[Congressional Record Volume 140, Number 118 (Friday, August 19, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 19, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                          HEALTH SECURITY ACT

  The Senate continued with the consideration of the bill.
  Mr. DOLE. Mr. President, finally, I have not had an opportunity to 
meet with the majority leader on the program for the balance of the day 
and the program for tomorrow and maybe we can do that sometime soon 
because a lot of our colleagues are asking questions, I assume on that 
side, too. We do not have any answers.
  Mr. MITCHELL addressed the Chair.
  The PRESIDING OFFICER. The majority leader.
  Mr. MITCHELL. Mr. President, I believe that we have made a proposal 
to Senator Dole's staff perhaps in the time that he was speaking, and I 
am now going to suggest that he and I consult personally. I suggest the 
absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  Does the Senator withhold the quorum call?
  Mr. MITCHELL. Mr. President, I withhold the request.
  Mr. HELMS addressed the Chair.
  The PRESIDING OFFICER. The Senator from North Carolina.
  Mr. HELMS. Mr. President, I am advised that the majority leader 
wishes to discuss the schedule for the rest of the day and the rest of 
the weekend and, without losing my right to the floor, I yield to him.
  The PRESIDENT pro tempore. Without objection, the Senator will not 
lose his right to the floor.
  The majority leader.
  Mr. MITCHELL. Mr. President, I thank the Senator.


                      Unanimous-Consent Agreement

  Mr. MITCHELL. Mr. President, I ask unanimous consent that, upon the 
completion of Senator Helms' remarks, Senator Hutchison be recognized 
to offer an amendment striking a provision in the substitute amendment; 
that upon the disposition of her amendment, Senator Harkin be 
recognized to offer an amendment regarding disability insurance 
coverage; that no other amendments be in order to S. 2351 during 
today's consideration; that when the Senate completes its business 
today, it stand in recess until 10 a.m. on Monday, August 22; and that 
at that time the Senate resume consideration of S. 2351 and Senator 
Moynihan be recognized to offer a Moynihan-Packwood amendment regarding 
medical school training.
  The PRESIDENT pro tempore. The Chair, hearing no objection, the 
several requests are granted.
  Mr. MITCHELL. Mr. President, this agreement is the culmination of 
discussions with the managers of the bill, the distinguished Republican 
leader, and several of the interested Senators.
  We have agreed upon the following: We will take up the Hutchison 
amendment, and that will be accepted without a rollcall vote. We will 
then take up the Harkin amendment, and that will be accepted without a 
roll call vote.
  So there will be no further rollcall votes today. There will be 
continued debate on the subject for as long as Senators wish to address 
the subject today. The Senate will not be in session tomorrow.
  As all of our colleagues know, Senator Chafee and Senator Breaux, and 
the other members of the so-called mainstream group, expect to deliver 
their proposals to me and to Senator Dole today. I have suggested that 
it would be a more efficient use of our time if we have over the 
weekend--tomorrow and Sunday--to review those recommendations in 
detail. Therefore, it is my conclusion, agreed to by my colleagues, 
that we would accomplish more by permitting Senators to do that than 
being in session and simply debating an amendment.
  We will return to session on Monday at 10 a.m., at which time Senator 
Moynihan will offer an amendment on behalf of himself and Senator 
Packwood. That is a major amendment that is going to be debated at some 
length. Although we do not know when we will reach a vote on that, I 
have advised my colleagues, and now state, that no vote on that 
amendment will occur prior to 6 p.m. So Senators will know that--
although we cannot be assured that a vote will occur at 6 or when 
thereafter, because there may be more time than from 10 to 6 required 
for debate--in any event, under no circumstances will there be a vote 
prior to 6 p.m. But those Senators who wish to participate in the 
debate on that amendment regarding medical school training should be 
present during the day on Monday.
  Mr. President, I note the presence on the floor of the distinguished 
Republican leader. I want to now yield and ask him to first correct any 
statement I have made that does not accurately reflect our 
understanding, and for any other further comments he wishes to make.
  Mr. DOLE. Mr. President, I think the agreement reflects the 
understanding. There will be two voice votes, but there will be time 
for additional debate. We have a number of Senators that want to 
discuss health care later this afternoon, and they can do that as long 
as they desire.
  Mr. MITCHELL. That is correct; as we do, as well. So there will be, I 
think, several Senators participating in the debate. We will remain in 
session today for as long as any Senators wish to address the subject.
  Mr. MOYNIHAN addressed the Chair.
  The PRESIDENT pro tempore. Under the order, the Senator from North 
Carolina resumes the floor.
  Does the Senator yield to the manager of the bill?
  Mr. HELMS. I am delighted to yield.
  Mr. MOYNIHAN. Mr. President, on behalf of Senator Packwood and 
myself, I thank our friends and colleagues, the majority leader and the 
Republican leader. It seems a good way to proceed. We will have two 
amendments disposed of today and we will be on another one Monday.
  I thank the Chair and I thank my friend from North Carolina.
  Mr. HELMS addressed the Chair.
  The PRESIDING OFFICER. The Senator from North Carolina.
  Mr. HELMS. I do not know about the people in the galleries, but I am 
sure the people who have been watching on C-SPAN this morning and early 
this afternoon, if they are still awake, must have wondered what goes 
on in the Senate. A couple things came to my mind as I heard some of 
the ``debate.'' One of them is Shakespeare who in ``As You Like It'' 
said, ``All the world is a stage and all the men and women merely 
players.''
  Well, we have had stage here this morning. I hope that the C-SPAN 
listeners and anybody else who happened to hear this debate took notice 
of the fact that everybody on the other side who participated in the 
debate and flashed their health cards, Blue Cross-Blue Shield, not one 
of them has ever seen a big Federal spending bill he did not love. They 
are the big spenders of the Senate. They do not know and they do not 
care what this bill will cost the American taxpayers.
  They want to be good to their constituencies, so that the people in 
the next election will vote these big spenders back in office. That is 
what it is all about. This is a political game.
  By the way, the big spenders of the U.S. Senate and the U.S. House of 
Representatives have sent a set a pretty good benchmark on how reckless 
they are and have been with the people's money. As of the close of 
business Wednesday, the Federal debt stood at $4,668,682,813,919.54. 
And if this bill becomes law, that debt will increase dramatically.
  The more I observe and listen to the health care debate, the more 
vividly I recall an incident that happened a long time ago at a little 
country newspaper office where I began work at the age of 9 years. I 
can still smell the aroma of the printer's ink, and I can smell the 
smoke that came from the Linotype machine because of the melting metal, 
and the clanging and clacking of that old duplex press downstairs.
  Mr. Rowland Beasley, the editor and copublisher of the Monroe 
Journal, smoked a pipe incessantly, and he smoked Prince Albert 
tobacco. I remember it came in a little can. His brother, George, did 
not smoke, but he enjoyed an occasional pinch of snuff which he kept in 
a Campbell's soup can by his desk.
  There was a fine old colored gentlemen who was my immediate boss. His 
name was Mose. He could always be relied upon to come up with a classic 
comment when his opinion was asked for, which it often was because we 
liked to hear what Mose had to say.
  Anyhow, Mose had a hearing difficulty which resulted in a certain 
degree of raised voices, even shouting, when one was attempting to 
communicate with Mose. One Christmas season, the two Messrs. Beasley 
decided to help Mose with that hearing problem, and all of us at the 
paper pitched in a little money to help get Mose one of those then 
newfangled hearing devices. I remember I furnished a quarter. We wanted 
to give it to Mose for his Christmas present. Compared with today's 
model of hearing aids, this was sort of a Rube Goldberg contraption. It 
was a rather large box with a big dial on it to control the volume, and 
it hung around your neck. It had only one earplug in those days.
  We were all instructed to gather at Mr. Rowland Beasley's office just 
before the Friday afternoon newspaper went to press. And when Mose came 
in, we began singing a Christmas carol. We wished Mose merry Christmas, 
and then Rowland Beasley presented Mose with the wrapped Christmas 
present. And Mose slowly unwrapped it. Mose put it around his neck, and 
put in the earphone. Then we adjusted the battery, and the instrument 
was turned on. The noise level knob was turned up, and it was very 
clear when Mose began to hear those sounds, because his eyes rolled and 
he slowly shook his head, but he said absolutely nothing, absolutely 
nothing. We were so disappointed.
  Finally, Mr. Beasley said, ``Mose, does it help your hearing?'' And 
Mose responded without hesitation. He said, ``Yes, sir, it helps my 
hearing, but it don't help my understanding none.''
  That is the problem with the U.S. Senate. That is the problem with 
the health care debate. We hear a lot, but we do not understand very 
much.
  We certainly do not understand anything about what is being done in 
this country in terms of the debt of over $4.5 trillion that has been 
run up by people so willing to give away other people's money. That is 
what is at issue right now in this Senate.
  I thought of Mose a thousand times during the past several weeks as I 
have sat here, and as I have sat in my office looking at the television 
set, seeing the incredibly confusing turns the Senate has taken on 
health care reform.
  Make no mistake about it, what is at stake here is whether we are 
going to vote to socialize America's health care system, which warts 
and all, is nonetheless the best system mankind has ever known.
  I first came to the Senate very late in the year 1951 as an 
administrative assistant to a North Carolina Senator. I had not really 
wanted to come to Washington because my daughters were very young. 
Nancy was still a baby. But Dot and I decided that she and our two 
little girls should stay in Raleigh and I could commute home every 2 
weeks. But that was when Congress usually adjourned for the year in 
early July. How I wish that were still true.
  Congress was not like it is today when one Senator can command the 
other 99 Senators to cancel their vacations and family plans to stay 
here to pass a health care bill which the vast majority of the American 
people say they do not want.
  Harry Truman was President when I came to Washington the first time 
in 1951. Alben Barkley was Vice President. There was, of course, a lot 
of politics in Washington in those days. But I do not recall the rancor 
and the mean-spiritedness that exists now. There was no constant 
interference with family lives of Senators, an exercise that is a 
needless power play.
  I have talked with dozens of people from all over America during the 
past few weeks, some by telephone, some whom I've met in my office. 
Thousands of letters are pouring into our office, and I am sure into 
the offices of other Senators as well. Most are concerned about the 
strenuous efforts by the majority leader to push through this Senate, 
with threat after threat, his health care plan.
  There are three of them. First there is Mitchell health care plan No. 
1, which has 1,410 pages. There is Mitchell health care plan No. 2, 
which has 1,448 pages. And finally, there is Mitchell health care plan 
No. 3; and it has 1,443 pages.
  So you can see that the majority leader's health care plan changes 
spots like a chameleon, about every 2 or 3 days. And proponents of this 
bill are making claims that cannot be substantiated.
  The same is true for the so-called crime bill that was shot down at 
least temporarily by the House of Representatives last week. I do not 
know if they can revive it or not, but they are trying to.
  I spoke the other day with a long-time friend in another State who is 
a Federal judge. He asked: ``Isn't your majority leader treating you 
fellows like a surly Federal judge sometimes treats his bailiff, 
ordering all 99 of you around? I knew him when he was on the Federal 
bench.'' And then the judge dropped the subject and moved on to the 
crime bill. At that time, the crime bill had not been dealt the blow 
that was to come a few days later, and the judge feared it would pass. 
He described that bill as a disgrace, and obviously the House of 
Representatives in the majority agreed.
  He spoke of the political shenanigans going on with the health care 
situation. I wrote down what he said. He said: ``You fellows are not 
going to be able to come up with a responsible piece of legislation in 
the atmosphere that prevails up there now, nor the political hardball 
that is being played. You are right.''
  He was talking about my recent amendments which suggested that we put 
off health reform until the first of the year and start over and do it 
right.
  The judge said: ``You are right. You should put down a peg and come 
back next year; start right in this January and do it right.''
  It's just like old Mose said, more than 60 years ago: the hearing aid 
helped his hearing, but it did not help his understanding.
  I think that is the problem of the American people, and it is 
certainly the problem of the U.S. Senate. As I said earlier, we are 
hearing a cacophony of sounds of hysteria, but there is scarcely any 
way to make sense out of the bedlam.
  The Congress of the United States should never engage in deliberate 
deceit or emasculation of the truth to get any piece of legislation 
passed.
  And Congress should never, ever approve any piece of legislation just 
to get away and go home.
  That is exactly how the Federal income tax began, both the 
constitutional amendment that authorized it and the implementing 
legislation. Statements made back then on this floor of the Senate were 
just not so. There was almost a fist fight in this Chamber between two 
Senators because one of them had suggested that an income tax, if it 
ever became law in the United States, would take 10 percent of every 
American taxpayer's income. The author of the bill did not like that. 
He said, ``It is just not so.'' Well, I wish we could have kept it at 
10 percent.
  So much of what is being said in favor of the various health care 
proposals could never withstand the scrutiny of the American people. 
And that is the best reason I know to submit it to the American people 
next year.
  We do not need to legislate this way. We should never legislate this 
way.
  Several days ago, I suggested to Americans who happened to be 
watching on C-SPAN that they may want to call their Senators and let 
their Senators know how they feel about health care reform. Should the 
majority leader's bill No. 3 be shoved willy-nilly through the Congress 
this year? What is magic about doing it this year that is not 
political? Or, would it be better to wait until the first of next year, 
when Congress and the American people will have had some time to 
examine all of the alternatives, including the three versions of the 
more than 1,400-page Clinton-Mitchell bills?
  Most Senate offices, certainly mine, received hundreds of calls, the 
overwhelming majority of which pleaded with us to wait until next year.
  Last week, I put the Capitol switchboard number on an easel and that 
led to the calls that came into the Capitol and to the Senators' 
offices. People looking at C-SPAN may want to write down this number, 
and call 1-202-224-3121 and ask for their Senators.
  You may want to let both your Senators know if you agree with the 
Clinton-Mitchell plan or if you believe the Clinton-Mitchell plan will 
make things worse than they are now. It may influence your Senators' 
decisions if you call.
  Mr. President, the American people do have a monumental decision to 
make about health care reform. Robert Frost once wrote about the two 
roads that diverge in the wood. The question is, which of those roads 
will Congress follow. Will Congress take the one less traveled? And 
that was the point of Robert Frost's poem. Or will Congress follow the 
well-traveled route to a destination of blunder? When it comes to 
turning power over to the Federal bureaucrats, Congress has too often 
taken the well-traveled path. It is easy to do. Pass a law. Set up a 
new bureaucracy. Hire employees. Raise the debt. Spend the money.
  The American people are beginning to comprehend where this path 
leads. It starts out with a noble idea. Along the way, politicians add 
this agency and that commission, a new tax here and a new tax there, 
and presto, that old road is clogged with bureaucrats, and new taxes 
and burdensome regulations that no one remembers what the original road 
looked like.
  Mr. President, the Clinton-Mitchell plan is a perfect example of 
taking the easy, deceptive, self-defeating big Government road. The 
Clinton-Mitchell bill includes 17 new taxes, creates 170 new 
bureaucracies and 6 new entitlements, and if this were not enough, it 
requires that every health insurance policy cover a Government-mandated 
set of benefits, one of which is abortion.
  Clinton-Mitchell, as the Senator from Oregon referred to it, is truly 
Lethal Weapon No. 3.
  Mr. President, I had hoped, and still do, that we might take ``the 
road less traveled,'' and steer clear of socialized medicine in 
America's health care. Let us chart a narrow course to fix whatever is 
broken in our health care system and go no further than that. Senator 
Dole and 39 other Senators have sponsored such a plan, including both 
of the Senators from North Carolina.
  Mr. President, let me address a few points that I have heard this 
morning and on previous occasions. Several times I have heard it said 
that none of the Clinton-Mitchell bills is a Government-run health 
care.
  I would just like to mention that the Clinton-Mitchell bill contains 
the word ``shall'' 2,618 times. I did not count them, but staff from 
the distinguished Senator from Indiana has. This means there are 2,618 
times where the Government tells doctors, hospitals, businesses, 
States, and patients what to do. If that is not a Government-run health 
care system, tell me what is.
  I also want to ask the Senators who were engaged in their little one-
act play this morning, if they could tell me how much the Federal 
Government--that means the American taxpayers--already pays every year 
for our major welfare programs? I am referring to things like Social 
Security, Medicare, Medicaid, veterans health, unemployment, food 
stamps, AFDC, and so forth and so on.
  In 1993, the total Federal outlay for these programs was $1.4 
trillion. And any one of the Clinton-Mitchell bills would add another 
$1 trillion in new government subsidies over the next 10 years.
  By the way, do any of my colleagues know how many million dollars 
there are in a trillion dollars? There are a million, million dollars 
in a trillion dollars. So when the American taxpayers owe $4.6 
trillion, all of that speaks for itself.
  Now, as to the debate this morning, I so appreciated Senator Warner's 
trying to steer the conversation and the debate down the factual road. 
He was saying: Get a second opinion. He was saying, inferentially, you 
folks are not telling it like it is. And they were not.
  This morning, my colleagues on the other side made much of their 
health insurance cards that they have under the Federal Employee Health 
Benefit Program. They waived them around and said that every American 
should have a card like that. The truth is that 70 percent or more of 
the American people already have health care cards at this moment. And 
many who don't have health cards at this moment will have them 
tomorrow, because many will change jobs or move away. Clinton-Mitchell 
1, 2, and 3 would take everyone's cards away and replace them with a 
card that entitles them to a one-size-fits-all set of benefits--meaning 
a Government program.
  Senator Nickles of Oklahoma offered a bill which I cosponsored. It 
was based on the Federal Employees Health Benefits Program. Under that 
proposal, Americans who did not have cards--that is, insurance--would 
be able to get them. And those cards would ensure Americans of a choice 
of benefits, not a Government-determined set of choices.
  Taking the road less traveled, as Robert Frost would put it, means 
rejecting Federal mandates, increased taxes, caps on private spending, 
politically determined, and mandatory health benefits. A walk down the 
road to sensible health care reform would look like this:
  It would include insurance reform so people do not lose health 
insurance because they lose or change their jobs.
  It would require insurance companies to renew health insurance 
policies and limit preexisting condition restrictions.
  It would let doctors take care of patients without worrying about 
frivolous lawsuits being filed against them.
  It would allow individuals to establish medical savings accounts as 
an incentive to wisely spending each health care dollar.
  The Clinton-Mitchell proposal is silent in seven languages in all but 
a few of these sensible reforms and instead hands over to a vast array 
of new Government bureaucracies the health care of every American.
  So far, those of us in my office who have been reading Clinton-
Mitchell have been able to uncover about 170 new bureaucracies. Senator 
Specter of Pennsylvania developed a chart that identifies all the 
bureaucracies. The chart has a myriad of boxes, each of which 
represents a new bureaucracy that would be created by the Clinton-
Mitchell bill. Two that give me the most heartburn are the National 
Health Benefits Board and the National Health Care Cost and Coverage 
Commission. Under Clinton-Mitchell these two boards become the central 
nervous system of the entire health care network. But I will get to 
that later.
  Our health care system today, with all of its warts, still delivers 
the best quality health care in the world. Can it be improved? Yes. 
Should it be improved? Yes.
  Rather than targeted solutions to health care reform, Clinton-
Mitchell threatens to turn over to the Federal Government's 
bureaucracies, our entire health care system. I ask you, Mr. President, 
when was the last time an enterprise prospered after the Federal 
Government and the Federal bureaucracy grabbed control of it? I cannot 
think of one.
  Michael Ruby, coeditor of the fine magazine U.S. News & World Report, 
described the Federal Government this way, ``It's not that the big guy 
is aloof: it's just that he's overweight, awkward and frequently ill-
informed, and in his eagerness to help, to solve something, he 
sometimes makes it worse.''
  In the context of health care reform, the Government will undoubtedly 
make things worse. All we need is for the post office mentality to take 
over and you can bet the farm that America's health care system will 
never again be the envy of the world. That will be it. If we cannot 
trust the Federal Government to deliver the mail, what makes us think 
we can trust the Federal Government to deliver our health care.
  Under the Clinton-Mitchell bill, Government bureaucrats will decide 
what medical care is medically necessary or appropriate for each 
American citizen. If you do not believe that, look at page 119. Section 
1213 of Clinton-Mitchell says the National Health Benefits Board, an 
unelected, partisan group of bureaucrats, is authorized to establish:

       (A) criteria for determinations of medical necessity or 
     appropriateness; (B) procedures for determinations of medical 
     necessity or appropriateness; and, (C) regulations or 
     guidelines to be used in determining whether an item or 
     service is medically necessary or appropriate.

  Do you want the Federal Government, the Government that operates your 
Postal System, to decide whether you should have an operation or not? 
With this kind of Government intervention, what is left for the doctor 
and the patient to decide?
  Those not accustomed to reading legislative language may not 
understand the intent behind these words, but the Clinton-Mitchell bill 
will have a politically appointed Government bureaucrat decide what 
care and which procedures are medically necessary and appropriate for 
each and every American. I do not like that. And if I am a little bit 
strong in my comments today, it is because I do not like it and I fear 
it and I think the vast majority of the American people feel the same 
way about it.
  But the National Health Benefits Board is only one of the monoliths 
proposed in the Clinton-Mitchell bill. There's the National Health Care 
Cost and Coverage Commission, a National Quality Council, a Commission 
on Worker's Compensation Medical Services, a Prescription Drug Payment 
Review Commission and a National Council on Graduate Medical Education.
  These are just a smattering of the 170 new bureaucracies. It kind of 
makes your head spin, all those boxes and arrows. How can this tangled 
web of bureaucracy ever work? The answer is that it cannot work. And 
just imagine how these bureaucracies will damage the quality health 
care we expect and deserve.
  The National Health Benefits Board will not only tell you what is 
necessary and appropriate medical care, it will also tell you which 
insurance benefits you can and cannot have.
  Under the Clinton-Mitchell bill, all Americans will be required to 
purchase a one-size-fits-all package of benefits, treatments and 
procedures, whether they want them or not. Americans will have no 
choice. You see, one of the central tenets of Clinton-Mitchell is that 
Americans are not really smart enough to decide what benefits their 
families need or want.
  The Government-established package includes benefits contained in 
most health insurance policies, but it also includes many benefits 
which are not. One of those benefits is abortion on demand. Clinton-
Mitchell requires that every health insurance policy sold in America 
must provide coverage for abortion on demand. I say no, no, no to that.
  This means that every American will pay for abortion coverage 
regardless of whether he or she wants it, or needs the coverage, or is 
opposed to abortion on principle. You pay for abortion and you're 
covered for abortion services whether you want it or not. This means 
that men will pay for abortion coverage. It means that women beyond 
childbearing age will pay for abortion coverage. It means that people 
who recognize that abortion is the deliberate destruction of innocent 
human life will nonetheless pay for abortion coverage and you will have 
no choice about it.
  Mr. President, it is no accident that abortion is mandated as a 
benefit. Pro-abortion groups, such as Planned Parenthood, the National 
Abortion Rights Action League and the Alan Guttmacher Institute, just 
to name two or three, have lobbied, picketed, screamed, yelled to get 
abortion included in the mandatory Government package and, as a 
political result, it is included. Could it be that these groups want to 
use health care reform as a means to expand the availability of 
abortion in this country? There is no doubt in my mind that these 
people want abortion in the United States to become as routine as 
having your tonsils taken out.
  Every poll that I have seen on the issue has demonstrated that the 
American people consistently reject abortion as a mandated benefit. A 
recent USA Today poll said 59 percent of Americans oppose abortion as a 
mandated benefit.
  In addition to mandating that abortion be included in the standard 
benefits package, the bill requires that all taxpayers pay for 
abortions for every woman who receives a health care subsidy from Uncle 
Sam. In short, this is the backdoor repeal of the Hyde amendment, which 
prohibits taxpayer funded abortions except in cases of rape, incest or 
when the life of the mother is in danger.
  Mr. KERRY. Mr. President, will the Senator----
  Mr. HELMS. I prefer to finish my statement.
  Mr. KERRY. I simply want to ask my colleague----
  Mr. HELMS. Mr. President, the Clinton-Mitchell bill will overturn and 
override dozens of State laws that limit abortions. If Clinton-Mitchell 
goes into effect, State provisions requiring waiting periods, parental 
consent and restrictions on third trimester abortions will be wiped off 
the books.
  One of the most pernicious provisions in the Clinton-Mitchell bill is 
what I call the abortion clinic mandate. Clinton-Mitchell requires 
abortion to be ``uniformly available across the Nation and readily 
accessible within each service region in each State.'' And this means 
that in areas where abortion is not readily accessible, we will be 
forced to construct facilities and train personnel to provide abortion.
  A June 16 survey by the Alan Guttmacher Institute reveals that 51 
percent of metropolitan counties and 94 percent of nonmetropolitan 
counties currently do not have abortion providers. Just so that 
everybody can get a perspective, there are more than 3,000 counties in 
America, and today about 2,600, or 87 percent, have no abortion 
providers. The Clinton-Mitchell bill would require that the Federal 
Government, via the American taxpayers, build these facilities and 
train personnel to perform abortion in at least 2,600 counties across 
America.
  Others may differ on this. But in the name of God, Mr. President, 
this is an outrage. We are talking about a Federal mandate to require 
the establishment of abortion clinics in literally hundreds of 
communities that do not have them now. Whether they are pro-life or 
pro-abortion, most Americans do not want to pay for abortion clinics to 
be built and physicians to be trained in each and every county of 
America, but that is what Clinton-Mitchell requires.
  Now, Mr. President, let us look at the price tag for all of these 
reforms. The Clinton-Mitchell plan for health care reform is so full of 
new entitlements and governmental programs that it has had to propose 
17 new taxes to pay for them. And most of these taxes fall squarely on 
the middle class, the working man and woman.
  There is a tax on all health insurance policies, a tax on 
comprehensive insurance plans, a tax on tobacco three times greater 
than today's 24-cent tax, a tax on handgun ammunition, and a hidden tax 
on all of America's youth. And if 95 percent of all Americans are not 
insured by the year 2000, Clinton-Mitchell would impose a tax on all 
businesses to buy insurance for their employees. There are 11 other new 
or increased taxes, for a total of 17.
  I am particularly outraged about this because North Carolina will be 
the fourth hardest hit State of the Union by these new or increased 
taxes.
  The number crunchers estimate that by the year 2002, Clinton-
Mitchell, if it becomes law, will mean an increase of $1.7 billion in 
additional costs to the businesses of North Carolina alone.
  Is it a coincidence, Mr. President, that the businesses hardest hit 
by these taxes just happen to be located in the South and in the West? 
Businesses in the northeastern States will save money, if Clinton-
Mitchell is enacted. A recent study shows that in States such as Maine, 
Massachusetts, Ohio, Michigan, Illinois, New York, and New Jersey, 
businesses will actually reduce their medical care expenditures.
  One tax particularly bothers me because it unfairly targets a single 
industry. I am talking, of course, about the proposed triple-fold 
increase in the tobacco tax.
  The dramatic increase in the tobacco tax will hit hardest those least 
able to afford it. In other words, the poor will suffer most. You can 
say, ``well, they ought not to smoke,'' and you may be right, but the 
fact remains--the poor will suffer most under this kind of tax.
  The Congressional Budget Office, in a study on the distributional 
effects of an increase in selected Federal excise taxes, found that an 
increase in the tax on tobacco would be the most regressive of all the 
taxes considered.
  CBO went on to explain that the average increase in the tobacco tax 
as a percent of total income would be about three times as large for 
families with incomes between $10,000 and $20,000 when compared to 
families with incomes of $50,000 or more.
  Moreover, it is unfair for Government to single out those who happen 
to smoke to pay for a Government takeover of health care. Professor of 
economics, Robert Tollison, testified before the Senate Finance 
Committee and he said:

       It would be unfair to make smokers and only smokers pay 
     through increased excise taxes for any health care cost that 
     [the Government] may impose by virtue of their chosen 
     lifestyle, and in any event smokers are more than paying 
     their way at current tax levels.

  The Office of Technology Assessment has estimated that smokers cost 
Federal and State and local governments $8.9 billion in health care 
expenditures due to smoking-related illness. But I wonder how many 
Senators are aware that these same smokers already pay more than $13 
billion in excise and sales taxes. What this says is that the smokers 
are already paying $4.4 billion more in taxes than they cost the 
taxpayers.
  Furthermore, I wonder how many people have stopped to think that if 
the tobacco tax is increased to pay for health reform, thousands of 
honest, hardworking Americans will lose their jobs. A 1992 Price 
Waterhouse study estimated that a 45 cent increase in the tobacco tax 
would eliminate a total of 118,000 jobs--51,000 jobs in the tobacco 
sector, and 67,000 more in retail and other related industries.
  Of course, when these people lose their jobs, they will have no 
choice in many cases but to go on unemployment and possibly other 
public assistance programs. And based on the estimates of Professor 
Tollison, unemployed tobacco workers could cost the taxpayers $680 
million a year.
  I've not even mentioned what the increased Federal tax on cigarettes 
will do to State revenues. The Congressional Research Service found 
that reduced cigarette sales, due to higher Federal taxes, will reduce 
State revenues by almost $7 billion a year. And who will make up for 
the lost State revenues? You got it. You and I will, in the form of 
higher State taxes on other goods and services.
  One last point on the tobacco tax, and I will move on because I have 
a few more things to say about the Clinton-Mitchell bill. With so many 
experts yearning to follow health care reforms adopted in other 
countries, I wonder if anybody has given any thought to what happened 
when Canada raised its tobacco tax. For years, the Canadian system 
simply avoided the increased tax by exporting tax-free cigarettes to 
the United States and then smuggling them back into Canada. This way 
they avoided the Canadian tax. The Government of Quebec admits that 
half of the cigarettes consumed there came into Quebec in this manner.
  Tax evasion became par for the course in Canada. Imagine how revenues 
from the tobacco tax must have plummeted from all of those black market 
sales. Finally, in February of this year the Canadian Government wised 
up and it cut its Federal tax on cigarettes by more than a third.
  Let's not repeat Canada's mistake. And for that matter, let's not 
repeat the mistake that Congress made the last time it turned health 
care over to the Government.
  I wonder how many Senators have considered the distinct possibility 
that Congress, right now, is on the verge of repeating a very serious 
mistake. This mistake occurred about 6 years ago.
  Maybe Senators recall the Medicare Catastrophic Coverage Act of 1988. 
I am proud to say that I was one of the 11 Senators who voted against 
this bill. This little jewel, though much more modest in its scope than 
the Clinton-Mitchell proposal, proved to be one of the biggest 
legislative disasters Congress has ever known. It was so bad that there 
was a stampede in this Chamber to repeal it a year later. I do not 
think any Senator voted from his seat. He stood down in the well and 
yelled, ``Repeal it, repeal it.''
  Does anybody remember why we repealed it? Congress realized that 
Government does not always know best. Congress, at least then, realized 
that when the details are fully understood, the American people, not 
politicians, know what is best.
  The Medicare Act of 1988 was rife with bureaucracy. No sooner than 
the ink was dry on this legislation, Senators began to realize the 
monster the Senate had created. Actually implementing the bill proved 
to be much more difficult than anybody had originally assumed. And the 
Catastrophic Coverage Act was an infant compared to the Clinton-
Mitchell bill granddaddy.
  Under the Catastrophic Coverage Act, the Health Care Financing 
Administration was responsible for developing: A new implementation 
plan; a new monitoring and reporting system; a revised computer 
software program to process all of these new claims; a comprehensive 
public information program to insure that everyone understood what the 
new law said, contracts for developing computer software to track new 
Medicare out-of-pocket expense limits; special instructions to the 
States regarding new State mandates to cover low-income individuals, 
and a coordination strategy with the Department of Treasury.
  To meet these complex responsibilities, dozens of new commissions, 
agencies, boards, and offices were created. Does that sound familiar? 
What I have just listed are some of the administrative nightmares that 
are replete in Clinton-Mitchell. Each one of these nightmares comes 
with its own bureaucracy, and Clinton-Mitchell has 170 of them.
  Is there any doubt that if we take the Clinton-Mitchell road to 
health care reform, we will be repeating the very same mistake we made 
back in 1988? Today we have an opportunity to turn away from 
Government-run health care and all of its onerous bureaucracy. Calvin 
Coolidge was an interesting gentleman. I wish I could have known him. 
But I have read so much about him and the things that he said. He used 
to talk about Thomas Jefferson. It's funny how everybody in every 
generation likes to talk about Thomas Jefferson, and I am one of them. 
Thomas Jefferson is one of my heroes. I have book after book about 
Jefferson and Jeffersonian philosophy. But that was true in Calvin 
Coolidge's day as well. One day he said:

       The trouble with us is that we talk about Jefferson, but we 
     do not follow him. Jefferson's theory was that the people 
     should manage their Government, and not be managed by the 
     government, and Jefferson was everlastingly right.

  I believe that, and I believe most Americans do too. Would it not be 
nice again to have a President that refers to Jeffersonian principles 
and is actually guided by them? Certainly, the people should manage 
their Government and not be managed by their Government. And it follows 
that the people, not Federal bureaucrats, should manage health care.
  Congress has a golden opportunity to improve our health care system. 
Let us not choose the road to higher taxes, greater bureaucracy, and 
more bureaucratic controls--and certainly not the road to socialized 
medicine. For two generations, Congress has traveled that road to 
oblivion. This time, let us take ``the road less traveled,'' as Robert 
Frost cautioned us. And as Robert Frost further said, that will make 
``all the difference,'' because the American people will be spared the 
trials and the tribulations of socialized medicine.
  When we gave that fine old gentleman named Mose that antique hearing 
aid more than 60 years ago in the office of the Monroe Journal, he 
pondered that it helped his hearing, but as he put it, ``it don't help 
my understanding none.''
  This time I sincerely believe that the American people are listening 
and hearing more and understanding more, and the latter is the most 
important. If the American people have their way, they will not permit 
Congress to force them into buying a pig-in-a-poke or, for that matter, 
socialized medicine.
  I thank the Chair. I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDENT pro tempore. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. PRESSLER. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDENT pro tempore. Without objection, it is so ordered.
  Mr. PRESSLER. Mr. President, I ask unanimous consent to proceed for 5 
minutes as in morning business.
  The PRESIDENT pro tempore. Without objection, it is so ordered.

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