[Congressional Record Volume 140, Number 108 (Monday, August 8, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 8, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                              HEALTH CARE

  Mr. HARKIN. Mr. President, I ask that since we are not debating 
anything else on the bill and since we will be facing the debate, 
starting on our health care reform bill I guess by Wednesday of this 
week, in 2 days.
  I was in Iowa all weekend at a number of town meetings, cafe-stop 
meetings, I have around the State. A question came up repeatedly. If we 
only have 95 percent coverage, who is it that will be left out? I do 
not know that I had a good enough answer for them.
  I just ask the Senator from Illinois, if we had 95 percent coverage, 
who are the 5 percent that will be left out? Who are the ones that will 
be uncovered? Will it be the elderly who are not yet on Medicare, for 
example? Maybe between 55 and 65? Maybe they have a disability, they 
are out of their job, their employers now do not have to cover them or 
anything like that, maybe they will be the ones who will be left out?
  Or will it be young people who may think they are invulnerable and 
are healthy so why should they have health insurance? So they are out 
of it and then they have an accident which causes a disability or life-
threatening illness or, God forbid, some young person might come down 
with cancer or heart disease? Are those the ones who are left out?
  I just wonder if the Senator from Illinois could enlighten us, who is 
going to be left out of this program?
  Mr. SIMON. That is a very, very important question. Literally we do 
not know the answer to that. There are perhaps 80 people in the gallery 
right now. That means 1 out of 20 in the gallery will not be covered. I 
do not know which ones. All I know is every other Western 
industrialized nation, with the exception of South Africa and the 
United States, covers all their citizens. I do not want to see people 
left out.
  You were there, I believe, Senator Harkin, when this woman who works 
for Kentucky Fried Chicken testified 2 weeks ago. She spends $120 a 
month for medicine for her heart disease, two different types of 
medicine. She works 30 hours a week. She has to make a choice of 
medicine or food and she has made the choice of food: understandable.
  Somehow we have to do better than that. I believe the American people 
clearly want all Americans covered, and I hope the Senate will resist 
the pressure from a lot of people who make money on the present system, 
who are trying to stop us from changing it.
  Mr. HARKIN. The other question I had this weekend--there was a recent 
Iowa poll in the Des Moines Register. It showed about 80 percent--
mirrored the national poll--about 80 percent of the people in Iowa 
wanted universal coverage. The question I was asked was, if 8 out of 10 
people want universal coverage, why do we not do it? Are we not here 
elected to represent the people of this country? It seems like there is 
an overwhelming majority of people in this country who want universal 
coverage and want it a lot sooner than the year 2002. Again, why is it 
so impossible for us to represent the will of the people?
  Mr. SIMON. Mr. President, that is one I think I have the answer for. 
That is, there are some insurance companies, and others, including 
specialists in the field of medicine, who do not want the system 
changed. It is very interesting. You have a coalition, an unusual 
coalition, the AFL-CIO, the American Association of Retired Persons, 
and the American Medical Association, all saying we ought to have 
universal coverage.
  You mentioned an Iowa poll saying 80 percent. The New York Times poll 
said 79 percent of the American people say it is very important to have 
universal coverage; 17 percent say it is somewhat important; that is 96 
percent; 3 percent say it is not important; 1 percent do not have an 
opinion.
  When you have this coalition, plus what the American people 
instinctively know is right, we ought to act. But the confusion that is 
out there caused by people who make money on the present system, is 
what is stopping us from moving ahead. I hope we listen to the American 
people as we make this decision.
  I thank my colleague from Iowa.
  Mr. HARKIN. I thank the Senator from Illinois for his great 
leadership on this issue. He has been a leader on this for many, many 
years. I look forward to when the debate and amendments come up to 
ensure we do have universal coverage, and a lot sooner than the year 
2002.
  Mr. SIMON. Let me just add, because some people are viewing this on 
television, if the American people respond--and they are going to have 
to respond--we are hearing more from the opposition, at least judging 
by my mail, than we are from people who support universal health care.
  Mr. HARKIN. That is what I said to people in Iowa this weekend: Watch 
the debate. When these issues come up, start lighting up the 
switchboard, put in your phone calls, because the special interests are 
here.
  I daresay, they are all going to be out here in the lobby, in the 
hallways and in the offices. We need to hear from people around the 
country. They need to get on the phone and start lighting up the 
switchboards around here and demanding we have universal coverage, and 
a lot sooner than the year 2002. I do not see why we cannot do it by 
1998; at the latest by the end of the century.
  Mr. SIMON. We really should not have to wait that long.
  Mr. HARKIN. We should not have to wait that long.
  Mr. SIMON. I thank my colleague.
  Mr. HARKIN. I thank the Senator from Illinois.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, I think the Senator from Illinois has 
raised a very important issue on raising the question about the 
coverage of the bill and why it does not do more. I think the Senator 
from Iowa has made a very valuable comment about what he has heard in 
Iowa with his constituency.
  In the absence of any bill pending, I think this is an opportunity to 
discuss some of the concerns which I have, which mirror, to some 
extent, the concerns which have already been raised.
  During the course of this past weekend, I took the train back to 
Philadelphia on Friday afternoon and people had questions there, and 
again on the train coming back to DC this morning. I was in a shopping 
mall on Saturday and they had questions about what is happening in 
Washington on health care; also in restaurants at dinner. At the squash 
court this morning, my opponent wanted to know what was happening on 
health care. There are many, many unanswered questions. I am concerned 
that there may be too much partisan politics in what we are doing, too 
much special interest, as the Senator from Illinois suggests, and 
really not enough time for the kind of thoughtful consideration about 
many, many important questions, such as the one raised by the Senator 
from Illinois this morning about coverage.
  On Friday afternoon, I think that we saw just a little theatrics with 
a scale and how much one bill weighed and how much the absence of 
another bill did not weigh. I believe these questions are much too 
serious, and I believe that the tone of partisan politics has been 
very, very dominant, which we ought to try to untangle.
  In the 14 years I have been in this body, I have seen on so many 
measures that about 40 Senators line up on one side, ideologically, and 
about 40 Senators line up on the other side, ideologically, and there 
are about 20 in the middle. And it is a floating 20, which really come 
down in a pragmatic way on the facts.
  I believe that we should have taken up health care a long time ago. I 
tried to bring it to the floor as early as July 29, 1992, and again in 
late 1993, because I thought that we should have been taking 
incremental steps to reform our health care system. Those efforts were 
defeated.
  In the past several weeks, I have said repeatedly that I would not 
join a filibuster on health care legislation, but now, Mr. President, I 
am not so sure, and I am rethinking that position because of the 
complexity of the pending legislation by Senator Mitchell and because 
of the insufficient time for public comment.
  I am not saying that hearings are indispensable, because while 
hearings may be important, very frequently only one or two Senators are 
present, and we have heard a great deal in the hearing process. But 
there is a time of analysis and digestion and consideration, radio talk 
shows, comments back home, comments on the editorial pages, comments on 
the op ed pages, which give a distillation.
  A physician stopped me in the King of Prussia shopping center and 
said, ``Senator, what is this bill all about?'' And then he asked me 
some questions which I could not answer. I got his card and told him I 
would get back to him. I could not answer them, although I have been 
very deeply involved in health care issues for all of the 14 years that 
I have been in the Senate, as reflected by my senior ranking status on 
this appropriations bill.
  I might say, Senator Harkin and I and the others on the subcommittee 
work out our issues in a nonpartisan manner. Politics does not enter 
into it one bit.
  I might say on the political line, I saw an article in the Sunday 
Philadelphia Inquirer which said the Democrats will have to do it all 
themselves; there will be little or no help from Republicans, so said 
the article. I want to compliment my colleagues on the other side of 
the aisle to the extent that they may well be winning the public 
relations battle on whether there is really an effort by Republicans to 
cooperate.
  For just a moment, I would like to state briefly the kind of 
Republican cooperation there has been, because there are many of us 
over here who are very anxious to see health care reform. My own view 
is that we have the best health care system in the world as it applies 
to 86.1 percent of the American people, but that we definitely do need 
changes. We need to cover the 37 million to 40 million people who are 
now not covered. We need to make sure that there is coverage when 
people change jobs. We need to make sure that there is coverage for 
preexisting conditions. We need to hold down the spiraling costs of 
health care legislation.
  Toward that end, I introduced a comprehensive reform bill on the 
first day of this Congress, on January 21, 1993. I tried to bring my 
health care bill to the floor in April 1993. The reason I tried to do 
it at that time was that the President's original goal of legislation, 
as I recollect it, within 100 days, started to falter.
  There were a variety of statements, one by the chairman of the Ways 
and Means Committee, Congressman Rostenkowski, at that time, who said 
we would not have health care legislation in 1993. Then Congressman 
Gephardt, the majority leader, said we would not have health care 
legislation in 1993. Each time that was said, I came to the floor and 
said we ought to move ahead now. The tally was made in the 102d 
Congress, and we found there were about 102 health care bills which 
were up at that time.
  Senator Chafee has been a leader in the Congress on pushing for the 
first bill, which was introduced in November 1993, which had, I think, 
about 23 Republican cosponsors.
  Mr. SIMON. Will my colleague yield?
  Mr. SPECTER. I will after I finish just two or three more sentences. 
I want to finish this point.
  There came out of the Finance Committee a bipartisan group, well 
represented by Republicans--Senator Chafee, Senator Danforth, and 
Senator Durenberger. In addition, Senator Jeffords, a Republican, was 
one of the first to sign on to President Clinton's health care plan. 
There are other Republicans who have introduced health care 
legislation. Early on, Senator Cohen introduced legislation, Senator 
Bond introduced legislation, and Senator Kassebaum introduced 
legislation.
  There has been legislation introduced more recently by Senator Dole, 
Senator Gramm, and Senator Nickles. Now, there has been some contention 
that some of these bills may have been in response to initiatives by 
the Democrats, and that they were an effort to hold back some reform. 
That kind of a partisan argument has been advanced. I do not think that 
that is so, but some have argued it. But no one can say that the 
efforts by Senators Chafee, Durenberger, and Danforth were anything 
less than a genuine bipartisan spirit, or what Senator Jeffords did was 
not done in a genuine bipartisan spirit, or that the legislation I 
introduced and tried to bring to the floor was not made in a 
cooperative effort.
  Senator Kennedy, the chairman of the Labor and Human Resources 
Committee, asked me for support, and I told him that I was prepared to 
consider that if we could work out legislation which did not have the 
massive Clinton bureaucracy, which I put on a chart. And Senator 
Kennedy and I sat down on two occasions, and finally he raised a 
concern that some of the proposals I offered had not been costed out by 
the Congressional Budget Office. So the two of us wrote a joint letter 
months ago to the Congressional Budget Office, and we received a reply 
that the Congressional Budget Office was too busy to give us a figure, 
which raises a very serious question about the adequacy of 
congressional resources to try to tackle this issue.
  But I for one am very anxious to see reform legislation passed which 
is targeted at the specific problems in our health care system, and 
there are many other Republicans who are anxious to do that as well.
  So that I would take issue with what the Inquirer article said on 
Sunday--it is an article; it is not an editorial; it does not reflect 
the Philadelphia Inquirer's general position, but it was an article--
and I say now that I would like to see us move forward with 
comprehensive reform. I want to see coverage for everyone, as does the 
Senator from Illinois and the Senator from Iowa. I endorse that 
objective.
  What I was trying to do with the legislation that I put in in the 
Chamber on July 29, 1992, was to take two big bites; to assist the 
self-employed, who now have no tax benefits. If you are employed by a 
corporation, the corporation gets a full deduction. The beneficiary 
pays no taxes. That is a very unusual provision in the Internal Revenue 
Code to promote health coverage. But if you are self-employed, you get 
nothing by way of deduction.
  Had we enacted legislation for the self-employed, I think we would 
have picked up several million Americans. How many, I am not sure--4, 
5, 6 million. If we had had insurance market reform back in 1992, we 
would have picked up, I think, many small businesses from lower costs. 
How many, I am not sure--6, 7, 8, maybe 9. We would have eaten 
significantly into the 37 to 40 million Americans now not covered, a 
concept which I said in my floor statement on January 21, 1993, or at 
least since--I do not remember every word of it --it was trial and 
correction to see how we go.
  But I am impressed with what the Senator from Illinois has said about 
not being able to answer the question about which 5 percent are not 
covered. I am very much concerned about what the costs are. I want to 
comment about that, but first I wish to yield to my colleague from 
Illinois.
  Mr. SIMON. Mr. President, I thank my colleague for yielding, and I 
appreciate the Senator's comments.
  I agree; this should not be a partisan thing. And in the Committee on 
Labor and Human Resources, for example, Senator Bingaman, one of the 
more thoughtful, creative Members of this body, offered an amendment, a 
very significant amendment, that was carried 17 to nothing. You cannot 
have a more bipartisan vote than that.
  I think the basis for bipartisanship may be what the Senator said, 
when the Senator says, ``We need coverage for 37 to 40 million 
Americans not now covered.'' And then later, the Senator said, ``I want 
to see coverage for everyone.'' If we can start with that premise--and 
that is the Chafee bill; it says coverage for all Americans--I am 
willing to work with Members on that side of the aisle to fashion some 
amendments. But it does seem to me we have to say to all Americans, we 
are going to see that you get coverage.
  And so I volunteer to work with Senator Specter and others, too, on 
that side of the aisle. Let us see if we can fashion some kind of 
bipartisan group that will move toward universal coverage.
  Mr. HARKIN addressed the Chair.
  The ACTING PRESIDENT pro tempore. The Senator from Iowa is 
recognized.
  Mr. HARKIN. Mr. President, I thank my colleague and friend from 
Pennsylvania for his comments and his insights. Senator Specter is one 
of the more judicious and more moderate Members of the Senate. I have 
thoroughly enjoyed working with him on this subcommittee and on other 
issues since I have been in the Senate. I think he brings a judicious 
tone and approach to the health care reform bill.
  I must, however, say that I am concerned from what I may have heard, 
and maybe I did not hear it correctly, that my friend from Pennsylvania 
now says perhaps, because the bill now is so complex, he might join 
those forces that would want to filibuster the bill and to hold it up. 
I certainly hope that I did not hear that correctly. Perhaps he will 
respond; we will get into a little colloquy.
  In regard to the complexity of the bill and the complexity of the 
issues of health care reform, let me just say that we have been 
debating health care reform since 1948. It was Harry Truman who first 
campaigned in 1948 for a national health insurance program that would 
cover all Americans. We have been debating it ever since. We have had 
little bits and pieces here and there--we had Medicare, Medicaid, and a 
couple other things like that. For almost 50 years, we have been 
talking about it in American society, and certainly for the last year 
and a half very intensively.
  I wish to again publicly compliment both the President and Mrs. 
Clinton, especially. Mrs. Clinton took this on as her responsibility 
right after the inauguration, to move us toward a final vote on health 
care reform this year. And she has just done a magnificent job in 
pulling the country together and airing all of the different concerns 
about health care. Thanks to Mrs. Clinton, there is not one group in 
this country who has not had input in the process of health care reform 
legislation--small business, large business, labor, doctors, hospitals, 
insurance. Everyone has had input in this process. No one can 
legitimately say that they have been left out of this process and it 
has moved out without them. Everyone has been heard. Everyone has had 
their day in court.
  Out of this lengthy process, which lasted for almost 1 year, came the 
Clinton bill, the White House bill, which was introduced. Then the 
various committees in the Congress began their processes of developing 
legislation. I serve on the Labor and Human Resources Committee. 
Senator Kennedy is the chairman of that. We had about 3 weeks, I say to 
my friend from Pennsylvania, where we met every morning at 8 o'clock in 
the morning. And I know the present occupant of the chair, from New 
Mexico, was there every day; 8 o'clock in the morning, we would meet, 
and we would go all day, sometimes until 10 o'clock at night, hammering 
out the various aspects of this legislation, as all of us do here in 
the Senate. That is what committees are for. We work this out in 
committee.
  I might say to my friend from Pennsylvania that on the final vote--
now, some of the votes on amendments were party-line votes, many of 
them were split, some Republicans, some Democrats, and it was sort of 
as you might expect in a committee process. On the final vote, on 
reporting out the bill to the floor of the Senate, again it was a 
bipartisan vote.
  I believe, if I am not mistaken, Senator Jeffords from Vermont voted 
to put it out. So here we had a bill come out of our Labor and Human 
Resources Committee on a bipartisan vote. Then the Finance Committee 
did its work. I do not know how long they met. I am not a member of the 
Finance Committee. But I believe they met several days at least. They 
had their votes in committee. They reported the bill out. Then Senator 
Mitchell took the two bills, using his prerogative of being the 
majority leader of the Senate, and melded these two bills together. And 
that is what Senator Mitchell has introduced into the Senate as the 
basis for debate and amendment on the Senate floor.
  There are some aspects of the Mitchell bill that I disagree with. 
There are a lot of them that I do agree with. But I believe that is the 
process. I must admit even in our own bill that came out of the Labor 
and Human Resources Committee, though I voted for the final passage of 
it, there are some parts I did not agree with, and much of it I did. 
That is the process. We are not going to get everything each one of us 
wants.
  So now we have a bill before the Senate put forward by Senator 
Mitchell which has gone through a lengthy process of public hearings 
for over a year, part of it the Mitchell bill and some of it is the 
Clinton bill.
  So we have had a process that we have gone through in this country. 
It has been open. It has been fair, and no one has been excluded.
  The Senator says that he was asked some questions in Pennsylvania 
this weekend about the bill that he could not answer. I have to tell 
you. Even sitting for 3 weeks in the Labor and Human Resources 
Committee and putting that bill out and studying it every day, I think 
if someone had asked me a specific question about a specific point in 
the bill I probably could not have answered it either. I am not an 
expert in a lot of these things. I would have gone back to the bill, or 
have gotten a staff person who understood that little area a little bit 
better to answer. So there are going to be specific questions that none 
of us will be able to answer until we go back and examine it.
  I guess what I am responding to my friend from Pennsylvania with is 
this: We have had this process, the long process. Everyone has been 
involved. We are now at the point in time that the Senate should debate 
it. We should have the amendments. If the Senator from Pennsylvania has 
amendments--and he may well have some, and I may support him because I 
have supported a lot of what the Senator from Pennsylvania has done in 
the past. As I said, he is a judicious, moderate Member of the Senate. 
But let us have the amendments. Let us have the debate--reasoned 
debate, which I think will be a great debate by the way, and then let 
us vote. Let us vote up or down on the amendments and see what the 
Senate wants to do. After all the amendments are offered, then let us 
vote up or down on the bill.
  But please let us not have some filibuster and say, ``Well, we will 
put it off until next year.'' We know the issues. We have been through 
this process. We will have the opportunity to debate it and amend it 
here on the floor.
  I think the people of this country--and I sense it in Iowa, too, and 
I think the polls reflect it. I wish I had the Iowa poll with me here. 
I did not anticipate talking about this this morning. But if I am not 
mistaken, the Iowa polls showed nearly 80 percent wanted universal 
coverage. They wanted the Congress to act on health care reform. But if 
I am not mistaken, less than half, or around half, thought we might do 
it. I think almost the majority of the people said Congress would do 
it.
  I think people are sick and tired of all of the talk and rhetoric. 
And, yes, the Senator is right. The scales and weighing this and 
getting into these penny ante little partisan snipings about this or 
that, who is right, who is wrong, how much this weighs and how much 
that weighs, I think people are fed up with that. And they are tired of 
all of the hot air. They want us to act on health care reform. Bring it 
up, and offer amendments in good faith. I may have some myself. I 
probably will. I do not intend to take a long time debating but a 
reasonable amount of time to debate the amendments. And then let us 
have our votes. Let the American people watch it on television.
  I think it could be one of the best debates this country has had this 
century. Thank God, now we have modern means of communication and with 
television here in the Senate the American people can watch it. As we 
go through this process of bringing the bill out, debating it, amending 
it, debating the amendments and voting on them, I think the American 
people will be fully informed, fully advised as to what the Senate and 
the House will do on health care or has done after the votes are taken.
  So, again, I respond to my friend from Pennsylvania. I hope the 
Senator will do as he has done in the past, offer amendments in good 
faith to try to improve the bill as he sees fit. But I certainly hope 
that my friend from Pennsylvania--and I say it to all of my friends on 
the other side of the aisle--will not be part of some process to 
filibuster, slow it down and say somehow we can put this off until next 
year or some time in the future. The American people want us to act. 
They are tired of the hot air. Let us vote. Let us get health care 
reform through. Let us do something.
  Mr. SPECTER. Mr. President, I thank my colleague from Iowa for his 
complimentary comments, and I would return them to him, about being 
judicious and thoughtful. And I think it is reflected in the work which 
he and I have done for 5 years now that he has been chairman of this 
subcommittee and I have been the ranking Republican. We have discussed 
hundreds of items and not once has politics entered into anything that 
we have discussed. We have brought what I think are good bills to the 
floor, including this one.
  I appreciate his extended comment in hoping that I would not join a 
filibuster because there are a few of us in the so-called centrist 
position on the Republican side who characteristically decline to join 
in filibusters. When my colleague from Iowa says I have not done so in 
the past, that is correct. There are rare occasions when I do, because 
I did on the so-called enhancement package in April 1993 where I felt 
that $1.9 billion was unnecessary because the money was in the 
pipeline. But more important, I thought we had an oppressive majority 
on that case where the manager of the bill had tied up the procedure to 
preclude amendments, and an objection was even raised by Senator Boren 
and Senator Breaux about that. I tried to get the floor and could not 
get the floor to offer an amendment. There was a very extended attack. 
And I say that word reluctantly. But it was on Senator Dole, the 
Republican leader. I believe that particular issue was very unique. And 
I joined a filibuster on that occasion. But on almost all other 
occasions I have declined to join a filibuster.
  The Senator from Iowa--I think his words were filibuster forces. And 
it is not a secret. It is an open comment which has been made more on 
the Senator's side of the aisle than mine about Republican forces which 
want to filibuster simply to stop any legislation. I have said publicly 
and privately in Republican caucuses that I would not be a party to 
that. But I said earlier this morning that although in the past several 
weeks I have said I would not join a filibuster against health care 
legislation, now I am not so sure. I am rethinking that position 
because of the complexity of the bill.
  Mr. President, I think this discussion which Senator Harkin and I are 
having now is a very useful one. Before giving some impressions about 
some complexities which bother me, I am not saying I am going to 
filibuster, but I am thinking about it. I am going to talk to a group 
of those key Senators on this side of the aisle who characteristically 
do not filibuster who have advanced legislation for health care reform 
to see what they heard when they went back to their States this week.
  Let me say that I agree with my colleague from Iowa in complimenting 
President Clinton and Mrs. Clinton for bringing health care to center 
stage. I think they are entitled to a lot of credit for that. When 
President Clinton went to Ambridge, PA last November, I went with him. 
I stood with him in my State, Pennsylvania. He invited me to go. And 
when I stood with him. I said that I agreed with his objective to cover 
all Americans. I said I did not agree with everything he is doing, and 
I am not going to be committed to his legislation. But I joined him 
because I felt that I should when I agreed with his objective to 
provide universal coverage.
  When Mrs. Clinton went to Philadelphia to visit Children's Hospital 
in February of this year, she invited me to go. I went with her. I said 
to her on that trip, as I had said to the President on the trip in 
November, ``How about Senate bill 18?'' I had a very extended 
discussion with Mrs. Clinton. I said let us cover the people who are 
not covered through insurance market reforms that make coverage 
affordable, cover preexisting conditions, and include cost containment 
measures. She said to me, ``Well, how about upping the underinsured?'' 
I said, ``Well, I think you are right about that.''
  I then urged Mrs. Clinton to have a meeting with our Republican 
leadership. The time was not quite right for that, or so it was said. I 
sat down twice with Senator Kennedy, as I have said, to see if I might 
support the bipartisan bill. Senator Jeffords the Republican, as 
Senator Harkin says accurately, came out of that Labor and Human 
Resources Committee where the Presiding Officer, Senator Bingaman, 
sits, and I considered helping on that bill if the objectives I was 
concerned about could be achieved; that is, to retain the essence of 
the present system, to target the specific problems and move ahead. 
When the Senator from Iowa talks about what the polls show, I happen to 
have the morning paper with me. So I can tell you what the Washington 
Post states in a reference today to a Newsweek poll: ``A Newsweek poll 
released this week found that 65 percent of those surveyed said 
Congress should wait until next year to pass health care reform.'' 
Sixty-five percent said that we should wait.

  Mr. President, I do not want to wait if we can do it right. But I do 
not want to do it on a political timetable; I do not want to do it on a 
Republican timetable, and I do not want to do it on a Democratic 
timetable. As there is talk about obstructionism on this side of the 
aisle, there is a lot of talk about passing this health care bill to 
help the Democrats in the election this November.
  Parenthetically, by way of a footnote, there has been talk about the 
crime bill, that we ought not to have a crime bill because it is going 
to help President Clinton. I said privately and publicly that I am 
prepared to say, whatever help it gives President Clinton to pass a 
crime bill, I think we ought to pass it. There is a lot in the crime 
bill I do not like, but all factors considered, I think it is a step 
forward. It is an anomaly, but if the President of the United States 
were killed today in Washington, DC, on a conspiracy and a contract 
killing, those conspirators and murderers would not face the death 
penalty because there is no death penalty in the District of Columbia.
  The bill provides for a great many prisons. The crime bill provides 
for realistic rehabilitation--education and job training. And a lot of 
Senators do not like that, but I do.
  But there are parts I do not like. I think it is too expensive, and 
it has a lot of pork. I have not seen many bills come out of this body 
that do not have too much pork. There is political talk about the crime 
bill, and I think that is fine up to a point, but it has to stop where 
the benefits of the American people intervene.
  I think the same thing is true about this legislation. If this health 
bill is going to help President Clinton as a byproduct, so be it. I do 
not want to schedule this legislation to help President Clinton or to 
hurt President Clinton. I do not think the timetable ought to be a 
political timetable. I was very disappointed when I offered a very 
modest amendment back in July of 1992 and the majority leader came to 
the floor and said, ``This amendment does not belong on this bill.'' I 
agreed with him, and I said, ``I will take it down voluntarily if you 
give me a date certain.'' He said, ``I cannot do that.'' I pointed out 
the fact that there had been a date certain for product liability, 
which was the day after Labor Day. I said, ``Give me a date certain on 
my health bill, and I will take it down.''
  Now I learn through my wife Joan that MacNeil/Lehrer, or someone on 
that program--I did not watch it because I was on the Senate floor--
that they quoted a statement I made in 1992, perhaps in 1993, that we 
were ready to take up health care legislation--and we were--where there 
was full deductibility for the self-employed and matters which are 
limited in scope. We should have taken those up a long time ago, and we 
did not, and we did not pass them because there were many people who 
said, let us not take up a limited bill because it may hurt the 
possibility for a more comprehensive bill.
  I have looked for a comprehensive analysis from the major news 
media--from the New York Times, Philadelphia Inquirer, Washington Post, 
or some of the other major newspapers--and I have not seen it. But I 
have seen some comments about some of the cost factors which concern 
me. I know the Senator from Iowa does not have answers to these 
questions, but these are only a few of the questions which are on my 
mind at the present time. These are all good proposals, but we have to 
know what the costs are.
  For example, in the Mitchell program, as I am informed, there will be 
a subsidy for low-income families for the full cost of a health 
insurance policy. And the subsidy would gradually be phased out, 
stopping at $29,528. And a concern I have is, what will that cost me?
  We on this floor, Mr. President, as you know and as the Senator from 
Iowa knows--and we are the only three here--rave again and again about 
entitlements, and there is 100 percent agreement on this floor that the 
deficit is too big and the national debt is too big.
  If there is one subject talked about more than any other in the 
Senate since I have been here, it has been the deficit, which is in 
excess of $200 billion, $250 billion a year no matter what we try to 
do. The national debt is now in excess of $4.5 trillion. There have 
been programs offered by Senator Domenici and Senator Nunn as the 
leadership to try to hold down the growth in entitlement spending. 
There is widespread consensus here, if not universal agreement. But are 
we going to enact an entitlement program here which is going to have 
costs which we do not know the answer to?
  I intend to ask these questions of Senator Mitchell when the debate 
starts. Children under 19 and pregnant women would receive full 
subsidies up to 185 percent of the poverty level, which would be phased 
out when salaries come to slightly under $45,000 a year. Temporarily 
unemployed people would have subsidies for 6 months of coverage. 
Employers who expand their insurance coverage would be eligible for up 
to 5 years of subsidies. They would pay no more than 50 percent of the 
premium or 8 percent of a worker's wage, whichever is less.
  This touches the very sensitive subject of employer mandates, which I 
have spoken out against. I am not going to support a health bill which 
has mandates, because my view is that it is a tax which cannot be 
afforded, especially by small business. I have heard that again and 
again and again. I had three open-house town meetings last Monday. I 
had to do them by satellite in Philadelphia, Pittsburgh, and 
Harrisburg, and that was the theme I heard all over my State and 
beyond. The small businesses, which provide up to 60 percent of the new 
jobs, cannot afford a mandate and further costs imposed by the Federal 
Government.
  And now we have a proposal which I read about in the press and have 
not been able to confirm in the text, and I want to know what that is 
going to cost. There are new benefits for the elderly and the Federal 
Government. I think that we do need something on prescription drugs and 
something on long-term health care, and I have introduced legislation 
on long-term health care. I have talked to Pennsylvania companies where 
there are many pharmaceutical companies, and they have said they would 
be willing to hold their costs to the rate of inflation, to the 
consumer price index rise, if they would not be sued under the 
antitrust laws. That is a suggestion that this might be an occasion to 
carefully craft an exception to the antitrust laws.
  So those are very important matters which I support in principle, Mr. 
President. But I want to know what it is going to cost. From the 
estimates I have seen, by fiscal year October 1, 2001, on this one 
item, on the disabled and mentally ill, where the Federal Government 
will help the States pay for services, it would rise to $15.4 billion 
annually. And when I see those figures, Mr. President, I wonder about 
the accuracy of the projections. One of the things that I have always 
been concerned about is the reliability of statistics which are cited 
on the Senate floor and the accuracy of statistics which are provided 
to me and to others from a variety of sources.
  My own training has been in the courtroom where the evidence has to 
be competent. You have to know exactly, without hearsay, what 
information is provided.
  So I cite these statistics with some concern about accuracy. But I 
have been provided with materials which show that Medicare projected in 
1965 would cost $9 billion in 1990. When 1990 came it cost $106 
billion. Medicaid, in 1965, was projected to total less than $1 billion 
in 1990, and instead it cost $76 billion.
  So when I see the kinds of subsidies which are involved in the 
legislation offered by Senator Mitchell, my question is, what will it 
end up costing?
  The Medicare prescription drug benefit, which would begin purportedly 
on January 1, 1999, would have a certain deductible, would have a 
reimbursement for 80 percent of prescription costs. And once the 
payments reached a certain level, $1,275 a year, Medicare would pay the 
entire bill. As I understand it, the bill calls for the exact figure of 
the deductible to be determined by the Secretary of Health and Human 
Services.
  (Mrs. MURRAY assumed the chair.)
  Mr. SPECTER. Madam President, I think we ought to have a better idea 
as to what we are getting into than what we know at the present time.
  I noted this morning in the New York Times that our colleague from 
the House of Representatives, Congressman Dan Glickman, expressed his 
concern about what the fine print would show. And it is a concern which 
I have. Once we get to the fine print and have time to read it--we have 
to do more, Madam President, than just reading it--we have to read it, 
we have to understand the details, we have to analyze it. Then we have 
to have input from people who have experience in the field to know 
whether there are implications which are not apparent on the surface.
  Congressman Dan Glickman is quoted in this morning's New York Times:

       Members are genuinely concerned that once the fine print is 
     written there will be sleepers that come back and haunt us.

  Continuing, he says:

       This is a bill that's going to affect every single American 
     intimately. Most of the things we work on don't.

  Congressman Glickman's quotation points up two very, very important 
factors. One of them is the importance of health care legislation in a 
field which now comes close to $1 trillion a year, about 14 percent of 
the gross national product. So if we make a mistake here, it is an 
enormous mistake. It touches everybody. And when you rush through a 
bill as long as this one--I do not propose to weigh it or cite the 
number of pages--you want to be very, very concerned that you read the 
fine print.
  Madam President, that is why I said--and I appreciate my colleague 
from Iowa wanting to know my sense of it--that although in the past 
several weeks I have said I will not join a filibuster against health 
care legislation, now I am not so sure. I am rethinking that position.
  Just one personal note, a very personal note: I talked to my Aunt 
Rosie Eisenberg in Wichita over the past weekend--I talk to my Aunt 
Rosie with some frequency. She is a wise woman. I have known her since 
my birth. She was living with my family in Wichita, KS, when I was born 
and in the absence of parents, my Aunt Rosie sort of takes their place.
  I talked to her about the 1986 tax reform bill. She said to me at 
that time, ``Why am I going to be taxed as much as millionaires?'' We 
had the tax bill that came in for a 20-percent marginal tax. I said: 
``Rosie, you raise a good point. I do not know why you are going to be 
taxed as much as millionaires. There are a lot of loopholes that are 
being taken out. Frankly, I do not like the fact that you will be taxed 
as much as millionaires.''
  So I came over to the Senate floor the next day. Senator Bradley was 
the major proponent of this measure. I brought up Aunt Rosie 
Eisenberg's points to Senator Bradley, and I relayed Senator Bradley's 
answer to my Aunt Rosie. She was not very happy with Senator Bradley's 
answer, and she was not very happy about paying as much tax as 
millionaires.
  One Thursday night when the Senate Judiciary Committee was in the 
midst of the Justice Thomas hearings--we were going to start the next 
day--she had heard over the television what the Senate committee was 
going to do about questioning Professor Hill who was coming up, and she 
heard I was going to lead in the questioning. She called me up as I was 
in my condo working over a pile of papers, and she gave me some good 
advice. She also gave the Judiciary Committee some good advice. I did 
not tell the committee. But I did not take her advice.
  Mr. METZENBAUM. The Senator should have.
  Mr. SPECTER. Senator Metzenbaum said I should have. I do not object 
to that comment, Madam President. I will not say whether I should have 
taken her advice or not. I will say Aunt Rosie was a very wise woman.
  I called her this week. I said: ``Rosie, what do you think about 
health care?'' She said, ``Buzzie,'' which is what she called me, ``I 
do not like what I have heard.'' She said: ``Eighty-five percent of the 
American people are covered. I think the rest of them ought to be 
covered. I think we ought to help out the poor people. But,'' she said, 
``I pay $91 for my insurance on top of Medicare. What is this going to 
do to me? What is this bill going to do to me?''
  Then she made some comments which were unfavorable to Democrats and 
Republicans--more unfavorable to Republicans than Democrats, perhaps. 
She said, ``I do not like this bill.'' Then she asked me some 
questions. Again I could not answer the questions as to what she had 
asked me. I told her again I would get back to her.
  But I have a lot of questions, Madam President, about this 
legislation. Although I have said publicly I would not join a 
filibuster, I am rethinking that. And it may be that the schedule ought 
not to be to take up this health bill tomorrow. We have had less than a 
week to study it. Maybe the schedule ought to be that we take up this 
health bill after Labor Day and that we work through the October recess 
instead of the August recess. We have 3 weeks to work on this bill 
during the August recess. We have 3 weeks to work on this bill during 
the October recess.
  Now I am not unaware that if you work during the October recess it 
impacts campaigning in October, and that there are many more Democrats 
who are up for reelection in this body than Republicans. I am not 
unaware that the political impact would be more onerous on Democrats in 
the Senate, perhaps in the House as well.
  But I think we have to put the politics aside on national health care 
because of the importance of this legislation. We ought not do it on 
anyone's political timetable. Some people said we ought not do it this 
year and the poll I referred to that was cited in the Washington Post 
this morning, the Newsweek poll, said 65 percent of the American people 
think we ought not to do it this year. I do not think we ought to rush 
to judgment, Madam President. I think I am still prepared to work on 
it, but I am not prepared to work on it on a political timetable.
  I see two of my colleagues have risen, so I will yield the floor.
  Mr. METZENBAUM. Madam President, will the Senator from Pennsylvania 
yield for a question?
  Mr. SPECTER. I yield.
  Mr. METZENBAUM. It is a very simple question.
  Mr. SPECTER. I am not sure that I will hear a simple question, but I 
will try to respond to it whether it is simple or not.
  Mr. METZENBAUM. Will the Senator from Pennsylvania be good enough to 
share with the Senate Aunt Rosie's telephone number? I want to call her 
on occasion.
  Mr. SPECTER. No, I will not be good enough to share with the Senate 
her telephone number. I will be willing to share it privately with 
Senator Metzenbaum.
  Mr. METZENBAUM. I thank the Senator.
  The PRESIDING OFFICER. The Senator from Iowa.
  Mr. HARKIN. I know Senator Metzenbaum wants to speak on a different 
topic. I just want to respond as briefly as I can to Senator Specter's 
comments. He raised the issue of what is the cost--what is the cost of 
this, what is the cost of that. Furthermore, the Senator said that we 
had the finest health care system in the world for those that are 
covered and all we have to do is cover those that are not covered.

  I respectfully disagree. We do not have a health care system in this 
country. We have a sick care system. If you get sick, you get care.
  What we need is a system that moves us more towards keeping people 
healthy in the first place, more preventive health care. That is what 
the Mitchell bill does. That is what a lot of the bills are moving us 
toward. As long as we leave people uncovered, they will seek help and 
health care in the emergency rooms.
  Now, Madam President, we have already made a decision in this 
country. We have made the decision that if someone shows up in the 
emergency room and they do not have health insurance and they need 
health care, we are not going to tell them, ``Go out and die.'' We are 
going to take care of those people. And we do it 24 hours a day, 7 days 
a week, 365 days a year in emergency rooms across the Nation. It is the 
most expensive way of providing the sick care to people.
  So as long as we have made the decision that we are not going to tell 
people to go out and die--if you do not have health insurance, we will 
take care of you in the emergency room when you are the sickest--as 
long as we have made that decision, it seems to me we ought to do it in 
the smartest way. If we are going to spend this money, let us spend it 
smarter. Let us extend health care coverage to people so they do not 
have to wait to go to the emergency room, so they can go to the doctor 
and get a shot or an immunization or a prescription or some form of 
help early on before they have to seek help in the emergency room. It 
just seems to me to be the smartest thing to do.
  So when the question is raised, ``What is this going to cost?'' I 
only point to the present system. The present system is bankrupting us. 
And if we do not do something, it will further bankrupt us. It will 
take more money out of the private sector that can be used for job 
creation, new technologies, education, and rebuilding the 
infrastructure of this country. It is going to take it all out of there 
and put it more and more into health care.
  So, again, I say to my friend and colleague from Pennsylvania, let us 
move away from the sick care system we have now and move to a health 
care system.
  Again, I listened to the Senator from Pennsylvania; very erudite. He 
talked about the complexities in the bill and how do you do this and 
how do you do that. Again, we have to get back to the basics. Let us 
get back to the basics of what we are talking about in terms of health 
care coverage.
  He talked about the employer mandates and small businesses saying 
they could not live with it.
  Well, I ask my friend and colleague from Pennsylvania if he looked at 
the Labor and Human Resources bill that we passed out. We exempted 
small businesses of less than 10 employees. We said if you have from 1 
to 5 employees, you pay 1 percent of your gross earnings to the pool. 
If you have 6 to 10 employees, you pay 2 percent into the pool. That is 
all. And then, if you have from 10 employees up to 75 employees, you 
get subsidies, depending upon how many you have and what the average 
payroll is.
  Now, I have talked about this aspect to small businesses not only in 
Iowa but in other places. They think that is a pretty good deal--1 
percent if you have less than 5 employees; 6 to 10, you pay 2 percent.
  So when you hear about employer mandates and talk about small 
businesses, I hope that we will keep in mind that at least the Labor 
and Human Resources bill exempted those with less than 10 employees.
  So, again, when you get all these complexities, we get back to the 
basics, really, of what the bill is about.
  Finally, Madam President, I keep hearing the Senator and others who 
say, ``We agree with the objective. We agree with the objective of 
health care coverage for all.''
  Well, it reminds me of, you know, recently I was in Normandy at the 
50th anniversary of the Normandy invasion. And I looked at the beaches 
there--and I talked to a lot of people who had been on Normandy Beach 
that day and who fought their way through Europe to the final conquest 
of Hitler and the Nazis--and I think of that, and I think of a military 
objective of taking the hill or taking an objective.
  Well, there comes a time you have to get out of the foxhole. There 
comes a time when you have to get out of the water and ocean and off 
the beach and take the hill.
  We have been talking about health care reform for almost 50 years. We 
know the objective. We know how to get to that objective. All we have 
to do is get out of the foxhole and quit talking go about it.
  That is why I hope that my friend and colleagues will not yield to 
the temptation to filibuster this bill, but get out of the foxhole, 
offer the amendments, let us have the debate, let us vote them up or 
down, and then let us move on to the objective of health care coverage 
for all. We will not get it if we stay in the foxholes.
  Mr. SPECTER addressed the Chair.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Madam President, again, I thank my colleague from Iowa 
for his comments.
  I would reply to him that I moved back to this section of the Senate 
because I want to refer briefly to charts.
  But I say to my colleague from Iowa that I have been out of the 
foxhole on health care legislation for a long time. I got out of the 
foxhole in the early 1980's, when I introduced health care legislation 
for low-birthweight babies.
  When the Senator from Iowa talks about a sick care system, I have 
been concerned about preventive care for a long time. I was amazed when 
I saw my first 1-pound baby, a child about as big as my hand, weighing 
16 ounces. There are many children born into this world who weigh 16, 
18, 20 ounces.
  I was amazed to find that the city of Pittsburgh, which has a fine 
health care system, had the highest infant mortality rate among 
African-American babies of any city in the country, and I introduced 
legislation on this back in 1984.
  For the last 5 years--I have been on the subcommittee for 14 years of 
Health and Human Services appropriations--Senator Harkin and I have 
worked together to craft an appropriations bill which this year is 
almost $70 billion, with a tremendous amount of it going toward 
preventive care.
  There is nothing more important than the National Institutes of 
Health, where almost every year, regardless of who was President, 
Democrat or Republican, the figures came in for a reduction and our 
subcommittee has added money. Now it is up to $11.3 billion. We added 
$395 million this year. We added $600 million last year, because that 
is a priority.
  Before Senator Harkin was chairman, Senator Lawton Chiles, now 
Governor of Florida, did it as chairman; before that, Senator Weicker, 
now Governor of Connecticut, was chairman and he did it. That is a very 
proud history, to have the medical research increased when there have 
been so many budget cuts in such a tight budget system. So I agree with 
the Senator totally when he talks about not just having a sick care 
system. We have done it on breast cancer and prostate cancer and on 
AIDS--tremendous efforts in preventive medicine. So I agree with him 
about that completely.
  When the Senator from Iowa says that his subcommittee took care of 
small business by having an exemption for those with under 10 
employees, I say to him, respectfully, that is not enough.
  Senator Mitchell's bill has an exemption for those with 25 and under. 
But there are still many, many small businesses who have more than 10 
employees.
  My wife had a bakery, which was a small business. Some of the 
comments I heard in the car, in addition to on the train and in the 
restaurant and at ball games, the Phillies ball game, were comments of, 
``Senator, what is this bill going to do?''
  I heard a comment from my wife Joan, who had a small bakery, who 
said, ``I could not have made it if they asked me to pay $2,000 in 
addition for each employee.''
  And when the Senator from Iowa talks about the subsidy--and I will 
not ask him now what the subsidy would cost for people in the Kennedy 
bill, but I will ask him later privately to find out how much the 
subsidies will cost. He and I work together closely, and when we have 
questions for each other, we ask them privately; we do not ask them 
publicly--but when the Senator from Iowa talks about the Kennedy plan, 
we made a chart of the Kennedy plan. I have never shown this chart. I 
am very sorry I do not have a chart on the Mitchell bill, but I will by 
tomorrow. I have had people working over the weekend to prepare the 
chart for tomorrow when the Mitchell bill comes to the floor.
  This is the chart on the Kennedy program. I might make reference 
first to the chart that my office made on the President's health care 
program. We have the two charts.
  A brief word of explanation might be in order. When I read President 
Clinton's health care proposal I was surprised by the number of 
agencies, boards, and commissions which were created. So I asked my 
assistant, Sharon Helfant, to make a list. I was not ingenious enough 
to think of a chart, but Sharon Helfant made a chart instead of a list. 
And that is this chart, which is the President's health care system. It 
is Senate bill 1757; 1,342 pages, and every orange box on this chart is 
a new agency, board, or commission. There are 105 of them. And every 
box in green is an existing agency or program with new or expanded 
responsibilities, and there are 47 of those.
  This chart was made somewhat famous by Senator Dole when he used it 
in his response to President Clinton's State of the Union speech last 
January. It so happened, perhaps only coincidentally, but that was, 
many say, about the time of the turning point where people started to 
oppose President Clinton's health care plan.
  I think it is important to focus on that for just a minute. When 
President Clinton's health care program came out on October 27, 1993 
the initial reaction was very positive to it. But when we had a time to 
read it and to analyze it and to think about it and to put it on a 
chart, then people did not like it. The polls reflect a consistent 
decline in acceptance from the President's health care proposals and so 
much of a decline that when the new proposals have come out they are 
different from what President Clinton had in mind. What came out of the 
Senate Committee on Labor and Human Resources, what came out of the 
Senate Committee on Finance, what came out of the House committees, 
Senator Mitchell's bill, and Congressman Gephardt's bill--all have 
announced explicit differences from the President Clinton's bill 
because people do not like it.
  But at the outset there was a lot of favorable comment. It was right 
about the time when Senator Dole made his reply to the President's 
State of the Union speech and talked about the chart that President 
Clinton's support declined. Senator Dole says it was his speech. I 
think it was my chart. Maybe it was both. Maybe it was neither. But the 
Clinton health care plan has declined markedly in public support, so 
much so that all the new plans have candidly deserted it.
  Here is the chart of Senator Kennedy's bill. This is the bill which 
was reported out by the Committee on Labor and Human Resources, called 
the Health Security Act. This chart depicts 107 new agencies, boards, 
and commissions--two more than the President's bill. And it shows 30 
existing agencies, boards, and commissions which are given new or 
expanded responsibilities.
  Here the color code is a little different. The red color code are new 
agencies, boards, and commissions which are identical to those in 
President Clinton's plan. The yellow boxes are new agencies, boards, 
and commissions which were added in by Senator Kennedy--he took some 
out from the Clinton bill, but the Kennedy bill ends up with 107 new 
agencies, boards, and commissions, those depicted in both red and 
yellow, and ends up with 30 existing bureaus being given new jobs. As I 
say, tomorrow we will have the chart for Senator Mitchell's bill.
  When this chart was used by Senator Dole in his reply to President 
Clinton's State of the Union speech, the White House immediately said 
that it was erroneous. They said it was more complicated than the New 
York subway system. And I think it may be more complicated than the New 
York subway system. When he said it was erroneous we pointed to the 
fact that every box on the chart has a page number. It is all factual--
footnoted right down to the last agency, board, or commission. Then 
they said it was a Republican conspiracy. So the Washington Post went 
out to interview Sharon Helfant. As I said, I had just asked my staff 
to make a list and my staffer made the chart.
  When they went to Sharon Helfant, my staffer, they found out things 
that I did not know. They found out that she was a Democrat. They found 
out that she had voted for President Clinton. They found out that she 
was a big fan of Mrs. Clinton--all questions irrelevant to being a good 
staffer, but certainly not someone who is about to make up a bogus or 
false or partisan chart.
  When they came to the point about the big Republican conspiracy 
Sharon Helfant said when she took out a piece of typewriter paper, 8\1/
2\ by 11, that it was too small; she could not put the whole chart on 
it; she had to scotch tape pieces of paper together--not really 
indicative of a Republican conspiracy.
  So, Madam President, this discussion began when the Senator from 
Illinois, Senator Simon, came to the floor a little after 10, asking 
for unanimous consent to talk as in morning business for 3 minutes, and 
raised a question which he had heard about in Illinois about Senator 
Mitchell's bill: Which 95 percent would be covered? Who would be the 5 
percent uncovered? Since then, we have had a discussion which I think 
is a useful one.
  It is the complexity of the Mitchell plan, the absence of public 
input, the concern I have that once the Clinton plan was understood it 
was rejected by the American people--that leads me to believe that we 
need to have input from the American people who will be affected by it: 
By the senior citizens who will be affected by it, by rural Americans, 
by consumers generally, by providers including doctors, by taxpayers, 
to make some assessment as to what the projected costs are going to be. 
And that is why, after I saw the little debate on Friday with the scale 
and the theatrics and the histrionics, that I have been giving very 
serious thought as to whether or not I would be willing to join in a 
filibuster on this bill so we can know what we are doing.
  I think it is very important when we deal with a $1 trillion segment 
of America that we not rush to judgment, that we not do it on anybody's 
political timetable.
  I yield the floor.

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