[Congressional Record Volume 140, Number 19 (Monday, February 28, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: February 28, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                          AMENDMENTS SUBMITTED

                                 ______


                          HEALTH SECURITY ACT

                                 ______


                 HARKIN (AND OTHERS) AMENDMENT NO. 1472

  Mr. HARKIN (for himself, Mr. Hatfield, Mr. Kennedy, and Mrs. 
Kassebaum) proposed an amendment to the bill S. 1779, a bill to ensure 
individual and family security through health care coverage for all 
Americans in a manner that contains the rate of growth in health care 
costs and promotes responsible health insurance practices, to promote 
choice in health care, and to ensure and protect the health care of all 
Americans; as follows:

       At the appropriate place in title III, insert the following 
     new subtitle:
                     Subtitle ____--Health Research

     SEC. ______1. SHORT TITLE.

       This subtitle may be cited as the ``Health Research Act of 
     1994''.

     SEC. ______2. FINDINGS.

       The Congress finds the following:
       (1) Nearly 4 of 5 peer reviewed research projects deemed 
     worthy of funding by the National Institutes of Health are 
     not funded.
       (2) Less than 2 percent of the nearly one trillion dollars 
     our Nation spends on health care is devoted to health 
     research, while the defense industry spends 15 percent of its 
     budget on research.
       (3) Public opinion surveys have shown that Americans want 
     more Federal resources put into health research and support 
     by having a portion of their health insurance premiums set 
     aside for this purpose.
       (4) Ample evidence exists to demonstrate that health 
     research has improved the quality of health care in the 
     United States. Advances such as the development of vaccines, 
     the cure of many childhood cancers, drugs that effectively 
     treat a host of diseases and disorders, a process to protect 
     our Nation's blood supply from the HIV virus, progress 
     against cardiovasculor disease including heart attack and 
     stroke, and new strategies for the early detection and 
     treatment of diseases such as colon, breast, and prostate 
     cancer clearly demonstrates the benefits of health research.
       (5) Among the most effective methods to control health care 
     costs are prevention and cure of disease and disability, 
     thus, health research which holds the promise of cure and 
     prevention of disease and disability is a critical component 
     of any comprehensive health care reform plan.
       (6) The state of our Nation's research facilities at the 
     National Institutes of Health and at universities is 
     deteriorating significantly. Renovation and repair of these 
     facilities are badly needed to maintain and improve the 
     quality of research.
       (7) Because the Omnibus Budget Reconciliation Act of 1993 
     freezes discretionary spending for the next 5 years, the 
     Nation's investment in health research through the National 
     Institutes of Health is likely to decline in real terms 
     unless corrective legislative action is taken.
       (8) A health research fund is needed to maintain our 
     Nation's commitment to health research and to increase the 
     percentage of approved projects which receive funding at the 
     National Institutes of Health to at least 33 percent.

     SEC. ______3. NATIONAL FUND FOR HEALTH RESEARCH.

       (a) Establishment.--There is established in the Treasury of 
     the United States an account, to be known as the ``National 
     Fund for Health Research'' (hereafter referred to in this 
     section as the ``Fund''), consisting of such amounts as are 
     transferred to the Fund under subsection (b) and any interest 
     earned on investment of amounts in the Fund.
       (b) Transfers to Fund.--
       (1) In general.--The Secretary of the Treasury shall 
     transfer to the Fund an amount equal to the amounts 
     designated under paragraph (2) and received in the Treasury.
       (2) Amounts.--
       (A) In general.--With respect to each calendar year 
     beginning with the first full calendar year during which a 
     comprehensive health care reform program utilizing a regional 
     and corporate health alliance structure has been implemented, 
     each such alliance shall set aside and transfer to the 
     Treasury of the United States the applicable amount under 
     subparagraph (B) and under section 6097 of the Internal 
     Revenue Code of 1986.
       (B) Applicable amount.--The applicable amount under this 
     subparagraph with respect to a regional or corporate alliance 
     shall be equal to--
       (i) with respect to the first full calendar year described 
     in subparagraph (A), .25 percent of all health premiums 
     received by the alliance for such year;
       (ii) with respect to the second calendar year described in 
     subparagraph (A), .50 percent of all health premiums received 
     by the alliance for such year;
       (iii) with respect to the third calendar year described in 
     subparagraph (A), .75 percent of all health premiums received 
     by the alliance for such year; and
       (iv) with respect to the fourth and succeeding calendar 
     years described in subparagraph (A), 1 percent of all health 
     premiums received by the alliance for such year.
       (3) Designation of Overpayments and Contributions.--
       (A)  In general.--Subchapter A of chapter 61 of the 
     Internal Revenue Code of 1986 (relating to returns and 
     records) is amended by adding at the end the following new 
     part:

   ``PART IX--DESIGNATION OF OVERPAYMENTS AND CONTRIBUTIONS FOR THE 
                   NATIONAL FUND FOR HEALTH RESEARCH

``Sec. 6097. Amounts for the National Fund for Health Research.

     ``SEC. 6097. AMOUNTS FOR THE NATIONAL FUND FOR HEALTH 
                   RESEARCH.

       ``(a) In General.--Every individual (other than a 
     nonresident alien) may designate that--
       ``(1) a portion (not less than $1) of any overpayment of 
     the tax imposed by chapter 1 for the taxable year, and
       ``(2) a cash contribution (not less than $1),
     be paid over to the National Fund for Health Research 
     established under section ______3 of the Health Research Act 
     of 1994. In the case of a joint return of a husband and wife, 
     each spouse may designate one-half of any such overpayment of 
     tax (not less than $2).
       ``(b) Manner and Time of Designation.--Any designation 
     under subsection (a) may be made with respect to any taxable 
     year only at the time of filing the original return of the 
     tax imposed by chapter 1 for such taxable year. Such 
     designation shall be made either on the 1st page of the 
     return or on the page bearing the taxpayer's signature.
       ``(c) Overpayments Treated as Refunded.--For purposes of 
     this section, any overpayment of tax designated under 
     subsection (a) shall be treated as being refunded to the 
     taxpayer as of the last day prescribed for filing the return 
     of tax imposed by chapter 1 (determined with regard to 
     extensions) or, if later, the date the return is filed.
       ``(d) Designated Amounts Not Deductible.--No amount 
     designated pursuant to subsection (a) shall be allowed as a 
     deduction under section 170 or any other section for any 
     taxable year.
       ``(e) Termination.--This section shall not apply to taxable 
     years beginning in a calendar year after a determination by 
     the Secretary that the sum of all designations under 
     subsection (a) for taxable years beginning in the second and 
     third calendar years preceding the calendar year is less than 
     $5,000,000.''.
       (B) Clerical amendment.--The table of parts for subchapter 
     A of chapter 61 of such Code is amended by adding at the end 
     the following new item:

``Part IX. Designation of overpayments and contributions for the 
              National Fund for Health Research.''.
       (C) Effective date.--The amendments made by this paragraph 
     shall apply to taxable years beginning after December 31, 
     1993.
       (c) Expenditures From Fund.--
       (1) In general.--The Secretary of the Treasury shall pay 
     annually, within 30 days after the President signs an 
     appropriations Act for the Departments of Labor, Health and 
     Human Services, and Education and related agencies, or by the 
     end of the first quarter of the fiscal year, to the Secretary 
     of Health and Human Services on behalf of the National 
     Institutes of Health, an amount equal to the amount in the 
     National Fund for Health Research at the time of such 
     payment, to enable the Secretary to carry out the purpose of 
     section 404F of the Public Health Service Act, less any 
     administrative expenses which may be paid under paragraph 
     (3).
       (2) Purposes for expenditures from fund.--Part A of title 
     IV of the Public Health Service Act (42 U.S.C. 281 et seq.) 
     is amended by adding at the end the following new section:

     ``SEC. 404F. EXPENDITURES FROM THE NATIONAL FUND FOR HEALTH 
                   RESEARCH.

       ``(a) In General.--From amounts received for any fiscal 
     year from the National Fund for Health Research, the 
     Secretary of Health and Human Services shall distribute--
       ``(1) 2 percent of such amounts during any fiscal year to 
     the Office of the Director of the National Institutes of 
     Health to be allocated at the Director's discretion for the 
     following activities:
       ``(A) for carrying out the responsibilities of the Office 
     of the Director, National Institutes of Health, including the 
     Office of Research on Women's Health and the Office of 
     Research on Minority Health, the Office of the Alternative 
     Medicine and the Office of Rare Diseases Research; and
       ``(B) for construction and acquisition of equipment for or 
     facilities of or used by the National Institutes of Health;
       ``(2) 2 percent of such amounts for transfer to the 
     National Center for Research Resources to carry out section 
     1502 of the National Institutes of Health Revitalization Act 
     of 1993 concerning Biomedical and Behavioral Research 
     Facilities;
       ``(3) 1 percent of such amounts during any fiscal year for 
     carrying out section 301 and part D of title IV with respect 
     to health information communications; and
       ``(4) the remainder of such amounts during any fiscal year 
     to member institutes of the National Institutes of Health and 
     Centers in the same proportion to the total amount received 
     under this section, as the amount of annual appropriations 
     under appropriations Acts for each member institute and 
     Centers for the fiscal year bears to the total amount of 
     appropriations under appropriations Acts for all member 
     institutes and Centers of the National Institutes of Health 
     for the fiscal year.
       ``(b) Plans of Allocation.--The amounts transferred under 
     subsection (a) shall be allocated by the Director of NIH or 
     the various directors of the institutes and centers, as the 
     case may be, pursuant to allocation plans developed by the 
     various advisory councils to such directors, after 
     consultation with such directors.''.
       (3) Administrative expenses.--Amounts in the National Fund 
     for Health Research shall be available to pay the 
     administrative expenses of the Department of the Treasury 
     directly allocable to--
       (A) modifying the individual income tax return forms to 
     carry out section 6097 of the Internal Revenue Code of 1986;
       (B) carrying out this section with respect to such Fund; 
     and
       (C) processing amounts received under this section and 
     transferring such amounts to such Fund.
       (4) Trigger and release of fund monies.--No expenditures 
     shall be made pursuant to section ____3(c) during any fiscal 
     year in which the annual amount appropriated for the National 
     Institutes of Health is less than the amount so appropriated 
     for the prior fiscal year.
       (d) Budget Enforcement.--Amounts contained in the National 
     Fund for Health Research shall be excluded from, and shall 
     not be taken into account for purposes of, any budget 
     enforcement procedures under the Congressional Budget Act of 
     1974 or the Balanced Budget Emergency Deficit Control Act of 
     1985.
                                 ______


                          HEALTH SECURITY ACT

                                 ______


                 HARKIN (AND OTHERS) AMENDMENT NO. 1473

  Mr. HARKIN (for himself, Mr. Hatfield, Mr. Kennedy, and Mrs. 
Kassebaum) proposed an amendment to the bill S. 1757, a bill to ensure 
individual family security through health care coverage for all 
Americans in a manner that contains the rate of growth in health care 
costs and promotes responsible health insurance practices to promote 
choice in health care, and protect the health care of all Americans; as 
follows:

       At the appropriate place in title III, insert the following 
     new subtitle:
                     Subtitle ____--Health Research

     SEC. ______1. SHORT TITLE.

       This subtitle may be cited as the ``Health Research Act of 
     1994''.

     SEC. ______2. FINDINGS.

       The Congress finds the following:
       (1) Nearly 4 of 5 peer reviewed research projects deemed 
     worthy of funding by the National Institutes of Health are 
     not funded.
       (2) Less than 2 percent of the nearly one trillion dollars 
     our Nation spends on health care is devoted to health 
     research, while the defense industry spends 15 percent of its 
     budget on research.
       (3) Public opinion surveys have shown that Americans want 
     more Federal resources put into health research and support 
     by having a portion of their health insurance premiums set 
     aside for this purpose.
       (4) Ample evidence exists to demonstrate that health 
     research has improved the quality of health care in the 
     United States. Advances such as the development of vaccines, 
     the cure of many childhood cancers, drugs that effectively 
     treat a host of diseases and disorders, a process to protect 
     our Nation's blood supply from the HIV virus, progress 
     against cardiovasculor disease including heart attack and 
     stroke, and new strategies for the early detection and 
     treatment of diseases such as colon, breast, and prostate 
     cancer clearly demonstrates the benefits of health research.
       (5) Among the most effective methods to control health care 
     costs are prevention and cure of disease and disability, 
     thus, health research which holds the promise of cure and 
     prevention of disease and disability is a critical component 
     of any comprehensive health care reform plan.
       (6) The state of our Nation's research facilities at the 
     National Institutes of Health and at universities is 
     deteriorating significantly. Renovation and repair of these 
     facilities are badly needed to maintain and improve the 
     quality of research.
       (7) Because the Omnibus Budget Reconciliation Act of 1993 
     freezes discretionary spending for the next 5 years, the 
     Nation's investment in health research through the National 
     Institutes of Health is likely to decline in real terms 
     unless corrective legislative action is taken.
       (8) A health research fund is needed to maintain our 
     Nation's commitment to health research and to increase the 
     percentage of approved projects which receive funding at the 
     National Institutes of Health to at least 33 percent.

     SEC. ______3. NATIONAL FUND FOR HEALTH RESEARCH.

       (a) Establishment.--There is established in the Treasury of 
     the United States an account, to be known as the ``National 
     Fund for Health Research'' (hereafter referred to in this 
     section as the ``Fund''), consisting of such amounts as are 
     transferred to the Fund under subsection (b) and any interest 
     earned on investment of amounts in the Fund.
       (b) Transfers to Fund.--
       (1) In general.--The Secretary of the Treasury shall 
     transfer to the Fund an amount equal to the amounts 
     designated under paragraph (2) and received in the Treasury.
       (2) Amounts.--
       (A) In general.--With respect to each calendar year 
     beginning with the first full calendar year during which a 
     comprehensive health care reform program utilizing a regional 
     and corporate health alliance structure has been implemented, 
     each such alliance shall set aside and transfer to the 
     Treasury of the United States the applicable amount under 
     subparagraph (B) and under section 6097 of the Internal 
     Revenue Code of 1986.
       (B) Applicable amount.--The applicable amount under this 
     subparagraph with respect to a regional or corporate alliance 
     shall be equal to--
       (i) with respect to the first full calendar year described 
     in subparagraph (A), .25 percent of all health premiums 
     received by the alliance for such year;
       (ii) with respect to the second calendar year described in 
     subparagraph (A), .50 percent of all health premiums received 
     by the alliance for such year;
       (iii) with respect to the third calendar year described in 
     subparagraph (A), .75 percent of all health premiums received 
     by the alliance for such year; and
       (iv) with respect to the fourth and succeeding calendar 
     years described in subparagraph (A), 1 percent of all health 
     premiums received by the alliance for such year.
       (3) Designation of Overpayments and Contributions.--
       (A)  In general.--Subchapter A of chapter 61 of the 
     Internal Revenue Code of 1986 (relating to returns and 
     records) is amended by adding at the end the following new 
     part:

   ``PART IX--DESIGNATION OF OVERPAYMENTS AND CONTRIBUTIONS FOR THE 
                   NATIONAL FUND FOR HEALTH RESEARCH

``Sec. 6097. Amounts for the National Fund for Health Research.

     ``SEC. 6097. AMOUNTS FOR THE NATIONAL FUND FOR HEALTH 
                   RESEARCH.

       ``(a) In General.--Every individual (other than a 
     nonresident alien) may designate that--
       ``(1) a portion (not less than $1) of any overpayment of 
     the tax imposed by chapter 1 for the taxable year, and
       ``(2) a cash contribution (not less than $1),
     be paid over to the National Fund for Health Research 
     established under section ______3 of the Health Research Act 
     of 1994. In the case of a joint return of a husband and wife, 
     each spouse may designate one-half of any such overpayment of 
     tax (not less than $2).
       ``(b) Manner and Time of Designation.--Any designation 
     under subsection (a) may be made with respect to any taxable 
     year only at the time of filing the original return of the 
     tax imposed by chapter 1 for such taxable year. Such 
     designation shall be made either on the 1st page of the 
     return or on the page bearing the taxpayer's signature.
       ``(c) Overpayments Treated as Refunded.--For purposes of 
     this section, any overpayment of tax designated under 
     subsection (a) shall be treated as being refunded to the 
     taxpayer as of the last day prescribed for filing the return 
     of tax imposed by chapter 1 (determined with regard to 
     extensions) or, if later, the date the return is filed.
       ``(d) Designated Amounts Not Deductible.--No amount 
     designated pursuant to subsection (a) shall be allowed as a 
     deduction under section 170 or any other section for any 
     taxable year.
       ``(e) Termination.--This section shall not apply to taxable 
     years beginning in a calendar year after a determination by 
     the Secretary that the sum of all designations under 
     subsection (a) for taxable years beginning in the second and 
     third calendar years preceding the calendar year is less than 
     $5,000,000.''.
       (B) Clerical amendment.--The table of parts for subchapter 
     A of chapter 61 of such Code is amended by adding at the end 
     the following new item:

``Part IX. Designation of overpayments and contributions for the 
              National Fund for Health Research.''.

       (C) Effective date.--The amendments made by this paragraph 
     shall apply to taxable years beginning after December 31, 
     1993.
       (c) Expenditures From Fund.--
       (1) In general.--The Secretary of the Treasury shall pay 
     annually, within 30 days after the President signs an 
     appropriations Act for the Departments of Labor, Health and 
     Human Services, and Education and related agencies, or by the 
     end of the first quarter of the fiscal year, to the Secretary 
     of Health and Human Services on behalf of the National 
     Institutes of Health, an amount equal to the amount in the 
     National Fund for Health Research at the time of such 
     payment, to enable the Secretary to carry out the purpose of 
     section 404F of the Public Health Service Act, less any 
     administrative expenses which may be paid under paragraph 
     (3).
       (2) Purposes for expenditures from fund.--Part A of title 
     IV of the Public Health Service Act (42 U.S.C. 281 et seq.) 
     is amended by adding at the end the following new section:

     ``SEC. 404F. EXPENDITURES FROM THE NATIONAL FUND FOR HEALTH 
                   RESEARCH.

       ``(a) In General.--From amounts received for any fiscal 
     year from the National Fund for Health Research, the 
     Secretary of Health and Human Services shall distribute--
       ``(1) 2 percent of such amounts during any fiscal year to 
     the Office of the Director of the National Institutes of 
     Health to be allocated at the Director's discretion for the 
     following activities:
       ``(A) for carrying out the responsibilities of the Office 
     of the Director, National Institutes of Health, including the 
     Office of Research on Women's Health and the Office of 
     Research on Minority Health, the Office of the Alternative 
     Medicine and the Office of Rare Diseases Research; and
       ``(B) for construction and acquisition of equipment for or 
     facilities of or used by the National Institutes of Health;
       ``(2) 2 percent of such amounts for transfer to the 
     National Center for Research Resources to carry out section 
     1502 of the National Institutes of Health Revitalization Act 
     of 1993 concerning Biomedical and Behavioral Research 
     Facilities;
       ``(3) 1 percent of such amounts during any fiscal year for 
     carrying out section 301 and part D of title IV with respect 
     to health information communications; and
       ``(4) the remainder of such amounts during any fiscal year 
     to member institutes of the National Institutes of Health and 
     Centers in the same proportion to the total amount received 
     under this section, as the amount of annual appropriations 
     under appropriations Acts for each member institute and 
     Centers for the fiscal year bears to the total amount of 
     appropriations under appropriations Acts for all member 
     institutes and Centers of the National Institutes of Health 
     for the fiscal year.
       ``(b) Plans of Allocation.--The amounts transferred under 
     subsection (a) shall be allocated by the Director of NIH or 
     the various directors of the institutes and centers, as the 
     case may be, pursuant to allocation plans developed by the 
     various advisory councils to such directors, after 
     consultation with such directors.''.
       (3) Administrative expenses.--Amounts in the National Fund 
     for Health Research shall be available to pay the 
     administrative expenses of the Department of the Treasury 
     directly allocable to--
       (A) modifying the individual income tax return forms to 
     carry out section 6097 of the Internal Revenue Code of 1986;
       (B) carrying out this section with respect to such Fund; 
     and
       (C) processing amounts received under this section and 
     transferring such amounts to such Fund.
       (4) Trigger and release of fund monies.--No expenditures 
     shall be made pursuant to section ____3(c) during any fiscal 
     year in which the annual amount appropriated for the National 
     Institutes of Health is less than the amount so appropriated 
     for the prior fiscal year.
       (d) Budget Enforcement.--Amounts contained in the National 
     Fund for Health Research shall be excluded from, and shall 
     not be taken into account for purposes of, any budget 
     enforcement procedures under the Congressional Budget Act of 
     1974 or the Balanced Budget Emergency Deficit Control Act of 
     1985.

 Mr. HARKIN. Mr. President, I rise today on behalf of myself 
and Senators Hatfield, Kennedy, and Kassebaum to introduce the fund for 
health research as a bipartisan amendment to President Clinton's Health 
Security Act. Congressman Coyne of Pennsylvania will be sponsoring this 
measure in the House. This is a critically important amendment that 
addresses an issue that has been largely overlooked.
  As health care spending devours more and more of the national budget, 
our medical research budget is dying of starvation. This year the 
Nation will spend nearly $1 trillion looking after the sick and less 
than 2 percent of that looking for cures, preventive measures and more 
effective treatment.
  By comparison, the Department of Defense spends 15 percent of its 
budget on research. The cold war is over, but the war against disease 
and disability continues. It's time that our budget reflects that 
reality.
  The fund for health research represents a bipartisan solution, and 
health care reform is the appropriate vehicle.
  Mr. President, we commend the President and Hillary Clinton for 
taking the lead on health-care reform. Two years ago this Nation was 
discussing whether to reform our health-care system. Thanks to their 
courage and commitment, today we're not talking about whether, but 
when--and what kind of reform we're going to have.
  But unfortunately, until now the thrust of the health care debate has 
been over how to pay the health-care bills--not how to prevent them. 
Unless we address the main cause of skyrocketing costs--disease and 
disability--any steps we take on health-care reform will be about as 
effective as re-arranging the deck chairs on the Titanic.
  We propose giving medical research a boost by amending the 
President's Health Security Act. The fund for health research would 
increase funding for the National Institutes of Health by $5 billion a 
year. It would be financed by a 1 percent set-aside from each health-
insurance premium as well as proceeds from a check-off on Federal 
income-tax forms. This would increase NIH research funding by 50 
percent.
  Mr. President, medical research is lagging in the United States 
because funding for approved NIH grants has fallen below 25 percent, 
compared to rates of 30 percent or more just a decade ago.
  Sadly, the United States is cutting back on medical research at the 
same time medical researchers stand poised on the verge of major 
lifesaving discoveries.
  Just 3 months ago, researchers announced they had identified a 
genetic flaw linked to as many as one in seven cases of colon cancer, 
as well as a number of other fatal cancers. Last December researchers 
reported they may have identified a genetic risk factor for Alzheimer's 
disease.
  If confirmed, this finding could lead to a simple diagnostic blood 
test, saving over $250 million a year, and could ultimately lead to a 
treatment for the disease.
  This could save the Nation as much as $50 billion in long-term care 
costs alone--aside from the costs in human suffering, which we can't 
begin to measure.
  But because the budget agreement Congress just negotiated freezes 
discretionary spending for 5 years, we lack the resources to meet this 
vital need.
  The only way to change course, Mr. President, is to fund health 
research with a revenue source outside the budget process. The fund for 
health research would use an appropriate vehicle: Health insurance 
premiums.
  Mr. President, our proposal has tremendous support. It has been 
endorsed by over 200 national organizations representing consumers, 
business groups, seniors, physicians, and top researchers. It is 
supported by numerous Nobel Prize-winners as well as our distinguished 
former Surgeon General, C. Everett Koop.
  Most Americans support the goal of the fund for health research, as 
well as the financing mechanism. In a recent Lou Harris poll, 9 out of 
10 Americans favored spending more money on health research. More than 
70 percent said they're willing to pay $1 more per week in insurance 
premiums to support health research.
  The timing of the introduction of the fund for health research is 
especially appropriate in light of the death last Monday of one of 
America's most tireless crusaders for health research, philanthropist 
Mary Lasker. Mary Lasker died at age 93 at her home in Greenwich, CT.
  Thanks to her we have the National Institutes of Health--the world's 
preeminent health research institute. She is truly the mother of the 
NIH, and was integral to establishing each of its 13 institutes. In 
1984, a center at the NIH was named in her honor: the Mary Woodard 
Lasker Center for Health Research and Education.
  The best way to honor the legacy of Mary Lasker is to focus on 
alleviating disease and suffering as soon as possible. I encourage our 
colleagues to support the fund for health research so we can focus on 
preventing disease rather than just paying the bills.
  Mr. President, I ask unanimous consent that a list of the groups 
endorsing our amendment, a set of questions and answers regarding the 
fund, and a recent Lou Harris survey on this subject be included in the 
Record along with a copy of the amendment at this point.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                 Fund For Health Research--Endorsements

       AIDS Treatment News.
       Albert and Mary Lasker Foundation.
       Allergan.
       Allergy and Asthma Network.
       Alliance for Aging Research.
       Alliance for Eye and Vision Research.
       Allied Signal.
       Alzheimer's Association.
       Ambulatory Pediatric Association.
       American Academy of Allergy and Immunology.
       American Academy of Audiology.
       American Academy of Child and Adolescent Psychiatry.
       American Academy of Dermatology.
       American Academy of Neurology.
       American Academy of Opthamology.
       American Academy of Orthopedic Surgeons.
       American Academy of Otolaryngolog-Head and Neck Surgery, 
     Inc.
       American Academy of Physician Assistants.
       American Association for Cancer Research.
       American Association for Dental Research.
       American Association for the Study of Liver Diseases.
       American Association of Anatomists.
       American Association of Blood Banks.
       American Association of Colleges of Nursing.
       American Association of Colleges of Osteopathic Medicine.
       American Association of Colleges of POharmacy.
       American Association of Colleges of Podiatric Medicine.
       American Association of Mental Retardation.
       American Association of University Professors.
       American Cancer Society.
       American Cleft Palate Association.
       American College of Allergy and Immunology.
       American College of Human Genetics.
       American College of Neuropsychopharmacology.
       American College of Nurse-Midwives.
       American College of Rheumatology.
       American Congress of Rehab Medicine.
       American Family Foundation.
       American Federation for Aging Research.
       American Gastroenterological Association.
       American Geriatrics Society.
       American Health Foundation.
       American Heart Association.
       American Lung Association.
       American Nurses Association.
       American Neurological Association.
       American Occupational Therapy Association.
       American Otological Society.
       American Pediatric Society.
       American Physiological Society.
       American Podiatric Medical Association.
       American Porphyria Foundation.
       American Psychiatric Association.
       American Psychological Association.
       American Psychological Society.
       American Social Health Association.
       American Society for Biochemistry and Molecular Biology.
       American Society for Cell Biology.
       American Society for Gastrointestinal Endoscopy.
       American Society for Microbiology.
       American Society for Pharmacology & Experimental 
     Therapeutics.
       American Society of Addiction Medicine.
       American Society of Clinical Nutrition.
       American Society of Hematology.
       American Society of Human Genetics.
       American Society of Nephrology.
       American Society of Therapeutic Radiology and Oncology.
       American Society of Tropical Medicine and Hygiene.
       American Surgical Association.
       American Thoracic Society.
       American Urological Association.
       American Veterinary Medical Association.
       Anxiety Disorder Association of America.
       Arthritis Foundation.
       Association for Chemoreception Sciences.
       Association for Medical School Pharmecology.
       Association for Practitioners in Infection Control.
       Association for Research in Vision and Ophtamology.
       Association of Academic Departments of Otolaryngology.
       Association of Academic Health Science Library Directors.
       Association of American Cancer Institutes.
       Association of American Medical Colleges.
       Association of American Physicians.
       Association of American Veterinary Medical Colleges.
       Association of Anatomy Cell Biology Neurobiology 
     Chairpersons.
       Association of Behavioral Sciences & Medical Education.
       Association of Chairman of Departments of Physiology.
       Association of Medical and Graduate Departments of 
     Biochemistry.
       Association of Medical School Pediatric Department 
     Chairman.
       Association of Pathology Chairman.
       Association of Pediatric Oncology Nurses.
       Association of Professors of Dermatology.
       Association of Professors of Medicine.
       Association of Reproductive Health Professionals.
       Association of Schools of Public Health.
       Association of Teachers of Preventive Medicine.
       Association of University Environmental Health Sciences 
     Centers.
       Association of University Professors of Opthamalogy.
       Autism Society of America.
       Biophysical Society.
       Bowman Gray School of Medicine Department of Biochemistry.
       Brown University School of Medicine.
       Candlelighters Childhood Cancer Foundation.
       Central Society for Clinical Research.
       Child Neurology Society.
       Children's Blood Foundation.
       Citizens for Public Action on Blood Pressure and 
     Cholesterol, Inc.
       Cleft Palate Foundation.
       Coalition of Patient Advocates for Skin Disease Research.
       College on Physicians and Surgeons, Columbia University.
       Cooley's Anemia Foundation.
       Cooper Hospital/University Medicare Center.
       Corporation for the Advancement of Psychiatry.
       Council of Community Blood Centers.
       Crohn's and Colitis Foundation of America.
       Cult Awareness Network.
       Cystic Fibrosis Foundation.
       DES Action.
       Deafness Research Foundation.
       Digestive Disease National Coalition.
       Dystrophic Epidermolysis Bullosa Research Foundation of 
     America.
       Eczema Association for Science and Education.
       Endocrine Society.
       Epilepsy Foundation of America.
       FDA Council.
       Federation of American Societies for Experimental Biology.
       Federation of Behavioral, Psychological and Cognitive 
     Sciences.
       Foundation for Ichthyosis & Related Skin Types.
       Fred Hutchinson Cancer Research Center.
       Friends of NIDCD.
       General Clinical Research Centers Director's Association.
       Genetics Society of America.
       Health Care Engineering Policy of IEEE--USA.
       Human Rights Campaign Fund.
       Huntington's Disease Society of America.
       IEEE--USA, Health Care Engineering Policy Committee.
       Infectious Diseases Society of America.
       International Rett Syndrome Association.
       Johns Hopkins University, School of Medicine.
       Joint Council of Allergy and Immunology.
       Joslin Diabetes Center.
       Juvenile Diabetes Foundation.
       Learning Disabilities Association.
       Leukemia Society of America.
       Lupus Foundation of America.
       Medical Library Association.
       Microscopy Society of America.
       Myasthenia Gravis Foundation.
       Nathan W. and Margaret T. Shock Aging Research Foundation, 
     Inc.
       National Allergy and Asthma Network.
       National Alliance for the Mentally Ill.
       National Association for Biomedical Research.
       National Association for Rural Mental Health.
       National Association of Development Disabilities Councils.
       National Association of Nurse Practitioners in Reproductive 
     Health.
       National Association of Pediatric Nurse Associates and 
     Practitioners.
       National Association of Psychiatric Treatment Centers for 
     Children.
       National Breast Cancer Coalition.
       National Caucus of Basic Biomedical Science Chairs.
       National Caucus and Center on Black Aged.
       National Coalition for Cancer Research.
       National Committee to Preserve Social Security and 
     Medicare.
       National Council on Spinal Cord Injury.
       National Depressive and Manic-Depressive Association.
       National Foundation for Depressive Illnesses.
       National Head Injury Foundation, Inc.
       National Hemophilia Foundation.
       National Marfan Foundation.
       National Minority AIDS Council.
       National Multiple Sclerosis Society.
       National Neurofibromatosis Foundation.
       National Organization for Rare Disorders.
       National Osteoporosis Foundation.
       National Parkinson's Foundation.
       National Perinatal Association.
       National Psoriasis Foundation.
       National Rehabilitation Association.
       National Spinal Cord Injury Foundation.
       National Sudden Infant Death Syndrome Alliance.
       Older Women's League.
       Paget Foundation.
       Paralyzed Veterans of America.
       Parkinson's Action Network.
       Research Rett Syndrome.
       School of Medicine and Dentistry, University of Rochester.
       Scleroderma Research Foundation.
       Sickle Cell Disease Association of America.
       Society for Academic Anesthesiology Chairs.
       Society for Critical Care Medicine.
       Society for Gynecological Investigation.
       Society for Investigative Dermatology.
       Society for Neuroscience.
       Society for Investigative Dermatology.
       Society for Surgery of the Alimentary Tract.
       Society for the Advancement of Women's Health Research.
       Society of Chairman of Academic Radiology Departments.
       Society of Surgical Chairman.
       Society of Toxicology.
       Society of University Otolaryngologists.
       Spina Bifida Association of America.
       Susan Komen Breast Cancer Foundation.
       Surgical Infection Society.
       The American Parkinson Disease Association, Inc.
       The French Foundation for Alzheimer Research.
       The Gerontological Society of America.
       The Jeffrey Modell Foundation.
       The National Center for Voice & Speech.
       The Society of Surgical Oncology.
       Tourette Syndrome Association.
       United Scleroderma Foundation.
       University of Alabama School of Medicine.
       University of Michigan Medical School.
       University of Vermont College of Medicine.
       Upjohn Company.
       Wake Forest University Medical Center.
       Yale University School of Medicine.
       YWCA of the U.S.A.
                                  ____


            Fund for Health Research--Questions and Answers

                    What does the proposal call for?

       As a component of health care reform, a mechanism would be 
     established to provide additional funds for health research 
     over and above those provided to the National Institutes of 
     Health (NIH) in the annual appropriations process. When fully 
     phased in, approximately 1 percent of all the monthly health 
     insurance premiums collected by corporate and regional 
     alliances would be set aside and regularly transferred by the 
     alliances into a Fund For Health Research in a manner 
     consistent with the set aside for graduate medical education 
     and academic health centers proposed in the President's 
     health care reform plan. This additional set aside should 
     generate sufficient funds to provide for an approximately 50 
     percent increase in funding for the NIH.
       Each year amounts within the Fund would automatically be 
     allotted to each of the NIH Institutes and Centers. Five 
     percent of the monies would be directed to extramural 
     construction and renovation of research facilities, the 
     National Library of Medicine, and the Office of the Director. 
     So that an appropriate range of basic and applied research is 
     supported, each Institute and Center would receive the same 
     percentage of the remaining Fund monies as they received of 
     the total NIH appropriation for that fiscal year. In order to 
     insure that the additional funds generated do not simply 
     replace regularly appropriated NIH funds, monies from the 
     Fund would be released only if the total appropriated for the 
     NIH in that year equal or exceed the prior year 
     appropriations.
       Additional monies for the Fund would be generated by a 
     voluntary Federal income tax check-off. Every year, when 
     filing their Federal income tax returns, Americans would be 
     given the opportunity to designate tax overpayments and 
     contributions for health research. Monies from the check-off 
     would be deposited in the Fund.

                    Why is this proposal necessary?

       Health research has brought us the advances in treatment 
     and prevention of disease and disability that define our 
     current high standards of medical practice and promises even 
     more remarkable advances in the near future. Perhaps more 
     than any other component of our health care system, it holds 
     the promise of both reducing medical costs and improving 
     quality. Yet, because the Federal budget agreement freezes 
     discretionary spending for the next four years, Federal 
     funding for health research will likely not even keep up with 
     inflation unless a separate funding stream is established. 
     Health care reform offers the best opportunity to establish 
     such a new stream.

          What is the status of the Harkin/Hatfield proposal?

       A formal amendment detailing the proposal will be 
     introduced February 28, 1994. Efforts will focus on having 
     the proposal attached to any health care reform proposal 
     reported out by the Committees and adopted by the full 
     Senate. It is anticipated that a similar proposal will be put 
     forward in the House of Representatives. A hearing focusing 
     on the Fund was held before the Senate Labor and Human 
     Resources Committee on December 8, 1993.

    Will the Fund simply replace exiting monies appropriated to NIH?

       No. Monies generated by the Fund would be in addition to, 
     not in replacement of those provided to each of the NIH 
     Institutes in the normal appropriations process. Monies from 
     the Fund could not be allotted unless total NIH 
     appropriations in that year were equal or greater than the 
     prior year appropriations. Therefore, the Fund could not be 
     used as a mechanism to replace to reduce regularly 
     appropriated funds.

    What is the relationship of the premium set-aside in the Harkin/
  Hatfield proposal to the set aside for academic health centers and 
     graduate medical education in the Clinton health reform plan?

       The two are separate and complementary. The graduate 
     medical education and academic health center set aside will 
     provide many important research institutions with needed 
     support. However, this set aside does not directly fund 
     health research. The Harkin/Hatfield proposal does.

 How would money from the Fund be allocated among research priorities?

       The proposal does not pick winners and losers among areas 
     of health research. It does not interfere with the funding 
     decisions made through the normal appropriations process. 
     Funds would be allocated to each of the NIH Institutes and 
     Centers based on the percentage that each of these entities 
     received of the total NIH appropriation for that year. Monies 
     allotted to each NIH entity would be spent according to a 
     plan developed by the entities' advisory council in 
     consultation with the Director. Each Institute would decide 
     the appropriate distribution of Fund monies among various 
     research priorities within the Institute.
       In recognition of the poor state of many medical research 
     facilities, 2 percent of the total Fund would be taken off 
     the top for extramural construction and renovation of 
     research building and facilities. In accordance with 
     traditional funding patters, 1 percent of the total Fund 
     would go to the National Library of Medicine. An additional 2 
     percent would go to the NIH Director for intramural 
     construction and renovation and other activities supported by 
     the Office of the Director.

      How much support is there for the Fund for Medical Research?

       The Harkin/Hatfield proposal has widespread support among 
     the American people and among the health, health research and 
     business communities. A Louis Harris poll released in 
     December found that over 70 percent of Americans support such 
     a plan. Support was strong across all age and income groups 
     and in all regions of the country. In addition, over 200 
     organizations representing millions of Americans have 
     endorsed the proposal. The fund has been endorsed by numerous 
     Nobel Laureates, leading health care experts and business 
     leaders.
                                  ____


                        [From Research America]

  Medical Research and Health Care Concerns: A Survey of the American 
                                 Public

        (Conducted by Louis Harris & Associates, November 1993)

       The Harris nationwide poll was conducted by telephone 
     within the United States between November 11th and 15th, 
     among a cross section of 1,254 adults. Figures for age, sex, 
     race, education and region were weighted where necessary to 
     bring them into line with their actual proportions in the 
     population.
       Research!America, a national not-for-profit organization 
     dedicated to raising public awareness of and support for 
     medical research, commissioned Louis Harris and Associates to 
     ask seven questions about medical research as part of a 
     larger survey focusing on a broad range of current issues. 
     The margin of error is approximately 3 percent.


                               HIGHLIGHTS

       1. Americans rank medical research as their single highest 
     research priority.
       When asked which one type of scientific research is most 
     valuable, Americans overwhelmingly favor medical research 
     (66%). Environmental (18%), energy (6%) and defense (4%) 
     finish next. None of the other four types (space, 
     electronics, computers and transportation) is preferred by 
     more than 1 percent.
       The same question was asked nationally in April of 1992. 
     The only type of research to garner a significant increase 
     between April '92 and November '93 is medical research.
       Women are more likely than men to say medical research is 
     most valuable.

------------------------------------------------------------------------
                                                Nov.      Nov.     Nov. 
               Type                   April     1993,    1993,    1993, 
                                      1992    overall     men     women 
------------------------------------------------------------------------
Medical............................       49        66       59       73
Environmental......................       29        18       18       17
Energy.............................       10         6        9        3
Transportation.....................        3         1        2        1
Defense............................        2         4        5        3
Space..............................        2         1        2        1
Computer...........................        2         1        2        1
Electronics........................        1         1        2       --
------------------------------------------------------------------------

       2. Americans think this nation is not spending enough on 
     medical research.
       Nine out of ten Americans (91%) believe this nation should 
     spend more on medical research to better diagnose, prevent 
     and treat disease.
       In fact, 60% feel this country should spend a lot more on 
     medical research--more than those saying spend on energy, 
     space and defense research combined (35, 10 and 9 percent, 
     respectively).
       Sixty-four percent of women believe this nation should 
     spend a lot more on medical research compared to fifty-six 
     percent of men.
       3. Not only do Americans want more spent on medical 
     research, but Americans are willing to pay for it.
       If assured the money would be spent for additional medical 
     research:
       74% are willing to spend $1 more per week in taxes;
       75% are willing to spend $1 more per prescription drug; and
       77% are willing to spend $1 more per week in insurance 
     premiums.
       4. The actual amount spent on medical research is well 
     below what the American people believe should be spent.
       At the moment, about three cents out of each health care 
     dollar spent in the U.S. goes for medical research. The 
     median value suggested by those surveyed: 10 cents per 
     dollar.
       5. As we reform the health care system, the majority of 
     Americans think the commitment to medical research should be 
     higher.
       When asked about medical research specifically in the 
     context of health care reform, 56% of those surveyed said the 
     national commitment to medical research should be higher 
     while only 5% said it should be lower. Thirty-eight percent 
     said the commitment should remain about the same.
       In the context of health care reform, 58 percent of women 
     think the national commitment to medical research should be 
     higher and 55 percent of men feel it should be higher.


                               highlights

       1. Americans rank medical research as their single highest 
     research priority.
       When asked which one type of scientific research is most 
     valuable, Americans overwhelmingly favor medical research 
     (66%). Environmental (18%), energy (6%) and defense (4%) 
     finish next. None of the other four types (space, 
     electronics, computers and transportation) is preferred by 
     more than 1 percent.
       The same question was asked nationally in April of 1992. 
     The only type of research to garner a significant increase 
     between April `92 and November '93 is medical research.
       African-Americans value medical research significantly more 
     than the overall average.

------------------------------------------------------------------------
                                                                  Nov.  
                                           April       Nov.      1993,  
                  Type                      1992      1993,     African-
                                                     overall    American
------------------------------------------------------------------------
Medical................................         49         66         79
Environmental..........................         29         18          9
Energy.................................         10          6          2
Transportation.........................          3          1          1
Defense................................          2          4          3
Space..................................          2          1          3
Computer...............................          2          1          1
Electronics............................          1          1          1
------------------------------------------------------------------------

       2. Americans think this nation is not spending enough on 
     medical research.
       Nine out of ten Americans (91%) believe this nation should 
     spend more on medical research to better diagnose, prevent 
     and treat disease.
       In fact, 60% feel this country should spend a lot more on 
     medical research--more than those saying spend a lot more on 
     energy, space and defense research combined (35, 10 and 9 
     percent, respectively).
       Nearly three out of every four (74 percent) African-
     Americans believe that this nation should spend a lot more on 
     medical research.
       3. Not only do Americans want more spent on medical 
     research, but Americans are willing to pay for it.
       Percentage willing to spend more if assured the money would 
     be spent for additional medical research:

------------------------------------------------------------------------
                                                               African- 
                                                    Overall    American 
------------------------------------------------------------------------
$1 more per week in taxes........................         74          83
$1 more per prescription drug....................         75          84
$1 more per week in health insurance premiums....         77          89
------------------------------------------------------------------------

       4. The actual amount spent on medical research is well 
     below what the American people believe should be spent.
       At the moment, about three cents out of each health care 
     dollar spent in the U.S. goes for medical research. The 
     median value suggested by those surveyed: 10 cents per 
     dollar.
       5. As we reform the health care system, the majority of 
     Americans think the commitment to medical research should be 
     higher.
       When asked about medical research specifically in the 
     context of health care reform, 56% of those surveyed said the 
     national commitment to medical research should be higher 
     while only 5% said it should be lower. Thirty-eight percent 
     said the commitment should remain about the same.
       In the context of health care reform, 66 percent of all 
     African-Americans contend that as we reform the health care 
     system the national commitment to medical research should be 
     higher.


                               highlights

       1. Americans rank medical research as their single highest 
     research priority.
       When asked which one type of scientific research is most 
     valuable, Americans overwhelmingly favor medical research 
     (66%). Environmental (18%), energy (6%) and defense (4%) 
     finish next. None of the other four types (space, 
     electronics, computers and transportation) is preferred by 
     more than 1 percent.
       The same question was asked nationally in April of 1992. 
     The only type of research to garner a significant increase 
     between April '92 and November '93 is medical research.
       The Hispanic population values medical research four times 
     higher than any other type of scientific research.

------------------------------------------------------------------------
                                                       Nov.       Nov.  
                 Type                      April      1993,      1993,  
                                           1992      Overall   Hispanic 
------------------------------------------------------------------------
Medical................................         49         66         68
Environmental..........................         29         18         15
Energy.................................         10          6          3
Transportation.........................          3          1          3
Defense................................          2          4          1
Space..................................          2          1          3
Computer...............................          2          1  .........
Electronics............................          1          1          5
------------------------------------------------------------------------

       2. Americans think this nation is not spending enough on 
     medical research.
       Nine out of ten Americans (91%) believe this nation should 
     spend more on medical research to better diagnose, prevent 
     and treat disease.
       In fact, 60 percent feel this country should spend a lot 
     more on medical research-- more than those saying spend a lot 
     more on energy, space and defense research combined (35, 10 
     and 9 percent, respectively).
       Nearly two out of every three (65 percent) Hispanics 
     believe that this nation should spend a lot more on medical 
     research.
       3. Not only do Americans want more spent on medical 
     research, but Americans are willing to pay for it.
       Percentage willing to spend more if assured the money would 
     be spent for additional medical research:

------------------------------------------------------------------------
                                                    Overall    Hispanic 
------------------------------------------------------------------------
$1 more per week in taxes........................         74          78
$1 more per prescription drug....................         75          70
$1 more per week in health insurance premiums....         77         82 
------------------------------------------------------------------------

       4. The actual amount spent on medical research is well 
     below what the American people believe should be spent.
       At the moment, about three cents out of each health care 
     dollar spent in the U.S. goes for medical research. The 
     median value suggested by those surveyed: 10 cents per 
     dollar.
       5. As we reform the health care system, the majority of 
     Americans think the commitment to medical research should be 
     higher.
       When asked about medical research specifically in the 
     context of health care reform, 56% of those surveyed said the 
     national commitment to medical research should be higher 
     while only 5% said it should be lower. Thirty-eight percent 
     said the commitment should remain about the same.
 Mr. HATFIELD. Mr. President, my good friend, the great 
philanthropist, Mary Lasker said, ``If you think research is expensive, 
try disease.'' These words capture the motivation and message of 
Senator Harkin, Representative Coyne, and myself in proposing 
legislation in our respective Chambers to establish the national fund 
for health research.
  Disease is expensive, far more expensive than medical research, 
costing this Nation hundreds of billions of dollars annually. Yet none 
of the major health care reform bills currently under consideration 
take seriously the role of medical research--the single means by which 
we will conquer disease.
  Today, federally supported research on Alzhemier's disease totals 
$300 million, yet it is estimated that $90 billion is expended annually 
on care. Federally supported research on diabetes totals $290 million, 
yet it is estimated that $25 billion is expended annually on care. 
Federally supported research on mental health totals $613 million, yet 
it is estimated that $130 billion is expended annually on care.
  Disease drives the cost of health care. Without new knowledge to 
develop new strategies to prevent disease, new treatments to delay the 
progression of disease, and new interventions to cure disease, health 
care costs will continue to spiral out of control. We can cap costs in 
the near term, but without a long-term strategy to bring these costs 
down or eliminate them entirely, we have only a partial solution to our 
health care delivery dilemma.
  Health research is a central mechanism for controlling these health 
care costs and is an essential cost control element for comprehensive 
health care reform.
  Disease is also expensive in another sense; it takes a heavy toll on 
the quality of life for millions of Americans and their families. Yet, 
recent dramatic developments in molecular medicine and genetics have 
spawned tremendous optimism and opportunity for advancing understanding 
and new treatments.
  Uncovering the genes responsible for disorders, such as Huntington's 
disease, cystic fibrosis, certain rear disorders, and some forms of 
breast and colon cancers give hope to millions of afflicted 
individuals. But if we fail to maintain a vibrant health research 
enterprise these hopes will be dashed and the treatments of tomorrow 
will be the treatments of today.
  It is very troubling to me that at a time when the biomedical 
sciences have entered such an era of unprecedented opportunity, fault 
lines are appearing in our research infrastructure.
  In fiscal year 1993, one of the first red flags appeared. The 
Congress, for the first time since I have served in the Senate, 
appropriated less money for the National Institutes of Health than the 
President had requested. In fiscal year 1994 the outlook was worse. The 
President's budget recommended funding below the fiscal year 1993 level 
for 9 of the 19 NIH institutes and centers.
  At the time, the percentage of research grant applications the NIH is 
able to fund has reached a 10-year low. The NIH estimated that under 
the President's budget, the number of scientifically meritorious 
research grants funded would fall to only one in five. Fortunately, the 
Congress did not concur in the President's recommendation, but instead 
appropriated a 5.2-percent increase for each of the institutes and 
centers.
  This year, the budget requested by the President includes a 4.7-
percent increase for the NIH, although over half of the proposed 
increase is targeted to specific research programs. It is, 
nevertheless, a more promising starting point than the budget of a year 
ago. However, because we are in the middle of a 5-year freeze on 
discretionary spending, one can only predict that meeting the 
President's request for the NIH will be difficult at best.
  In the 1980's this country witnessed a massive military defense 
buildup. In the 1990's, nothing short of a disease defense buildup will 
yield the cost containment required and quality of life hoped for from 
enactment of comprehensive health care reform. Through the legislation 
we are introducing today to establish the national fund for health 
research, we are taking the first step toward this disease defense 
buildup--and we are doing so with the solid support of the American 
public.
  A recent Harris poll has shown that Americans strongly support health 
research and are willing to put their money behind their words. The 
poll asked Americans which type of scientific research they favored--66 
percent favored medical research. Environmental research followed at 18 
percent, energy research at 6 percent, and defense finished at 4 
percent. At the moment, about 3 cents out of each health care dollar 
spent in the United States goes to medical research. Of those surveyed, 
the value suggested was at least 10 cents per dollar. Even more 
encouraging is that if assured that the funds would be spent for 
medical research, 74 percent of Americans are willing to spend $1 more 
per week in taxes, 75 percent are willing to spend $1 more per 
prescription drug, and 77 percent are willing to spend $1 more per week 
in insurance premiums.
  As a member of the Senate Appropriations Committee for over 20 years, 
I know that the stability we need in medical research cannot be 
accomplished solely through the regular appropriations process. A 
dedicated funding source is required to ensure annual appropriations to 
meet the challenges of reduced health costs and improved quality of 
life for millions of Americans suffering from disease and disability.
  The national fund for health research, which would fall outside of 
the Federal budget process, achieves this objective. When fully 
implemented, funding for medical research would increase by 50 percent 
and yield support for 1 out of 3 meritorious research proposals. This 
is accomplished through two funding options: a setaside on health 
insurance premiums and a voluntary Federal income tax checkoff.
  Senator Harkin and I are introducing our legislation today as an 
amendment to S. 1779, the administration's health care reform plan as 
sponsored by Senator Kennedy, which is pending on the Senate calendar, 
and as an amendment to S. 1775, the administration's health care reform 
plan sponsored by Senator Moynihan, which is also pending on the Senate 
calendar. When these bills are referred to committee, our amendment 
will also be referred to both the Labor and Finance Committees. It is 
our intention to have this concept considered on every possible health 
care reform vehicle. It is already attached to S. 1770, the health care 
reform plan sponsored by Senator Chafee, of which I am a cosponsor. We 
will pursue it on any other moving vehicle which purports to be a 
comprehensive health care reform bill. It is our intention to see the 
national fund for health research established as soon as possible.
  On Thursday, February 17, the First Lady stated ``medical research 
and health care reform go hand in hand,'' and I agree. The legislation 
we are introducing today will make this shared objective a reality. I 
urge my colleagues to join in this truly bipartisan effort to make sure 
the Nation's response to health care reform is complete.
  Mrs. KASSEBAUM. Mr. President, I am pleased to cosponsor the Health 
Research Act of 1994, being introduced today by Senator Hatfield and 
Senator Harkin. This legislation is aimed at expanding research funding 
through the National Institutes of Health [NIH]. It would do this by 
establishing a biomedical research trust fund. This trust fund would 
augment, not replace, resources currently provided to NIH through the 
appropriations process.
  Americans of all ages benefit from the findings of biomedical 
research funded by the NIH. The foundation of this effort is the many 
committed scientists throughout this country. Through investigator-
initiated efforts, these individuals have developed effective 
diagnostic and treatment methods for debilitating or deadly illnesses. 
Unfortunately, the NIH is currently able to fund only one out of five 
research proposals.
  The $5 billion biomedical research trust fund created by this 
legislation would help reverse this situation. The funding raised 
through both a health insurance premium surcharge and a tax checkoff 
would allow the NIH to support a greater proportion of the grant 
proposals it receives. Such an increase in funding would help secure 
the benefits of biomedical research for generations to come.
  In addition to establishing the trust fund, this legislation would 
also authorize the distribution of the fund to each institute, in 
proportion to the institutes' appropriations. While this approach has 
merit, I hope to work with my colleagues to improve this method. Mr. 
President, I believe that a portion of the trust fund, or the entire 
trust fund, should be distributed to the NIH director to be used at his 
own discretion.
  Leaving the distribution of the trust fund in the hands of the 
Director is advantageous for a couple of reasons. First, control of the 
trust fund would help strengthen the role of the NIH Director. Because 
NIH funds are appropriated directly to each institute, the NIH Director 
currently has limited powers. Second, the ability to fund trans-
institute efforts would improve research for many illnesses which 
require collaborative efforts among different institutes. Such 
illnesses are not currently well served by the existing funding walls 
posed by the institutes and the institute-specific appropriations 
process.
  Mr. President, I look forward to working with the Senator from Oregon 
and the Senator from Iowa to improve this legislation. I ask unanimous 
consent that my statement be made part of the Record at the appropriate 
place.

                          ____________________