[Congressional Record Volume 140, Number 112 (Friday, August 12, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 12, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                          HEALTH SECURITY ACT

  The PRESIDING OFFICER. Under the previous order, the Senate will now 
resume consideration of the pending business, S. 2351, which the clerk 
will report.
  The legislative clerk read as follows:

       A bill (S. 2351) to achieve universal health insurance 
     coverage, and for other purposes.

  The Senate continued with the consideration of the bill.
  Mr. MITCHELL. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mrs. MURRAY. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Is there objection?
  Mr. MITCHELL. Mr. President, I object.
  The PRESIDING OFFICER. Objection is heard.
  The legislative clerk continued with the call of the roll.
  Mr. MITCHELL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


 statement under section 27 of the concurrent resolution on the budget

  Mr. SASSER. Mr. President, on behalf of the Committee on the Budget, 
under section 27 of the concurrent resolution on the budget, House 
Concurrent Resolution 218, I hereby submit revised budget authority and 
outlay allocations to the Senate Committee on Finance and revised 
aggregates in connection with the Mitchell amendment to S. 2351, the 
Health Security Act.
  Section 27 of the budget resolution states, in relevant part:

     SEC. 27. DEFICIT-NEUTRAL RESERVE FUND IN THE SENATE.

       (a) * * *
       (2) Budget authority and outlay allocations and revenue 
     aggregates.--In the Senate, budget authority and outlays may 
     be allocated to a committee (or committees) and the revenue 
     aggregates may be reduced (as provided under subsection (c)) 
     for direct-spending or receipts legislation in furtherance of 
     any of the purposes described in subsection (b)(2) within 
     that committee's jurisdiction, if, to the extent that this 
     concurrent resolution on the budget does not include the 
     costs of that legislation, the enactment of that legislation 
     will not increase (by virtue of either contemporaneous or 
     previously passed deficit reduction) the deficit in this 
     resolution for--
       (A) fiscal year 1995; or
       (B) the period of fiscal years 1995 through 1999.

                           *   *   *   *   *

       (b) * * *
       (2) Purposes under subsection (a)(2).--Budget authority and 
     outlay allocations may be revised or the revenue floor 
     reduced under subsection (a)(2) for--

                           *   *   *   *   *

       (B) to make continuing improvements in ongoing health care 
     programs, to provide for comprehensive health care reform, to 
     control health care costs, or to accomplish other health care 
     reforms;

                           *   *   *   *   *

       (c) Revised Allocations and Aggregates.--
       (1) Upon reporting.--Upon the reporting of legislation 
     pursuant to subsection (a), and again upon the submission of 
     a conference report on that legislation (if a conference 
     report is submitted), the chairman of the Committee on the 
     Budget of the Senate may submit to the Senate appropriately 
     revised allocations under sections 302(a) and 602(a) of the 
     Congressional Budget Act of 1974 and revised aggregates to 
     carry out this section.
       (2) Adjustments for amendments.--If the chairman of the 
     Committee on the Budget submits an adjustment under this 
     section for legislation in furtherance of the purpose 
     described in subsection (b)(2)(B), upon the offering of an 
     amendment to that legislation that would necessitate such a 
     submission, the chairman shall submit to the Senate 
     appropriately revised allocations under sections 302(a) and 
     602(a) of the Congressional Budget Act of 1974 and revised 
     aggregates, if the enactment of that legislation (as proposed 
     to be amended) will not increase (by virtue of either 
     contemporaneous or previously passed deficit reduction) the 
     deficit in this resolution for--
       (A) fiscal year 1995; or
       (B) the period of fiscal years 1995 through 1999.
       (d) Effect of Revised Allocations and Aggregates.--Revised 
     allocations and aggregates submitted under subsection (c) 
     shall be considered for the purposes of the Congressional 
     Budget Act of 1974 as allocations and aggregates contained in 
     this concurrent resolution on the budget.

  On August 9, 1994, I submitted an adjustment under this section for 
S. 2351, the Health Security Act. Within the meaning of section 
27(c)(2) of the budget resolution, the Health Security Act constitutes 
``legislation in furtherance of the purpose described in subsection 
(b)(2)(B).''
  The Mitchell amendment to the Health Security Act also meets the 
other requirement of section 27(c)(2) of the budget resolution that:

       * * * the enactment of that legislation (as proposed to be 
     amended) will not increase (by virtue of either 
     contemporaneous or previously passed deficit reduction) the 
     deficit in this resolution for--
       (A) fiscal year 1995; or
       (B) the period of fiscal years 1995 through 1999.

  As the Mitchell amendment to the Health Security Act complies with 
the conditions set forth in the budget resolution, under the authority 
of section 27(c)(2) of the budget resolution, I hereby submit to the 
Senate appropriately revised budget authority and outlay allocations 
under sections 302(a) and 602(a) and revised aggregates to carry out 
this subsection.
  Note that, as this reserve fund submission accommodates an amendment, 
it covers the time that the amendment is either pending or adopted (if 
the amendment is adopted). If the Senate rejects the amendment, this 
reserve fund submission shall lapse, and the allocations and aggregates 
shall revert to the levels they would have in the absence of this 
reserve fund submission.
  I ask unamious consent that the reserve fund table be printed in the 
Record.
  There being no objection, the table was ordered to be printed in the 
Record, as follows:

 RESERVE FUND FILING PURSUANT TO SECTION 27 OF THE CONCURRENT RESOLUTION
                   ON THE BUDGET FOR FISCAL YEAR 1995                   
         [Adjustments to aggregates and allocations; $ billions]        
------------------------------------------------------------------------
                                     The Mitchell substitute            
  Reserve fund filing  -------------------------------------------------
         for              1995      1996      1997      1998      1999  
------------------------------------------------------------------------
Aggregate totals:                                                       
    Budget authority..    -2,400    -4.900    10.900    24.200    32.500
    Outlays...........    -2.400    -4.900    10.900    24.200    32.500
    Revenues..........    -2.400    -4.900    10.900    24.200    32.500
------------------------------------------------------------------------


------------------------------------------------------------------------
          Finance committee allocations               1995      1995-99 
------------------------------------------------------------------------
Budget authority..................................     -2,400     60.300
Outlays...........................................     -2.400     60.300
                                                   ---------------------
Revenue...........................................     -2.400     60.300
------------------------------------------------------------------------

  Mr. LOTT addressed the Chair.
  The PRESIDING OFFICER. The Senator from Mississippi.
  Mr. LOTT. Mr. President, I seek recognition on this amendment.
  I would like to begin by yielding for a question to the Senator from 
Connecticut about his amendment.
  I yield to the Senator from Indiana, Senator Coats.
  Mr. COATS. If I could just get the attention of the Senator from 
Connecticut.
  Mr. DODD. If the Senator will withhold. It is a little difficult.
  The PRESIDING OFFICER. Is there objection to the Senator from Indiana 
directing a question to the Senator from Connecticut?
  Without objection, it is so ordered.
  Mr. LOTT. I do not believe I have to ask for unanimous consent. I had 
the floor and I yielded to the Senator from Indiana for a question.
  The PRESIDING OFFICER. The Senator from Indiana may ask a question of 
the Senator from Mississippi under the regular order.
  Mr. MOYNIHAN. Mr. President, we must have order at the moment.
  The PRESIDING OFFICER. The Senate will be in order.
  Mr. DODD. Mr. President, if the Senator will yield, I will be glad to 
respond to a question.
  Mr. LOTT. If the Senator will address the question to me, I will 
yield to the Senator from Connecticut to respond.
  Mr. COATS. I would like to ask the Senator from Mississippi if he 
will ask the Senator from Connecticut a question.
  I have been trying to get an answer here now for nearly 45 minutes 
and I apologize for not knowing the procedure to do that.
  One of the problems that we have on this side is trying to analyze 
the bill, because the underlying bill keeps changing. So in order to 
respond to amendments that are offered from the Senator from 
Connecticut, or indications or references to the bill, we are not sure 
which bill we are talking about.
  The amendment that was offered by the Senator from Connecticut, I ask 
the Senator from Mississippi, says that it is an amendment to S. 2351 
which, as I understand it, is the underlying Finance Committee bill.
  The amendment says, ``At the end of section 1201, insert the 
following new subsection.''
  I cannot find section 1201 in the underlying Finance Committee bill. 
I was wondering if the Senator from Mississippi will ask the Senator 
from Connecticut how I find section 1201 in the bill that the amendment 
is offered to.
  While we were debating the amendment offered by the Senator from 
Connecticut, a third health bill was delivered to the desk, unbound, 
but it is now the third Mitchell bill. So we have three Mitchell bills, 
plus the underlying Finance Committee bill.
  I signed a pledge to read all the bills. I want to know which bill to 
read.
  Mr. BREAUX. All of them.
  Mr. COATS. Maybe I should read all of them. It will take an awful lot 
of time.
  I would like to know which bill we are on. I would like to find 
section 1201.
  Mr. LOTT. I will be glad to yield to the distinguished Senator from 
Connecticut to respond to that question. It is certainly a valid 
question, because we do not know which bill we are dealing with or 
which section we are dealing with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DODD. Mr. President, I will not respond by asking some other 
Senator to respond to the Senator from Mississippi, to respond to the 
Senator from Indiana.
  The amendment is offered as an amendment to the substitute that was 
offered by the majority leader. Now, there may be a particular glitch, 
which we will be glad to correct to conform to the appropriate section 
as it relates to children and the effective date. That is a very 
appropriate question and we will conform it to that.
  I will in a moment ask to modify my own amendment, from the 
parliamentary standpoint, to modify the amendment to see that it does 
conform to the Mitchell substitute, which is the pending bill
  Mr. LOTT. Mr. President, I will be glad to yield to the Senator from 
Indiana.
  Mr. COATS. One last followup question, I say to the Senator from 
Mississippi.
  Do we know or have reason to find out whether or not the third 
Mitchell bill, which was just delivered, whether it is carried through 
the section in the Finance Committee bill, which went to the first 
Mitchell bill, which went to the second Mitchell bill; do we now know 
that that is part of the second Mitchell bill?
  Mr. LOTT. I ask unanimous consent to yield to the Senator from 
Connecticut.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DODD. I respond as I did a moment ago. The pending matter is the 
substitute offered by the majority leader. There may be a requirement 
to modify it to make sure it conforms.
  Clearly, the section pertains, as I said in my opening remarks. I 
pointed out specifically what was in the Mitchell proposal as it 
related to benefits to be provided to pregnant women, infants, and 
children.
  We are merely extending, or backing, the effective date on that from 
1997 to July of 1995. That is all the amendment does except for some 
minor points. I will be glad to see to it that the appropriate pages 
conform. But that is the purpose.
  Mr. LOTT. Mr. President, if I could proceed now to reclaim my time? 
Perhaps the Senator from Connecticut----
  Mr. DODD. I would just say, if the Senator will yield?
  Mr. LOTT. I yield.
  Mr. DODD. The bill reads ``S. 2351.'' That is the Mitchell 
substitute.
  Mr. LOTT. Mr. President, again claiming my time, I think it is time 
to review the bidding here a little bit. This afternoon at about 5 
o'clock the majority leader laid down a bill that we do now have the 
yeas and nays on. This was the third version of his bill.
  Here is the latest version. I note the first Mitchell bill that we 
got, I think it was last week, maybe Thursday, was 1,410 pages. The one 
we saw earlier this week I believe was 1,438. And the latest one now is 
1,443 pages long. And we first saw this bill at 5 o'clock this 
afternoon. We have not had a chance to go through it, certainly. We do 
not know how the sections or subsections relate to the earlier 
iterations, and so we are going to have to take some time to go through 
that.
  It makes it very difficult to offer amendments, by the Senator from 
Connecticut, the Senator from Indiana, or any other Senator, because we 
are not sure exactly what we have before us and how an amendment would 
or could or should be offered.
  So I understand the Senator from Connecticut will need some time to 
make that correction and other Senators will need some time to draft 
amendments.
  Mr. DODD. Will the Senator yield for just one point?
  Mr. LOTT. I will be glad to, yes.
  Mr. DODD. I am informed now the amendment as submitted is correct, 
that it amends amendment No. 2560 to S. 2351, which is the Mitchell 
substitute.
  So the amendment as presented to the clerk conforms.
  Mr. LOTT. Clarification, because it is very confusing. Then you have 
the right section to the third version of the Clinton-Mitchell bill. 
But the mistake apparently was there is an indication there it was to 
the Finance Committee bill? Instead of to the Clinton-Mitchell bill?
  Mr. DODD. Amendment offered by Mr. Dodd to S. 2351 to amendment No. 
2560, which is the Mitchell substitute.
  Mr. LOTT. We will work with you on that.
  But, again, I think it is important to emphasize, after having heard 
this discussion, that there is confusion and we are going to need time 
to make sure we are all talking on the same level. We need more time to 
talk about this whole area of health care, let alone this specific 
bill. I want to emphasize, while we have had 8 speakers, I think, on 
this side during the week at different times, three times, to speak on 
this subject, we still have 20 Senators on this side who are very 
anxious to make an opening statement or express their interest in or 
concern or support for, you know, the Dole bill or Mitchell bill, I, 
II, or III.
  I have really, like a lot of others, been waiting for 3 days for an 
opportunity to just make an opening statement on that subject. I am 
glad I am going to have that chance tonight at 7 o'clock on a Friday 
night. Others will speak tomorrow, I am sure. We will be speaking on 
this amendment before us on over to next week.
  I want to note the fact that one Senator said, ``At last we are 
getting to health care.''
  I agree. You know, this week everybody has been trying to be 
accommodating so we have been on the Labor-HHS appropriations bill. 
Then we have been on health care. Then we are on DOD appropriations. 
Then we are on health care. Today we have been on intelligence 
authorization and child nutrition--and now at 5 o'clock we got back on 
health care.
  I do not think that is a very good way to debate what everybody 
agrees is clearly one of the most important issues we have had before 
this body in 25, 40, 50 years--in a kind of disjointed fashion, a 
little bit here and a little bit there.
  Now, all of a sudden, we have a bill, the third version of the same 
bill, and an amendment which we are now trying to discuss. I am sure 
this will, hopefully, move forward. I know the distinguished Senator 
from New York would like it to be done in an orderly, sensible way. I 
guess next week we will all get our desks cleared off and really get 
down to being serious about it and continue to work only on health 
care. But it is confusing not to know exactly what version we are 
talking about and how an amendment should be offered.
  I thank the Senator from Indiana for his point. I would like to ask a 
question, if I could, before the Senator works on making sure to get 
all the corrections on his amendment.
  One of the points that you made that I think is very important, that 
really bothers me on this amendment you offered, is the fact that, as I 
understand it, it would go into effect immediately----
  Mr. DODD. That is not correct.
  Mr. LOTT. Let me propound the question--go into effect immediately 
before the subsidies begin. Which would mean, I take it, there is an 
interim, then, after which this amendment would take effect but before 
the subsidies begin, and, therefore, there would be an additional cost 
for families with children to have to deal with; is that correct?
  Mr. MOYNIHAN. Mr. President, may I offer a parliamentary inquiry?
  Mr. LOTT. Mr. President, I understand----
  The PRESIDING OFFICER. The Senator from Mississippi has the floor.
  Mr. LOTT. I understand I do not have to yield for the purpose of a 
parliamentary inquiry, but because of my high regard for the chairman 
of the Finance Committee, I am delighted to yield.
  Mr. MOYNIHAN. Mr. President, is it not the case Senators must address 
the Chair and not one another directly?
  The PRESIDING OFFICER. Senators should address their questions to 
other Senators through the Chair in the third person.
  Mr. MOYNIHAN. I thank the Chair.
  Mr. LOTT. I thank the Senator for that point. It is obvious we need 
to maintain absolute decorum in how we handle this debate. I would be 
glad, Mr. President, to address the question through the Chair to the 
Senator from Connecticut because I think this is a very important 
question and I am very sincere about it.
  Is your amendment intended--Mr. President, does the Senator intend 
for it to go into effect immediately? Is there a lag before the 
subsidies begin? If that is true, then I think we are going to need to 
know what the costs of that amendment would be in the interim for 
families with children? And in that connection, I wonder, has his 
amendment been costed out by CBO? Do we have a CBO estimate of the cost 
of this particular amendment? Because if, in fact, families with 
children--in the private sector, Mr. President, I might say--are going 
to have this additional cost to make up for the fact that they will not 
have the subsidies involved, then you are talking about revenue loss, 
and we need to know what that is going to be. What is the CBO estimate? 
What is the revenue impact? And what is the impact on families with 
children? I would be glad to yield to the Senator from Connecticut for 
a response to that question without----
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. DODD. Mr. President, let me respond to my friend from 
Mississippi. Others have raised issues about this. This amendment has 
nothing to do with the subsidy program, nothing whatsoever to do with 
the subsidy program. All this amendment says is that insurers, private 
insurers, private areas must start including preventive services for 
children and pregnant women in any policy that they sell. That they 
sell. So there is no subsidy issue here at all.
  So, while that is an interesting question, if you are looking at cost 
here, what do the carriers--what is the effect on the premiums to other 
insured parties?
  I inquired. Just to give you some idea, it works out Travelers 
Insurance Co. has told me that the benefit for this, for children, 
would cost roughly about 9 cents a day for other insured parties. 
Estimates run a little higher than that when you talk to others.
  So, again, I emphasize to you, this is not a part of the subsidy 
program. It deals with the benefits. And all it says is that, if you 
are selling insurance, we require that as a part of that package you 
include assistance to pregnant women and children for prevention. So it 
is not a part of the subsidy deal.
  The cost implications regarding CBO--and we made inquiries on that--
the estimates are roughly $100 million for the first year, and as much 
as $300 million in the outyears. I would say to my colleague, Mr. 
President, responding to my colleague from Mississippi, we were 
initially told there would be no budgetary implications or impact. Then 
last evening we were informed there may be some.
  There is built into the majority leader's proposal a surplus into the 
several billions of dollars. If there are any financial or fiscal 
implications, that is the maximum extent to which they would occur, 
according to the CBO's response to our inquiries.
  Mr. LOTT. Mr. President, again, I do think we should make clear we at 
least understand what the impacts will be. I appreciate the 
clarification I received here. But as I understand it, one of the 
impacts would be, as he suggested, premiums would go up, which would 
affect the tax deductions, which would go up. There clearly would be a 
revenue loss. And we need to know before we vote--eventually, sometime, 
I guess, next week or whenever--on this amendment what that effect 
would be.
  Mr. DODD. If my colleague will yield?
  Mr. LOTT. If I could proceed? I hope my colleague from Connecticut 
will pursue that further. We will pursue that later, what revenue 
impact that might have. And we will have a chance to clear it up before 
we vote on this amendment.
  Mr. President, I certainly am going to review this amendment more in 
the next few hours and days. We will have a great deal more discussion 
on it to try to understand exactly what it means in the overall debate, 
but I have some other points I would like to make here.
  In addition to talking about the fact we are dealing with the third 
version of this bill, I think it is important to also note to our 
colleagues that the House, the other body, is not going to deal with 
health care this month--not at all.
  They are going to leave this weekend, and they are coming back next 
week. They are going to take up some suspensions and deal with the 
crime bill. They are not going to take up or vote on health care at all 
this month.
  So we are talking about the Senate proceeding down an uncertain path. 
We do not know where it is leading or how long it is going to lead us 
there. But at some point, I presume we will have a vote or votes on 
what I think really is a revenue bill which really I thought had to 
pass the House first before we could even take it up.
  They are not even going to take this issue up. They are doing the 
right thing. They are making sure that the various alternatives they 
have pending are understood by the Members, have been costed out by 
CBO, which is overworked and overtaxed, I am sure, and have time to 
think about it.
  Also, they are going to have to listen to their constituents. They 
are going to be back in their various States, and they are going to be 
listening to the people. And when they come back, there will not be a 
Gephardt bill. It is history. And more than likely, there is not going 
to be a Mitchell bill 1, 2, 3, or 5, or 6, or whatever, because when 
they get home and start listening to the people, they are going to find 
out the people do not want this Government takeover. They do not want 
this bill. They do not want the Gephardt bill.
  I am sure my colleagues are very well aware of the fact that in a 
recent CNN poll, 68 percent of the American people, who are smarter 
than we are, obviously, say keep talking about this thing, keep working 
on it and do it next year in the cool of the night when you understand 
what you are doing, because they know that we do not know what we are 
doing.
  There may be a few Senators on the Finance Committee who have some 
foggy idea of what is in this bill, but not many.
  The only way this bill will have a chance, I presume, is after we 
adopt a lot of amendments--a lot of amendments--and a lot of them 
probably will not be adopted even if the effort is made.
  So I think we need to think about that. This is a case where we Btu'd 
the House last year. That was on the tax issue. They voted for the Btu 
tax. It came over here and we wisely knocked it out. And they said, 
``Oh, my goodness, you made us walk the plank, we have been Btu'd.''
  They are turning the tables this time. They say this may be a revenue 
bill, and any other time they would be screaming that we are proceeding 
on a bill that should constitutionally have begun in the House of 
Representatives. But this time, they are saying, ``You all go first; go 
ahead on.'' Yes, we are going to go ahead, we are going to cast the 
votes, and they are going to come back and say the people do not want 
this thing.
  The people do not want and we do not need a government takeover of 
health care to make the improvements we do need in health care. We do 
not need this massive thing. I do not understand why we are insisting 
on moving the envelope forward on something that the people are 
rejecting.
  We do not need 18 new taxes to fix the problems we have in the 
American health care system. It is not necessary, it is not needed, and 
the people do not want it.
  We do not need 50 new bureaucracies and a whole list of other 
commissions and Government controls, including the National Health 
Benefits Board with new powers that we are not quite sure what they 
are. I keep asking myself: Why should 85 percent of the American people 
who now are insured or covered one way or the other be taxed more, get 
less, lose choice and all kinds of things we are not sure of yet so 
that another 10 percent of the people may be covered somewhere down the 
line?
  It is not necessary to do all these things to address the problems we 
need to cover millions that do need insurance coverage.
  Mr. President, I am not saying that we should do nothing. I am saying 
there are some things we should do. I have been saying it for years. 
Others have said that. And as proof of it, I offer the fact that last 
October, a year ago--well, October, not quite a full year--I introduced 
as the original sponsor in the Senate the bill developed primarily 
under the leadership of Congressman Bob Michel, the Republican leader 
in the House, the bill, Affordable Health Care Now Act of 1993.
  So this is something that I was working on a year ago, and it is a 
bill that really addresses the problems we have that we can fix. It is 
a bill that probably 98 Senators could say, ``Yeah, we could do all 
that, or we should do all that, but we would like to do a lot more.''
  In talking about this whole area, in talking about the Senator's 
amendment and health care in general, I want tonight to point out what 
was in that bill that I sponsored last year.
  It sought three things: Better access to health care, security of 
health coverage, and control of health care costs.
  The bill was introduced by the distinguished minority leader in the 
House, Bob Michel, along with about 140 other House Members. You might 
say, ``Well, that bill didn't have a lot of support.'' This bill has 
more cosponsors than any other bill pending in the Congress: 140, 
approximately, House Members and about 14 Senators. So we have 154 
Members of the Congress that are cosponsors of this bill.
  It would increase employee access to coverage by requiring all 
employers to offer but not pay for basic insurance. It allows employers 
to obtain affordable insurance through group purchasing arrangements.
  I do not understand how in the world or why in the world we have not 
allowed that long before now. It would really provide a lot of help, a 
lot of relief, and certainly we should do that.
  It would require insurers who sold small group plans to offer a 
standard plan, catastrophic plan and a medisave plan to all companies 
with two to 50 workers and mandate targeted insurance reforms to limit 
premium rate variations and to remove regulatory barriers.
  The bill encourages the creation of tax-exempt personal medical 
savings accounts which could be used to purchase insurance or pay for 
out-of-pocket expenses.
  Medicaid reform, 100 percent tax deductibility of health costs to 
individuals lacking coverage and the self-employed and expansion of 
community and rural health programs are also in this legislation.
  One of the problems we have in my State is not just coverage but 
access. In a lot of rural areas, you cannot get to a doctor or clinic, 
let alone a hospital. So I do feel any bill that we pass has to have a 
strong rural community service center aspect, and it has to include 
urban areas, too. So it has to be rural and urban community centers. I 
support that so that we will have people, even if they have insurance, 
who can get to some sort of preventive maintenance or some sort of 
health care.
  The bill, known as the Michel-Lott bill, eliminates the fear of 
losing coverage by limiting preexisting condition restrictions and 
allowing portability of insurance. That is the issue that has driven an 
awful lot of desire for health care reform; that issue right there, 
plus costs and the transfer payments. If we can fix just those three 
areas, most people would say, ``Hallelujah, let that be done,'' and 
that would be enough.
  The bill also controls the growth of health care costs by real 
malpractice reform removing antitrust impediments and eradicating fraud 
and abuse.
  Mr. President, you might wonder why I have not mentioned the word 
``Government'' yet when describing this package. The reason is my 
legislation seeks to make our current health care system--now the best 
in the world--even better through market reforms. It is a commonsense, 
free-market solution to fixable problems.
  I cannot say the same for the main bill that we are now discussing, 
even though I have not had a chance to look at the latest version of 
the Clinton-Mitchell bill. It is high time to tell the truth about the 
so-called health reform bills that have the Government taking over 14.5 
percent of our economy.
  Over the past year and a half, opponents of Government-run health 
care legislation, like the original Clinton bill, the Clinton-Mitchell 
bill 1, 2 and 3 and the House Clinton-Gephardt bill have been trying to 
scare the middle-income Americans to death. These bills are really less 
health care and more health scare.
  I really worry about their impact on middle-income working Americans. 
I do think that there are a lot of good things we could do. We all 
agree. The amendment of the Senator from Connecticut, how could you be 
against that?
  But I think it is also irresponsible if we do not say, How much is 
this going to cost? Who is going to pay for it? There seems to be this 
mythical bank in the sky in which we say, ``Don't worry about that; you 
know, nobody really gets hurt.''
  Well, think about it a minute. Somebody pays. It is not going to be 
the low-income folks. They get help whether it is at 100 percent of 
parity, 200, 300. Whatever it is, they will be helped. There are not 
enough rich people to pay all these extra costs. Guess who pays? The 
same folks that pay every time. The working people of America are going 
to get this bill. The shipyard workers in my hometown where my father 
was a pipefitter, hard hat, blue-collar guy, that is who always gets 
the bill. That is where the money is. It is in the middle. They are 
going to get this bill, and it is going to be big, monstrous, a $1 
trillion increase over the next 8 years.
  So I am here tonight to make two points. One, there are reasonable 
alternatives. There are bipartisan opportunities. I know the chairman 
of the Finance Committee would prefer that that is the way we would go, 
hard as it may be, but it may be the way we eventually do go somehow or 
another.
  But I want to make one more point, and I will make it over and over 
and over as we go through this debate. On every amendment that comes 
up, I am going to ask, How much is it going to cost? And who is going 
to pay? The middle-income workers will pay, and they are being squeezed 
to death already. My 26-year-old, working, entrepreneurial son is going 
to have to pay, and he is going to be told, you have to pay a lot more 
under these so-called community ratings. You are going to get really 
jacked up. And he is the guy that is out there working trying to create 
jobs--not just take care of himself, create jobs. He is trying to find 
a way to make sure that the people that work with him get health care 
coverage.
  But as I understood the earlier version of the Clinton-Mitchell bill, 
one of the things that was in there--maybe it is not now; I do not 
know--if you cover one of your workers with health care, even if it is 
supervisory or management, you must cover them all.
  If that is the case, there are very many things that could happen, 
but here are some of them. One, nobody will get the coverage--zero. 
None of the supervisory, none of the management, none of the desk 
workers, none of the people. Or he is going to have to lay off people; 
raise his costs.
  All the options are bad. But what you have been hearing here in this 
health scare debate, the mantra that you have heard is you may lose 
your insurance; you may go broke and use up all of your savings; you 
may not be fully covered unless the Government steps in and takes over.
  Oh, yes, let the Government do it all. Why should we be worried about 
the people that are working and paying the taxes? They can handle it. 
They can take a little more. They can pay for everybody else. Sooner or 
later, everybody is going to say, ``Hey, I want to ride on the wagon. I 
don't want to pull it. It's heavy. It's hard. I want to get all this 
free stuff myself.''
  Where is the Senate going to be? We raised taxes last year on 
bonuses. People that work hard, make some savings, make a little extra 
money, they got their taxes raised. It is discouraging people from 
working hard, making some savings.
  This is all about a bunch of quackery. Those who want the Government 
to run health care with the efficiency of the Postal Service and the 
compassion of IRS are not, in my opinion, telling the truth about what 
Government would do if it takes over health care. Government-run health 
care will not save money, but it will cost jobs. And guess whose jobs? 
Some of them will be low-income jobs, but a lot of middle-income jobs 
are really going to get hit. The middle class after Government-run 
health care are going to find their wallets a lot thinner and in far 
too many instances pink slips in their wallets.
  One of the things that we have come across in looking at this 
legislation is the fact that these employer mandates have a 
particularly hard impact on families with children. In fact, I have a 
study here, and I would like to submit it for the Record, Mr. 
President. I ask unanimous consent to insert a study from the Family 
Research Council in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

 Nowhere To Run, No Place To Hide: State Data on the Family Impact of 
                     Employer-Mandated Health Care

       In June, the Family Research Council released a family-
     impact analysis of leading employer-mandated health care 
     proposals being considered in Congress. The principal finding 
     of the econometrics study FRC commissioned is that parents 
     with children under 18 will suffer the brunt of the job 
     losses for all types of employer-mandates studied.
       FRC's econometric study also found that families with 
     children in every region of the country--indeed, each state--
     will disproportionately experience job loss. This is 
     significant because it means that families thrown out of work 
     in one area of the country are not likely to find better job 
     prospects in another state or region of the country.
       CONSAD Research Corporation supplied the data in the FRC 
     analyses. CONSAD is an independent, Pittsburgh-based, public 
     policy research firm that focuses on applied social system 
     research. Founded in 1963, it has for thirty years produced 
     numerous analyses on a wide spectrum of subjects ranging from 
     program and management evaluations to economic and 
     environmental impact assessments. It specializes in 
     econometric modeling, which combines traditional economic 
     theory, public and private databases, and statistical methods 
     to define problems and identify solutions
       The following charts present the data for each state, based 
     on the particular legislative provisions of 3 employer-
     mandated health care proposals studied--the Clinton bill, the 
     Kennedy bill, and the House Education and Labor bill. The 
     state data is listed for each plan with and without the 
     benefit of the business subsidies included in each (depicted 
     by the italicized columns).
       The data displays a uniform pattern of disproportional 
     impact on families for each of the states. A quite similar 
     pattern occurs in analyses of the aggregated data for the 
     nation. Families with children generally by represent about 
     46 percent of a state's work force, but they experience about 
     55 percent of the job losses. When the impacts are computed 
     for the plans without their subsidies to businesses to defray 
     the cost of health insurance, the disproportional impact 
     climbs to about 60 percent. Assessing the family impact of 
     plans without business subsidies provides insight into 
     scenarios where future political considerations affect the 
     level of subsidy associated with the mandate being phased-in 
     or ``triggered'' at some later date, as some have purposed.
       Jobs losses are of special concern where children are 
     impacted. The state analysis cannot provide a statistically 
     valid estimate of the actual number of implicated children. 
     However, it is reasonable to assume that the total number of 
     children living in homes with a jobless parent is in excess 
     of the numbers of jobs lost by families with children.


                             technical note

       The econometric model that CONSAD has developed to estimate 
     the impacts of health care reform on employment and the 
     federal deficit incorporates detailed representations of the 
     work force, the numbers of businesses in specific industries, 
     and the sizes of businesses. The databases and economic 
     theory used for these analyses are widely accepted as ``state 
     of the art'' in the field.
       The CONSAD model characterizes the population of workers in 
     the U.S. with data from the March 1993 current Population 
     Survey (CPS), a database maintained by the U.S. Department of 
     Commerce. The March 1993 CPS contains sample data on the 
     occupations of workers, the industries in which they work, 
     their full-time or part-time status, their annual wages, 
     whether or not they have health care insurance, and the 
     source of that insurance. In order to describe the number of 
     business establishments and average salaries of workers in 
     businesses in different industry sectors and size categories, 
     data is compiled from the 1990 County Business Patterns (CBP) 
     of the U.S. Department of Commerce. The model uses estimates 
     of current health insurance premiums from the U.S. 
     Congressional Budget Office and wage elasticities of demand 
     (econometric parameters necessary for the estimation of the 
     amount of job loss) from the economics literature.

                                                  CLINTON PLAN                                                  
----------------------------------------------------------------------------------------------------------------
                                                                Families    Total jobs                          
                        Total jobs   Total jobs    Families    percent of      lost      Total jobs    Families 
        State              lost       lost by     percent of   total work    without      lost by     percent of
                                      families    total loss     force      subsidies     families    total loss
----------------------------------------------------------------------------------------------------------------
Alabama..............       12,100        6,700           55           47       53,400       32,500           60
Alaska...............        1,200          600           50           47        6,500        3,800           60
Arizona..............       10,800        5,900           55           46       53,000       31,700           60
Arkansas.............        6,900        3,700           54           46       30,500       18,400           60
California...........      101,000       54,400           55           46      459,000      275,600           60
Colorado.............       10,800        5,900           55           46       52,000       31,000           60
Connecticut..........       14,000        7,700           55           46       58,500       35,000           60
Delaware.............        2,600        1,500           58           46       11,500        6,900           60
District of Columbia.        4,800        2,700           56           45       18,600       11,000           59
Florida..............       39,500       21,200           54           46      203,000      121,000           60
Georgia..............       20,900       11,400           55           46       96,800       58,000           60
Hawaii...............        3,800        2,000           53           46       19,000       11,400           59
Idaho................        2,500        1,400           56           46       13,200        8,000           60
Illinois.............       42,000       23,500           55           46      182,000      109,000           60
Indiana..............       20,100       11,000           55           46       88,700       53,700           60
Iowa.................        9,100        5,000           55           46       43,100       26,000           60
Kansas...............        8,000        4,400           55           46       37,500       22,600           60
Kentucky.............       10,400        5,700           55           46       49,400       29,700           60
Louisiana............       10,700        5,800           54           47       51,900       31,200           60
Maine................        3,800        2,100           55           46       18,700       11,200           60
Maryland.............       15,800        8,500           54           46       75,600       45,000           60
Massachusetts........       27,300       15,000           55           46      114,000       68,400           60
Michigan.............       32,000       17,800           55           46      144,200       87,200           60
Minnesota............       16,500        9,000           55           46       74,000       44,600           60
Mississippi..........        6,200        3,400           55           47       33,800       20,300           60
Missouri.............       18,600       10,200           55           46       81,900       49,300           60
Montana..............        1,700          900           53         4646       10,400        6,200           60
Nebraska.............        5,400        2,900           54           46       25,500       15,300           60
Nevada...............        6,100        3,400           56           46       25,100       15,000           60
New Hampshire........        3,700        2,000           54           46       18,800       11,300           60
New Jersey...........       27,500       15,000           55           46      120,200       72,100           60
New Mexico...........        3,500        1,900           54           46       19,100       11,400           60
New York.............       71,100       39,000           55           46      287,000      172,000           60
North Carolina.......       24,700       13,600           55           47      106,000       64,000           60
North Dakota.........        1,600          900           53           46        8,900        5,300           60
Ohio.................       39,900       21,900           55           46      174,400      105,000           60
Oklahoma.............        8,100        4,400           54           46       39,800       24,000           60
Oregon...............        8,200        4,400           54           46       53,400       25,400           60
Pennsylvania.........       43,000       23,600           55           46      187,500      112,800           60
Rhode Island.........        3,600        2,000           56           46       16,300        9,800           60
South Carolina.......       11,400        6,200           55           46       50,700       30,000           60
South Dakota.........        1,700          900           53           46        9,400        5,600           60
Tennessee............       17,000        9,300           55           46       74,000       44,700           60
Texas................       51,900       28,300           55           46      238,000      142,800           60
Utah.................        5,600        3,100           55           46       29,000       17,400           60
Vermont..............        1,700          900           53           46        9,300        5,500           60
Virginia.............       20,000       11,100           55           46       96,000       57,000           60
Washington...........       15,500        8,400           54           46       72,000       44,000           61
West Virginia........        4,300        2,300           53           47       20,600       12,400           60
Wisconsin............       17,400        9,500           55           46       79,000       47,600           60
Wyoming..............          900          500           56           47        5,500        3,300           60
----------------------------------------------------------------------------------------------------------------
Note.--Actual numbers listed for job losses have been rounded down to the nearest one hundred. Percentages      
  listed reflect the relationships of the numbers before rounding.                                              

  (Mr. AKAKA assumed the chair.)
  Mr. LOTT. It points out that the employer-mandated health care would 
have a disproportionate impact on families with children and that there 
will be total jobs lost--now, I do admit this is under, I think the 
original Clinton bill, and there have been a lot of changes. Maybe it 
is not as bad. Maybe it will be different. But you are talking about 
total jobs lost under the employer mandate under the Clinton bill: 
18,600 in Missouri; 8,200 in Oregon; in my own State of Mississippi, 
which can ill afford it, 6,200. You are talking about job losses for 
families with children.
  Obviously, there are problems with our health care system. We can fix 
specific problems, problems that most Americans fear--portability, 
availability, exclusion of those Americans with preexisting conditions. 
Targeted reforms are popular, are possible, and I think are essential.
  Mr. ROCKEFELLER. Will the Senator yield?
  Mr. LOTT. And sooner or later that is what we are going to.
  Mr. President, if I could, I do have a few more pages to go. Allow me 
to complete that, and I will be glad to yield further.
  We do not need Government-run health care. We do not need new 
bureaucracy. We do not need mandates. Government-run health care is 
like giving a lobotomy when they only have a headache. It is overkill. 
Middle-class Americans know this, Mr. President.
  So I ask unanimous consent to enter at this point in the Record an 
article from the July 21, 1994, Wall Street Journal by Dr. Martin 
Feldstein, who wrote an article called ``Mandates Would Hurt the Middle 
Class.''
  There being no objection, the article was ordered to be printed in 
the Record, as follows:

                  Mandates Would Hurt the Middle Class

                         (By Martin Feldstein)

       President Clinton's campaign to rescue his health care plan 
     emphasizes that his proposed health insurance mandates would 
     be good for the middle class. Although the president repeats 
     this claim in every speech, nothing could be further from the 
     truth. Mr. Clinton said this week that there might be room 
     for compromise on mandates, but if Congress enacts anything 
     like the Clinton health plan, the American middle class would 
     be the big losers.
       The Clinton health program would hurt the vast middle class 
     in order to provide insurance to a relatively small number of 
     currently uninsured low-income people and to transfer income 
     to many more low-income people who are already insured. The 
     program would be wasteful and inefficient, a ``negative sum 
     game'' in which the middle class would lose far more than the 
     poor gain. It can be understood only as a technique for 
     achieving a redistribution of income that could not be 
     enacted in a more straightforward way.


                            Primary Concern

       If President Clinton really wanted to help the middle 
     class, he would focus on the health insurance issue that he 
     knows is its primary concern: the ability to maintain 
     existing insurance coverage after a job change or the loss of 
     an employed spouse. Relatively simple legislation could 
     require insurance companies not to cancel existing policies 
     and not to exclude pre-existing conditions when an individual 
     transfers to a new group. Companies that sell insurance could 
     also be required to offer periodic enrollment opportunities 
     for any one who wishes to purchase insurance with premiums 
     limited by using assigned risk pools to deal with high-risk 
     individuals or groups.
       But instead of reforming the existing insurance to deal 
     with the legitimate concerns of the middle class, the 
     president and Mrs. Clinton have pursued the goal of building 
     a massive government-managed system for redistributing health 
     care and income.
       The middle class could hardly be the big winner from 
     mandating universal coverage, as President Clinton claims, 
     since more than two-thirds of the uninsured are in families 
     with below average income. Moreover, the relatively small 
     number of currently uninsured middle-class families who would 
     become insured under the Clinton plan would have to pay for 
     that insurance by a decline in their wages.
       Virtually all economists agree that most firms that are 
     required to provide health insurance must offset the higher 
     cost of fringe benefits by paying lower wages or laying off 
     workers. The Congressional Budget Office has stated this 
     clearly in its analysis of health insurance options. Even the 
     administration has recognized this in its congressional 
     testimony.
       A currently uninsured individual who now earns $40,00 would 
     suffer a wage decline of more than $2,500 because of the 
     Clinton employer mandate. A two-earner couple with $40,000 of 
     combined earnings would experience twice as large a wage 
     decline. These wage cuts might not be immediate, but within a 
     few years wages would inevitably be depressed below what they 
     would otherwise have been. If wages could not fall that much, 
     jobs would be lost as firms respond to the higher overall 
     cost of labor by moving production offshore, subcontracting, 
     and substituting equipment for employees.
       Some firms would be able to avoid reducing wages by the 
     full amount of the mandated insurance costs because they have 
     the market power to pass along some of the higher employment 
     costs through price increases. When that happens, middle-
     class consumers as a whole would pay for the expanded 
     insurance.
       The currently insured middle class would also be hit in 
     other ways. The Clinton plan would require middle-class-
     income families to pay substantial premiums out of their own 
     pockets. For the typical married couple, the required out-of-
     pocket premium would be $872 a year. The administration has 
     acknowledge that more than 40% of Americans would face higher 
     out-of-pocket premium under the Clinton plan than they do 
     today.
       Although the middle class has to pay for its health 
     insurance through reduced wages, the Clinton plan would 
     subsidize the premiums of low-wages firms. These subsidies 
     would translate into higher incomes for millions of lower-
     wage employees who are now insured. The cost of providing 
     these subsidies would be borne by the middle-class in the 
     form of extra premium payments and an explicit increase in 
     taxes.
       The administration has claimed that it can finance the 
     subsidies to low-income employees with a tax on cigarettes 
     (another hit to the middle-class). In reality, the Clinton 
     plan would face a much larger financing gap of about $120 
     billion a year before the end of the decade. This gap could 
     be financed only by substantially higher taxes on the middle 
     class. Official estimates might understate the financing cost 
     in order to make it easier for Congress to enact the 
     legislation. But once the benefits are enacted, the middle-
     class taxpayers will have to pay for them.
       Little is heard these days of the administration's early 
     claim that, by controlling the cost of care, it could avoid 
     such a financing gap. No one really believed that the 
     administration could achieve cost reductions of the magnitude 
     that it projected. Moreover, middle-class voters were rightly 
     worried that controls on health-care costs would restrict 
     their choice of doctors and hospitals and would force 
     reductions in the quality and quantity of care that they 
     received.
       But although such tough cost controls are not part of the 
     president's current sales pitch for his health plan, they 
     would play an important role if the Clinton plan were 
     enacted. Only by controlling middle-class spending on health 
     care can doctors and other health providers be redirected to 
     meet the increased demands from lower-income individuals that 
     would result from expanding their health insurance. And 
     limiting the future growth of government health spending is 
     crucial to the president's goal of containing the budget 
     deficit while increasing welfare payments and expanding other 
     government social programs.


                             very bad-deal

       So the middle class would not only face lower wages, higher 
     premiums, and a substantial tax increase but would also see a 
     decline in the quantity and quality of middle-class health 
     care. In short, the Clinton health plan would be a very bad 
     deal for the middle class.
       If the president is the expert on domestic policies that he 
     claims to be, why doesn't he understand all this? And if he 
     does understand it, why doesn't he level with the middle 
     class and admit that it is being asked to pay more and accept 
     less health care in order to redistribute income and health 
     care to lower-income groups?
  Mr. LOTT. Mr. President, Dr. Feldstein is the former chairman of the 
President's Council of Economic Advisers, and he wrote, among other 
things, in this article about health care, this quote. And it really 
caught my attention when I saw it. This is not some professor off the 
street or somebody who has not studied this issue. This is a guy that 
is very qualified, an eminent professor, and he has really studied the 
subject. He said:

       The middle class--

  I do not like that terminology. I do not like this class warfare, but 
the middle-income people,

     Would not only face lower wages, higher premiums, and 
     substantial tax increases, but also see a decline in quantity 
     and quality of middle-class health care.

  And I believe that was true under the original Clinton bill, probably 
more so than under the latest version. But we need to study it and see 
exactly what is in it.
  Mr. President, I would like to ask unanimous consent to also enter 
into the Record an article from the July 13, 1994, Washington Post by 
Robert J. Samuelson called ``Congress Should Simply Start Over.''
  There being no objection, the article was ordered to be printed in 
the Record, as follows:

               [From the Washington Post, July 13, 1994]

                   Congress Should Simply Start Over

                        (By Robert J. Samuelson)

       The best thing Congress could do now on health care would 
     be to start over next year. The most important social 
     legislation in a quarter-century should not be approved as a 
     last-minute, poorly understood patchwork. From the start, the 
     debate has suffered from the Clintons' wild promises that 
     they could achieve ``universal coverage'' at little extra 
     cost. This has produced five inconsistent congressional bills 
     that all--in one way or another--fantasize a health care 
     future that will never happen.
       Health politics has become bumper-sticker politics. 
     Everything is being done for image and immediate bragging 
     rights. Vast promises are made of new benefits with little 
     effective control on cost. Health spending already 
     constitutes 21 percent of Federal spending and one-seventh of 
     all spending in the economy. The danger of a poorly crafted 
     program is that, although it might be ``popular in the short-
     run, [it] could encumber our economy with long-term 
     commitments that we simply cannot afford,'' warns the 
     bipartisan Committee for a Responsible Federal Budget.
       What really is at stake is the integrity of government. 
     Popular cynicism is no secret. In surveys, Americans express 
     discontent with government. Yet surveys also show that 
     Americans want more from government in the way of health 
     care, education, environmental protection and economic 
     security. Politicians pander to the inconsistencies by posing 
     government as a ``solution'' to a multitude of problems. The 
     Clintons are practitioners of this style of politics. The 
     trouble is that when the ``solutions'' don't match the 
     promises, public disillusion deepens.
       ``Universal coverage'' is a swell slogan but a meaningless 
     concept. Almost no one today has complete insurance coverage 
     against all health risks. For example, only about 5 percent 
     of the elderly have insurance for long-term care. And the 
     idea that complete coverage can be constructed is a mirage, 
     because health care is an infinitely elastic concept. It 
     expands with every new technology, drug or discovered 
     ailment. Consider: Between 1982 and 1991, the number of 
     cornea transplants doubled, from 18,500 to 41,400. We will 
     never be able to afford everything; some rationing, by income 
     or availability, will always exist.
       What the debate skirted is the morally awkward issue of 
     whether health care is a ``right''--and if so, what care is a 
     ``right.'' The Clintons evaded this question by promising to 
     control costs and expand benefits. The claim was 
     always dubious. Five outside groups re-estimated the 
     Clintons' ``basic package'' of insurance benefits. All 
     found higher costs than the White House did. For 
     individual coverage, the costs were put from 9 percent to 
     26 percent higher; for two-parent families, the costs were 
     13 to 59 percent higher. No matter. The Clintons set 
     Congress's agenda.
       How bad are the resulting bills? Examine the Senate Finance 
     Committee bill, described as ``moderate.'' Its goal is to 
     raise the share of Americans with insurance to 95 percent by 
     the year 2002. Small firms with fewer than 100 workers could 
     buy health insurance from big purchasing cooperatives. 
     Insurers would have to accept almost anyone who applied. 
     There would be insurance subsidies for everyone with an 
     income of up to twice the poverty line (in 1992, the poverty 
     line for a family of four was $14,335). What are the bill's 
     defects? Herewith the top three:
       (1) It creates a huge ``off budget'' entitlement, True, the 
     bill doesn't compel companies to buy insurance. But it does 
     decree what all insurance must cover, and the coverage is 
     lavish. Aside from most doctor and hospital bills, it also 
     includes mental health, rehabilitation services, drug- and 
     alcohol-abuse services, hospice care and family-planning 
     services. Although a National Health Board would set the 
     details, Congress would have the final say. And it has little 
     reason to resist inevitable demands for new benefits, because 
     ``mandates'' could be expanded without imposing new taxes.
       (2) There is no effective cost control. Indeed, because the 
     bill mandates comprehensive insurance, it would probably 
     accelerate spending. The new spending pressures would 
     overwhelm the tiny measures intended to curb costs: putting 
     small companies in buying pools and instituting a complex, 
     probably unworkable tax on ``high-priced'' insurance plans.
       (3) Subsidies for the poor aren't financed. No one yet 
     knows how much the subsidies should cost, but the tax 
     increases in the bill (the cigarette tax goes from $0.24 a 
     pack to $1.24 a pack) might cover only half the amount.
       In short, the Finance bill would probably speed up health 
     spending, skimp on subsidies and miss its 95 percent coverage 
     target. Other bills are as bad or worse. The House Ways and 
     Means Committee wants bigger mandates and subsidies. It pays 
     for its subsidies mainly from ``savings'' generated by price 
     and spending controls. But no one knows whether the controls 
     would work or be acceptable. A ``single-payer'' bill has the 
     honesty of avoiding mandates and pays for government 
     insurance with taxes. However, benefits are so generous that, 
     by one estimate, they would raise health spending by an extra 
     $300 billion by the year 2000. The increase is assumed away 
     with cost controls.
       All these bills indulge in make-believe. Although they 
     sound good, they would break down in practice. A sensible 
     bill might be put together with some modest insurance 
     reforms. But this seems unlikely, precisely because it would 
     be so politically unexciting. What should not be forgotten in 
     the inevitable clamor to ``do something'' is that a bad bill 
     would be worse than no bill at all. Opposing such a bill is 
     prudence, not obstructionism.
       The country deserves a more candid debate than Congress can 
     provide this year. It is between those who consider health 
     care a ``right'' and those (like me) who think the first 
     focus should be on cost control. If it is a ``right,'' then 
     put the spending in the budget and pay for it with the taxes. 
     If the focus is costs, then curb tax subsidies for insurance 
     or impose strict spending controls. Neither approach would be 
     easy. Any sweeping reform requires public understanding. This 
     is now missing. ``Great innovations'' Thomas Jefferson once 
     said, ``should not be forced on slender majorities.''

  Mr. LOTT. That is a great idea. Start over. I know members of the 
Finance Committee would not want to do that. But I think we have gotten 
so far into this we are completely balled up. We have no idea what we 
are really debating. We cannot figure out how to stop it or change it.
  I wish we could just take a clean sheet--and we could get four or 
five of our experts here, the Senator from New York, the Senator from 
Oregon--and say, ``Look, let's do what we need to do, what we can 
afford and no more. Get it for us by the morning.'' They could do it. 
And we ought to start all over.
  Mr. Samuelson points out that the health scare legislation like the 
Clinton-Mitchell bill and the Clinton-Gephardt bill create large off-
budget entitlements. The Clinton-Mitchell bill mandates that all 
insurance policies cover a mandated--mandated--set of benefits, even 
benefits like drug counseling, which many people, certainly most 
people, do not need, and the benefits are set by a National Health 
Benefits Board and approved by Congress.
  Great. No doubt, in the future, the number of benefits will expand 
because of political pressure. There will be more. We will include this 
and then they will do that, and then there will be another one. 
Senators have an endless stream of great ideas of benefits that ought 
to be covered. And the way it works, even though you know there is a 
tremendous cost involved, and it is not being paid for, when the 
amendment is offered to add more benefits in the Congress--and that is 
included in the legislation--who is going to walk up here and vote 
against more assistance for children? Or more assistance for mental 
health?
  Mental health, now, I think there is maybe--I do not know what is in 
the latest bill, but I think there was like 30 days' assistance, so 
maybe we could double that to 60. Anybody want to vote against that? It 
is very hard.
  So there is going to be an endless stream of more benefits added. We 
ought to just go ahead and put everything in it we can think of at 
once, get it over with, and see if there is any way we can pay for it, 
which I doubt. When benefits expand, costs will soar and spending will 
go through the roof. Who will pay for this? The middle-class, middle-
income people. They will pay. Not the poor, very little of the wealthy.
  The Clinton-Mitchell and the Clinton-Gephardt bills also tax ``high-
priced private insurance plans.''
  I want to get more into what is the definition of the high-priced 
plans. But I will bet you this: A lot of middle-income people would 
have what would be described as ``high-priced private insurance 
plans.'' Once again, the middle-income folks are going to be told, 
``You have to pay more taxes; more money out of your pockets; less 
choice in health care.''
  Yes. There are subsidies also in the Clinton-Mitchell and Clinton-
Gephardt bills because these are not fully financed, as I understand 
it. Maybe in the new version it is. I doubt it. But we are going to 
have to address that at some point.
  If health insurance for the poor is not fully financed, guess who 
pays? The middle-income folks get it again.
  These are the general problems with all of this health scare 
legislation. The bills cost too much, and the costs are passed on to 
the middle-income folks in the form of higher taxes and less health 
coverage.
  The bills also have what I would consider to be extreme criminal 
penalties, or at least criminal penalties for what is quite often 
relatively harmless behavior. But in the earlier version of the 
Clinton-Mitchell bill, ``criminal'' and ``crime'' are words mentioned 
many, many times. I saw a count on that earlier; that it ran way up. I 
believe the earlier Mitchell bill uses the terms ``ban,'' ``criminal,'' 
``enforce,'' ``fine,'' ``limit,'' ``penalty,'' ``prison,'' 
``prohibit,'' ``requires,'' ``restriction,'' ``sanction,'' ``violate'' 
a total of 1,488 times.
  Hey. That is a new idea. This is the crime bill. We have been looking 
for it. Maybe this is the crime bill. Because the earlier version--and 
I presume the latest version of the Clinton-Mitchell bill has an 
astronomical number of instances where crime and criminal acts are 
included. I do not understand that.
  In fact, under the earlier bill, Section 5324 of the Clinton-Mitchell 
bill, if you tip your doctor to get an extra special care, you could 
spend up to 15 years in prison. Maybe that has been taken out, and we 
will look for that and see what happened. But it was in there. There is 
no way you can deny that.
  Further, these health scare bills will suck jobs out of the economy. 
Many people--in fact almost everybody knows--know it is going to cost 
some jobs. Some of the bills have direct employer mandates. Maybe they 
will not in the end. I do not know. But if you do not have employer 
mandates, how is this thing going to be paid for? I do not see it. If 
employer mandates go down, this legislation probably goes down.
  There have been many studies on the effects of employer mandates on 
the employment in this country. None of the studies I know of have said 
that mandates will create jobs; none of them.
  In a February 1994 report, the CBO put the range of job loss because 
of employer mandate at between 300,000 and l.2 million. A research 
study commissioned by the National Association of Independent 
Businesses estimates that an employer mandate would cost 850,000 jobs 
nationally with potential job loss of 3.8 million. The study found 34 
million workers would suffer wage cuts of over $63 billion because of 
these mandates.
  So when the Senator from Connecticut says we need to add things that 
are very good, somebody is going to pay, and somebody is going to be 
forced to pay for it, and employer mandates are an important part of 
it. And jobs are at stake.
  A study done by the Office of Planning and Research by the State, in 
this case the State of California, estimates that employer mandates 
would cost America 2.6 million jobs.
  The Employment Policy Institute estimates that a Clinton-like plan 
with mandates in a best-case scenario would destroy between 780,000 and 
890,000 jobs; in the worst-case scenario, as high as 2.1 million jobs 
would be destroyed.
  Guess where so many of these jobs come from? Some of them will be 
low-income jobs. But a great number of them once again would impact 
middle-income jobs.
  I see the majority leader on the floor. Did he want me to yield for 
point of business?
  Mr. MITCHELL. I am awaiting the appearance of the Republican leader, 
so I then can make an announcement with respect to the schedule.
  I thank the Senator for his courtesy. I suggest he proceed until such 
time as the Republican leader arrives.
  Mr. LOTT. I thank the majority leader.
  The President's own Council of Economic Advisers--this is not some 
Republican group or some conservative group--the President's advisers 
in its 1994 report found that between 350,000 and 600,000 jobs would be 
lost.
  So there is instance after instance of respected groups that point 
out that employer mandates would cost jobs. Yes. We want people to have 
insurance coverage. We want access in rural areas. But do we want to 
lose hundreds of thousands, maybe a million jobs in the process?
  My point tonight is it does not have to be that way. We can do what 
we need to do and not lose the jobs. But what we need to do is only 
what we need to do, and not in our wildest dreams that we have been 
thinking about for 20 years.
  I would be glad at this point to yield to the majority leader for 
this important announcement.
  Mr. MITCHELL. Mr. President, I thank my colleague. I ask unanimous 
consent that my remarks appear in the Record so as not to interrupt the 
remarks of the Senator from Mississippi.
  Mr. President, I understand that the distinguished Republican leader 
will not be coming to the floor but will be represented by the Senator 
from Oregon.
  So I would like to advise Senators of my decision with respect to the 
schedule, and the proposal that I have made for proceeding to the 
Republican leader.
  Earlier today, I met with the Republican leader and advised him that 
we Democrats had several amendments which we were prepared to offer, 
and provided our Republican colleagues with copies of two of those 
amendments, and the remainder will be provided as soon as they are 
ready.
  I suggested to Senator Dole that we were prepared to proceed in a 
manner that we would offer one amendment, and it would be debated and 
disposed of. And then the Republicans would offer an amendment, and 
that we would alternate in an effort so that both sides could have 
amendments ready.
  Senator Dole indicated that the Republicans had no amendments ready 
at that time. We agreed that we would then proceed with our amendments 
until such time as our Republican colleagues had amendments which they 
wished to offer.
  We therefore began with the first amendment which is the pending 
amendment offered by Senator Dodd regarding children. I expressed to 
Senator Dole my hope that we could proceed to have a vote on that 
amendment either today or tomorrow.
  As all Senators know, under the rules of the Senate, any Senator can 
speak for as long as he or she wants, and prevent the Senate from 
voting or acting. And, of course, the minority has that ability.
  Senator Dole has advised me that our Republican colleagues will 
prevent the vote from occurring on that amendment this week and will 
use their right of unlimited debate to prevent any vote from occurring. 
I regret that. But I accept it as the reality of the Senate's rules.
  I, therefore, suggested the following course of procedure to Senator 
Dole: That we would continue to debate this evening, and tomorrow, 
under a procedure in which the time would be equally divided between 
the two parties, and would alternate in 30-minute segments; so that the 
Republicans would speak for 30 minutes and Democrats would have 30 
minutes and back and forth, and that way the time would not only be 
equally divided, but equally divided in reasonable segments every time.

  Mr. LOTT. That would begin from here forward? That would not be 
applicable to me, would it?
  Mr. MITCHELL. No. But since the Senator has been talking about 45 
minutes, I hope he will wrap up in a reasonable time and permit the 
process to begin.
  Mr. LOTT. I have about another 10 or 12 minutes. I was not aware of 
this agreement. These things have welled up inside me, and I finally 
got my chance to talk. I hope I will be able to conclude.
  Mr. MITCHELL. I am describing the circumstances leading up to the 
proposed agreement. It is not an agreement yet.
  I think it is appropriate that it would be completed in that time, 
because prior to the last vote, Democrats spoke for about an hour, so 
that would make it roughly even on the subject during the day today.
  I then suggested that we reconvene on Monday morning and that we 
offer the second amendment, a copy of which was provided to our 
Republican colleagues several hours ago, and that we then debate that 
on Monday, and that we have votes on the two amendments at 5 p.m. on 
Monday.
  I further suggested to Senator Dole that if we could identify a 
subject on which Republicans would have amendments ready by Tuesday, 
then we could devote time to that subject on Tuesday, and Republicans 
could offer amendments on that subject, and Democrats could as well. 
And we could deal with a discrete subject, discrete provisions in the 
bill that are of interest to both sides and all parties.
  Since it is clear that Republicans have the ability under the rules 
to prevent any vote from occurring on the amendment today or tomorrow, 
and since the only recourse I would have would be to insist on votes on 
procedural matters, I have concluded that I will not at this time 
exercise that right, because I do not believe any useful purpose will 
be served by it.
  Therefore, there will be no further votes this evening, or tomorrow. 
Senator Dole has indicated that he is not able at this time to agree to 
the proposal I outlined with respect to the schedule on Monday and 
beyond, but hopes to be able to do so tomorrow. Therefore, I will limit 
my request this evening to the allocation of time this evening and 
tomorrow. I will make an announcement tomorrow with respect to the 
schedule on Monday.
  I have attempted to proceed on this matter in a way that is fair to 
all, and also which would permit a full exploration of the issues, both 
with respect to the bill and the pending and future amendments. I hope 
that we can do that in the coming days.
  Mr. President, the Senator from Mississippi wanted how much more 
time?
  Mr. LOTT. Well----
  Mr. MITCHELL. Would 15 minutes be reasonable?
  Mr. LOTT. I think so, Mr. President.

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