are enforceable. for the patient and what the insurer gaged to be married. She is gone and her parents and her f believes is best for the health plan, who fiance ask every day: Why wasn’t her makes the final call? That is what this RECESS doctor allowed to give Tracey what she bill is all about. It is about decision- needed? Even if it was 50–50, or 25–75, The PRESIDING OFFICER. Under making, and not decisionmaking on a the previous order, the Senate stands why didn’t she get what she wanted? Saturday afternoon whether you go to For those who think McCain-Ed- in recess until the hour of 2:15 p.m. the beach or go to the ball park. It is Thereupon, at 1 p.m., the Senate re- wards-Kennedy is some kind of ab- about decisionmaking when all of us cessed until 2:15 p.m. and reassembled stract debate, the difference this bill, are at our most strained, when a loved when called to order by the Presiding this proposal would have made to Tra- one is in a health care problem or with Officer (Mr. CLELAND). cey Shea, under McCain-Edwards-Ken- The PRESIDING OFFICER. The Sen- a health care crisis. That is when the nedy, is Tracey would have had a hear- ator from Nevada. decisionmaking really matters. ing and an answer in a few days. Under When a child becomes sick or a par- f the Frist-Breaux-Jeffords proposal, ent becomes ill, when a spouse dis- Tracey may not have lived long enough STATUS OF SENATOR BRYAN covers a lump on her breast, and a to get an answer. Mr. REID. Mr. President, while we judgment call needs to be made about A case in Binghamton: Rene are talking about patients and a Pa- care, who has the deciding vote? Is it Muldoon-Murray’s little boy Logan was tients’ Bill of Rights, I want to report your doctor or is it an actuary some- born hydrocephalic, a condition that to my colleagues on Senator Bryan, where hundreds of miles away who has many of us have seen. It is when the who has been quite ill. not had one jot of medical training? spinal fluid builds up and puts pressure I talked with Senator Bryan last Fri- That is what this boils down to. on the brain. It is terribly painful. The day. He was in St. Mary’s Hospital in Those six of us supporting the Muldoon-Murray’s health plan con- Reno when I spoke to him. He had for McCain-Edwards-Kennedy bill believe tained no pediatric neurosurgeons, the a couple of days a bad sore throat, for the decision should be made by the doc- very people who should have looked at lack of a better description. Friday tor; the decision should be made by little Logan. The one adult neuro- morning, he was in Reno and his throat someone who is trained to make med- surgeon, one who did not have experi- was really sore. He has a son in Reno ical decisions, not a managed care bu- ence with children—the brain of a child who is a cardiologist. He went to the reaucrat whose primary interests—do is quite different than the brain of an emergency room. He was admitted to not blame these individuals, but their adult—the one adult neurosurgeon the hospital. primary interest, what they are in- available in the plan could only work They did a CT scan and found an ab- structed to do, is look at cost, not under supervision because his license scess in his throat area. Friday and health. Health may be in the equation was suspended. Saturday they administered anti- but cost comes first. That is why that Imagine, the only person you can go biotics, hoping he would get better actuary is getting paid, whereas for the to when your child is in agony, the soon. He got worse, and Sunday morn- doctor who has taken the Hippocratic only one the HMO will let you go to, is ing they operated. He has been on a oath, health care comes first. someone whose license was suspended. ventilator since then in intensive care. We want to pass this Patients’ Bill of That is the only one the HMO in Bing- I spoke with the nurses taking care Rights to restore the pendulum. I am hamton provided as 3-year-old Logan of him—by the way, he was back here not against HMOs. They were brought was in pain, pain, pain.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00029 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.066 pfrm03 PsN: S19PT1 S6416 CONGRESSIONAL RECORD — SENATE June 19, 2001 What did Miss Muldoon-Murray do? doctors could make the decisions—not get that hearing. A mother named She was not a wealthy woman but she actuaries, not insurance companies— Susan gave riveting testimony. She refused treatment. She wasn’t going to we have had untold suffering. Multiply stood and held up a picture of her son, let her son be operated on by someone that suffering, not just by the indi- Christopher Thomas for us to see. whose license was suspended. When a vidual child or the young woman in Christopher Thomas died on his 16th medical crisis required an emergency Tracey’s case, who suffered, but their birthday of leukemia. His parents’ room, a lifesaving spinal surgery, the parents and brothers and sisters, their health plan denied him the investiga- place they found was New Jersey. It friends and the community. tional chemotherapy drug he needed. cost them $27,000. The HMO refused to Mr. DORGAN. I wonder if my friend At the end of her testimony Susan held pay the bill. will yield. up a large colored picture of her hand- Again, the huge difference between Mr. SCHUMER. I am happy to yield. some 16-year-old son. She was crying. the two pieces of legislation: Under Mr. DORGAN. The Senator from New She said Christopher Thomas had McCain-Edwards-Kennedy, Rene would York probably remembers the hearing looked up at her from his bed as he lay have had the right to take little Logan we held about a year ago, when a con- dying of cancer, and said, ‘‘Mom, I to a pediatric neurosurgeon, even stituent from New York came to the don’t understand how they can do this though her plan did not include one, hearing. Her name was Mary to a kid.’’ and the plan would be required to cover Lewandowski. Mary is the mother of Do what? This young man never got the treatment just as if it had been ad- the late Donna Marie McIlwaine who the treatment he needed to help fight ministered by a plan doctor. died when she was only 22 years old. the cancer that he had. This young boy Under Frist-Breaux-Jeffords, the Mary came to tell us the story about and his family were put in a cir- health plan would decide whether or her daughter and her experience with cumstance of having to fight cancer not to cover an out-of-plan specialist the HMO. and fight the managed care organiza- and Rene would have most likely ended I will not soon forget Mary’s testi- tion at the same time. That was not up in the same place, in an emergency mony. Mary is not getting paid to fair. room hundreds of miles away, stuck come to Washington but she des- That is what our patient protection with a $27,000 bill. perately wants the Congress to pass legislation is about. This legislation is Again, the difference between these this patient protection legislation. about empowering patients who expect two bills is not simply paper and pen- Mary told us that her daughter passed to get the health care they are prom- cil. It is not some abstract idea, argued away on February 8, 1997. Donna had ised. by lawyers. It is real. People would be been to the doctor four times in 5 days When I heard my colleague from New alive, people would be not suffering if for an upper-respiratory infection. The York speaking, I simply wanted to this bill had been in effect. doctors couldn’t quite figure out what come to the floor and say that we have How about in Buffalo, at the other was happening, but her symptoms kept had plenty of hearings. Discussion has end of our State: Bailey Stanek. Bailey worsening. gone on for some while on the issue of suffers from apnea. This is a sometimes On the evening of February 8, she was a Patients’ Protection Act, or Pa- fatal condition in which a little one in a tremendous amount of pain, her tients’ Bill of Rights. stops breathing while sleeping. The mother said. She called the hospital. I will never forget the testimony of- HMO refused to pay for a heart mon- The hospital said: No, you can’t bring fered at the hearing during which itor which would warn Bailey’s parents your daughter to the hospital unless it Mary, the mother from New York came if his breathing ceased. If you have a is absolutely life or death, or unless and talked about her daughter Donna, child with apnea, it is a heart monitor you have a doctor’s referral. She tried and the hearing in Las Vegas when that can save you. His life depended on in vain to reach Donna’s doctor, and an Susan came and talked about her son, it. Who would not do this for their lit- hour later her daughter, Donna, col- Christopher Thomas Roe. I could stand tle 8-week-old boy? The Staneks, again lapsed into a coma and died. here and cite examples from testimony not wealthy people, now pay $400 a After she died, as my colleague from after testimony of patients not getting month out of pocket for a heart mon- New York will remember, her mother the care they needed. I could discuss itor. told us that she discovered that Donna endless tragic stories and untimely These cases go on and on. If McCain- had a blood clot the size of a football in deaths we have been told about. The Edwards-Kennedy were around, the her lung. sheer numbers of testimonies that re- Staneks could appeal the decision. Donna’s doctor later told her mother veal needless suffering make me so They could go to an independent, ob- that a $750 lung scan would likely have angry because none of it should have jective review board—not someone identified that blood clot and saved her had to happen. People should have got- sponsored by the HMO who is told by daughter’s life. But the lung scan was ten the health care they deserved. the HMO: if you approve bills of more not ordered because it could not be jus- They should have been able to get to than a certain amount all told, you are tified by the HMO. an emergency room when they had an out. This would be an independent, ob- These are the kinds of problems that emergency, or been able to get the jective review board. Then we would are raised related to the development treatment they needed when they were know if little Bailey needed this heart of for-profit medicine. Too often the suffering from cancer and trying to monitor, which most physicians think practice of managed care medicine be- fight it. Yet in case after case, we dis- he would, and they would get a deci- comes an enterprise of looking at a pa- cover that someone made a bad deci- sion. tient in terms of profit, rather than sion, and no one was held accountable Under the Frist-Breaux-Jeffords plan, evaluating what doctors should provide for that decision. The patient wasn’t this would not have happened. Why? in terms of needed medical services to given the medical treatment they de- Listen to this, for everyone concerned patients. served. about this issue. Who chooses the re- The Patients’ Bill of Rights, or Pa- Let me quickly say, if I might, to my view board under the Frist-Breaux-Jef- tient Protection Act, is a piece of legis- colleague, that there are some wonder- fords plan? The HMO. And the board lation that says you ought not have to ful organizations around this country— cannot make independent decisions fight your illness or your disease and yes, managed care organizations, some about medical necessity. So the choice have to fight the insurance company as insurance companies, and health care is very clear. well. You ought not have to lose your organizations—that do great work. God These are just three cases in my life because someone said it wasn’t bless them every day. But there are State. Look at the case of little Logan worth $750 to do a lung scan on a 22- some who look at patients as profit Muldoon-Murray from Binghamton; year-old girl who had a blood clot the centers and decide against providing the case of the late Tracey Shea, from size of a football in her lung. That treatment that a patient thinks they Long Island; the case of little Bailey ought not happen to people. are going to get. Sometimes it is too Stanek in Buffalo. In all three cases, My colleague from Nevada, Senator late when they discover the con- because there was not a fair review, be- REID, and I held a hearing in Las sequence of that. It was too late for cause we do not have protections so the Vegas, NV, for one day. I will never for- Donna and for Christopher.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00030 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.068 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6417 We are trying, with a piece of legisla- I was glad to hear our leader say that in New York and Nevada, and other tion, to say it ought not be too late for if we have to, we will stay here every places, as a result of something very any more Americans at any other time day through the Fourth of July break unusual that happened around here; to not get the medical care they need. or through the summer to get this bill and that is, Senator DORGAN, as chair- Let us pass this legislation, the Pa- finished. All of us have concerns and man of the Democratic Policy Com- tients’ Protection Act, so that people our families. We want to be with them. mittee, held a series of hearings around in this country can rely on getting the We want to be back in our States. But the Nation. Why? That isn’t the ordi- care that they deserve. what could be more important than nary role of the Democratic Policy When I heard the Senator from New this? Committee. But because we were in the York, Senator SCHUMER speak, I want- We are so close to the precipice of minority, we were unable to hold hear- ed to speak and to mention Donna be- passing a real bill—the kind of bill that ings in the committees that had juris- cause I know he knows her mother, has been put together by our col- diction over the Patients’ Bill of Mary Lewandowski. I know that all of leagues from Massachusetts, Arizona, Rights. So Senator DORGAN came up us have the same passion to want to do and North Carolina. We are right on with the idea to hold these hearings the right thing. We can do this. This the edge. How dare we give up. How around the country. will take some time. There will be peo- dare we let ourselves be diverted by ex- I am sure the hearings around the ple coming to the floor saying they traneous issues and political games. country went as well as the hearing in don’t want to do it. They will have ob- I thank the Senator from North Da- the State of Nevada. If that is the case, jections to our Patients’ Bill of Rights. kota as well as so many others. The which I am certain it is, the Senator Mark Twain was once asked if he Senator from North Carolina spent the from North Dakota deserves all kinds would be involved in a debate. He re- last year working out this compromise of accolades because if he did nothing plied: Yes; of course, as long as I can be with the Senator from Massachusetts other than the hearing in Nevada, it on the opposing side. because this is so important. said reams about what is going on in They said: We never told you about There used to be a slogan in the 1970s. this country regarding the delivery of the subject matter. You don’t need a weatherman to know health care. Mark Twain said: It doesn’t matter. which way the wind blows. Yes, you are So I will never, ever forget the hear- It doesn’t take any preparation at all right. We will hear a lot of arguments ing we held at the University of Nevada to take the opposing side and to argue from the other side. But look at every at Las Vegas on the Patients’ Bill of it effectively. group that is represented here—the Rights. The men and women, the boys We will have some people in Congress Mary Lewandowskis, the Tracy Sheas, and girls, the doctors and nurses who say we should not pass this patients’ and all of the others. They are on our testified there told us why we need this protection legislation. They are side. They are for this bill. bill. naysayers. It is very simple. The only people So I say to my friend from North Da- We know in our hearts that this is who seem to be against us are the very kota, thank you very much for coming important legislation for the American people out there who have done these up with this unusual procedure so that people. We must do this now. things, not by design but the way the the American people, and the people of Mr. SCHUMER. Mr. President, I system is set up—done these things Nevada, know how the rendition of thank my colleague from North Da- that have left the gaping wounds in so health care is not going properly—not kota. Along with the story I told about many as they have needlessly lost peo- all the good things, but you were able three New Yorkers, he added Mary ple. to put, in a very direct perspective, Lewandowski and her daughter, Donna. It is bad enough to lose somebody what was going on in the country in re- I want to add something. Mary has you love, but when you know you did gard to health care. So I personally ap- been down here three or four times. not have to lose them, and somebody preciate very much you doing what you Each time she comes into my office made a decision somewhere based on did because, but for this, we were sty- with her husband. They are not dollars, the hole in your heart never mied from explaining to people what wealthy people. They are humble peo- goes away. We have examples such as was going on around the country with ple. A trip from Rochester to Wash- Mary Lewandowski from Rochester, health care. ington is not easy for them. NY, who has come down here and said: Mr. SCHUMER. Will the Senator But the memory of Donna and what Please, please, please. from Nevada yield? happened to her burns within them. I would like to say to Mary—and I Mr. REID. I am happy to yield. They come and sit by my desk. They think I speak on behalf of the six of us Mr. SCHUMER. I just want to add my try and I try to talk about when this in this Chamber—we are not going to thanks to my friend from North Da- bill might come up and what is pre- give up. We are going to make this kota. Again, just as was the hearing in venting it from coming up. I was happy fight until we pass this bill, no matter Nevada, the hearing in New York was to let them know that since we took what it takes. moving, factual, and brought the case over the majority, Senator DASCHLE With that, I thank my colleagues. I to real life as to why we need this pro- decided to make this our highest pri- know my time has expired. And I posal. And the Senator did. He went ority. In fact, I have asked them if thank my friend from Iowa for waiting. around the country, everywhere, like they want to come down and watch a I yield the floor. Paul Revere, letting people know they little bit of this debate. It will never The PRESIDING OFFICER. The Sen- didn’t have to just curse the darkness; bring Donna back, but it will make ator from Nevada is recognized. that they could actually get something them feel good that future Donnas will Mr. REID. Mr. President, I wish to done with legislation that would really not die in vain. make a brief statement. And I ask matter to people, knowing that this is Imagine what they are thinking unanimous consent that the Senator not just a political game. now—that there is an attempted fili- from Iowa be recognized for 15 minutes I add my voice to thank the Senator buster to prevent this bill from coming after my statement, and then, with the from North Dakota, as chair of the Pol- up. This is not legislative gamesman- patience of my friends from North icy Committee, for the great work he ship. It is not an exaggeration in this Carolina and Massachusetts, Senator has done. case to talk about life and death. Every CLINTON was planning to be here at 3 Mr. DORGAN. Mr. President, let me one of us, as we traverse our States, o’clock to speak for up to 15 minutes. ask the Senator from Nevada to yield hear these stories and share the em- The PRESIDING OFFICER. Is there for a moment. Then I know the Sen- braces and the tears with the people objection? ator from Iowa has a statement to who have been damaged more irrep- Without objection, it is so ordered. make. Will the Senator from Nevada arably than any of us have. The only Mr. REID. Thank you, Mr. President. yield for a question? thing we can do is bring our passion, I say to my friend from North Da- Mr. REID. I am happy to yield. our knowledge, our work, and our kota, and everyone within the sound of Mr. DORGAN. I did want to take the sweat, blood, and tears to this floor my voice, we were able to give specific time to show the picture of the young and move this bill. examples of situations that developed 16-year-old man mentioned earlier,

VerDate 19-JUN-2001 01:45 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00031 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.071 pfrm03 PsN: S19PT1 S6418 CONGRESSIONAL RECORD — SENATE June 19, 2001 named Christopher Roe. The Senator other mothers and fathers who have those are the ones we know about. from Nevada and I both told his moth- testified at the hearings I have held, That is just the tip of the iceberg. er, Susan, that her testimony would your testimony was not in vain. We Think about the many more Americans make a difference. This is the picture have put together a record that dem- who have been denied the care but in Susan held up at our hearing in Las onstrates the need to pass this legisla- their desperation they went elsewhere. Vegas, NV. As she held up this picture tion, and we intend to do just that. Maybe they paid for it out of their of her 16-year-old son, Susan described The PRESIDING OFFICER. The Sen- pocket; they moved on with their lives. the difficulties obtaining treatment for ator from Iowa is recognized. The stories we hear are the tip of the Christopher through their managed Mr. HARKIN. Mr. President, I first iceberg. There are many more about care organization. Susan’s family faced say a big thank you to Senator KEN- which we don’t know. These are real these difficulties in addition to the NEDY for his many years of leadership stories and these are real people. These fight Christopher was trying to win in on this issue, and also thank Senator are real hurts they have. his battle against cancer. It was a bat- EDWARDS for his leadership and spon- It is very simple: Your HMO either tle this young boy lost, and it was a sorship of this bill, along with Senator fulfills its promises to pay for medi- battle that had become an unfair fight MCCAIN. cally necessary services or it doesn’t. because he had to fight cancer and he This is not a new issue in this Cham- We have heard enough to know that in and his family had to fight the man- ber. Senator KENNEDY led the battle on too many cases it doesn’t. As I said, I aged care organization at the same this, starting about 5 years ago, if I am didn’t have to look very far to find time. not mistaken. We passed it last year, such situations in my own State of This is the boy who died on his birth- as you know. The House passed a good Iowa. day. This is the boy who looked up bill, but the Senate passed a rather bad Let me relate the story of Eric from from his bed and said to his mother: bill. We went to conference, and we Cedar Falls who has had health insur- Mom, I don’t understand how they can could not get anything out of con- ance through his employer. Eric is 28 do this to a kid—‘‘this’’ meaning, how ference. We used to meet periodically years old with a wife and two children. could they not have allowed him to get over here in a room, in Senator NICK- He suffered cardiac arrest while help- all of the treatment that was necessary LES’ room, to try to hammer things ing out at a wrestling clinic. He was to give him a shot at beating cancer? out, but it became clear that the more rushed to the hospital where he was He died on his 16th birthday. we met, the less that was going to get fortunately resuscitated. But trag- To his mother Susan, who also is a done. So now we have a chance, this ically, while in cardiac arrest, Eric’s tireless fighter, and who believes also year, to catch up on all that and to brain was deprived of sufficient oxygen. that there must be change, we say your pass this meaningful legislation. He fell into a coma and was placed on son’s memory, I hope, will give all of us I believe we are on the verge of a big life support. The neurosurgeon on call in this Chamber the incentive and the victory for the American people. They recommended that Eric’s parents get initiative and the passion to do the have been waiting too long for this in right thing and to pass a Patients’ Pro- the waiting rooms—about 5 years— him into rehabilitation. It was then that the problems began. tection Act. where mothers, fathers, and children Although Eric’s policy covered reha- I mentioned yesterday that I, too, have been forced to spend countless bilitation, his insurance company re- have lost a child. And I get so angry— hours negotiating the massive bureauc- fused to cover his care at a facility so angry—sometimes when I hear these racy of their managed care plans, des- that specialized in patients with brain stories. I didn’t lose a child because of perately trying to get the health care a decision by a managed care organiza- services they need and deserve. injury. Well, thankfully, Eric’s parents tion, but I lost a child to a disease. And Unfortunately, it is clear that the op- were able to find another rehabilita- you never, ever get over it. ponents of a Patients’ Bill of Rights tion facility in Iowa. Eric began to im- When I see mothers such as Susan, are not giving up their fight. They may prove. His heart pump was removed, holding up a picture of her son, saying, succeed in convincing a few to delay it his respirator was removed, and his ‘‘this death should not have happened, for a few more days, but they are not lungs are now working fine. But even I should not have lost my son, my son going to be successful in stopping the with this progress, Eric’s family re- should have had a chance to live, my Senate from passing the protections ceived a call from his insurance com- son should have been given the oppor- that patients should have had years pany saying they would no longer tunity to fight this cancer that was in- ago. cover the cost of his rehabilitation be- vading his body’’, then I say we ought Right now, as I understand, we have cause he was not progressing fast to have enough passion and we ought an objection from the Republican side enough. to have enough determination and grit to proceed to the bill, an objection Eric’s mother wrote to me and said: to stay here until we pass a piece of from the Republican side to not even This is when we found out we had abso- legislation that says no more Chris- take the bill up. That is unfortunate, lutely no recourse. They can deny any treat- topher Roes in this country will lie in but I think it indicates that we have to ment and even cause death, and they are not responsible. bed dying of cancer having treatment be resolute in our determination to an- withheld from them; it will never hap- swer the call of our patients all over In the coming weeks in this Cham- pen again because we will make sure it America. ber, we have a critical choice before us. does not. We do not have to look too hard to We can choose for Eric and his family. Patients in this country have basic see that there are too many people We can choose between real or illu- protections and rights, and they have being denied appropriate care. We have sionary protections. We can choose be- the right to the treatment they need at all heard the horror stories of individ- tween ensuring health care for millions the time they need it. They have the uals unable to see their doctor in a of Americans or perpetuating the bur- right to see specialists, and they have timely manner, of patients unable to geoning profit margins of the managed the right to know all their options for access the specialists they need. We care industry. medical treatment, not just the cheap- just heard a number of stories from the I have been working on this issue est. They have the right to go to an Senator from North Dakota and the with my colleagues for over 5 years. emergency room when they have an Senator from New York. I am certain Last year I was a conferee trying to emergency. we will hear many more as we are here work out this bill with the House. It There are basic protections and in this Chamber during this debate. came to naught. We have debated this rights that are in this legislation that These are all individuals who have issue for years. We have negotiated dif- every American deserves to have. We been denied the treatment their doctor ferences of opinion to find common are going to see that we get Americans has recommended or their health spe- ground. We have worked across party protected and their rights ensured by cialist has recommended because the lines to develop the best bill possible. I the time we finish the debate on this HMO simply doesn’t want to pay the am delighted to say that amendments I important legislation. bill. offered during the past debates, such as I thank my colleague from Nevada. I hope we will all remember, as we access to specialists and provider non- And again I say to Susan, and all of the hear all these stories coming out, that discrimination, have been incorporated

VerDate 19-JUN-2001 01:45 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00032 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.073 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6419 into the underlying bill. S. 1052 truly presiding. I compliment him on the your State have for the fight that you represents the best of all of our collec- way he has presided and thank him have waged on behalf of real people and tive ideas and, most importantly, very much for his willingness to do so. families and children to try to protect meets the needs of the American peo- The PRESIDING OFFICER. The them against HMO abuses. ple. Chair thanks the majority leader. I wonder if the Senator would mind Our bill establishes a minimum level Mr. DASCHLE. I thank the Senator sharing with us what the people in his of patient protections by which man- for yielding. State have said to him in town hall aged care plans must abide. States can, Mr. HARKIN. I thank our leader for meetings, visits on the street corner and it is my hope that they will, pro- pointing that out. I, too, congratulate about how they feel about a clerk sit- vide even greater protections, as nec- my friend and dear colleague from ting behind a desk somewhere over- essary for individuals in HMOs in their Georgia for being a good friend of mine ruling experienced, well-trained doc- States. As a starting point, we need to and for being a great Senator. tors and nurses as to health care deci- pass a strong and substantive Patient A patient should have the right to sions that can literally affect the lives Protection Act. appeal an HMO’s decision to deny or of their families. S. 1052, our Patients’ Bill of Rights delay care to an independent entity Mr. HARKIN. First, I thank my Act, delivers on what Americans want and to receive a binding and timely de- friend from North Carolina for his kind and what they need: Real protection cision and, finally, the right to hold words and for visiting my State. I in- against abuse; direct access to needed HMOs accountable when their decisions vite him back soon and often. I thank specialists, especially pediatrics spe- to deny or delay care lead to injury or the Senator from North Carolina for cialists and OB/GYNs for women; the death. his great leadership on this issue, and I right for patients to see a doctor not It was my friend from North Caro- am delighted to be a soldier in his on their HMO list, if the list does not lina, Senator EDWARDS, who said ear- army to fight this battle and make include a provider qualified to treat lier that there are only two groups in sure our patients get decent care. their illness; access to the closest the United States that can’t be sued— Mr. REID. Will my friend yield for a emergency room; the right for patients diplomats and HMOs. It is time to end unanimous consent request? Mr. HARKIN. Sure. with ongoing serious or chronic condi- the HMO diplomatic immunity in this Mr. REID. Mr. President, I ask unan- country and to allow them to be held tions such as cancer or arthritis or imous consent that following the state- heart disease to see their medical spe- accountable. ment of Senator CLINTON—she will I know there is a lot of talk about cialist without asking for permission speak for 15 minutes when she arrives— the right to sue. Let’s face it: Most of from their HMO or primary care doctor the Republicans be recognized for 1 the situations will be resolved through every time they need to see their spe- hour following that time to make up the strong and binding appeals process cialist; the right for patients to con- for the time we have used. tinue to see their doctor through a that is in the bill. But the HMOs The PRESIDING OFFICER. Without course of treatment or a pregnancy, should not have special immunity objection, it is so ordered. even if the HMO drops their doctor when they harm patients. The reality Mr. REID. Mr. President, the one from its list or their employer changes is that unless HMOs are held account- thing I ask of my friends on the minor- HMOs. able when they make inappropriate ity side today, Senator ZELL MILLER This is so important. Right now, so medical decisions that harm a patient, has asked to come over. When he shows many people in managed care plans are there is no guarantee that they will up, after a Republican speaker finishes seeing a doctor for a course of treat- change their ways and stop putting his statement, perhaps Senator MILLER ment. It could be a difficult pregnancy. profits before patients. can speak, and you would wind up get- The mother-to-be has every confidence As this debate unfolds, I know that I ting your full hour. in this specialist. Then her employer and others will be coming to the floor The PRESIDING OFFICER. Is there changes HMOs and this doctor is not on to point out the tremendous profit objection? their approved list, not on their list for margins some of these managed care Without objection, it is so ordered. HMOs. Many HMOs will just drop that. industries have. When you think about Mr. HARKIN. Mr. President, I was at What this bill says is: If you started it, that is hundreds of billions of dol- a town hall meeting in Iowa, where I on a course of treatment, you can con- lars a year being sucked out of medical first heard this comment made by a tinue to see the doctor of your choice care that people need in this country gentleman who I think really brought through that course of treatment even and given to their shareholders or it all home. He said to me: I don’t want if the HMO has changed or if they have sometimes to a very small group who my doctor doing my taxes, and I don’t dropped the doctor from their list. happen to own the HMO or the man- want my accountant deciding my This bill has the right for patients to aged care system. health care needs. To me, that sort of get the prescription drug their doctor I don’t mind HMOs making profits— brought it all home and pointed out says they need, not an inferior sub- that is fine—but they should not be what we are trying to do: let the doc- stitute that the HMO chooses because able to make these unconscionably tors and health care professionals it is cheaper. high profits by disallowing appropriate make the decisions, and not the ac- CONGRATULATING SENATOR CLELAND care for patients. That is what I mean. countants, on what kind of health care Mr. DASCHLE. Mr. President, will The HMOs cannot continue to put prof- we need. the Senator yield for just a moment? its ahead of patients. As I said earlier, the stories we hear Mr. HARKIN. I am delighted to yield. Mr. EDWARDS. I wonder if my col- about the lack of medical care from Mr. DASCHLE. I appreciate very league will yield for a question. people in HMOs in Iowa—again, this is much the senior Senator from Iowa Mr. HARKIN. I am delighted to yield the tip of the iceberg. We are going to yielding. The hour is almost over, and to my colleague and friend and a great hear a lot of stories. These are real I do want to call attention to an impor- leader on this issue. people with real injuries and real hurt. tant matter for me personally, for our Mr. EDWARDS. Mr. President, one of We have to keep in mind that these are caucus, and certainly for the Senate. the reasons we are beginning this im- just the ones we know about. How Our colleague from Georgia, Senator portant discussion of an issue that will many more that we don’t know about CLELAND, has never had the oppor- affect the lives of so many Americans are out there? tunity to preside before, in large meas- is that for years now you have helped I retold a story here about Eric, a 28- ure because we have not been in the lead the fight on HMO reform, on a real year-old man who was working and had majority during the time he has been Patients’ Bill of Rights and on patient a wife with two kids. He was helping in the Senate. I want to call attention protection. I had the honor last year, out at a wrestling clinic and he had to the fact that MAX CLELAND, our col- during the Presidential campaign, of cardiac arrest. They rushed him in and league from Georgia, has been the Pre- visiting in the Senator’s State. he was resuscitated. His brain had been siding Officer for this last hour. I con- I say to my colleague, I heard over denied sufficient oxygen, so he needed gratulate him. I wish him well as he and over everywhere I went around the special rehabilitation. The neuro- pursues his golden gavel of 100 hours of State the passionate feelings people in surgeon recommended to his family to

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00033 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.075 pfrm03 PsN: S19PT1 S6420 CONGRESSIONAL RECORD — SENATE June 19, 2001 get him into rehabilitation. His insur- tantly, I have had the good oppor- Mr. HARKIN. I thank my friend from ance policy covered rehabilitation, but tunity of working closely with the Sen- Massachusetts for postulating this his insurance company refused to cover ator in the development of this legisla- question because it is really important. his care at a rehabilitation facility tion. The Senator can agree with me Before I answer it, I again thank the that specialized in brain-injured reha- that the protections we have in this Senator for his 5 years of leadership. bilitation. So his family took him to bill are basically pretty mainstream The Senator from Massachusetts was another place in Iowa. He began his re- kinds of protections that I think fami- the leader on this issue when it started habilitation. lies could recognize right at the outset. 5 years ago. He was our leader last The good news is that he had pro- I don’t have the particular chart here. year, and he is our leader again this gressed very well. The heart pump was We will have an opportunity to get into year trying to bring to the American removed, the respirator was removed, those as the debate proceeds. people commonsense decency. and his lungs are now working fine. We are talking about emergency As the Senator said, there is nothing But just at this point, the HMO calls room coverage and about specialty in the bill that would not meet the test his family and says they will no longer care, and we are talking about clinical of good old common sense. cover the cost of his rehabilitation be- trials and OB/GYN; and we are talking Yes, I want to know if those on the cause he is not making enough about prohibiting gagging doctors and other side who oppose this are going to progress fast enough. I would never talking about continuity of care and offer an amendment that says, no; if a have known about this except that his about point of service, so we can make woman is seeing an OB/GYN, if she is mother wrote me a letter and said: sure we can get the best treatment for having a difficult pregnancy—this may This is when we found out we had abso- families needing those kinds of protec- be a specialist in whatever the dif- lutely no recourse. They can deny any tions. The list goes on: prescription ficulty might be. But then the woman’s treatment and even cause death and drugs, the right kinds of prescription employer changes HMOs and drops the they are not responsible. drugs, and then appeals, internal and doctor. Right now they can refuse to I hear stories such as this all over my external, and then accountability pro- pay that specialist. She would have to State. That is why we need to move visions. go to someone else and start over. ahead aggressively and why we have to Doesn’t the Senator, at times, won- Doesn’t it make common sense that keep in mind, when this debate occurs der with me what are the particular she should at least be able to see that and we hear all these amendments protections in there to which the oppo- specialist through the end of her preg- being proposed, that we are talking nents object? What are the protections nancy, the birth, and have that same specialist see her? That is common about real people, real consequences, to which they most object? They say: sense. and real hurt that is happening to We can’t do this; we oppose this; we I question out loud, will someone on these families. The need is clear. won’t let you bring this up. the other side offer an amendment to This bill is not about doctors, nurses, These are basic kinds of protections disallow that? Fine, if they want to do or politicians; it is about patients, which, as the Senator knows, are ei- that, if that is their opinion. I want to about our friends and our families ther protections that exist under Medi- see how many people vote against when they get sick and they need to care or Medicaid or have been rec- something such as that. That is just have the peace of mind that the health ommended by the insurance commis- common sense. sioners who are not known to be Demo- care they need and deserve—and that Or a person with a disability who has crats or necessarily Republicans—pret- they have already paid for—will be to see a specialist on a continuing ty bipartisan and nonpartisan in most available in a timely manner. basis, I cannot tell the Senator—he We have a chance to pass real and re- States. The only provisions that we knows this as well as I do; he has been sponsible legislation. The time is now. have taken in the Patients’ Bill of very supportive. The American people have been in the Rights—additional protections—were Mr. KENNEDY. Madam President, waiting room for far too long. It is those that were unanimously rec- has the time expired? time to pass a meaningful Patients’ ommended by a bipartisan commission The PRESIDING OFFICER (Mrs. LIN- Bill of Rights. Let’s not delay any that was set up under President Clin- COLN). The time has expired. longer. We will have the debate. Let’s ton. They were unanimously rec- Mr. THOMAS. Madam President, the have the amendments that are perti- ommended, without dissent effectively. time is to change at 3:15 p.m. We ask nent. Let’s get it done once and for all. They recommended that the HMO as- that be done. Mr. KENNEDY. Will the Senator sociation adopt them. We said, because Mr. HARKIN. Madam President, I yield for a question? they were so important, to protect will finish with 1 more minute. Mr. HARKIN. I yield to the Senator. them we would put them in as a floor As I was saying to my friend from Mr. KENNEDY. Mr. President, I to make sure they are accepted. Does Massachusetts, many people with dis- thank the Senator for his strong lead- the Senator not wonder with me what abilities have to see a specialist, but so ership in this battle over a very long the principal objectives are? many times it is hard for a person with period of time. As the Senator was Finally, let me ask, does the Senator a physical disability to get out, get the mentioning in the beginning of his re- not believe that every day we fail to bus, get special transportation. Now marks, this has been a 5-year pilgrim- pass this legislation people are being they have to see the gatekeeper every age, where those who have fought for hurt? time. this legislation have effectively been I took the opportunity yesterday to The HMO says: No, you have to come denied the opportunity to bring this mention briefly what the Kaiser Foun- in and qualify for each and every time measure up on its own in the Senate. dation has found and what the various you want to see that specialist. This The Senator can remember last year studies show. They show that every bill does away with that. when we had actually a numerical ma- day we fail to take action, families, Will someone offer an amendment jority in this body, bipartisan in na- real people—parents, mothers, fathers, that says to someone with a disability: ture, who would have voted for this. sons, daughters—their injuries are I do not care; you have to go through But we were denied that opportunity. being expanded and their hurt and suf- that gatekeeper time after time to see Now, as the first order of business fering is increased and enhanced be- the specialist you need to see. under the leadership of Senator cause we are failing to pass this legis- I agree with the Senator from Massa- DASCHLE—I think it was the first com- lation. chusetts; the bipartisan commission ment he made after assuming leader- Doesn’t the Senator agree that for all worked this out. These are common- ship, that this was going to be a first of these reasons, and others, the impor- sense approaches. You can take this priority following completion of the tance of passing this legislation in a bill to any townhall meeting in Massa- education bill. timely way, the importance of passing chusetts, Iowa, or Arkansas and lay it I have a couple of questions because it now, the importance of supporting out for average Americans, and they I, too, have had the good opportunity, our leader and saying let’s finish before will say: Yes, this makes sense. This as the Senator from North Carolina we consider other work, deserves the bill makes sense and that is why we has, to travel to Iowa. More impor- support of everyone in this body? have to do it.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00034 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.078 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6421 Mr. KENNEDY. I thank the Senator. the issue of whether we should proceed. taurant, end up being drawn into that The PRESIDING OFFICER. The time It seems to me there are a few croco- lawsuit? But I will be under this law, of the Senator has expired. The Sen- dile tears on that issue. under this proposal as it is structured. ator from Nevada. There is a legitimate reason for not I find it consistently ironic that the Mr. REID. Madam President, I have immediately moving to the bill, and Senator from North Carolina, who has spoken with the manager of the bill, that is we do not know what the bill is, his name on this bill, continues to say the Senator from New Hampshire. He and we do not know the specifics of the employers are not subject to suits made a very valuable suggestion. I ask bill. We should have a chance to read it when the bill specifically says employ- to revise the unanimous consent agree- before we proceed to it. ers are subject to suits. It says it in ment that is before us. I ask unani- I use the very excellent example of two places that are very significant. mous consent that the Republicans the position of Members of the other He suggested I read his bill. I did read have control of the time speaking as in side of the aisle when we were taking his bill. I might suggest he also take a morning business until 4 o’clock, and up the education bill when they sug- look at his bill because it does not ap- thereafter, until direction of the ma- gested we do 2 weeks. We are not going pear he has, if he continues to conclude jority leader, we will go on the half to suggest 2 weeks, but we are going to employers are not subject to liability. hour, from 4 to 4:30 p.m. will be Demo- suggest a reasonable amount of time to No. 1, the language is, as we mentioned crats, from 4:30 p.m. to 5 p.m. will be proceed on the issue of reviewing the earlier on page 144, very specific. Republicans until we decide we have bill before we address it. Granted, the headlines for the language had enough for the night. This probably would not have been are ‘‘exclusion of employers and other The PRESIDING OFFICER. Without necessary if we had had hearings on plan sponsors.’’ But when it gets to objection, it is so ordered. The Senator this bill. One must remember, there part (B), it says, ‘‘notwithstanding from New Hampshire. has not been a hearing on this bill that [anything] in subparagraph (A), a cause Mr. GREGG. Madam President, I is being brought before us even though of action may arise against an em- thank the assistant majority leader for it is extremely important legislation. ployer or other plan sponsor....’’ helping organize the speeches this In fact, in the Senate, there have been That is the term, ‘‘employer.’’ I de- afternoon. There are a lot of Members no hearings on the issue of patients’ fine ‘‘employer’’ as employer, not in- who want to talk on this bill. That is rights in 2 years—since March of 1999. surance company. I think anybody else reflective of the fact and one of the We have taken up the language of the would, too. So right there, at the base reasons why we cannot move imme- Patients’ Bill of Rights a couple of of it, employers are sued under this diately into the amendment process. It times, but we have not done any hear- bill, and for a significant amount of re- is not that we on this side are not in- ings in the committee that has juris- sponsibility here, because the defini- terested in moving to the amendment diction or responsibility in the last 2 tion of what an employer is going to be process; we honestly are. There are years. sued for goes on to say, ‘‘where the em- many on our side champing at the bit That is important because at those ployer participated—had direct partici- to get into this bill and amend it and hearings, we could have gotten con- pation by the employer or other spon- address fundamental issues. structive input. If we had had hearings sors in the decision of the plan.’’ We also on our side want to have the on this bill, for example, we would have Direct participation has become an opportunity to bring forward sub- seen a number of people from commu- extremely broad term, as I mentioned stantive and thoughtful approaches on nities across this country coming for- earlier today. Basically, if the em- how to address this issue in an even ward—small business people, people ployer says, as you are heading off to more effective way than the bill before who are running mom-and-pop busi- the hospital—you are working for the us that has been drafted by Senator nesses with 9, 10, 15, 20, 30 employees restaurant; there are 30 people at the MCCAIN and Senator KENNEDY. saying: Listen, the hardest thing I have restaurant and you get burned in the The point, however, is that we just in my business is the cost of health in- kitchen and the employer says, you got this bill. It was one bill on Wednes- surance. I want to insure my employ- have to get down to the hospital, let day of last week. Then it was a dif- ees. I want health insurance for them, me make sure you get to this hospital ferent bill on Thursday. We have had 2 but if the McCain bill passes, I will not versus that hospital, the employer is working days. We are talking about the be able to afford health insurance be- libel. The employer is libel for how you bill, but it is a moving target for us. To cause I suddenly will not only be buy- are treated at that hospital under this get up to speed on it takes a little ing health insurance, I will be buying bill. time, and there are a lot of people who lawsuits. Instead of the present law Then there is this new cause of ac- want to talk about that, a lot of people which insulates the small employer es- tion, which is a massive new expansion who have had intimate knowledge with pecially from being sued for medical of the ability of people to be sued, em- what has been going on with this issue malpractice or medical malfeasance or ployers specifically, under this bill. for a long time but are not familiar medical events that their employees This new cause of action is created by with the specifics of the McCain-Ken- incur in the process of dealing with the subsection 302, subsection (A)(ii), I nedy bill and, therefore, believe they health insurer with which the small think it is the right cite, on page 141 of need some time to be brought up to business individual has contracted, in- Senator MCCAIN’s bill: speed before getting into the amend- stead of having that insulation, that . . . otherwise fail to exercise ordinary ment process. goes down, the wall goes down. care in the performance of a duty under the I note as an aside, and I think it is Under this bill, those employers, terms or conditions of a plan with respect to important to note, this is one of the those small mom-and-pop employers a participant or beneficiary. most far-reaching and important pieces especially—all employers for that mat- Then, the agent or the plan sponsor of legislation we will address as a Sen- ter—will suddenly find themselves is subject to be sued. Plan sponsors are, ate this year, certainly on the author- being sued for medical issues. by definition of ERISA, employers. izing level. We just completed another A person who runs a restaurant with That is very clear, unequivocal in major piece of legislation, the edu- 30 employees is probably saying: I don’t ERISA. So we are talking about the cation bill, which is extremely impor- mind being sued if I put out a bad meal fact that there is now a new Federal tant legislation. We spent 2 weeks—ac- and somebody gets sick. That is my re- cause of action for what amounts to tually 21⁄2 weeks—on the motion to pro- sponsibility. But if one of my employ- the failure of a plan, the insurer, to ceed to the education bill. That was ees to whom I have given health insur- give information which traditionally when the Republican Party held the ance, which I think is important to had been managed through regulatory majority in the Senate. At that time, I them, goes to the local doctor and the activity—the failure of that plan to do did not hear Senators from the other doctor doesn’t treat them correctly or a whole series of things. side saying we were moving too slowly they get bad advice from their insur- I put up a list earlier of potentially as we are now hearing today from Sen- ance company on the way they should 200 different places, between COBRA, ators on the other side, even though we have been treated or their options, why HIPAA, and ERISA, that you would have not spent more than 6 hours on should I, as the owner of the little res- have a cause of action that could be

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00035 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.080 pfrm03 PsN: S19PT1 S6422 CONGRESSIONAL RECORD — SENATE June 19, 2001 brought on an activity of the insurer or able under the two new claims, these Also, responding to requests for addi- people who are involved in the plan in two new ERISA claims, include unlim- tional group health plan documents a ministerial way as employers. They ited economic and noneconomic dam- under ERISA; and, finally, group would now be subject to lawsuits in a ages and up to $5 million in what this health plan reports under the Depart- Federal action. There would now be a new euphemism is, ‘‘civil penalties,’’ ment of Labor. Federal action against them on that in otherwise known as punitive damages. In all of these areas they can be sued. over 200 different places—not quite 200, I guess that was too punitive a word to The list goes on and on. Employers somewhere around 200 different places put into this bill so they used the cannot be sued on this today. All of where employers could be sued. words ‘‘civil penalties.’’ this is new. This is a brand new litiga- I understand—I was not here but it They have created these claims. They tion area. was represented to me by people who have taken the tops off the liability As I said, we will need to add many were here—that, once again, the Sen- and basically said, OK, go find an em- new law schools in order to absorb all ator from North Carolina said that is ployer and shoot him dead with unlim- the new lawyers we will need in order not true; that only counts if it is a ited economic damages, unlimited non- to bring all of these lawsuits. medically reviewable event. Then that economic damages, and $5 million in The McCain-Kennedy bill proposes up brings in the employer. punitive damages. to $5 million for punitive damages for I don’t know. I think I can read lan- The second new ERISA claim, the COBRA, HIPAA reporting, and disclo- guage. The language is abundantly terms and conditions in the one I just sure violations despite the fact that all clear, and I don’t think you can reach talked about, is extremely broad, cov- of these requirements have their own that conclusion because the language ering virtually any administrative ac- specific ERISA enforcement provisions. is clear. The language the Senator tion that does not involve a claim for In other words, under present law, quoted in support of that position, benefits, including the S. 1052 McCain there are already enforcement provi- which actually is a 180 degree exact op- bill new patient protection require- sions for this activity and the ones I posite conclusion of what the Senator ments under COBRA and HIPAA. just listed. But they don’t run to the from North Carolina said, the point he The McCain bill establishes a com- employer to benefit the patient. The was making, if it was correctly rep- plicated scheme which attempts to patient doesn’t have an individual resented to me. limit Federal and State suits against cause of action in this area. Rather, Under clause (2), again of 302, it says: employers provided the employer does these are strong administrative proce- IN GENERAL.—A cause of action is estab- not directly participate in the decision dures which keep the employer from lished under paragraph (1)(A) only if the de- in question. It is a very complicated violating the purposes of ERISA. But cision referred to in clause (i) or the failure scheme, but what is the effect of it? described in clause (ii) does not [‘‘not’’] in- now we have punitive damages up to $5 The effect of this direct participation million, unlimited economic damages, clude a medically reviewable decision. at this time will mean that employer Just the opposite. It is not because and unlimited noneconomic damages. protections are essentially meaningless Some of the things that occur today there is a medically reviewable deci- for suits alleging a failure under the sion that you get brought into this. It in order to enforce these laws but terms and conditions of the plan. which do not involve private cause of is because there was no medically re- Further, the McCain-Kennedy bill action as created under the bill are as viewable decision, which means all continues to allow unfettered class ac- follows: these ministerial events, which have tion suits—including suits against em- There is a $100 per day excise tax pen- unlimited liability attached to them, ployers—where no limits on damages alty under Code section 4980B(b) viola- can create the lawsuits against em- would apply under the current law pro- tions of the COBRA requirements—tax ployers. visions of ERISA or other Federal stat- penalties are up to $500,000 for employ- So employers are going to be hit with utes, including the RICO statute. ers and $2 million for insurers. There is a plethora of new lawsuits from attor- So you have, first, a whole new set of an additional $100 per day civil penalty neys across this country. This is a Federal claims created against employ- under ERISA section 502(c) for failing whole new industry. We will have to ers, unlimited economic damages, un- to satisfy the COBRA notice require- probably build another 20 or 30 law limited noneconomic damages and $5 ments. Plan participants may sue em- schools across this country just to take million of punitive damages, which es- ployers and insurers—for benefits and care of all the new lawyers who are sentially have a figleaf entry level that injunctive relief under ERISA section going to join the trade in order to any good lawyer is going to be able to 502. make money suing people under this punch through called directed partici- McCain-Kennedy bill. We are going to pation. Then you have the continu- There is a $100 per day excise tax pen- have to expand law schools radically, ation of class action suits giving law- alty under Code section 4980D(b) and a which may be good for law schools but yers another forum with things such as $100 per day penalty under section I am not sure it is good for our society the RICO statute. 2722(b)(2) of the Public Health Service as a whole. Because employers inherently carry Act for violations of the HIPAA pre- I want to go into a little more depth out their duties under the ERISA’s existing conditions limitations provi- here, if I have a minute—I understand statutory scheme, the McCain-Kennedy sions. In addition, plan participants somebody else is coming to speak—on bill will leave employers wide open to may sue for benefits and injunctive re- the specifics so I get it right, especially new Federal personal injury suits. Em- lief under ERISA section 502. on this whole issue of the Federal tort ployers will be sued based on alleged Willful violations of ERISA’s report- claim, this new Federal action. This is errors in: ing and disclosure rules, including the a huge event which should not be un- Offering continuation coverage and requirements relating to the provision derestimated. It is technical but it is providing notices under COBRA; of SPD and documents upon request, huge and the implications are radical. Providing certification of prior cred- are subject to criminal fines and im- We are going to get a chart put up just ible coverage under HIPAA’s port- prisonment under ERISA section 501. to make it a little easier for people to ability rules; Failure to provide documents upon understand. Distributing summary plan descrip- request is subject to civil penalties Basically what this bill does is it cre- tions; describing the plan’s claim pro- under ERISA section 502(c). ates two new types of lawsuits in Fed- cedures under the plan; and describing So you already have a very extensive eral court. Under the first type of ac- the plan’s medical necessity or experi- administrative and legal liability situ- tion, participants can sue over a failure mental care benefit exclusions. ation for employers and insurers that to exercise ordinary care in making Here are some of the others: do not meet the conditions of COBRA, nonmedically reviewable claims deter- Also, providing notices of material HIPAA, and ERISA. But what you are minations. The second Federal cause of reduction in group health plan benefits now layering on top of that is a brand action broadly allows suits for failure as required by ERISA. new concept where you have a private to perform a duty under the terms and These are all areas where they can be right of action, where individuals can conditions of the plan. Remedies avail- sued. go out and allege these violations as

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00036 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.082 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6423 part of the injury they claim they re- are going to drop their health care in- their HMO telling them what it is they ceived and have a whole new cause of surance. should have and what it is they should action against the employer. Couple with that this huge, newly not have—whether it is their OB/GYN What small-time employer—what built, unintended consequence—in- or specialists or a primary care pro- employer, period—is going to want to tended consequence; it is not unin- vider. All of them have that language keep a health plan if they have that tended at all—which will be that em- or rely on State law which has that level of liability facing them? ployers, and especially small employ- language and which is equal to the lan- McCain-Kennedy would impose po- ers, will simply say, I am not going to guage in the bill that is being proposed. tentially huge new compensatory and run the risk of being put out of busi- So those issues, as compelling as punitive damages remedies for viola- ness by these lawsuits which bring me they are, truly are not relevant to the tions of COBRA, HIPAA, and ERISA’s personally into the fray. debate in this Chamber because under disclosure requirements. Moreover, Then you have the result that more anything that passes this Chamber, under the statute’s own requirements, and more people will become unin- you have a 100-percent vote to take the employer is specifically required to sured. Thus, more and more pressure is care of those issues. carry out COBRA and disclosure re- created in the marketplace of politics The question before this Chamber is quirements—the employer is almost al- for a nationalized plan. whether or not we are going to drive up ways the administrator. Thus, McCain- You have to remember, if you are a the costs of health care by creating Kennedy imposes a huge new liability small businessperson and you are em- new liability for employers, forcing on employers that employers cannot ploying 20, 30, or 50, or even 100 people, employers to drop health care, and avoid; despite the fact that when Con- and you are confronted with one of whether or not we are going to usurp gress adopted COBRA and HIPAA with these law lawsuits—which you sud- the authority of States to set out their large bipartisan majorities no discus- denly find you are confronted with be- ideas as to how to address this issue, sion was given to the need for punitive cause the Federal law has the ability of where many States have already done damages to enforce the new require- making you personally liable because an extraordinarily good job and really ments. you happen to be the employer or the do not need a Federal law in order to Practically what you have here is a health plan sponsor—what is your al- protect their citizenry because the pro- decision by the drafters of this bill to ternative? What are your alternatives tections have already occurred. say we are not really so much inter- as a small businessperson? You have to There are a lot of other issues in ested in delivering better health care go out and hire an attorney. How much here, too—lesser issues. But those are and in giving patients better health is that going to cost you? It will cost the two big ones. That is what this de- care; we are really interested in cre- literally tens of thousands of dollars bate is about. It is not about the folks ating a massive new opportunity for probably to defend yourself in court or who have not been treated well because lawsuits. you have to settle the suit. Even those folks are going to be treated well In doing that, I think they are ac- though you don’t believe you owe any- under whatever bill passes. And it is complishing one of the goals—which I thing, you have to settle the suit rath- not about people not being able to go believe is a subliminal goal and maybe er than pay the attorneys or you decide to their health care provider and get a more formal goal in truism—which is to pay the person who brought the suit. the type of specialists or the type of to create more people who are not en- That is going to cost you a lot of treatment they want in a context sured because that can be the only con- money. which everyone would describe as rea- clusion from their lawsuit structure. Either way, as a small employer, if sonable because that is in every one of The only thing that can come from all you are running a mom-and-pop res- these bills. of these lawsuits, from all of these new taurant, it will probably wipe out your It is about the cost of health care, causes of action, and from all of the profit because you suddenly find that the liability of employers, and the new pressures it will put on employers you are subject to lawsuits to which usurpation of States rights with States is that fewer employers will insure you were never subject before simply having the opportunity to legislate in their employees, especially small em- because you gave health insurance to the area of insurance which for years is ployers. your employees. It is absolutely the something that has been a tradition in Inevitably, there will be more unin- wrong result. We have heard a lot from this country. sured. Why would anybody be for more the other side of the aisle about indi- So as we go down the road—and hope- uninsured? If you are around here and viduals who had serious problems with fully we will get a final form of a bill you want to pass a national health care HMOs. We are all sympathetic to those to debate from—I believe that is the plan, the biggest argument you have in individuals. Photographs that have proper framing of this debate. I look your favor is that there are too many been brought to this Chamber—and forward to it. uninsured in our country, that the only brought to this Chamber last time—by I yield the remainder of our time to way to handle the uninsured is to na- Members from different States are very the Senator from Texas. tionalize the system and put everybody moving photographs. But you have to The PRESIDING OFFICER. The Sen- into a national plan so everybody is remember, that is not the issue here ator from Texas. covered. because the proposal put forward by Mr. GRAMM. Madam President, I We heard that argument intermi- Senator NICKLES last time, the pro- thank our dear ranking member for nably in 1993 when there were only 23 posal put forward by Senators FRIST, yielding to me. million uninsured. After 8 years of the BREAUX, and JEFFORDS, and the pro- I wanted to come over today in the 15 Clinton administration, there are now posal from Senators KENNEDY and minutes we have left to talk about this something like 42 million uninsured. MCCAIN, all take care of those individ- version of the Patients’ Bill of Rights. We have increased the number of unin- uals’ concerns. Those are straw men. Lest this stack of legislation on my sured people by 19 million over this ap- None of those folks, I suspect—or the desk fall over and kill me, let me make proximately 8-year period when we vast majority of them; I suspect none the point that it seeks to make. This were supposed to be improving our of them—would have the problems they stack on my desk demonstrates our big health care delivery system. And the had with their HMO if any one of those problem in trying to bring up one of call for a national plan will grow and three bills passed because all those the most important bills we are going grow as the number of uninsured grow. bills had a very aggressive procedure to consider in this Congress; a bill If you pass this proposal, because of for redress for the person who believes that, by the definition used by its prin- the costs it will create on employers they are not getting fair treatment cipal authors, will cause net pay of and because of the increased cost in the from their HMO—very aggressive. American workers to decline by $55 bil- insurance premiums, which the Con- All of those bills had very extensive lion over the next 10 years. Senator gressional Budget Office scored at 4.2 proposals for coverage of different KENNEDY talks about the bill costing a for every 1 percent of increased cost, types of services which people believe Big Mac. It really is 25 billion Big CBO estimates that 300,000 people will they have a right to, and should be able Macs. It is a lot of hamburgers and a drop insurance. So 1.2 million people to get, and should not have to have lot of dollars.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00037 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.085 pfrm03 PsN: S19PT1 S6424 CONGRESSIONAL RECORD — SENATE June 19, 2001 Looking toward the debate on one of that everybody would be forced to be a that vastly expands lawsuits and ex- the most important bills that we will member of—that the government was pands cost. consider, after having spent several going to set standards for health care, Now, why is this such a big deal? weeks trying to analyze and under- and they were going to give these 33 Why is there so much passion about stand the old version of the bill, S. 872, million people access to health insur- this? Let me explain why. This simple we now have a new version, S. 1052, and ance. chart explains why. This simple chart we understand that there is yet an- The price we were going to pay was tells us how unique America is in all other version which is coming. that you did not have any choice about the world, and how different we are Why is this important? It is impor- joining this government-run HMO. You than any other developed country in tant because if we are going to debate are going to hear Senator KENNEDY and the world. We have all heard of the G– an issue that will have a profound ef- others talk about forcing these private 7 nations. Those are the seven richest fect on every working American and HMOs to have a point-of-service option. countries in the world. every user of health care—which is ev- But he is not going to point out that in What I have done in this simple chart erybody alive—it is vitally important the original Clinton bill, the point-of- is to take the G–7 nations and ask a that we know what the proposal is that service option was that if the health simple question: What percent of the we are going to debate. A perfect exam- care purchasing collective in your area population in the seven most developed ple of why that is important is the did not approve a treatment, and the countries in the world get their health Clinton health care debate that we had doctor provided that treatment, he was care through the government and what in 1993 and in 1994. We kept hearing a fined $10,000. And if you paid him sepa- percentage get it through private debate from the White House about rately for the treatment, he was sent choice, private health insurance and their bill, and what it did; but in re- to prison for 5 years. decisions that they actually control ality, as that debate was in the process You are going to hear a lot of debate that relate to their family and their of beginning, we had one, two, three, about the right to sue HMOs, but you children? If this chart does not scare four, five, six, seven, eight, then nine are not going to hear that 7 years ago, you, then I think there is something different versions of the bill. Senator KENNEDY, on behalf of Bill wrong. Why was it changing so much? It was Clinton, proposed a bill that severely What does this chart show? It shows changing so much because it was inde- limited the right of anybody to sue a that of the seven most developed and fensible. The problem is—at least the doctor or any health care provider or richest countries in the world, the problem I had—is that every time I any faceless bureaucrat running a United States is profoundly different in studied a new version, by the time we health care purchasing collective. health care. Sixty-seven percent of got to the floor of the Senate to debate The argument 7 years ago was, forget Americans buy health care as a private it, the version had changed dramati- about freedom. Instead, worry about purchaser through private health in- cally. It was not an insurmountable the fact that 33 million people don’t surance and through individual choice; problem because each and every one of have health insurance and give up your 33 percent of Americans get their these versions wanted the government freedom and let the government run health care through a government pro- to take over and run the health care the system, and we will solve that gram. system. When the American people problem. That was the argument 7 When you look at the next freest knew what they were trying to do, they years ago. country in terms of private decision- were not for it. When people understood it meant making regarding health care in the But I think we can expedite this de- that when your mama got sick she was developed world, next to America, bate if we simply know what is being going to talk to a bureaucrat instead of which has 67 percent of its people buy- proposed. So I would like to propose to a doctor, the American people killed ing health care through their choice, our colleagues a solution to our prob- that proposal. But notice the 180 that through private health insurance, and lem; and that is, if there is about to be has occurred in those 7 years. Today individual decision-making, the next a new version, and if the authors of the 42.6 million people do not have health freest country is Germany, where 92 bill would give us their final version, insurance, almost 40 percent more than percent of health care is purchased then I believe that we could, with a in 1989. But now we have a proposal be- through government programs and gov- couple of days’ study, be in a position fore us that simply assumes that every ernment decision-making. to debate the bill. And we could get on employer absorbs part of the cost of in- As we go into this debate, why am I with it. creased health care that will come so concerned about driving up health Why is this issue so important? You from the bill before us, however, we care costs and forcing people to give up are going to hear a lot of debate about know that the increased costs will their private health insurance and forc- what this could mean to health care in guarantee at a minimum that 1.2 mil- ing companies to cancel insurance? I America, what it could mean to the lion people will lose their health insur- can tell you why I am concerned. I availability of health insurance. Why is ance. don’t want, 10 years from now, the that so important? First of all, it is im- Why, if we were willing to let the United States to be up to 92 percent of portant because I think people need to government take over the health care its health care run by government or 99 realize that when we debated the Clin- system 7 years ago because people percent of its health care run by gov- ton health care bill in 1993 and in 1994, didn’t have health insurance, do we ernment or 100 percent of its health the argument that was made through- now, in the name of giving them the care run by government. If you want out that debate was: Don’t worry about very rights we would have taken away America to be at the top of this list, the right to have choices. Don’t worry from everybody 7 years ago, make it so then you don’t care if the bill before us about a point-of-service option. Don’t that 1.2 million people, at a minimum, produces a situation where companies worry about the right to sue. Worry don’t have health insurance who have cancel health insurance because you about access to health care because the it today? have the answer already. The answer is figure that was used in that debate was I will explain the answer. I am deeply government. the latest number we had, as a good worried about people losing health in- This is a big issue. This is one I be- number, which was that 33 million peo- surance and I want to preserve private lieve deserves thoughtful deliberation. ple did not have health insurance. medicine in America. But if 7 years ago Finally, I will pick three issues. I Today, 42.6 million people do not have you wanted the government to take will use the old bill because that is the health insurance. over the health care system, then if one I know. I have checked out the new What was the solution to that prob- you destroy the health care system we bill and, with one exception, there is lem that Senator KENNEDY proposed in have today, if more people lose their not a change. There has been one word presenting the Clinton health care bill? health insurance 2 or 3 years from now, dropped. I will explain why it is so im- The solution was to have the Govern- you can come back and say: let’s allow portant that we have a copy of the ment, through health care purchasing the government take it over to solve a final bill so we know what is in it. Let collectives—which would be these problem which, in fact, you have cre- me take three issues that will make giant HMOs run by the government ated with a bill like the bill before us my point.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00038 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.089 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6425 The first issue is the one that there The PRESIDING OFFICER. The Sen- Houses of Congress since 1997. We have was a lot of talk about on the weekend ator from New York is recognized. now been waiting and waiting for the talk shows. In fact, one of our Demo- Mrs. CLINTON. Mr. President, I only Congress to act. Now is the time. crat colleagues was asked about suing caught the tail end of the remarks by I believe we should act not because it employers. He responded: under our the Senator from Texas. But I will just has been on the agenda for a long time, bill, you can’t sue employers. Sure point out that this bill, which we are although it has, and not because it is enough, if you open their bill up to hoping to consider today, has been in one of those issues to which finally the page 144, right in bold headlines, it the works for years. It has gone stars seemed aligned and with the says that you can’t sue employers. In through a number of drafts; it has been Democratic majority now in charge of fact, in a super-bold headline it says: voted on in previous incarnations. It is the Senate we can actually get it to Exclusion of employers and other plan not a new issue. It is ready for the full the floor but because of the patients sponsors. And then a subhead line debate and disposition in the Senate. It and their families who are out there called paragraph (A), it says: Causes of is not like a budget bill that is pre- waiting and literally praying for us to action against employers and plan sented without any debate and without act. sponsors precluded. Gosh, it sure looks any adequate preparation, as we expe- Each of the patients I have met and like it precludes suing employers. rienced a few months ago. This is an heard from, and each of the families Then it says: Subject to subpara- issue that is more than ripe for the whom all of us have heard from, tell a graph (B), paragraph (A) does not au- consideration of this body. story that describes an urgent situa- thorize a cause of action against an I thank Senator DASCHLE for making tion needing timely and responsive employer. But guess what. When you the McCain-Edwards-Kennedy Pa- care. That is why this bill is so impor- get down to paragraph (B), it says: Cer- tients’ Bill of Rights the first bill he tant. tain causes of actions permitted. Not- has brought to the floor as our Senate It is about getting the care you need withstanding subparagraph (A), a cause majority leader. when you need it. It is about getting of action may arise against an em- I really rise today on behalf of the care in a timely manner from doctors ployer or other plan sponsor or against countless New Yorkers, and really mil- you trust and choose. It is about hav- an employee of such an employer or lions of Americans across our country, ing doctors and nurses in charge of sponsor acting within the scope of em- who have been waiting for this day for your health care, not accountants and ployment. a very long time. I heard some remarks bookkeepers. Why are we so concerned about get- by the Senator from Texas about the My colleague, TOM HARKIN from ting to see the final bill before we de- efforts that were made, I guess, 6, 7 Iowa, had a memorable phrase today at bate it? Because the bill is full of these years ago now, to try to provide health the press conference. He said, ‘‘The bait-and-switch provisions. Here in one care coverage to every single Amer- American people don’t want their doc- paragraph it says you can’t sue an em- ican. I was deeply involved in those ef- tors doing their taxes and they don’t ployer, and then in another paragraph forts, and although we were not suc- want their accountants providing their it says you can. cessful, the goal was one that I think health care.’’ Let me give two more examples. One we should still keep at the forefront of Each of us should be able to look to is, can you force an insurance company our minds and hearts because when we our doctors, our nurses, our health care to pay for a benefit that is specifically began our work in 1993, there were ap- professionals for the care that we trust excluded in the policy? Let’s say the proximately 33 million Americans and need. This is about access to an policy says that the plan does not pro- without insurance; today we are up to emergency room when we need it. vide coverage for heart and lung trans- 42 million. This is after the so-called I recall being in Ithaca, NY, about 2 plants and, as a result, the plan is managed care/HMO revolution oc- years ago and meeting a young woman cheaper. And so my small little com- curred, where people have been finding who came to see me with a stack of pany I work for buys the plan, and I it harder to afford coverage, afford the medical records, literally a foot high, know in advance it does not cover that. deductibles, afford the copayments, just desperate. She had been in a very So the question is, are you bound by with the result that we have more peo- dangerous, nearly fatal accident on one the contract? If you look at the bill on ple uninsured today than when many of of those winding roads that go through page 35, it sure looks like you are. In us tried to address this problem some that beautiful part of New York. Some fact it says no coverage for excluded years ago. of you may have traveled through benefits. And then it has a paragraph There are many urgent health care Ithaca or may have gone to Cornell. that tells you if they are specifically issues before us as a nation such as sky You know what beautiful country it is, excluded, they are excluded. Until you high prescription drugs for our seniors, but it has also a lot of winding roads. turn over to the next page and it says: too many without adequate coverage, She was in a devastating accident, Except to the extent that the applica- and once they have Medicare they lying unconscious on the side of the tion or interpretation of the exclusion can’t afford the additional coverage road. Luckily, someone came upon her or limitation involves a determination that is required in order to give them and called for aid and they were able to under paragraph 2. the kind of health care they should medivac her out with a helicopter, save Then you turn back two pages and have. There are gaps in our health safe- her life, and she was in hospital care you see that anything that is medi- ty net, a shortage of nurses in our hos- and rehab for nearly a year. She gets cally reviewable or has to do with ne- pitals and nursing homes, and the very out and what does she find? She gets a cessity or appropriateness can be man- difficult conditions under which so bill from her HMO for the helicopter dated, even if the contract specifically many of our nurses now labor. And, of medivac emergency service because— excludes it. In other words, another course, there is the growing crisis of get this—she didn’t call for permission bait and switch. the uninsured. So we have our work cut first. She is unconscious on the side of The PRESIDING OFFICER. Under out for us in order to deliver on the the road and they want to charge her the previous order, the time controlled promise of quality, affordable, acces- $10,000 because she didn’t call for per- by the minority has expired. sible health care for all Americans. mission. Mr. GRAMM. Let me say, we will That is why I am urging we proceed So this is about getting the emer- have plenty of time to debate this and without further delay or obfuscation gency care you need when you need it. I will continue my examples later. and pass a Patients’ Bill of Rights—the It is about seeing a specialist when you However, the point I wanted to make bipartisan Patients’ Bill of Rights that need it, when your doctor says: I have now was that we need to see the final Senators MCCAIN, EDWARDS, and KEN- gone as far as I can go; you need to go version of the bill so we can prepare to NEDY have worked so hard to present, see a specialist. It is about women debate it. which has bipartisan support in the being able to designate their OB/GYN Maybe if we can take some of these House. as their specialist, and about mothers inconsistencies out, we could be closer We have to finish this job. We have and fathers being able to designate to having an agreement than we think been laboring over it since 1996, in ear- their pediatrician as their child’s gen- we are. I thank the Chair. nest with the efforts within both eral practitioner as well. It is about all

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00039 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.091 pfrm03 PsN: S19PT1 S6426 CONGRESSIONAL RECORD — SENATE June 19, 2001 of these and more—the kinds of issues Dr. Lee was called to the emergency passed such protections, including that are not just written somewhere in room one day about a year ago because Texas, specifically aimed to permit in- a headline but are lived with day in a patient—not his patient; it was some- jured patients to hold their health and day out, which are talked about one he had never seen before—a young plans accountable for their injuries. around the kitchen table, around the woman in her early thirties collapsed President Clinton signed an Execu- water cooler—the life-and-death issues at work. She was brought to the emer- tive order giving 85 million Americans that really make a vital difference to gency room. with federally sponsored health care, families all over New York and Amer- Dr. Lee did his neurosurgical anal- such as Medicare and Medicaid, protec- ica—families such as that of Susan ysis, did the tests that were necessary, tions similar to what we are trying to Nealy, from the Bronx, whose husband and discovered this young woman had a give to all Americans through a 1998 had a serious heart condition but very serious tumor that was pressing act. whose referral to a cardiologist was de- on vital parts of her brain and needed Even Federal courts, notably in the layed a month. The day before the ap- to be operated on. case of Andrews-Clarke v. Travelers In- pointment was finally scheduled, Mr. They found her husband, thankfully, surance, have urged the Congress to Nealy died of a massive heart attack, and they called the HMO that insured act. In that case, Judge William Young states: leaving behind his widow and two the family and asked for permission to young children, ages 5 and 3. perform the surgery right then. Dr. Lee Although the alleged conduct of Travelers and Greenspring in this case is extraor- It is like the family of the 15-year-old said it was, if not a matter of life and dinarily troubling, even more disturbing to boy from New York who developed death, a matter of paralysis and nor- the Court is the failure of Congress to amend complications from heart disease, but mal life, and they were denied. They a statute...that has come conspicuously his health plan refused to allow him to were told that because Dr. Lee was not awry from its original intent. see an out-of-network specialist famil- one of their network physicians, be- Yet because of our failure to enact iar with the case and instead sent the cause the Northern Westchester Hos- such a statute, at least 43 percent of all teenager to a network provider who did pital Center was not the hospital cen- Americans with employer-sponsored not see him for 4 months, and then the ter they preferred to use, he could not private coverage are still left out in boy’s lungs were filling with blood, and do the surgery. the cold. These Americans cannot af- 2 days later he collapsed in the street For 3 hours, Dr. Lee, his nurse, and ford to wait any longer. Forty percent and died. the hospital staff were engaged in an of Americans know that passing a law These are just two of the stories I argument with the HMO instead of per- today is even more urgent than it was could pick from my innumerable con- forming the lifesaving surgery. It 2 years ago, and a majority of them versations and letters that I have re- breaks one’s heart to think about this thought it was urgent then. ceived. There are so many more we neurosurgeon who could be saving lives Let’s work in a bipartisan way. This could tell. getting on the phone trying to get per- bill is bipartisan. Senator MCCAIN, Sen- For every one of these stories, there mission to do what he is trained to do. ator EDWARDS, and Senator KENNEDY are untold stories of families whose Finally, he was so fed up, he said: have all worked to get to this point. struggles for the care they needed were Look, this young woman’s life is at They have all made compromises. denied or delayed. According to patient stake. I will perform the surgery free of Their bill is the only bill before the reports, health plans delay needed care charge so long as you will cover the Senate that applies to all 190 million for 35,000 patients every day. In fact, hospitalization. With that deal struck, Americans with private health cov- delayed care and payment is a business the HMO let him proceed. erage. It is the only bill before the Sen- practice that health plans have per- I am very proud Dr. Lee is practicing ate that has all the protections of fected. medicine in my neck of the woods, but Medicare and Medicaid. It is the only I have heard from many doctors who I do not expect doctors and neuro- bill that has the support of over 500 tell me that each day a health plan surgeons to perform lifesaving heroic consumer and provider advocates. withholds payments represents lit- surgery for free. That is not the way Anybody who knows anything about erally thousands of dollars in interest the system is supposed to work. These some of these provider groups, such as that a health plan could earn. The are people who go to school for decades the American Medical Association, practice of delay is so widespread that to do this work, and they deserve the knows that Congress is not their pre- ferred venue. They are not keen on there is a term for it. It is called ‘‘liv- respect and compensation we should be having the Congress tell them to do or ing off the float.’’ Unfortunately, not putting into our health care system, not do anything, but doctors are so everyone who is subject to it actually not to satisfy HMOs but to pay for the frustrated that even the American ends up living. services of trained physicians and Medical Association has come time and Look, I don’t blame the accountants health care professionals. again asking that this bill be passed. and the bookkeepers. They are trying For the past 5 years patient advo- It is the only bill that guarantees to maximize their shareholders’ return, cates have worked on this bill, and we coverage for the routine costs of FDA- their profits. That is the business they have seen every delaying tactic one can approved clinical trials which are so are in. But this cannot go on. There imagine. I had a front seat to this when important to patients with cancer and have to be rules that say you must, re- I was down at the other end of Pennsyl- so important particularly to children gardless of your being in business and vania Avenue. We were working very with cancer. regardless of having to make quarterly hard to get this bill through the Con- This is the only bill that guarantees returns, put patients, doctors, and gress. Every excuse one can come up an internal and external review as soon nurses first. with was thrown in the way. It became as it is medically necessary. The physicians and nurses I speak so frustrating to all of us who knew In sum, this is the only bill before with are so frustrated about this. They that lives were at stake, care was being the Senate that protects patients, not are caught between the sharp conflict, denied and delayed; that passage of HMOs. between business practices that I per- needed protections was being derailed. Just as delaying tactics by managed sonally think are unscrupulous, but We come to this day. Luckily for us, care organizations have injured and nevertheless they are engaged in, and we are here not only because it is the even killed millions of Americans over the principles of the oaths that they right thing to do but because States time, delaying tactics by the opponents take to do no harm, to get the health and courts have realized they just can- of this bill have taken their toll. care to the patient when the patient not wait any longer. They have seen I want my colleagues to look at this needs it when it can do some good. firsthand what is going on in our coun- patient survey that is behind me. Each Life-or-death situations rarely wait for try. day, 35,000 patients have a specialty re- prior authorization. New York passed a State managed ferral delayed or denied; 18,000 every Last summer, I met Dr. Thomas Lee, care protection bill in 1996; they even day are forced to change medications a neurosurgeon at the Northern West- passed a law in 1998 to strengthen the as a result of their health plan’s deter- chester Hospital Center, just up the protections—all before the Congress minations—not their doctors but their road from where we live in Chappaqua. chose to act. Many more States have health plans.

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00040 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.093 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6427 When I say ‘‘health plans,’’ I mean would not stand for not getting the need. They don’t want a lawyer; they somebody sitting in an office, usually care their child needs. If they had a want a doctor; and they want the doc- hundreds of miles from where the pa- daughter who was suffering day after tor to take care of them according to tient or doctor is, second-guessing the day after day, and the doctors could the doctor’s best judgment. That is doctor, saying; I am sorry, your doctor not tell her what was wrong and they what doctors are telling us. They are may have 30, 40 years of practice and kept sending her home, I can guarantee not being permitted to do that. experience, but I am going to sit in this that those executives and those lobby- I appreciate my friend from Illinois office without ever having seen you ists would get some other source of raising that point because, as this de- and decide that I can second-guess care for their daughter. bate proceeds, you are going to hear a what kind of prescription medication But Mary is a school bus driver. She lot of arguments about why we just you should have. didn’t know where else to turn. Having cannot do this. You know, we just can- Forty-one thousand patients a day insurance was a pretty big deal. They not take care of Donna and her mother experience a worsening of their condi- didn’t know what else to do, other than Mary and all the other Donnas and tion because of actions by their HMOs. just keep going back, as Donna’s condi- Marys in our country. There will be all One can go through this list and see tion got worse and worse and worse. sorts of red herrings and all kinds of what patients are saying. Then one can Patients buy health insurance in arguments made that just do not hold look at another list that comes from order to feel assured that when they water. There is no basis in fact for surveys of doctors, those who are on seek care under the benefits for which them, but they sound good. Maybe they the front lines. They are saying they they have paid, that care will be avail- will scare some people. But we are believe their patients are confronting able and it will be available in time to tired of being scared and intimidated. serious declines in their health from be effective. Yet we know that that This is no longer just a political issue, plan abuse. This is the kind of informa- does not happen. In one State, the this goes to the very heart of who we tion that concerns me because when I State of New York, according to De- are as Americans. go to the doctor, I expect my doctor to partment of Insurance statistics, of the Are we going to take care of each take care of me. He or she has sworn an nearly 18,000 HMO decisions challenged other? Are we going to let doctors and oath, they have been well trained, and on appeal, over 10,000 were reversed. nurses practice their professions? Or I have checked them out. I feel like I This means that when patients can test are we going to turn our lives over to am putting myself in someone’s hands their HMO’s decision to deny needed HMO accountants and bookkeepers and whom I can trust, and doctors are say- care, over half the time the patients the like? ing they are not being permitted to are right. I am hoping we will not only proceed practice medicine. They are being told Yet, through a loophole in Federal to this bill, which deserves a full hear- they have to subject their decisions to law, there are too many consumers in ing, deserves a full debate, and deserves people they have never met nor seen. New York—over 2.25 million—who still a unanimous vote in this Chamber. I It is because of the desire of HMOs to are not protected against these incor- hope when we pass this, we will be slow down payment, to deny payment, rect and dangerous decisions. They sending a very clear message to all the to keep that float I talked about going, have no recourse. There is nothing mothers and fathers and family mem- basically to use the money they should they can do because we have not given bers that this will never happen again. be paying to doctors and hospitals for them a Patients’ Bill of Rights. They This beautiful young woman whose life taking care of us for their own pur- need a Federal law to give them the was cut short tragically would still be poses, for their own profits, for their parity and protection their neighbors with us today if that HMO had just bottom lines. and coworkers have. said: maybe we should let you go ahead In my office I keep a picture of a Mr. DURBIN. Will the Senator yield and have that test. young, beautiful woman named Donna for a question? I look forward to working with my Munnings. This is Donna. This is a Mrs. CLINTON. I am happy to yield. colleagues. This has been 5 years in the young woman who reminds me every Mr. DURBIN. I believe the Senator making. Let’s end the politics of delay single day when I look up at her pic- from New York was at a briefing this and move forward with the motion to ture in my office of what can happen morning where we discussed the experi- proceed. when the system does not respond until ence in the State of Texas. In 1997, a The PRESIDING OFFICER. The Sen- it is too late. Donna’s mother Mary is certain Governor of Texas, who has ator from Nevada. a school bus driver from Scottsville, now moved to Washington, had a Pa- (Disturbance in the visitors’ gallery.) NY. She has been lobbying and advo- tients’ Bill of Rights established in The PRESIDING OFFICER. The gal- cating for this bill for years. Her Texas. Maybe the Senator from New leries will cease making a display. Any daughter Donna died February 8, 1997, York can help me with these numbers, expressions of approval or disapproval after having visited her primary care but I believe in the 4-year period of are not permitted in the Senate gal- physician repeatedly, only to be told time that the State Patients’ Bill of lery. The Sergeant at Arms will en- that she had an upper respiratory in- Rights has been in effect in Texas, force it. fection and suffered from panic attacks there have been 1,300 appeals of deci- Mr. REID. Mr. President, I pro- and that no diagnostic tests were nec- sions by insurance companies and only pounded a unanimous consent request essary. Had the doctors performed a 17 lawsuits filed in 4 years. some time ago that the Senator from $750 lung scan in time, they would have So the argument that giving the peo- New York was to be recognized until seen not an upper respiratory infection ple the right to go to court will mean 4:15, the Senator from New Jersey from but a football-sized blood clot in her a flood of cases brought in court has 4:15 to 4:30. There is no one here on the lung. been disproven in the home State of other side. The Senator will proceed Her mother Mary said: the President. Does the Senator from until Republicans show up. In my subsequent research I found that New York recall that? The PRESIDING OFFICER. The Sen- HMOs can and do penalize doctors for order- Mrs. CLINTON. Indeed, the Senator ator from New Jersey is recognized. ing tests which HMOs feel are unnecessary. from New York does recall that. I ap- Mr. TORRICELLI. Mr. President, But all for the sake of money [all for the preciate the Senator from Illinois rais- this debate is symbolic in many ways. sake of a $750 test] we lost a vital, beautiful ing that because that, of course, is one It holds the prospect of ending a five- young lady who had only begun her life. of the objections the opponents are try- year effort to pass meaningful HMO re- We are going to hear a lot of debate. ing to throw up, that this bill will open form. In fact, we are debating whether we the floodgates for lawsuits. In Texas A Patients’ Bill of Rights that recog- can even proceed with this bill: Yet that has not happened. It has not hap- nizes, that while the move to HMO more delaying tactics, yet more efforts pened anywhere in the country where based health care may have started to obstruct the kind of care that every these protections have been afforded with the best of intentions, the results one of us needs. I can guarantee the under State law. have been less than spectacular. people out in that lobby and the people People are not rushing to the court- Beyond the prospect of finally enact- in the offices they represent, they house. They want the care that they ing HMO reform, this debate marks the

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00041 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.095 pfrm03 PsN: S19PT1 S6428 CONGRESSIONAL RECORD — SENATE June 19, 2001 beginning of the tenure of TOM For example, my state of New Jersey child with cancer, for example, would DASCHLE as majority leader. It is a tes- became a national health care reform have the right to see a pediatric tament to the priority that he and our leader with the passage of the Health oncologist whenever the care is needed. caucus have given to this issue, that it Care Quality Act in 1997. Today, many HMOs restrict physi- is the first legislation we have brought The law now prohibits gag clauses, cians from discussing all treatment op- to the floor. For too long this debate provides an independent health care tions with their patients and cut reim- has been one-sided and bottled-up by appeals program and requires that in- bursement rates for doctors who advo- partisanship. surers provide clear information on cate with the HMO on behalf of their I was hopeful that Majority Leader covered services and limitations. These patients. This bill will prohibit HMOs DASCHLE’s earlier commitment to a reforms, long sought by Democrats and from financially penalizing doctors full and fair debate on amendments consumers, were passed by a Repub- who provide the best quality care for would begin this debate on a positive lican legislature and signed by a Re- their patients. note. However, I am disappointed that publican governor. HMOs typically have the last word my colleagues on the other side have But no matter how many individual when they decide to deny a needed test, objected to the motion to proceed and states act, the reality is that an over- procedure or treatment. We will guar- that it potentially will be days before whelming number of Americans won’t antee medical decisions by HMO bu- we can begin the debate on amend- be protected because their state laws reaucrats will be subject to a swift in- ments. are exempt under ERISA. ternal review and a fair external review The Senate HELP Committee has Mr. President, 83 percent—124 mil- process. done a study and found that each day lion—of Americans who get their And when reckless medical decisions of delay on this issue has very real con- health care from their employer are made by HMOs injure or kill, they are sequences. Every day 41,000 patients ex- not covered by state laws, and 50 per- shielded from any responsibility. Now perience a worsening of their condi- cent of people enrolled in an HMO in we will finally ensure that all Ameri- tion, 35,000 patients have needed care New Jersey are exempt from State pro- cans will have the right to hold HMOs delayed, 10,000 patients are denied a di- tections. accountable in court. agnostic test or treatment, and 7,000 Originally designed to protect em- These protections will provide a new patients are denied a referral to spe- ployees from losing pension benefits sense of health care security but un- cialist. due to fraud, the Employee Retirement doubtedly over the next weeks we will As important as the education debate Security Act of 1974 has provided HMOs hear arguments that the price for these over the past month has been, no issue with immunity from state regulations protections will be higher cost and in- will touch more families than what we for their negligent behavior. So despite creases in the uninsured. But the CBO do on HMO reform. the progress in states like New Jersey, report on this legislation states that it Today, more than 90 percent of work- complaints about the quality of care by would increase premiums by only 4.2 ing Americans receive insurance from HMOs continue to rise. percent over 10 years, this will mean a their employer. Most do not have a A survey by Rutgers University and choice about the type of coverage. This little over $1 per month for the average the state Department of Health found means that many working families are employee. overall that one in four New Jerseyans There will be arguments that this is stuck with an HMO despite any con- enrolled in an HMO was dissatisfied cerns they may have with the quality unnecessary because HMO’s have re- with their health plan. Last October a of care they receive. There are over 160 sponded to criticisms and already pro- state report card found that patients in million Americans with HMO insur- vide these protections. If this were NJ were less satisfied with their HMO ance. truly the case, then costs should not Mr. President, 33 percent of the resi- care than the previous year. rise at all. dents of my state—2.3 million—are in The bipartisan legislation being They will also argue that with every an HMO. A vast majority of these brought to the floor this week, is sup- one percent increase in premiums, ap- Americans are in favor of and are de- ported by more than 500 doctor and pa- proximately 300,000 Americans lose manding fundamental change in the tient rights groups, and will finally ex- their health insurance coverage. But in way HMOs provide care. tend patient protections to all Ameri- 2000, when overall health insurance A poll by the Kaiser Family Founda- cans in an HMO. premiums increased 10 percent, the tion conducted just 60 days ago found This promises to be a long debate and number of uninsured actually dropped. that 85 percent of Americans want while I look forward to dealing with Mr. President, we will debate many comprehensive HMO reform. These many of the important details, I want issues in this Congress but none with Americans believe, as I do, that doc- to outline the fundamental principles more impact on more people than this. tors, not HMO accountants should be in we must address. I want to thank our new majority control of medical decisions. Under current practices, many HMOs leader, Senator DASCHLE, for bringing The reality is that HMOs are a prod- force a patient with a chronic condi- this to the floor so quickly and I look uct of the runaway health care infla- tion like heart disease to be treated by forward to its debate. tion of the 1970’s and 1980’s that drove only the family doctor. The Kennedy- The PRESIDING OFFICER. Under the ranks of the uninsured. Edwards bill will guarantee access to a the previous order, the time controlled It was hoped that by providing a pre- cardiologist or other needed specialist, by the majority has expired. determined list of doctors and medical even one outside his or her network. Mr. TORRICELLI. Thank you, Mr. coverage, the costs of medical care Currently, if your sick or suffer an President. could be contained and coverage pro- injury while traveling or on vacation The PRESIDING OFFICER. The Sen- vided to more people. But after three you must get prior approval from your ator from Tennessee. decades of cutting costs and services to HMO before going to the emergency Mr. FRIST. Mr. President, I rise to keep costs low, it is clear that HMOs room. Our plan will ensure that a pa- address the issue of a Patients’ Bill of have failed to strike the necessary bal- tient could go to the nearest emer- Rights. As a physician, and as one who ance. gency room without having to first get has participated very directly in this Today, we are faced with a situation permission from the HMO. debate over the past several years, I where medical decisionmaking is dis- Under current HMO policies, many am one who welcomes the opportunity proportionately in the hands of insur- women must obtain a referral from to have discussion on this important ance company bureaucrats. That is their primary care doctor before seeing issue over the coming hours and days why, from patients to doctors, there is an OB/GYN. This bill will guarantee ac- and over, I assume, the next couple of unanimity in making some common cess to an OB/GYN without a referral. weeks. sense reforms. HMOs often force a child with a We do have a unique opportunity, I While Washington has been paralyzed chronic, life threatening condition to believe, to pass a strong bill of rights by partisan gridlock, state legislatures seek approval from a primary care doc- for patients, an enforceable bill of have been debating and acting on this tor before seeing a specialist. The Ken- rights for patients, under the leader- issue for years. nedy-Edwards plan would ensure a ship of President George Bush as he

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00042 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.035 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6429 outlined in his principles last Feb- or injury—with strong internal and ex- Second, limitless lawsuits help law- ruary. ternal appeals with an independent yers, not patients. As the American people listen to us physician making that final decision, Third, turning state regulation of discuss this legislation this afternoon, and then, yes, at the end of the day, if health care on its head is a losing pros- tonight, and over the coming days, I there has been harm or injury—the ex- pect for consumers whose needs have hope they will understand broadly that ternal review system of the physician historically been better served by their we, as a body, whether it is Democrat says the plan made a mistake, sue the own state insurance commissioner. or Republican, will come together in HMO, but do not sue the employer. Sue While I would like to spend my time this session and pass a bill that I am the HMO and not the employer. today making a general statement very hopeful will be signed by the I see my colleague from Wyoming is about the need for a Patients’ Bill of President of the United States. I am with us today. I am going to yield my Rights, I plan to revisit in detail the confident that he will sign it if it is time and look forward to participating issues I just mentioned as the debate consistent with the principles that he either later tonight or tomorrow in moves ahead. outlined. this debate. During both the Floor debate and The bill that is going to be brought Just as an aside, I enjoyed very much earlier in the Health, Education, to the floor, the McCain-Edwards-Ken- working with the Senator from Wyo- Labor, and Pensions Committee consid- nedy bill, is a starting place. We can’t ming over the last several years as we eration of the Patients’ Bill of Rights, end there because, yes, it has the pa- have addressed this issue. Everybody I asserted strong positions on several tients’ protections and appeals process, has been so entrenched. At the same key components of the managed care external and internal, but at the same time, we have been studying this issue reform debate. I wish, once again, to time it opens floodgates to a new, mas- and working hard. He is one of our col- reiterate my support for adoption of a sive, repetitive wave of frivolous law- leagues who has invested a tremendous bill that protects consumers, improves suits which very quickly translate amount of time putting together a Pa- the system of health care delivery and down into increased costs and in- tients’ Bill of Rights that really meets shrinks the rolls of the uninsured. I creased charges. the balance of getting health care to will do everything I can to prevent in- Much of that money that is taken people when they need it rather than creasing the number of uninsured. out of the health care system goes into focusing on these frivolous lawsuits I believe that as we consider a bill as the pockets of trial lawyers. Increased which might potentially hurt the pa- important as the Patients’ Bill of costs translate very directly down to tient. Rights, we must never lose sight of our loss of insurance, as we talked about I yield the floor. shared goal of having a strong bill. The The PRESIDING OFFICER. The Sen- the uninsured that are increasing politics should be left at the door in ator from Wyoming. 900,000 to 1 million every year. our effort to emerge with the best pol- We absolutely must, as we address Mr. ENZI. Thank you, Mr. President. icy for patients. That was the commit- gag clauses, access to specialists, ad- I thank the Senator from Tennessee for ment the principals in the conference mission to emergency rooms, and clin- his comments. I thank him for the tre- made to the public more than a year ical trials, and as we look at patient mendous job he has done. He is the ago. protection, bring some sort of balance only doctor in the Senate. He has done to the system to make sure that if a tremendous job of educating us in all I really cannot go further without there is harm or injury—after exhaus- of the areas of a Patients’ Bill of commenting on that conference. I have tion of internal and external appeals Rights and medical care and has saved been told by my more senior colleagues processes—that compensation to that quite a few people along the way. We that Members have never logged as patient is full, if there has been injury really appreciate that. I particularly many hours in trying to thoroughly or if there has been damage. But we thank him for the education he has understand and work a bill as we did can’t allow exorbitant, out-of-control given me. last year. The effort was not in vain. lawsuits because they drain money out Mr. President. I rise today to join all We learned a tremendous amount of the system itself. It drives premiums of my colleagues in calling for a Pa- about the value of enacting a good Pa- up and punishes the working poor. tients’ Bill of Rights. The President tients’ Bill of Rights. We also learned They are the ones right now who are has clearly stated his desire to sign a that preserving access to quality having a hard time struggling to even bill into law, but has also been very health care is the most important pa- buy that insurance, even when it is in clear on what he won’t sign. I support tient protection we can provide to con- part covered by their employer. That is his goal of protecting Americans that sumers. why when we drive these premiums have been mistreated by their HMO, Together, Senators GREGG, FRIST, up—whether it is 1, 2, 3 or 4 percent for and I also support his goal of only en- GRAMM, JEFFORDS, and HUTCHINSON, every 1 percent—the increased cost acting a bill that will preserve access Chairman NICKLES, and I demonstrated drives those premiums up, and about to insurance for those that already every day our commitment to doing 300,000 people lose their health insur- have it, and increase access for those the right thing for patients. I offer a ance. Americans that are uninsured. The leg- special thanks to Senator NICKLES for When we get into the business of islative and political history on this being a patient gentleman as he led us mandating patient protection, those matter stretches back a ways. In fact, through this negotiation process. rights cost money. Somebody has to in three of the four-and-a-half years I I do think, as that process went on, pay that money in some way. It is the have been in the Senate, we have some saw the possibility that we would people. It is distributed throughout the passed a Patients’ Bill of Rights. I hope complete it. Most of us thought it premiums. When those premiums go to keep that streak going this year, would be completed. Some thought it up, some people can’t afford to buy only I hope what we pass finally gets was better as an issue than a solution them anymore, and they forego that signed into law to the benefit, not the and jumped out of the processes and insurance. detriment, of consumers. started bringing votes back here in this That is the sort of balance that we While there is a lot of consensus be- Chamber. We could have had this done need to at least be aware of as we are tween all parties on the need for a last year. on this floor debating. number of patient protections, a strong All of the bills we have ever consid- I look forward very much to partici- internal and external appeals process, a ered, including the bill before us today, pating in that debate as we go forward right to hold health plans accountable have offered a series of patient protec- on having this strong, enforcement pa- in certain instances, and an assurance tions to consumers—direct access to tient bill of rights, which has strong that all Americans be afforded such OB/GYN and pediatric providers, a ban access to emergency room, access to protections, there remains some dis- on gag clauses, a prudent layperson clinical trials, access to specialists, agreement on key issues. standard for emergency services, a and elimination of gag rules. If there is First, the appeals process should be point-of-service option, continuity of any sort of concern about whether or meaningful and required because it care, and access to specialists—that not benefit is given when there is harm gets people the right care, right away. would provide all consumers many of

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00043 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.098 pfrm03 PsN: S19PT1 S6430 CONGRESSIONAL RECORD — SENATE June 19, 2001 the same protections already being of- lished. Many employers and health strongly enough my objection to fered to State-regulated health plan plans already voluntarily refer dis- wrenching from States their authority participants. puted claims to an independent med- to regulate on these matters. This is a bill for managed care. There ical review. But when it comes to for- The only hard proof we have right are already State protections for mal Federal action pertaining to the now is that States are, by and large, State-regulated health plan partici- employer plans regulated solely by the good regulators, while the Federal Gov- pants. Department of Labor, we are just now ernment has done a lousy job regu- Additionally, health plans would be examining how to proceed. In other lating on behalf of its health care con- required to disclose extensive compara- words, it works at the State level; it sumers. The General Accounting Office tive information about coverage of has not worked at the Federal level. has been reporting that to us since we services and treatment options, net- Now we are considering a Federal solu- passed the Health Insurance Port- works of participating physicians and tion. ability and Accountability Act, other providers, and any cost-sharing Since its inception in 1974, this is the HIPAA, in 1996. And that is the con- responsibilities of the consumer. first major reform effort of ERISA, the sumer enforcement protection mecha- All of these new protections are Employee Retirement Income Security nism around which the bill is written. crowned by the establishment of a new, Act, as it pertains to the regulation of I know I am on the verge of sounding binding, independent external appeals group health plans. The focus of the like a broken record, but I would like process, the linchpin of any successful mission—regardless of politics—should to sketch out the effect of the bill’s consumer protection effort. be to protect patients. Protecting pa- scope, as it is currently drafted. It is While I still do not believe that suing tients means not only improving the done best with a story about Wyoming. health plans is the biggest concern of quality of care but expanding access to Wyoming, as I mentioned, has its own consumers, holding health plans ac- care and allowing consumers and pur- unique set of health care needs and countable for making medical deci- chasers the flexibility to acquire the concerns. Every State does. For exam- sions is a key component of a Patients’ care that best fits their needs. ple, despite our elevation, we do not Bill of Rights. This leads me to another concern I need the mandate regarding skin can- For the record, I believe the biggest have with the bill before us. It requires cer that Florida has on the books. concern of patients is getting the best States to forsake laws they have al- My favorite illustration of just how health care they can get, right when ready passed dealing with patient pro- crazy a nationalized system of health they need it most, not the ability to tections included in the bill if they are care mandates would be comes from sue. Most people I know value their not the same as the new Federal stand- my own time in the Wyoming Legisla- health over all else. Money does not ards. The technical language in the bill ture. It is about a mandate for which I buy happiness, but good health can reads ‘‘substantially equivalent,’’ voted and still support today. You see, make a nice downpayment. ‘‘does not prevent the application of,’’ unlike in Massachusetts or California, Our success will absolutely be meas- and under the process of certifying in Wyoming we have few health care ured by whether we get patients the these facts with the Secretary of providers, and their numbers virtually medical treatment they need right Health and Human Services, the State dry up as you head out of town. We can away. Everyone agrees that the essen- will have to prove that their laws are see every single town by driving out- tial mechanism is an independent, ex- ‘‘substantially equivalent and effective side of it. They do not run together ternal appeals process. The last thing patient protections.’’ anywhere. we should do is establish a system that The proponents of this language say So we passed an ‘‘any willing pro- would require patients to earn their it will not undo any existing State vider’’ law that requires health plans care through a lawsuit. It is for this laws that are essentially comparable. to contract with any provider in Wyo- very reason that the bill I will support But that is not what their bill requires. ming that is willing to do so. While securely places the responsibility for Instead, when I see the requirement of that idea may sound strange to my medical decisions in the hands of inde- ‘‘substantially equivalent,’’ I read that ears in any other context, it was the pendent medical reviewers whose if there is any difference, then they are right thing to do for Wyoming. I know standard of review is based on the best obviously not equivalent and do not it is not the right thing to do for Mas- available medical evidence and con- meet the test. What does ‘‘substantial’’ sachusetts or California. I wouldn’t sensus conclusions reached by medical mean? And how does it modify ‘‘equiva- dream of asking them to shoulder that experts. These decisions would be bind- lent’’ at the end of the day? These kind of a mandate for our sake, when ing on health plans. questions are not being answered. we can simply responsibly apply it One of the specific concerns that will Is it that the proponents aren’t over- within our borders. be directly addressed by the inde- ly concerned with the implementation What is even more alarming to me is pendent review process is that of the of the law versus being able to say that that Wyoming has opted not to enact ‘‘medical necessity or appropriateness’’ their bill meets the political test of health care laws that specifically re- of the care requested by the patient covering all Americans, regardless of late to HMOs because there are no and their physician. Consumers and existing meaningful protections that HMOs in the State, with one exception, health care providers have repeatedly State legislatures have enacted? If the which is very small and is operated by requested that there be a prohibition laws just have to be comparable, then a group of doctors who live in town. on health plans manipulating the defi- why don’t we use that phrase? They are not a nameless, faceless in- nition of ‘‘medical necessity’’ to deny I am very leery of one-size-fits-all surance company. Yet under the pro- patient care. I think all of the bills legislation. Every State has dif- posal the Democrats insist is best for have attempted to address this con- ferences, geographical differences, dif- everybody, the State of Wyoming cern. I do have concerns, however, ferences in the mix of people, dif- would have to enact and actively en- about how the bill before us goes be- ferences in distance, differences in cli- force at least 15 new laws to regulate a yond addressing this concern and obvi- mate, and, more particularly, dif- style of health insurance that doesn’t ates the health care contract alto- ferences that affect medical care. exist in the State. gether, eliminates the contract alto- In Wyoming we have few doctors, we What Wyoming does currently re- gether. Imagine trying to price the have few people, and we have lots of quire is that plans provide information contract if you do not know what the miles. We do not have competing hos- to patients about coverage, copays, and contract contains. That provision will pitals anywhere in the State. And we so on, much as we would in this bill; a have to be fixed in the final bill. have a need for doctors—I love this—we ban on gag clauses between doctors and The issue of ensuring that patients have a need for doctors, including vet- patients; and an internal appeals proc- receive medically necessary and appro- erinarians, in every single county. ess to dispute denied claims. I am hope- priate care they have been promised in I will get into this issue in more de- ful the State will soon enact an exter- their contract has been addressed by a tail as the debate proceeds. I do believe nal appeals process, too. number of States already through the we can strike a compromise on the This is a list of patient protections appeals processes they have estab- matter of scope, but I cannot state that a person in any kind of health

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00044 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.100 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6431 plan needs, which is why the State has Mr. REID. Mr. President, I see no of how HMOs have wrongly denied care to acted. But requiring Wyoming to enact others on the side of the minority so I patients in the past, this is an industry that a series of additional laws that don’t will proceed. needs some accountability. While the law- have any bearing on consumers in our The PRESIDING OFFICER. Without suit provision is essential if a patient’s bill of rights is to carry any weight, few patients State is an unbelievable waste of a cit- objection, it is so ordered. would ever want to pursue this option. What izen legislature’s time and resources. Mr. REID. Mr. President, Las Vegas they want is immediate care. The Demo- Let me explain a citizen legislature. has two daily newspapers. One is the cratic plan tries to ward off people from In Wyoming, they meet for 20 days one Las Vegas Daily Journal; The other is heading to court, requiring patients to first year and 40 days the next year. They do the Las Vegas Sun. I was very im- go to an independent review panel before no special sessions. If you are only em- pressed with the editorial in the Las seeking relief through the courts. ployed as a legislator—and I use that Vegas Sun newspaper yesterday. The If there is a glimmer of hope it is that term loosely on being employed be- Bush has softened some of his earlier hard- newspaper is a relatively new news- line positions on the environment after hear- cause they hardly get paid anything— paper by American standards. It is 40, ing quite a bit of criticism. In the same vein, for 20 days one year and 40 days the 50 years old. It was started by an entre- the president should listen to reason and en- next year, you have to have a bona fide preneur by the name of Hank dorse a patient’s bill of rights that requires job. You have to have real work in the Greenspun who was a real pioneer in HMOs to finally be held accountable for their real world. And they do. So they meet Las Vegas. He developed a newspaper actions. for 20 days one year—and incidentally, that was feisty. It was a newspaper Mr. President, that is an editorial the 20 days is the year that they do the that took on Senator McCarthy before from a Las Vegas newspaper. It is sim- budget work, and they make it balance it was fashionable to do so. He took on ple. It is direct. It is to the point. It is every time—20 days one year and 40 the gaming interests when it was a what this debate is all about. If, as I days the next. You have to live the rest very small newspaper and won an anti- have heard today, the minority thinks of the year under the laws that you trust suit against them for their failing the bill has some things that they passed, which gives you a different per- to advertise and they, in fact, boy- don’t like, don’t understand, wish spective on laws than perhaps in States cotted his newspaper. weren’t there, let’s debate this bill. where the legislature meets for longer So I give this background to indicate Let’s not hide behind some procedural periods of time and definitely a dif- it is a great newspaper. It was. It still gimmick that prevents us from bring- ferent perspective than we have in this is. ing this matter to the fore for the body. That is a citizen legislature. The editorial they wrote yesterday American people. Speaking of limited resources, I can be paraphrased but not very well. The people of Minnesota, the State would be remiss if I didn’t touch once It is a short editorial. I will read the the Presiding Officer represents, the more on our most important charge in editorial into the RECORD. It is entitled people of New Jersey, the junior Sen- the debate; that is, to preserve Ameri- ‘‘Patient rights get some life.’’ ator from New Jersey being on the cans’ access to health insurance. If we The subtitles say: floor, the people of the State of Nevada make it too difficult for employers to The Senate is expected to take up this and the rest of the country need this voluntarily provide health care to their week a patient’s bill of rights. legislation. This is about patient pro- employees, then it should come as no They have under that: tection. It is about having a doctor surprise to any of us that they will Our take: It is unfortunate that so far take care of a patient, something we simply stop volunteering to do so. In- President Bush opposes the Democratic plan, used to take for granted—that if a doc- surance for most businesses is a volun- which also is favored by some Republicans, tor thought a patient needed some- teer effort. I won’t support a bill that that finally would make HMOs accountable. thing, the doctor ordered it for the pa- denies people access to health care. If The editorial begins as follows: tient. They can’t do that anymore. my colleagues don’t believe me now, [From the Las Vegas Daily Journal, June 18, That is too bad. they can bet their constituents will 2001] Patient care has been hindered, come calling when they lose their in- President Bush’s campaign pledge to be ‘‘a harmed, and damaged. What we want surance or have it priced forever be- uniter, not a divider’’ has been a bust in the to do with the Patients’ Bill of Rights yond their reach. early going of this administration. The is reestablish the ability of a doctor Sometimes changes we make in the White House’s embracing of extraordinarily and a nurse to take care of my daugh- Senate drive up the cost, as the Sen- conservative views, which are far removed ter, my sons, my wife, my children, my ator from Tennessee was explaining from the mainstream, have given the presi- neighbors. Anyone who needs a doc- earlier. For every 1 percent that costs dent some real problems in living up to his tor’s care should be able to have the go up, 300,000 people in this country conciliatory vow, especially on environ- doctor’s care. I don’t want a doctor lose their insurance. mental issues. Now Bush will soon face an- I will make a promise to my own con- other test of his ability to bring warring doing my taxes. I also don’t want an stituents right now that I will work sides together on another divisive matter: a accountant doing my medical care. patient’s bill of rights. That is what we have in America, in hard to enact a Patients’ Bill of The Senate, which recently came under Rights. I will fight any measure that many instances, and it is wrong. This Democratic control, plans this week to take legislation that we are trying to bring threatens their access to health care. I up a patient’s bill of rights, which for years will reserve further remarks until we has been stymied by Senate Republican lead- up—and we will get to it; it is just a delve into the process of considering ers. It’s not just Democrats supporting the question of when—is supported by the different provisions of the bill. plan, notable Republicans such as John many organizations. I will soon read I, again, extend the hand of com- McCain also back the bill. It also is impor- into the RECORD the entities that sup- promise and the offer to all of my col- tant that last week Rep. Charlie Norwood, port this legislation. Virtually every leagues that we rally around our com- R–Ga., signed on to a similar Democratic health care entity in America, every measure in the House. Norwood for years had mon position on many of the patient consumer group, every doctor group, championed a patient’s bill of rights, but he including the American Medical Asso- protections and forge ahead on the rest had held off his support this year in def- of the bill towards an end that has an erence to the White House, which said it ciation and, surprisingly, because I eye on what is best for the patients. wanted to work out a compromise. But even have never known them to agree on This bill is about them. If someone else Norwood’s loyalty wore thin, finally causing anything, the AMA and the American is benefiting from a provision, then I him to break company with Bush on this Trial Lawyers agree this legislation is would suggest that our drafting is not issue. The president, who has threatened to necessary. quite done. There are some of those veto a patient’s bill of rights that allows Who opposes it? The people providing provisions. lawsuits in state courts against HMOs, just the care, the managed care entities do I look forward to my continued role wouldn’t budget on this key provision. not support this legislation. They are The patient’s bill of rights isn’t that com- the ones paying for the millions of dol- in the process. I thank the Chair and plicated: It’s all about accountability. Cur- reserve the remainder of any time we rently, health insurance companies are the lars worth of ads on television trying have. only businesses in the nation that are im- to confuse and frighten the American The PRESIDING OFFICER. The Sen- mune to lawsuits if they harm someone. No people—just as they did with the ator from Nevada. one else gets such special treatment. In light health care plan in 1993. They spent

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00045 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.103 pfrm03 PsN: S19PT1 S6432 CONGRESSIONAL RECORD — SENATE June 19, 2001 $100 million or more in advertising to Health and Disability; American Association Mr. President, I suggest the absence frighten and confuse the American peo- on Mental Retardation; American Board of of a quorum. Examiners in Clinical Social Work; Amer- ple. I have to hand it to them; they did The PRESIDING OFFICER. The a great job. They did frighten the ican Board of Examiners in Social Work; American Cancer Society; American Chil- clerk will call the roll. American people. We are not going to dren’s Home in Lexington, NC. let them do that. The assistant legislative clerk pro- American Chiropractic Association; Amer- ceeded to call the roll. We are going to complete this legis- ican College of Cardiology; American College lation. We are going to complete this of Gastroenterology; American College of Mr. CORZINE. Mr. President, I ask legislation very soon. What is very Legal medicine; American College of Nurse unanimous consent that the order for soon? By next Thursday, a week from Midwives; American College of Obstetricians the quorum call be rescinded. this Thursday, and then if we finish it and Gynecologists; American College of Os- The PRESIDING OFFICER (Mr. by that date, we are going to do our teopathic Emergency Physicians; American College of Osteopathic Family Physicians; REID). Without objection, it is so or- Fourth of July recess. If we do not American College of Osteopathic Pediatri- dered. complete our legislation by a week cians; American College of Osteopathic Sur- Mr. CORZINE. Mr. President, I am from Thursday, we are going to work geons; American of Physicians—American honored to rise today, particularly here, according to the majority leader, Society of Internal Medicine; American Col- with the Presiding Officer who is in the TOM DASCHLE, until we finish it. We are lege of Surgeons. American Congress of Community Sup- Chair, to support a motion to proceed going to work Friday, Saturday, and to S. 1052, the Bipartisan Patients’ Bill we are going to work Sunday; the only ports and Employment Services; American Council on the Blind; American Counseling of Rights. day we are going to take off is July 4. Association; American Dental Association; I commend Senators MCCAIN, ED- Mr. President, this legislation is American Family Foundation; American WARDS, and KENNEDY for the tremen- overdue. It is important, and we are Federation of Teachers; American Founda- going to pass this legislation before we tion for the Blind; American Gastro- dous effort they put in to develop a go back to be in parades for the Fourth enterological Association; American Group strong, enforceable, and bipartisan bill of July. Psychotherapy Association; American Head- with the support of over 500 consumer I suggest the absence of a quorum. ache Society; American Health Quality Asso- provider and health care groups, as the The PRESIDING OFFICER. The ciation; American Heart Association. Presiding Officer just demonstrated to American Lung Association; American us with the A’s. clerk will call the roll. Medical Association; American Medical Re- The assistant legislative clerk pro- habilitation Providers Association; Amer- More importantly, I commend the ceeded to call the roll. ican Medical Student Association; American American people because the American Mr. REID. Mr. President, I ask unan- Medical Women’s Association, Inc.; Amer- people know what makes common imous consent that the order for the ican Mental Health Counselors Association; sense with regard to the need to pro- quorum call be rescinded. American Music Therapy Association; Amer- vide everyone quality health care that The PRESIDING OFFICER (Mr. ican Network of Community Options and Re- puts the relationship between the doc- sources; American Nurses Association; CORZINE). Without objection, it is so or- tor, the nurse, and the patient first. American Occupational Therapy Associa- dered. tion; American Optometric Association; Over the last 30 years, managed care Mr. REID. Mr. President, we have American Orthopsychiatric Association. organizations have come to dominate heard utterances in this Chamber American Osteopathic Association; Amer- our health care system. These organi- today about the Patients’ Bill of ican Pain Society; American Pharmaceutical zations both pay for and make deci- Rights by Senator JOHN MCCAIN that Association; American Physical Therapy As- sions about medical care, often pre- we have a lot of groups that support sociation; American Podiatric Medical Asso- empting the fundamental relationship ciation; American Psychiatric Association; this legislation. I don’t have a total be- in the health care equation between cause it is growing every day. I am American Psychiatric Nurses Association; American Psychoanalytic Association; doctor and patient. going to read into the RECORD a partial American Psychological Association; Amer- However, unlike doctors, nurses, or list of those entities and organizations ican Public Health Association; American almost anybody in our society, HMOs, that support the Patients’ Bill of Small Business Association; American Soci- managed care institutions, are not held Rights, the legislation before this ety of Cataract & Refractory Surgery. accountable for their medical decisions body: American Society of Clinical Pathologists; and treatment decisions. Abbott House of Irvington, NY; Abbott American Society of Gastrointestinal Endos- House, Inc. in SD; AIDS Action; Alliance for copy; American Society of General Surgeons; We just spent 8 weeks in the Senate Children and Families; Alliance for Families American Society of Internal Medicine; talking about education and account- & Children; Alpha 1 Association; Alternative American Society of Nuclear Cardiology; ability. We need to talk about account- Services, Inc.; American Academy of Child American Speech-Language-Hearing Asso- ability within the context of the pa- ciation; American Therapeutic Recreation and Adolescent Psychiatry; American Acad- tient-doctor relationship, and that is emy of Dermatology; American Academy of Association; American Urogynecologic Asso- ciation; American Urological Association; what this debate will be all about if we Emergency Medicine; American Academy of can ever get to the bill. Facial Plastic and Reconstructive Surgery; American Urological Society; Americans for American Academy of Family Physicians. Democratic Action; Anxiety Disorders Asso- Unfortunately, in the case of some American Academy of Neurology; Amer- ciation of America. HMOs, they have sometimes skimped ican Academy of Ophthalmology; American Association for Ambulatory Behavioral on care that undermines the health of Healthcare; Association for Education and Academy of Otolaryngology; American Acad- our patients, the health of the Amer- emy of Pain Medicine; American Academy of Rehabilitation of the Blind and Visually Im- paired; Association for the Advancement of ican people for the preemption and Pediatrics; American Academy of Physical benefit of the bottom line, and, in fact, Medicine and Rehabilitation; American As- Psychology; Association of Academic Psy- sociation for Geriatric Psychiatry; American chiatrists; Association of Academy it is all about protecting the bottom Association for Marriage and Family Ther- Physiatrists; Association of Community line. Cancer Centers; Association of Persons in apy; American Association for Psychosocial That is why this legislation is abso- Rehabilitation; American Association for Supported Employment; Association of Women’s Health, Obstetric and Neonatal lutely critical. The McCain-Edwards- the Study of Liver Diseases; American Asso- Kennedy bill will ensure at long last ciation of Children’s Residential Centers; Nurses; Assurance Home in Roswell, NM; and American Association of Neurological Sur- Auberle of McKeesport, PA. that managed care companies are held geons. Those are the A’s. I have completed accountable for their actions. Just as American Association of Nurse Anes- the groups beginning with the letter A. in all of industry—every doctor and, thetists; American Association of Pastoral I will come back later and start with frankly, every individual in America— Counselors; American Association of People the B’s and go through the hundreds of everyone is held accountable. with Disabilities; American Association of groups that support this legislation. We cannot afford to wait any longer Private Practice Psychiatrists; American Association of University Affiliated Pro- The overwhelming number of American before passing legislation to curb in- grams for Person with Developmental Dis- people support this legislation, as ref- surance company, managed care abilities; American Association of Univer- erenced by those organizations that abuses. According to physician reports, sity Women; American Association on begin with the letter A. every single day we delay passage of

VerDate 19-JUN-2001 01:54 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00046 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.105 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6433 this legislation, 14,000 doctors see pa- Patients will have access to an emer- leave or minimum wage or a whole se- tients whose health has seriously de- gency room, any emergency room, ries of things, people are just trying to clined because an insurance plan re- when and where they need it. scare folks into believing that taking fused to provide coverage for a pre- Women will have easy access to OB/ action that is going to help the people scription drug; 10,000 physicians see pa- GYN services without unnecessary bar- of America is somehow going to result tients whose health has seriously de- riers. in very negative results that ought to clined because an insurance plan did Children will have direct access to keep us from doing this and moving not approve a diagnostic test or proce- pediatricians and, most importantly, forward. It is just a bad argument. dure; 7,000 physicians see patients pediatric specialists. They are scare tactics at their worst. whose health has seriously declined be- Patients can participate in poten- In sum, I believe health decisions cause an insurance plan did not ap- tially lifesaving clinical trials. This is should be made based on what is best prove a referral to a medical specialist; a critical protection for patients with for the patient. We need to assure the 6,000 physicians see patients whose Alzheimer’s, cancers, or other diseases American people that the practice of health has seriously declined because for which there are no sure cures. medicine is in the hands of the doctors. an insurance plan did not approve an Fourth, the legislation protects the We trust them with our lives. We overnight hospital stay. Think about crucial provider-patient relationship— should trust them to decide what care that. That is 35,000 folks a day who are doctor-patient, nurse-patient. we need. I urge my colleagues to agree left with diminished and substandard It contains antigag rule protections to take up the bipartisan McCain-Ed- care because we do not have the right ensuring health plans cannot prevent wards-Kennedy Patients’ Bill of relationship between doctors and pa- doctors and nurses from discussing all Rights. I see one of the authors now. I tients in place with the interference of treatment options with their patients. congratulate him and the other spon- bureaucrats at insurance companies It sounds like common sense, and it sors for moving an important part of and HMOs. limits improper incentive arrange- what needs to be done to make Amer- This legislation has all the key com- ments by the insurance industry. ica’s health care more secure for every- ponents that Americans have de- Finally, this legislation makes sure one. manded to respond to these problems. that the rights we seek to guarantee The PRESIDING OFFICER. The Sen- It contains strong, comprehensive pa- are enforceable. Yes, this legislation ator from North Carolina. tient protections. allows individuals harmed by an HMO Mr. EDWARDS. Mr. President, let me It creates a uniform floor of protec- to sue their HMO. This is a critical pro- first thank my colleague from New Jer- tions for all Americans with private vision because, let’s face it, a right sey for his passionate support for this health insurance, regardless of whether without a remedy is no right at all. important piece of legislation, the Pa- something has been done in the States. Again, that fundamental account- tients’ Bill of Rights. I want to talk It provides a right to a speedy and ability issue we have been talking about several subjects briefly, if I may. genuinely independent external review about, whether it is with regard to edu- First, some people have argued, in process when care is denied. It is not cation, we also ought to be talking the press, the media, and on the floor guaranteeing a lawsuit, it is guaran- about it with health care. of the Senate during this debate today, teeing a speedy independent external No matter what health care treat- that the only difference between the review. ment protections are passed into law, McCain-Edwards-Kennedy Patients’ Finally, it provides consumers with unless patients can enforce their Bill of Rights, the Patients Protection the ability to hold managed care plans rights, the HMO is free to ignore those Act, and the bill that has been pro- accountable when plan decisions to requests. Health insurers must under- posed by Senator FRIST and others, is withhold or limit care result in injury stand that unless they deliver high- on the issue of accountability, taking or death, harm and pain to the patient. I wish to speak briefly about a few of quality health care that protects the HMOs to court. There are multiple differences be- the most important provisions in this rights of patients, they can and will be bill, but this is all about common held accountable. tween these bills. There are differences sense. I wish to address for a moment the in how you determine whether a State First, this bill protects all Americans argument that this legislation will lead can opt out of the protections covered in all health plans. If we are serious to more uninsured Americans. by the Patient Protection Act, i.e., about providing consumers with pro- There is perhaps no issue about how much coverage there is, how many tections, we must be serious about cov- which I am more passionate than the people are covered by the bill. ering all Americans. The McCain-Ed- uninsured, about 44 million in America. There are differences in access to wards-Kennedy bill does just that. No I believe health care is a basic right, specialists outside the plan. Our bill person is left without rights because and neither the Government nor the specifically provides you can have ac- they live in a State with weaker pro- private sector is doing enough to se- cess to a specialist. If a child needs to tections. cure that right for everyone. I hope one see a pediatric oncologist, a child with Second, the legislation ensures a day we will have that debate. But let cancer, the child has a right to do that. swift, internal review process is fol- me be clear; if I believed this bill would Under their bill, the HMO is in charge lowed and a fair and independent exter- increase the number of uninsured—I of that decision. Under our bill, there nal appeals process if it is necessary. believe a number of Senators believe is a true independent review by the This will guarantee that health care the same—we would not support this. independent review panel. If a claim providers, not health plans, will con- Let me also point out the hundreds of has been denied by an HMO, that ques- trol basic medical decisions. It does health care and consumer groups that tion has been appealed within the not guarantee a lawsuit; it provides a support this legislation are also the HMO, and then if that was unsatisfac- process for a legitimate review of a pa- very groups that are working the hard- tory, the next appeal is to an inde- tient’s claims. est to expand coverage for the unin- pendent review panel. Our bill specifi- Third, the legislation guarantees ac- sured. They also would not support this cally provides that panel must in fact cess to necessary care. Patients should legislation if they believed it would re- be independent. The HMO can’t have not have to fight their health plan at sult in more uninsured. That issue is anything to do with choosing them. the same time they are fighting an ill- nothing but a diversion, a red herring, Neither can the patient or the physi- ness. That is why the legislation guar- a scare tactic, because the CBO itself cian involved in the care. antees access to necessary specialists, has said this legislation would only in- Unfortunately, the Frist bill does not even if it means going out of a plan’s crease premiums by 4.2 percent over a provide the HMO cannot have control provider network. It seems pretty sim- 10-year period. over that panel, which means the HMO ple we ought to get to the right doctor This legislation will not result in essentially can have control. It is like for the disease that is diagnosed. higher numbers of uninsured. It will re- picking their own judge and jury in a Chronically ill patients will receive sult in better quality for patients. I case involving somebody’s health, the speciality care they need with this heard Senator KENNEDY today saying, health care that could affect the fam- bill. whether it was about family medical ily.

VerDate 19-JUN-2001 01:54 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00047 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.108 pfrm03 PsN: S19PT1 S6434 CONGRESSIONAL RECORD — SENATE June 19, 2001 The bottom line is, from start to fin- dividual who is listening to this debate. never met him and with no medical ex- ish, whether it is coverage, access to All the rest of us are responsible for pertise said: We are not paying for this. specialists, access to a true inde- what we do. We are held accountable, We don’t think he needs it. They lit- pendent review, if, as a matter of last and we are responsible. The HMOs are erally cut off his oxygen. resort a case has to go to court, having virtually the only entity in America What was Steve Grissom going to do? that resolved quickly and efficiently or that can deny care to a child and the He was like every family, every child, having it dragged out over years and family can do nothing about it. They and every patient in America with an years and years in a Federal court—on cannot question it; they cannot chal- HMO that makes a decision. He every single issue of difference, there is lenge it; they cannot appeal it; and couldn’t do anything about it. He a simple thing. Our bill protects pa- they cannot take the HMO to court be- couldn’t challenge it. He couldn’t ap- tients. Our bill is on the side of fami- cause the HMOs are privileged citizens peal it. He couldn’t take them to court. lies and doctors. Their bill is slanted to in this country. He was absolutely helpless. the HMOs. I have to ask, if you were to send out That is what this legislation is So it is not an accident that the a questionnaire to the American people about. It is about giving Steve American Medical Association and and say: Here are 10 groups of Ameri- Grissom—when the HMO says we are over 300 health care groups—virtually cans—physicians, doctors, patients— not giving you your oxygen that your every health care group in America— and on that list were HMOs, and you specialist says you need—the ability to support our bill. It is not an accident said, on this list, whom would you do something about it. It is about al- that the majority of the Senate sup- want to protect from any account- lowing him to go to an appeal, and ports our bill. It is not an accident that ability, from ever being able to be most importantly to a truly inde- the majority of the House of Rep- taken to court, to be treated as privi- pendent review panel of doctors who, in resentatives supports our bill. All these leged citizens, I suggest the likelihood every single case such as Steve’s, will organizations that deal with these that the HMOs would end up at the top reverse the decision. issues every day—I am not talking of that list is almost nonexistent. When his heart specialist at Duke about Members of the Senate, I am What we have is an anachronism. We University Medical Center says you talking about doctors who practice have a law that was passed in 1974, be- need this oxygen 24 hours a day, and medicine every day, who deal with fore the advent of managed care, before you put that question to a panel of problems with HMOs, I am talking HMOs were making health care deci- three doctors, what do you think the about patients groups who hear these sions. Then after the passage of this result is going to be? They are going to horror stories regularly about HMOs, law, with the passage of these protec- order that the HMO pay for the oxygen who have analyzed this legislation, tions that gave managed care compa- that Steve needs. looked at it word by word by word from nies privileged status, they started That is what this debate is about. start to finish and have come to a sim- making health care decisions. There are real differences between ple conclusion: Our bill is a true pa- We have a situation that needs to be our bill and the Frist bill. tient protection act. Their bill is an corrected. All this is about is treating For example, when Steve’s care was HMO protection act. Our bill protects HMOs as every other entity and indi- denied, we go to a panel that the HMO patients, doctors and families. Their vidual in America. We want them to be can have no control over; that a truly bill, instead of being a Patients’ Bill of like all the rest of us. It is just that independent patient can’t have any- Rights, is a patient’s bill of suggestions simple. They are not entitled to be thing to do with; that Steve couldn’t because the rights contained therein treated better than the rest of us. But, have any connection with; and that the are not enforceable. surprise, surprise; they don’t like it. HMO can’t have any connection with. To the extent there is an argument They are being dragged, kicking and It is objective and fair. made during the course of this debate screaming every step of the way, and Unfortunately, under the Frist bill that there are no differences, there are they are spending millions and mil- the HMO could choose the people on differences. There are important dif- lions of dollars on television ads, on the review panel. There is absolutely ferences. From the beginning to the public relations campaigns to defeat nothing to prohibit that. Steve will be end of this bill, there are important our bill. Why? They like being privi- making his case to a judge and jury differences. The best evidence of those leged. They like being treated like no- picked by the HMO. differences is the fact that the Amer- body else in America is treated. They That is an important difference be- ican Medical Association and doctors like the fact that they can decide tween our bill and this bill. and health care providers and nurses something and nobody can do anything The bottom line is that what we are groups all over America support our about it. Why wouldn’t they like it? about is trying to empower patients bill. They know what the problems are. Why wouldn’t they want to keep things and empower doctors to make health They want to be able, along with fami- exactly as they are? care decisions; have people who are lies, to make health care decisions. That is what this debate is about. Ul- trained and experienced to make those They want these decisions made by timately, we are going to have to de- decisions and the people who are im- health care providers and families and cide on the floor of the Senate and at pacted by them. That is what this leg- not by some bureaucrat or clerk with the end of Pennsylvania Avenue, hope- islation is about. no training and experience, sitting be- fully, if we can get this bill through To the extent that people suggest hind a desk somewhere, who has never the Senate and the House, whether we this is going to result, No. 1, in em- seen the patient. That is the difference are on the side of the big HMOs or ployers being sued, we will debate this between these two pieces of legislation. whether we are on the side of patients issue going forward. But it is very clear As to the issue of accountability, and doctors. in our legislation that we protect em- that means what happens if you have Earlier today I made reference to a ployers. It is equally clear that we gone through the internal appeal at the story of a man in North Carolina abide completely by the President’s HMO. The HMO denies care to a family. named Steven Grissom. He was a young principle on this issue. The President You go to the HMO and you attempt to man who developed leukemia. He be- said only employers who retain respon- appeal that. They deny it again. Then came sicker and sicker. He got to the sibility for and make final medical de- you go to a truly external independent point where his specialist at Duke Uni- cisions should be subject to suit. appeal, under our bill, and that is not versity Medical Center had to put him That is exactly what our bill does. successful. As a matter of last resort, on 24-hour-a-day oxygen. Our bill does exactly what the Presi- if, after all of that, the patient has This is Steve Grissom, the man I re- dent’s principle provides. On this issue been injured, the patient can go to ferred to earlier. of employers being protected from law- court. His wife’s employer HMO covered suits, we are in complete agreement The whole purpose of that is to treat Steve Grissom. Unfortunately, his with the White House. HMOs as every other health care pro- wife’s employer changed HMOs. Some As to the cost issue, the difference in vider, as every small business, as every clerk sitting behind a desk somewhere cost between our bill and Senator large business in America, as every in- who had never seen Steven and had FRIST’s bill—the bill that the White

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00048 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.112 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6435 House has endorsed—is 37 cents per em- going to see their rates reduced effec- have addressed the problem our friend, ployee per month. This is what they tive July 1. I think that is positive. the Senator from North Carolina, just contend is going to result in a massive That is a positive impact bill. This is a addressed. loss of insurance coverage, 37 cents a bill that will have a significant impact He said an individual, Steve Grissom, month. The difference between the on everybody who has health care. was denied health care. That was un- bills on taking the HMO to court—the A lot of people have health insur- fortunate. The bill we passed last year accountability provision—is 12 cents a ance. Then some people have health had internal-external appeals. That ex- month. Between 12 and 37 cents a care. There is a difference. A lot of peo- ternal appeal would have been quick. month is not going to cause people not ple are uninsured. That person would have had health to be insured. When we wrestle with the problem of care and would not have had to go to More importantly, we will give peo- health care, we need to address the court and would not have had to choose ple a better price. We give them real number of people who are uninsured, between State court and Federal court, quality health care. The reason that it and we need to reduce that number. By seen trial attorneys—would not have is 37 cents a month more for employees all means, we shouldn’t pass any legis- had to do any of that. They would have is because they get better care. They lation that is going to increase the had health care. They would have had get better access to clinical trials, bet- number of uninsured. an appeals process, and that appeals ter access to specialists, and better ac- Everybody realizes when we have process would have been binding. cess to emergency rooms. When the 42,500,000 uninsured people, that is too Somebody said: We need account- HMO does something wrong, they can many. I think Democrats and Repub- ability. We need enforceability. get that decision reversed by the inde- licans, conservatives and liberals, We had it binding where, if the plan pendent review panel. agree with that. We ought to be work- did not comply with the external ap- That is what this debate is about. ing to reduce the number of uninsured peal, they would be fined $10,000 a day. We have a decision to make over the as much as we possibly can. We prob- So I think in that case—and that is a course of the next few weeks. I hope for ably will never get it down to zero, but terrible case, where maybe somebody, unfortunately, was denied care—they the sake of the Steve Grissoms all over we ought to make some improvement. would have gotten the care; and they this country—many of whose stories But for crying out loud, let’s not pass would have gotten it quickly; and they have been told today and will continue legislation that will increase the num- would not have gone to court. They to be told on behalf of these families— ber of uninsured. would not have received the care in the that we will do what is necessary to Unfortunately, I believe that is what courtroom but would have received it make sure that HMOs and insurance would happen if we passed this so- by doctors. I agree. Let’s solve that companies in this country are treated called McCain-Edwards-Kennedy bill. I believe if we pass this bill in its problem. just as everybody else, and that fami- We were very close to an agreement present form, we are going to increase lies and doctors can make health care on internal-external appeals to resolve the number of uninsured, probably in decisions that affect their lives. 99 percent of these cases. That is not the millions. I wish that were not the I yield the floor. the case with the bill we have before case. I hope by the time we finish the Mr. NICKLES. Mr. President I sug- us. In the bill we have before us, I debate and amendment procedure in gest the absence of a quorum. would say, for the 128 million private- this Senate Chamber that will not be The PRESIDING OFFICER (Mr. sector Americans who are in private CORZINE). The clerk will call the roll. the case. I very much hope President health care, who receive their health The bill clerk proceeded to call the Bush can join with us and sign a bill care from their employer, look out, be- roll. and we can be shaking hands. I have cause there is legislation coming, with Mr. NICKLES. Mr. President, I ask mentioned this to Senator KENNEDY— a very good name, that makes the em- unanimous consent that the order for we have been adversaries on this issue ployer liable in almost all cases, not the quorum call be rescinded. for a couple years now—I hope we can just the HMOs, and it makes them lia- The PRESIDING OFFICER. Without be shaking hands and saying we have ble to the extent that a lot of employ- objection, it is so ordered. done a good job; we have protected pa- ers are going to be scared to offer their Mr. NICKLES. Mr. President, I rise tients, and we did it in a way that did employees health care. Some may opt to speak on the issue of the Patients’ not really increase costs very much, out. Bill of Rights. I love the title. It is a and maybe we did some things that In addition, it will increase costs so great title. I hope we can pass a posi- would increase the number of insured significantly that a whole lot of people tive and good Patients’ Bill of Rights— in the process, so that we did not do are going to say: Wait a minute, these one that really provides patient protec- any damage. costs are so high, I can’t afford it. My tions but doesn’t increase costs and We should do no harm. Congress employees didn’t appreciate how much doesn’t scare employers away. would be much better off not to pass money we were spending on health Unfortunately, I don’t think that is any bill than to pass a bill that greatly care. So I asked them, instead of me the case with the bill we are consid- increased the cost to people buying spending $5,000 or $6,000 a year per fam- ering today, S. 1052. health care and/or increasing the num- ily on health care—up to $7,000 now— I haven’t quite figured it out. Last ber of uninsured. would you prefer the money and you week, we were on the McCain-Edwards- Let’s say we want to pass a Patients’ can buy health care on your own? A lot Kennedy bill, S. 871. That was last Bill of Rights. Great. But let’s do no of employees will say: Yes, count me; I Wednesday. I was reviewing it and try- harm. Let’s not increase costs dramati- would like to have that money. Maybe ing to become more familiar with the cally. Let’s not increase the number of they will buy health care on their own, sections and what that bill meant to uninsured, especially if we are talking and maybe they won’t. employers, to people providing health about millions. And that is what we Unfortunately, a lot of employees care, to Federal employees, and so on. are talking about in the bill before us would not, so the number of uninsured Now we are considering a different bill, today. I wish that were not the case. would rise, and I believe rise dramati- S. 1052. It is important for us to know Let’s go through the bill. And I think cally. So employers would be scared as Senators because we are going to be we will have some time. We need some from the cost standpoint, and they voting on the legislation. This is one of time since we have not had any hear- would also be frightened because there a few bills. Every once in a while we ings on this bill. This bill has never would be unlimited liability. consider legislation that will have a been through a Senate markup. There has been some misrepresenta- significant impact on everybody’s In the last Congress, we did mark up tion by some, saying: This bill has caps lives. We did that when we passed the the Norwood-Dingell bill. We did not on liability. It does not have any caps tax cut package recently. That will pass Norwood-Dingell in the Senate. on noneconomic damages. There are all change everybody’s taxes. People are We passed a substitute bill on which kinds of damages. And this bill has new going to see tax refunds coming in the many of us worked. I thought it was a causes of action for Federal lawsuits. It mail in the next couple of months. I positive piece of legislation. I thought has new causes of action for State law- think that is very positive. People are it had a lot of good things. It would suits. It allows people to be able to

VerDate 19-JUN-2001 01:54 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00049 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.114 pfrm03 PsN: S19PT1 S6436 CONGRESSIONAL RECORD — SENATE June 19, 2001 jury shop: Let’s find a good jury in a cluded.’’ Great. That will make DON this is consistent with the Texas plan, good county. With one good jury, you NICKLES happy, and others happy. That and so on. I do not think that is factu- can become a billionaire nowadays. sounds pretty good. That is paragraph ally correct. So I wanted to mention Wow. A lot of employees would say: (A). that. Thank you very much, but I can’t af- Paragraph (B): ‘‘Certain Causes of I want to do a good bill. This does ford that exposure; I can’t afford that Action Permitted. Notwithstanding not fit the pattern. liability, the fact that one jury case, subparagraph (A), a cause of action What about a couple of other things? for something I had nothing to do with may arise against an employer or other Should the Federal Government take whatsoever, could put me into bank- plan sponsor. . . .’’ over what the States are doing in the ruptcy. So they might say: We are just Look out, employers. You had better regulation of health care? Some people going to opt out. We don’t have to pro- read paragraph (B). You are liable. Oh, obviously think we should. As a matter vide this benefit. there are a few little exemptions. If of fact, I look at the scope sections of Some people would like to mandate they do this, this, and this, they will the bill, and I am almost amused. We that employers provide health care, not be liable. But it does not cover ev- are going to have a preemption: State but that is not going to pass, and they erybody. I promise you, as an em- flexibility. It says, on page 122, ‘‘[noth- know that is not going to pass. ployer, if they complete their fiduciary ing shall] be construed to supersede So the net effect is, a lot of employ- responsibilities, they are liable. And any provision of State law which estab- ers will say: I don’t have to provide when employers find out they are lia- lishes, implements, or continues in ef- this benefit. I want to, but I can’t af- ble, they are going to be scared of this fect any standard or requirement sole- ford the exposure. bill and the results of this bill, and a ly relating to health [insurers]. . . .’’ I just met somebody today who owns lot of them will quit providing health Boy, that sounds good. I like that a restaurant. Actually, today, I met care for their employees. In other section. I don’t know if there is a bait- with two people who own a restaurant words, if we take legislative action, and-switch section in here or what, but each. I heard people say: Hey, you are maybe with very good intentions, there that sounds so good. That sounds like going to choose between the HMOs and may be very adverse results. something I would put in there. But it the people. I met with two people today They did that in the State of Cali- doesn’t stop there. It goes on. who each owns and operates a res- fornia on energy. They passed a bill Then it says, on the next couple pages: If the State law provides for at taurant. One owns a small restaurant that had a great title calling it a de- least substantially equivalent and ef- in Maryland. They said, if this bill regulation bill, but it had all kinds of fective patient protections to the pa- passes, because of the liability provi- regulations, and it had a lot of adverse tient protection requirements which sions, they probably won’t provide results. This bill, I am afraid, if we the law relates. In other words, we are health care for their employees. They passed it today, and it became law, not going to mess with the States un- just started providing health care for would have a lot of adverse results. less the States, of course, have to pro- their employees. Restaurants are the President Bush has said he would vide at least substantially equivalent type of business where not everybody veto this bill. And he is right in doing and effective patient protections as provides health care for their employ- so. And we have the votes to sustain this bill does. ees. that veto. Well, what does substantially equiva- All the major automobile manufac- Some people said: Why not pass this lent and effective mean? It means, turers provide health care for their em- bill as it is, let the President veto it, States, you need to do exactly what we ployees. They will probably continue to you sustain his veto, and, hey, you tell you to do. We are going to preempt do so because of collective bargaining have covered the subject? I do not everything you have. If you have an ER agreements. Interestingly, there is a think that is responsible legislating. provision, it has to match our ER pro- little section that exempts collective Maybe it would be the easy way out. vision, our emergency room provision. bargaining agreements. Whoops. I That way, we can just raise a few ob- If you have access to OB/GYN, you thought we were providing all these jections, vote no, and let him veto the have to match our access provision to protections for everybody. But there is bill. I do not think that is responsible. OB/GYN. And there is a lot of dif- a protection for organized labor here I think we need to review this bill. I ference. that kind of exempts the organized think every Senator should know what If you have clinical trials in your labor contracts for the duration of is in this bill. I will tell you, from the State, you have to match these clinical their contracts. So they might be ex- public comments I have heard, in some trials, which are enormously expensive empt for years. cases the sponsors of this bill may not clinical trials, which are covered by We will get into some of the loop- know what is in this legislation. anything that NIH would offer or any- holes left in this provision. But this So we need to consider what is in this thing by FDA or anything by DOD or small restaurant owner said: I don’t bill. We need to talk about it. We need anything by the VA. There are a lot of think I can afford the liability. I am to see if we can improve it. Hopefully, clinical trials. You have to pay for afraid of doing that. And this person— we can improve it to the degree that them. It may be the State of New Jer- female—operates her own business, we will have bipartisan support for a sey did pay for them or did not. which is family operated, I believe sec- solution with perhaps 80 sponsors of Under this bill, there is not one State ond generation, and they have had the the bill and have overwhelming sup- in the Union that meets the clinical business for 30-some-odd years, I be- port. I would love to see that happen. I trial provisions of this bill. Why? Be- lieve. It is not all that large. About will work to see that happen. I have in- cause they are very expensive provi- half her employees now have health vested a lot of time on this issue. I sions; because they are unknown provi- care. She said today, she does not want to pass a good bill. This bill does sions; because no one knows how much think she can continue providing not meet that definition. they would cost. And so the States health care if this bill passes. I heard a couple people say this bill is have been kind of cautious on putting I met with a restaurant owner who consistent with the principles the in clinical trial provisions. They have has a larger restaurant not too far President outlined. That is factually done it rather cautiously. The State of from here in Northern Virginia. This inaccurate. That is a gross misinter- Delaware is considering clinical trials person started providing health care pretation of the President’s principles. today, legislation on a patients’ bill of for their employees and said: No way, They were not written that fuzzily. I rights. They have a clinical trial provi- not with this liability. You would will outline in another speech what are sion, and it is not nearly as expensive make it impossible. the President’s principles and where as the one that is mandated in this bill. Wait a minute; employers are ex- this bill falls fatally short—not short The essence of this bill is, State, we empt. I heard that today. Oh, employ- in a gray area but fatally short. don’t care what you have negotiated. ers are exempt? Yes, there is a section I am just concerned that maybe some We don’t care how many hearings you in this bill exempting employers, on people are a little loose in their state- had. We don’t care if the legislature page 144: ‘‘Causes of Action Against ments, saying this is consistent with worked on this for months and nego- Employers and Plan Sponsors Pre- what the President wants, and so on, tiated it with the Governors and the

VerDate 19-JUN-2001 00:39 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00050 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.119 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6437 providers in your State. We don’t care HCFA, the Health Care Finance Ad- plans. We are going to mandate you do because we know what is best. One size ministration, couldn’t enforce that. all these things. We exempted Federal fits all. I guess two or three Senators There is no way in the world. There is employees. Whoops. decided they know what is best. They a list of patient protections that every You mean we are going to mandate know better than every single State in- State has done. In my State, it is 40 all State employees, all teacher plans. surance commission. They know better some; in most States it is 30, 40, 50 dif- We are going to mandate that all of than every State legislature. They ferent State protections. We are going those have to have what we have de- know better than every Governor, to say: We don’t care what you have cided big government knows best. Yet every person who is in the buying busi- done. Those aren’t good enough. We are for Federal employees, whoops, we ex- ness. We are going to mandate that going to basically say these protec- empted them. Organized labor, if they these have to be in your contract, in tions are preeminent. These will super- have a contract, we exempted them. your coverage. sede what your State has done. You Medicare, for we exempted them. Med- I accidently said the word ‘‘con- must do as we tell you to do. If you icaid, low-income individuals, whoops, tract.’’ Most of this is done by con- don’t, the Federal Government will these don’t apply to Medicaid. They tract. There is a provision in here that take over enforceability of those provi- don’t apply to Medicare. They don’t says you don’t have to abide by the sions. apply to Federal employees. They don’t contract. That is a heck of a deal. So Then you will have the awkward sit- apply to union members, until their when people try to have a contract, uation of having the Federal Govern- contract is renewed, maybe 5 years or here is what we will cover, here is what ment enforce some provisions in your so before that happens, if they have a we don’t cover, so you can have some health care contract but not all the long-term contract. kind of limitation on cost. provisions. That is really going to There are a lot of little gaps. If this There is a little provision in the bill make a lot of sense. Then there is is so good for the private sector, why that says the reviewer shall consider don’t we put it on the public sector? but ‘‘not be bound by the definition going to be this little period of time used by the plan or issuer of medically where the State has been enforcing Why don’t we put it on the Senate? A necessary and appropriate.’’ Not be these State regulations. Now we have a Senator or their family members, can bound—in other words, they can pro- new Federal regulation, and it is sup- they sue the Government? If they are vide anything they want to provide. It posed to be prevailing. But the State aggrieved, can you sue the Govern- doesn’t make any difference what is in regulation, we are used to enforcing it. ment? The answer is no. You still the contract. That is in this little bill. Which one do we abide by? They are can’t. Even if this bill passes, you can’t How do you get a cost estimate of not familiar with the Federal enforce- sue the Government. Everybody else how much this bill is going to cost? Be- ability. No one has ever enforced this can sue their employer. You can’t sue cause no one knows. The contracts one before. So should the State enforce yours. aren’t binding. Wow. There are a lot of the Federal regulation? They can’t do I wonder if cost has anything to do things in here. it. The HCFA person hasn’t signed off. with it. There are some things that Then I have heard people say: We are Therefore, HCFA is going to take over, just don’t fit. It is fine for us to do this going to make sure the States have and they don’t have anybody to enforce on all private sector plans, act as if provisions that are substantially equiv- it. that will only cost 37 cents a day. alent and as effective. Who is going to Now what you have is language say- Maybe they said a week. The cost of determine if something is as effective? ing you have these protections, but you health care right now for a family is We are going to have the Federal Gov- don’t have anybody to enforce it be- about $7,000. At 4.2 percent of $7,000, ernment. HCFA is going to review the cause HCFA can’t do it. They abso- figuring this up, you are talking about State standards. HCFA will determine lutely can’t do it. $300 a year. Some people say: That is whether or not you are substantially Somebody should ask the Secretary just cents; that is a dollar a week or equivalent and as effective. The only of Health and Human Services, do you something. It is not a dollar a week. It way you are going to get there with have the capability to regulate State is $300 a year. Maybe that is about a any certainty is to have identical lan- insurance to enforce these provisions dollar a day. That is about the equiva- guage. And then who is going to know that the McCain-Kennedy-Edwards bill lent of the tax cut that a lot of Ameri- whether or not it is as effective? That would do? The answer is no. No, they cans are going to receive this year. We is as subjective as it could possibly be. couldn’t do it. So we are going to have are just going to take it away. So we You have a standard that is higher a long list of protections that we sup- give a tax cut with one hand and we than HCFA. You have a standard high- posedly are telling everybody they take it away with higher health care er than anybody has ever imposed. It have: look what we have done for you, costs in the next by this bill? We can says: Here is everything we mandate. If but there is no enforceability because sure do that. you want Federal, nationally dictated the Federal Government doesn’t have Somebody said: I broke even for the health care, it is in this bill. Wow. I the wherewithal to do it. year. What if you are one of the 1 or 2 didn’t know we were taking over for And we shouldn’t do it. That is not million people who lost your health the State. I didn’t know we had the our responsibility. Yet we are going to care because your employer dropped it? people to do it. have that kind of takeover. I think You came out on the real bad end of Guess what. We don’t. There is no that would be a serious mistake as the deal. way in the world the Federal Govern- well. This didn’t cost you a dollar a day. ment has the resources in HCFA, the Then what about this comment: This didn’t cost you a Big Mac. This Health Care Finance Administration— Under this bill, we insure all Ameri- cost you your health care—probably to which now has a new name which I cans. Wow, sounds really good. We are a person who needs health care the can’t remember and won’t for the time really going to provide protections for most. A lot of people who are in that being—there is no way in the world all Americans. low-income bracket, maybe working they could do this. Every State has in- First, I should ask: Are we disabusing for a small restaurant in Montana, or surance commissioners or regulators Federal employees? Are we disabusing someplace, and maybe their employer that are in charge of making sure the our families, Senators’ families who just started to provide health care, or insurance companies in their State are are under the Federal employees health wants to provide it, and they could not adequately financed, meet their fidu- care plans? Do they have such a crum- do it because they could not afford it, ciary responsibilities, that they meet my deal that we need to change their or because they are afraid of the liabil- their insurance responsibilities, that plans? The truth is, we don’t change ity. they uphold what they say they are Federal employees. We change State The PRESIDING OFFICER. The time going to do in the contracts, every employees. I hope everybody knows of the Senator has expired. State. I would imagine in New Jersey, that we are going to go out and tell Mr. NICKLES. I ask unanimous con- it is hundreds of people—hundreds. I every Governor, every State insurance sent for an additional 5 minutes. am sure it is in the hundreds. My State commissioner: we are going to change The PRESIDING OFFICER. Without of Oklahoma is in the hundreds. your public employees’ health care objection, it is so ordered.

VerDate 19-JUN-2001 01:01 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00051 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.121 pfrm03 PsN: S19PT1 S6438 CONGRESSIONAL RECORD — SENATE June 19, 2001 Mr. NICKLES. My point is, let’s be The PRESIDING OFFICER (Ms. then have a full debate on these mat- very careful not to do damage to the STABENOW). The Senator from Massa- ters. There are some who wonder system, not to do damage to a quality chusetts is recognized. whether this is a bipartisan bill. I was health care system that is far from per- Mr. KENNEDY. Madam President, I listening to my friend and colleague fect. Let’s do some things to make sure see my friend from Nevada on the floor. from Oklahoma say he really wonders that we increase the number of people I wanted to make a few comments at whether this is a bipartisan bill. Well, who have insurance. Let’s not do any- the end of our first day of discussion. Congressman NORWOOD, Congressman thing that would increase the number Madam President, I just hope those GANSKE, and 63 Republican Members of of uninsured. That is doing a very seri- who are watching this debate have the House of Representatives certainly ous harm. If anybody says, hey, this some understanding about the history believe that it is a bipartisan bill. We bill has so much momentum, so let’s of this legislation and what it really is are certainly proud of the Republicans pass it regardless of what it costs or all about. This legislation was first in- who have supported this measure in what the consequences are, I beg to dif- troduced 5 years ago. So that is why we the Senate. I think that gives us hope. fer. It is worth spending a little bit of hear on the Senate floor that our col- I see the Senator from Nevada. time to try to be at least responsible in leagues are glad to consider the legisla- Mr. REID. I want to ask the Senator this area. Let’s not do damage. Let’s tion. We should be eager to consider a question when he has a minute. not supersede the States. Let’s not act this legislation because every day that Mr. KENNEDY. At the end of this as if the Federal Government knows we let go by there are more than 50,000 discussion today, we ought to realize best: Sorry States, we are going to people who are experiencing increased that virtually every single medical or- take over the regulation of your health suffering and injury. ganization—the American Medical As- care system because we know better. There are 35,000 people today who sociation, children’s health, women’s Every person here who works in this didn’t get the specialist they need in health, disability organizations, senior system for very long knows that we do order to help them mend and get bet- health organizations, and patient orga- not know better. We do a crummy job. ter. There are 12,000 patients who, to- nizations—is supporting this bipartisan HCFA does a crummy job in admin- night, will be taking prescription drugs proposal. There are but a handful of or- istering Medicare. They are way behind that were not what the doctor ordered, ganizations that support our oppo- even in enforcement and compliance but what the HMO is giving them. nents’ proposal, and virtually all of with the Health Insurance Portability There are countless illustrations these organizations have also endorsed Act. Some States still aren’t in compli- where the HMOs’ decisions are being our bill. I put that out as a challenge. ance. HCFA is supposed to take over made by bureaucrats and bean counters I hope those who are opposed to this bi- regulation of that act. If they haven’t in cities many miles away from the partisan proposal are going to at least done that, how in the world can they highly trained professional medical give us the credit for the very breadth do it for private care? They could not personnel who are trying to provide of support that comes to this proposal. do it. care. These health care professionals This comes from people who have stud- Let’s pass a positive bill. I stand are making decisions that are being ied this issue, worked this issue, and ready to work with my colleagues on countered by accountants and bean whose livelihood is affected by this both sides of the aisle to do that. I am counters who aim to enhance the bot- issue in terms of the type of care they willing to spend a lot of time to work tom line of the HMOs. can provide for families all across this out a real bipartisan bill, one that has The real issue, when it is all said and country. support by a majority of the Members done, is whether we are going to put So, Madam President, I look forward on both sides. To say that this is a bi- into law some rather minimum stand- to the debate. partisan bill when you have 3 Repub- ards that are already effective in Medi- Mr. REID. Will the Senator yield for licans sponsoring it and 40-some odd care and Medicaid. These fundamental a question? vigorously opposed to it is stretching standards have been recommended by Mr. KENNEDY. Yes. it. That is not bipartisan. Let’s have a the insurance commissioners, and Mr. REID. I have been interested in bipartisan bill where you have a major- unanimously by a bipartisan panel. the debate from the other side. Isn’t it ity of both Democrats and Republicans I have listened carefully to a number interesting that they are so concerned supporting the bill. That is real bipar- of the statements that have been made about the uninsured now with the Pa- tisan bill. Let’s get a bill that Presi- out here recently. I did not detect any tients’ Bill of Rights? As the Senator dent Bush will sign and become law, statements directly before the Senate from Massachusetts will recall, we not just have campaign rhetoric. Let’s that are critical of the proposal that tried to do something about the unin- make something happen that we can has been advanced here. Yet there has sured, and no one was too interested say we have passed a positive bill. I been an objection made. I haven’t then. hope we can do so. It remains to be heard them say: let us not have that Mr. KENNEDY. That is right. seen. protection for the people, or let’s not Mr. REID. In fact, it has gone up There is going to have to be some give them the emergency care protec- since then. willingness to compromise. Some peo- tion, let’s not give them the specialty I also ask the Senator if he recog- ple say we have compromised enough. protection, let’s not give them the clin- nizes that one of the things they are This bill is not a compromise. This bill ical trials in there. Did anybody hear saying is HCFA is understaffed and is to the left of the Norwood-Dingell that during the course of the after- would not be able to handle the new bill that we had last year. It is more noon? I did not hear that. duties given to them by this legisla- expensive than that bill. The liability That is what this is about. That is tion. Who has been cutting back their provisions are more intrusive and ex- what this is about. As we all know, budget all these years, strangling these pensive than the bill Congressmen NOR- people try to make the best case they organizations so they cannot render WOOD and DINGELL and Senator KEN- can in opposition. And at the end of appropriate care to the constituency NEDY were pushing last year. It is not a this first day, I find I am very much they are delegated to serve? compromise. It is a move in the wrong encouraged by the range of speakers Has the Senator heard them com- direction. who have spoken in favor of this legis- plaining about understaffing? Let’s move toward the center. I have lation. I think there is increasing un- Mr. KENNEDY. The answer is yes, shown a willingness—maybe more than derstanding by the American people, as not only have I heard it, but I remem- I should have—to compromise and try in the debate here in the Senate, about ber debating with my good friend from to come up with a positive bill. Let’s the importance of this legislation. Oklahoma on the increase for HCFA, work together as both Democrats and We know the HMOs are spending mil- which was recommended by the Gen- Republicans to come up with a bill that lions of dollars on distortion and mis- eral Accounting Office—that there we can all be proud of, that President representation. They ought to be would be an $11 million increase for Bush can sign, and one that can be- spending that on patients’ care, but HCFA to administer. He opposed that. come law. they are not. We welcome the oppor- He fought it tooth and nail. So they did I yield the floor. tunity to get to the bill before us and not get the additional support. And

VerDate 19-JUN-2001 01:01 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00052 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.124 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6439 then they complain when they are in- tects children, women, and families. It eral courts, and those will be limited to adequately staffed to do the job. is about doctors, nurses, and families contract cases. Thankfully, $2 million came out of making decisions that will not be over- The Senator is quite correct that we the committee, even though we were ridden by bureaucrats and HMOs. That are relying upon the State system of unable to get anything on the floor. I is what this legislation is about. justice, and that is the way it ought to said this to my friend, Senator NICK- We welcome the chance finally, fi- be in this case. Senator MCCAIN, Sen- LES, so I do not mind mentioning it nally, finally, to have it before the ator EDWARDS, and others involved in here in his absence because—he is here Senate. We look forward to the amend- the development of that proposal found now. He remembers his battle against ments to begin. a good solution to it. giving additional funding to HCFA to I suggest the absence of a quorum. Mr. REID. Our majority leader is in implement the Kassebaum-Kennedy Mr. REID. Will the Senator withhold the Chamber now, and I want to make bill, and he took great relish in that for a minute? While the Senator is a brief statement and see if the Sen- opposition. The Senator from Nevada here, I want to ask him another ques- ator will agree with me. has pointed that out. tion. We talked about the uninsured, We heard this harangue that this is I agree HCFA is a challenge because and we heard the other side talk about legislation that deals with lawyers. we have given them a great deal of ad- the shortage of staff. We have heard The fact is, as to the two States where ditional responsibility in recent times. now a new one that has been going on there is a Patients’ Bill of Rights, in 1 We have given them the CHIP program all afternoon on the other side about State there has been no litigation which is working in the States. They States rights—how are the Governors whatsoever; in the State of Texas, are doing a good job. They have Kasse- going to put up with this terrible bill? where the President is from, in 4 years baum-Kennedy, which is the port- I say to my friend from Massachu- there have been 17 lawsuits filed. That ability legislation to help those who setts, isn’t it interesting that no mat- is about four a year. That does not are disabled move around through jobs ter what happens, there are always ex- sound outrageous to me. Does it to the and not be discriminated against. cuses that we cannot pass a Patients’ Senator from Massachusetts? I am reminded by my staff that the Bill of Rights? This has been going on Mr. KENNEDY. The Senator is cor- latest GAO report shows HCFA is doing for 5 years. We now have a bipartisan rect, and I will end with this note. We a good job, and virtually every State is piece of legislation. I acknowledge the can speculate and theorize, but under effectively administering the Mothers first legislation that came out was par- these circumstances we ought to look and Infants Protection Act and the tisan, just the Democrats authored it, at the record. We have 50 million Women’s Cancer Act, which have been even though some Republicans sup- Americans who have protections like additional responsibilities for HCFA. ported it. Now we have bipartisan leg- what we are trying to provide for 170 They are doing a good job with that as islation. Senators MCCAIN, KENNEDY, million additional Americans in the li- well. and EDWARDS have written this legisla- ability provisions. Those who have pro- I know it is easy to have whipping tion. They are the chief sponsors of it. tections are State and local employees boys around here. HCFA is out there. But now it is still not good enough. and individuals who purchase insur- We all can probably find instances in Have we not heard in the 5 years we ance. They have the right to sue. There our own States where we wish they had have already spent on this legislation is absolutely no evidence that there made other decisions. That certainly about States rights? I ask the Senator has been a proliferation of lawsuits. should not be used as an excuse in op- from Massachusetts, do you not think There has not been any kind of abuse position to this legislation. we resolve these States rights problems of the system, although those who are Mr. NICKLES. Will the Senator yield with this legislation? opposed to our legislation have alleged for a question? Mr. KENNEDY. The Senator is ex- that. Mr. KENNEDY. Yes. actly correct. Under the proposal be- Secondly, there is absolutely no evi- Mr. NICKLES. Did I understand my fore us, if there is substantial compli- dence that the costs for these various friend and colleague to say the State of ance, then the State provisions will policies are in any way more costly Massachusetts now complies with the rule the responsibility and liability than those without the liability provi- Health Insurance Portability Act? provisions. That is why I was so inter- sions. Mr. KENNEDY. Not completely. ested in what the Senator from Okla- I yield the floor. What the State of Massachusetts com- homa said about not being able to de- The PRESIDING OFFICER. The ma- plies with is the CHIP program. Massa- cide this in Washington, DC, because it jority leader. chusetts is the No. 1 State in the Union is one size does not fit all; we have all Mr. DASCHLE. Madam President, as with the lowest number of uninsured learned that. I indicated earlier today, Senator LOTT children. We have done an outstanding That is not, of course, what this leg- and I and others have been discussing job with that. We still have work to do islation does. It lets the States make the manner under which we might be in other areas, such as HIPAA. Rather the judgments about liability. able to proceed to the bill. Earlier than take the spirit of the legislation I am very interested in the fact there today, the unanimous consent request that Senator Kassebaum believed to be are a number of Senators on the other to proceed to the bill was not agreed the case—I had serious doubts about side who do not want to permit their to. We have been discussing the matter it—which was that there would not be States to make the judgments with re- throughout the day. I think I am now a significant increase in premiums—we gard to liability issues. That is where prepared to propound a unanimous con- find a number of States, with the sup- the liability and negligence issues have sent agreement that reflects an under- port of the insurance industry, have been decided for over 200 years. The standing about the way we might pro- raised rates so high as to undermine States have the knowledge about these ceed later this week. the effectiveness of the program. issues, and transferring responsibility I ask unanimous consent that at 9:30 Mr. NICKLES. So the State of Massa- into the Federal system does not make on Thursday, June 21, the Senate vote chusetts still does not comply with the a lot of sense. There are long delays, on a motion to proceed to S. 1052, the Health Insurance Portability Act we more distance, and it is more costly to Patients’ Bill of Rights, and that the passed several years ago? the patients. time between the completion of that Mr. KENNEDY. Parts of it they do; We will have a full opportunity to de- vote and 12 noon be equally divided be- not all of it, I say to the Senator. bate those issues. I look forward to tween the two leaders or their des- Mr. NICKLES. I was just wondering. that debate. ignees for debate only, and that at 12 Mr. KENNEDY. That is fine. I am not The Senator is quite correct, we have noon the Republican manager or his going to get into whether the Repub- in this legislation, in the liability pro- designee be recognized to offer an lican Governors in my State were in visions, shown very special deference, amendment. opposition to enforcing it. That is not as has been stated during the course of The PRESIDING OFFICER. Without relevant here tonight. the day. Effectively 90 percent of these objection, it is so ordered. The point is, Mr. President, this leg- cases will be tried in State courts. Only Mr. DASCHLE. Madam President, it islation we have before us tonight pro- 10 percent will actually be tried in Fed- is my intention, then, to stay on the

VerDate 19-JUN-2001 01:01 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00053 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.126 pfrm03 PsN: S19PT1 S6440 CONGRESSIONAL RECORD — SENATE June 19, 2001 motion to proceed until the 9:30 time Mr. DASCHLE. We certainly PRESIDENT BUSH RECOGNIZES LT. that we have now just agreed to on wouldn’t have any votes scheduled COL. BILL HOLMBERG AS AN Thursday. Should there be any interest after around 1 o’clock on Friday. AMERICAN HERO in accelerating that, we would cer- Mr. NICKLES. To further clarify, I Mr. DASCHLE. Mr. President, I want tainly entertain it. However, at least heard the intention that you would to call my colleagues’ attention to a now we know we will have a vote at like to have this completed by the specific passage in President Bush’s 9:30, and that our Republican col- Fourth of July, but correct me if I am commencement address at the U.S. leagues will be recognized to offer their wrong. We spent a little over 2 weeks Naval Academy last month that was first amendment at noon on Thursday. on the education bill just on the mo- particularly meaningful to me. In that I appreciate very much the willing- tion to proceed. I believe on the edu- reference, the President paid tribute to ness of Senator NICKLES and certainly cation bill in total we spent 6 or 7 the heroism of a longtime friend of the Republican leader and others who weeks, and the education bill is a very mine, retired Marine Corps Lt. Colonel have been discussing this matter with important bill. Likewise, this is a very William C. Holmberg, class of ’51. me for the last couple of hours. important bill. And this bill, like the I would like to quote from the Presi- Mr. REID. Could I ask the majority education bill, in my opinion, needs to dent’s speech: leader a question? be amply reviewed. But there are many others from the Class Mr. DASCHLE. Yes. of ’51 whose stories are lesser known, such as Mr. REID. In that we will start this I don’t know the period of time, but retired Lieutenant Colonel William C. debate this coming Thursday, is it still at least it is this Senator’s intention Holmberg. One year and a handful of days the intention of the leader to finish we thoroughly consider what is in the after graduation, Second Lieutenant this bill before we take the Fourth of language and how it can be improved. Holmberg found himself on the Korean pe- ninsula, faced with a daunting task: to infil- July recess. Some Members want to have signifi- cant changes so the bill can be signed. trate his platoon deep behind enemy lines in Mr. DASCHLE. There are two mat- an area swarming with patrol; to rout a te- ters I think it is imperative we finish. I am not sure if that can be done or nacious enemy; to seize and hold their posi- This is the first of the two, I answer completed in the time anticipated or tion. And that’s what he did. And that’s my colleague, the assistant Democratic hoped for. I appreciate the dilemma the what his platoon did. leader; and the other is the supple- majority leader is in and his desire to Along the way, they came under heavy fire mental. I think 2 good weeks of debate conclude it a week from Thursday or and engaged in fierce hand-to-hand combat. Despite severe wounds, Lieutenant Holmberg on this issue is certainly warranted. Friday, but I am not sure that is ob- tainable. We will see where we are next refused to be evacuated, and continued to de- We have had a debate on this matter liver orders and direct the offensive until the in previous Congresses. I think we week. mission was accomplished. should be prepared to work late into Mr. DASCHLE. I agree. I don’t know And that’s why he wears the Navy Cross. the night Thursday night. We will be whether it is attainable or not. But I And today, his deeds, and the deeds of other here on Friday. We will be in session on do know this: We will continue to have heros from that class, echo down through the Friday, with amendments and votes. ages to you. You can’t dictate the values votes into the recess period to accom- that make you a hero. You can’t buy them, We will stay on the bill throughout modate the completion of this bill. but you can foster them. next week. As I say, we will hopefully My concern is, very frankly, we will I commend the President for his rec- set at least a desirable time for final come back after the Fourth of July re- ognition of this very special American. consideration Thursday of next week. cess—and I have talked to Senator I have known Bill Holmberg ever since Should we need Friday, we can cer- LOTT about this—with the realization I came to Washington as a freshman tainly accommodate that particular we have 13 appropriations bills to do Congressman more than 20 years ago. I schedule, and if we need to go longer and a recognition that we have a very know Bill not as a war hero, but as an into the weekend to do it, my intention short period of time within which to do indefatigable champion of the environ- is to stay here until we complete our them. I know the administration wants ment and as a visionary who under- work. to finish these appropriations bills and stood the potential of renewable fuels So, yes, I emphasize, as I have the Senator LOTT has indicated he, too, is for improving air quality and reducing last couple of days, that the Senate concerned about the degree to which our dependence on imported oil long will complete this work, and hopefully we will be able to adequately address before they were accepted as a viable the supplemental prior to the time we all of the many complexities of these alternative to fossil fuels. leave for the July recess. bills as they are presented to the Sen- Bill is a true American hero who Mr. REID. We will work this Friday ate. stands as a model for us all. His selfless with votes, no votes on Monday, but we commitment to making the world a I want to leave as much time as pos- will work on Monday. better place to live has been dem- sible during that July block for the ap- Mr. DASCHLE. Correct. onstrated not only on distant battle- propriations process to work its will, Mr. NICKLES. I heard the leader say fields, but also by his daily pursuit of a and it is for that reason, in particular, we would be working on the legisla- more secure, environmentally sustain- that I want to complete our work on tion, considering amendments on Fri- able and just society. this bill so we can accommodate that day. Did the leader clarify whether or I join with President Bush in salut- schedule. not there will be votes on Friday? ing Lt. Colonel William C. Holmberg, a Mr. DASCHLE. There will probably Again, I appreciate the desire of the sustainable American hero. be votes on Friday but no votes on Senator from Oklahoma to vet this and f Monday. to debate it. I hope we can find a way Mr. NICKLES. I thought I understood to resolve it prior to the time we reach THE EXECUTION OF JUAN RAUL the majority leader to say we would the end of next week. GARZA hold votes ordered on Friday to Tues- There will, therefore, be no votes Mr. FEINGOLD. Mr. President, I rise day. today. to speak on the Federal Government’s Mr. DASCHLE. If I misspoke, I apolo- execution today of Juan Raul Garza. gize. I intended to say, if I didn’t say, I suggest the absence of a quorum. This is a sad day for our Federal we would have votes and amendments The PRESIDING OFFICER. The criminal justice system. The principle offered on Friday but that there clerk will call the roll. of equal justice under law was dealt a wouldn’t be any votes on Monday, but The assistant legislative clerk pro- severe blow. The American people’s there would be amendments considered ceeded to call the roll. reason for confidence in our Federal and hopefully we can make some ar- criminal justice system was dimin- rangement to consider these votes as Mr. REID. Mr. President, I ask unan- ished. And the credibility and integrity early on Tuesday morning as possible. imous consent that the order for the of the U.S. Department of Justice was Mr. NICKLES. Does the leader have quorum call be dispensed with. depreciated. any indication how late we will vote on The PRESIDING OFFICER. Without President Bush and Attorney General Friday? objection, it is so ordered. Ashcroft failed to heed the calls for

VerDate 19-JUN-2001 01:01 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00054 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.128 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6441 fairness. Instead, the Government put The Justice Department now ac- THE TALIBAN IN AFGHANISTAN Juan Garza to death. knowledges that it has not conducted a Mr. SANTORUM. Mr. President, I Now, no one questions that Juan complete review and that more study is rise to discuss the critical situation Garza is guilty of three drug-related needed. Before the Department com- concerning the Taliban in Afghanistan. murders. And no one questions that the pletes that thorough review, and before The seriousness of the Taliban’s gross Government should have punished him it finishes that study, the Federal Gov- injustices is alarming. This movement severely for those crimes. ernment should not execute one more continues to make outrageous demands But serious geographic and racial dis- person. on religious minorities, women, and parities exist in the Federal Govern- I once again call on the President to the relief workers trying to alleviate ment’s system of deciding who lives implement a moratorium on execu- the suffering of the Afghan people. and who dies. The government has tions by the Federal Government. I call With impunity, the Taliban has largely failed to address those disparities. And for it in the name of the credibility and ignored international condemnation, President Bush and Attorney General integrity of the Department. I call for becoming increasingly fanatical and Ashcroft failed to recognize the funda- it in the name of justice. And I call for strict. mental unfairness of proceeding with it in the name of equal justice under I am cosponsoring a bill with Sen- executions when the Government has law. ators BROWNBACK and BOXER which not yet answered those questions. No, Mr. THURMOND. Mr. President, I condemns the Taliban for its harsh de- the government put Juan Garza to rise today to discuss the Federal execu- mands on Muslims, Hindus, women, death. tion that was carried out earlier today. and religious minorities. The legisla- Today, most of those who wait on the I believe that the Justice Depart- tion strongly urges the Taliban to re- Federal Government’s death row come ment did what was right today when it open United Nations offices and hos- from just three States: Texas, Mis- carried out the death penalty against pitals so that the people of Afghanistan souri, and Virginia. And 89 percent of drug kingpin and murderer Juan Raul may receive necessary relief. I encour- those who wait on the Federal Govern- Garza. age my colleagues to consider cospon- ment’s death row are people of color. Steadfast death penalty opponents soring this legislation. But President Bush and Attorney Gen- have tried to use Mr. Garza’s case to Hindus and all other religious mi- eral Ashcroft failed to recognize the justify a moratorium on the death pen- norities have been ordered to distin- fundamental unfairness of executing alty. It is puzzling why they would be- guish themselves from Muslims by Juan Garza, a Hispanic man from cause his case in no way supports their wearing yellow badges. This decree is reminiscent of the Nazis forcing the Texas, before the Government had an- arguments about innocence and racial Jews to wear the yellow star of David. swered why those disparities exist. disparity in the administration of the It is shocking that the Taliban would On December 7, President Clinton death penalty. stayed the execution of Juan Garza ‘‘to order this kind of religious branding. First, Mr. Garza was clearly guilty. allow the Justice Department time to Furthermore, Muslims and non-Mus- He was convicted of murdering three gather and properly analyze more in- lims are prohibited from living to- people, one of who he shot in the back formation about racial and geographic gether, and religious minorities are not of the head, and he was tied to five disparities in the federal death penalty permitted to construct new places of other killings. Even his lawyers are not system.’’ That day, President Clinton worship. The fanatic Taliban religious claiming innocence. said, ‘‘I have . . . concluded that the ex- police invoke terror on city streets, amination of possible racial and re- Second, there was no evidence that sometimes whipping those who are not gional bias should be completed before his race had anything to do with him attending mosques at designated times. the United States goes forward with an receiving the death penalty. The judge This kind of religious intolerance is execution in a case that may implicate and the main prosecutor in his case abominable and should not be allowed. the very questions raised by the Jus- were Hispanic, as were all of his vic- The Taliban’s iron grip on Afghani- tice Department’s continuing study. In tims except one. The majority of the stan not only affects religious prac- this area there is no room for error.’’ jurors had hispanic surnames, and all tices, it is further devastating the suf- But today, the thorough study that the jurors certified that race was not fering Afghan people by obstructing re- President Clinton and Attorney Gen- involved in their decision. lief efforts by the United Nations and eral Reno ordered is nowhere near com- Moreover, there were six death-eligi- other humanitarian organizations. The pletion. Even so, the Government put ble cases in this district, the Southern United Nations World Food Program Juan Garza to death. District of Texas, all involving His- believes it may be forced to close It now appears that, until recently, panic defendants. Yet, Mr. Garza’s was around 130 bakeries in Afghanistan’s this administration’s Justice Depart- the only case for which the local U.S. capital city if the Taliban will not ment had no plans to proceed with this Attorney recommended the death pen- allow women to help address the needs thorough study. We now see that, on alty, and the only one for which it was of the hungry. Without the aid of both June 6, the Justice Department re- sought. men and women, program leaders can- leased a report that contained no new Mr. Garza was convicted under a law not maintain the bread distribution analysis but nonetheless reached the that Congress passed in 1988, which re- program. Also in the capital, a 40-bed conclusions that they wanted to reach. instated the death penalty and directed surgical hospital was forced to close its Yes, after I called for a hearing and it at ruthless drug kingpins like Mr. doors. Sixteen international staff demanded that the thorough study re- Garza who commit murder as part of members escaped to Pakistan because sume, the Justice Department did their drug trafficking. By following there were genuine concerns about agree to renew its thorough examina- through with the death penalty in ap- their safety. This is not the first time tion of racial and geographic dispari- propriate cases such as this, the Attor- foreign staff have had to flee. Several ties in the Federal death penalty sys- ney General is simply enforcing the U.N. workers have even been arrested, tem. But even so, the Government put laws he has a duty to uphold. a gross violation of a previous agree- Juan Garza to death. Mr. Garza was treated fairly and had ment between the Taliban and the U.N. Experts at that hearing of the Judici- full access to the extensive protections that relief workers would be protected. ary Subcommittee on the Constitution of the criminal justice system. This The Taliban is compromising both the testified that the facts did not support execution is not a case study in injus- safety of international relief workers the conclusions that the Justice De- tice. It is a case study in how the sys- and the well-being of the Afghan people partment reached in its June 6 report. tem works properly. with their harsh and unreasonable poli- Experts testified that more informa- I agree that continued study of the cies. tion is needed before the Justice De- death penalty is worthwhile, but stud- The injustice meted out by the partment could credibly conclude that ies should not be used as an excuse to Taliban is sobering and demands con- racial bias is absent from the Federal place a moratorium on the death pen- tinued attention. That is why I am co- death penalty system. But even so, the alty while opponents endlessly search sponsoring S. Con. Res. 42 with Sen- Government put Juan Garza to death. for flaws in the system. ators BROWNBACK and Boxer, and it is

VerDate 19-JUN-2001 01:01 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00055 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.059 pfrm03 PsN: S19PT1 S6442 CONGRESSIONAL RECORD — SENATE June 19, 2001 my fervent wish that the suffering en- tion’s armed forces at one of the high- Local Law Enforcement Act of 2001 dured by all the Afghan people and est rates in our country. would add new categories to current international workers be quickly re- Thousands of Puerto Ricans have lost hate crimes legislation sending a sig- lieved. their lives in service of their country nal that violence of any kind is unac- f during all the wars of the 20th century. ceptable in our society. We need the good training to protect I would like to describe a terrible THE ADMINISTRATION’S DECISION all our troops, many of whom are Puer- crime that occurred June 2, 1999 in OF VIEQUES BOMBING RUNS to Rican. West Palm Beach, FL. Two teenagers Mrs. CLINTON. Mr. President, last So this is not a matter in which the admitted they beat a homosexual man week, the administration made head- people of Vieques or Puerto Rico to death last year, alleging the attack lines when it said it would stop the should be pitted against the interests was provoked when the 118-pound vic- bombing in Vieques. of national security. We are all Ameri- tim called one of the young men ‘‘beau- But is that really true? Let’s look at cans. We are all on the same team and tiful.’’ the fine print. we want the same thing: the best I believe that government’s first duty First, the administration did not trained armed forces in the world. is to defend its citizens, to defend them commit to stopping the bombing im- And so, I agree with President Bush against the harms that come out of mediately and permanently, as so when he says the ‘‘Navy will find an- hate. The Local Law Enforcement En- many of us have called for. In fact, the other place to practice.’’ I agree with hancement Act of 2001 is now a symbol bombing runs continue this week. Secretary Powell when he says, ‘‘Let’s that can become substance. I believe Second, the administration said it find alternative ways of making sure that by passing this legislation, we can would stop the bombing by May 1, 2003. that our troops are ready . . . using change hearts and minds as well. But is that really something new? technology, using simulators and also f Let’s look at the date by which the finding a place to conduct live fire.’’ bombing would stop under the current But here’s the bottom line: Under THE DR. MARTIN LUTHER KING agreement and existing law, which pro- current law, if the people of Vieques JR. COMMEMORATIVE COIN ACT vides for an end to the bombing if the vote in November to end the bombing OF 2001 people vote for it. The current agree- by May 1, 2003, the bombing must end Mr. CORZINE. Mr. President, I rise ment and existing law call for an end by that date. Pure and simple. How- today in support of S. 355, a bill requir- to the bombing by May 1, 2003—the ever, under the administration’s plan, ing the Secretary of the Treasury to very same date. there will be no referendum. And there- mint coins in commemoration of the In other words, the administration is fore, there will be no mandate and no contributions to our nation of the Rev. saying nothing more than what current requirement to end the bombing by Dr. Martin Luther King, Jr. The Dr. law mandates if the people of Vieques 2003. Only a policy to do so. And that Martin Luther King Jr. Commemora- vote to stop the bombing. policy could be altered by the Presi- tive Coin Act of 2001, S. 355, was intro- If that is all the administration an- dent anytime between now and 2003. duced by Senator MARY LANDRIEU on nounced—that the bombing would stop In fact, Secretary Rumsfeld has al- February 15. by the same date provided for under ready said that the Navy might stay on As we approach the 40th anniversary current law—then this flurry of atten- Vieques for another, and I quote, ‘‘two, of Dr. king’s ‘‘I have a dream’’ speech, tion would be little more than an over- three, four years’’ until it can arrange we remember that Dr. King was a man blown story about this President’s de- ‘‘the training that’s needed in other larger than life who had an extraor- sire to abide by the letter and spirit of ways.’’ Defense Department officials dinary impact not only on the civil the agreement entered into between were also quick to point out that while rights movement, but also on the his- the Federal Government and the rep- the President said that the Navy would tory of America. He was living proof resentatives of the people of Vieques find another place to practice within that non-violence can change the and Puerto Rico. ‘‘a reasonable period of time’’ he never world. But that is not all the administra- defined ‘‘reasonable.’’ In the last session of Congress, this tion announced. It also announced that Secretary England said he wanted to measure was introduced in both the it wanted to stop the November ref- ‘‘have us control our destiny,’’ mean- House and Senate, but no action was erendum. The devil is in the details, ing the Navy, as opposed to allowing taken on the floor. My constituents, they say. Well, this is one powerful what he called ‘‘this level of emotion’’ however, concerned themselves with devil of an idea that has not received distract ‘‘our attention from the real the issues and the Borough Council of the scrutiny it deserves. issue.’’ Fair Lawn, NJ, passed Resolution 315– For what the administration is really In other words, the will of the people 2000 urging that the measure be adopt- attempting to do is to undermine the of Vieques is an ‘‘emotion’’ that must ed and the commemorative coins be au- intent of the law and subvert the will be put aside, and the people of Vieques thorized for the year 2003. of the people of Vieques. should not control their destiny—the David L. Ganz, the Mayor of the Bor- The administration says that a ref- Navy should. ough of Fair Lawn is a former member erendum is unnecessary, because it al- I believe that is the wrong way to of the Citizens Commemorative Coin ready plans to end the bombing by 2003. deal with this very important issue. I Advisory Committee, a long-time advo- I say a referendum is more important believe we should work toward a solu- cate of using commemorative coins than ever, because without an electoral tion to this problem without circum- properly, and an avid coin collector. In mandate to require an end to the venting the law of the land, without an article appearing in COINage maga- bombing, any administration expres- abrogating an agreement, without ob- zine, a monthly trade publication, in sion of intent is nothing more than viating the will of the American citi- the July 2001 issue, Mr. Ganz argues that: an expression of intent. Not a zens of Vieques. that ‘‘the accomplishments of Dr. Mar- legal requirement. And ‘‘intentions’’ I will stand up against any effort to tin Luther King, Jr. transcend the can change at a moment’s notice. shut down the referendum in Vieques. work of presidents and academicians I wholeheartedly support all efforts Let the votes be cast. Let them be and cut across cultural lines. His life’s to find a viable alternative site to train counted. And let the voice of the people work ultimately affected the fabric of our naval forces. We need such train- be heard and respected. American society . . . worthy of the ing, to protect our national interest f Nobel Peace Prize in 1904 . . . [and lead- and to protect our troops. And we must ing to] social justice for a whole class work hard to find places and ways to LOCAL LAW ENFORCEMENT ACT of citizens and a generation of Ameri- provide such a vital element of our de- OF 2001 cans.’’ fense. Mr. SMITH of Oregon. Mr. President, This is a remarkable opportunity to As I have said before, the people of I rise today to speak about hate crimes honor a remarkable man, and I urge Puerto Rico are great patriots; its sons legislation I introduced with Senator the Banking Committee, and ulti- and daughters volunteer for our Na- KENNEDY in March of this year. The mately this body, to promptly enact

VerDate 19-JUN-2001 02:03 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00056 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.042 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6443 this legislation into law and authorize long-held in this country; and that is, According to the Senate Budget Com- this distinctive tribute to a distinctive local control of our schools. I am con- mittee, ESEA spending totaled $17.6 American. cerned that this bill will put us on a billion in fiscal year 2001. That same f fast-track towards thoroughly federal- year, we spent over $6.3 billion on spe- izing education. cial education. That’s a total of $23.9 BETTER EDUCATION FOR As it has been said before on the floor billion of Federal funds for kinder- STUDENTS AND TEACHERS ACT of the Senate, one size does not fit all garten through grade 12. It also rep- Mr. VOINOVICH. Mr. President, if when it comes to education. Different resents a 21 percent increase over fiscal there is one thing that the Senate can districts have different requirements, year 2000. agree on wholeheartedly, it is that we, with the needs of rural areas differing S. 1 as reported authorized $27.7 bil- as a Nation, need to invest in our chil- from the needs of our cities. And that lion for ESEA alone for fiscal year 2002. dren’s educational future. There is no has been the guiding force in American Since the beginning of the debate on other issue that hits closer to home for education for over 200 years. the floor of the Senate until its passage America’s families. But some of my colleagues think the on June 14th, a period of some 7 weeks, But, even as we recognize the impor- Congress is the national school board. the Senate added an additional $11.1 tance of education, we must realize Well, we are not the national school billion in education spending for fiscal that close to home is where education board here in this Congress! year 2002. works best in America, and simply With the expansion of education pro- That’s a total of $38.8 billion and, as spending more and more Federal dol- grams that the Federal Government I said earlier, a 62 percent increase in lars on more and more Federal ‘‘one would undertake in this bill, I have a just one year! size fits all’’ education directives will genuine concern that in ten or fifteen Over the life of the bill, these amend- not, by itself, make our education sys- years, Washington will be dictating ments add $211 billion to ESEA for a tem perform better. what is happening in every schoolhouse total of $416 billion. That is an increase S. 1, the Better Education for Stu- across the nation. of 101 percent over seven years. dents and Teachers Act, that the Sen- Indeed, in spite of the limited ex- When you consider that the House ate passed last Thursday contains sev- penditure of Federal funds for edu- and Senate agreed to a budget resolu- eral provisions that I favor. cation, this bill stipulates that every tion that included a modest increase in The bill contains a modest pilot school district in America will test Federal spending over last year’s budg- ‘‘Straight A’s’’ provision that will help their students from grades 3 through 8. et of approximately 5 percent, it’s obvi- This testing will occur regardless of us build on the Education Flexibility ous that if we are to fund ESEA with a how well students are performing in Partnership Act that I worked to help 62 percent increase, many legitimate their particular school districts, and pass in the 106th Congress to allow functions that are the true responsi- despite the fact that most of our states States to consolidate Federal edu- bility of the federal government will have mechanisms already in place that cation programs to meet State and not be met. Otherwise, we will not be test students’ educational perform- able to live within the parameters of local needs. ances. It also contains an amendment that I the FY 2002 budget resolution. For instance, just last week in my I am concerned that a number of my sponsored, that will provide loan for- state of Ohio, Governor Taft signed colleagues may have voted for many of giveness to Head Start teachers in ef- into law a bill to revamp the State’s the amendments to S. 1, as well as the fort to encourage teachers to go into testing program. final version of the bill—even with its early childhood education. Governors, legislators, school boards, expensive price tag—believing that the Further, S. 1 expands local flexibility parents and most of all, teachers, all Appropriations Committee will not and control by block-granting funds, understand how onerous additional fed- fully-fund each and every authorized consolidating some programs, and in- erally mandated testing provisions program. cludes another amendment that I spon- truly are. In my view, we should only vote to sored to allow local districts to spend I can assure you that there are many authorize what we are actually willing Title II funds, if they desire, on pupil teachers in Ohio who are going to be to appropriate. services personnel. saying, ‘‘here we go again.’’ That’s because, I am very sure that However, taken as a whole, S. 1 is fis- In addition, there are other provi- there will be tremendous pressure on cally irresponsible and violates my sions in this legislation that usurp the the appropriators to fully-fund the pro- deeply held principles of federalism. authority of states and local school grams included in this bill. And, at 62 Over the course of my 35 years of districts in their ability to make deci- percent over last year’s level, the pro- public service to the people of Ohio, I sions that will affect their students. grams in S. 1 just cost too much money have developed a passion for the issue For example, S. 1 lays out specific for this Congress to spend. of federalism—that is, assigning the steps that states and school districts In fact, I am concerned that the level appropriate role of the Federal Govern- must take to address failing schools. of spending in this bill will put us back ment in relation to State and local Also under S. 1, the Federal Govern- on the path towards a repeat of last government. ment would be able to tell States that year’s ‘‘budget busting’’ appropriations Our forefathers outlined this rela- its teachers in low-income schools cycle; a cycle that saw the Congress tionship in the 10th Amendment: must meet certain Federal qualifica- spend 14.3 percent more in non-defense The powers not delegated to the United tion and certification requirements. discretionary spending than the year States by the Constitution, nor prohibited Further, the Federal Government before. by it to the states, are reserved to the states would be able to continue to tell school That is why over the last few weeks, respectively, or to the people. districts how to spend funds in a num- I have been working with my friend Education is one such responsibility, ber of areas including: reading; teacher from Kentucky, Senator BUNNING, to and it has only been in the last 35 years development; technology; and pro- get the signatures of our Senate col- that the Federal government has had grams for students with limited leagues on a letter to President Bush much of a role to play in education pol- English language skills, instead of pro- to show him that we are willing to sup- icy, albeit a small one. viding States and local school districts port him in his efforts to instill fiscal As my colleagues know, the Federal with full flexibility to spend funds on discipline in the appropriations proc- Government currently provides ap- their own identified priorities. ess. proximately 7 percent of all money Besides violating a long-held prin- In addition, our letter is meant to spent on education in America, while ciple regarding State and local control put Congress on notice that excessive 93 percent of the money is provided at over schools, the bill’s fatal flaw is spending will not be tolerated. the state and local level. that it increases authorized and appro- Although President Bush has indi- In my view, S. 1 not only violates priated spending for education by more cated that he will not hesitate to use that principle of federalism and the than 62 percent over last year’s budget, his veto pen on spending bills, Senator proper role of the Federal Government and it demolishes the budget resolution BUNNING and I felt he needed a ‘‘Back- in education, it violates a principle that Congress recently passed. bone 34’’—a contingent of at least 34

VerDate 19-JUN-2001 01:01 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00057 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.044 pfrm03 PsN: S19PT1 S6444 CONGRESSIONAL RECORD — SENATE June 19, 2001 Senators who would agree to uphold two trillion, forty-four billion, four of fairness and equality both at home the President’s veto on bloated spend- hundred ninety-seven million. and abroad. ing bills, should it be necessary. Twenty-five years ago, June 18, 1976, Finally, I think of Homer Hickam, an I am pleased to say that Senator the Federal debt stood at aerospace engineer who, in spite of his BUNNING and I collected the signatures $610,653,000,000, six hundred ten billion, humble background, attended college of 35 Senators who have agreed to six hundred fifty-three million, which and achieved great professional suc- ‘‘vote against any congressional effort reflects a debt increase of more than $5 cess. Today, Homer attributes his ac- to override [vetoes] to enforce fiscal trillion, $5,024,033,176,609.17, five tril- complishments to the early influence discipline.’’ lion, twenty-four billion, thirty-three of an outstanding teacher. His story What these 35 signatures do is send million, one hundred seventy-six thou- demonstrates that educators inspire an important message to all of our col- sand, six hundred nine dollars and sev- students and open doors. Most impor- leagues regarding the need for the Sen- enteen cents during the past 25 years. tantly, it reminds us of why we should collectively invest in education. ate to stay within the budget resolu- f tion guidelines. Today, I commend all of West Vir- Simply put, the President will have ADDITIONAL STATEMENTS ginia’s heroes, those that are well the support he needs in Congress to known and those who remain anony- mous. I hope all Americans are inspired sustain his veto of spending bills that WEST VIRGINIA DAY are not fiscally responsible. by the generosity, integrity, and devo- ∑ Mr ROCKEFELLER. Mr. President, I tion displayed by the people of this As far as I am concerned, the ‘‘easy’’ ∑ vote would have been to vote in favor am enormously proud to reflect upon great State. of S. 1. However, I was not elected to West Virginia’s years of accomplish- f the Senate to take the easy votes and ment and good works on this, its 138th TRIBUTE TO TIM BEAULAC anniversary as a State. Among West hide from my responsibilities to the ∑ Mr. SMITH of New Hampshire. Mr. taxpayers of Ohio and this nation. Virginia’s greatest achievements are its outstanding citizens who have had President, I rise today to pay tribute It is high-time for us to stand-up and to Tim Beaulac of Gorham, NH, for show that we have the courage to be an influence, not only on their home State, but also on the Nation as a being named as the Pharmacist of the fiscally responsible, to prioritize our Year for the Northeast Region, which whole. West Virginia is home of some spending on the basis of those respon- includes Maine, New Hampshire and a of the country’s greatest educators, au- sibilities that are truly Federal in na- portion of Vermont. ture, and to make the tough choices. thors, and scientists. Like all great He achieved the award with the as- If Congress won’t do it, I hope the Americans, these luminaries worked sistance of other members of the phar- President will, because the American for the advancement of others. Like all macy staff at the Gorham WalMart people deserve to know that their gov- great West Virginians, they pursued Store including: assistant pharmacist, ernment is serving in their best inter- their goals while remembering their Kellie Lapointe, department manager, est. roots. Sandy Trottier, and pharmacy techni- In my view, the funding expectations I am reminded of Anna Jarvis, a cians Mona Garneau and Karen Taylor. that are established in S. 1 are just too teacher who longed to heal the rift be- Tim is a graduate of the Massachu- unrealistic, and if the President does tween brothers during the Civil War. setts College of Pharmacy and began not insist on a final bill that is more Miss Jarvis strove to provide a com- his career at Berlin City Drug as a fiscally responsible, I do not doubt that mon bond between all Americans, pharmacist for ten years. He also was my friends across the aisle will demand northern and southern, that could employed at the former City Drugs in that he fund ESEA to the fully author- serve as a stepping-stone toward a Gorham for several years. ized level in his next budget. more lasting peace. To this end, she Tim and his wife, Marylou, have one That’s why I urge President Bush to founded ‘‘Mother’s Friendship Day,’’ daughter, Holly, who is a sixth grader insist that the Members of the con- now known as Mother’s Day, which at Gorham Middle School. ference committee to S. 1 eliminate honors the sacrifices of all mothers. In- I commend Tim on this exemplary the enormous excess in spending that deed, Anna achieved her goal; and, she achievement and recognition in the this bill contains before it is sent back created a tradition that endures today. pharmaceutical industry. He has served to each of the respective Houses of Another West Virginian, author the citizens of Gorham with dedication and care for many years. The people of Congress for a final vote. Pearl S. Buck, sought much the same Gorham and our entire state have ben- By so doing, it will show the citizens goal. Ms. Buck’s revolutionary novel, efitted from his contributions. It is of this nation that their President ‘‘The Good Earth’’, highlighted the truly an honor and a privilege to rep- truly is not only the Education Presi- plight of poor women and children in resent him in the U.S. Senate.∑ dent, but that he cares about putting early-20 century China. In addition, an end to Congress’ spendthrift ways as Pearl worked tirelessly to advance the f well. civil rights movement, as well as the TRIBUTE TO COLONEL WILLIAM J. f women’s rights movement. Her efforts GRAHAM brought increased understanding and ∑ Mr. CLELAND. Mr. President, it is THE VERY BAD DEBT BOXSCORE tolerance for the underprivileged. with great pleasure that I rise today to Mr. HELMS. Mr. President, at the Pearl S. Buck was inspired by the tol- pay special tribute to an outstanding close of business yesterday, Monday, erance and charity of her fellow West soldier who has dedicated his life to the June 18, 2001, the Federal debt stood at Virginians and instilled these ideals in service of our Nation. Colonel William $5,634,686,176,609.17, five trillion, six a new generation of Americans. J. Graham will take off his uniform for hundred thirty-four billion, six hun- Like Anna and Pearl, Reverend Leon the last time this month as he retires dred eighty-six million, one hundred Sullivan recognized his ability to from the U.S. Army following 21 years seventy-six thousand, six hundred nine change the lives of others through ex- of active duty commissioned service. dollars and seventeen cents. ample. A Baptist minister, educator, Colonel Graham began his military Five years ago, June 18, 1996, the Fed- and civil rights activist, Leon also career with an appointment to the U.S. eral debt stood at $5,118,201,000,000, five served on the board of directors of the Military Academy at West Point. He trillion, one hundred eighteen billion, General Motors Corporation. There, he completed the rigorous course of study two hundred one million. promoted the idea of corporate respon- at the academy and graduated with a Ten years ago, June 18, 1991, the Fed- sibility abroad. His desire for racial Bachelor of Science degree, having fo- eral debt stood at $3,496,571,000,000, egalitarianism worldwide forged the cused his studies in the areas of gen- three trillion, four hundred ninety-six path for the Sullivan principles; these eral engineering and national security. billion, five hundred seventy-one mil- beliefs were instrumental in the aboli- He was commissioned a second lieuten- lion. tion of apartheid in South Africa. ant in 1980. Fifteen years ago, June 18, 1986, the Though he recently passed away, Rev- During Colonel Graham’s career as Federal debt stood at $2,044,497,000,000, erend Sullivan leaves a lasting legacy an Army aviator, he was selected to

VerDate 19-JUN-2001 02:53 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00058 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.048 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6445 command at every level from platoon systems to China which it is aiming at U.S. already delivered (and the four more to through brigade. He reorganized, built, forces and by the February 2001 Russian come) skim the ocean at twice the speed of and fine-tuned several record-setting military exercises that included mock nu- sound, can carry nuclear warheads and were organizations, and enjoyed making clear attacks against U.S. military units designed to sink U.S. aircraft carriers. In the viewed as opposing a Chinese invasion of Tai- 1990s, Russia sold China about $9 billion to things happen. His leadership, manage- wan. $20 billion in advanced weapons systems ment, problem-solving and team-build- The relationship between Russia and China aimed at U.S. forces (jet fighters, sub- ing skills have been proven during went from alliance in the 1950s to deep hos- marines, destroyers, anti-air/missile sys- combat, peacekeeping operations, and tility from 1960 to 1985 followed by gradual tems) with another $20 billion to $40 billion peacetime, and he is a proven expert in normalization during the Gorbachev years. in weapons and high-technology sales crisis management, organizational After 1991, Boris Yeltsin continued negotia- planned through 2004. The income from these planning, and training. tions to demarcate the disputed border but sales also helps Russia further modernize its kept a political distance because China re- Colonel Graham’s aviation units were strategic nuclear forces that currently have mained communist and had publicly wel- 4,000 warheads on about 1,000 ICBMs. among the most frequently deployed to comed the 1991 coup attempt by Soviet com- challenging international security en- A fourth negative result is that Russia and munist hard-liners and also opposed Mr. China are working together and in parallel vironments. During his career he Yeltsin’s democratic aspirations. to oppose any U.S. decision to deploy na- Mr. Yeltsin and the first President Bush served in and deployed to many of the tional or Asian regional missile defenses; had three summit meetings in 1992 and 1993, world’s ‘‘hotspots,’’ including Korea, they are seeking to persuade U.S. allies to and Russia declared its intention to move to- Germany, Bosnia, Macedonia, Hungary, oppose this and refuse cooperation. At the ward a ‘‘strategic partnership and in the fu- same time Russia has sold China one of its Croatia, Panama, Honduras, and Gre- ture, toward alliance’’ with the U.S. The mu- most advanced weapons (S–300), originally nada. Colonel’s Graham’s career cul- tually positive and hopeful initial relation- designed to shoot down the Pershing medium minated with duty as the Deputy Leg- ship with the new, post-Soviet Russia, also range missile as well as aircraft and cruise islative Assistant to the Chairman of included a signed agreement on reductions in missiles, along with a similar medium-range offensive nuclear weapons and a joint deci- the Joint Chiefs of Staff where he system (Tor-M1) in such quantity that China sion on modifying ‘‘existing agreements’’ served as liaison between the Nation’s is now in effect already deploying its own (including the ABM treaty) to permit global most senior military officer and the missile/air defense system on the coast. U.S. Senate. missile defense which both Presidents Yeltsin and Bush acknowledged were needed. Fifth, Russia and China have been pro- Colonel Graham’s retirement rep- Unfortunately the Clinton administration viding weapons of mass destruction compo- resents a loss to both the Joint Forces did not pursue the opportunity for Russian- nents, technology and expertise to a number and the U.S. Army. Throughout a ca- U.S. agreement on missile defense. of dictatorships such as North Korea, Iraq, reer of distinguished service, he has In April 1996, Mr. Yeltsin decided to agree Iran and Libya which are hostile to the made innumerable long-term and posi- with China on a ‘‘strategic partnership’’ and United States and its allies. Russia and increased Russian weapons sales. Through a China have also established military supply tive contributions to both the military links with Cuba and the pro-Castro Chavez and our Nation. As Colonel Graham series of regular summit meetings, China moved the ‘‘partnership’’ with Russia toward regime in Venezuela. The risk of conflict in- transitions to tackle new challenges in strategic alignment marked by an ever-larg- creases as all these dangerous regimes be- the business community, we will cer- er component of shared anti-U.S. political come militarily stronger and also believe tainly miss him and wish continued objectives (e.g. support for Iraq, opposition they are backed by both China and Russia. success for both him and his family.∑ to missile defense) along with increased Rus- The sixth negative result is that the ever- f sian military sales and military cooperation. closer relationship with China strengthens This was ignored by the previous administra- the authoritarian tendencies with Russia, THE GROWING ALLIANCE tion. thereby increasing the risk it will become BETWEEN RUSSIA AND CHINA As a result, for the first time in 40 years more aggressive internationally. While the the U.S. faces coordinated international ac- ∑ Mr. HELMS. Mr. President, Dr. Con- Chinese government develops relations with tions by China and Russia. This could have the Putin government and military, the Chi- stantine Menges has a distinguished six principal negative implications starting, nese Communist Party has revived direct re- career in the field of national security. first, with the fact that Russia has accepted lations with the Communist Party in Russia. He has written a timely piece on the and repeats most of communist China’s At their June 16, 2001, meeting in Slovenia, growing alliance between Russia and views about the U.S., for example that the it is urgent that President Bush seek to per- China. I hope my colleagues will read U.S. seeks to dominate the world. suade President Putin that Russia should as- this article and heed his expert advice. Second, the Chinese view of the coming sure the U.S. and the world that there is no July 2001 treaty emphasizes that, when one I ask that the article be printed in the open or secret military component to the of the parties to the treaty ‘‘experiences July 2001 China-Russia treaty. Mr. Bush RECORD. military aggression,’’ the other signatory The article follows: should remind Mr. Putin that the U.S. has no state should when requested ‘‘provide polit- territorial or other claims of any kind on [From the Washington Times, June 14, 2001] ical, economic, and military support and Russia. In contrast, communist China has on CHINA-RUSSIA: PREVENTING A MILITARY launch joint attacks against the invading numerous occasions during the 1950s and ALLIANCE forces.’’ through 1992 formally demanded that Russia As the American public has learned from ‘‘return’’ virtually all of the Russian Far (By Constantine Menges) the April 2001 reconnaissance aircraft event, East that China alleges was stolen by an ‘‘il- An important item on the agenda of Presi- China defines not only Taiwan but also most legal’’ 1860 treaty. Russia is arming a poten- dent Bush as he meets President Putin of of the international South China Sea and all tially very dangerous country, perhaps mak- Russia should be the new 30-year treaty of its islands as its sovereign territory. If the ing the same mistake Josef Stalin did in cooperation which the leaders of Russia and United States should threaten or take any selling weapons to arm Germany which then China are scheduled to sign in July 2001. type of counteraction (political, economic or attacked the Soviet Union in 1941. This treaty will formalize the ever-increas- military) against China to uphold the rights ing Chinese-Russian strategic coordination of US aircraft or ships in that international Unless Russia excludes such a military of recent years, which is intended to counter air and sea space or to help allies or other component in the new treaty, Mr. Bush the United States around the globe. countries defend themselves against coercion should indicate that the U.S. will view this Why would the leadership of China and by China, which has territorial disputes with as a China-Russia military alliance and a po- Russia believe they need to join for this pur- 11 neighboring countries including Japan and tentially grave threat to be met by the sig- pose? At their summit meeting in July 2000, India, China could define this as ‘‘black- nificant reductions in U.S. economic support Mr. Putin endorsed China’s view as expressed mail’’ and a violation of its ‘‘sovereignty’’. It for Russia directly, through debt restruc- in their joint statement that the U.S. ‘‘is would then hope to draw Russia in mili- turing, international institutions and trade seeking unilateral military and security ad- tarily, if only as a potential counter-threat access. Further the U.S. would see the need vantages’’ in the world. Mr. Putin also criti- as suggested by the February 2001 Russian to immediately accelerate movement toward cized the ‘‘economic and power domination military exercise. missile defense. of the United States’’ and agreed with China A third negative consequence is ever-in- The U.S. and its allies need to give the on the need to establish a still undefined creasing Russian military sales and other China-Russia strategic alignment effective ‘‘new political and economic order.’’ support for the buildup of Chinese advanced attention. With skill and foresight it is still The new China-Russia treaty will not only weapons systems specifically targeted at possible to turn back the momentum by mean a significantly increased political-stra- U.S. air, sea and electronic military capa- hard-liners in both Russia and China toward tegic challenge to the U.S., it will also pose bilities and vulnerabilities in the Pacific. more confrontation while adopting realistic additional military risks. These are illus- For example the Russian anti-ship missiles U.S. policies that maintain deterrence and trated by Russia’s sale of advanced weapons that accompany the two Russian destroyers peaceful relations.∑

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00059 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.050 pfrm03 PsN: S19PT1 S6446 CONGRESSIONAL RECORD — SENATE June 19, 2001 MESSAGES FROM THE PRESIDENT bia, transmitting, pursuant to law, a report mittee on Commerce, Science, and Transpor- on D.C. Act 14–68, ‘‘Child Fatality Review tation. Messages from the President of the Committee Establishment Temporary Act of EC–2497. A communication from the Senior United States were communicated to 2001’’; to the Committee on Governmental Legal Advisor to the Bureau Chief, Mass the Senate by Ms. Evans, one of his Affairs. Media Bureau, Federal Communications secretaries. EC–2487. A communication from the Chair- Commission, transmitting, pursuant to law, f man of the Council of the District of Colum- the report of a rule entitled ‘‘Amendment of bia, transmitting, pursuant to law, a report Section 73.622(b), Table of Allotments, DTV EXECUTIVE MESSAGES REFERRED on D.C. Act 14–70, ‘‘Earned Income Tax Cred- Broadcast Stations; Galesburg, IL’’ (Doc. No. As in executive session the Presiding it Act of 2001’’; to the Committee on Govern- 01–53) received on June 14, 2001; to the Com- Officer laid before the Senate messages mental Affairs. mittee on Commerce, Science, and Transpor- EC–2488. A communication from the Chair- tation. from the President of the United man of the Council of the District of Colum- EC–2498. A communication from the Senior States submitting sundry nominations bia, transmitting, pursuant to law, a report Legal Advisor to the Bureau Chief, Mass which were referred to the appropriate on D.C. Act 14–71, ‘‘Real Property Tax As- Media Bureau, Federal Communications committees. sessment Transition Temporary Act of 2001’’; Commission, transmitting, pursuant to law, (The nominations received today are to the Committee on Governmental Affairs. the report of a rule entitled ‘‘Amendment of printed at the end of the Senate pro- EC–2489. A communication from the Chair- Section 73.622(b), Table of Allotments, DTV ceedings.) man of the Council of the District of Colum- Broadcast Stations; Atlantic City, NJ’’ (Doc. bia, transmitting, pursuant to law, a report No. 01–49) received on June 14, 2001; to the f on D.C. Act 14–74, ‘‘51 Percent District Resi- Committee on Commerce, Science, and EXECUTIVE AND OTHER dents New Hires Amendment Act of 2001’’; to Transportation. COMMUNICATIONS the Committee on Governmental Affairs. EC–2499. A communication from the Acting EC–2490. A communication from the Chair- Director of the Office of Sustainable Fish- The following communications were man of the Council of the District of Colum- eries, National Marine Fisheries Service, De- laid before the Senate, together with bia, transmitting, pursuant to law, a report partment of Commerce, transmitting, pursu- accompanying papers, reports, and doc- on D.C. Act 14–72, ‘‘Department of Mental ant to law, the report of a rule entitled ‘‘At- uments, which were referred as indi- Health Establishment Temporary Amend- lantic Tuna Fisheries; Regulatory Adjust- cated: ment Act of 2001’’; to the Committee on Gov- ment; Deadline for Atlantic Tunas Permit ernmental Affairs. Category extended until May 31 for 2001 EC–2478. A communication from the Clerk EC–2491. A communication from the Senior only’’ (RIN0648–AP29) received on June 18, of the United States Court of Federal Legal Advisor to the Bureau Chief, Mass 2001; to the Committee on Commerce, Claims, transmitting, pursuant to law, a re- Media Bureau, Federal Communications Science, and Transportation. port relative to S. 1456; to the Committee on Commission, transmitting, pursuant to law, EC–2500. A communication from the Acting the Judiciary. the report of a rule entitled ‘‘Amendment of Deputy Director of the Financial Crimes En- EC–2479. A communication from the Regu- Section 73.622(b), Table of Allotments, DTV forcement Network, Department of the lations Coordinator of the Department of Broadcast Stations; Panama City, FL’’ (Doc. Treasury, transmitting, pursuant to law, the Health and Human Services, transmitting, No. 01–57) received on June 14, 2001; to the report of a rule entitled ‘‘Extension of a pursuant to law, the report of a rule entitled Committee on Commerce, Science, and Grant of Conditional Exception’’ received on ‘‘National Research Service Awards’’ Transportation. June 13, 2001; to the Committee on Banking, (RIN0925–AA16) received on June 18, 2001; to EC–2492. A communication from the Senior Housing, and Urban Affairs. the Committee on Health, Education, Labor, Legal Advisor to the Bureau Chief, Mass EC–2501. A communication from the Presi- and Pensions. Media Bureau, Federal Communications dent and Chairman, Export-Import Bank of EC–2480. A communication from the Acting Commission, transmitting, pursuant to law, the United States, transmitting, pursuant to Administrator of the Rural Utilities Service, the report of a rule entitled ‘‘Amendment of law, a report relative to a transaction in- Department of Agriculture, transmitting, Section 73.622(b), Table of Allotments, DTV volving U.S. exports to Chile; to the Com- pursuant to law, the report of a rule entitled Broadcast Stations; Great Falls, MT’’ (Doc. mittee on Banking, Housing, and Urban Af- ‘‘Water and Waste Disposal Programs Guar- No. 00–114) received on June 14, 2001; to the fairs. anteed Loans’’ (RIN0572–AB57) received on Committee on Commerce, Science, and EC–2502. A communication from the Dep- June 18, 2001; to the Committee on Agri- Transportation. uty Secretary of the Division of Corporation culture, Nutrition, and Forestry. EC–2493. A communication from the Senior Finance, Securities and Exchange Commis- EC–2481. A communication from the Execu- Legal Advisor to the Bureau Chief, Mass sion, transmitting, pursuant to law, the re- tive Resources and Special Programs Divi- Media Bureau, Federal Communications port of a rule entitled ‘‘Application of the sion, Environmental Protection Agency, Commission, transmitting, pursuant to law, Electronic Signatures in Global and National transmitting, pursuant to law, the report of the report of a rule entitled ‘‘Amendment of Commerce Act to Record Retention Require- a nomination confirmed for the position of Section 73.622(b), Table of Allotments, DTV ments Pertaining to Issuers under the Secu- Deputy Administrator, received on June 14, Broadcast Stations; Oklahoma City, OK’’ rities Act of 1933, Securities Exchange Act of 2001; to the Committee on Environment and (Doc. No. 99–297) received on June 14, 2001; to 1934 and Regulation S–T’’ (RIN3235–AI14) re- Public Works. the Committee on Commerce, Science, and ceived on June 14, 2001; to the Committee on EC–2482. A communication from the Coun- Transportation. Banking, Housing, and Urban Affairs. sel to the Inspector General, United States EC–2494. A communication from the Senior EC–2503. A communication from the Under General Services Administration, transmit- Legal Advisor to the Bureau Chief, Mass Secretary for Export Administration, trans- ting, pursuant to law, the report of a va- Media Bureau, Federal Communications mitting, pursuant to law, a report relative to cancy and the designation of acting officer Commission, transmitting, pursuant to law, the export of ammonium nitrate; to the for the position of Inspector General, re- the report of a rule entitled ‘‘Amendment of Committee on Banking, Housing, and Urban ceived on June 8, 2001; to the Committee on Section 73.622(b), Table of Allotments, DTV Affairs. Governmental Affairs. Broadcast Stations; Monticello, Maine’’ EC–2504. A communication from the Acting EC–2483. A communication from the Dep- (Doc. No. 01–64) received on June 14, 2001; to Chair of the Federal Subsistence Board, Fish uty Secretary of Defense, transmitting, pur- the Committee on Commerce, Science, and and Wildlife Service, Department of the Inte- suant to law, a report relative to the Federal Transportation. rior, transmitting, pursuant to law, the re- Financial Assistance Management Improve- EC–2495. A communication from the Senior port of a rule entitled ‘‘Subsistence Manage- ment Act of 1999; to the Committee on Gov- Legal Advisor to the Bureau Chief, Mass ment Regulations for Public Lands in Alas- ernmental Affairs. Media Bureau, Federal Communications ka, Subpart C and D—2001–2002 Subsistence EC–2484. A communication from the Chair- Commission, transmitting, pursuant to law, Taking of Fish and Wildlife Regulations’’ man of the Council of the District of Colum- the report of a rule entitled ‘‘Amendment of (RIN1018–AG55) received on June 13, 2001; to bia, transmitting, pursuant to law, a report Section 73.622(b), Table of Allotments, DTV the Committee on Energy and Natural Re- on D.C. Act 14–67, ‘‘Arena Fee Rate Adjust- Broadcast Stations; Lima, OH’’ (Doc. No. 01– sources. ment and Elimination Act of 2001’’; to the 51) received on June 14, 2001; to the Com- EC–2505. A communication from the Acting Committee on Governmental Affairs. mittee on Commerce, Science, and Transpor- Director of the Office of Surface Mining, De- EC–2485. A communication from the Chair- tation. partment of the Interior, transmitting, pur- man of the Council of the District of Colum- EC–2496. A communication from the Senior suant to law, the report of a rule entitled bia, transmitting, pursuant to law, a report Legal Advisor to the Bureau Chief, Mass ‘‘Kentucky Regulatory Program’’ (KY–230– on D.C. Act 14–69, ‘‘Advisory Neighborhood Media Bureau, Federal Communications FOR) received on June 18, 2001; to the Com- Commission Temporary Amendment Act of Commission, transmitting, pursuant to law, mittee on Energy and Natural Resources. 2001’’; to the Committee on Governmental the report of a rule entitled ‘‘Amendment of EC–2506. A communication from the Chief Affairs. Section 73.622(b), Table of Allotments, DTV of the Regulations Unit, Internal Revenue EC–2486. A communication from the Chair- Broadcast Stations; Butte, MT’’ (Doc. No. 01– Service, Department of the Treasury, trans- man of the Counsel of the District of Colum- 29) received on June 14, 2001; to the Com- mitting, pursuant to law, the report of a rule

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00060 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.052 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6447 entitled ‘‘Minimum Cost Requirement Per- ice System; to the Committee on Armed that go far beyond the seven ‘‘regulatory mitting the Transfer of Excess Assets of a Services. gaps’’ identified in the report; and Defined Benefit Pension Plan to a Retiree EC–2518. A communication from the Assist- Whereas, The BLM inserted several addi- Health Account’’ (RIN1545–AY43) received on ant Director for Executive and Political Per- tional provisions that ignored the findings of June 18, 2001; to the Committee on Finance. sonnel, Department of Defense, transmit- the NRC report, including a ‘‘mine veto’’ EC–2507. A communication from the Regu- ting, pursuant to law, the report of the dis- provision that was never subject to public re- lations Coordinator of the Department of continuation of service in acting role for the view and comment, as required by the fed- Health and Human Services, transmitting, position of Secretary of the Air Force; to the eral’’ Administrative Procedures Act’’ and pursuant to law, the report of a rule entitled Committee on Armed Services. the United States Constitution; and ‘‘State Child Health; Implementing Regula- EC–2519. A communication from the Dep- Whereas, The BLM further ignored the ad- tions for the State Children’s Health Insur- uty Secretary of Defense, transmitting, pur- vice and recommendations of the Western ance Program: Further Delay of Effective suant to law, a report relative to the identi- Governors Association, which specifically Date’’ (RIN0938–AI28) received on June 18, fication of the Requirements to Reduce the advised the BLM to adhere to the findings of 2001; to the Committee on Finance. Backlog of Maintenance and Repair of De- the NRC report; and EC–2508. A communication from the Regu- fense Facilities for 2001; to the Committee on Whereas, The State of Nevada and two in- lations Coordinator of the Department of Armed Services. dustry organizations have filed suit asking Health and Human Services, transmitting, EC–2520. A communication from the Assist- that the regulations which became effective pursuant to law, the report of a rule entitled ant Secretary of Defense, Force Management on the last day of the former presidential ad- ‘‘Medicare Program; Provisions of the Bene- Policy, transmitting, pursuant to law, a re- ministration be set aside; and fits Improvement and Protection Act of 2001; port relative to Army Communications-Elec- Whereas, The litigation calls into substan- Inpatient Payments and Rates and Costs of tronic Command Research, Development, tial question the validity of the 3809 regula- Graduate Medicaid Education’’ (RIN0938– and Engineering Community; to the Com- tions; and AK78) received on June 18, 2001; to the Com- mittee on Armed Services. Whereas, The BLM has conducted a pre- liminary review of the regulations, has con- mittee on Finance. f EC–2509. A communication from the Chair- cerns about ‘‘substantial policy and legal man of the United States International PETITIONS AND MEMORIALS issues’’ raised in these lawsuits, and wants to resolve such concerns before implementing a Trade Commission, transmitting, pursuant The following petitions and memo- to law, a report entitled ‘‘The Year in Trade new regulatory program; and 2000’’; to the Committee on Finance. rials were laid before the Senate and Whereas, The BLM published a proposal on EC–2510. A communication from the Assist- were referred or ordered to lie on the March 23, 2001, 66 Federal Register 16162, to ant Director for Executive and Political Per- table as indicated: suspend all or some parts of the regulations sonnel, Department of the Navy, transmit- POM–107. A resolution adopted by the City that took effect on January 20, 2001, pending ting, pursuant to law, the report of the dis- Council of North Olmsted, Ohio relative to a complete review of the issues; and Whereas, If such regulations were sus- continuation of service in acting role for the national health care insurance plan; to the pended, mining activities would be subject to position of Secretary of the Navy; to the Committee on Health, Education, Labor, and the state and federal laws and regulations Committee on Armed Services. Pensions. that the NRC found to be effective in pro- EC–2511. A communication from the Assist- POM–108. A resolution adopted by the tecting the environment and that were in ant Director for Executive and Political Per- House of the Legislature of the State of Col- place prior to the adoption of the current sonnel, Department of Defense, transmit- orado relative to federal regulation gov- scheme; and ting, pursuant to law, the report of the dis- erning mining on public lands; to the Com- Whereas, The BLM’s and the new presi- continuation of service in acting role for the mittee on Energy and Natural Resources. position of Under Secretary of Defense (Ac- dential administration’s actions once again HOUSE RESOLUTION 01–1015 quisition, Technology and Logistics); to the demonstrate the willingness to provide a bal- Committee on Armed Services. Whereas, The regulations at 43 C.F.R. Part ance between important goals of environ- EC–2512. A communication from the Assist- 3809 (3809 regulations) governing the manage- mental protection and responsible develop- ant Director for Executive and Political Per- ment of mining operations for hardrock min- ment of our nation’s mineral resources; now, sonnel, Department of Defense, transmit- erals on federal lands that were published by therefore, be it ting, pursuant to law, the report of the dis- the Bureau of Land Management (BLM) on Resolved by the House of Representatives of continuation of service in acting role for the November 21, 2000, 65 Federal Register 69998, the Sixty-third General Assembly of the State of position of Under Secretary of Defense (Per- and which became effective January 20, 2001, Colorado; sonnel and Readiness); to the Committee on will have substantial adverse impacts on the That the Colorado House of Representa- Armed Services. mining industry in Colorado and throughout tives hereby expresses its support for the ac- EC–2513. A communication from the Assist- the United States; and tion of the Department of the Interior and ant Director for Executive and Political Per- Whereas, The BLM has forecast that the the Bureau of Land Management in review- sonnel, Department of Defense, transmit- implementation of the regulations will re- ing and proposing to suspend the 3809 regula- ting, pursuant to law, the report of the dis- sult in the loss of up to 6,000 jobs, costing tions that took effect on January 20, 2001. continuation of service in acting role for the American workers almost $400 million in per- That the Colorado House of Representa- position of Department of Defense General sonal income, and the agency also projects tives urges the Bureau of Land Management Counsel; to the Committee on Armed Serv- that mine production from public lands to promulgate new 3809 regulations that ad- ices. under the regulations could also decline by here to the specific recommendations of the EC–2514. A communication from the Assist- as much as 30% or $484 million; and report of the National Research Council of ant Director for Executive and Political Per- Whereas, The regulations would also im- the National Academy of Sciences entitled sonnel, Department of Defense, transmit- pose massive additional obligations on state Hardrock Mining on Federal Lands, as the ting, pursuant to law, the report of a nomi- regulators charged with the responsibility of United States Congress has mandated. Be it nation for the position of Assistant Sec- regulating mining on public lands through further retary of the Navy (Manpower and Reserve cooperative agreements with the BLM; and Resovled, That copies of this resolution be Affairs); to the Committee on Armed Serv- Whereas, Congress commissioned the Na- transmitted to the President of the United ices. tional Research Council (NRC) of the Na- States; to the United States Department of EC–2515. A communication from the Assist- tional Academy of Sciences to conduct a the Interior, Bureau of Land Management, ant Director for Executive and Political Per- comprehensive analysis of mining regula- Washington, D.C.; to the Honorable Gale sonnel, Department of Defense, transmit- tions; and Norton, Secretary of the Interior, Wash- ting, pursuant to law, the report of a nomi- Whereas, Congress prohibited the BLM ington, D.C.; and to the United States House nation for the position of General Counsel of from promulgating final 3809 regulations, ex- of Representatives and the United States the Department of the Army; to the Com- cept for revisions that are ‘‘not inconsistent Senate. mittee on Armed Services. with’’ the recommendations contained with- EC–2516. A communication from the Assist- in the NRC report, Hardrock Mining on Fed- POM–109. A joint resolution adopted by the ant Director for Executive and Political Per- eral Lands, published in 1999; and Legislature of the State of Colorado relative sonnel, Department of Defense, transmit- Whereas, The NRC report concluded that to the Railroad Retirement and Survivors ting, pursuant to law, the report of the dis- the existing array of federal and state laws Improvement Act; to the Committee on Fi- continuation of service in acting role for the regulating mining is ‘‘generally effective’’ in nance. position of Assistance Secretary of Defense protecting the environment, and that ‘‘im- HOUSE JOINT RESOLUTION 01–1012 (Force Management Policy); to the Com- provements in the implementation of exist- Whereas, The Railroad Retirement and mittee on Armed Services. ing regulations present the greatest oppor- Survivors Improvement Act of 2000 was ap- EC–2517. A communication from the Dep- tunity for improving environmental protec- proved in a bipartisan effort by 391 members uty Director, Selective Service System, tions’’; and of the United States House of Representa- transmitting, pursuant to law, the report of Whereas, Notwithstanding the unequivocal tives in the 106th Congress, including Rep- a nomination and a nomination confirmed findings of the NRC report, the BLM pub- resentatives Diana DeGette, Scott McInnis, for the position of Director, Selective Serv- lished amendments to the 3809 regulations Thomas Tancredo, and Mark Udall; and

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00061 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.053 pfrm03 PsN: S19PT1 S6448 CONGRESSIONAL RECORD — SENATE June 19, 2001 Whereas, More than 80 United States Sen- and streams that contribute to the annual tucky and Tennessee for addition to Cum- ators, including Senator Ben Nighthorse occurrence of hypoxia in the Gulf of Mexico, berland Gap National Historic Park, and for Campbell, signed letters of support for this while aiding rural communities and benefit- other purposes; to the Committee on Energy legislation; and ting farmers; and and Natural Resources. Whereas, The bill now before the 107th Whereas, agricultural conservation incen- By Mr. DURBIN (for himself, Ms. COL- Congress modernizes the railroad retirement tive programs are an efficient and effective LINS, Mr. BIDEN, Mrs. CLINTON, Mr. system for its 748,000 beneficiaries nation- use of tax dollars to restore habitats and pre- FEINGOLD, Mrs. FEINSTEIN, Mr. JOHN- wide, including over 9,000 Colorado citizens; vent the degradation of soil, water, and habi- SON, and Mr. INOUYE): and tat over a long term and, with WRP and S. 1062. A bill to amend the Public Health Whereas, Railroad management, labor, and CRP, overproduction of crops and direct sub- Service Act to promote organ donation and retiree organizations have agreed to support sidy payments are reduced; and facilitate interstate linkage and 24-hour ac- this legislation; and Whereas, the Lower Mississippi Valley Ini- cess to State donor registries, and for other Whereas, This legislation provides tax re- tiative (LMVI), a multi-state partnership to purposes; to the Committee on Health, Edu- lief to freight railroads, Amtrak, and com- address agriculturally based environment cation, Labor, and Pensions. muter lines; and stewardship consisting of producers, univer- By Mr. ROCKEFELLER (by request): Whereas, This legislation provides benefit sities, natural resource agencies, and con- S. 1063. A bill to amend chapter 72 of title improvements for surviving spouses of rail servation organizations in Louisiana, Arkan- 38, United States Code, to improve the ad- workers who currently suffer deep cuts in in- sas, Mississippi, Missouri, Kentucky, and ministration of the United States Court of come when the rail worker retiree dies; and Tennessee formed to inform the process of Appeals for Veterans Claims; to the Com- Whereas, No outside contributions from developing the conservation provisions of the mittee on Veterans’ Affairs. taxpayers are needed to implement the next farm bill, has recognized the impor- By Mr. BOND (for himself, Mr. REID, changes called for in this legislation; and tance to the environment, the farming com- Mr. SMITH of New Hampshire, Mr. Whereas, All changes will be paid for from munity, and the future of agriculture of stra- KERRY, Mr. WARNER, Mr. CHAFEE, Mr. within the railroad industry, including a full tegically enlarging and enhancing farm bill WYDEN, Mr. CLELAND, Mr. ENSIGN, share to be paid by active employees; now, conservation programs; and and Ms. LANDRIEU): therefore, be it Whereas, although agricultural conserva- S. 1064. A bill to amend the Comprehensive Resolved by the House of Representatives of tion programs authorized by the 1996 farm Environmental Response, Compensation, and the Sixth-third General Assembly of the State of bill have reached their acreage and funding Liability Act of 1980 to provide certain relief Colorado, the Senate concurring herein: caps, additional funding has not been in- from liability for small businesses; to the That the Colorado General Assembly urges cluded in the proposed FY 2002 budget; and Committee on Environment and Public the United States Congress to enact the Whereas, legislation has been introduced in Works. Railroad Retirement and Survivors Improve- Congress to expand agricultural conserva- f ment Act in the 107th Congress. Be it further tion programs to meet the needs of farmers Resolved, That copies of this Joint Resolu- and the environment until the next farm bill SUBMISSION OF CONCURRENT AND tion be sent to the President of the United is enacted. Therefore, be it SENATE RESOLUTIONS States, the President of the United States Resolved, That the Legislature of Louisiana The following concurrent resolutions Senate, the Speaker of the United States does hereby urge and request the president of and Senate resolutions were read, and House of Representatives, and each member the United States and memorializes the Con- referred (for acted upon), as indicated: of the Colorado Congressional delegation. gress of the United States to expand and fund federal agricultural conservation pro- By Mrs. BOXER (for herself and Mrs. POM–110. A concurrent resolution adopted grams, including the Conservation Reserve, FEINSTEIN): S. Res. 113. A resolution congratulating the by the Legislature of the State of Louisiana Wetlands Reserve, Environmental Quality Los Angeles Lakers on their second consecu- relative to increasing funding for agricul- Incentives, Wildlife Habitat Improvement, tive National Basketball Association cham- tural conservation programs; to the Com- and Forestry Incentives Programs. Be it fur- pionship; considered and agreed to. mittee on Appropriations. ther By Mr. BROWNBACK (for himself and SENATE CONCURRENT RESOLUTION NO. 134 Resolved, That a copy of this Resolution Mr. LOTT): shall be transmitted to the President of the Whereas, since the adoption of the 1985 S. Con. Res. 51. A concurrent resolution United States, the Secretary of the United Farm Bill and subsequent iterations of fed- recognizing the historical significance of States Senate, the clerk of the United States eral farm legislation in 1990 and 1996, U.S. Juneteenth Independence Day and expressing House of Representatives, and to each mem- agriculture policy has included major vol- the sense of Congress that history be re- ber of the Louisiana delegation to the Con- untary conservation incentive programs garded as a means of understanding the past gress of the United States. such as the Conservation Reserve Program and solving the challenges of the future; to (CRP) and Wetlands Reserve Program f the Committee on the Judiciary. (WRP); and f Whereas, the most popular of the federal INTRODUCTION OF BILLS AND agricultural conservation programs in Lou- JOINT RESOLUTIONS ADDITIONAL COSPONSORS isiana have been the WRP with 368 approved The following bills and joint resolu- S. 127 easements on 137,632 acres, the Environ- tions were introduced, read the first mental Quality Incentives Program (EQIP) At the request of Mr. MCCAIN, the with 4,803 approved contracts on 494,006 and second times by unanimous con- name of the Senator from New York acres, the Wildlife Habitat Incentives Pro- sent, and referred as indicated: (Mr. SCHUMER) was added as a cospon- gram (WHIP) with 168 contracts on 12,900 By Mr. HUTCHINSON (for himself and sor of S. 127, a bill to give American acres, and the Forestry Incentives Program Mr. DAYTON): companies, American workers, and (FIP) with all available funds having been al- S. 1058. A bill to amend the Internal Rev- American ports the opportunity to located; and enue Code of 1986 to provide tax relief for compete in the United States cruise farmers and the producers of biodiesel, and Whereas, Louisiana has the most easement market. acres enrolled in the WRP of all partici- for other purposes; to the Committee on Fi- pating states, 407 pending applications on nance. S. 170 over 102,000 acres, and a potential WRP en- By Mr. BAYH: At the request of Mr. REID, the name rollment demand of up to 474,000 acres; and S. 1059. A bill to amend the Internal Rev- of the Senator from South Carolina Whereas, Louisiana is second only to Texas enue Code of 1986 to provide that certain (Mr. THURMOND) was added as a cospon- in the number of EQIP contracts with an es- postsecondary educational benefits provided sor of S. 170, a bill to amend title 10, timated potential demand of three to four by an employer to children of employees United States Code, to permit retired times the allocation currently available and shall be excludable from gross income as a members of the Armed Forces who only one out of every four applications for scholarship; to the Committee on Finance. assistance able to be funded; and By Mr. BAYH: have a service-connected disability to Whereas, the demand for participation in S. 1060. A bill to amend the Internal Rev- receive both military retired pay by WHIP and FIP also exceeds available funds; enue Code of 1986 to provide that certain reason of their years of military serv- and postsecondary educational benefits provided ice and disability compensation from Whereas, CRP, which benefits Louisiana by an employer to children of employees the Department of Veterans Affairs for primarily through improving upstream shall be excludable from gross income as their disability. water quality and providing nesting habitats part of an educational assistance program; S. 312 for waterfowl and other migratory birds, and to the Committee on Finance. OHNSON these other agricultural programs have pro- By Mr. MCCONNELL: At the request of Mr. J , his found beneficial impacts on wildlife habitat S. 1061. A bill to authorize the Secretary of name was added as a cosponsor of S. and water quality in our state, including the Interior to acquire Fem Lake and the 312, a bill to amend the Internal Rev- ameliorating the nutrient loading of rivers surrounding watershed in the States of Ken- enue Code of 1986 to provide tax relief

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00062 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.069 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6449 for farmers and fishermen, and for AKAKA) was added as a cosponsor of S. provide enhanced benefits to employees other purposes. 550, a bill to amend part E of title IV of and beneficiaries. S. 318 the Social Security Act to provide eq- S. 718 At the request of Mr. DASCHLE, the uitable access for foster care and adop- At the request of Mr. MCCAIN, the name of the Senator from Washington tion services for Indian children in name of the Senator from North Caro- (Ms. CANTWELL) was added as a cospon- tribal areas. lina (Mr. HELMS) was added as a co- sor of S. 318, a bill to prohibit discrimi- S. 556 sponsor of S. 718, a bill to direct the nation on the basis of genetic informa- At the request of Mr. JEFFORDS, the National Institute of Standards and tion with respect to health insurance. name of the Senator from Wisconsin Technology to establish a program to S. 321 (Mr. FEINGOLD) was added as a cospon- support research and training in meth- At the request of Mr. GRASSLEY, the sor of S. 556, a bill to amend the Clean ods of detecting the use of perform- name of the Senator from Texas (Mrs. Air Act to reduce emissions from elec- ance-enhancing drugs by athletes, and HUTCHISON) was added as a cosponsor of tric powerplants, and for other pur- for other purposes. S. 321, a bill to amend title XIX of the poses. S. 721 Social Security Act to provide families S. 583 At the request of Mr. HUTCHINSON, of disabled children with the oppor- At the request of Mr. KENNEDY, the the name of the Senator from New Jer- tunity to purchase coverage under the name of the Senator from South Da- sey (Mr. CORZINE) was added as a co- medicaid program for such children, kota (Mr. JOHNSON) was added as a co- sponsor of S. 721, a bill to amend the and for other purposes. sponsor of S. 583, a bill to amend the Public Health Service Act to establish S. 345 Food Stamp Act of 1977 to improve nu- a Nurse Corps and recruitment and re- At the request of Mr. ALLARD, the trition assistance for working families tention strategies to address the nurs- names of the Senator from Colorado and the elderly, and for other purposes. ing shortage, and for other purposes. (Mr. CAMPBELL), the Senator from Wy- S. 611 S. 805 oming (Mr. ENZI), and the Senator from At the request of Ms. MIKULSKI, the At the request of Mr. WELLSTONE, the Arizona (Mr. MCCAIN) were added as co- name of the Senator from Louisiana names of the Senator from Washington sponsors of S. 345, a bill to amend the (Ms. LANDRIEU) was added as a cospon- (Ms. CANTWELL) and the Senator from Animal Welfare Act to strike the limi- sor of S. 611, a bill to amend title II of Idaho (Mr. CRAPO) were added as co- tation that permits interstate move- the Social Security Act to provide that sponsors of S. 805, a bill to amend the ment of live birds, for the purpose of the reduction in social security bene- Public Health Service Act to provide fighting, to States in which animal fits which are required in the case of for research with respect to various fighting is lawful. spouses and surviving spouses who are forms of muscular dystrophy, including S. 347 also receiving certain Government pen- Duchenne, Becker, limb girdle, con- At the request of Mr. THOMAS, the sions shall be equal to the amount by genital, facioscapulohumeral, name of the Senator from Idaho (Mr. which two-thirds of the total amount myotonic, oculopharyngeal, distal, and CRAIG) was added as a cosponsor of S. of the combined monthly benefit (be- emery-dreifuss muscular dystrophies. 347, a bill to amend the Endangered fore reduction) and monthly pension S. 824 Species Act of 1973 to improve the proc- exceeds $1,200, adjusted for inflation. At the request of Mr. GRAHAM, the esses for listing, recovery planning, S. 651 name of the Senator from Hawaii (Mr. and delisting, and for other purposes. At the request of Mr. REED, the name INOUYE) was added as a cosponsor of S. S. 392 of the Senator from Massachusetts 824, a bill to establish an informatics At the request of Mr. SARBANES, the (Mr. KENNEDY) was added as a cospon- grant program for hospitals and skilled names of the Senator from Maine (Ms. sor of S. 651, a bill to provide for the es- nursing facilities. COLLINS) and the Senator from Dela- tablishment of an assistance program S. 837 ware (Mr. BIDEN) were added as cospon- for health insurance consumers. sors of S. 392, a bill to grant a Federal At the request of Mr. BOND, the name Charter to Korean War Veterans Asso- S. 654 of the Senator from Virginia (Mr. ciation, Incorporated, and for other At the request of Mr. TORRICELLI, the ALLEN) was added as a cosponsor of S. purposes. name of the Senator from Alaska (Mr. 837, a bill to amend the Internal Rev- MURKOWSKI) was added as a cosponsor enue Code of 1986 to provide a safe har- S. 454 of S. 654, a bill to amend the Internal bor for determining that certain indi- At the request of Mr. BINGAMAN, the name of the Senator from Colorado Revenue Code of 1986 to restore, in- viduals are not employees. crease, and make permanent the exclu- (Mr. CAMPBELL) was added as a cospon- S. 847 sor of S. 454, a bill to provide perma- sion from gross income for amounts re- At the request of Mr. DAYTON, the nent funding for the Bureau of Land ceived under qualified group legal serv- names of the Senator from Idaho (Mr. Management Payment in Lieu of Taxes ices plans. CRAIG) and the Senator from North program and for other purposes. S. 657 Carolina (Mr. HELMS) were added as co- S. 530 At the request of Mr. LUGAR, the sponsors of S. 847, a bill to impose tar- At the request of Mr. GRASSLEY, the names of the Senator from Arkansas iff-rate quotas on certain casein and name of the Senator from Rhode Island (Mrs. LINCOLN), the Senator from Ar- milk protein concentrates. (Mr. CHAFEE) was added as a cosponsor kansas (Mr. HUTCHINSON), and the Sen- S. 859 of S. 530, a bill to amend the Internal ator from Iowa (Mr. GRASSLEY) were At the request of Mr. THOMAS, the Revenue Code of 1986 to provide a 5- added as cosponsors of S. 657, a bill to names of the Senator from North Caro- year extension of the credit for pro- authorize funding for the National 4-H lina (Mr. EDWARDS) and the Senator ducing electricity from wind. . Program Centennial Initiative. from Montana (Mr. BURNS) were added S. 543 S. 688 as cosponsors of S. 859, a bill to amend At the request of Mr. WELLSTONE, the At the request of Mr. SCHUMER, the the Public Health Service Act to estab- name of the Senator from Arkansas name of the Senator from New York lish a mental health community edu- (Mrs. LINCOLN) was added as a cospon- (Mrs. CLINTON) was added as a cospon- cation program, and for other purposes. sor of S. 543, a bill to provide for equal sor of S. 688, a bill to amend title 49, S. 860 coverage of mental health benefits United States Code, relating to the air- At the request of Mr. GRASSLEY, the with respect to health insurance cov- port noise and access review program. names of the Senator from Hawaii (Mr. erage unless comparable limitations S. 697 AKAKA) and the Senator from Maine are imposed on medical and surgical At the request of Mr. BAUCUS, the (Ms. COLLINS) were added as cosponsors benefits. name of the Senator from Florida (Mr. of S. 860, a bill to amend the Internal S. 550 GRAHAM) was added as a cosponsor of S. Revenue Code of 1986 to provide for the At the request of Mr. DASCHLE, the 697, a bill to modernize the financing of treatment of certain expenses of rural name of the Senator from Hawaii (Mr. the railroad retirement system and to letter carriers.

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00063 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.054 pfrm03 PsN: S19PT1 S6450 CONGRESSIONAL RECORD — SENATE June 19, 2001 S. 871 Con. Res. 35, a concurrent resolution based products. I believe a tax incen- At the request of Mr. CLELAND, the expressing the sense of Congress that tive for soy-based biodiesel will in- name of the Senator from Vermont Lebanon, Syria, and Iran should allow crease domestic production and cap- (Mr. LEAHY) was added as a cosponsor representatives of the International ture the agricultural, environmental of S. 871, a bill to amend chapter 83 of Committee of the Red Cross to visit and economical benefits associated title 5, United States Code, to provide the four Israelis, Adi Avitan, Binyamin with using this renewable source of en- for the computation of annuities for air Avraham, Omar Souad, and Elchanan ergy. traffic controllers in a similar manner Tannenbaum, presently held by Most Americans don’t realize that as the computation of annuities for law Hezbollah forces in Lebanon. farm communities sit atop a vast and enforcement officers and firefighters. S. CON. RES. 37 virtually untapped source of renewable S. 917 At the request of Mr. LIEBERMAN, the fuels in the form of agriculture crops. At the request of Ms. COLLINS, the name of the Senator from Michigan Farmers in Arkansas are interested in name of the Senator from Massachu- (Ms. STABENOW) was added as a cospon- developing new markets for soybean setts (Mr. KENNEDY) was added as a co- sor of S. Con. Res. 37, a concurrent res- and oilseed products. In Arkansas for sponsor of S. 917, a bill to amend the olution expressing the sense of Con- example, farmers grew 94 million bush- Internal Revenue Code of 1986 to ex- gress on the importance of promoting els, or 2.5 million metric tons, of soy- clude from gross income amounts re- electronic commerce, and for other beans last year. Nationally, farmers ceived on account of claims based on purposes. produced 2.6 billion bushels of soybeans certain unlawful discrimination and to S. CON. RES. 45 in 1999–2000, equal to 72 million metric allow income averaging for backpay At the request of Mr. FITZGERALD, tons. The oil derived from soybeans and frontpay awards received on ac- the name of the Senator from New Jer- and other oilseed crops can be refined count of such claims, and for other pur- sey (Mr. CORZINE) was added as a co- into a diesel additive or diesel alter- poses. sponsor of S. Con. Res. 45 , a concur- native. According to a USDA study re- S. 940 rent resolution expressing the sense of leased in 1996, an annual market for At the request of Mr. DODD, the name Congress that the Humane Methods of biodiesel of 100 million gallons in the of the Senator from Minnesota (Mr. Slaughter Act of 1958 should be fully United States would raise the price of DAYTON) was added as a cosponsor of S. enforced so as to prevent needless suf- soybeans by up to seven cents per bush- 940, a bill to leave no child behind. fering of animals. el. Given the recent U.S. soybean crop, S. 1014 f that kind of annual market would re- At the request of Mr. BUNNING, the sult in more than $168 million directly name of the Senator from North Caro- STATEMENTS ON INTRODUCED related to the use of soy-based bio- lina (Mr. HELMS) was added as a co- BILLS AND JOINT RESOLUTIONS diesel. sponsor of S. 1014, a bill to amend the By Mr. HUTCHINSON (for him- Producing biodiesel domestically Social Security Act to enhance privacy self and Mr. DAYTON): also means that more money stays in protections for individuals, to prevent S. 1058. A bill to amend the Internal the U.S. Instead of purchasing more fraudulent misuse of the Social Secu- Revenue Code of 1986 to provide tax re- foreign petroleum, manufacturers can rity account number, and for other lief for farmers and the producers of reduce their dependence on overseas oil purposes. biodiesel, and for other purposes; to the by adding biodiesel blends for use in ex- S. 1030 Committee on Finance. isting diesel engines. If domestic com- At the request of Mr. CONRAD, the Mr. HUTCHINSON. Mr. President, panies are encouraged to develop the name of the Senator from Louisiana the debate over energy use in America infrastructure necessary to produce (Ms. LANDRIEU) was added as a cospon- has gripped our national attention for more biodiesel, the economic effect sor of S. 1030, a bill to improve health well over a year. A week doesn’t go by will be more U.S. jobs, lower prices for care in rural areas by amending title that you don’t pick up a newspaper or the consumer and larger markets for XVIII of the Social Security Act and magazine and read at least one story farmers. the Public Health Service Act, and for about our Nation’s domestic or foreign Developing markets for agricultural other purposes. energy crisis. One issue in the energy commodities and reducing our depend- S. 1037 debate that has caught my attention and that of farmers in my State is re- ence on foreign oil is good, but there At the request of Mrs. HUTCHISON, the are environmental benefits as well. It names of the Senator from Idaho (Mr. newable fuels. The technology to convert agricul- is well documented that the burning of CRAIG) and the Senator from North Da- tural crops into combustible fuel, suit- biofuels in combustion engines reduces kota (Mr. DORGAN) were added as co- the emissions of harmful greenhouse sponsors of S. 1037, a bill to amend title able for use in modern diesel and gaso- line engines, has existed for more than gases and particulate matter. In fact, 10, United States Code, to authorize biodiesel passes some of the Environ- disability retirement to be granted 100 years. I believe this process con- tinues to hold great potential for mental Protection Agency’s most posthumously for members of the stringent emissions and health stand- Armed Forces who die in the line of America. The production and use of biofuels offers our Nation a safe, re- ards for fuel additives and fuel alter- duty while on active duty, and for natives. This becomes important when other purposes. newable source of energy for travel and transport, not to mention the long- you consider the EPA’s recent an- S. 1041 term economic benefits for farmers and nouncement that California should At the request of Ms. COLLINS, her consumers. continue to use ethanol as a fuel oxy- name was added as a cosponsor of S. That is why I rise today to introduce genate to improve air quality. As more 1041, a bill to establish a program for the Biodiesel Renewable Fuels Act. I cities and States are faced with having an information clearinghouse to in- am pleased that Senator DAYTON has to improve the quality of their air, I crease public access to defibrillation in joined with me as my lead cosponsor. believe biofuels are a sensible alter- schools. This bill encourages the use of bio- native to existing oxygenates which S. 1050 diesel by establishing a tax credit for are not as friendly to the environment At the request of Mr. SANTORUM, the manufacturers who produce a blend of or human health. name of the Senator from New Hamp- conventional diesel and soybean or oil- If using biodiesel improves air qual- shire (Mr. SMITH) was added as a co- seed additives. By reducing the diesel ity, reduces our dependence on foreign sponsor of S. 1050, a bill to protect in- fuel excise tax, suppliers will receive a oil and provides a value-added market fants who are born alive. 3-cent-per-gallon credit for using a die- for soybean and oilseed crops, then we S. CON. RES. 35 sel blend that contains at least 2 per- should support legislation to further At the request of Mr. SCHUMER, the cent biodiesel. This tax credit is very development of this renewable source name of the Senator from Maine (Ms. similar to the existing tax incentive of fuel. My bill is good for farmers, it’s COLLINS) was added as a cosponsor of S. for ethanol, a biofuel made from corn- good for consumers and it’s good for

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00064 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.054 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6451 the environment. I ask unanimous con- ‘‘(C) CASUAL OFF-FARM PRODUCTION NOT ELI- the unused business credit for any taxable sent that the text of the Biodiesel Re- GIBLE.—No credit shall be allowed under this year which is attributable to the biodiesel newable Fuels Act be printed in the section with respect to any casual off-farm fuels credit determined under section 40A production of a qualified biodiesel mixture. may be carried back to a taxable year begin- RECORD. ‘‘(c) COORDINATION WITH EXEMPTION FROM ning before January 1, 2003.’’ There being no objection, the bill was EXCISE TAX.—The amount of the credit de- (2) Section 196(c) is amended by striking ordered to be printed in the RECORD, as termined under this section with respect to ‘‘and’’ at the end of paragraph (9), by strik- follows: any biodiesel shall, under regulations pre- ing the period at the end of paragraph (10), S. 1058 scribed by the Secretary, be properly reduced and by adding at the end the following: Be it enacted by the Senate and House of Rep- to take into account any benefit provided ‘‘(11) the biodiesel fuels credit determined resentatives of the United States of America in with respect to such biodiesel solely by rea- under section 40A.’’ Congress assembled, son of the application of section 4041(n) or (3) The table of sections for subpart D of section 4081(f). SECTION 1. SHORT TITLE; ETC. part IV of subchapter A of chapter 1 is ‘‘(d) DEFINITIONS AND SPECIAL RULES.—For (a) SHORT TITLE.—This Act may be cited as amended by adding after the item relating to purposes of this section— section 40 the following new item: the ‘‘Biodiesel Renewable Fuels Act’’. ‘‘(1) BIODIESEL DEFINED.— (b) AMENDMENT OF 1986 CODE.—Except as ‘‘(A) IN GENERAL.—The term ‘biodiesel’ ‘‘Sec. 40A. Biodiesel used as fuel.’’ otherwise expressly provided, whenever in means the monoalkyl esters of long chain (d) EFFECTIVE DATE.—The amendments this Act an amendment or repeal is ex- fatty acids derived from vegetable oils for made by this section shall apply to taxable pressed in terms of an amendment to or a re- use in compressional-ignition (diesel) en- years beginning after December 31, 2001. peal of a section or other provision, the ref- gines. Such term shall include esters derived SEC. 3. REDUCTION OF MOTOR FUEL EXCISE erence shall be considered to be made to a from vegetable oils from corn, soybeans, sun- TAXES ON BIODIESEL MIXTURES. section or other provision of the Internal flower seeds, cottonseeds, canola, crambe, (a) IN GENERAL.—Section 4081 (relating to Revenue Code of 1986. rapeseeds, safflowers, flaxseeds, and mustard manufacturers tax on petroleum products) is SEC. 2. CREDIT FOR BIODIESEL USED AS FUEL. seeds. amended by adding at the end the following (a) IN GENERAL.—Subpart D of part IV of ‘‘(B) REGISTRATION REQUIREMENTS.—Such new subsection: subchapter A of chapter 1 (relating to busi- term shall only include a biodiesel which ‘‘(f) BIODIESEL MIXTURES.—Under regula- ness related credits) is amended by inserting meets the registration requirements for fuels tions prescribed by the Secretary— after section 40 the following new section: and fuel additives established by the Envi- ‘‘(1) IN GENERAL.—In the case of the re- ‘‘SEC. 40A. BIODIESEL USED AS FUEL. ronmental Protection Agency under section moval or entry of a qualified biodiesel mix- ‘‘(a) GENERAL RULE.—For purposes of sec- 211 of the Clean Air Act (42 U.S.C. 7545). ture, the rate of tax under subsection (a) tion 38, the biodiesel fuels credit determined ‘‘(2) BIODIESEL MIXTURE NOT USED AS A shall be the otherwise applicable rate re- under this section for the taxable year is an FUEL, ETC.— duced by the biodiesel mixture rate (if any) amount equal to the biodiesel mixture cred- ‘‘(A) IMPOSITION OF TAX.—If— applicable to the mixture. it. ‘‘(i) any credit was determined under this ‘‘(2) TAX PRIOR TO MIXING.— ‘‘(b) DEFINITION OF BIODIESEL MIXTURE section with respect to biodiesel used in the ‘‘(A) IN GENERAL.—In the case of the re- CREDIT.—For purposes of this section— production of any qualified biodiesel mix- moval or entry of diesel fuel for use in pro- ‘‘(1) BIODIESEL MIXTURE CREDIT.— ture, and ducing at the time of such removal or entry ‘‘(A) IN GENERAL.—The biodiesel mixture ‘‘(ii) any person— a qualified biodiesel mixture, the rate of tax credit of any taxpayer for any taxable year ‘‘(I) separates the biodiesel from the mix- under subsection (a) shall be the otherwise is the sum of the products of the biodiesel ture, or applicable rate, reduced by the amount de- mixture rate for each blend of qualified bio- ‘‘(II) without separation, uses the mixture termined under subparagraph (B). diesel mixture and the number of gallons of other than as a fuel, ‘‘(B) APPLICABLE REDUCTION.—For purposes the blend of the taxpayer for the taxable of subparagraph (A), the amount determined then there is hereby imposed on such person year. under this subparagraph is an amount equal a tax equal to the product of the biodiesel ‘‘(B) BIODIESEL MIXTURE RATE.—For pur- to the biodiesel mixture rate for the quali- mixture rate applicable under subsection poses of subparagraph (A), the biodiesel mix- fied biodiesel mixture to be produced from (b)(1)(B) and the number of gallons of the ture rate shall be— the diesel fuel, divided by a percentage equal mixture. ‘‘(i) the applicable amount for a B–1 blend, to 100 percent minus the percentage of bio- ‘‘(B) APPLICABLE LAWS.—All provisions of ‘‘(ii) 3.0 cents for a B–2 blend, and diesel which will be in the mixture. law, including penalties, shall, insofar as ap- ‘‘(iii) 20.0 cents for a B–20 blend. ‘‘(3) DEFINITIONS.—For purposes of this sub- plicable and not inconsistent with this sec- ‘‘(C) BLENDS.—For purposes of this para- section, any term used in this subsection tion, apply in respect of any tax imposed graph— which is also used in section 40A shall have under subparagraph (A) as if such tax were ‘‘(i) B–1 BLEND.—The term ‘B–1 blend’ the meaning given such term by section 40A. imposed by section 4081 and not by this chap- means a qualified biodiesel mixture if at ‘‘(4) CERTAIN RULES TO APPLY.—Rules simi- ter. least 0.5 percent but less than 2.0 percent of lar to the rules of paragraphs (6) and (7) of ‘‘(3) PASS-THRU IN THE CASE OF ESTATES AND the mixture is biodiesel. subsection (c) shall apply for purposes of this TRUSTS.—Under regulations prescribed by ‘‘(ii) B–2 BLEND.—The term ‘B–2 blend’ subsection.’’. the Secretary, rules similar to the rules of means a qualified biodiesel mixture if at (b) CONFORMING AMENDMENTS.— subsection (d) of section 52 shall apply. (1) Section 4041 is amended by adding at least 2.0 percent but less than 20 percent of ‘‘(e) ELECTION TO HAVE BIODIESEL FUELS the end the following new subsection: the mixture is biodiesel. CREDIT NOT APPLY.— ‘‘(iii) B–20 BLEND.—The term ‘B–20 blend’ ‘‘(n) BIODIESEL MIXTURES.—Under regula- ‘‘(1) IN GENERAL.—A taxpayer may elect to tions prescribed by the Secretary, in the case means a qualified biodiesel mixture if at have this section not apply for any taxable least 20 percent of the mixture is biodiesel. of the sale or use of a qualified biodiesel mix- year. ture (as defined in section 40A(b)(2)), the ‘‘(D) APPLICABLE AMOUNT.—For purposes of ‘‘(2) TIME FOR MAKING ELECTION.—An elec- this paragraph, the term ‘applicable amount’ rates under paragraphs (1) and (2) of sub- tion under paragraph (1) for any taxable year section (a) shall be the otherwise applicable means, in the case of a B–1 blend, the may be made (or revoked) at any time before amount equal to 1.5 cents multiplied by a rates, reduced by any applicable biodiesel the expiration of the 3-year period beginning mixture rate (as defined in section fraction the numerator of which is the per- on the last date prescribed by law for filing 40A(b)(1)(B)).’’. centage of biodiesel in the B–1 blend and the the return for such taxable year (determined (2) Section 6427 is amended by redesig- denominator of which is 1 percent. without regard to extensions). nating subsection (p) as subsection (q) and ‘‘(2) QUALIFIED BIODIESEL MIXTURE.— ‘‘(3) MANNER OF MAKING ELECTION.—An by inserting after subsection (o) the fol- ‘‘(A) IN GENERAL.—The term ‘qualified bio- election under paragraph (1) (or revocation lowing new subsection: diesel mixture’ means a mixture of diesel thereof) shall be made in such manner as the ‘‘(p) BIODIESEL MIXTURES.—Except as pro- and biodiesel which— Secretary may by regulations prescribe.’’ vided in subsection (k), if any diesel fuel on ‘‘(i) is sold by the taxpayer producing such (b) CREDIT TREATED AS PART OF GENERAL which tax was imposed by section 4081 at a mixture to any person for use as a fuel; or BUSINESS CREDIT.—Section 38(b) is amended rate not determined under section 4081(f) is ‘‘(ii) is used as a fuel by the taxpayer pro- by striking ‘‘plus’’ at the end of paragraph used by any person in producing a qualified ducing such mixture. (14), by striking the period at the end of biodiesel mixture (as defined in section ‘‘(B) SALE OR USE MUST BE IN TRADE OR paragraph (15) and inserting ‘‘, plus’’, and by 40A(b)(2)) which is sold or used in such per- BUSINESS, ETC.—Biodiesel used in the produc- adding at the end the following: son’s trade or business, the Secretary shall tion of a qualified biodiesel mixture shall be ‘‘(16) the biodiesel fuels credit determined pay (without interest) to such person an taken into account— under section 40A.’’ amount equal to the per gallon applicable ‘‘(i) only if the sale or use described in sub- (c) CONFORMING AMENDMENTS.— biodiesel mixture rate (as defined in section paragraph (A) is in a trade or business of the (1) Section 39(d) is amended by adding at 40A(b)(1)(B)) with respect to such fuel.’’. taxpayer; and the end the following: (c) EFFECTIVE DATE.—The amendments ‘‘(ii) for the taxable year in which such ‘‘(11) NO CARRYBACK OF BIODIESEL FUELS made by this section shall take effect on sale or use occurs. CREDIT BEFORE JANUARY 1, 2003.—No portion of January 1, 2002.

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00065 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.046 pfrm03 PsN: S19PT1 S6452 CONGRESSIONAL RECORD — SENATE June 19, 2001 SEC. 4. HIGHWAY TRUST FUND HELD HARMLESS. efits provided by an employer to chil- on Taxation has scored this provision There are hereby transferred (from time to dren of employees shall be excludable at $231 million over 10 years. I look for- time) from the funds of the Commodity Cred- from gross income as a scholarship; to ward to working to make sure that this it Corporation amounts equivalent to the re- the Committee on Finance. provision is fully offset in a responsible ductions that would occur (but for this sec- tion) in the receipts of the Highway Trust manner. I hope my colleagues will join By Mr. BAYH: me to help ease the burden of American Fund by reason of the amendments made by S. 1060. A bill to amend the Internal this Act. Such transfers shall be made on the families with the soaring costs of high- basis of estimates made by the Secretary of Revenue Code of 1986 to provide that er education. the Treasury and adjustments shall be made certain postsecondary educational ben- to subsequent transfers to reflect any errors efits provided by an employer to chil- By Mr. MCCONNELL: in the estimates. dren of employees shall be excludable S. 1061. A bill to authorize the Sec- Mr. DAYTON. Mr. President, I rise from gross income as part of an edu- retary of the Interior to acquire Fern today to introduce, along with my dis- cational assistance program; to the Lake and the surrounding watershed in tinguished colleague Senator HUTCH- Committee on Finance. the States of Kentucky and Tennessee Mr. BAYH. Mr. President, I am INSON from Arkansas, legislation that for addition to Cumberland Gap Na- will increase the use of biodiesel fuel pleased to introduce legislation today tional Historic Park, and for other pur- throughout our country. that will help thousands of American poses; to the Committee on Energy and Biodiesel is a natural additive to die- workers with the financial burden asso- Natural Resources. sel fuel, much as ethanol is to regular ciated with sending a daughter or son Mr. MCCONNELL. Mr. President, last gasoline. It is also a fuel in its own to college. In this climate of labor month the Bush Administration un- shortages, U.S. companies are looking right. Biodiesel is made from soybeans veiled a new national energy strategy for innovative ways to maintain and and other vegetable oils. Its use as a 2- that strikes an important balance be- attract a dedicated and qualified work- percent blend with diesel fuel, and in tween the twin priorities of production force. Some companies have creatively some instances as high as a 20-percent and conservation. Today I am proud to turned to providing college scholar- blend, will increase the demand for introduce legislation with Congress- ships for their employees’ children. My these commodities, boost their market man HAL ROGERS that takes a step to- legislation would allow employees to price, and reduce the toxic carbon ward fulfilling the conservation side of deduct these scholarships from their emissions from trucks and other vehi- that energy equation in my home state gross income. Under current law, an cles across this Nation, all at no addi- of Kentucky. employee generally is not taxed on Our bill, the Fern Lake Conservation tional cost to American taxpayers. post-secondary education assistance Our legislation would provide a 3- and Recreation Act of 2001, will author- provided by an employer for the benefit ize the Cumberland Gap National His- cent-per-gallon credit to diesel fuel of the employee. My bill would extend suppliers using 2-percent biodiesel and torical Park to purchase Fern Lake, a this treatment to employer-provided natural landmark on the Kentucky- up to a 20-cent-per-gallon credit for education assistance for the employ- blends containing 20-percent biodiesel. Tennessee border that has served as ees’ children, up to $2,000 per child. the municipal water supply for As soybean prices rise then due to As many of my colleagues know, em- Middlesboro, KY since the lake was the increased usage, Federal spending ployer-provided education assistance is constructed in 1893. This bill will pro- on the U.S. Department of Agriculture considered an integral tool in keeping Marketing Assistance Loan Program America’s workforce well trained and tect the lake as a clean and safe source will be reduced accordingly, resulting equipped to deal with the changing face of rural water for Kentuckians, en- in substantial savings for the American of the New Economy. Current law not hance the scenic and recreational value taxpayers. only allows companies to keep an up- of Cumberland Gap National Historical A credit such as this would otherwise to-date labor pool, but also allows Park, and increase tourism opportuni- reduce the revenues that would be many workers to move from low-wage, ties in the three states that border the going into the highway trust fund. entry level positions up the economic Park—Kentucky, Tennessee, and Vir- Given the deterioration of many of our ladder of success. Extending tax-free ginia. Nation’s highways, that would be un- treatment to the children of employees For those who may be less familiar wise. Thus, this legislation provides for not only will help working families, with this part of the country, Fern the Commodity Credit Corporation to but will contribute to our Nation’s Lake is a beautiful and pristine body of reimburse the highway trust fund for competitiveness in an increasingly dy- water set against the backdrop of the its forgone revenues. namic global economy. Appalachian Mountains. The 150-acre Our current energy crisis is also an My legislation is very simple. It al- lake presently sits adjacent to the opportunity for our country. I cur- lows employees whose companies pro- Park and is part of the viewshed from rently have a van driving around the vide educational scholarships for em- Pinnacle Overlook, which is one of the State of Minnesota that uses 85-percent ployees’ children to exclude up to $2000 Park’s most popular attractions. It is ethanol fuel with no difficulties what- from gross income per child. An em- said that the glassy surface of Fern soever. These agricultural fuels are not ployee may not exclude more than Lake is so clear that you can see fish just possible tomorrow, they are prac- $5,250 from gross income for employer swimming 10 feet below the surface. tical today. We just need to help them education assistance. This is the limit Perhaps that is one of the reasons why become financially competitive, until established under Section 127(a)(2) of Middlesboro Mayor Ben Hickman de- these industries can reach the volume the Internal Revenue Code for em- scribes his town’s water supply as one of production necessary to compete ployer education assistance. In essence, of the best in the United States. with the giant oil industry. there would be ‘‘family cap.’’ Workers With a lake of such natural beauty In conclusion, this legislation is an could deduct a $2,000 scholarship for and exceptional water quality, it is no important step in several right direc- their child and could also exclude up to wonder that the citizens and commu- tions—toward less foreign oil depend- $3,250 of educational benefits for them- nity leaders want to protect it. Al- ency, toward higher agricultural com- selves, however, the combined amounts though Fern Lake has been privately modity prices for American farmers, could not exceed $5,250. owned for most of its existence, it has toward lower taxpayer costs for our In today’s economy, American com- been for sale since July 2000, and there struggling farm economy, and toward a panies are no longer looking purely for is concern in Middlesboro that a new cleaner air quality for us all. I respect- a high-school diploma, but require that owner may not share the same inter- fully urge my colleagues to support their workers have some sort of post- ests regarding the lake as those em- this important legislation. secondary education or training. Many braced by the community. That is why working families struggle in providing a growing chorus of community leaders By Mr. BAYH: this basic start which will help their and citizens have called for the Cum- S. 1059. A bill to amend the Internal children get well-paying jobs. berland Gap National Historical Park Revenue Code of 1986 to provide that This piece of legislation is also a to purchase Fern Lake. This solution certain postsecondary educational ben- modest proposal. The Joint Committee would guarantee management of this

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00066 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.066 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6453 wonderful resource consistent with the I ask unanimous consent that the Secretary may acquire lands described in needs of the community. text of the bill be printed in the subsection (b) by donation, purchase with do- This legislation is needed because RECORD. nated or appropriated funds, or exchange. currently the Park is prohibited by law There being no objection, the bill was However, the lands may be acquired only with the consent of the owner. from expanding its boundaries by pur- ordered to be printed in the RECORD, as (2) EASEMENTS.—At the discretion of the chasing new land with appropriated follows: Secretary, the Secretary may acquire land funds. Our bill, therefore, authorizes S. 1061 described in subsection (b) that is subject to the Park to use appropriated funds, if Be it enacted by the Senate and House of Rep- an easement for the continued operation of necessary, to purchase Fern Lake (and resentatives of the United States of America in providing the water supply for the City of up to 4,500 acres of the surrounding wa- Congress assembled, Middlesboro, Kentucky, and environs. tershed) and to manage the lake for SECTION 1. SHORT TITLE. (d) BOUNDARY ADJUSTMENT AND ADMINIS- public recreational uses. This bill also This Act may be cited as the ‘‘Fern Lake TRATION.—Upon the acquisition of land under Conservation and Recreation Act of 2001’’. this section, the Secretary shall revise the requires the Park to maintain Fern boundaries of the park to include the land in Lake as a source of clean drinking SEC. 2. FINDINGS AND PURPOSES. the park. Subject to subsection (e), the Sec- water, authorizes the Park to sell (a) FINDINGS.—The Congress finds the fol- retary shall administer the acquired lands as water to the city of Middlesboro, and lowing: part of the park in accordance with the laws permits the proceeds of the water sales (1) Fern Lake and its surrounding water- and regulations applicable to the park. to be spent by the Secretary of the In- shed in Bell County, Kentucky, and Clai- (e) SPECIAL ISSUES RELATED TO FERN borne County, Tennessee, is within the po- terior without further appropriation. LAKE.— tential boundaries of Cumberland Gap Na- (1) PROTECTION OF WATER QUALITY.—The And because the scenic and rec- tional Historical Park as originally author- Secretary shall manage public recreational reational values of Fern Lake will ben- ized by the Act of June 11, 1940 (54 Stat 262; use of Fern Lake, if acquired by the Sec- efit the tourism industry in all three 16 U.S.C. 261 et seq.). retary, in a manner that is consistent with adjacent states—Kentucky, Tennessee, (2) The acquisition of Fern Lake and its the protection of the lake as a source of safe, and Virginia—the legislation directs surrounding watershed and its inclusion in clean, drinking water. the Secretary of the Interior to consult Cumberland Gap National Historical Park (2) SALE OF WATER.—In the event the Sec- with appropriate officials in these would protect the vista from Pinnacle Over- retary’s acquisition of land includes the look, which is one of the park’s most valu- states to determine the best way to water supply of Fern Lake, the Secretary able scenic resources and most popular at- may enter into contracts to facilitate the manage the municipal water supply tractions, and enhance recreational opportu- sale and distribution of water from the lake and to promote the increased tourism nities at the park. for the municipal water supply for the City opportunities associated with Park (3) Fern Lake is the water supply source of Middlesboro, Kentucky, and environs. The ownership of Fern Lake. for the City of Middlesboro, Kentucky, and Secretary shall ensure that the terms and This bill is a small but important ex- environs. conditions of any such contract is consistent ample of the type of targeted conserva- (4) The 4500-acre Fern Lake watershed is with National Park Service policies for the tion measures that are essential to privately owned, and the 150-acre lake and protection of park resources. Proceeds from making a national energy policy work part of the watershed are currently for sale, the sale of the water shall be available for but the Secretary of the Interior is precluded for all Americans. This is not the con- expenditure by the Secretary at the park by the first section of the Act of June 11, 1940 without further appropriation. servation of environmental extremism (16 U.S.C. 261), from using appropriated funds (3) CONSULTATION REQUIREMENTS.—In order that seeks to divide communities, to acquire the lands. to better manage Fern Lake and its sur- vilify opponents, or present unwork- (b) PURPOSES.—The purposes of the Act rounding watershed, if acquired by the Sec- able approaches in the name of polit- are— retary, in a manner that will facilitate the ical opportunism. Rather, this is con- (1) to authorize the Secretary of the Inte- provision of water for municipal needs as servation that builds upon community rior to use appropriated funds if necessary, well as the establishment and promotion of in addition to other acquisition methods, to new recreational opportunities made pos- consensus. It is common sense con- acquire from willing sellers Fern Lake and servation that seeks environmental so- sible by the addition of Fern Lake to the its surrounding watershed in order to protect park, the Secretary shall consult with— lutions that will enhance rather than scenic and natural resources and enhance (A) appropriate officials in the States of disturb local industries such as tour- recreational opportunities at Cumberland Kentucky, Tennessee, and Virginia and polit- ism, which have been so vital to eco- Gap National Historical Park; and ical subdivisions of these States; nomically depressed areas such as (2) to allow the continued supply of safe, (B) organizations involved in promoting southeastern Kentucky. And finally, clean, drinking water from Fern Lake to the tourism in these States; and this is conservation that is careful to City of Middlesboro, Kentucky, and environs. (C) other interested parties. consider, and where necessary, to pro- SEC. 3. LAND ACQUISITION, FERN LAKE, CUM- BERLAND GAP NATIONAL HISTOR- By Mr. DURBIN (for himself, Ms. tect, the property rights of affected ICAL PARK. COLLINS, Mr. BIDEN, Mrs. CLIN- landowners. This bill requires that the (a) DEFINITIONS.—In this section: TON, Mr. FEINGOLD, Mrs. FEIN- Park acquire land from willing sellers (1) FERN LAKE.—The term ‘‘Fern Lake’’ STEIN, Mr. JOHNSON, and Mr. only, and the National Park Service means Fern Lake located in Bell County, INOUYE): has assured us that it has no authority Kentucky, and Claiborne County, Tennessee. (2) LAND.—The term ‘‘land’’ means land, S. 1062. A bill to amend the Public to place land-use restrictions on pri- Health Service Act to promote organ vate land until the land is actually ac- water, interests in land, and any improve- ments on the land. donation and facilitate interstate link- quired by the Park. (3) PARK.—The term ‘‘park’’ means Cum- age and 24-hour access to State donor Targeted and consensus-driven con- berland Gap National Historical Park, as au- registries, and for other purposes; to servation measures such as this one are thorized and established by the Act of June the Committee on Health, Education, not always easy to craft, but they are 11, 1940 (54 Stat 262; 16 U.S.C. 261 et seq.). Labor, and Pensions. always worth the effort. This bill is (4) SECRETARY.—The term ‘‘Secretary’’ Mr. DURBIN. Mr. President, this proof that environmental protection means the Secretary of the Interior, acting year the waiting list for organ trans- through the Director of the National Park and economic development need not be plants among Americans stands at at odds, and that there are a number of Service. (b) ACQUISITION AUTHORIZED.—The Sec- more than 75,000. I rise to urge all Sen- responsible and practical conservation retary may acquire for addition to the park ators, and all Americans to become opportunities that can bring commu- lands consisting of approximately 4,500 acres organ donors. I rise to introduce legis- nities together rather than tear them and containing Fern Lake and its sur- lation to make it easier for individuals apart. Indeed, if this simple formula for rounding watershed, as generally depicted on to donate and make it simpler to iden- finding consensus conservation oppor- the map entitled ‘‘Fern Lake Watershed tify the decedents’s donation wishes. I tunities—broad community support, Boundary Addition, Cumberland Gap Na- am pleased that Senators COLLINS, tional Historical Park’’, numbered 380/80,004, local employment, and private prop- BIDEN, CLINTON, FEINGOLD, FEINSTEIN, erty protections—was replicated in all and dated May 2001. The map shall be on file in the appropriate offices of the National JOHNSON, and INOUYE join me in this ef- 50 States, we could make actual and Park Service. fort. noticeable strides as a nation toward (c) AUTHORIZED ACQUISITION METHODS.— Access to organ transplantation re- protecting and promoting our natural (1) IN GENERAL.—Notwithstanding the Act mains limited by the shortage of do- treasures. of June 11, 1940 (16 U.S.C. 261 et seq.), the nated organs. Each day, an average of

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00067 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.057 pfrm03 PsN: S19PT1 S6454 CONGRESSIONAL RECORD — SENATE June 19, 2001 17 people on the waiting list will die. tial donors wishes to the family, a reg- so. The bill establishes a National And the waiting list is growing. In fact, istry documentation can aid in secur- Organ and Tissue Donation Resource since 1990 the number of men, women ing next of kin consent. Despite the Center, informed by a task force of na- and children awaiting life-saving trans- fact that 85 percent of Americans sup- tional experts, to develop registry plants has grown by at least 10 percent port organ donation for transplants, guidelines for States based on best easy year. We need to move expedi- studies indicate that only about 50 per- practices. The Center would maintain a tiously to reduce these deaths due to cent of families consent to donation. donor registry clearinghouse, including the scarcity of willing organ donors. Well-designed databases can improve a web site, to collect, synthesize, and Every 14 minutes we do not act, an- coordination between hospitals, physi- distribute information about what other name is added to the national cians, organ procurement organiza- works. The proposal also requires that transplant waiting list. tions and families. Registries can also a mechanism be established to link Over the last several years, I have assist in evaluating education and out- State registries and to provide around- worked with many of my colleagues on reach efforts by providing information the-clock access to information. To a variety of initiatives to increase about registrant demographics and au- help ensure that registry development organ donation. In 1996, I authored leg- dience-specific effectiveness of aware- is based on evidence of effectiveness islation to include an organ donation ness campaigns. Yet currently only and best practices, and to help us un- card with every Federal income tax re- about a dozen States operate mature, derstand better how to utilize the reg- fund mailed. More than 70 million centralized organ and tissue donor reg- istry tool to increase donations, the donor cards were mailed, the largest istries. DONATE Act asks an advisory task distribution in history. In 1997, I au- I am proud that the State of Illinois force to examine state registries and thored a provision in the Labor, Health was one of the first and is currently make recommendations to Congress and Human Services, and Education the largest such system. In Illinois, in- about the states of such systems and Appropriation bill that authorized a dividuals can indicate their willingness ways to develop linkages between state study of hospital best practices for in- to donate by signing their drivers li- registries. creasing organ donation. More re- cense. Drivers’ license applicants are Public education is equally as impor- cently, I launched a campaign known also asked if they wish to have their tant as developing better technical as ‘‘Give Thanks, Give Life’’ with the name listed on the confidential state- tools and programs to increase dona- National Football League and a large wide registry. In addition to signing up tion if we are to do a better job of coalition of advocacy organizations to at a driver services facility, persons matching the number of donors to peo- promote family discussions over can join the registry by calling an ple in need of a transplant. The DO- Thanksgiving of family members’ de- eight hundred number or electronically NATE Act launches a national effort to sire to become organ donors. via the web. More than 3 million Illi- raise public awareness about the im- But we need to do more. Major bar- noisans have already joined and 100,000 portance of organ donation and funds riers to donation still exist. A recent more sign up each month. Today, par- research to find better ways to improve analysis by the Lewin Group, Inc., ticipation in the Illinois Donor Reg- donation rates. The bill authorizes found low rates of family consent to istry is 39 percent statewide, an in- State grants for innovative organ donation. In addition, there are many crease of 77 percent since 1993. In addi- donor awareness and outreach initia- missed opportunities in the process of tion, about one fifth of all facilities are tives and programs aimed at increasing identifying and referring all potential reporting participation rates at or donation. donors to procurement organizations above 50 percent. Most importantly, A number of additional innovative so that families may be approached. A organ donation has risen 40 percent initiatives are included in this bill. The 1996 study of potential organ donors in since 1993 and the Regional Organ Bank DONATE Act would directly assist liv- hospitals found that in nearly a third of Illinois has led the nation in the ing donors, providing financial assist- of all cases, potential donors were not number of organs recovered for trans- ance to offset travel, subsistence and identified or no request was made to plantation since 1994. other expenses incurred toward making the family. But unfortunately Illinois is the ex- living donations of their organs. Simi- Today I am introducing a comprehen- ception and not the rule. Most States lar provisions recently cleared the sive proposal to address these obsta- do not have programs and gaps in House of Representatives by more than cles, including a number of new initia- knowledge exist. In fact, no one kept 400 votes. The DONATE Act includes tives. The DONATE Act: 1. Establishes track of which States operate organ the House passed bill, with a number of a national organ and tissue donor reg- donor registries until recently. We improvements. For example, the Act istry resource center at the Depart- have little information about what does not restrict such assistance to ar- ment of Health and Human Services; 2. works best when developing registries. tificial residency requirements and it Authorizes grants to States to support Guidance for States about the basic does not limit assistance only to those the development, enhancement, expan- components of effective systems such who donate organs to low income re- sion and evaluation of statewide organ as the core functions and content, legal cipients. and tissue donor registries; 3. Funds and ethical standards, privacy protec- The DONATE Act also provides additional research to learn more tions and data exchange protocols, is grants to hospitals and organ procure- about effective strategies that increase scarce. ment organizations to fund staff posi- donation rates; 4. Provides financial as- And in addition to the fact that most tions for organ coordinators. These in- sistance to donors for travel and sub- States do not operate registries, among house organ coordinators would be re- sistence expenses incurred toward those who do, currently no mechanism sponsible for coordinating organ dona- making living donations of their or- exists to share information between tion and recovery at a hospital or a gans; 5. Expands Federal efforts to edu- these registries. So if a Illinoisan dies group of hospitals. Research has shown cate the public about organ donation in Wisconsin, law enforcement or hos- that these types of initiatives can have and improve outreach activities; 6. pital officials in Wisconsin have no dramatic results. A four-year retro- Provides grants to hospitals and organ easy way of knowing of the victims in- spective study of a large public hos- procurement organizations to fund tent to donate. To be effective, reg- pital in Houston that implemented a organ coordinators; and 7. Directs the istries need to be accessible to the coordinator program resulted in a 64 Secretary of the Treasury to strike a proper authorities around the clock percent increase in the consent rate bronze medal to commemorate organ without regard for State boundaries. along with a 94 percent increase in the donors and their families. To be effective, registries also need to number of organ donors. Organ and tissue donor registries function as an advance directive, en- Finally, the DONATE Act incor- have the potential to greatly improve suring that the donors wishes are hon- porates a valuable initiative developed donation rates. Registries provide med- ored. by Senator BILL FRIST to present do- ical and/or procurement personnel easy The DONATE Act both funds State nors or the family of a donor with a access to the donation wishes of brain- registry development and creates the Congressional medal recognizing their dead patients. By indicating the poten- technical expertise States need to do gift of life. The bronze medal is just

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00068 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.071 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6455 one small, meaningful way we can ac- doesn’t work, it must be reformed. Un- tion champions and thus champions of the knowledge the important act of donat- fortunately we haven’t gotten past the world; ing to save another person’s life. rhetoric to fix the problem. Instead of Whereas this is the second consecutive sea- son that the Los Angeles Lakers have won A great deal of input from experts, making changes that will produce re- the National Basketball Association cham- and from my colleagues as well, con- sults that are better for the taxpayers, pionship; tributed to this legislation. All of these better for the environment, and more Whereas the Los Angeles Lakers are one of important provisions come with the efficient for everyone involved—gov- America’s preeminent sports franchises and strong support and input of many ernment agencies, Federal bureaucrats, have won their 13th NBA Championship. groups whose mission it is to help save and Congress have protected this trou- Whereas the Los Angeles Lakers sealed bled and inefficient program from their second consecutive championship with lives by increasing organ donation, in- the best playoff record in the history of the cluding the American Liver Founda- meaning reform. National Basketball Association, and be- tion, the American Society of Trans- As Washington has played politics came the first team to go through the play- plantation and the American Society with the Superfund program, innocent offs undefeated on the road; of Transplant Surgeons. I strongly be- Main Street small business owners Whereas this exceptionally gifted team is lieve that this type of concrete invest- across the nation, the engine of our guided by Phil Jackson, one of the most suc- ment and commitment from the Fed- economy, continue to be unfairly cessful coaches in the history of professional pulled into Superfund’s legal quagmire. basketball, who led the Lakers to victory in eral government is overdue and will 23 of their last 24 games; make a real difference. And in this case We now have the opportunity to put all Whereas the Los Angeles Lakers’ 2001 Na- a real difference is someone’s life. of that behind us and move forward tional Basketball Association championship I urge my colleagues to join me in with bipartisan, common-sense reform. was characterized by a remarkable team ef- this effort to wipe out the waiting list Let’s put a human face on this: re- fort, led by the series Most Valuable Player for transplants. I urge you all to co- cently, just across the Missouri bor- Shaquille O’Neal; and der—in Quincy, Illinois—160 small busi- Whereas it is appropriate and fitting to sponsor the DONATE Act and move ex- now offer these athletes and their coach the peditiously to pass this legislation. ness owners were asked to pay the EPA more than $3 million for garbage le- attention and accolades they have earned: Now, therefore, be it By Mr. BOND (for himself, Mr. gally hauled to a dump more than 20 Resolved, That the Senate congratulates REID, Mr. SMITH of New Hamp- years ago. The situation in Quincy is the entire 2001 Los Angeles team and its shire, Mr. KERRY, Mr. WARNER, just one example of the very real, ongo- coach Phil Jackson for their remarkable Mr. CHAFEE, Mr. WYDEN, Mr. ing Superfund legal threat to small achievement, and their drive, discipline, and dominance. CLELAND, Mr. ENSIGN, and Ms. business owners across the nation. LANDRIEU): We all know that Superfund was cre- Mrs. BOXER. Mr. President, last Fri- S. 1064. A bill to amend the Com- ated to clean up the Nation’s most-haz- day, as millions of Americans and bas- prehensive Environmental Response, ardous waste sites. Superfund was not ketball fans around the world watched Compensation, and Liability Act of created to have small business owners on television and listened on the radio, 1980 to provide certain relief from li- sued for simply throwing out their the Los Angeles Lakers defeated the ability for small businesses; to the trash! These small business owners are Philadelphia 76ers to become the 2001 Committee on Environment and Public faced with so many challenges already, National Basketball Association cham- Works. that the thousands of dollars in pen- pions. Mr. BOND. Mr. President, it is a alties and lawsuits leave them with no This is the second consecutive year pleasure for me to introduce the Small choice but to mortgage their busi- that the Lakers have won the NBA Business Liability Protection Act of nesses, their employees and their fu- championship. No team has ever enjoyed a post-sea- 2001. This bill will provide a lifeline for ture to pay for the bills of a broken son quite like the Lakers. They the thousands of small business owners government program. clinched the championship in five threatened by lawsuits and litigation How many times will we tell our- games, finishing the playoffs with a under the broken Superfund liability selves that this unacceptable situation record of 15–1—the best ever. They were system. Joining me in introducing this must be fixed before we act? Small also the first team to go through the legislation are Senators REID, SMITH, business owners literally cannot afford to wait around while we delay action playoffs without losing a single game KERRY, WARNER, CHAFEE, CLELAND, on the road. LANDRIEU, ENSIGN, and WYDEN. on the common-sense fixes required to protect them and our environment. Throughout the playoffs and cham- The bill is simple. All this bill does is pionship series, one player in par- protect those who contributed very Is this legislation everything I would like to see. No. But this bill does move ticular came to symbolize the Lakers’ small amounts of waste, or waste no march to victory: The Big Man— different than common household gar- us in the direction we need to go to en- sure cleanup, fairness, and progress in Shaquille O’Neal. Because of his ster- bage, to a Superfund site. The bill will ling play and leadership, Shaquille also speed up the process for handling reforming the Superfund program. In recognition of our small busi- O’Neal was named Most Valuable Play- those little fish with a limited ability nesses around the country, I introduce er for the series. O’Neal, of course, ben- to pay towards a Superfund site’s this bill and look forward to ensuring efitted from a sterling supporting cast cleanup. that included Kobe Bryant, Rick Fox, The exact same version of this bill speedy adoption of this long overdue legislation. Derek Fisher, Robert Horry and others. passed the House unanimously in May Indeed, Mr. President, this year’s and I am proud to have similar bipar- f championship was truly a team effort. tisan support for this Senate version. STATEMENTS ON SUBMITTED While the lion’s share of the credit We have members from both the Envi- RESOLUTIONS for their remarkable victory goes to ronment Committee and the Small the players themselves, I also want to Business Committee supporting this acknowledge the outstanding coaching bill at introduction and I encourage all SENATE RESOLUTION 113—CON- staff led by head coach Phil Jackson. my colleagues to join our effort. GRATULATIONS TO THE LOS AN- This is Coach Jackson’s eighth NBA My bill will not let polluters off the GELES LAKERS ON THEIR SEC- title and his second with the Lakers. hook. This common-sense proposal will OND CONSECUTIVE NATIONAL I think it is safe to say that these make the Superfund program a little BASKETBALL ASSOCIATION Los Angeles Lakers are a basketball more reasonable and workable. With CHAMPIONSHIP dynasty-in-the-making, and I am de- this legislation, we can begin to pro- Mrs. BOXER (for herself and Mrs. lighted to introduce this resolution ac- vide some relief to small business own- FEINSTEIN) submitted the following res- knowledging their efforts and con- ers who are held hostage by potential olution; which was considered and gratulating the Lakers and their fans Superfund liability. agreed to: in California and around the world. For years now, members from both S. RES. 113 Mrs. FEINSTEIN. Mr. President, I sides of the aisle have said that the Whereas the Los Angeles Lakers are the rise today to congratulate the Los An- Superfund program is broken, it undisputed 2001 National Basketball Associa- geles Lakers for winning the National

VerDate 19-JUN-2001 03:40 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00069 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.073 pfrm03 PsN: S19PT1 S6456 CONGRESSIONAL RECORD — SENATE June 19, 2001 Basketball Association championship current resolution; which was referred ‘‘SEC. 33. PEST MANAGEMENT IN SCHOOLS. for a second year in a row. to the Committee on the Judiciary: ‘‘(a) DEFINITIONS.—In this section: The Lakers overcame internal con- S. CON. RES. 51 ‘‘(1) BAIT.—The term ‘bait’ means a pes- flict and numerous injuries to go on to ticide that contains an ingredient that Whereas news of the end of slavery did not serves as a feeding stimulant, odor, a remarkable season. reach frontier areas of the Nation, especially They put together a remarkable pheromone, or other attractant for a target in the southwestern United States, until pest. string of victories at the end of the sea- long after the conclusion of the Civil War; ‘‘(2) CONTACT PERSON.—The term ‘contact son to bring home another World Whereas the African Americans who had person’ means an individual who is— Championship to the City of Los Ange- been slaves in the Southwest thereafter cele- ‘‘(A) knowledgeable about school pest man- les, winning 23 out of 24 of their final brated June 19, known as Juneteenth Inde- agement plans; and games and going 15 and 1 in the play- pendence Day, as the anniversary of their ‘‘(B) designated by a local educational offs—the best playoff record ever. emancipation; agency to carry out implementation of the This Lakers team demonstrated what Whereas those African Americans handed school pest management plan of a school. down that tradition from generation to gen- it truly means to be a champion and ‘‘(3) EMERGENCY.—The term ‘emergency’ eration as an inspiration and encouragement means an urgent need to mitigate or elimi- represents the best of what the city of for future generations; Los Angeles has to offer. nate a pest that threatens the health or safe- Whereas Juneteenth Independence Day ty of a student or staff member. Led by the inspired play of Shaquille celebrations have thus been held for 136 ‘‘(4) LOCAL EDUCATIONAL AGENCY.—The O’Neal and the coaching of Phil Jack- years to honor the memory of all those who son, the Lakers swept through the term ‘local educational agency’ has the endured slavery and especially those who meaning given the term in section 3 of the opening three rounds of the playoffs— moved from slavery to freedom; and Elementary and Secondary Education Act of easily defeating the talented Portland Whereas the faith and strength of char- 1965. acter shown by those former slaves remains Trailblazers, Sacramento Kings, and ‘‘(5) SCHOOL.— an example for all people of the United San Antonio Spurs. ‘‘(A) IN GENERAL.—The term ‘school’ means In the final round, the Lakers faced a States, regardless of background, region, or a public— gritty Philadelphia 76ers team led by race: Now, therefore, be it ‘‘(i) elementary school (as defined in sec- Resolved by the Senate (the House of Rep- tion 3 of the Elementary and Secondary Edu- the incomparable Allen Iverson. resentatives concurring), That— cation Act of 1965); Iverson and the Sixers showed tremen- (1) Congress recognizes the historical sig- ‘‘(ii) secondary school (as defined in sec- dous determination and heart, handing nificance of Juneteenth Independence Day, tion 3 of the Act); an overtime defeat to the Lakers in the an important date in the Nation’s history, ‘‘(iii) kindergarten or nursery school that first game of the series. and encourages the continued celebration of is part of an elementary school or secondary that day to provide an opportunity for all But as the series moved on, the school; or people of the United States to learn more Lakers outmatched the Sixers and ‘‘(iv) tribally-funded school. about the past and to better understand the proved, once again, that they were the ‘‘(B) INCLUSIONS.—The term ‘school’ in- experiences that have shaped the Nation; and best team in professional basketball. cludes any school building, and any area out- (2) it is the sense of Congress that— This was truly a team effort: side of a school building (including a lawn, (A) history should be regarded as a means Shaquille O’Neal, the series Most Valu- playground, sports field, and any other prop- for understanding the past and solving the erty or facility), that is controlled, managed, able Player, dominated the Sixers on challenges of the future; or owned by the school or school district. both ends of the floor, averaging 33 (B) the celebration of the end of slavery is ‘‘(6) SCHOOL PEST MANAGEMENT PLAN.—The points per game, 15.8 rebounds, 4.8 as- an important and enriching part of the his- term ‘school pest management plan’ means a sists, and 3.4 blocks in the final series. tory and heritage of the United States; and pest management plan developed under sub- With his unselfish play, Kobe Bryant (C) the Secretary of the Senate should section (b). provided the spark for the offense—in transmit a copy of this concurrent resolu- ‘‘(7) STAFF MEMBER.— game four, for instance, he scored 19 tion to the National Association of ‘‘(A) IN GENERAL.—The term ‘staff member’ Juneteenth Lineage as an expression of ap- points, had 10 assists, and had 9 re- means a person employed at a school or local preciation for the association’s role in pro- bounds. educational agency. moting the observance of the end of slavery. Derek Fisher, Rick Fox, Robert ‘‘(B) EXCLUSIONS.—The term ‘staff member’ Horry and Brian Shaw made significant f does not include— contributions to the championship— AMENDMENTS SUBMITTED AND ‘‘(i) a person hired by a school, local edu- each cooly made three point shots at PROPOSED cational agency, or State to apply a pes- critical points in the series. ticide; or Horace Grant and Ron Harper pro- SA 805. Mr. DURBIN (for Mr. TORRICELLI) ‘‘(ii) a person assisting in the application vided the veteran experience that proposed an amendment to the bill H.R. 1, to of a pesticide. helped the Lakers push back the 4th close the achievement gap with account- ‘‘(8) STATE AGENCY.—The term ‘State agen- ability, flexibility, and choice, so that no cy’ means the an agency of a State, or an quarter surges of the Sixers. child is left behind. agency of an Indian tribe or tribal organiza- And finally, Tyronn Lue, deserves SA 806. Mr. REID (for Mr. HARKIN (for him- tion (as those terms are defined in section 4 honorable mention for his dogged de- self and Mr. LUGAR)) proposed an amendment of the Indian Self-Determination and Edu- fense against Allen Iverson, especially to the bill S. 657, to authorize funding for the cation Assistance Act (25 U.S.C. 450b)), that in Game 1. Without his play, the National 4-H Program Centennial initiative. exercises primary jurisdiction over matters Lakers would have been unable to con- f relating to pesticide regulation. tain the speedy Sixer guard. ‘‘(9) UNIVERSAL NOTIFICATION.—The term Once again let me congratulate the TEXT OF AMENDMENTS ‘universal notification’ means notice pro- Los Angeles Lakers for their victory. It SA 805. Mr. DURBIN (for Mr. vided by a local educational agency or school was a great effort by a tremendous TORRICELLI) proposed an amendment to to— team. the bill H.R. 1, to close the achieve- ‘‘(A) parents, legal guardians, or other per- I look forward to another winning sons with legal standing as parents of each ment gap with accountability, flexi- child attending the school; and season next year. bility, and choice, so that no child is ‘‘(B) staff members of the school. f left behind; as follows: ‘‘(b) SCHOOL PEST MANAGEMENT PLANS.— SENATE CONCURRENT RESOLU- At the appropriate place insert the fol- ‘‘(1) STATE PLANS.— lowing: TION 51—RECOGNIZING THE HIS- ‘‘(A) GUIDANCE.—As soon as practicable SEC. 9ll. PEST MANAGEMENT IN SCHOOLS. (but not later than 180 days) after the date of TORICAL SIGNIFICANCE OF (a) SHORT TITLE.—This section may be enactment of the School Environment Pro- JUNETEENTH INDEPENDENCE cited as the ‘‘School Environment Protec- tection Act of 2001, the Administrator shall DAY AND EXPRESSING THE tion Act of 2001’’. develop, in accordance with this section— SENSE OF CONGRESS THAT HIS- (b) PEST MANAGEMENT.—The Federal Insec- ‘‘(i) guidance for a school pest management TORY BE REGARDED AS A ticide, Fungicide, and Rodenticide Act is plan; and MEANS OF UNDERSTANDING THE amended— ‘‘(ii) a sample school pest management PAST AND SOLVING THE CHAL- (1) by redesignating sections 33 and 34 (7 plan. LENGES OF THE FUTURE U.S.C. 136x, 136y) as sections 34 and 35, re- ‘‘(B) PLAN.—As soon as practicable (but spectively; and not later than 1 year) after the date of enact- Mr. BROWNBACK (for himself and (2) by inserting after section 32 (7 U.S.C. ment of the School Environment Protection Mr. LOTT) submitted the following con- 136w–7) the following: Act of 2001, each State agency shall develop

VerDate 19-JUN-2001 03:01 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00070 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.044 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6457 and submit to the Administrator for ap- termined by the Administrator), the State (as defined in clauses (i) and (ii) of section proval, as part of the State cooperative agency may maintain the school pest man- 2(mm)(1)(A))) for at least 3 years after the agreement under section 23, a school pest agement plan and shall not be required to de- date on which the pesticide is applied; and management plan for local educational agen- velop a new school pest management plan ‘‘(v) make that data available for inspec- cies in the State. under subparagraph (B). tion on request by any person. ‘‘(C) COMPONENTS.—A school pest manage- ‘‘(2) IMPLEMENTATION BY LOCAL EDU- ‘‘(4) NOTIFICATION.— ment plan developed under subparagraph (B) CATIONAL AGENCIES.— ‘‘(A) UNIVERSAL NOTIFICATION.—At the be- shall, at a minimum— ‘‘(A) IN GENERAL.—Not later than 1 year ginning of each school year, at the midpoint ‘‘(i) implement a system that— after the date on which a local educational of each school year, and at the beginning of ‘‘(I) eliminates or mitigates health risks, agency receives a copy of a school pest man- any summer session (as determined by the or economic or aesthetic damage, caused by agement plan of a State agency under para- school), a local educational agency or school pests; graph (1)(E), the local educational agency shall provide to staff members of a school, ‘‘(II) employs— shall develop and implement in each of the and to parents, legal guardians, and other ‘‘(aa) integrated methods; schools under the jurisdiction of the local persons with legal standing as parents of stu- ‘‘(bb) site or pest inspection; educational agency a school pest manage- dents enrolled at the school, a notice de- ‘‘(cc) pest population monitoring; and ment plan that meets the standards and re- scribing the school pest management plan ‘‘(dd) an evaluation of the need for pest quirements under the school pest manage- that includes— management; and ment plan of the State agency, as deter- ‘‘(i) a summary of the requirements and ‘‘(III) is developed taking into consider- mined by the Administrator. procedures under the school pest manage- ation pest management alternatives (includ- ‘‘(B) EXCEPTION FOR EXISTING PLANS.—If, on ment plan; ing sanitation, structural repair, and me- the date of enactment of the School Environ- ‘‘(ii) a description of any potential pest chanical, biological, cultural, and pesticide ment Protection Act of 2001, a State main- problems that the school may experience (in- strategies) that minimize health and envi- tains a school pest management plan that, at cluding a description of the procedures that ronmental risks; a minimum, meets the standards and criteria may be used to address those problems); ‘‘(ii) require, for pesticide applications at established under this section (as determined ‘‘(iii) the address, telephone number, and the school, universal notification to be pro- by the Administrator), and a local edu- website address of the Office of Pesticide vided— cational agency in the State has imple- Programs of the Environmental Protection ‘‘(I) at the beginning of the school year; mented the State school pest management Agency; and ‘‘(II) at the midpoint of the school year; plan, the local educational agency may ‘‘(iv) the following statement (including and maintain the school pest management plan information to be supplied by the school as ‘‘(III) at the beginning of any summer ses- and shall not be required to develop and im- indicated in brackets): sion, as determined by the school; plement a new school pest management plan ‘As part of a school pest management ‘‘(iii) establish a registry of staff members under subparagraph (A). plan, ø¿ may use pesticides to control of a school, and of parents, legal guardians, ‘‘(C) APPLICATION OF PESTICIDES AT pests. The Environmental Protection Agency or other persons with legal standing as par- SCHOOLS.—A school pest management plan (EPA) and ø¿ registers pesticides for ents of each child attending the school, that shall prohibit— that use. EPA continues to examine reg- have requested to be notified in advance of ‘‘(i) the application of a pesticide to any istered pesticides to determine that use of any pesticide application at the school; area or room at a school while the area or the pesticides in accordance with instruc- ‘‘(iv) establish guidelines that are con- room is occupied or in use by students or tions printed on the label does not pose un- sistent with the definition of a school pest staff members (except students and staff par- reasonable risks to human health and the en- management plan under subsection (a); ticipating in regular or vocational agricul- vironment. Nevertheless, EPA cannot guar- ‘‘(v) require that each local educational tural instruction involving the use of pes- antee that registered pesticides do not pose agency use a certified applicator or a person ticides); and risks, and unnecessary exposure to pesticides authorized by the State agency to imple- ‘‘(ii) the use by students or staff members should be avoided. Based in part on rec- ment the school pest management plans; of an area or room treated with a pesticide ommendations of a 1993 study by the Na- ‘‘(vi) be consistent with the State coopera- by broadcast spraying, baseboard spraying, tional Academy of Sciences that reviewed tive agreement under section 23; and tenting, or fogging during— registered pesticides and their potential to ‘‘(vii) require the posting of signs in ac- ‘‘(I) the period specified on the label of the cause unreasonable adverse effects on human cordance with paragraph (4)(G). pesticide during which a treated area or health, particularly on the health of preg- ‘‘(D) APPROVAL BY ADMINISTRATOR.—Not room should remain unoccupied; or nant women, infants, and children, Congress later than 90 days after receiving a school ‘‘(II) if there is no period specified on the enacted the Food Quality Protection Act of pest management plan submitted by a State label, the 24-hour period beginning at the end 1996. That law requires EPA to reevaluate all agency under subparagraph (B), the Adminis- of the treatment. registered pesticides and new pesticides to trator shall— ‘‘(3) CONTACT PERSON.— measure their safety, taking into account ‘‘(i) determine whether the school pest ‘‘(A) IN GENERAL.—Each local educational the unique exposures and sensitivity that management plan, at a minimum, meets the agency shall designate a contact person to pregnant women, infants, and children may requirements of subparagraph (C); and carry out a school pest management plan in have to pesticides. EPA review under that ‘‘(ii)(I) if the Administrator determines schools under the jurisdiction of the local law is ongoing. You may request to be noti- that the school pest management plan meets educational agency. fied at least 24 hours in advance of pesticide the requirements, approve the school pest ‘‘(B) DUTIES.—The contact person of a local applications to be made and receive informa- management plan as part of the State coop- educational agency shall— tion about the applications by registering erative agreement; or ‘‘(i) maintain information about the sched- with the school. Certain pesticides used by ‘‘(II) if the Administrator determines that uling of pesticide applications in each school the school (including baits, pastes, and gels) the school pest management plan does not under the jurisdiction of the local edu- are exempt from notification requirements. meet the requirements— cational agency; If you would like more information con- ‘‘(aa) disapprove the school pest manage- ‘‘(ii) act as a contact for inquiries, and dis- cerning any pesticide application or any ment plan; seminate information requested by parents product used at the school, contact ø ‘‘(bb) provide the State agency with rec- or guardians, about the school pest manage- ¿’. ommendations for and assistance in revising ment plan; ‘‘(B) NOTIFICATION TO PERSONS ON REG- the school pest management plan to meet ‘‘(iii) maintain and make available to par- ISTRY.— the requirements; and ents, legal guardians, or other persons with ‘‘(i) IN GENERAL.—Except as provided in ‘‘(cc) provide a 90-day deadline by which legal standing as parents of each child at- clause (ii) and paragraph (5)— the State agency shall resubmit the revised tending the school, before and during the no- ‘‘(I) notice of an upcoming pesticide appli- school pest management plan to obtain ap- tice period and after application— cation at a school shall be provided to each proval of the plan, in accordance with the ‘‘(I) copies of material safety data sheet for person on the registry of the school not later State cooperative agreement. pesticides applied at the school, or copies of than 24 hours before the end of the last busi- ‘‘(E) DISTRIBUTION OF STATE PLAN TO material safety data sheets for end-use dilu- ness day during which the school is in ses- SCHOOLS.—On approval of the school pest tions of pesticides applied at the school, if sion that precedes the day on which the ap- management plan of a State agency, the data sheets are available; plication is to be made; and State agency shall make the school pest ‘‘(II) labels and fact sheets approved by the ‘‘(II) the application of a pesticide for management plan available to each local Administrator for all pesticides that may be which a notice is given under subclause (I) educational agency in the State. used by the local educational agency; and shall not commence before the end of the ‘‘(F) EXCEPTION FOR EXISTING STATE ‘‘(III) any final official information related business day. PLANS.—If, on the date of enactment of the to the pesticide, as provided to the local edu- ‘‘(ii) NOTIFICATION CONCERNING PESTICIDES School Environment Protection Act of 2001, cational agency by the State agency; and USED IN CURRICULA.—If pesticides are used as a State has implemented a school pest man- ‘‘(iv) for each school, maintain all pes- part of a regular vocational agricultural cur- agement plan that, at a minimum, meets the ticide use data for each pesticide used at the riculum of the school, a notice containing requirements under subparagraph (C) (as de- school (other than antimicrobial pesticides the information described in subclauses (I),

VerDate 19-JUN-2001 03:01 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00071 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.065 pfrm03 PsN: S19PT1 S6458 CONGRESSIONAL RECORD — SENATE June 19, 2001

(IV), (VI), and (VII) of clause (iii) for all pes- ‘‘(F) REISSUANCE.—If the date of the appli- ‘‘(1) precludes a State or political subdivi- ticides that may be used as a part of that cation of the pesticide needs to be extended sion of a State from imposing on local edu- curriculum shall be provided to persons on beyond the period required for notice under cational agencies and schools any require- the registry only once at the beginning of this paragraph, the school shall issue a no- ment under State or local law (including reg- each academic term of the school. tice containing only the new date and loca- ulations) that is more stringent than the re- ‘‘(iii) CONTENTS OF NOTICE.—A notice under tion of application. quirements imposed under this section; or clause (i) shall contain— ‘‘(G) POSTING OF SIGNS.— ‘‘(2) establishes any exception under, or af- ‘‘(I) the trade name, common name (if ap- ‘‘(i) IN GENERAL.—Except as provided in fects in any other way, section 24(b). plicable), and Environmental Protection paragraph (5)— ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.— Agency registration number of each pes- ‘‘(I) a school shall post a sign not later There are authorized to be appropriated such ticide to be applied; than the last business day during which sums as are necessary to carry out this sec- ‘‘(II) a description of each location at the school is in session preceding the date of ap- tion.’’. school at which a pesticide is to be applied; plication of a pesticide at the school; and (c) CONFORMING AMENDMENT.—The table of ‘‘(III) a description of the date and time of ‘‘(II) the application for which a sign is contents in section 1(b) of the Federal Insec- application, except that, in the case of an posted under subclause (I) shall not com- ticide, Fungicide, and Rodenticide Act (7 outdoor pesticide application, a notice shall mence before the time that is 24 hours after U.S.C. prec. 121) is amended by striking the include at least 3 dates, in chronological the end of the business day on which the sign items relating to sections 30 through 32 and order, on which the outdoor pesticide appli- is posted. inserting the following: ‘‘(ii) LOCATION.—A sign shall be posted cation may take place if the preceding date ‘‘Sec. 30. Minimum requirements for training under clause (i)— is canceled; of maintenance applicators and ‘‘(I) at a central location noticeable to in- ‘‘(IV) all information supplied to the local service technicians. dividuals entering the building; and educational agency by the State agency, in- ‘‘Sec. 31. Environmental Protection Agency ‘‘(II) at the proposed site of application. cluding a description of potentially acute minor use program. ‘‘(iii) ADMINISTRATION.—A sign required to and chronic effects that may result from ex- ‘‘Sec. 32. Department of Agriculture minor be posted under clause (i) shall— posure to each pesticide to be applied based use program. ‘‘(I) remain posted for at least 24 hours ‘‘(a) In general. on— after the end of the application; ‘‘(b)(1) Minor use pesticide data. ‘‘(aa) a description of potentially acute and ‘‘(II) be— ‘‘(2) Minor Use Pesticide Data chronic effects that may result from expo- ‘‘(aa) at least 81⁄2 inches by 11 inches for Revolving Fund. sure to each pesticide to be applied, as stated signs posted inside the school; and ‘‘Sec. 33. Pest management in schools. on the label of the pesticide approved by the ‘‘(bb) at least 4 inches by 5 inches for signs ‘‘(a) Definitions. Administrator; posted outside the school; and ‘‘(1) Bait. ‘‘(bb) information derived from the mate- ‘‘(III) contain— ‘‘(2) Contact person. rial safety data sheet for the end-use dilu- ‘‘(aa) information about the pest problem ‘‘(3) Emergency. tion of the pesticide to be applied (if avail- for which the application is necessary; ‘‘(4) Local educational agen- able) or the material safety data sheets; and ‘‘(bb) the name of each pesticide to be used; cy. ‘‘(cc) final, official information related to ‘‘(cc) the date of application; ‘‘(5) School. the pesticide prepared by the Administrator ‘‘(dd) the name and telephone number of ‘‘(6) Staff member. ‘‘(7) State agency. and provided to the local educational agency the designated contact person; and by the State agency; ‘‘(8) Universal notification. ‘‘(ee) the statement contained in subpara- ‘‘(b) School pest management ‘‘(V) a description of the purpose of the ap- graph (A)(iv). plans. plication of the pesticide; ‘‘(iv) OUTDOOR PESTICIDE APPLICATIONS.— ‘‘(VI) the address, telephone number, and ‘‘(1) State plans. ‘‘(I) IN GENERAL.—In the case of an outdoor ‘‘(2) Implementation by local website address of the Office of Pesticide pesticide application at a school, each sign Programs of the Environmental Protection educational agencies. shall include at least 3 dates, in chrono- ‘‘(3) Contact person. Agency; and logical order, on which the outdoor pesticide ‘‘(4) Notification. ‘‘(VII) the statement described in subpara- application may take place if the preceding ‘‘(5) Emergencies. graph (A)(iv) (other than the ninth sentence date is canceled. ‘‘(c) Relationship to State and of that statement). ‘‘(II) DURATION OF POSTING.—A sign de- local requirements. ‘‘(C) NOTIFICATION AND POSTING EXEMP- scribed in subclause (I) shall be posted after ‘‘(d) Authorization of appro- TION.—A notice or posting of a sign under an outdoor pesticide application in accord- priations. subparagraph (A), (B), or (G) shall not be re- ance with clauses (ii) and (iii). ‘‘Sec. 34. Severability. quired for the application at a school of— ‘‘(5) EMERGENCIES.— ‘‘Sec. 35. Authorization of appropriations.’’. ‘‘(i) an antimicrobial pesticide; ‘‘(A) IN GENERAL.—A school may apply a (d) EFFECTIVE DATE.—This section and the ‘‘(ii) a bait, gel, or paste that is placed— pesticide at the school without complying amendments made by this section take ef- ‘‘(I) out of reach of children or in an area with this part in an emergency, subject to fect on October 1, 2001. that is not accessible to children; or subparagraph (B). ‘‘(II) in a tamper-resistant or child-resist- ‘‘(B) SUBSEQUENT NOTIFICATION OF PARENTS, SA 806. Mr. REID (for Mr. HARKIN (for ant container or station; and GUARDIANS, AND STAFF MEMBERS.—Not later himself and Mr. LUGAR)) proposed an ‘‘(iii) any pesticide that, as of the date of than the earlier of the time that is 24 hours amendment to the bill S. 657, to au- enactment of the School Environment Pro- after a school applies a pesticide under this thorize funding for the National 4–H tection Act of 2001, is exempt from the re- paragraph or on the morning of the next quirements of this Act under section 25(b) business day, the school shall provide to Program Centennial Initiative; as fol- (including regulations promulgated at sec- each parent or guardian of a student listed lows: tion 152 of title 40, Code of Federal Regula- on the registry, a staff member listed on the Beginning on page 2, strike line 14 and all tions (or any successor regulation)). registry, and the designated contact person, that follows through page 3, line 22, and in- ‘‘(D) NEW STAFF MEMBERS AND STUDENTS.— notice of the application of the pesticide in sert the following: After the beginning of each school year, a an emergency that includes— (b) GRANT.— local educational agency or school within a ‘‘(i) the information required for a notice (1) IN GENERAL.—The Secretary of Agri- local educational agency shall provide each under paragraph (4)(G); and culture may provide a grant to the National notice required under subparagraph (A) to— ‘‘(ii) a description of the problem and the 4–H Council to pay the Federal share of the ‘‘(i) each new staff member who is em- factors that required the application of the cost of— ployed during the school year; and pesticide to avoid a threat to the health or (A) conducting a program of discussions ‘‘(ii) the parent or guardian of each new safety of a student or staff member. through meetings, seminars, and listening student enrolled during the school year. ‘‘(C) METHOD OF NOTIFICATION.—The school sessions on the National, State, and local ‘‘(E) METHOD OF NOTIFICATION.—A local may provide the notice required by para- levels regarding strategies for youth devel- educational agency or school may provide a graph (B) by any method of notification de- opment; and notice under this subsection, using informa- scribed in paragraph (4)(E). (B) preparing a report that— tion described in paragraph (4), in the form ‘‘(D) POSTING OF SIGNS.—Immediately after (i) summarizes and analyzes the discus- of— the application of a pesticide under this sions; ‘‘(i) a written notice sent home with the paragraph, a school shall post a sign warning (ii) makes specific recommendations of students and provided to staff members; of the pesticide application in accordance strategies for youth development; and ‘‘(ii) a telephone call; with clauses (ii) through (iv) of paragraph (iii) proposes a plan of action for carrying ‘‘(iii) direct contact; (4)(B). out those strategies. ‘‘(iv) a written notice mailed at least 1 ‘‘(c) RELATIONSHIP TO STATE AND LOCAL RE- (2) COST SHARING.— week before the application; or QUIREMENTS.—Nothing in this section (in- (A) IN GENERAL.—The Federal share of the ‘‘(v) a notice delivered electronically (such cluding regulations promulgated under this cost of the program under paragraph (1) shall as through electronic mail or facsimile). section)— be 50 percent.

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00072 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.065 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6459 (B) FORM OF NON-FEDERAL SHARE.—The sales by public utilities of electric en- SUBCOMMITTEE ON INTERNATIONAL TRADE AND non-Federal share of the cost of the program ergy at wholesale in the western en- FINANCE under paragraph (1) may be paid in the form ergy market, and for other purposes; Mr. REID. Mr. President, I ask unan- of cash or the provision of services, material, and sections 508–510 (relating to whole- imous consent that the Subcommittee or other in-kind contributions. on International Trade and Finance of (3) AMOUNT.—The grant made under this sale electricity rates in the western en- subsection shall not exceed $5,000,000. ergy market, natural gas rates in Cali- the Committee on Banking, Housing, (c) REPORT.—The National 4–H Council fornia, and the sale price of bundled and Urban Affairs be authorized to shall submit any report prepared under sub- natural gas transactions) of S. 597, the meet during the session of the Senate section (b) to the President, the Secretary of Comprehensive and Balanced Energy on June 19, 2001 to conduct a hearing Agriculture, the Committee on Agriculture Policy Act of 2001. on ‘‘Reauthorization of the U.S. Ex- of the House of Representatives, and the The PRESIDING OFFICER. Without port-Import Bank.’’ Committee on Agriculture, Nutrition, and objection, it is so ordered. The PRESIDING OFFICER. Without Forestry of the Senate. objection, it is so ordered. (d) FUNDING.—The Secretary may fund the COMMITTEE ON FINANCE grant authorized by this section from— Mr. REID. Mr. President, I ask unan- f (1) funds made available under subsection imous consent that the Committee on PRIVILEGE OF THE FLOOR (e); and Finance be authorized to meet during (2) notwithstanding subsections (c) and (d) the session of the Senate on Tuesday, Mr. REID. Mr. President, on behalf of of section 793 of the Federal Agriculture Im- June 19, 2001, to here testimony regard- Senator KENNEDY, I ask unanimous provement and Reform Act of 1996 (7 U.S.C. consent that Stacey Sachs, a fellow in 2204f), funds from the Account established ing Medicare Governance: Perspectives under section 793(a) of that Act. on the Centers for Medicare and Med- his office, have the privileges of the (e) AUTHORIZATION OF APPROPRIATIONS.— icaid Services (formerly HCFA). floor during the pendency of the debate There is authorized to be appropriated to The PRESIDING OFFICER. Without on S. 1052. carry out this section $5,000,000. objection, it is so ordered. The PRESIDING OFFICER. Without objection, it is so ordered. f COMMITTEE ON INDIAN AFFAIRS Mr. HARKIN. Mr. President, I ask NOTICE OF HEARING Mr. REID. Mr. President, I ask unan- unanimous consent that floor privi- imous consent that the Committee on COMMITTEE ON ENERGY AND NATURAL leges be granted to my health policy Indian Affairs be authorized to meet on fellow, Kris Hagglund, for the duration RESOURCES June 19, 2001, at 10:00 a.m. in room 485 Mr. BINGAMAN. Mr. President, I of the debate on the Patients’ Bill of Russell Senate Building to conduct a Rights. would like to announce for the infor- hearing to receive testimony on the mation of the Senate and the public The PRESIDING OFFICER. Without goals and priorites on the member objection, it is so ordered. that the Committee has scheduled a tribes of the Midwest Alliance of hearing to consider the nominations of Mr. REID. Mr. President, I ask unan- Soveregn Tribes For he 107th session of imous consent that Alaine Perry, a fel- Vicky A. Bailey to be an Assistant Sec- the Congress. retary of Energy (International Affairs low on Senator DASCHLE’s staff, be The PRESIDING OFFICER. Without granted privileges of the floor during and Domestic Policy), and Frances P. objection, it is so ordered. Mainella to be Director of the National debate on S. 1052. Park Service. COMMITTEE ON VETERANS’ AFFAIRS The PRESIDING OFFICER. Without The hearing will take place in room Mr. REID. Mr. President, I ask unan- objection, it is so ordered. imous consent that the Committee on 366, Dirksen Senate Office Building on f Wednesday, June 27, immediately fol- Veterans’ Affairs be authorized to meet lowing the committee’s 9:30 a.m. busi- during the session of the Senate on ORDER FOR STAR PRINT—S. 1041 ness meeting. Tuesday, June 19, 2001, for a markup on Mr. REID. Madam President, I ask Those wishing to submit written the nomination of Gordon H. Mansfield unanimous consent that S. 1041 be star statements on the nominations should to be Assistant Secretary for Congres- printed with the changes which are at address them to the Committee on En- sional Affairs at the Department of the desk. ergy and Natural Resources, United Veterans Affairs. The meeting will The PRESIDING OFFICER. Without States Senate, Washington, D.C., 20510. take place off the Senate chamber objection, it is so ordered. For further information, please con- after the first roll call vote of the day. f tact Sam Fowler at 202/224–7571. The PRESIDING OFFICER. Without objection, it is so ordered. f IMPORTANCE OF MEMBERSHIP OF SUBCOMMITTEE ON AGING THE UNITED STATES ON THE AUTHORITY FOR COMMITTEES TO Mr. REID. Mr. President, I ask unan- UNITED NATIONS HUMAN MEET imous consent that the Committee on RIGHTS COMMISSION COMMITTEE ON COMMERCE, SCIENCE, AND Health, Education, Labor, and Pen- Mr. REID. Madam President, I ask TRANSPORTATION sions, Subcommittee on Aging be au- unanimous consent that the Senate Mr. REID. Mr. President, I ask unan- thorized to meet for a hearing on ‘‘Ger- proceed to the immediate consider- imous consent that the Committee on iatrics: Meeting the Needs of Our Most ation of Calendar No. 50, S. Res. 88. Commerce, Science, and Transpor- Vulnerable Seniors in the 21st Cen- The PRESIDING OFFICER. The tation be authorized to meet on Tues- tury,’’ during the session of the Senate clerk will report the resolution by day, June 19, 2001, At 9:30 a.m. on local on Tuesday, June 19, 2001, at 10:00 a.m. title. competition. The PRESIDING OFFICER. Without The assistant legislative clerk read The PRESIDING OFFICER. Without objection, it is so ordered. as follows: objection, it is so ordered. SUBCOMMITTEE ON HOUSING AND A resolution (S. Res. 88) expressing the COMMITTEE ON ENERGY AND NATURAL TRANSPORTATION sense of the Senate on the importance of RESOURCES Mr. REID. Mr. President, I ask unan- membership of the United States on the Mr. REID. Mr. President, I ask unan- imous consent that the Subcommittee United Nations Human Rights Commission. imous consent that the Committee on on Housing and Transportation of the There being no objection, the Senate Energy and Natural Resources be au- Committee on Banking, Housing, and proceeded to consider the resolution. thorized to meet during the session of Urban Affairs be authorized to meet Mr. REID. Madam President, I ask the Senate on Tuesday, June 19 at 9:00 during the session of the Senate on unanimous consent the resolution and a.m. to conduct a hearing. The com- June 19, 2001, to conduct an oversight preamble be agreed to en bloc, the mo- mittee will receive testimony on S. 764, hearing on the Multifamily assisted tion to reconsider be laid upon the a bill to direct the Federal Energy Reg- Housing Reform and Affordability Act table en bloc, and any statements re- ulatory Commission to impose just and of 1997. lated thereto be printed in the RECORD. reasonable load-differentiated demand The PRESIDING OFFICER. Without The PRESIDING OFFICER. Without rate or cost-of-service based rates on objection, it is so ordered. objection, it is so ordered.

VerDate 19-JUN-2001 03:01 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00073 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.062 pfrm03 PsN: S19PT1 S6460 CONGRESSIONAL RECORD — SENATE June 19, 2001 The resolution (S. Res. 88) and its Elchanan Tannenbaum, presently held by The PRESIDING OFFICER. Without preamble were agreed to en bloc. Hezbollah forces in Lebanon. objection, it is so ordered. The resolution, with its preamble, There being no objection, the Senate The concurrent resolution (S. Con. reads as follows: proceeded to consider the concurrent Res. 42) and the preamble was agreed to S. RES. 88 resolution. en bloc. Whereas the United States played a crit- Mr. REID. Madam President, I ask The concurrent resolution, with its ical role in drafting the Universal Declara- unanimous consent that the concur- preamble, reads as follows: tion of Human Rights, which outlines the rent resolution and the preamble be S. CON. RES. 42 universal rights promoted and protected by agreed to en bloc, the motion to recon- Whereas the Taleban militia took power in the United Nations Human Rights Commis- sider be laid upon the table en bloc, Afghanistan in 1996, and now rules over 90 sion; and that any statements related there- percent of the country; Whereas the United Nations Human Rights to be printed in the RECORD. Whereas, under Taleban rule, most polit- Commission is the most important and visi- ical, civil, and human rights are denied to ble international entity dealing with the The PRESIDING OFFICER. Without objection, it is so ordered. the Afghan people; promotion and protection of universal Whereas women, minorities, and children human rights and is the main policy-making The concurrent resolution (S. Con. Res. 35) and its preamble were agreed suffer disproportionately under Taleban rule; entity dealing with human rights issues Whereas, according to the United States within the United Nations; to en bloc. Department of State Country Report on Whereas the 53 member governments of the The concurrent resolution, with its Human Rights Practices, violence against United Nations Human Rights Commission preamble, reads as follows: women and girls in Afghanistan occurs fre- prepare studies, make recommendations, S. CON. RES. 35 quently, including beatings, rapes, forced draft international human rights conven- marriages, disappearances, kidnapings, and tions and declarations, investigate allega- Whereas on October 7, 2000, Hezbollah units, in clear violation of international law, killings; tions of human rights violations, and handle Whereas Taleban edicts isolate Muslim and communications relating to human rights; crossed Lebanon’s international border and kidnapped three Israeli soldiers, Adi Avitan, non-Muslim minorities, and will require the Whereas the United States has held a seat thousands of Hindus living in Taleban-ruled on the United Nations Human Rights Com- Binyamin Avraham, and Omar Souad; Whereas on October 15, 2000, Hezbollah an- Afghanistan to wear identity labels on their mission since its creation in 1947; clothing, singling out these minorities for Whereas the United States has worked in nounced that it had abducted a fourth Israeli, Elchanan Tannenbaum; discrimination and harsh treatment; the United Nations Human Rights Commis- Whereas Taleban forces have targeted eth- sion for 54 years to improve respect for Whereas these captives are being held by Hezbollah in Lebanon; nic Shiite Hazaras, many of whom have been human rights throughout the world; massacred, while those who have survived, Whereas the United Nations Human Rights Whereas the 2000 Department of State re- port on foreign terrorist organizations stated are denied relief and discriminated against Commission adopted significant resolutions for their religious beliefs; condemning ongoing human rights abuses in that Hezbollah receives substantial amounts of financial assistance, training, weapons, Whereas non-Muslim religious symbols are Cuba, Iran, Iraq, Chechnya, Congo, Afghani- banned, and earlier this year Taleban forces stan, Equatorial Guinea, Burundi, Rwanda, explosives, and political, diplomatic, and or- ganizational assistance from Iran and Syria; obliterated 2 ancient statues of Buddha, Burma, and Sierra Leone in April, 2001, with claiming they were idolatrous symbols; the support of the United States; Whereas Syria, Lebanon, and Iran voted in favor of the Universal Declaration of Human Whereas Afghanistan is currently suffering Whereas, on May 3, 2001, the United States from its worst drought in 3 decades, affecting was not re-elected to membership in the Rights in the United Nations General Assem- bly; almost one-half of Afghanistan’s 21,000,000 United Nations Human Rights Commission; population, with the impact severely exacer- Whereas some of the countries elected to Whereas the International Committee of the Red Cross has made numerous attempts bated by the ongoing civil war and Taleban the United Nations Human Rights Commis- policies denying relief to needy areas; sion have been the subject of resolutions by to gain access to assess the condition of these prisoners; and Whereas the Taleban has systematically the Commission citing them for human interfered with United Nations relief pro- rights abuses; and Whereas the International Committee of the Red Cross has been denied access to grams and workers, recently closing a new Whereas it is important for the United hospital and arresting local workers, closing States to be a member of the United Nations these prisoners: Now, therefore, be it Resolved by the Senate (the House of Rep- United Nations World Food Program bak- Human Rights Commission in order to pro- resentatives concurring), That it is the sense eries providing much needed food, and clos- mote human rights worldwide most effec- of Congress that Lebanon, Syria, and Iran ing offices of the United Nations Special tively: Now, therefore, be it Mission to Afghanistan in 4 Afghan cities; Resolved, That it is the sense of the Senate should allow representatives of the Inter- Whereas, as a result of those policies, there that— national Committee of the Red Cross to visit are more than 25,000,000 persons who are in- (1) the United States has made important the four Israelis, Adi Avitan, Binyamin ternally displaced within Afghanistan, and contributions to the United Nations Human Avraham, Omar Souad, and Elchanan Tan- this year, contrary to past practice, the Rights Commission for the past 54 years; nenbaum, presently held by Hezbollah forces Taleban rejected a United Nations call for a (2) the recent loss of membership of the in Lebanon. cease-fire in order to bring assistance to the United States on the United Nations Human f internally displaced; Rights Commission is a setback for human CONDEMNATION OF THE TALEBAN Whereas, as a result of Taleban policies, rights throughout the world; and there are now more than 2,200,000 Afghan ref- (3) the Administration should work with Mr. REID. Madam President, I ask ugees in Pakistan, and 500,000 more refugees the European allies of the United States and unanimous consent that the Senate are expected to flee in the coming months other nations to restore the membership of proceed to the immediate consider- unless some form of relief is forthcoming; the United States on the United Nations ation of Calendar No. 52, S. Con. Res. Whereas Pakistan has closed its borders to Human Rights Commission. 42. Afghanistan, and has announced that Paki- f The PRESIDING OFFICER. The stani and United Nations officials will begin ALLOWING RED CROSS VISITATION clerk will report the resolution by screening refugees in June with a view to- title. ward forcibly repatriating all those who are Mr. REID. Madam President, I ask The assistant legislative clerk read found to be staying illegally in Pakistan; unanimous consent that the Senate as follows: Whereas the Taleban leadership continues proceed to the immediate consider- to give safe haven to terrorists, including A concurrent resolution (S. Con. Res. 42) ation of Calendar No. 51, S. Con. Res. Osama bin Laden, and is known to host and condemning the Taleban for their discrimi- provide training ground to other terrorist or- 35. natory policies, and for other purposes. The PRESIDING OFFICER. The ganizations; and There being no objection, the Senate clerk will report the resolution by Whereas the people of Afghanistan are the proceeded to consider the concurrent greatest victims of the Taleban, and in rec- title. ognition of that fact, the United States has The assistant legislative clerk read resolution. Mr. REID. Madam President, I ask provided $124,000,000 in relief to the people of as follows: unanimous consent that the concur- Afghanistan this year: Now, therefore, be it A concurrent resolution (S. Con. Res. 35) rent resolution and the preamble be Resolved by the Senate (the House of Rep- expressing sense of Congress that Lebanon, resentatives concurring), That Congress— Syria and Iran should allow representatives agreed to en bloc, the motion to recon- (1) condemns the harsh and discriminatory of the International Committee of the Red sider be laid upon the table en bloc, policies of the Taleban toward Muslims, Hin- Cross to visit the four Israelis, Adi Avitan, and that any statements related there- dus, women, and all other minorities, and Binyamin Avraham, Omar Souad, and to be printed in the RECORD. the attendant destruction of religious icons;

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00074 Fmt 0624 Sfmt 0634 E:\CR\FM\G19JN6.131 pfrm03 PsN: S19PT1 June 19, 2001 CONGRESSIONAL RECORD — SENATE S6461

(2) urges the Taleban to immediately re- (3) AMOUNT.—The grant made under this (d) FUNDING.—The Secretary may fund the open United Nations offices and hospitals subsection shall not exceed $5,000,000. grant authorized by this section from— and allow the provision of relief to all the (c) REPORT.—The National 4–H Council (1) funds made available under subsection people of Afghanistan; shall submit any report prepared under sub- (e); and (3) commends President George W. Bush section (b) to the President, the Secretary of (2) notwithstanding subsections (c) and (d) and his administration for their recognition Agriculture, the Committee on Agriculture of section 793 of the Federal Agriculture Im- of these urgent issues and encourages Presi- of the House of Representatives, and the provement and Reform Act of 1996 (7 U.S.C. dent Bush to continue to respond to those Committee on Agriculture, Nutrition, and 2204f), funds from the Account established issues; Forestry of the Senate. under section 793(a) of that Act. (4) recognizes the burdens placed on the (d) FUNDING.—The Secretary may fund the (e) AUTHORIZATION OF APPROPRIATIONS.— Government of Pakistan by Afghan refugees, grant authorized by this section from— There is authorized to be appropriated to and calls on that Government to facilitate (1) funds made available under subsection carry out this section $5,000,000. (e); and the provision of relief to these refugees and f to abandon any plans for forced repatriation; (2) notwithstanding subsections (c) and (d) and of section 793 of the Federal Agriculture Im- CONGRATULATING THE LOS (5) calls on the international community provement and Reform Act of 1996 (7 U.S.C. ANGELES LAKERS to increase assistance to the Afghan people 2204f), funds from the Account established and consider granting asylum to at-risk Af- under section 793(a) of that Act. Mr. REID. Madam President, I ask ghan refugees. (e) AUTHORIZATION OF APPROPRIATIONS.— unanimous consent that the Senate There is authorized to be appropriated to f proceed to the consideration of S. Res. carry out this section $5,000,000. 113 submitted earlier today by Sen- NATIONAL 4–H PROGRAM The bill (S. 657), as amended, was ators BOXER and FEINSTEIN. CENTENNIAL INITIATIVE read the third time and passed, as fol- The PRESIDING OFFICER. The Mr. REID. Madam President, I ask lows: clerk will report. unanimous consent that the Agri- S. 657 The assistant legislative clerk read culture Committee be discharged from Be it enacted by the Senate and House of Rep- as follows: further consideration of S. 657, and resentatives of the United States of America in A resolution (S. Res. 113) acknowledging that the Senate then proceed to its Congress assembled, that the Los Angeles Lakers are the undis- consideration. SECTION 1. NATIONAL 4–H PROGRAM CENTEN- puted 2001 National Basketball Association NIAL INITIATIVE. The PRESIDING OFFICER. Without champions and congratulating them for out- (a) FINDINGS.—Congress finds that— standing drive, discipline and dominance. objection, it is so ordered. (1) the 4–H Program is 1 of the largest The clerk will report the bill by title. youth development organizations operating There being no objection, the Senate The assistant legislative clerk read in each of the 50 States and over 3,000 coun- proceeded to consider the resolution. as follows: ties; Mr. REID. Madam President, I ask A bill (S. 657) to authorize funding for the (2) the 4–H Program is promoted by the unanimous consent that the resolution National 4–H Program Centennial Initiative. Secretary of Agriculture through the Coop- and preamble be agreed to en bloc, the erative State Research, Education, and Ex- motion to reconsider be laid upon the There being no objection, the Senate tension Service and land-grant colleges and proceeded to consider the bill. universities; table, and that any statements relating Mr. REID. Madam President, Sen- (3) the 4–H Program is supported by public thereto be printed in the RECORD with ators HARKIN and LUGAR have an and private resources, including the National no intervening action. amendment at the desk. I ask unani- 4–H Council; and The PRESIDING OFFICER. Without mous consent that the amendment be (4) in celebration of the centennial of the objection, it is so ordered. agreed to, the bill, as amended, be read 4–H Program in 2002, the National 4–H Coun- The resolution (S. Res. 113) and the three times and passed, the motion to cil has proposed a public-private partnership preamble were agreed to en bloc. to develop new strategies for youth develop- (The text of S. Res. 113 is located in reconsider be laid upon the table with- ment for the next century in light of an in- out any intervening action, and that creasingly global and technology-oriented today’s RECORD under ‘‘Statements on any statements relating thereto be economy and ever-changing demands and Submitted Resolutions.’’) printed in the RECORD. challenges facing youth in widely diverse f The PRESIDING OFFICER. Without communities. ORDERS FOR WEDNESDAY, JUNE objection, it is so ordered. (b) GRANT.— The amendment (No. 806) was agreed (1) IN GENERAL.—The Secretary of Agri- 20, 2001 to, as follows: culture may provide a grant to the National Mr. REID. Madam President, I ask 4–H Council to pay the Federal share of the unanimous consent that when the Sen- (Purpose: To modify the funding for the cost of— National 4–H Program Centennial Initiative) (A) conducting a program of discussions ate completes its business today, it ad- Beginning on page 2, strike line 14 and all through meetings, seminars, and listening journ until the hour of 10 a.m. on that follows through page 3, line 22, and in- sessions on the National, State, and local Wednesday, June 30. I further ask sert the following: levels regarding strategies for youth devel- unanimous consent that on Wednesday (b) GRANT.— opment; and immediately following the prayer and (1) IN GENERAL.—The Secretary of Agri- (B) preparing a report that— the pledge, the Journal of proceedings culture may provide a grant to the National (i) summarizes and analyzes the discus- be approved to date, the morning hour 4–H Council to pay the Federal share of the sions; be deemed expired, the time for the two cost of— (ii) makes specific recommendations of (A) conducting a program of discussions strategies for youth development; and leaders be reserved for their use later through meetings, seminars, and listening (iii) proposes a plan of action for carrying in the day, and the Senate resume con- sessions on the National, State, and local out those strategies. sideration of the motion to proceed to levels regarding strategies for youth devel- (2) COST SHARING.— S. 1052, the Patients’ Bill of Rights, opment; and (A) IN GENERAL.—The Federal share of the with time for debate on the motion al- (B) preparing a report that— cost of the program under paragraph (1) shall ternating in 30-minute increments be- (i) summarizes and analyzes the discus- be 50 percent. tween Senator KENNEDY or his designee sions; (B) FORM OF NON-FEDERAL SHARE.—The and Senator GREGG or his designee be- (ii) makes specific recommendations of non-Federal share of the cost of the program strategies for youth development; and under paragraph (1) may be paid in the form ginning with the first block of time (iii) proposes a plan of action for carrying of cash or the provision of services, material, controlled by the Democratic manager, out those strategies. or other in-kind contributions. Senator Kennedy. (2) COST SHARING.— (3) AMOUNT.—The grant made under this The PRESIDING OFFICER. Without (A) IN GENERAL.—The Federal share of the subsection shall not exceed $5,000,000. objection, it is so ordered. cost of the program under paragraph (1) shall (c) REPORT.—The National 4–H Council be 50 percent. shall submit any report prepared under sub- f (B) FORM OF NON-FEDERAL SHARE.—The section (b) to the President, the Secretary of PROGRAM non-Federal share of the cost of the program Agriculture, the Committee on Agriculture under paragraph (1) may be paid in the form of the House of Representatives, and the Mr. REID. Madam President, as the of cash or the provision of services, material, Committee on Agriculture, Nutrition, and majority leader indicated just a few or other in-kind contributions. Forestry of the Senate. minutes ago, on Wednesday the Senate

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00075 Fmt 0624 Sfmt 0634 E:\CR\FM\A19JN6.064 pfrm03 PsN: S19PT1 S6462 CONGRESSIONAL RECORD — SENATE June 19, 2001 will continue to consider the motion to As the leader indicated, when we get DEPARTMENT OF AGRICULTURE proceed to the Patients’ Bill of Rights back from the break, if in fact there is JAMES R. MOSELEY, OF INDIANA, TO BE DEPUTY SEC- all day tomorrow. Under a previous a break, there are 13 appropriations RETARY OF AGRICULTURE, VICE RICHARD E. ROMINGER, consent agreement, the Senate will bills on which we have to work. This is RESIGNED. vote on a motion to proceed to the Pa- the time to do the Patients’ Bill of DEPARTMENT OF DEFENSE tients’ Bill of Rights on Thursday at 10 Rights, and Senator DASCHLE has said MICHAEL PARKER, OF MISSISSIPPI, TO BE AN ASSIST- a.m., and for the time prior to 12 that we are going to complete it prior ANT SECRETARY OF THE ARMY, VICE JOSEPH W. o’clock we will have a discussion on to the Fourth of July break. WESTPHAL. that motion to proceed and general de- f DEPARTMENT OF STATE bate. Thereafter, the Republicans will ADJOURNMENT UNTIL 10 A.M. MICHAEL E. GUEST, OF SOUTH CAROLINA, A CAREER offer the first amendment. MEMBER OF THE SENIOR FOREIGN SERVICE, CLASS OF TOMORROW MINISTER-COUNSELOR, TO BE AMBASSADOR EXTRAOR- The majority leader asked that I con- Mr. REID. Madam President, if there DINARY AND PLENIPOTENTIARY OF THE UNITED STATES OF AMERICA TO ROMANIA. vey to everyone that the RECORD be is no further business to come before spread with the fact that the majority the Senate, I ask unanimous consent THE JUDICIARY leader is going to conclude this debate that the Senate stand in adjournment LAURIE SMITH CAMP, OF NEBRASKA, TO BE UNITED on the Patients’ Bill of Rights prior to under the previous order. STATES DISTRICT JUDGE FOR THE DISTRICT OF NE- our taking any recess for July 4. It is BRASKA, VICE WILLIAM G. CAMBRIDGE, RETIRED. There being no objection, the Senate, PAUL G. CASSELL, OF UTAH, TO BE UNITED STATES going to be difficult. But if it is not at 6:44 p.m., adjourned until Wednes- DISTRICT JUDGE FOR THE DISTRICT OF UTAH, VICE done, that is what he is going to do. He day, June 20, 2001, at 10 a.m. DAVID SAM, RETIRED. has indicated that we will work Friday, f Saturday, and Sunday. The only day DEPARTMENT OF JUDICIARY we are going to take off is the holiday, NOMINATIONS SHAREE M. FREEMAN, OF VIRGINIA, TO BE DIRECTOR, COMMUNITY RELATIONS SERVICE, FOR A TERM OF FOUR July 4, until we finish this very impor- Executive nominations received by YEARS, VICE ROSE OCHI, TERM EXPIRED. tant legislation. the Senate June 19, 2001:

VerDate 19-JUN-2001 02:26 Jun 20, 2001 Jkt 089060 PO 00000 Frm 00076 Fmt 0624 Sfmt 9801 E:\CR\FM\G19JN6.136 pfrm03 PsN: S19PT1