[Congressional Record Volume 140, Number 113 (Saturday, August 13, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 13, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                       ISSUES BEFORE THE CONGRESS

  Mr. DOLE. Mr. President, I think it is pretty clear we have a lot of 
big issues we are trying to deal with, and one right now is health 
care. There are other big issues out there, such as crime. One that is 
coming up is the trade bill--particularly implementing legislation for 
the Uruguay round agreement.
  Mr. President, there are a number of momentous issues before the 
Congress right now--each of them deserves thorough scrutiny and 
extensive debate before Congress acts.
  I am certain that every office has been like mine. I have had more 
calls on GATT than I have ever had on NAFTA. For some reason, people 
say they do not have enough information, or they are just outright 
opposed to GATT. Maybe it is because they do not understand it.
  Calls and letters have been flooding into my office--and I am sure to 
my colleagues' offices too--on the subject of the GATT. People are 
uneasy, Mr. President. They are concerned, they are afraid they do not 
have enough information, or they are just outright opposed.
  My own office in Wichita is receiving more calls in opposition to 
this trade agreement than we received on the North American Free-Trade 
Agreement. I do not know whether opposition will build to the same 
national level. But I do know that the administration has done a poor 
job of explaining this bill, not to mention the underlying trade 
agreement, to the American people.
  It is a big, big agreement. NAFTA, by comparison, is very, very, very 
small.
  Mr. President, I want to make it clear that I favor free trade and 
opening of foreign markets. I fought hard for the North American Free-
Trade Agreement. Overall, I favor the GATT agreement because I believe 
it will help the American farmer and American manufacturers by 
providing greater global market access. And it will help the American 
consumer, by lowering tariffs worldwide and thereby lowering the prices 
of products.
  But, Mr. President, people have a right to know what else is in this 
agreement. People have a right to know how the World Trade Organization 
will function, what powers it will have, what authority it will have to 
tell the United States what to do. People have a right to know how the 
agreement will be paid for, and how it will benefit them in the long 
run. I know these are significant concerns to Members on both sides of 
the aisle here in the Senate.
  In addition, people have a right to know how this trade agreement 
fits into the President's long-term trade strategy. President Clinton 
wants fast-track authority for future trade agreements.
  I do not fault him for that. He wants language in the trade bill 
referencing all kinds of environmental and labor objectives and 
linkages of trade policy to environmental policy and labor policy. 
People want to know whether the President's strategy is to turn over 
our trade laws to environmental groups to be used as clubs over the 
heads of less-developed countries. They want to know whether labor 
unions will decide who we should trade with--based on the level of 
enlightenment in our trading partners' labor laws.
  What disturbs me, Mr. President, is the failure of the administration 
to allow adequate time for the American people to get answers to these 
and other valid questions about this trade bill.
  We have to ask ourselves, we have to ask ourselves right now: Is 
there a rush? Do we have to do this this year?
  I think everyone on the Finance Committee wants to be cooperative.
  What is the rush? There is no rush. Yet we read in this morning's 
paper about a deal the administration cut yesterday with Members of the 
House that supposedly will allow this bill to move forward.
  Maybe so; maybe not. I have talked to some of the House Members. They 
are not certain if they have any agreement. But it seems to me that 
with all the things we have coming up, if we are going to do this, 
maybe we ought to do it this year; maybe we ought to set the pattern 
for other countries. But we ought to make certain precisely what we are 
looking at and what we are dealing with and, I think, also, maybe 
listen to our constituents.
  Again, they want to be heard. They do not maybe understand the fast 
track or all of these things. What they do not understand, they just do 
not understand why we are trying to move on something when they think 
there may be a problem.
  So we still have some time. I know the chairman is on the floor. He 
has worked very hard. We have reported out implementing legislation. 
But I think what I would say is let us not race to complete a major 
trade bill before we can calm the doubts of almost everyone.
  You are never going to calm the doubts of everyone until we can 
answer the questions of most people out there. Some are going to be 
critics forever. But I think for those who have legitimate concerns, 
they are certainly entitled to legitimate answers.
  What is the rush?
  There is plenty of time for Congress, and the American people, to 
take a close look at the results of the Uruguay round. There is no need 
whatsoever to force this bill through in the closing days of this 
session, when most Members of Congress are fully engaged in other, 
momentous issues. This is an important issue. This trade agreement will 
have a profound impact on our trade relations with every nation on 
Earth, on our rights as the largest trading nation on Earth and on our 
ability to resolve trade disputes as they arise with other countries.
  I urge my colleagues to listen to their constituents, take the time 
to carefully consider this important legislation, and give the American 
people the chance to be heard on this issue. This bill gets fast-track 
treatment in Congress. That means that once the committees complete 
their work and the House and Senate work out their differences, the 
President can submit the bill any time and no amendments are permitted.
  So let us take the time to get it right. The committees involved do 
not need to rush to wrap up their work on the GATT bill this week or 
next week or even next month. The worst thing that happens if we take 
time for careful consideration is that everyone, including the people 
who live outside the beltway, will understand what this trade bill is 
all about, and may even decide it is a good thing for the country.
  For now, Mr. President, let us not race to complete a major trade 
bill before everyone's doubts are calmed and questions fully answered. 
We owe it to the American people.
  I thank the Chair. I thank my colleague.
  Mr. MOYNIHAN addressed the Chair.
  The PRESIDING OFFICER. The senator from New York.
  Mr. MOYNIHAN. Mr. President, if I may just join with the 
distinguished and indefatigable Republican leader in commenting on the 
reports in the press this morning that an agreement has been 
tentatively reached between the administration and the Republican 
Members of the House, and that authorizing legislation has to be worked 
out in the Committee on Ways and Means.
  The Committee on Finance has finished its work, pending a conference 
with the House Ways and Means Committee. This Uruguay round is a 
culmination of 60 years of American foreign trade policy that began 
literally 60 years ago, in 1934, with the Multilateral Trade Agreements 
Act under President Roosevelt and Cordell Hull.
  The Uruguay round was commenced by President Reagan, and continued by 
President Bush, and finalized by President Clinton. It is an enormous 
undertaking. I would hope I could go out to Wichita and tell some of 
those people that it is the best opportunity for American agriculture 
that we have ever negotiated--an end to export subsidies.
  We are the most competitive agriculture in the world, drowned out by 
subsidies, particularly in the European Union. We bring activities such 
as counter under the free trade rules, and 117 nations are brought into 
the system--well, half of them are--but truly into the system.
  It is an enormous opportunity. A curious left and right alliance has 
risen up against it. I think we can answer their questions. We will 
certainly have an opportunity to do so in conference with the House. 
But when the President sends us back the bill, we will have an 
opportunity on this floor to set it forth.
  We think that in the end we will be better off. There will be more 
jobs, more wealth, and more revenue for the Federal Government. That 
was the basis on which a substantially unanimous Finance Committee 
acted. And, of course, the Republican leader was one of the leaders of 
that action. I acknowledge his leadership and thank him. I say, Mr. 
President, the news this morning was good news.
  I yield the floor.
  Mr. MACK addressed the Chair.
  The PRESIDING OFFICER. The Senator from Florida [Mr. Mack], is 
recognized.
  Mr. MACK. Mr. President, I yield myself whatever time I may consume.
  The PRESIDING OFFICER. The Senator is recognized.
  Mr. MACK. Mr. President, this debate has been a difficult personal 
voyage for me. Over the years, my family, like so many others has been 
in and out of hospitals and doctors offices, as patients, visitors 
family members and friends. I have experienced the spectrum of 
emotions--the grief and depression that set in after my brother Michael 
died of cancer; the highs and the lows--the roller coaster ride of his 
12-year fight against melanoma; the euphoria that followed the delivery 
of my daughter's third son after her successfully fight against 
cervical cancer; the pride I felt for my mother in her stoic and 
determined battle she won against breast cancer; the fear of loss, 
loneliness, and permanent separation that flashed through my mind when 
my wife, Pricilla, told me she had discovered a lump during a self 
breast exam; the terror that rocked me when I was told that I was 
diagnosed with melanoma, the same vicious  cancer that had killed my 
brother 15 years ago.

  In a matter of seconds, I relived the trauma, the pain and suffering 
my family endured during Michael's struggle. Michael's life was 
extended 12 years, and four of the five of us are alive today because 
of receiving services from the best health care system in the world.
  I will fight the destruction of our system with everything I have 
because of my own very strong beliefs and because the people of America 
share these same ideals.
  Let me take a few moments to talk about our present system. Our 
system provides us with the freedom to choose providers and benefits. 
We have the highest quality of care and lead the world in innovation. 
These are the defining features which make our system second to none. 
The quality of our system attracts patients from all over the world, 
whose own health care system has failed them.
  We provide employers with positive incentives to provide health care 
for their employees. The decision is the employer's as to whether or 
not they are financially able to do so. We encourage Americans to take 
advantage of preventive services, such as periodic screening for 
diseases and immunization for our children. We advocate routine 
exercise programs and eating a balanced diet. We lead the world in 
research and development of pharmaceutical drugs and medical devices--
products which have saved millions of lives and which have improved the 
quality of life for so many Americans--individuals with so much life 
still to live.
  Is it a perfect system? No, it is not. There are indeed many reforms 
needed which would significantly improve opportunities for health care 
coverage.
  While Mrs. Clinton says her opponents lack compassion, this could not 
be further from the truth. I want health care for all Americans. I just 
do not believe that big government is the answer. Later I will go over 
the legislative changes that are needed and should be passed.
  Accomplishing specific reforms ought to be straightforward. In fact, 
the American people should know that these reforms could have been 
passed already. Two years ago, I served on a bipartisan health care 
task force to pave the way for passage of reforms. We all agreed it 
would enhance the opportunity for health care coverage for more 
Americans. These included: Insurance market reforms and small group 
purchasing organizations, as advocated in the Bentsen bill; community 
health centers; deductibility of health insurance premiums for the self 
employed and individuals; State experimentation; medical liability 
reform; reduced administrative costs, and primary and preventative care 
incentives--all would significantly improve the health care of our 
citizens.
  Two years ago, Republicans were prepared to pass these needed 
reforms--incentives which could already be providing greater access to 
our health care system at affordable rates. So why did it not pass? 
Because Democrats informed us that it was all or nothing; either create 
a Government-controlled system or nothing. During the past 2 years, 
more people have lost their insurance because the Democrats said, ``all 
or nothing.'' During the past 2 years, people have been denied coverage 
because of preexisting conditions because Democrats said ``all or 
nothing.'' During the past 2 years, the self-employed have been 
financially disadvantaged because the Democrats said ``all or 
nothing.'' During the past 2 years, administrative burdens have 
increased because the Democrats said ``all or nothing.''

  History has a nasty habit of repeating itself. Guess what, folks. Two 
years later, we are confronted with that same choice: A Government-
controlled, Government-dictated health care system with less quality, 
less choice, and less freedom on the one hand, or a market-driven 
health care system with high quality and more choice and more freedom 
on the other. The decision for me is simple--the American people do not 
want to be told where they must get care, from whom they must receive 
it, and the type of care they are entitled to, according to an all-
powerful Government board.
  Much of this debate has focused on the concept of universal coverage. 
People ask, ``Are you for universal coverage or are you against 
universal coverage?'' It has become clear that there is no single 
definition for the term ``universal coverage.'' Does it mean 100 
percent coverage? Does it mean 95 percent coverage? Does it mean 91 
percent coverage or, perhaps, something in between? If universal 
coverage means that everyone is mandated to participate, what does that 
say about our commitment to individual freedom?
  President Clinton continually stresses security as his No. 1 goal, 
along with universality. The Clinton-Mitchell plan would force everyone 
to participate in these plans--like it or not. I have friends on the 
other side of the aisle who want to push through a health care bill 
regardless of the views of the American people. I believe that a social 
system that is built on the idea of security and guaranteed benefits, 
separates consequences from action, separates freedom from 
responsibility, and will eventually reduce, restrict, limit, and could 
finally lead to the destruction of our liberties.
  Recently, Thomas Sowell wrote an article entitled ``Selling Freedom 
for Rhetoric.'' I would like to share some of his thoughts with you:

       Make no mistake about it. Your freedom and independence--
     what you celebrate on the Fourth of July--are precisely what 
     must be taken away, in order that we may all become dependent 
     on the largess of Washington and become the guinea pigs of 
     the social experimenters * * * We are talking about the 
     government telling you and your doctors what you can and 
     cannot do, politicians and bureaucrats micromanaging medicine 
     * * * Government is not about `asking.'* * * It is about 
     telling * * *

  What about our freedoms as Americans? Thomas Sowell could not 
possibly have been more clear when he said: ``No freedom can be more 
personal than the freedom to decide for yourself what should be done to 
preserve your health and your life.''
  Let us examine the destruction of our freedom envisioned in the 
Clinton-Mitchell health bill.
  First, the issue of choice. Polls have consistently shown the 
American people want to choose the type of care they get and from whom 
they can get that care. A Government bureaucrat should not be making 
that decision for them.
  I want to go back to my comments earlier about my brother's death due 
to melanoma in 1979. While that was 15 years ago, it seems as vivid 
today as it was then. I am going to talk about that in using this chart 
which shows the bureaucracy in the Clinton-Mitchell bill.
  First, I want to say there are probably some who think this is just a 
chart that someone has made up, a figment of someone's imagination, but 
I assure you this chart, put together by Senator Specter was developed 
by going through the 1,400-and-some page bill. Senator Coats and 
Senator Gregg put this primer together which details the 50-plus new 
bureaucracies. Every one of these new programs, every one of these new 
bureaucracies is identified as to the section of the bill from which it 
comes.
  I will just say to those who are listening, can you imagine what it 
must be like or could be like if you were sitting with me in a hospital 
room in Atlanta, GA, in 1979, when your brother, a brother you loved so 
dearly, was suffering so much. There you were working with his doctor 
trying to figure out what was the next best option, what procedure 
might be used, what medication might be available to reduce his pain, 
what new technology might be available that could possibly extend his 
life or improve the quality of his life. Right in the middle of that 
discussion, right between me and Michael's doctor is this massive new 
Government bureaucracy--a wall, in essence, that has been established 
that acts as a barrier, a group of bureaucrats, who I will say are 
well-intended, who would say to me or to the doctor that that medical 
procedure is not available any longer or that new technology has not 
been approved by the Board.
  Now, I must tell you I do not believe that this is the kind of health 
care that the overwhelming majority of Americans want for this country.
  (Mr. ROCKEFELLER assumed the chair.)
  Mr. MACK. Mr. President, the Clinton-Mitchell bill provides no real 
choice of health care benefit plans at all. All plans will be cloned 
with the same set of standard benefits determined by the National 
Health Benefits Board. Oh, sure, you might be able to decide whether 
your health care benefits will be handled by an HMO or preferred-
provider arrangement or a fee-for-service plan, but all benefits will 
be the same--fixed by Government. But, despite the rhetoric from 
my colleagues, you will not have the freedom to choose the physicians 
or treatment that you need. The Board will be given the power to 
determine whether health care is medically necessary and appropriate, 
not the physicians.

  Representing a State of more than 13 million people, you can imagine 
the correspondence and phone calls that I have received on this issue. 
The other day I received a letter indicative of many others I have 
received. The writer stated:

       I do not delegate the right to take care of my health care 
     and medical needs to the U.S. Government.

  What does the national Board know about what is appropriate and 
medically necessary for families in Ruskin, FL, or a grandfather in 
Little Rock, AR? These decisions must be made by a patient in 
consultation with his or her medical provider--case closed.
  What about this take-it-or-leave-it standard benefits package? The 
American people know that one size does not fit all. I want no part of 
a plan that forces Americans to change insurance plans they are 
satisfied with because the Government knows better than the American 
people what type of benefits they need.
  Frankly, this reminds me of the catastrophic coverage debate of 1988 
and 1989 when Medicare beneficiaries were being forced to give up the 
supplemental coverage they already have because the Government believed 
a one-size-fits-all package was better. Before the ink was dry, we had 
to repeal it. Americans rebelled then and, Mr. President, they are 
rebelling today.
  One of the bills I sponsored is the Consumer Choice Health Security 
Act. This legislation is modeled after the Federal Employees Health 
Benefit Plan [FEHBP], the plan Congress and over 3 million Federal 
employees belong to around the country. It offers members the choice of 
more than 300 health insurance plans with a vast variety of benefit 
options.
  The Dole bill encourages Americans to join FEHBP and choose the 
health care plan with benefit options that are best for them and their 
families. Unfortunately, the Clinton-Mitchell plan takes a good program 
full of choice and obliterates it.
  Choice will be severely affected by the premium caps in the Clinton-
Mitchell bill as well as the 18 new taxes proposed in the bill. As 
Government squeezes down on resources, we will be forced to give up 
choices of benefits, of plans, of providers--choices which we have 
always believed would be available to us in our health care delivery 
system.
  Mr. President, that brings to mind a conference on health care that I 
held in Jacksonville, FL, several years ago. We had two physicians from 
Canada who came to talk about the Canadian system. They told us that 
there was overwhelming support in Canada for their system. But, one of 
the things that they said that I think is very, very important and 
should never be forgotten is, that you cannot take the ideas and plans 
that have created a health care system for society, for some other 
nation, and superimpose them on yours. They said to us: ``You've got to 
develop a plan, you've got to develop a health care system based on the 
values of your society.''
  And that is why this debate is so important, and it is so important 
for us to listen to what the American people, in fact, are telling us.
  Next, let us look at the issue of quality within the Clinton-Mitchell 
bill. The bill states that the National Health Benefits Board shall be 
authorized to establish guidelines as to what is medically appropriate. 
Furthermore, the bill mandates that a health plan has developed a 
treatment guideline or utilization protocol, then it must provide this 
in a written statement at least 60 days ahead of time to each affected 
provider and the Government entity which certifies the plan.

  Can you imagine how this process could interfere in the practice of 
medicine and patient care? Let me give you an example. A person goes to 
a doctor to have a mole removed from his neck. The doctor discovers 
that more tissue needs to be removed because what first looked like a 
harmless mole may possibly be a melanoma. So the guideline for 
treatment is different. What should the doctor do or have done 
differently?
  The doctor asks a colleague for a second opinion who suggests a 
different approach because of the appearance of the surrounding tissue. 
What may be very good medicine may not fit the protocol for the already 
approved procedure. Did they follow the guideline? Did they modify the 
guideline? Did the outcome fit with the expectation for the treatment? 
Is this the thought process we want physicians to go through apart from 
what they think is best for their patients?
  Many of us, who have experienced our children coming down with the 
croup, can remember the anxious time we spent at night listening to 
that raspy and painful sounding cough while trying to decide whether to 
go to the emergency room. The August 4 edition of the New England 
Journal of Medicine describes how a new drug inhaled through a 
nebulizer allowed children with the croup to be discharged from the 
emergency room significantly earlier and needed less medication 
afterward than the children who had received a placebo.
  I assure you, if my grandson had the croup tonight, I would want him 
to have the option to receive this treatment. How are pediatricians in 
health plans going to do this if a Government-preapproved guideline is 
not in place? After all, this is not a tried and true treatment but 
something new and innovative.
  The next area I want to address is price controls. Price controls 
were originally advocated by President Clinton and are now being 
proposed by Senator Mitchell in the form of taxes on insurance plans 
and a target for premiums which will threaten the quality of care.
  Those who favor price controls, in whatever form, often do so without 
addressing the effects of those controls. For every action, there is an 
equal and opposite reaction. If we place a cap on how much is spent, 
there will have to be some reaction to it. The number of medical 
procedures will decline and rationing of services will occur. Specialty 
services will be terminated and consolidated with fewer services 
available to most people. Research and education will be slashed as a 
means to meet the cap. Development of new drugs will come to a 
standstill. The quality of our health care will be dramatically 
affected.
  Soon after the Clinton health care bill was introduced, a letter 
signed by 562 leading economists was sent to the President. These 
economists wrote that the administration's government-run health care 
system ``will produce shortages, black markets, and reduced quality.''
  The economists concluded that,

       In countries that have imposed these types of regulations, 
     patients face delays of months and years for surgery, 
     government bureaucrats decide treatment options instead of 
     doctors or patients, and innovations in medical techniques, 
     and pharmaceuticals are drastically reduced.

  Finally, the economists concluded,

       Caps, fee schedules and other government regulations may 
     appear to reduce medical spending, but such gains are 
     illusory. We will instead end up with lower-quality medical 
     care, reduced medical innovation, and expensive new 
     bureaucracies to monitor compliance.

  Unfortunately for all Americans, this same letter could have been 
written about the Clinton-Mitchell plan.
  I would like to share with your some examples from other countries 
that have imposed price controls.
  Last Christmas, in an effort to meet budgets, some 100 hospitals in 
Ontario--Canada's most populous province--shutdown wards and surgeries 
for 3 weeks with doctors going unpaid and nonemergency patients 
untreated.
  On June 8, 1994, the Times in London featured a story entitled, 
``Patient with Indigestion gets April 1996 appointment.''
  Again, ``Patient with Indigestion gets April 1996 appointment. 
Consultant serves 280,000 people, twice recommended level.''
  The patient, David Fullbrook, received a letter from the National 
Health Service Trust, which stated the following, ``No guarantee can be 
given that you will be seen precisely at the time stated or by the 
consultant named.''
  The article discusses the doctor's frustrations with the fact that he 
is the only specialist serving a large area. A spokesperson for the 
British health care system acknowledges that these waiting periods need 
to be urgently corrected and a review of medical manpower is underway. 
Can you imagine what this gentleman must be feeling? Two years to see a 
specialist, but do not worry, he is told, his government is going to 
study how to speed things up for him.
  A woman in Florida told me her father, who gets his care under 
Britain's Government-controlled system, had to wait so long for a 
cataract operation that by the time the surgery was scheduled, his eyes 
were inoperable. My father had cataract surgery when he needed it and I 
want to make certain our citizens have quality health care when they 
need it.
  The Clinton-Mitchell bill wants to control the number of specialists 
in our country similar to the British system. The Clinton-Mitchell 
bill, in fact, creates a National Commission on Graduate Medical 
Education tasked with controlling the number of specialists in our 
country. This bureaucracy would require a ratio of 55 percent 
generalists to 45 percent specialists. So, if your life-long dream has 
been to be an ophthalmologist or to discover a cure for breast cancer, 
you might want to rethink your dreams. The Government may have other 
plans for you. This is an arbitrary ratio which will not only limit 
care but also reduce research. They have forgotten that specialists are 
the pioneers of medical innovation. Do we really want to set 
bureaucratic limits on the talent we allow into the system? I think 
not. Such limitations will forever change the quality of our care, and 
severely restrict our choice of providers and services.
  Another victim of the Clinton-Mitchell bill is research. We are close 
to amazing breakthroughs in medicine--maybe the kind of discoveries 
that could have saved my brother Michael's life. The American spirit of 
innovation can only flourish with less government, not more government.
  Innovations in American laboratories during the first half of this 
century have practically eradicated such killers as measles, 
tuberculosis, polio, and whooping cough. We are in danger of destroying 
that spirit.
  The mere threat of price controls by the administration on the 
pharmaceutical industry has been decreased research and development at 
drug companies. From December 1992 to March 1994, the total decline of 
the industry stock value was approximately $50.5 billion, a decrease of 
25 percent. This is capital that would be used to find cures that could 
affect your family members and loved ones.
  Mr. President, this is a point I do want to focus on for just a 
minute, because I think its consequences could be extremely serious.
  Before I make some other relevant points, I have read some rather 
interesting books on the subject of DNA, gene therapy, immunotherapy, 
and the work that is being done to identify genes related to specific 
diseases.
  I refer to two books, ``The Secret of Life,'' and the other, ``The 
Transformed Cell,'' a book written by Dr. Steven Rosenberg, a 
physician-scientist out at the National Cancer Institute.
  This book is of particular interest to me, since Dr. Rosenberg 
focuses in on the issue of melanoma. About the time Michael was 
diagnosed with the disease, frankly, there was no treatment. But today, 
at the National Cancer Institute, we are seeing remarkable things 
happen. We are seeing people who have, in fact, been cured of melanoma 
because of work done by Dr. Steven Rosenberg, in being able to turn on 
the immune system. Ironically, for some reason, the immune system sees 
cancer cells and believes that those cells are natural cells to the 
body and the immune system does not attack it.
  What Dr. Rosenberg and others have been working on is how do you use 
a protein to identify that cancer cell which sends a signal to the 
immune system to turn on and attack it and kill the disease. And they 
are making real progress.
  But, again, Mr. President, my concern is that under a Government-
controlled system in which there will be some cap or some effort to 
control how much we spend on health care, what is going to happen, 
which is natural through the political process, is that we are going to 
take scarce resources and we are going to identify and target those to 
what most people would think should be done. And that is the day-to-day 
concerns of people in the hospitals, clinics, and doctors' offices 
around the country. In the end, money that will be available for 
research will dry up.

  The loss in value of American drug companies is one cause among 
several to have had a profound effect on the ability of American 
scientists to bring the fruits of their genius and innovation into 
production for the benefit of patients. This slowdown has occurred for 
five major reasons. First, the loss of capitalization of American 
health care product manufacturers, that I just mentioned, affects their 
ability to borrow and invest in the development of new products. 
Second, the decline in research funding reduces the fuel to drive the 
NIH intramural and extramural intellectual scientific engine which is 
behind the phenomenal medical advances of the last 30 years.
  Third, the costly maze of regulation required by the FDA inhibits 
bringing products to market. Fourth, the impact of the fear of 
liability by device manufacturers and their suppliers. This is no 
longer just a question of whether a device worked properly but includes 
the reluctance of suppliers to sell materials to manufacturers and then 
have to defend their product later on in court. And, fifth, the refusal 
by third party payers; insurance companies, HMO's, Medicare; to pay for 
new or improved technology.
  For years university researchers created ideas that were supported by 
the NIH. Investors then funded these ideas so that they could be 
further refined into a product which then had to be tested, approved, 
and brought to market. All of this took place in the United States. 
Now, we see American companies first bringing products to market 
overseas. Europeans, South Americans, and others are quickly able to 
use American products that cannot make it through our regulatory maze. 
One leading midwestern manufacturer of therapeutic medical devices has 
not introduced a major new project first to the U.S. market in 10 
years. There is a shift in the international center of gravity for 
medical device innovation out of the United States. Products are now 
introduced, then manufactured and ultimately developed in research and 
development facilities overseas.
  I ask unanimous consent to print in the Record a statement on this 
problem by Dr. Pierre M. Galletti, professor of medical sciences at 
Brown University and current president of the American Institute for 
Medical and Biological Engineering.
  There being no objection, the letter was ordered to be printed in the 
Record, as follows:

                                             Brown University,

                                  Providence, RI, August 12, 1994.
     Senator Connie Mack,
     Hart Senate Office Building,
     Washington, DC.
       Dear Senator Mack: One neglected issue in the debate on 
     health care reform is the impact of proposed legislation on 
     innovation in medical technology and the resulting 
     competitiveness of the U.S. medical product industry. I speak 
     to these issues as an investigator in artificial organs and 
     implants with substantial experience in technology transfer 
     from the research laboratory to industry, and as chairman or 
     member of Scientific Advisory Boards to several product 
     manufacturers here and abroad.
       There is no denying that the mere fact of debating health 
     care reform with the dominant accent on cost containment has 
     had a profound negative influence on technological innovation 
     in medicine. The market valuation of U.S. pharmaceutical 
     companies has been substantially diminished, and with it the 
     capacity to invest in new product development. To maintain 
     competitiveness, a counter-strategy has evolved whereby drug 
     manufacturers seek to protect their market share by alliances 
     with somewhat monopolistic distribution networks or 
     investment in less expensive generic products.
       No such strategy exists for medical device manufacturers. 
     This branch of the U.S. industry consists primarily of medium 
     size and small companies. They do not have the cash reserves 
     needed for a major strategic shift and, because of their 
     division in multiple market segments, cannot easily ally 
     themselves with provider or consumer groups. As a result, the 
     stocks of biotech companies have plunged by more than fifty 
     percent compared to a year ago. The willingness of 
     manufacturers to proceed with new products has been 
     discouraged. The availability of private venture capital has 
     been severely curtailed. Clinical product evaluation and, 
     increasingly, production are shifting from the U.S. to 
     Europe, where the business and regulatory climate are felt to 
     be less stifling.
       The net effect, after perhaps a short period of savings on 
     health care costs because of unavailability of new products, 
     will be a long term increase in health care costs. Think 
     simply where we would be if there had not been products for 
     one-day hospitalization for gall bladder surgery with 
     minimally invasive technology; no intraocular implants for 
     the treatment of cataracts; and no cardiac pacemakers for 
     controlling chaotic heart action. None of these advances 
     would have been possible without an investment of government 
     funds in research, and a much larger investment of private 
     capital to turn inventions into products. Most researchers 
     are in this game for the satisfaction of being identified 
     with medical advances. Most investors are in the game for 
     turning out a profit. This synergy has worked to the 
     advantage of the American economy: the U.S. medical product 
     industry, particularly in the artificial organ and 
     implantable device area, dominates the world market and has 
     grown to a volume of several billion dollars, employing tens 
     of thousands of people.
       If we drive early stage research abroad, if we continue to 
     let our regulatory apparatus delay authorizations to proceed 
     with product evaluation with senseless queries, if we make 
     capital investment in new medical products less rewarding, 
     then we will effectively kill the U.S. leadership in bringing 
     new medical products to the market. Exports will eventually 
     become imports. An apparent short term saving will become a 
     new health care burden, because the American people simply 
     will not do without products which have demonstrably 
     increased their quality of life and, in many cases, their 
     actual life expectancy.
           Cordially,
                                   Pierre M. Galletti, M.D., Ph.D.
                      Vice President Emeritus, Biology & Medicine.

  Mr. MACK. I also want to read just a bit from that. He says:

       There is no denying that the mere fact of debating health 
     care reform with the dominant accent on cost containment has 
     had a profound negative influence on technological innovation 
     in medicine. The market valuation of U.S. pharmaceutical 
     companies has been substantially diminished, and with it the 
     capacity to invest in new product development.

  He goes on:

       The net effect, after perhaps a short period of savings on 
     health care costs because of unavailability of new products, 
     will be a long term increase in health costs.

  As we ratchet down on health care dollars to pay for an explosion in 
Government bureaucracy, we will ration technology innovation and, in 
the end, invest less resources to improve quality of life.
  Researchers at the National Center for Human Genome Research and 
grant recipients from the Center are closing in on identifying the 
breast cancer gene. Once the gene is discovered, we will actually be 
able to let women know at an early age if they are predisposed to 
developing breast cancer due to genetic makeup.
  The following are just a few of the many promising drugs in the final 
phase of FDA approval: Ropinerole, which shows great promise for people 
with Parkinson's disease; Arvin, which will be used for stroke, and 
affliction which kills more than 17,000 people a year; and Casodex for 
prostate cancer, which kills 38,000 men a year. The development of 
these and other future wonder drugs will be placed at risk by the 
Clinton-Mitchell Government-controlled medicine.
  Let us take a look at innovation in delivery of services under the 
Clinton-Mitchell bill, specifically the ability to self-insure. The 
bill makes it illegal to self-insure if you have under 500 employees.
  In my travels around the State, I have spoken with many employers who 
have instituted innovative ideas to ensure a healthy workforce--a 
company doctor, an onsite health clinic, incentives for healthy 
lifestyles such as an in-house jogging track and exercise room.
  Many employers in my State who have self-insured plans have done a 
tremendous job in holding down health care costs for their employees. A 
citrus packer in Ocoee with 13 employees has been self-funded for 3 
years and has saved $75,000 during that time. A law firm in Tampa, FL, 
with 26 employees has saved more than $75,000 over 4 years. How? By 
being innovative, encouraging their employees to seek preventive care, 
and by promoting individual responsibility in health care.
  Under the Clinton-Mitchell bill these creative and cost saving ideas 
as part of a self-insured plan would be outlawed for employers with 
less than 500. Why? Because Clinton-Mitchell rests on the premise that 
the Federal Government can make better choices than you can.
  Before abdicating our rights to the Government, we should examine the 
Government's track record in estimating the costs and complexity of 
Government programs. It is not good.
  Last year, Joseph Califano, Secretary of HHS under President Jimmy 
Carter wrote about the effects of the unintended consequences of 
Government actions:

       As the President, Hillary Rodham Clinton and Congress set 
     out to reinvent health care in America, they are wise to 
     consult widely, since we got into much of the current mess by 
     acting on the best of intentions without foreseeing the worst 
     of unintended consequences.

  Medicare was estimated to cost $9 billion in 1990 when it was 
originally estimated in 1965. Instead, the actual cost in 1990 was off 
by 1,178 percent, nearly 12 times higher--the unintended consequenses 
of Government action.
  The Mitchell bill contains at least 50 new bureaucracies designated 
to simplify the health care system--the National Health Care Cost and 
Coverage Commission; the National Health Benefits Board; the Mandatory 
State-based Alternative Dispute Resolution, and the list goes on and 
on--what will be the unintended consequences of these Government 
actions? The administration and my Democratic colleagues will try and 
tell you that the Republicans are using scare tactics.
  Earlier I went through how we came up with this information. It is 
clearly and well defined. It comes right from the Clinton-Mitchell bill 
that has been introduced.
  Finally, let us take a look at the disastrous effects of the Clinton-
Mitchell bill when it comes to the employer mandate. Under the original 
Clinton bill, estimates on job loss ranged from 600,000 to 3.8 million. 
The new Clinton-Mitchell bill would also clearly result in substantial 
job loss.
  A trigger for an employer mandate in the future is no different than 
an employer mandate today. A mandate is a disguised tax, making 
employers legally responsible for financing a huge Government 
entitlement program. CBO, in essence, acknowledged that employer 
mandates are taxes.
  In the final analysis, a tax trigger as advocated by the Clinton-
Mitchell bill will result in job loss, wage reductions and major 
administrative paperwork nightmares for small business owners and their 
employees.
  Small business owners are wise to Washington. They know what an 
employer mandate means--a disguised way to pay for a new social 
experiment. A recent NFIB survey recognized this truth when over two-
thirds of the 600,000 members polled opposed Congress establishing a 
mandatory national health insurance program.
  Since beginning this health care debate over 3 years ago, I have been 
actively pursuing ways to improve the best health care system in the 
world.
  I have been an active member of the Senate Republican Health Care 
Task Force, and I worked with my colleagues, Senators Nickles and Hatch 
and the Heritage Foundation in developing the Consumer Choice Health 
Security Act. Modeled after the Federal Employees Health Benefit Plan, 
the bill provides individuals and families the opportunity to purchase 
the health care plan that best addresses their individual needs. It 
empowers individuals with choice and individual responsibility.
  Because of my strong interest in prevention and specifically, the 
issue of cancer prevention, I introduced legislation to provide 
refundable tax credits for all individuals to avail themselves of 
cancer screening procedures. The American Cancer Society says this one 
proposal alone could save up to 100,000 lives per year.
  As a member of the Appropriations Committee, I have been a vocal 
advocate for increased funding for research and for the CDC breast and 
cervical cancer program for low-income women, a successful program with 
proven results.
  We are on the verge of breakthroughs in many drugs that might one day 
eradicate cancer, Alzheimer's, and heart disease and cystic fibrosis. 
But when resources are squeezed to fund a $1 trillion explosion in 
Government bureaucracy, the prevention of those diseases could be put 
off to another generation.
  I worked with the minority leader and Senator Packwood to develop the 
Dole/Packwood bill. Forty Members have endorsed this legislation. The 
legislation recognizes the value of a free market approach and imposes 
no costly employer mandates that would cause job loss.
  The Dole-Packwood bill does not impose a one-size-fit-all standard 
benefit package that limits the free choice of benefits and outlaws 
existing health insurance plans.
  The Dole-Packwood bill does not create a national health board to 
oversee a government-run health care system;
  Does not prohibit small firms from self-insuring and being innovative 
in delivery of health care services;
  Provides all Americans with access to health insurance that is 
guaranteed to be renewable, portable, and available regardless of any 
pre-existing conditions;
  Preserves unlimited choice of health care plans that are tailored to 
your needs;
  Phases in tax equity for the self-employed and for individuals who do 
not have employer-sponsored coverage;
  It creates medical savings accounts which can be used to pay medical 
bills or to meet long-term care expenses. The best cost control known 
to man is a system which allows individuals to make their own choices 
with their own money on health care;
  Allows self-employed and small businesses, 2 to 50 workers, to enroll 
in the Federal Employees Health Benefit Plan [FEHBP], giving them the 
same choices among benefit packages that Members of Congress enjoy;
  Provides premium subsidies for low-income people for the purchase of 
a health care plan;
  Reforms medical malpractice laws, including capping awards for 
noneconomic damages and sliding scale limits on attorney fees;
  Allows for the development of truly voluntary purchasing pools.
  In conclusion, I once again find myself thinking about the response I 
gave to the President's health care address to the Nation in September 
1993.
  The message I send my colleagues today is the same message I 
delivered almost 1 year ago: The American people don't want more 
bureaucracy, more mandates, and more Government control over their 
health care choices.
  The Clinton-Mitchell proposal, which comes with a price tag of at 
least $1 trillion, creates a Government-controlled, Government-dictated 
health care system that will hinder quality, choice, and freedom. It 
imposes at least 17 new taxes, including a surtax of 1.75 percent on 
every health insurance policy, enacts price controls, requires employer 
mandates, and creates at least 50 new bureaucracies. In short, it's a 
prescription for disaster.
  Two recent letters from my constituents express the concerns of many 
Floridians:

       Please do not reduce the quality and availability of health 
     care by voting for the Federal Government to ``improve'' it 
     by using price controls and redtape. The past 
     ``accomplishments'' of the Government * * * have resulted in 
     the tremendous cost overruns and recent and constant tax 
     increases * * * I strongly feel that the private sector 
     through market competition can reduce health care costs. 
     Please, vote ``no'' to any proposed Government control of 
     health care.

  The second letter reads, and again I quote:

       I am very concerned about the Health care bills before you. 
     The Mitchell bill I'm afraid will be used as a vehicle to get 
     in Conference where Clinton-Gephardt can be inserted under 
     another name and avoid Debate. * * * The best bill will be * 
     * * the * * * simplest with the least Government involved and 
     the most Free Enterprise as has served to make the Country 
     Strong and Rich.

  Mr. President, I want to see that other families, just like mine, 
have health care. While my Democratic colleagues may have the right 
motives for reforming our health care system, their method will destroy 
the best health care system in the world.
  My vote, on behalf of my constituents, will be a resounding ``no'' on 
the Clinton-Mitchell bill. I will work hard with my colleagues to pass 
the reforms the American people want and I will not impose upon them a 
solution they do not want.
  A Government controlled system? Never. I will never cast away our 
freedom for the sake of constructing a social experiment on a 
foundation of quicksand--the Federal bureaucracy. It is a formula 
proven time and time again to fail. We must look for solid ground to 
build any such reforms * * * that ground has always been free markets 
and free choice. They have served as the foundation for every great 
stride made by this country in the last 200 years. I will not abandon 
them nor will the American people abandon them either now or later.
  I yield the floor.
  Mr. PRYOR addressed the Chair.
  The PRESIDING OFFICER. The Senator from Arkansas.
  Mr. PRYOR. Mr. President, if I might inquire of the Chair, how much 
time is left on this side?
  The PRESIDING OFFICER. Just about 28 minutes.
  Mr. PRYOR. I thank the Chair.
  Mr. President, I first want to congratulate my colleague from Florida 
for his very timely remarks. I also want to congratulate my colleague, 
Senator Bennett, for his remarks earlier today. I thought it was a 
very, very constructive dialog, a very constructive part of this debate 
on this late Saturday afternoon in the U.S. Senate. I am glad that this 
debate is occurring, and I am glad also, Mr. President, that I have the 
opportunity, to correct some of the misimpressions--I know not 
intentionally made--by my very good friend and colleague from Florida, 
Senator Mack.
  First, there is something I agree with. I agree with my colleague 
from Florida that we have the highest quality of medical care of any 
country in the world. I agree 100 percent. I agree 100 percent with my 
colleague from Florida that we have the highest quality system of 
medical care for those who have insurance, for those who are wealthy, 
for those who can afford it, for those who have not had their insurance 
canceled, for those who have not lost their jobs, and for those who 
have not been transferred to another State or to another company where 
they have lost their insurance.
  We have a very high quality of health care. And I would like to 
further state that for those who are in the system, the system is good.
  For those who are outside the system, the system is very, very bad. 
It is so bad, Mr. President, that we have a crisis, and unless we do 
something, we are going to see the great majority of American families 
in the next decade, one, not have insurance coverage and, two, not be 
able to participate in what our colleague from Florida refers to as the 
best system of health care in the world.
  There is another misimpression that my colleague and others of his 
friends on his side of the aisle have been leaving for the last several 
days and weeks, and that is that the so-called Mitchell plan is a 
Government takeover.
  It is just the opposite of a Government takeover. The so-called 
Mitchell plan is a plan to free up the individual to make their own 
decisions about health care. It is not a Government takeover, and to 
imply, to state that 17 new taxes--17 new taxes--are going to be 
imposed under the Mitchell plan is totally, absolutely in error.
  Second, to imply that 50 new bureaucracies--50 new bureaucracies--are 
going to be created under the Mitchell plan? Mr. President, it is not 
true.
  Earlier in the day I was looking at the chart of my friend from 
Florida. In fact, I went over to examine that chart. I have seen it on 
TV; I have seen it on the floor all week. So I took the time to go and 
look at it.
  I looked down in the lower left-hand portion or quadrant, of that 
particular chart about how bad this Mitchell plan proposal is going to 
be, how many bureaucracies it is going to create. What I saw in the 
chart that we have seen displayed most of today on the Senate floor is 
basically part of the system that we have now, that we are trying to 
get rid of, that we are trying to replace with a new system that is 
going to be affordable and accessible to every American citizen. Most 
of that chart, Mr. President, was a chart and I repeat, of the system 
that we have now.
  It is for this reason that we are using an example from the State of 
Iowa, a small town in the State of Iowa, Clive, IA. We have a chart of 
a Dr. Gleason's office before Senator Mitchell's plan. Here it is. Here 
is what happens in this small doctor's office in this small town in 
Iowa: The literally hundreds of forms and steps that must take place 
when a patient of Dr. Gleason receives service.
  What do we have first? First, we have 1,500 insurance companies in 
America. The distinguished occupant of the chair knows all of this, 
probably better than any Member of this body. He has passionately--
passionately--pursued this issue and tried to make those necessary 
changes that make this system not only the best, but keep it the best 
and make it accessible and affordable to every American.
  Look, Mr. President, here we have Medicare, Medicaid. Here are the 
Blue Cross/Blue Shield programs right here. Here are all the different 
color codes that show--each different color code is a new form that 
must be filled out before Mary Jones has her examination or has her 
finger bandaged, or what have you. Then we have all of the other 
insurance companies. We could not put all the rest of them on here 
because there would be over 1,400 of them and they would encircle this 
entire Senate Chamber. For every one of those insurance companies, 
there is a different form to fill out.
  Under the Mitchell plan, you are not getting more government, you are 
getting less government. You are not getting less service, you are 
getting more service. You are not getting a lower quality of health 
care, you are getting a higher quality of health care.
  What you are ultimately getting, though, Mr. President, is efficiency 
in that system and you are getting simplicity in that system. Because 
after Senator Mitchell's plan is enacted--if those on the other side 
will let us enact it--we will see a much simpler plan with basically 
only three different forms that have to be filled out when Mary Jones 
visits the office of Dr. Gleason in Clive, IA.
  We think this is remarkable progress, Mr. President. We think it is 
progress because we think the Mitchell plan is very far superior to 
that plan offered by Senator Dole and Senator Mack and his colleagues 
on the other side.
  Just one example. Because we think it is better, we will give you one 
reason we think it is better, among others.
  The Senator from Florida represents a State with the highest 
percentage of elderly population. By the way, Arkansas is second or 
third in line. I am not sure we are second to Florida, but Florida is 
first. Florida has more elderly people than any other State 
percentagewise, yet, mysteriously, the proposal by Senator Dole and 
Senator Mack does not include prescription drug benefits for seniors. 
It does not exist. It is not in the Dole plan. It is nonexistent. It is 
not even mentioned.
  Whereas, in the Mitchell plan, we do begin for Medicare recipients a 
prescription drug plan that we think is a very, very good start. And we 
are proud of it. We are proud that we have a prescription drug 
proposal. We are proud of the fact that the elderly and the seniors and 
those on Medicare are no longer going to have to reach in their pockets 
and pay the highest conceivable prices for their prescription drugs.
  We can do better as a country. We will do better as a country if we 
adopt the Mitchell plan for prescription drugs. I think this 
afternoon's debate has been a good debate because we are beginning to 
compare, really compare, without all the rhetoric, the Mitchell plan to 
the Dole plan. Another thing we like better about our plan is we have a 
proposal, as the Presiding Officer knows, because he was one of the 
instrumental forces in putting it into the Finance Committee bill, 
merged into the Mitchell bill, is something that we call long-term 
care. It is a beginning.
  The distinguished occupant of the chair, Senator Rockefeller, has 
worked for years and years to tell our country of the need for long-
term care and to keep people as long as possible out of nursing homes.
  Well, Mr. President, if we do nothing--and we have the opportunity 
here to do nothing, which would be the wrong opportunity to take, I 
might add, Mr. President, but if we do nothing and if we fail to seize 
upon this opportunity to do something, a once-in-a-lifetime opportunity 
to do something about a health care system that is unavailable to 37 
million people, that is unaffordable to millions and millions of 
people, a system that is losing hundreds and hundreds of thousands of 
insured each year, if we fail that opportunity, I think we have failed 
in our obligation to the American people as Members of the Senate.
  Look at this. We have more than 1,500 health insurance companies in 
this country, and today we see that we have to fill out 15 more forms 
for one patient's hospital stay. The lack of standardization of these 
forms is resulting in higher and higher administrative costs. The 
number of health administrators, for example, has increased by 300 
percent during the past decade. The number of physicians has increased 
by only 18 percent.
  The private insurance carriers in this country employ more than 2.4 
million people, almost 2\1/2\ million. This is almost as many people as 
are employed in all of the legislative, judicial, and nondefense 
executive agencies of the American Federal Government, including all of 
the postal workers.
  If we do nothing, this is going to continue to explode. If we do 
nothing, I say to my friend from Florida, we are going to see 
Children's Hospital bills not at the $2 million a year it costs to fill 
out reports today, but $10 million a year in the coming years. We are 
going to see the continued explosion of the health care bureaucracy in 
our country.
  Mr. President, earlier this morning, one of the lead speakers, a very 
good speaker, a very good Senator, a good friend, the vice chairman of 
the Senate Special Committee on Aging, a real addition, a good addition 
to this body, stated--and I cannot quote him exactly--our friend, 
Senator Cohen, said he did not know why the newspaper headlines this 
morning ``blamed us, the Republicans, for slowing down the health care 
bill'' or ``impeding the health care bill.'' I do not know exactly the 
term he used.
  Well, I do not know why my friend the junior Senator from Maine, 
Senator Cohen, was surprised, because only last Wednesday on the floor 
of the Senate it was Senator Phil Gramm, and I quote, who declared ``No 
one person will be able to comprehend the entire bill by next week,'' 
so he said he will divide up the measure, assign sections to individual 
GOP Senators, and have them explain their designated positions on the 
floor. He said then that process, and I quote, ``will take a week, 
and,'' he said, ``after that, the bill is dead.''
  ``After that, the bill is dead.''
  So why would our friend from Maine be surprised to see that now the 
newspapers or the press people, the media, might be accusing or 
implying that the Republican side of the aisle would like to slow down 
and ultimately kill this bill.
  Our friend from Utah, Senator Bennett, spoke this afternoon--he gave 
a very, very good speech, I thought. He quoted from Newsweek regarding 
the so-called Mitchell bill and the Clinton plan, et cetera. But what 
he did not state was that Newsweek, in the same article, predicted, and 
I quote, Mr. President, ``The Dole plan will increase premiums for 
middle-class people and could increase the number of uninsured.''
  What we are talking about, Mr. President, is 30 million people 
uninsured, left out of the system, forgotten, run away from should the 
Dole plan become law.
  Mr. President, the other day--and I have used this before; this will 
be the second time--when we talked about delaying the vote, delaying 
consideration, stopping now and coming back in September, stopping now 
and coming back next year, when we do all of this, Mr. President, what 
I think we were saying is that we are giving up. I do not believe we 
can give up. I believe that we have to work harder. I do believe that 
we have to try to achieve a bipartisan proposal that we can take to the 
American people and say this is a better system than we have now.
  When I thought about how to conjure up all the resources of the 
Senate, I added up the number of years that collectively all of us, all 
100 of us that sit in this Chamber on a daily basis, how many years of 
Senate service have we had collectively. The answer is 1,236 years. I 
have been here 15 years. Senator Thurmond, I think, has been here over 
35 or 36 years. Senator Hatch over there has been here over 20 years. 
Senator Daschle has been here since 1986, so he has not been here quite 
a decade.
  But you add all of our service up together and, Mr. President, it is 
12 centuries, over 12 centuries of public service in the U.S. Senate. 
And somehow I believe, with 12 centuries of experience, we do have the 
resources, we do have the ability; and hopefully, we have the will to 
come forward with a proposal that we can support, that we can take to 
the American people, and that we can be proud of as an institution.
  Mr. President, I know that the time is late.
  I know that we are all ready to go home. In fact, I would like to go 
home, Mr. President, and catch the last 30 or 40 minutes of the PGA 
Golf Tournament. That is where I would rather be this afternoon.
  But I want you to know, Mr. President, it has been a high honor and a 
privilege to be here working with my colleagues today, this week, and 
this weekend on this proposal. We are going to continue to work on it 
until we do it, until we do it right. And we can do it, and we must do 
it, because if we do not, we will have failed our country, we will have 
failed our children, and we will have failed their children.
  Mr. President, I thank the Chair, and I yield the floor.
  Mr. DASCHLE addressed the Chair.
  The PRESIDING OFFICER. The Senator from South Dakota.
  Mr. DASCHLE. Mr. President, let me commend the distinguished Senator 
from Arkansas for an excellent statement. He has been a student of this 
issue now for many years. He is a member of the Finance Committee. He 
has represented those of us who favor strongly the Mitchell bill.
  In closing our debate this afternoon, we thank him for his 
contribution, participation, leadership, and commend him especially for 
the excellent statement he has just made.

                          ____________________