[Congressional Record Volume 141, Number 71 (Tuesday, May 2, 1995)]
[Senate]
[Pages S5931-S5941]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          COMMONSENSE PRODUCT LIABIL- ITY AND LEGAL REFORM ACT

  The PRESIDENT pro tempore. Under the previous order, the Senate will 
resume consideration of H.R. 956, the product liability bill, which the 
clerk will report.
  The legislative clerk read as follows:

       A bill (H.R. 956) to establish legal standards and 
     procedures for product liability litigation, and for other 
     purposes.

  The Senate resumed consideration of the bill.

       Pending:
       (1) Gorton amendment No. 596, in the nature of a 
     substitute.
       (2) McConnell amendment No. 603 (to amendment No. 596) to 
     reform the health care liability system and improve health 
     care quality through the establishment of quality assurance 
     programs.
       (3) Thomas amendment No. 604 (to amendment No. 603) to 
     provide for the consideration of health care liability claims 
     relating to certain obstetric services.
       (4) Wellstone amendment No. 605 (to amendment No. 603) to 
     revise provisions regarding reports on medical malpractice 
     data and access to certain information.
       (5) Snowe amendment No. 608 (to amendment No. 603) to limit 
     the amount of punitive damages that may be awarded in a 
     health care liability action.
       (6) Kyl amendment No. 609 (to amendment No. 603) to provide 
     for full compensation for noneconomic losses in civil 
     actions.
       (7) Kyl amendment No. 611 (to amendment No. 603) to place a 
     limitation of $500,000 on noneconomic damages that are 
     awarded to compensate a claimant for pain, suffering, 
     emotional distress, and other related injuries.
       (8) DeWine amendment No. 612 (to amendment No. 603) to 
     clarify that the provisions of this title do not apply to 
     action involving sexual abuse.
       (9) Hatch amendment No. 613 (to amendment No. 603) to 
     permit the Attorney General to award grants for establishing 
     or maintaining alternative dispute resolution mechanisms.
       (10) Simon/Wellstone amendment No. 614 (to amendment No. 
     603) to clarify the preemption of State laws.
       (11) Kennedy amendment No. 607 (to amendment No. 603) in 
     the nature of a substitute.
       (12) Kennedy amendment No. 615 (to amendment No. 603) to 
     clarify the preemption of State laws.
       (13) DeWine (for Dodd) amendment No. 616 (to amendment No. 
     603) to provide for uniform standards for the awarding of 
     punitive damages.

  Mr. GORTON. Mr. President, we are now under a time agreement of 1 
hour for the final debate on all of the second-degree amendments to the 
McConnell amendment on medical malpractice.
  Seeing no Senator prepared to debate, I suggest the absence of a 
quorum and ask unanimous consent that it be charged equally against 
both sides.
  The PRESIDING OFFICER (Mr. Santorum). Without objection, it is so 
ordered. The clerk will call the roll.
   [[Page S5932]] The legislative clerk proceeded to call the roll.
  Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ROCKEFELLER. I thank the Chair.
  Mr. President, as a chief advocate and sponsor and manager of the 
product liability reform bill, which, as far as I know, is still being 
debated on the floor, I want to comment on the situation on the floor 
as I see it now.
  From just about every corner of the Senate floor, an amendment of 
some kind dealing with malpractice--not product liability, but 
malpractice--has been offered. So much so, in fact, that we now have 12 
amendments on malpractice in the pipeline. I am hoping that the Senate 
will not have to vote on 12 amendments, and I hope indeed some of them 
can be worked out, dropped, or whatever.
  As I also said on Thursday when I last spoke, I share my colleagues' 
interest in malpractice reform. In fact, I daresay that I more than 
share my colleagues' interest on this subject. To me, it is part of the 
problem with our health care system. It is intimately related to cost 
and psychology and whether doctors' kids or anyone's children want to 
go into medicine or not. And malpractice reform is something I want 
very much to do. But I do not want to do it at the risk of killing 
product liability reform. It is as simple as that.
  I think if we were to adopt malpractice reform in conflict, not only 
would it fail, but so would product liability. So in the interest of 
bringing malpractice reform into the discussion, everything would lose. 
We can win product liability on a clean bill, which Senator Gorton and 
I want. But we cannot win product liability if there are substantial or 
unsubstantial amendments attached to it, and malpractice reform is a 
very substantial amendment. We cannot win both.
  As I said, I think at some point Senators have to choose: Do they 
want product liability reform? Do they want medical malpractice reform? 
Do they want nothing? Of course, there are many who want nothing.
  I just do not see 12 amendments on medical malpractice to a product 
liability reform bill as the way to produce actual results, results 
which will be signed into law. It may make a lot of people feel good to 
offer their own iterations on medical malpractice to this bill. We have 
had some terrific speeches.
  As somebody trying to enact something called a product liability bill 
for the last 9 years, it just does not make me feel very confident that 
this is the route to actually enacting either product liability reform 
or medical malpractice reform.
  I repeat, I hope my colleagues understand this: If malpractice reform 
were to pass, and I do not think it will, if it were to pass and become 
part of the product liability bill, the product liability bill would 
lose. It is 100 percent guaranteed it would lose. So we would lose 
malpractice and we would lose product liability.
  I do not understand that. I do not understand that. I think 
malpractice reform ought to be pursued just the way a bipartisan team 
of Senators have tried to enact this product liability reform bill. It 
ought to be done in the same manner--separately. That is, by getting a 
bill reported out of committee, onto the Senate Calendar, having the 
majority leader call it up, debating it on its own terms and with the 
time needed to work out any differences and issues that can be resolved 
here in the Senate.
  Trying to enact malpractice reform by amending a product liability 
reform bill with enough issues of its own, for Heaven's sakes, just 
does not make sense to me. Maybe I will be proven wrong. I think the 
chances of that are almost zero percent. Maybe some kind of consensus 
will emerge around here on what form of malpractice reform should be 
attached to the product liability reform bill and we will suddenly have 
about 70 votes for a bill with both.
  That was the original conversation, because of the surge of that 
nature in the House. People said malpractice will help products. That 
is what Jim Todd with the American Medical Association said to me and 
Dick Davidson of the American Hospital Association, and Tom Scully of 
the Federation of American Health Systems. They all said that to me; it 
will help.
  All of the product liability alliance folks who surged in the House 
make the same assumption about the Senate. We are just very different. 
We are a very different body. It will not work here. This talk about 
getting 70 votes for a bill with both--I am highly skeptical.
  As somebody who has worked very hard, as have Senator Gorton and many 
others here, on trying to enact product liability reform, I want to 
send a very clear signal to the Senators and to the citizens who also 
want to see a law enacted to achieve this result, this is no time for 
loading up this bill--neither now with these malpractice amendments nor 
after they have been disposed of. After they have been disposed of, 
there will be a chance for more amendments. Then there will also be not 
the time to load up the bill.
  This is no time for amendment proliferation. This is no time to use 
this bill to make speeches on other issues to try to satisfy other 
interests, to try to feel good about writing amendments on other 
priorities, like malpractice reform.
  This is the time to focus on the job at hand, and it is called 
product liability. We have a large, good group of Senators on both 
sides of the aisle who are prepared to vote for product liability 
reform, one of the most contentious issues that we face in any year in 
which we take this subject up, which is every other year. Up until this 
time we have lost every single year. We have lost nefariously, we have 
lost flat out, we have just sort of lost, but we have lost. It has 
always been close.
  The majority of the Senate has always wanted product liability, but 
we have just fallen short, for one reason or another, of cloture. This 
year we can get it. This year we can do cloture and we can get a 
product liability bill which, in turn, will put the opposition in 
substantial disarray, and then we can move on to other aspects like 
malpractice reform, securities, that kind of thing, all of which I 
strongly favor, particularly malpractice.
  So, again, this is the time to focus on the job at hand. I think that 
malpractice reform, in fact, is such a serious subject that it deserves 
far more attention than it has gotten. It deserves far more debate than 
it has gotten.
  I am not convinced that there are 10 percent of the Senators who will 
vote on these amendments who understand what malpractice reform is all 
about. I do not mean that to insult any of my colleagues, but just as I 
think product liability reform is extremely complicated--particularly 
for nonlawyers such as myself--malpractice becomes more so because we 
are dealing with humans in a different way. It is a hard subject that 
deserves a very serious effort, but not on this bill.
  Again, and in concluding, I am more than anxious to take up a bill on 
malpractice reform. I understand the urgency and the voices of the 
doctors and the health care institutions in my State of West Virginia 
and elsewhere. It is not right that it has to take so long to do 
something about problems with malpractice. It is the No. 1 subject on 
the minds of physicians, the No. 1 subject on the minds of hospitals. 
They desperately want it.
  It also is not right to pretend that we can act on malpractice reform 
when trying to enact a serious piece of legislation on a different 
issue, which is called product liability.
  My hope is that we simply will concentrate on product liability, that 
we will try to keep away amendments, that we will drive this thing 
through to a conclusion and get one excellent piece of work done.
  I thank the Chair. I yield the floor. Mr. President, I suggest the 
absence of a quorum and ask the time be divided equally between the 
opponents and the proponents.
  The PRESIDING OFFICER. Without objection, it is so ordered. The clerk 
will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. GORTON. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
   [[Page S5933]] Mr. GORTON. Mr. President, I yield 6 minutes to the 
Senator from Connecticut.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. LIEBERMAN. Mr. President, we spent, now, 2 full days debating 
this underlying medical malpractice amendment and numerous second-
degree amendments. I am privileged to be a cosponsor of the underlying 
first-degree amendment with the Senator from Kentucky, [Mr. McConnell] 
and the Senator from Kansas [Mrs. Kassebaum]. I would like to take a 
few moments here to put this debate and the amendment in perspective.
  Surprisingly, to my knowledge this is the first time the full Senate 
has engaged in a real debate on medical malpractice reform, even though 
this issue has been the subject of countless debates in State 
legislatures throughout America going back to the 1970's, when I was 
part of the State Legislature of Connecticut. I am pleased the issue 
and the problem has finally come to this point, and I want to express 
my admiration to my colleagues on both sides of this issue for the 
thoughtful remarks they have made over the last days.
  We have heard a variety of views expressed, of course, but I am 
pleased to note there is broad agreement that our present system for 
compensating patients who have been injured by medical malpractice is 
ineffective, inefficient, and in many respects unfair. The system 
promotes the overuse of medical tests and procedures and simply diverts 
too much money away from victims. I know we have heard a lot of numbers 
in the past couple of days, but to me the most important one is this: 
Less than half of the money spent on medical malpractice in this 
country goes to the victims of malpractice. Less than 50 cents of every 
dollar that goes into the medical malpractice system in this country 
goes to those who are injured as a result of malpractice.
  So the aim of the amendment is not to protect doctors who are guilty 
or health professionals who are guilty of negligence that injures 
patients. Quite the contrary, the aim of the amendment is to make sure 
that more, rather than less than half a dollar of every dollar that 
goes into this system, goes to the patients who are injured and not to 
those, including the attorneys, who are churning, moving the current 
system.
  We can argue about the numbers, obviously, but I hope most of my 
colleagues will agree that the existing medical malpractice system does 
contribute to the high cost of health care. The cost of liability 
insurance has been estimated, the most recent number I could find, at 
$9 billion in 1992. That is not money that just comes out of the air or 
is printed by the Government; that is money that comes from everybody 
who is paying premiums for insurance for health care.
  The respected health care consulting firm Lewin-VHI has estimated 
conservatively the cost of defensive medicine--this is beyond the $9 
billion in premiums--but the cost of defensive medicine, which is to 
say medicine practiced by health professionals not for what they take 
to be the medical needs of their patients but defensively because they 
are worried about lawsuits, is $25 billion a year. Again, that is $25 
billion coming out of the pockets of everybody who is paying health 
care costs.
  That number may seem to some who look at the big picture of health 
care spending somehow small. If it does, they have perhaps lost touch 
with reality, because $25 billion is a lot of money. It is not small in 
any sense. We can and should do something to reduce that number.
  Taxpayers and health care consumers bear the financial burden of 
those costs. I say taxpayers because we are paying for it in Medicare 
and Medicaid and every other Government-supported health care program. 
Tens of billions of dollars every year is not a trivial amount of money 
to taxpayers and consumers in this country.
  The underlying amendment we will vote on today will begin to address 
the inefficiencies and perverse effect of our current malpractice 
system by directing a greater proportion of malpractice awards to 
victims, by discouraging frivolous lawsuits, and by enhancing programs 
that are aimed at improving the quality of medical practice, which is 
what this is all about.
  The amendment will also improve consumer information, a key part of 
preventing malpractice, by establishing an advisory panel to improve 
quality assurance programs and consumer information. The panel will 
also look at ways to strengthen the national practitioner data bank. My 
colleague, Senator Wellstone, has offered an amendment that would open 
the data bank without this review. I respectfully suggest that this 
amendment goes too far too quickly, though I am sympathetic to the 
goal.
  I believe the underlying amendment sponsored by Senators McConnell, 
Kassebaum, and myself will lead us appropriately down the path but will 
do it with some also appropriate caution.
  Mr. President, the underlying amendment is not new. It is not 
radical. It is a very moderate proposal which contains provisions from 
health care reform bills reported out of committees during the last 
Congress with the exception of the statute of limitations.
  With the exception of the statute of limitations, the 2-year time 
limit does not include a statute of repose and a cap on punitive 
damages which is identical to the cap in the underlying product 
liability bill. Every provision in the pending first-degree amendment 
was contained either in President Clinton's health care reform 
proposal, the bill reported out of the Senate Labor Committee, or the 
bill reported out of the Senate Finance Committee last year.
  I agree with my colleagues who have argued that medical liability 
reform is only a small part of health care reform. But it is a 
substantial and important beginning. As both Democrats and Republicans 
concluded last year, malpractice reform is an important part of health 
care reform. Today we have an opportunity to take a modest and 
reasonable proconsumer step forward on this problem.
  I thank the Chair. I thank my colleagues, and I urge them to vote for 
the underlying amendment.
  I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  Mr. GORTON. Mr. President, I yield 5 minutes to the Senator from 
Kentucky.
  The PRESIDING OFFICER. The Senator from Kentucky is recognized.
  Mr. McCONNELL. Mr. President, the opponents of this medical 
malpractice amendment have wildly attacked it. But, this amendment is 
very reasonable and moderate reform. In fact, if you compare it to some 
of the proposals from last year's health care debate, you will see many 
familiar provisions.
  For example, the original Clinton Health Security Act contained a cap 
on attorney contingent fees, collateral source reform, periodic payment 
of damages, and mandatory alternative dispute resolution. The medical 
malpractice provisions reported from the Finance Committee contained 
joint and several liability reform, a cap on noneconomic damages, and 
mandatory alternative dispute resolution with modified loser-pays for 
those who go onto court and do not improve upon the ADR decision. By 
omitting the cap on pain and suffering, this amendment does not go as 
far as the Finance Committee's proposals which were reported out of the 
committee, on a bipartisan basis.
  During last year's health care debate, some argued for the Canadian 
single-payer system. Canada's single-payer system also includes some 
very strict rules on malpractice cases. While Canada's doctors do not 
pay malpractice insurance premiums, they pay a membership fee to the 
Canadian Medical Protective Association. In the United States, doctors 
and hospitals buy malpractice insurance, costing tens of thousands of 
dollars annually. And, according to the Medical Liability Monitor, more 
than half of all doctors have experienced 9- to 15-percent increases in 
their malpractice premiums in each of 1993 and 1994.
  In Canada, noneconomic damages are capped at $240,000. The McConnell-
Lieberman-Kassebaum amendment does not cap noneconomic damages, 
although Senator Kyl has an amendment pending to add a cap of $500,000.
  In Canada, contingency fees are illegal in some parts of the country 
and uncommon in the rest of the country. 
[[Page S5934]] Our amendment sets a limit on attorney contingent fees, 
to ensure that most of the award goes to the injured party.
  In Canada, a plaintiff who loses, risks having to pay the defendant's 
legal fees. This amendment contains no loser-pays provision.
  So, Mr. President, in comparing this amendment to last year's efforts 
on medical malpractice, as well as to Canada's law, we have very 
moderate reform proposed here.
  And, those who support product liability reform should support 
medical malpractice reform. Enacting the underlying bill on its own 
will, in my judgment, make the legal system more complex. What will 
happen in a case where the injured party alleges malpractice over 
certain drug treatment? It product liability reform is enacted, the 
drug company will fall under the new law, but there will have to be a 
separate lawsuit regarding the conduct of the doctor or hospital. Such 
a result would be ridiculous.
  The opponents assert that we are somehow trying to shield negligent 
doctors and hospitals. Nothing could be further from the truth. No one 
loses the right to sue under this amendment. An injured party will be 
fully compensated for his or her injuries. Negligent doctors and 
hospitals will be held accountable for the injuries they cause.
  In addition, this amendment takes important steps in the direction of 
assuring quality care for all patients.
  While protecting the rights of the injured to get compensation for 
their injuries, this amendment also gives the American people relief 
from the tort tax. We know the litigation tax adds thousands of dollars 
annually to the household budgets of all American families. It adds 
extra costs to the delivery of a baby, as well as to the cost of a 
heart pacemaker.
  Relief from the tort tax and an end to the lawsuit gamble are the 
goals of our effort. We know that most of the money spent in the 
litigation system does not go to the injured victims; they get only 43 
cents of every dollar spent in the liability system. The legal system 
is akin to the casinos of Las Vegas and Atlantic City. Sometimes you 
win big, but most times the house--that is the system, made up of 
lawyers and related court costs, is the biggest winner.
  The only opponents we have in this legal reform fight are the trial 
lawyers. They have the biggest stake in maintaining the status quo. The 
injured people they represent will be treated better under this 
amendment. They will get more compensation for their injuries. So, if 
you are for the victims, you should vote for this amendment. I urge my 
colleagues to adopt the McConnell-Lieberman-Kassebaum amendment.
  I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  Mr. ROCKEFELLER. Mr. President, I yield 7 minutes to the Senator from 
California.
  The PRESIDING OFFICER. The Senator from California is recognized for 
7 minutes.
  Mrs. BOXER. Mr. President, I thank the Senator for yielding because I 
know he and I do not agree on this issue. So it must be in some ways a 
painful thing for him to yield to me. So I want to say to my friend, 
Senator Rockefeller, I thank him very much for yielding me this time.
  Mr. President, what are we doing here in the Senate today? We are 
voting, beginning to vote, to change a legal system that, while not 
perfect, is adjudged to be the best in the world. We are not tinkering 
around the edges. We are not dealing with frivolous lawsuits. We are in 
essence, if you follow the Contract With America, taking away the 
rights of average citizens to get justice in the courtroom. And what I 
find most remarkable about this in this Republican Congress is that 
this is the same Republican Congress that says let the States decide 
most matters, they are closer to the people. But in this case, the U.S. 
Senate and the House of Representatives, well, we are going to 
substitute our judgment for that of a local jury, a local judge, who 
knows the community, who is of, by, and from the community. I do not 
think we should be able to prejudge what a damage award should be, 
whether it is in a medical malpractice case or whether it is in a 
product liability case, the underlying bill.
  Let me give you an example. Most Americans were stunned to hear that 
a physician in Florida in treating a gentleman actually cut off the 
wrong leg of that man. It meant that they had to then cut off the other 
leg and the man lost both legs.
  In the debate on this subject of capping the damages and what people 
could receive in medical malpractice cases, a Republican Congressman--
who happens to be a doctor--took to the floor of the House. He has 
served there for many years. And this Congressman was asked by another 
colleague, a Democratic colleague, ``What do you think about the fact 
that a physician cut off the wrong leg of a victim, and now this 
gentleman has no legs at all?''
 He can never hope to have anything like a normal life. And this 
Republican doctor-Congressman said mistakes happen. These things 
happen. And then he was asked, what is it worth, the fact that a man 
has no legs and can never have the semblance of an ordinary life again? 
And he said, mistakes will happen.

  Well, he does not know what it is worth.
  These things happen.
  The fact is we do not know, but a jury and a judge together will make 
that decision in accordance with State law. But, no, we are going to 
destroy all of this.
  Now, the story which all America shared, unfortunately, is not that 
isolated. Although we know we have the best doctors in the world, the 
most healing doctors in the world, this is not isolated. It is a very 
small percent. Of all tort cases filed, only 7 percent are medical 
malpractice. But we are going to take the iron fist of the Senate and 
say we know best what a future victim should be awarded.
  Now, let me tell you about a couple of cases. You also probably read 
about Betsy Lehman, who died after given a massive overdose of a strong 
chemotherapy drug. That story was publicized by the Boston Globe. Are 
we to tell the family of this young woman what the damages should be to 
that family? I think not.
  How about Grand Rapids, MI? The wrong breast of a 69-year-old cancer 
patient was negligently cut off during a mastectomy. In Denver, CO, an 
anesthesiologist fell asleep during a routine operation on an 8-year-
old boy. The child died, and we are going to tell the people in 
Colorado what that family should be awarded. I think there is something 
misguided going on here.
  I have to believe there is some special interests that are involved 
here because the interests of the American people are not being served 
because we are all potential victims. We are all potential victims.
  At the New England Medical Center, two skin cancer patients died when 
a highly toxic drug called Cisplatin was given to them at three times 
the recommended dosage. In California, my great State, Harry Jordan 
went into the hospital to have a diseased kidney removed. Instead, the 
surgeons removed his healthy kidney, and he remained on dialysis for 
the rest of his life. He died last month, and we are going to tell the 
jury and the judge what to do in this kind of case.
  We could go on with examples. The fact is we have the safest products 
in the world, and we have the best physicians in the world. I have to 
believe that our system of justice, although not perfect, has played a 
role in this. And I say often to myself--and this has to do with the 
underlying bill on product safety--how many of us remember engines 
exploding in cars?
  The PRESIDING OFFICER. The time of the Senator from California has 
expired.
  Mrs. BOXER. I ask for 1 more minute, if I might.
  The PRESIDING OFFICER. The Senator from Washington controls the time.
  Mr. GORTON. I will yield a minute to the Senator.
  Mrs. BOXER. I thank the Senator so much. I say to my friends, I know 
these are arguments they do not enjoy hearing, and I therefore 
appreciate the generosity.
  We all remember engines of cars exploding, company executives saying, 
``Well, we figured we would have a few explosions. We write it off as a 
cost of 
[[Page S5935]]  doing business.'' This Senate wants to limit the 
punitive damages to those future companies that would act in such a 
despicable fashion. Most of our companies are good and most of them 
care, but the bad apples should know they will be hit with punitive 
damages, not just a slap on the wrist. Should this Republican contract 
pass, the most change will occur in the boardroom--not in the 
courtroom, in the boardroom--as people are getting ready to put new 
products on the market saying, well, we do not have to worry; the 
Senate, the Republican contract saved us from being hit with a 
meaningful punitive damages suit.
  So in closing, Mr. President, I wish to again thank my colleagues. I 
will be supporting some of these amendments that are coming before us 
because they will make the bill a little better. I will be opposing 
others. But nothing that we do here by way of amendment convinces me 
that we are on the right path.
  I thank the Chair. I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington has 6 minutes 
remaining.
  Mr. GORTON. Mr. President, among other things, the distinguished 
Senator from California spoke about special interests. I find that 
remarkable in light of an article which appeared a couple of weeks ago 
in the Wall Street Journal, and a followup report on campaign 
contributions to congressional candidates which shows that the largest 
single special interest involved in campaigns for Congress is the 
American Trial Lawyers Association and its members. In their 
contributions, they outdo the Fortune 500; they outdo organized labor; 
they outdo, multiplied by 4 or 5 times, oil and gas lobbyists' 
contributions. They are, by a significant margin, the No. 1 special 
interest from the point of view of contributions to political campaigns 
in the United States.
  Now, Mr. President, I do not normally argue this point of view. I am 
inclined to think that most of these lobbying organizations support the 
people who are already on their sides. But to attack the legislation as 
being special interest legislation, when the opponents are supported by 
the largest of all of the special interests, seems to me somewhat 
paradoxical.
  Mrs. BOXER. Will the Senator yield? Will the Senator yield to me on 
that point?
  Mr. GORTON. This is particularly true----
  Mrs. BOXER. Will the Senator yield to me on that point?
  Mr. GORTON. No, not right now.
  Mrs. BOXER. I will wait, thanks.
  Mr. GORTON. This is particularly true, Mr. President, when we reflect 
on the fact that it is that special interest which is the greatest 
beneficiary of the present system as, of all of the money that goes 
into medical malpractice, only 40 percent gets to the victims and 60 
percent goes to the transactions costs; that is to say, the attorneys, 
the expert witnesses, the insurance adjusters and the like who involve 
themselves in the question.
  The greatest amount of money by far goes not to victims but to 
transaction costs.
  In my view, that is the great scandal of the present system, whether 
we are dealing with medical malpractice or with product liability. The 
costs of the system outside of the compensation provided for any of the 
parties is so overwhelmingly on one side that I think it would be those 
who speak about victims and victims' rights who would be most in favor 
of a dramatic and drastic reform of the present system, most in favor 
of it, to create a system in which the transaction costs, the lawyer's 
fees were dramatically less, and a much greater percentage went to 
those who were victims.
  I will be perfectly happy to yield to the Senator from California for 
a question.
  Mrs. BOXER. I thank the Senator very much.
  Is the Senator aware that well over 100 organizations, including some 
from his State, oppose this underlying bill very, very strongly? 
Because I think what the Senator is doing in his remarks is leading 
people to believe that there is one group that is opposed to it.
  I read into the Record a number of groups the last time. Every single 
consumer organization you can name, both State based and nationally 
based: citizen action groups, public interest law people, Coalition of 
Silicon Survivors, and Colorado DES Action. The DES sons also oppose 
certain liability reforms.
  What I wish to point out to my friend is I really respect his right 
to disagree----
  Mr. GORTON. I understand the question now.
  Mrs. BOXER. I ask unanimous consent to put this list of people who 
oppose this bill into the Record at this time, and I thank my friend 
for yielding.
  There being no objection, the list was ordered to be printed in the 
Record, as follows:

State Based Organizations Opposed to ``Legal Reform'' in the Senate (S. 
                                  565)

       Alabama Citizen Action.
       Alaska PIRG.
       Arizona Consumers Council.
       Arizona Citizen Action.
       Consumer Federation of California.
       California Citizen Action.
       Center for Public Interest Law at the University of San 
     Diego.
       California Motor Voters.
       California Crime Victims Legal Clinic.
       California Public Interest Research Group (CALPIRG).
       Fair Housing Council of San Gabriel Valley.
       Colorado Coalition for Accountability & Justice.
       Colorado Steelworkers Union Local 2102.
       Coalition of Silicon Survivors.
       Colorado DES Action.
       Denver UAW.
       Colorado ACLU.
       Denver Gray Panthers.
       Colorado Public Interest Research Group (CoPIRG).
       Colorado Clean Water Action.
       Colorado Senior Lobby.
       Connecticut Citizen Action Group.
       ConnPIRG (Connecticut Public Interest Research Group).
       Delaware Coalition for Accountability and Justice.
       Delaware AARP.
       Delaware Council of Senior Citizens.
       Delaware AFL-CIO.
       Delaware Federation of Women's Clubs.
       Delaware Women and Wellness.
       Delaware Breast Cancer Coalition.
       Building Trades Council of Delaware.
       UAW Local 1183--Delaware.
       Delaware Sierra Club.
       Delaware Audubon Society.
       Save the Wetlands and Bays--Delaware.
       Florida Consumer Action Network.
       Florida PIRG.
       Florida Consumer Fraud Watch.
       Georgia Citizen Action.
       Georgia Consumer Center.
       Citizen Advocacy Center of Illinois.
       Chicago & Central States ACTWU.
       Idaho Citizens Action Network.
       Idaho Consumer Affairs, Inc.
       Illinois Public Action.
       Illinois Council Against Handgun Violence.
       Illinois PIRG.
       Citizens Action Coalition of Indiana.
       Iowa Citizen Action Network.
       Iowa UAW.
       Iowa State Council of Senior Citizens.
       Kentucky Citizen Action.
       Louisiana Citizen Action.
       Maine People's Alliance.
       Maryland Citizen Action.
       Maryland State Teachers Association.
       Maryland Coalition for Accountability & Justice.
       Planned Parenthood of Maryland.
       Law Foundation of Prince George's County.
       Maryland PIRG.
       Maryland Sierra Club.
       Teamsters Joint Council No. 62.
       UFCW Local 400.
       White Lung Association & National Asbestos Victims.
       Sexual Assault/Domestic Violence Center, Inc.
       IBEW Local 24.
       Maryland Clean Water Action.
       Maryland Employment Lawyers Association.
       Health Education Resource Organization (H.E.R.O.).
       Environmental Action Foundation.
       Massachusetts Jobs with Justice.
       Massachusetts Consumer Association.
       Massachusetts Citizen Action.
       MassPIRG (Massachusetts Public Interest Research Group).
       Michigan Consumer Federation.
       Michigan Citizen Action.
       Public Interest Research Group in Michigan (PIRGIM).
       Minnesota COACT.
       Minnesotans for Safe Foods.
       Missouri Citizen Action.
       Missouri PIRG.
       Montana PIRG.
       Nebraska Citizen Action.
       Nebraska Coalition for Accountability & Justice.
       Nebraska Farmers Union.
       Nebraska Women's Political Network.
       Nebraska National Organization for Women.
       United Rubber Workers of America, Local 286.
       Communications Workers of America, Local 7470.
       Nebraska Head Injury Association.
       Nebraska Center for Rural Affairs.
       [[Page S5936]] New Hampshire Citizen Action.
       New Jersey Citizen Action.
       White Lung Association of New Jersey.
       New Jersey Tenants Organization.
       Consumers League of New Jersey.
       Cornucopia Network of New Jersey.
       New Jersey DES Action.
       NJPIRG (New Jersey Public Interest Research Group).
       New Jersey Environmental Federation.
       New Mexico Citizen Action.
       Citizen Action of New York.
       Essex West Hudson Labor Council.
       Uniformed Firefighters Association of Greater New York.
       Empire State Consumer Association.
       New York Consumer Assembly.
       Niagara Consumer Association.
       North Carolina Citizen Action.
       North Carolina Consumers Council.
       North Dakota Coalition for Accountability & Justice.
       North Dakota Public Employees Association.
       North Dakota DES Action.
       North Dakota Clean Water Action.
       Dakota Center for Independent Living.
       North Dakota Breast Implant Coalition.
       North Dakota Progressive Coalition.
       Laborer's International Union, Local 580.
       Boilermaker's Local 647.
       Ironworkers Local 793.
       United Transportation Union.
       Sierra Club, Agassiz Basin Group.
       Plumbers & Pipefitters Local 338.
       United Church of Christ.
       Teamsters Local 116.
       Teamsters Local 123.
       Plumbers & Pipefitters, Local 795.
       Workers Against Inhumane Treatment.
       Ohio Citizen Action.
       Ohio Consumer League.
       Ohio PIRG.
       Oregon Fair Share.
       Oregon Consumer League.
       Oregon State Public Interest Research Group (OSPIRG).
       Pennsylvania Citizens Consumer Council.
       Pennsylvania Institute for Community Services.
       Victims Against Lethal Valves (V.A.L.V.).
       Citizen Action of Pennsylvania.
       Pennsylvania DES Action.
       Pennsylvania AFL-CIO.
       SmokeFree Pennsylvania.
       PennPIRG (Pennsylvania Public Interest Research Group).
       South Dakota Coalition for Accountability & Justice.
       South Dakota AFSCME.
       East River Group Sierra Club.
       Black Hills Group Sierra Club.
       South Dakota State University.
       IBEW, Local 426.
       South Dakota DES Action.
       South Dakota Peace & Justice Center.
       Native American Women's Health & Education Center.
       Native American Women's Reproductive Rights Coalition.
       South Dakota AFL-CIO.
       UFCW Local 304A.
       Yankton Sioux Tribe.
       South Dakota Coalition Against Domestic Violence.
       South Dakota Advocacy Network.
       South Dakota United Transportation Union.
       South Dakota United Paperworkers International Union.
       Tennessee Citizen Action.
       Texas Citizen Action.
       Texas Alliance for Human Needs.
       Texas Public Citizen.
       Defenders of the Rights of Texans.
       Vermont PIRG.
       Virginia National Organization for Women.
       Virginia Citizen Action.
       Virginia Citizens Consumer Council.
       Washington Citizen Action.
       WASHPIRG (Washington Public Interest Research Group).
       West Virginia Citizen Action Group.
       Wisconsin Consumers League.
       Wisconsin PIRG.
       Wisconsin Citizen Action.
       Center for Public Representation, Inc.
                                                                    ____


    Organizations Opposed to ``Legal Reform'' in the Senate (S. 565)

                       (95 as of April 24, 1995)

       Action on Smoking & Health.
       AIDS Action Council.
       Alliance Against Intoxicated Motorists.
       Alliance for Justice.
       American Association of Retired People (AARP).
       American Bar Association.
       American Coalition for Abuse Awareness.
       American Council on Consumer Awareness.
       American Fed. of Labor/Congress of Industrial Organizations 
     (AFL-CIO).
       American Public Health Association.
       Americans for Democratic Action.
       Americans for Non-Smokers' Rights.
       Arab American Anti-Discrimination Committee.
       Association of Trial Lawyers of America.
       Center for Public Interest Research.
       Business and Professional Women.
       Center for Women's Policy Studies.
       Children NOW.
       Citizen Action.
       Citizen Advocacy Center.
       Citizens Clearinghouse for Hazardous Waste.
       Clean Water Action.
       Coalition for Consumer Rights.
       Coalition of Labor Union Women.
       Coalition to Stop Gun Violence.
       Command Trust Network.
       Committee for Children.
       Conference of Chief Justices.
       Consumer Action.
       Consumer Federation of America.
       Consumers for Civil Justice.
       Consumer Protection Association.
       Consumers Union.
       Democratic Processes Center.
       DES Action USA.
       Families Advocating Injury Reduction (FAIR).
       Federation of Organizations for Professional Women.
       Fund for a Feminist Majority.
       Gray Panthers.
       Handgun Control Inc.
       Help Us Regain the Children (HURT).
       Hollywood Women's Political Committee.
       Intl. Assn. of Machinists & Aerospace Workers (IAM).
       Intl. Brotherhood of Teamsters.
       Intl. Ladies Garment Workers Union.
       Intl. Longshoremen's & Warehousemen Union.
       Institute for Injury Reduction.
       Lambda Legal Defense & Education Fund.
       Latino Civil Rights Task Force.
       Mothers Against Sexual Abuse.
       Motor Voters.
       NAACP (Natl. Assn. for the Advancement of Colored People).
       Natl. Asbestos Victims Legal Action Organizing Committee.
       Natl. Association of School Psychologists.
       Natl. Breast Implant Coalition.
       Natl. Conference of State Legislatures.
       Natl. Consumers League.
       Natl. Council of Jewish Women.
       Natl. Council of Senior Citizens.
       Natl. Fair Housing Coalition.
       Natl. Family Farm Coalition.
       Natl. Farmers Union.
       Natl. Gay & Lesbian Task Force.
       Natl. Head Injury Foundation.
       Natl. Hispanic Council on Aging.
       Natl. Minority AIDS Council.
       Natl. Organization on Disability.
       Natl. Rainbow Coalition.
       Natl. Women's Health Network.
       Natl. Women's Law Center.
       Native American Rights Fund.
       Network for Environmental & Economic Responsibility.
       NOW Legal Defense & Education Fund.
       Nuclear Information and Resource Service.
       People's Medical Society.
       Prevention First.
       Public Citizen.
       Public Voice for Food & Health Policy.
       Purple Ribbon Project.
       Safety Attorney Federation.
       Southern Christian Leadership Conference.
       STOP (Safe Tables Our Priority).
       The Sierra Club.
       Third Generation Network.
       Trauma Foundation.
       UAW (United Automobile, Aerospace & Agric. Imp. Workers of 
     America).
       U.S. Public Interest Research Group.
       USWA (United Steelworkers of America).
       Violence Policy Center.
       Voices for Victims Inc.
       Women Against Gun Violence.
       Women's Institute for Freedom of the Press.
       Women's Legal Defense Fund.
       YWCA (Young Women's Christian Association).
       Youth ALIVE.

  The PRESIDING OFFICER (Mr. Campbell). The Senator from Washington.
  Mr. GORTON. Mr. President, yes, the Senator from Washington is quite 
aware of that list of organizations. Of course, there are all kinds of 
organizations that are on both sides of this case. The point made by 
the Senator from Washington was that overwhelmingly of these special 
interests, the largest single special interest in the United States, 
when one measures that influence by the amount of money put into the 
political system, is ATLA, the trial lawyers.
  This is not surprising, given the fact that they are the principal 
beneficiaries to a considerably larger degree than the very victims 
whom they claim to be representing. That is the point from the 
perspective of organizations. The biggest special interest, the richest 
special interest, the special interest that gives the greatest amount 
of money leads the opposition to this view and contributes to many of 
the other organizations which are opposed to it.
  But that does not, as this Senator said, necessarily mean that they 
are wrong or that the other side is right. When, however, we have a 
system which hurts innovation, destroys American competitiveness in 
some industries, and gives 60 percent of all the money in the system to 
those who game the system rather than victims, there is something 
wrong, and that something ought to be corrected.
       preemption in the mcconnell-lieberman-kassebaum amendment

  Mrs. KASSEBAUM. Mr. President, last week I spoke in favor of the 
pending amendment on medical liability and addressed, very briefly, the 
issue of Federal preemption.
   [[Page S5937]] I want to take a few moments this morning to explain 
more fully my reasons for supporting a limited Federal preemption of 
State medical liability laws and to urge my colleagues to reject both 
the Simon and the Kennedy preemption amendments to the underlying 
McConnell-Kassebaum-Lieberman amendment.
  Mr. President, the Federal Government has a significant stake in 
reforming the health care liability system both because of the effect 
of the system on interstate commerce and because of the enormous amount 
spent by the Federal Government on health care.
  Last Thursday, I spoke of the need to achieve some degree of 
uniformity and certainty in the system. Without greater predictability, 
insurance rates will continue to reflect the potential for unlimited 
exposure to risk. And these higher insurance rates will continue to be 
passed along to the American consumer.


     the private sector deserves to benefit from the same type of 
      protections that the federal government has afforded itself

  The Federal Government already has taken significant steps to limit 
its own exposure for costs associated with health care liability. For 
example, damages resulting from health claims disputes and redress in 
claims dispute cases are limited for Federal employees receiving health 
coverage under the Federal Employees Health Benefit Act [FEHBA], and 
for Medicare beneficiaries. There are no punitive or extra-contractual 
damages allowed under FEHBA or Medicare. See Hayes v. Prudential Ins. 
Co., 819 F.2d 921 (9th Cir. 1987); Homewood Professional Care Ctr., 
Ltd. v. Heckler, 764 F.2d 1242 (7th Cir. 1985).
  Moreover, responding to an outcry from Federal Community Health 
Centers about skyrocketing malpractice insurance premiums, Congress in 
1992 limited the exposure of centers and their providers to malpractice 
claims by placing them under the Federal Tort Claims Act and taking 
steps that go well beyond the reforms in this legislation. In addition 
to having judgments paid from a Federal fund, that act: (1) allows 
liability to be determined by a judge rather than a jury (28 U.S.C. 
2402); (2) contains a 2-year stature of limitations that is more 
restrictive than the one contained in this legislation (28 U.S.C. 
2401); (3) prohibits the awarding of punitive damages (28 U.S.C. 2674); 
(4) places a cap on lawyers' contingency fees of 25 percent of a 
litigated claim and 20 percent of a settlement (28 U.S.C. 2678); 
disallows prejudgment interest (28 U.S.C. 2674), and requires claimants 
to exhaust administrative remedies before proceeding to court (28 
U.S.C. 2675).
  Mr. President, I believe that the private sector is entitled to the 
same type of protections that the Federal Government has extended to 
its own health providers.


   as the largest single payer of health care services, the federal 
  government has a compelling interest in health care liability reform

  While the Federal Government has limited its exposure to health care 
liability claims in certain instances, large gaps remain. In 
particular, liability for health care professionals and providers who 
treat Medicaid and Medicare patients remain subject to uneven and 
sometimes insufficient State medical liability reforms. One-third of 
total health care spending in this country is paid by the Federal 
Government. According to the Congressional Budget Office, Federal 
spending for Medicare will reach $177 billion in fiscal year 1995, 
while Medicaid grants to States will total $96 billion.
  Therefore, I believe that there is a direct, compelling Federal 
interest in reforming the Nation's outmoded medical liability system.
federal legislation is necessary because of the increasingly interstate 
                   character of health care delivery

  Moreover, some degree of uniformity is essential because health care 
markets are becoming increasingly regional, if not national. 
Telemedicine, by its very nature, is designed to overcome barriers to 
the delivery of medicine, including long distances, geographic 
limitations, and political borders. Some of the finest medical 
facilities in the United States--such as the Mayo Clinic in Minnesota, 
Stanford University in California, Barnes Hospital in Missouri, the 
Cleveland Clinic in Ohio, and the Dartmouth Medical Center in New 
Hampshire--treat patients from across the Nation, and around the world.
  While I do not believe there is a need for absolute uniformity in all 
aspects of the health care system, I do believe that some minimum level 
of medical liability reforms are necessary to the continued development 
of a cost-effective private health care system. This is particularly 
true where, as under this legislation, insurers and other third party 
payers may be sued as defendants in health care liability actions.
  As health care providers continue to consolidate and form integrated 
networks of care in response to market forces, economic pressure, and 
emerging treatment patterns, the number of individuals who receive 
health care services in one State while having them financed by 
entities in another will continue to increase.
  While health care services generally are delivered locally, this does 
not necessarily mean that health care is delivered within State 
borders. To the contrary: more than 40 percent of Americans live in 
cities and counties that border on State lines; in 26 States, more than 
half of the population lives in cities and counties that border on 
State lines, and over 50 percent of the population in 26 States lives 
in border cities and counties. In these areas, it is even more likely 
that a patient will live or work in one State, receive health care 
services in another, and have his or her bills paid by a third-party 
payer in another State. A recent analysis of health services purchased 
across State borders found, for example: First, that Vermont and New 
Hampshire residents visit an out-of-State physician nearly one-quarter 
of the time; second, that Wyoming residents visit out-of-State doctors 
over one-third of the time, and third, that nearly 40 percent of the 
patients admitted to Delaware hospitals travel from out of the State.
   federal legislation is necessary because of state constitutional 
                              impediments

  Some have argued that this legislation is an unnecessary intrusion 
into an area of the law that traditionally has been the domain of the 
States. I would like to point out, however, that many of the opponents 
of Federal medical liability reform are, at the same time, aggressively 
challenging State tort reform efforts by arguing that the reforms are 
unconstitutional under State constitutions. As a result, many States 
have been frustrated in their efforts to pass meaningful tort reform. 
For example: First, statutes of limitations in health care liability 
actions have been held to violate State constitutions in Arizona; 
second, limits on punitive damage awards in health care liability 
actions have been held unconstitutional in Alabama, and third, periodic 
payment schedules for damage awards in health care liability actions 
have been held to violate State constitutions in Arizona, New 
Hampshire, and Ohio.


  preemption provisions in the mcconnell-lieberman-kassebaum amendment

  Mr. President, the preemption provisions contained in the McConnell-
Lieberman-Kassebaum amendment are designed to give both the States and 
the courts clear guidance as to the scope of the reforms contained in 
the legislation.
  The amendment does not preempt State laws that: First, place greater 
restrictions on the amount of or standards for awarding noneconomic or 
punitive damages; second, place greater limitations on the awarding of 
attorneys fees for awards in excess of $150,000; third, permit a lower 
threshold for the periodic payment of future damages; fourth, establish 
a shorter period of time during which a health care liability action 
may be initiated or a more restrictive rule with respect to the time at 
which the period of limitations begins to run, or fifth, implement 
collateral source rule reform that either permits the introduction of 
evidence of collateral source benefits or provides for the mandatory 
offset of such benefits from damage awards.
  The amendment also states specifically that it should not be 
construed to preempt any State law which: First, permits State 
officials to commence health care liability actions; second, permits 
provider-based dispute resolution; third, places a limit on total 
damages awarded in a health care liability 
[[Page S5938]]  action; fourth, places a maximum limit on the time in 
which such an action may be initiated, or fifth, provides for defenses 
in addition to those contained in the act.
  Last week and again yesterday, some of my colleagues argued that the 
so-called one-sided preemption provisions contained in the McConnell 
amendment were both novel and, somehow, unfair. I believe these 
arguments are without merit.
  For the record, I would like to make clear that the characterization 
that all of the preemption provisions in the legislation are ``one-
sided'' is simply incorrect. Two examples are instructive. First, the 
preemption provisions allow State collateral source reform measures to 
differ widely from the provisions contained in the legislation. States 
not only have the flexibility under the McConnell-Lieberman-Kassebaum 
amendment to adopt evidentiary collateral source rules and mandatory 
offset rules that permit introduction of collateral source benefits 
after trial, but may, in fact, adopt a whole range of collateral source 
rule reforms that are more favorable to claimants than those contained 
in the amendment. Second, the amendment makes clear that State laws 
limiting attorneys fees for awards of $150,000 or less may be both more 
restrictive than the 33\1/3\ percent set forth in the legislation and 
less restrictive.
  In support of the preemption provisions contained in the McConnell-
Lieberman-Kassebaum amendment, I would like to note further the long 
history of this Congress in setting minimum Federal standards and 
allowing the States significant flexibility beyond those standards. 
See, e.g., Clean Air Act Amendments of 1990, Pub. L. 101-549; Safe 
Drinking Water Act, Pub. L. 93-523; Civil Rights Act of 1964, Pub. L. 
88-352; Americans With Disabilities Act, Pub. L. 101-336.
  Moreover, nearly every health care reform bill introduced last 
Congress--including President Clinton's ``Health Security Act''--
contained this type of Federal preemption for medical liability 
reforms. See, e.g., President Clinton's Health Security Act, H.R. 3600; 
Senator Dole and Senator Packwood's health care reform bill, S. 2374; 
Senator Chafee's Health Equity Access Reform Today Act, S. 1770; 
Representative Cooper's Managed Competition Act, H.R. 3222; the House 
Republican leadership plan, H.R. 3080; the bipartisan mainstream 
coalition health bill, and the House bipartisan health reform bill.
  Another recent and relevant example of liability reform legislation 
containing the type of Federal preemption language included in the 
McConnell-Lieberman-Kassebaum amendment is S. 1458, the General 
Aviation Revitalization Act of 1994. That legislation provided in part 
that no civil action for damages arising out of an accident involving a 
general aviation aircraft could be brought against the manufacturer of 
the aircraft or the manufacturer of any component part of the aircraft, 
if the accident occurred more than 18 years after the date of the 
aircraft's delivery or the component part's installation. S. 1458, 
which passed the Senate on March 16, 1994 by a vote of 91 to 8, 
preempts State law only to the extent that such law permitted civil 
actions to be commenced after 18 years. See Public Law 103-298.
  I believe that the underlying amendment is loyal to this tradition.
  In conclusion, Mr. President, I would like to point out that many of 
those who oppose the preemption principles embodied in this legislation 
have repeatedly and enthusiastically embraced those principles in other 
legislative contexts.
  For example, S. 7, the Family Health Insurance Protection Act, 
provides a clear example of one-sided preemption.
  Section 1011 provides that State laws will not be preempted only if 
they: First, contain preexisting condition waiting periods that are 
``less than those'' established in S 7; second, limit variations in 
premium rates ``beyond the variations permitted'' in S. 7, and third, 
expand the size of the small group market to include groups ``in excess 
of'' the size set forth in the legislation.
ction 1012 of that legislation contains even more expansive one-sided 
preemption provisions. It states that: ``Nothing in this Act shall be 
construed as prohibiting States from enacting [any] health care reform 
measures that exceed the measures established under this Act, including 
reforms that expand access to health care services--for example, higher 
taxes--control health care costs, and so forth, institute tighter 
  premium caps or cost controls, and enhance the quality of care.Mr. 
President, as I said earlier, I do not believe there is a need for 
absolute uniformity in this area. But I do believe it is important to 
set some very clear minimum Federal standards that all States must 
meet.
  The standards in the McConnell-Lieberman-Kassebaum amendment are only 
a floor. The amendment does not preempt States from going further with 
medical malpractice reforms they may decide are necessary. I think this 
is the best way to balance the need for some State flexibility with the 
need for greater certainty and predictability in the system.
                       Medical Malpractice Reform

  Mr. PELL. Mr. President, I wish to make a few observations regarding 
the effort sponsored by Senator McConnell to add comprehensive medical 
malpractice reform to the product liability legislation currently 
pending before us.
  I was much torn about the McConnell amendment because I support 
medical malpractice reform and believe the time has come to profoundly 
change the current system. Yet, in the end, I decided to vote against 
the McConnell amendment.
  I did so because I was deeply concerned that adding this desirable 
but controversial reform effort to the pending legislation would 
gravely endanger the cause of product liability reform, a cause I have 
supported for many years. After many years of frustration I have real 
hope that we will achieve product liability reform in this Congress and 
I wanted to avoid any action which would endanger that hope. I would 
add that I was persuaded in this regard by the sponsor of the product 
liability reform effort, Senator Rockefeller.
  However, I look forward to the opportunity to fully address medical 
malpractice reform later in this Congress when the issues can be aired 
fully and not be encumbered by the desire to achieve progress in other 
areas of legal system reform. While I do not support all the provisions 
of the McConnell amendment, I do support its thrust and would welcome 
the opportunity to debate the issue strictly on its own merits.
                       medical malpractice reform

  Mr. ROTH. Mr. President, I have always been a staunch supporter of 
our Federal system of government, which has as its most fundamental 
principle the idea that matters of governance ought to be left as much 
as possible to the States. Traditionally, one such matter left to the 
States has been the administration of medical malpractice law.
  By virtue of its overwhelming financial stake in the Nation's health 
care, however, the Federal Government has a unique and compelling 
interest in the delivery of care, and this interest leads me to support 
the McConnell amendment on medical malpractice reform. The McConnell 
amendment reforms medical malpractice law by creating certain minimum 
standards, such as a cap on punitive damages, that will apply 
nationwide. It permits States, however, to pass more thorough-going 
reforms if they wish to do so.
  The Federal Government is the largest purchaser of health care, and 
it finances 32 percent of the Nation's health care spending through the 
Medicare and Medicaid programs, federally qualified community health 
centers, the veterans health care, military health care, Indian health 
care, and many other programs. In fact, the Federal Government spent 
$280.6 billion in 1993 purchasing health care services--more than for 
any other service.
  Projections of the growth of health care expenditures continue to 
escalate, and the Federal Government's role in paying for these 
services will also continue to grow--unless we begin to take steps to 
control the rate of growth. In the meantime, we should be working on 
increasing access to health care coverage. Savings achieved through 
medical malpractice reform will not only save the taxpayers of America 
significant amounts, it will help expand access to care.
  [[Page S5939]] Based on the experience with federally qualified 
community health centers, the evidence is good that the McConnell 
amendment will lead to cost savings and expanded access to care. 
Currently, more than 500 of these community and migrant health centers 
receive Federal funding. These centers provide essential primary care 
for about 6 million people living in areas where there are few 
physicians or other health care providers. In fact, we have three such 
important centers in Delaware--the Henrietta Johnson Community Health 
Center in Southbridge, the West Side Community Health Center in 
Wilmington, and the DelMarVa Rural Ministries in Kent County. In 
October 1992, Congress enacted a type of medical malpractice reform for 
federally supported community health centers by extending the Federal 
Tort Claims Act [FTCA] to cover these centers. A Government Accounting 
Office report estimates that for calendar years 1993 through 1995, a 
total of $54.8 million was saved by bringing the community health 
centers within the reach of the FTCA.
  It is clear to me that medical malpractice reform is needed in order 
to control the Federal Government's enormous share of our national 
health care costs and, thus, to ensure broad access to quality care. 
The Physician Payment Review Commission, which is charged with advising 
Congress regarding Medicare policy, has advised in its latest report 
that Federal medical malpractice reform should be enacted. The report 
states that ``the medical liability system does not adequately prevent 
medical injuries or compensate injured patients. There is concern that 
the current functioning of this system promotes the practice of 
defensive medicine and may impede efforts to improve the cost 
effectiveness of care.'' Last year, these problems led me to vote in 
favor of medical malpractice reform when the Senate Finance Committee 
considered it during its deliberations on health care reform. Because 
the problems are with us still, this year I support the McConnell 
amendment.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. GORTON. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  Mr. GORTON. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GORTON. Mr. President, I ask unanimous consent that, following 
the conclusion of the first rollcall vote, all remaining consecutive 
rollcall votes be limited to 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GORTON. I now ask for regular order.


                           Amendment No. 604

  The PRESIDING OFFICER. Regular order provides for the Thomas 
amendment to recur as the pending amendment.
  Mr. ROCKEFELLER. Mr. President, I move to table the Thomas amendment 
and I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There appears to 
be a sufficient second.
  The yeas and nays were ordered.
  Mr. GORTON. Mr. President, for the information of all Senators, there 
is a potential for as many as 12 back-to-back votes, beginning now. All 
Senators are urged to remain on the floor during this voting sequence.
  I ask unanimous consent that, notwithstanding the consent for the 
recess at 12:30, the Senate stand in recess immediately following the 
disposition of the McConnell amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.


               Vote on Motion to Table Amendment No. 604

  The PRESIDING OFFICER. The question is on agreeing to the motion of 
the Senator from West Virginia [Mr. Rockefeller] to table the amendment 
of the Senator from Wyoming [Mr. Thomas].
  The yeas and nays have been ordered. The clerk will call the roll.
  The legislative clerk called the roll.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
who desire to vote?
  The result was announced--yeas 39, nays 61, as follows:
                      [Rollcall Vote No. 137 Leg.]

                                YEAS--39

     Akaka
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bumpers
     Cohen
     D'Amato
     Daschle
     DeWine
     Dodd
     Feingold
     Glenn
     Gorton
     Harkin
     Hatfield
     Heflin
     Hollings
     Inouye
     Jeffords
     Kassebaum
     Kennedy
     Kerry
     Kohl
     Lautenberg
     Levin
     Moseley-Braun
     Moynihan
     Murray
     Pell
     Robb
     Rockefeller
     Sarbanes
     Simon
     Snowe
     Specter
     Thompson
     Wellstone

                                NAYS--61

     Abraham
     Ashcroft
     Baucus
     Bennett
     Bond
     Brown
     Bryan
     Burns
     Byrd
     Campbell
     Chafee
     Coats
     Cochran
     Conrad
     Coverdell
     Craig
     Dole
     Domenici
     Dorgan
     Exon
     Faircloth
     Feinstein
     Ford
     Frist
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Helms
     Hutchison
     Inhofe
     Johnston
     Kempthorne
     Kerrey
     Kyl
     Leahy
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Mikulski
     Murkowski
     Nickles
     Nunn
     Packwood
     Pressler
     Pryor
     Reid
     Roth
     Santorum
     Shelby
     Simpson
     Smith
     Stevens
     Thomas
     Thurmond
     Warner
  So the motion to lay on the table the amendment (No. 604) was 
rejected.
  The PRESIDING OFFICER. The question is on agreeing to the amendment.
  The amendment (No. 604) was agreed to.
  Mr. GORTON. Mr. President, I move to reconsider the vote, and I move 
to lay that motion on the table.
  The PRESIDING OFFICER. Without objection, it is so ordered.


               Vote on Motion to Table Amendment No. 605

  The PRESIDING OFFICER. The question occurs on amendment numbered 605.
  Mr. GORTON. Mr. President, I move to table the Wellstone amendment 
and ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There is a 
sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. The question is on agreeing to the motion to 
table.
  The clerk will call the roll.
  The bill clerk called the roll.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 69, nays 31, as follows:
                      [Rollcall Vote No. 138 Leg.]

                                YEAS--69

     Abraham
     Ashcroft
     Baucus
     Bennett
     Biden
     Breaux
     Brown
     Bumpers
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Cohen
     Coverdell
     Craig
     D'Amato
     DeWine
     Dodd
     Dole
     Domenici
     Faircloth
     Feinstein
     Ford
     Frist
     Glenn
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Hatfield
     Heflin
     Helms
     Hutchison
     Inhofe
     Jeffords
     Johnston
     Kassebaum
     Kempthorne
     Kohl
     Kyl
     Leahy
     Lieberman
     Lott
     Lugar
     McCain
     McConnell
     Moynihan
     Murkowski
     Nickles
     Nunn
     Packwood
     Pressler
     Pryor
     Rockefeller
     Roth
     Santorum
     Shelby
     Simpson
     Smith
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner

                                NAYS--31

     Akaka
     Bingaman
     Bond
     Boxer
     Bradley
     Bryan
     Byrd
     Conrad
     Daschle
     Dorgan
     Exon
     Feingold
     Harkin
     Hollings
     Inouye
     Kennedy
     Kerrey
     Kerry
     Lautenberg
     Levin
     Mack
     Mikulski
     Moseley-Braun
     Murray
     Pell
     Reid
     Robb
     Sarbanes
     Simon
     Snowe
     Wellstone
  So the motion to lay on the table the amendment (No. 605) was agreed 
to.
  Mr. GORTON. Mr. President, I move to reconsider the vote by which the 
motion to lay on the table was agreed to.
  Mr. BREAUX. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                       Vote on Amendment No. 608

  The PRESIDING OFFICER. The question is on agreeing to the amendment 
offered by the Senator from Maine.
  Mr. KENNEDY. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  [[Page S5940]] The PRESIDING OFFICER. The question is on agreeing to 
the amendment offered by the Senator from Maine. On this question, the 
yeas and nays have been ordered, and the clerk will call the roll.
  The assistant legislative clerk called the roll.
  The result was announced--yeas 62, nays 38, as follows:
                      [Rollcall Vote No. 139 Leg.]

                                YEAS--61

     Abraham
     Bennett
     Bond
     Brown
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Cohen
     Conrad
     Coverdell
     Craig
     D'Amato
     Daschle
     DeWine
     Dole
     Domenici
     Faircloth
     Feinstein
     Frist
     Gorton
     Grams
     Grassley
     Gregg
     Hatch
     Helms
     Hutchison
     Inhofe
     Jeffords
     Kassebaum
     Kempthorne
     Kerrey
     Kohl
     Kyl
     Lautenberg
     Levin
     Lieberman
     Lott
     Mack
     McCain
     McConnell
     Mikulski
     Moseley-Braun
     Murkowski
     Nickles
     Nunn
     Packwood
     Pressler
     Robb
     Roth
     Santorum
     Shelby
     Simpson
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner

                                NAYS--39
     Akaka
     Ashcroft
     Baucus
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Byrd
     Dodd
     Dorgan
     Exon
     Feingold
     Ford
     Glenn
     Graham
     Gramm
     Harkin
     Hatfield
     Heflin
     Hollings
     Inouye
     Johnston
     Kennedy
     Kerry
     Leahy
     Lugar
     Moynihan
     Murray
     Pell
     Pryor
     Reid
     Rockefeller
     Sarbanes
     Simon
     Smith
     Wellstone
  So the amendment (No. 608) was agreed to.
  Mr. GORTON. Mr. President, I move to reconsider the vote.
  Mr. ROCKEFELLER. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 609

  The PRESIDING OFFICER. The question now occurs on agreeing to 
amendment No. 609 by the Senator from Arizona [Mr. Kyl].
  Mr. ROCKEFELLER addressed the Chair.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mr. ROCKEFELLER. I move to table the pending amendment and ask for 
the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There is a 
sufficient second.
  The yeas and nays were ordered.


               Vote on Motion to Table Amendment No. 609

  The PRESIDING OFFICER (Mr. Kempthorne). The question is on agreeing 
to the motion to table the amendment. The yeas and nays have been 
ordered. The clerk will call the roll.
  The bill clerk called the roll.
  The result was announced--yeas 65, nays 35, as follows:
                      [Rollcall Vote No. 140 Leg.]

                                YEAS--65

     Abraham
     Akaka
     Ashcroft
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Burns
     Campbell
     Cochran
     Cohen
     Conrad
     D'Amato
     Daschle
     DeWine
     Dodd
     Dorgan
     Exon
     Feingold
     Feinstein
     Ford
     Frist
     Glenn
     Gorton
     Graham
     Harkin
     Hatch
     Heflin
     Hollings
     Jeffords
     Johnston
     Kassebaum
     Kennedy
     Kerrey
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mack
     Mikulski
     Moynihan
     Murkowski
     Murray
     Nunn
     Packwood
     Pell
     Pressler
     Pryor
     Reid
     Robb
     Rockefeller
     Roth
     Sarbanes
     Shelby
     Snowe
     Specter
     Stevens
     Thompson
     Warner
     Wellstone

                                NAYS--35

     Baucus
     Bennett
     Bond
     Brown
     Byrd
     Chafee
     Coats
     Coverdell
     Craig
     Dole
     Domenici
     Faircloth
     Gramm
     Grams
     Grassley
     Gregg
     Hatfield
     Helms
     Hutchison
     Inhofe
     Inouye
     Kempthorne
     Kyl
     Lott
     Lugar
     McCain
     McConnell
     Moseley-Braun
     Nickles
     Santorum
     Simon
     Simpson
     Smith
     Thomas
     Thurmond
  So the motion to table the amendment (No. 609) was agreed to.
  Mr. GORTON. Mr. President, I move to reconsider the vote.
  Mr. ROCKEFELLER. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


               Vote on Motion to Table Amendment No. 611

  The PRESIDING OFFICER. The question now is on the Kyl amendment No. 
611.
  Mr. ROCKEFELLER. Mr. President, I move to table the amendment and ask 
for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk called the roll.
  The result was announced--yeas 56, nays 44, as follows:
                      [Rollcall Vote No. 141 Leg.]

                                YEAS--56

     Akaka
     Biden
     Bingaman
     Bond
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Byrd
     Cohen
     Conrad
     D'Amato
     Daschle
     DeWine
     Dodd
     Dorgan
     Feingold
     Feinstein
     Ford
     Glenn
     Gorton
     Graham
     Harkin
     Heflin
     Hollings
     Inouye
     Jeffords
     Johnston
     Kennedy
     Kerrey
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     McConnell
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Nunn
     Packwood
     Pressler
     Pryor
     Reid
     Robb
     Rockefeller
     Sarbanes
     Shelby
     Simon
     Simpson
     Specter
     Thompson
     Wellstone

                                NAYS--44

     Abraham
     Ashcroft
     Baucus
     Bennett
     Brown
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Coverdell
     Craig
     Dole
     Domenici
     Exon
     Faircloth
     Frist
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Hatfield
     Helms
     Hutchison
     Inhofe
     Kassebaum
     Kempthorne
     Kyl
     Lott
     Lugar
     Mack
     McCain
     Murkowski
     Nickles
     Pell
     Roth
     Santorum
     Smith
     Snowe
     Stevens
     Thomas
     Thurmond
     Warner
  So the motion to lay on the table the amendment (No. 611) was agreed 
to.
  Mr. GORTON. Mr. President, I move to reconsider the vote.
  Mr. ROCKEFELLER. I move to lay that motion on the table.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The motion to lay on the table was agreed to.


                       Vote on Amendment No. 612

  The PRESIDING OFFICER. The question is on agreeing to the amendment 
numbered 612, offered by the Senator from Ohio.
  Mr. GORTON. Mr. President, this is a noncontroversial amendment.
  So the amendment (No. 612) was agreed to.
  Mr. GORTON. Mr. President, I move to reconsider the vote.
  Mr. ROCKEFELLER. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                       Vote on Amendment No. 613

  The PRESIDING OFFICER. The question is on agreeing to the amendment 
numbered 613, offered by the Senator from Utah.
  Mr. GORTON. Mr. President, this is also a noncontroversial amendment.
  So the amendment (No. 613) was agreed to.
  Mr. GORTON. Mr. President, I move to reconsider the vote.
  Mr. ROCKEFELLER. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
                       Unanimous-Consent Request

  Mr. DOLE. Mr. President, I ask unanimous consent we have the next 
vote and then we recess for the policy luncheons until 2:15, and then 
come back and complete the additional rollcall votes.
  There will be one additional rollcall vote. The remainder of the 
votes will follow at 2:15.
  The PRESIDING OFFICER. Is there objection?
  Mr. DODD. Mr. President, reserving the right to object, I am going to 
withdraw my amendment at this point. I do not know if that affects the 
majority leader's schedule, but I ask unanimous consent to withdraw my 
amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 616) was withdrawn.
  Mr. DOLE. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
   [[Page S5941]] Mr. DOLE. Mr. President, I ask unanimous consent that 
the order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DOLE. Mr. President, after consultation with the Democratic 
leader and a number of people who are conducting hearings, I withdraw 
the request. We will just go ahead and complete the votes now.
  The PRESIDING OFFICER. Without objection, it is so ordered. The 
request is vitiated.


                           Amendment No. 614

  The PRESIDING OFFICER. The question, then, is on agreeing to the 
Simon amendment (No. 614).
  Mr. GORTON addressed the Chair.
  The PRESIDING OFFICER. The Senator from Washington is recognized.
  Mr. GORTON. Mr. President, I move to table the Simon amendment.
  Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.


               Vote On Motion To Table Amendment No. 614

  The PRESIDING OFFICER. The question occurs on the motion to lay on 
the table the amendment, No. 614.
  The yeas and nays have been ordered.
  The clerk will call the roll.
  The legislative clerk called the roll.
  The result was announced, yeas 51, nays 49, as follows:
                      [Rollcall Vote No. 142 Leg.]

                                YEAS--51

     Ashcroft
     Bennett
     Bond
     Brown
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Coverdell
     Craig
     Dodd
     Dole
     Domenici
     Exon
     Faircloth
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Hatfield
     Helms
     Hutchison
     Inhofe
     Jeffords
     Kassebaum
     Kempthorne
     Kyl
     Lautenberg
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Pressler
     Robb
     Rockefeller
     Roth
     Santorum
     Smith
     Snowe
     Stevens
     Thomas
     Thurmond
     Warner

                                NAYS--49

     Abraham
     Akaka
     Baucus
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Byrd
     Cohen
     Conrad
     D'Amato
     Daschle
     DeWine
     Dorgan
     Feingold
     Feinstein
     Ford
     Glenn
     Graham
     Harkin
     Heflin
     Hollings
     Inouye
     Johnston
     Kennedy
     Kerrey
     Kerry
     Kohl
     Leahy
     Levin
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Nunn
     Packwood
     Pell
     Pryor
     Reid
     Sarbanes
     Shelby
     Simon
     Simpson
     Specter
     Thompson
     Wellstone
  So the motion to lay on the table the amendment (No. 614) was agreed 
to.
  Mr. GORTON. Mr. President, I move to reconsider the vote.
  Mr. MACK. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                       Vote on Amendment No. 607

  The PRESIDING OFFICER. The question now occurs on amendment No. 607 
offered by the Senator from Massachusetts [Mr. Kennedy].
  Mr. GORTON. Mr. President, I move to table the Kennedy amendment and 
ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There is a 
sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. The question is on agreeing to the motion to 
table amendment No. 607. The yeas and nays have been ordered. The clerk 
will call the roll.
  The assistant legislative clerk called the roll.
  The result was announced--yeas 55, nays 45, as follows:
                      [Rollcall Vote No. 143 Leg.]

                                YEAS--55

     Abraham
     Ashcroft
     Bennett
     Bond
     Brown
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Coverdell
     Craig
     DeWine
     Dole
     Domenici
     Exon
     Faircloth
     Frist
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Hatfield
     Heflin
     Helms
     Hutchison
     Inhofe
     Jeffords
     Kassebaum
     Kempthorne
     Kyl
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Packwood
     Pressler
     Robb
     Rockefeller
     Roth
     Santorum
     Smith
     Snowe
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner

                                NAYS--45

     Akaka
     Baucus
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Byrd
     Cohen
     Conrad
     D'Amato
     Daschle
     Dodd
     Dorgan
     Feingold
     Feinstein
     Ford
     Glenn
     Harkin
     Hollings
     Inouye
     Johnston
     Kennedy
     Kerrey
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Nunn
     Pell
     Pryor
     Reid
     Sarbanes
     Shelby
     Simon
     Simpson
     Specter
     Wellstone
  So the motion to table the amendment (No. 607) was agreed to.
  Mr. GORTON. Mr. President, I move to reconsider the vote.
  Mr. JOHNSTON. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                       Vote on Amendment No. 615

  The PRESIDING OFFICER. The question is on agreeing to amendment No. 
615 offered by the Senator from Massachusetts [Mr. Kennedy].
  The amendment (No. 615) was agreed to.
  Mr. GORTON. Mr. President, I move to reconsider the vote and move to 
lay that motion on the table.
  The motion to lay on the table was agreed to.


                     Amendment No. 603, As Amended

  The PRESIDING OFFICER. The pending measure is amendment No. 603, as 
amended, offered by the Senator from Kentucky [Mr. McConnell].
  Mr. GORTON. Mr. President, I ask for the yeas and the nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.


                 Vote On Amendment No. 603, As Amended

  The PRESIDING OFFICER. The question is on agreeing to amendment No. 
603, as amended.
  The clerk will call the roll.
  The legislative clerk called the roll.
  The result was announced--yeas 53, nays 47, as follows:
                      [Rollcall Vote No. 144 Leg.]

                                YEAS--53

     Abraham
     Ashcroft
     Bennett
     Bond
     Brown
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Coverdell
     Craig
     DeWine
     Dole
     Domenici
     Exon
     Faircloth
     Feinstein
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Hatfield
     Helms
     Hutchison
     Inhofe
     Jeffords
     Kassebaum
     Kempthorne
     Kyl
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Nunn
     Pressler
     Robb
     Roth
     Santorum
     Simpson
     Smith
     Snowe
     Stevens
     Thomas
     Thurmond
     Warner

                                NAYS--47

     Akaka
     Baucus
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Byrd
     Cohen
     Conrad
     D'Amato
     Daschle
     Dodd
     Dorgan
     Feingold
     Ford
     Glenn
     Graham
     Harkin
     Heflin
     Hollings
     Inouye
     Johnston
     Kennedy
     Kerrey
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Packwood
     Pell
     Pryor
     Reid
     Rockefeller
     Sarbanes
     Shelby
     Simon
     Specter
     Thompson
     Wellstone
  So the amendment (No. 603), as amended, was agreed to.
  

                          ____________________