[Congressional Record Volume 141, Number 145 (Monday, September 18, 1995)]
[Senate]
[Pages S13729-S13737]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. HATFIELD (for himself, Mr. Harkin, and Mrs. Boxer):
  S. 1251. A bill to establish a national fund for health research to 
expand medical research programs through increased funding provided to 
the National Institutes of Health, and for other purposes; to the 
Committee on Finance.


               the national fund for health research act

  Mr. HATFIELD. Mr. President, this week finds us at the height of the 
appropriations process, as the end of the fiscal year rapidly 
approaches. It has been a season of difficult fiscal decisions which 
must be made to conform to the constraints of our balanced budget 
agreement. Never are the tradeoffs as vivid as when we consider 
spending levels for health and education programs, as we did this 
morning when the Senate Appropriations Committee completed action on 
the fiscal year 1996 Labor, HHS, and Education appropriations bill.
  I am pleased to report that the committee provided nearly $1.5 
billion more than the House for education programs. In addition, we 
provided a 2.7=percent increase for health research at the National 
Institutes of Health. While this level is less than that provided by 
the House, I believe it represents a fair balance between the vitally 
important issues of health and education. But clearly, my preference 
would have been to provide a much larger increase for medical research 
so that the engine which drives the quality of medical care and reduced 
health costs could run at full tilt.
  The current reality is, however, that available funds for 
discretionary spending are decreasing. We cannot continue to look 
solely to the appropriations process for the necessary resources to 
keep our biomedical research enterprise growing at a rate which takes 
advantage of the myriad medical breakthroughs on the horizon. We must 
look for a funding source to supplement annual appropriations to the 
National Institutes of Health.
  Today I am pleased to unite with my friend and colleague, Senator 
Harkin, in introducing legislation to establish the national fund for 
medical research. We joined forces in this effort last year and worked 
hard to see that medical research was a part of the health care reform 
debates. At the end of the process, although the issue was ultimately 
unresolved, we had received the attention and support of many Members 
in this Chamber. We introduce this bill today, with the support of 
Senator Boxer of California, with the intention of building on the 
momentum of last year to gain the support of our many colleagues in 
this body who are committed to the biomedical research infrastructure.
  Our legislation proposes to create a new fund in the U.S. Treasury, 
financed by an increase in Federal tobacco taxes and income generated 
through a voluntary Federal income tax checkoff. By raising the Federal 
tax on cigarettes by 25 cents per package, as well as raising the tax 
to an equivalent level on smokeless tobacco products, the Joint 
Committee on Taxation has estimated annual income for the fund of 
approximately $4.2 billion. These funds will be distributed on a 
phased-in basis to the National Institutes of Health to supplement, not 
replace, the funds the organization receives each year in the 
appropriations process. Funds will be distributed in accordance with 
the proportion of funds each of the member institutes and centers 
receive in the appropriations process, after 5 percent has been divided 
between the Office of the Director, the National Center for Research 
Resources, and the National Library of Medicine.
  Funds raised through this proposal will increase the budget of the 
NIH by 35 percent over the fiscal year 1995 appropriated level. This 
will allow many more research grant applications to be funded so that 
scientific opportunities of merit can be pursued and ultimately 
translated into cost-effective treatments and cures which will improve 
our national quality of life. I know of no better investment for the 
Federal Government than one which strengthens our human capital--be it 
in education or health research, our greatest strength is a healthy, 
and thus wealthy, populous.
  Mr. President, my good friend, the great philanthropist, Mary Lasker 
once said, ``If you think research is expensive, try disease.'' 
Diseases cost this country hundreds of billions of dollars annually. 
Last year, federally supported research on Alzheimer's disease totalled 
$300 million, yet it is estimated that $90 billion is expended annually 
on care. Federally supported research on diabetes totals $290 million, 
yet it is estimated that $25 billion is expended annually on care. 
Federally supported research on mental health totals $613 million, yet 
it is estimated that $130 billion is expended annually on care.
  As we struggle in the coming months to achieve a balanced budget, we 
must embrace policies that enable us to make the most out of our scarce 
Federal dollars. Federal funding for medical research should be a top 
priority because without new knowledge to develop new strategies to 
prevent disease, new treatments to delay the progression of disease and 
new interventions to cure disease; health care costs will continue to 
spiral out of control. Disease drives the cost of health care. A 
concerted Federal assault on disease will not only save precious funds, 
but it will provide hope to the afflicted.
  Watching a medical catastrophe affect a family or individual is one 
of the greatest tragedies we face in this country. The impacts are 
accentuated when this misfortune comes in the form of an incurable 
disease. Loved ones are left with no hope, and feeling powerless as 
they watch the debilitating effects of disease overcome the individual. 
I know many of my colleagues in the Senate have experienced this sense 
of powerlessness. They have watched helplessly while family members 
deteriorate from the effects of a deadly disease. The vibrant 
individual that they knew and loved is reduced to a withering shell of 
a human being. The one thing, and the only thing that provides comfort 
to the afflicted and to their loved ones, is hope. Hope for an end to 
the suffering. Hope for a return to a normal life. Hope for a cure. 
This hope does not have to be great, even the faintest glimmer brings 
happiness to someone faced with a fatal future.

  Medical research is the sole hope we can provide to millions of 
Americans who will experience disease and disability either in their 
own lives or in their families. We can care for them in our hospitals 
and clinics but we cannot alleviate their pain or end their suffering 
without cures and preventative treatments. Cures are the direct result 
of our investment in medical research.
  This legislation is important because it will help provide a more 
sustainable funding base for medical research. During the debate on the 
budget resolution, I offered an amendment to restore $7 billion of the 
nearly $8 billion cut for the NIH proposed by the Senate budget 
resolution over the next 7 years. This amendment passed by a vote of 
85-14. While this was a short-term victory for the NIH, it demonstrates 
the need for a stable endowment for medical research. The war against 
disease can not be fully waged if medical researchers have to engage in 
yearly squabbles with Congress over funding levels.

[[Page S 13730]]

  As most of my colleagues know, I am a practical man. I do not 
underestimate the difficulty any tax increase has in the current 
political climate, but I submit we must listen to the people who put 
the new Republican majority in power.
  A recent Harris Poll has shown that Americans strongly support health 
research and are willing to put their money behind their words. The 
poll asked Americans which type of scientific research they favored--66 
percent favored medical research and a pitiful 4 percent preferred 
defense research. This same poll determined that if assured that the 
funds would be spent for medical research, 74 percent of Americans are 
willing to spend $1 more in taxes. Other polling data consistently 
shows that more than two-thirds of Republican and Democratic voters, 
including voters in tobacco-growing States, favor raising tobacco 
taxes.
  These results make it clear that our constituents desire a strong 
Federal commitment to medical research, even if it means an increase in 
taxes. An increase in tobacco taxes is easily the most appropriate 
source of funding for this bill. The Centers for Disease Control and 
Prevention reports that the Federal Government spends more than $20 
billion per year to pay for the direct health care costs caused by 
tobacco. Tobacco taxes will help offset and reduce the economic costs 
of smoking. Taxes on tobacco products are a proven source of revenue 
around the world. Most major industrialized nations tax tobacco at $2 
to $3.60 per package.
  The increase in the tobacco tax will provide extensive health 
benefits. Tobacco use is the greatest cause of preventable death in 
America. About 1.3 million children and adults will be discouraged from 
smoking by a 25-cent tobacco tax. Because about half of all long-term 
smokers die of diseases caused by smoking, a 25-cent tobacco tax will 
save the lives of more than 300,000 Americans alive today. I hope these 
heart-wrenching statistics will put an end to the congressional 
coddling of the almighty tobacco lobby. Tobacco use imposes a great 
price on our society, and those who profit from tobacco use should 
contribute their fair share to this devastation.
  This legislation has everything to do with providing our Nation with 
a brighter future. While sustainable resources for medical research are 
essential for our Nation's prosperity, our young people will ultimately 
determine the future of our Nation. Zenia Kim, a finalist in the Miss 
Oregon Pageant, and an aspiring medical researcher, provides me with a 
personal impetus to progress on this legislation. Like many Zenia had 
not given disease or medical research much thought until a close 
relative was stricken with cancer. After seeing her family member 
experience the terrors of chemotherapy, she dedicated her life to 
finding a cure to cancer.
  Zenia has vigorously pursued this pledge by working during her 
college summers at Oregon Health Sciences University. It was here, at 
one of our Nation's top academic medical centers, that she encountered 
the problems of insufficient funds for medical research. This inspired 
her to develop a comprehensive proposal to cure cancer. The main 
component of this proposal is research. Kim writes, ``as a future 
medical scientist, I would like to know that there will be enough 
funding available to pursue my research endeavors.''
  I would like Zenia to someday realize her goal and find a cure for 
cancer. I would like to assure Zenia, that when she graduates from 
medical school, we will have adequate funding for medical research. I 
urge my colleagues to support the National Fund for Medical Research to 
help Zenia and others like her to provide hope for those tormented by 
disease and disabilities.
  I ask unanimous consent to include in the Record, a copy of the bill, 
a question and answer summary, a sample of letters of support, and a 
list of nearly 200 organizations supporting this effort.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1251

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``National Fund for Health 
     Research Act''.

     SEC. 2. FINDINGS.

       Congress finds the following:
       (1) Nearly 4 of 5 peer reviewed research projects deemed 
     worthy of funding by the National Institutes of Health are 
     not funded.
       (2) Less than 3 percent of the nearly one trillion dollars 
     our Nation spends on health care is devoted to health 
     research, while the defense industry spends 15 percent of its 
     budget on research.
       (3) Public opinion surveys have shown that Americans want 
     more Federal resources put into health research and are 
     willing to pay for it. Polling data consistently shows that 
     more than two-thirds of all voters support a major tobacco 
     tax increase if revenues generated are dedicated to health-
     related programs.
       (4) Ample evidence exists to demonstrate that health 
     research has improved the quality of health care in the 
     United States. Advances such as the development of vaccines, 
     the cure of many childhood cancers, drugs that effectively 
     treat a host of diseases and disorders, a process to protect 
     our Nation's blood supply from the HIV virus, progress 
     against cardiovascular disease including heart attack and 
     stroke, and new strategies for the early detection and 
     treatment of diseases such as colon, breast, and prostate 
     cancer clearly demonstrates the benefits of health research.
       (5) Health research which holds the promise of prevention 
     of intentional and unintentional injury and cure and 
     prevention of disease and disability, is critical to holding 
     down costs in the long term.
       (6) The state of our Nation's research facilities at the 
     National Institutes of Health and at universities is 
     deteriorating significantly. Renovation and repair of these 
     facilities are badly needed to maintain and improve the 
     quality of research.
       (7) Because the Concurrent Resolution on the Budget for 
     fiscal year 1996 (H. Con. Res. 67) freezes discretionary 
     spending for the next 5 years, the Nation's investment in 
     health research through the National Institutes of Health is 
     likely to decline in real terms unless corrective legislative 
     action is taken.
       (8) A health research fund is needed to maintain our 
     Nation's commitment to health research and to increase the 
     percentage of approved projects which receive funding at the 
     National Institutes of Health.
       (9) Each year 419,000 Americans die directly from tobacco 
     use and thousands more die from diseases caused by exposure 
     to environmental tobacco smoke. This year one out of every 
     five Americans who die will die from tobacco use.
       (10) A recent study by the Centers for Disease Control and 
     Prevention estimates that the Federal Government expended 
     more than $20,000,000,000 in 1993 alone to treat illnesses 
     associated with tobacco use.
       (11) A 25 cent increase in the tobacco tax would discourage 
     1,300,000 Americans from smoking and prevent more than 
     300,000 premature deaths.
       (12) An estimated 90 percent of all smokers start when they 
     are teenagers or younger.
       (13) Voluntary income tax checkoffs for medical research 
     for specific diseases exist in some States and have proven 
     successful in generating funds for such research.
               TITLE I--NATIONAL FUND FOR HEALTH RESEARCH

     SEC. 101. ESTABLISHMENT.

       (a) Establishment.--There is established in the Treasury of 
     the United States a fund, to be known as the ``National Fund 
     for Health Research'' (hereafter in this section referred to 
     as the ``Fund''), consisting of such amounts as are 
     transferred to the Fund under subsection (b) and any interest 
     earned on investment of amounts in the Fund.
       (b) Transfers to Fund.--
       (1) In general.--The Secretary of the Treasury shall 
     transfer to the Fund amounts equivalent to--
       (A) taxes received in the Treasury under section 5701 of 
     the Internal Revenue Code of 1986 (relating to taxes on 
     tobacco products) to the extent attributable to the increase 
     in such taxes resulting from the amendments made by title II 
     of the National Fund for Health Research Act; and
       (B) the amounts designated under section 6097 (relating to 
     designation of overpayments and contributions to the Fund).
       (2) Transfers based on estimates.--The amounts transferred 
     by paragraph (1) shall annually be transferred to the Fund 
     within 30 days after the President signs an appropriations 
     Act for the Departments of Labor, Health and Human Services, 
     and Education, and related agencies, or by the end of the 
     first quarter of the fiscal year. Proper adjustment shall be 
     made in amounts subsequently transferred to the extent prior 
     estimates were in excess of or less than the amounts required 
     to be transferred.
       (c) Obligations from Fund.--
       (1) In general.--Subject to the provisions of paragraph 
     (4), with respect to the amounts made available in the Fund 
     in a fiscal year, the Secretary of Health and Human Services 
     shall distribute--
       (A) 2 percent of such amounts during any fiscal year to the 
     Office of the Director of the National Institutes of Health 
     to be allocated at the Director's discretion for the 
     following activities:
       (i) for carrying out the responsibilities of the Office of 
     the Director, including the Office of Research on Women's 
     Health and the 

[[Page S 13731]]
     Office of Research on Minority Health, the Office of Alternative 
     Medicine, the Office of Rare Disease Research, the Office of 
     Behavioral and Social Sciences Research (for use for efforts 
     to reduce tobacco use), the Office of Dietary Supplements, 
     and the Office for Disease Prevention; and
       (ii) for construction and acquisition of equipment for or 
     facilities of or used by the National Institutes of Health;
       (B) 2 percent of such amounts for transfer to the National 
     Center for Research Resources to carry out section 1502 of 
     the National Institutes of Health Revitalization Act of 1993 
     concerning Biomedical and Behavioral Research Facilities;
       (C) 1 percent of such amounts during any fiscal year for 
     carrying out section 301 and part D of title IV of the Public 
     Health Service Act with respect to health information 
     communications; and
       (D) the remainder of such amounts during any fiscal year to 
     member institutes and centers, including the Office of AIDS 
     Research, of the National Institutes of Health in the same 
     proportion to the total amount received under this section, 
     as the amount of annual appropriations under appropriations 
     Acts for each member institute and Centers for the fiscal 
     year bears to the total amount of appropriations under 
     appropriations Acts for all member institutes and Centers of 
     the National Institutes of Health for the fiscal year.
       (2) Plans of allocation.--The amounts transferred under 
     paragraph (1)(D) shall be allocated by the Director of the 
     National Institutes of Health or the various directors of the 
     institutes and centers, as the case may be, pursuant to 
     allocation plans developed by the various advisory councils 
     to such directors, after consultation with such directors.
       (3) Grants and contracts fully funded in first year.--With 
     respect to any grant or contract funded by amounts 
     distributed under paragraph (1), the full amount of the total 
     obligation of such grant or contract shall be funded in the 
     first year of such grant or contract, and shall remain 
     available until expended.
       (4) Trigger and release of monies and phase-in.--
       (A) Trigger and release.--No expenditure shall be made 
     under paragraph (1) during any fiscal year in which the 
     annual amount appropriated for the National Institutes of 
     Health is less than the amount so appropriated for the prior 
     fiscal year.
       (B) Phase-in.--The Secretary of Health and Human Services 
     shall phase-in the distributions required under paragraph (1) 
     so that--
       (i) 25 percent of the amount in the Fund is distributed in 
     fiscal year 1997;
       (ii) 50 percent of the amount in the Fund is distributed in 
     fiscal year 1998;
       (iii) 75 percent of the amount in the Fund is distributed 
     in fiscal year 1999; and
       (iv) 100 percent of the amount in the Fund is distributed 
     in fiscal year 2000 and each succeeding fiscal year.
       (5) Administrative expenses.--Amounts in the Fund shall be 
     available to pay the administrative expenses of the 
     Department of the Treasury directly allocable to--
       (A) modifying the individual income tax return forms to 
     carry out section 6097 of the Internal Revenue Code of 1986; 
     and
       (B) processing amounts received under such section 6097 and 
     transferring such amounts to such Fund.
       (d) Budget Treatment of Amounts in Fund.--The amounts in 
     the Fund shall be excluded from, and shall not be taken into 
     account, for purposes of any budget enforcement procedure 
     under the Congressional Budget Act of 1974 or the Balanced 
     Budget and Emergency Deficit Control Act of 1985.
                     TITLE II--FINANCING PROVISIONS

     SEC. 201. AMENDMENT OF 1986 CODE.

       Except as otherwise expressly provided, whenever in this 
     title an amendment or repeal is expressed in terms of an 
     amendment to, or repeal of, a section or other provision, the 
     reference shall be considered to be made to a section or 
     other provision of the Internal Revenue Code of 1986.

     SEC. 202. INCREASE IN EXCISE TAXES ON TOBACCO PRODUCTS.

       (a) Cigarettes.--Subsection (b) of section 5701 is 
     amended--
       (1) by striking ``$12 per thousand ($10 per thousand on 
     cigarettes removed during 1991 or 1992)'' in paragraph (1) 
     and inserting ``$24.5 per thousand'', and
       (2) by striking ``$25.20 per thousand ($21 per thousand on 
     cigarettes removed during 1991 or 1992)'' in paragraph (2) 
     and inserting ``$51.45 per thousand''.
       (b) Cigars.--Subsection (a) of section 5701 is amended--
       (1) by striking ``$1.125 cents per thousand (93.75 cents 
     per thousand on cigars removed during 1991 or 1992)'' in 
     paragraph (1) and inserting ``$13.64 per thousand'', and
       (2) by striking ``equal to'' and all that follows in 
     paragraph (2) and inserting ``equal to 26.03 percent of the 
     price for which sold but not more than $61.25 per thousand.''
       (c) Cigarette Papers.--Subsection (c) of section 5701 is 
     amended by striking ``0.75 cent (0.625 cent on cigarette 
     papers removed during 1991 or 1992)'' and inserting ``1.53 
     cents''.
       (d) Cigarette Tubes.--Subsection (d) of section 5701 is 
     amended by striking ``1.5 cents (1.25 cents on cigarette 
     tubes removed during 1991 or 1992)'' and inserting ``3.06 
     cents''.
       (e) Smokeless Tobacco.--Subsection (e) of section 5701 is 
     amended--
       (1) by striking ``36 cents (30 cents on snuff removed 
     during 1991 or 1992)'' in paragraph (1) and inserting 
     ``$3.69'', and
       (2) by striking ``12 cents (10 cents on chewing tobacco 
     removed during 1991 or 1992)'' in paragraph (2) and inserting 
     ``$1.45''.
       (f) Pipe Tobacco.--Subsection (f) of section 5701 is 
     amended by striking ``67.5 cents (56.25 cents on pipe tobacco 
     removed during 1991 or 1992)'' and inserting ``$4.85''.
       (g) Application of Tax Increase to Puerto Rico.--Section 
     5701 is amended by adding at the end the following new 
     subsection:
       ``(h) Application to Taxes to Puerto Rico.--Notwithstanding 
     subsections (b) and (c) of section 7653 and any other 
     provision of law--
       ``(1) In general.--On tobacco products and cigarette papers 
     and tubes, manufactured or imported into the Commonwealth of 
     Puerto Rico, there is hereby imposed a tax at the rate equal 
     to the excess of--
       ``(A) the rate of tax applicable under this section to like 
     articles manufactured in the United States, over
       ``(B) the rate referred to in subparagraph (A) as in effect 
     on the day before the date of the enactment of the National 
     Fund for Health Research Act.
       ``(2) Shipments to puerto rico from the united states.--
     Only the rates of tax in effect on the day before the date of 
     the enactment of this subsection shall be taken into account 
     in determining the amount of any exemption from, or credit or 
     drawback of, any tax imposed by this section on any article 
     shipped to the Commonwealth of Puerto Rico from the United 
     States.
       ``(3) Shipments from puerto rico to the united states.--The 
     rates of tax taken into account under section 7652(a) with 
     respect to tobacco products and cigarette papers and tubes 
     coming into the United States from the Commonwealth of Puerto 
     Rico shall be the rates of tax in effect on the day before 
     the date of the enactment of the National Fund for Health 
     Research Act.
       ``(4) Disposition of revenues.--The provisions of section 
     7652(a)(3) shall not apply to any tax imposed by reason of 
     this subsection.''
       (h) Effective Date.--The amendments made by this section 
     shall apply to articles removed (as defined in section 
     5702(k) of the Internal Revenue Code of 1986, as amended by 
     this Act) after December 31, 1995.
       (i) Floor Stocks Taxes.--
       (1) Imposition of tax.--On tobacco products and cigarette 
     papers and tubes manufactured in or imported into the United 
     States or the Commonwealth of Puerto Rico which are removed 
     before January 1, 1996, and held on such date for sale by any 
     person, there is hereby imposed a tax in an amount equal to 
     the excess of--
       (A) the tax which would be imposed under section 5701 of 
     the Internal Revenue Code of 1986 on the article if the 
     article had been removed on such date, over
       (B) the prior tax (if any) imposed under section 5701 or 
     7652 of such Code on such article.
       (2) Authority to exempt cigarettes held in vending 
     machines.--To the extent provided in regulations prescribed 
     by the Secretary, no tax shall be imposed by paragraph (1) on 
     cigarettes held for retail sale on January 1, 1996, by any 
     person in any vending machine. If the Secretary provides such 
     a benefit with respect to any person, the Secretary may 
     reduce the $500 amount in paragraph (3) with respect to such 
     person.
       (3) Credit against tax.--Each person shall be allowed as a 
     credit against the taxes imposed by paragraph (1) an amount 
     equal to $500. Such credit shall not exceed the amount of 
     taxes imposed by paragraph (1) on January 1, 1996, for which 
     such person is liable.
       (4) Liability for tax and method of payment.--
       (A) Liability for tax.--A person holding cigarettes on 
     January 1, 1996, to which any tax imposed by paragraph (1) 
     applies shall be liable for such tax.
       (B) Method of payment.--The tax imposed by paragraph (1) 
     shall be paid in such manner as the Secretary shall prescribe 
     by regulations.
       (C) Time for payment.--The tax imposed by paragraph (1) 
     shall be paid on or before April 1, 1996.
       (5) Articles in foreign trade zones.--Notwithstanding the 
     Act of June 18, 1934 (48 Stat. 998, 19 U.S.C. 81a) and any 
     other provision of law, any article which is located in a 
     foreign trade zone on January 1, 1996, shall be subject to 
     the tax imposed by paragraph (1) if--
       (A) internal revenue taxes have been determined, or customs 
     duties liquidated, with respect to such article before such 
     date pursuant to a request made under the 1st proviso of 
     section 3(a) of such Act, or
       (B) such article is held on such date under the supervision 
     of a customs officer pursuant to the 2d proviso of such 
     section 3(a).
       (6) Definitions.--For purposes of this subsection--
       (A) In general.--Terms used in this subsection which are 
     also used in section 5702 of the Internal Revenue Code of 
     1986 shall have the respective meanings such terms have in 
     such section, as amended by this Act.
       (B) Secretary.--The term ``Secretary'' means the Secretary 
     of the Treasury or his delegate.
       (7) Controlled groups.--Rules similar to the rules of 
     section 5061(e)(3) of such Code shall apply for purposes of 
     this subsection.
       (8) Other laws applicable.--All provisions of law, 
     including penalties, applicable 

[[Page S 13732]]
     with respect to the taxes imposed by section 5701 of such Code shall, 
     insofar as applicable and not inconsistent with the 
     provisions of this subsection, apply to the floor stocks 
     taxes imposed by paragraph (1), to the same extent as if such 
     taxes were imposed by such section 5701. The Secretary may 
     treat any person who bore the ultimate burden of the tax 
     imposed by paragraph (1) as the person to whom a credit or 
     refund under such provisions may be allowed or made.

     SEC. 203. MODIFICATIONS OF CERTAIN TOBACCO TAX PROVISIONS.

       (a) Exemption for Exported Tobacco Products and Cigarette 
     Papers and Tubes To Apply Only to Articles Marked for 
     Export.--
       (1) Subsection (b) of section 5704 is amended by adding at 
     the end the following new sentence: ``Tobacco products and 
     cigarette papers and tubes may not be transferred or removed 
     under this subsection unless such products or papers and 
     tubes bear such marks, labels, or notices as the Secretary 
     shall by regulations prescribe.''
       (2) Section 5761 is amended by redesignating subsections 
     (c) and (d) as subsections (d) and (e), respectively, and by 
     inserting after subsection (b) the following new subsection:
       ``(c) Sale of Tobacco Products and Cigarette Papers and 
     Tubes for Export.--Except as provided in subsections (b) and 
     (d) of section 5704--
       ``(1) every person who sells, relands, or receives within 
     the jurisdiction of the United States any tobacco products or 
     cigarette papers or tubes which have been labeled or shipped 
     for exportation under this chapter,
       ``(2) every person who sells or receives such relanded 
     tobacco products or cigarette papers or tubes, and
       ``(3) every person who aids or abets in such selling, 
     relanding, or receiving,
     shall, in addition to the tax and any other penalty provided 
     in this title, be liable for a penalty equal to the greater 
     of $1,000 or 5 times the amount of the tax imposed by this 
     chapter. All tobacco products and cigarette papers and tubes 
     relanded within the jurisdiction of the United States, and 
     all vessels, vehicles, and aircraft used in such relanding or 
     in removing such products, papers, and tubes from the place 
     where relanded, shall be forfeited to the United States.''
       (3) Subsection (a) of section 5761 is amended by striking 
     ``subsection (b)'' and inserting ``subsection (b) or (c)''.
       (4) Subsection (d) of section 5761, as redesignated by 
     paragraph (2), is amended by striking ``The penalty imposed 
     by subsection (b)'' and inserting ``The penalties imposed by 
     subsections (b) and (c)''.
       (5)(A) Subpart F of chapter 52 is amended by adding at the 
     end the following new section:

     ``SEC. 5754. RESTRICTION ON IMPORTATION OF PREVIOUSLY 
                   EXPORTED TOBACCO PRODUCTS.

       ``(a) In General.--Tobacco products and cigarette papers 
     and tubes previously exported from the United States may be 
     imported or brought into the United States only as provided 
     in section 5704(d). For purposes of this section, section 
     5704(d), section 5761, and such other provisions as the 
     Secretary may specify by regulations, references to 
     exportation shall be treated as including a reference to 
     shipment to the Commonwealth of Puerto Rico.
       ``(b) Cross Reference.--

  ``For penalty for the sale of tobacco products and cigarette papers 
and tubes in the United States which are labeled for export, see 
section 5761(c).''
       (B) The table of sections for subpart F of chapter 52 is 
     amended by adding at the end the following new item:

``Sec. 5754. Restriction on importation of previously exported tobacco 
              products.''

       (b) Importers Required To Be Qualified.--
       (1) Sections 5712, 5713(a), 5721, 5722, 5762(a)(1), and 
     5763 (b) and (c) are each amended by inserting ``or 
     importer'' after ``manufacturer''.
       (2) The heading of subsection (b) of section 5763 is 
     amended by inserting ``Qualified Importers,'' after 
     ``Manufacturers,''.
       (3) The heading for subchapter B of chapter 52 is amended 
     by inserting ``and Importers'' after ``Manufacturers''.
       (4) The item relating to subchapter B in the table of 
     subchapters for chapter 52 is amended by inserting ``and 
     importers'' after ``manufacturers''.
       (c) Repeal of Tax-Exempt Sales to Employees of Cigarette 
     Manufacturers.--
       (1) Subsection (a) of section 5704 is amended--
       (A) by striking ``Employee Use or'' in the heading, and
       (B) by striking ``for use or consumption by employees or'' 
     in the text.
       (2) Subsection (e) of section 5723 is amended by striking 
     ``for use or consumption by their employees, or for 
     experimental purposes'' and inserting ``for experimental 
     purposes''.
       (d) Repeal of Tax-Exempt Sales to United States.--
     Subsection (b) of section 5704 is amended by striking ``and 
     manufacturers may similarly remove such articles for use of 
     the United States;''.
       (e) Books of 25 or Fewer Cigarette Papers Subject to Tax.--
     Subsection (c) of section 5701 is amended by striking ``On 
     each book or set of cigarette papers containing more than 25 
     papers,'' and inserting ``On cigarette papers,''.
       (f) Storage of Tobacco Products.--Subsection (k) of section 
     5702 is amended by inserting ``under section 5704'' after 
     ``internal revenue bond''.
       (g) Authority To Prescribe Minimum Manufacturing Activity 
     Requirements.--Section 5712 is amended by striking ``or'' at 
     the end of paragraph (1), by redesignating paragraph (2) as 
     paragraph (3), and by inserting after paragraph (1) the 
     following new paragraph:
       ``(2) the activity proposed to be carried out at such 
     premises does not meet such minimum capacity or activity 
     requirements as the Secretary may prescribe, or''.
       (h) Special Rules Relating to Puerto Rico and the Virgin 
     Islands.--Section 7652 is amended by adding at the end the 
     following new subsection:
       ``(h) Limitation on Cover Over of Tax on Tobacco 
     Products.--For purposes of this section, with respect to 
     taxes imposed under section 5701 or this section on any 
     tobacco product or cigarette paper or tube, the amount 
     covered into the treasuries of Puerto Rico and the Virgin 
     Islands shall not exceed the rate of tax under section 5701 
     in effect on the article on the day before the date of the 
     enactment of the Health Partnership Act of 1995.''
       (i) Effective Date.--The amendments made by this section 
     shall apply to articles removed (as defined in section 
     5702(k) of the Internal Revenue Code of 1986, as amended by 
     this Act) after December 31, 1995.

     SEC. 204. IMPOSITION OF EXCISE TAX ON MANUFACTURE OR 
                   IMPORTATION OF ROLL-YOUR-OWN TOBACCO.

       (a) In General.--Section 5701 (relating to rate of tax), as 
     amended by section 701, is amended by redesignating 
     subsections (g) and (h) as subsections (h) and (i) and by 
     inserting after subsection (f) the following new subsection:
       ``(g) Roll-Your-Own Tobacco.--On roll-your-own tobacco, 
     manufactured in or imported into the United States, there 
     shall be imposed a tax of $4.85 per pound (and a 
     proportionate tax at the like rate on all fractional parts of 
     a pound).''
       (b) Roll-Your-Own Tobacco.--Section 5702 (relating to 
     definitions) is amended by adding at the end the following 
     new subsection:
       ``(p) Roll-Your-Own Tobacco.--The term `roll-your-own 
     tobacco' means any tobacco which, because of its appearance, 
     type, packaging, or labeling, is suitable for use and likely 
     to be offered to, or purchased by, consumers as tobacco for 
     making cigarettes.''
       (c) Technical Amendments.--
       (1) Subsection (c) of section 5702 is amended by striking 
     ``and pipe tobacco'' and inserting ``pipe tobacco, and roll-
     your-own tobacco''.
       (2) Subsection (d) of section 5702 is amended--
       (A) in the material preceding paragraph (1), by striking 
     ``or pipe tobacco'' and inserting ``pipe tobacco, or roll-
     your-own tobacco'', and
       (B) by striking paragraph (1) and inserting the following 
     new paragraph:
       ``(1) a person who produces cigars, cigarettes, smokeless 
     tobacco, pipe tobacco, or roll-your-own tobacco solely for 
     the person's own personal consumption or use, and''.
       (3) The chapter heading for chapter 52 is amended to read 
     as follows:

    ``CHAPTER 52--TOBACCO PRODUCTS AND CIGARETTE PAPERS AND TUBES''.

       (4) The table of chapters for subtitle E is amended by 
     striking the item relating to chapter 52 and inserting the 
     following new item:

``Chapter 52. Tobacco products and cigarette papers and tubes.''

       (d) Effective Date.--
       (1) In general.--The amendments made by this section shall 
     apply to roll-your-own tobacco removed (as defined in section 
     5702(k) of the Internal Revenue Code of 1986, as amended by 
     this Act) after December 31, 1995.
       (2) Transitional rule.--Any person who--
       (A) on the date of the enactment of this Act is engaged in 
     business as a manufacturer of roll-your-own tobacco or as an 
     importer of tobacco products or cigarette papers and tubes, 
     and
       (B) before January 1, 1996, submits an application under 
     subchapter B of chapter 52 of such Code to engage in such 
     business,
     may, notwithstanding such subchapter B, continue to engage in 
     such business pending final action on such application. 
     Pending such final action, all provisions of such chapter 52 
     shall apply to such applicant in the same manner and to the 
     same extent as if such applicant were a holder of a permit 
     under such chapter 52 to engage in such business.

     SEC. 205. DESIGNATION OF OVERPAYMENTS AND CONTRIBUTIONS FOR 
                   THE NATIONAL FUND FOR HEALTH RESEARCH.

       (a) In General.--Subchapter A of chapter 61 (relating to 
     returns and records) is amended by adding at the end the 
     following new part:

   ``PART IX--DESIGNATION OF OVERPAYMENTS AND CONTRIBUTIONS FOR THE 
                   NATIONAL FUND FOR HEALTH RESEARCH

``Sec. 6097. Amounts for the National Fund for Health Research.

[[Page S 13733]]


     ``SEC. 6097. AMOUNTS FOR THE NATIONAL FUND FOR HEALTH 
                   RESEARCH.

       ``(a) In General.--Every individual (other than a 
     nonresident alien) may designate that--
       ``(1) a portion (not less than $1) of any overpayment of 
     the tax imposed by chapter 1 for the taxable year, and
       ``(2) a cash contribution (not less than $1),
     be paid over to the National Fund for Health Research. In the 
     case of a joint return of a husband and wife, each spouse may 
     designate one-half of any such overpayment of tax (not less 
     than $2).
       ``(b) Manner and Time of Designation.--Any designation 
     under subsection (a) may be made with respect to any taxable 
     year only at the time of filing the original return of the 
     tax imposed by chapter 1 for such taxable year. Such 
     designation shall be made either on the 1st page of the 
     return or on the page bearing the taxpayer's signature.
       ``(c) Overpayments Treated as Refunded.--For purposes of 
     this section, any overpayment of tax designated under 
     subsection (a) shall be treated as being refunded to the 
     taxpayer as of the last day prescribed for filing the return 
     of tax imposed by chapter 1 (determined with regard to 
     extensions) or, if later, the date the return is filed.
       ``(d) Designated Amounts Not Deductible.--No amount 
     designated pursuant to subsection (a) shall be allowed as a 
     deduction under section 170 or any other section for any 
     taxable year.
       ``(e) Termination.--This section shall not apply to taxable 
     years beginning in a calendar year after a determination by 
     the Secretary that the sum of all designations under 
     subsection (a) for taxable years beginning in the second and 
     third calendar years preceding the calendar year is less than 
     $5,000,000.''
       (b) Clerical Amendment.--The table of parts for subchapter 
     A of chapter 61 is amended by adding at the end the following 
     new item:

``Part IX. Designation of overpayments and contributions for the 
              National Fund for Health Research.''

       (c) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     1995.
                                                                    ____


      National Fund for Health Research Act--Questions and Answers

       What does the proposal call for?
       A National Fund For Health Research would be established to 
     provide additional resources for health research over and 
     above those provided to the National Institutes of Health 
     (NIH) in the annual appropriations process. The Fund would 
     greatly enhance the quality of health care by investing more 
     resources in finding preventive measures, cures and cost 
     effective treatments for the major illnesses and conditions 
     that strike Americans.
       Financing for the Fund comes from an increase in federal 
     tobacco taxes--25 cents per pack of cigarettes and an 
     equivalent tax on other tobacco products. This tax would 
     raise an estimated $4.2 billion annually. In addition to 
     providing revenue for the Fund, raising tobacco taxes will 
     protect children and save lives. Every day more than 3,000 
     children become smokers and more than 1,000 of them will 
     eventually die as a result of smoking. Raising tobacco taxes 
     is a highly effective way to reduce tobacco use by children. 
     A 25-cent tax will discourage an estimated 1.3 million 
     children and adults from smoking and will save the lives of 
     more than 300,000 Americans alive today.
       Each year amounts within the Fund would automatically be 
     allotted to each of the NIH Institutes and Centers. Five 
     percent of the monies would be directed to extramural 
     construction and renovation of research facilities, the 
     National Library of Medicine, and the Office of the Director. 
     So that an appropriate range of basic and applied research is 
     supported, each Institute and Center would receive the same 
     percentage of the remaining Fund monies as they received of 
     the total NIH appropriation for that fiscal year. In order to 
     insure that the additional funds generated do not simply 
     replace regularly appropriated NIH funds, monies from the 
     Fund would be released only if the total appropriated for the 
     NIH in that year equal or exceed the prior year 
     appropriations.
       Additional monies for the Fund would be generated by a 
     voluntary federal income tax check-off. Every year, when 
     filing their Federal income tax returns, Americans would have 
     the opportunity to designate tax overpayments and 
     contributions for health research. Monies from the check-off 
     would be deposited in the Fund.
       Why is this proposal necessary?
       Health research has brought us the advances in treatment 
     and prevention of disease and disability that define our 
     current high standards of medical practice. Perhaps more than 
     any other component of our health care system, health 
     research holds the promise of both reducing medical costs and 
     improving the quality of life of Americans. Yet, because the 
     federal budget agreement freezes discretionary spending for 
     the next four years, Federal funding for health research will 
     likely not even keep up with inflation unless a separate 
     funding stream is established.
       Will the Fund simply replace existing monies appropriated 
     to NIH?
       No. Monies generated by the Fund would be in addition to, 
     not in replacement of those provided to each of the NIH 
     Institutes in the normal appropriations process. Monies from 
     the Fund could not be allotted unless total NIH 
     appropriations in that year were equal to or greater than the 
     prior year appropriations. Therefore, the Fund could not be 
     used as a mechanism to replace or reduce regularly 
     appropriated funds.
       How would money from the Fund be allocated among research 
     priorities?
       The proposal does not pick winners and losers among areas 
     of health research. It does not interfere with the funding 
     decisions made through the normal appropriations process. 
     Funds would be allocated to each of the NIH Institutes and 
     Centers based on the percentage that each of these entities 
     received of the total NIH appropriation for that year. Monies 
     allotted to each NIH entity would be spent according to a 
     plan developed by the entities' advisory council in 
     consultation with the NIH Director. Each Institute would 
     decide the appropriate distribution of Fund monies among 
     various research priorities within the Institute.
       In recognition of the poor state of many medical research 
     facilities, 2 percent of the total Fund would be taken off 
     the top for extramural construction and renovation of 
     research building and facilities. In accordance with 
     traditional funding patterns, 1 percent of the total Fund 
     would go to the National Library of Medicine. An additional 2 
     percent would go to the NIH Director for intramural 
     construction and renovation and other activities supported by 
     the Office of the Director.
       Isn't research a major reason why the cost of health care 
     is so high in this country? Won't an increase in research 
     funding lead to an increase in health care costs?
       Absolutely not. Funding for research can be an effective 
     means of controlling health costs in the long run. Investment 
     in research pays off in terms of lower medical expenses, 
     reduced worker absenteeism, and improved productivity. For 
     example, according to NIH statistics, an investment of $1.2 
     million in the development of a mass screening device for 
     neonatal hypothyroidism in newborns has the potential 1-year 
     saving of over $206 million. An investment of slightly over 
     $679,000 for a treatment for preventing the recurrence of 
     kidney stones saves close to $300 million in annual treatment 
     costs and lost days work.
       Today, many families are anxiously looking for a treatment 
     and cure of Alzheimer's disease. Federally supported funding 
     for research on Alzheimer's disease totals $300 million 
     annually on caring for people with Alzheimer's. A cure or 
     treatment for Alzheimer's, in addition to relieving 
     suffering, would result in enormous savings.
       Won't more research lead to the development and over 
     utilization of new tests and expensive equipment?
       There are legitimate concerns about the over utilization 
     and duplication of expensive technologies. These concerns 
     should be addressed by an increased emphasis on outcomes and 
     effectiveness research. We should solve the problem of over 
     utilization of services but not at the expense of improving 
     quality and coming up with more effective treatments and 
     cures.
       Do the American people support increases in tobacco taxes 
     to pay for increases in health research?
       Polling data consistently show that more than two-thirds of 
     Republican and Democratic voters, including voters in 
     tobacco-growing states, favor raising tobacco taxes if 
     revenues are dedicated to health-related activities.
       Does the proposal include prevention research?
       Absolutely. Research is our first line of defense. It is 
     the ultimate investment in prevention. Research provides the 
     building blocks for prevention--research has produced 
     immunizations, critical information about the importance of 
     diet and exercise in preventing disease, and a screening test 
     to prevent the transmission of HIV through blood products. 
     Research is the key to prevention.
                                                                    ____


               Cancer Understanding and Research Efforts

                        (Statement of Zenia Kim)

       The CURE program is designed to focus on two areas of 
     cancer treatment: prevention and research.


                              introduction

       I remember when I was attending Junior High and High 
     School, I never really learned about cancer or the risk 
     factors involved. When I was a senior in high school, a very 
     close relative of mine became very ill and was diagnosed with 
     cancer. She started chemotherapy treatment but things got 
     worse. I promised myself at that moment that I was going to 
     perform my own research on cancer. What caused this disease 
     and why wasn't my loved one getting better? I began 
     volunteering at our local hospital in the Pathology lab, 
     where I observed doctors examining various forms of cancers. 
     I learned how to spot cancers of all sorts. As I continued my 
     education at Brigham Young University, I continued with my 
     cancer research. I worked with a Chemistry professor by the 
     name of Dr. James Thorne, and he assisted me in understanding 
     the chemical aspect of cancer research. We worked on a 
     treatment called Photodynamic Therapy. This form of cancer 
     treatment became very appealing because it did not have as 
     many negative side effects that chemotherapy had. I became so 
     involved with the research that I wrote my own paper on 
     Photodynamic Therapy. I am still continuing my research with 
     Dr. Thorne for the third year, and hope that this is our real 
     breakthrough in curing cancer. While I 

[[Page S 13734]]
     was performing research on Photodynamic Therapy, I really wanted to 
     continue my volunteer work in a hospital setting. I 
     volunteered at Utah Valley Regional Medical Center in the 
     Oncology Department. Here, I got to experience the other 
     side, the patient's side. I remember talking with many cancer 
     patients and listening to their distress, their hopeless 
     feelings. I became so determined . . . that I was going to 
     find a cure for cancer. As my research continued at BYU, I 
     discovered that research funds were very limited. The 
     national funding organizations can hardly support any of the 
     proposals coming in. As a future medical research specialist, 
     I became disheartened. Over the summer, I worked at Oregon 
     Health Sciences University Medical School performing medical 
     cancer research, and there too discovered the limited funding 
     available for research. This is why I became so inspired to 
     develop my own program called the CURE.


               cancer understanding and research efforts

       The CURE focuses on two areas of cancer treatment. The 
     first is prevention. I believe that if many students learned 
     about the risks involved with cancer as a junior high or high 
     school student, there would be a significant decrease in the 
     incidents of cancer. I would like to see a unit integrated 
     within the health curriculum that emphasizes the risks of 
     cancer. Furthermore, I would like to invite guest speakers, 
     perhaps one who has fought and recovered from cancer or the 
     loved ones of a cancer victim, to tell about their side of 
     their story. I think that by personalizing a real situation, 
     students feel more sensitive and more in tune with the 
     problem. That is exactly what we need. We need students to 
     feel realistic, sad, or even scared so that they won't 
     associate with any of the risks involved with cancer. The 
     decisions that students in their junior high and high school 
     years make can indefinitely affect the course of their lives. 
     Furthermore, this is the time that they opt to engage in such 
     acts as smoking, using tobacco, sun tanning, etc. So, 
     by integrating a cancer unit within secondary education, 
     the hope is that the future generations will choose to 
     stay risk free and beat the battle against cancer.
       The second area of cancer treatment that the CURE focuses 
     on is research. Prevention is great to eliminate cancer but 
     for those already afflicted with cancer, there must be 
     another alternative. I would like to personally declare, to 
     those of all ages, that research is the first and most 
     important step towards cancer cure. By understanding the 
     mechanism of how cancer cells undergo their uncontrolled rate 
     of division, we can come closer to finding the right reagents 
     to stop it. I know that cancer research has been going on for 
     many years, and I believe that we are coming so much closer 
     to the cure. We really need to support the research funding. 
     I have sadly discovered that less than 10 percent of all the 
     proposals that are sent to large funding organizations, such 
     as the National Institute of Health, actually get funded. 
     This to me is a horrifying reality. But the question always 
     seems to be, ``Where are we going to get the money?'' I 
     believe that we can first start with larger corporations. 
     They have elicited a certain percentage of their profits into 
     donations. I would like to encourage those corporations to 
     donate more of their profits into research. Also, I support 
     Senator Hatfield's and Senator Harkin's Trust Fund Proposal 
     in allocating more money towards research from a tobacco tax. 
     By raising the tobacco tax by a small fraction, we will not 
     destroy the tobacco industry and we will be able to fund more 
     scientific discoveries. As a future medical scientist, I 
     would like to know that there will be enough funding 
     available to pursue my research endeavors. I love research 
     and I thrive off making new scientific discoveries. I just 
     hope that I can continue my love for research when I work in 
     my own laboratory someday soon.
       As Miss Tri-Valley, I have actually had the opportunity to 
     speak to students in junior high and high schools throughout 
     the Beaverton/Portland area. I always emphasize these two 
     important points that I have established in the CURE Program: 
     Prevention and Research--these are our two means of defeating 
     cancer.
                                                                    ____



                                    American Lung Association,

                                               September 14, 1995.
     Hon. Mark Hatfield,
     U.S. Senate, Hart Senate Office Building, Washington, DC.
       Dear Senator Hatfield: The American Lung Association 
     strongly endorses the legislation you are introducing today, 
     Research Trust Fund Act. Enactment of the Research Trust Fund 
     Act will be a win-win proposition for the health and well-
     being of the American people.
       The Research Trust Fund Act will save lives through 
     prevention. Each year 419,000 Americans die from causes 
     directly related to tobacco use and thousands more die from 
     diseases caused by exposure to environmental tobacco smoke. 
     These preventable deaths represents a huge human loss to our 
     society. The proposed $0.25 increase in the federal excise 
     tax on tobacco products will help reduce the number of people 
     who smoke. It is estimated that for every $0.25 increased in 
     the federal tobacco tax, about one million people living 
     today will be discouraged from smoking and 200,000 to 300,000 
     premature deaths will be prevented.
       The Research Trust Fund Act will save health care dollars. 
     The cost of treating people who suffer from tobacco related 
     illnesses places a staggering financial burden on the 
     American health care system. Although smokers tend to die 
     younger, over the course of their life, current and former 
     smokers generate an estimated $501 billion in excess health 
     care costs. Treating tobacco related illnesses cost the $21 
     billion per year, with an additional estimated cost of $47 
     billion in lost productivity. Reducing the number of people 
     who use tobacco products by increasing the federal tobacco 
     tax will help reduce the economic burden tobacco consumption 
     places on the U.S. health care system.
       The Research Trust Fund Act will save lives through 
     improved treatments and cures. The estimated $4 billion to $5 
     billion generated by the Research Trust Fund will provided 
     needed additional funding for biomedical research sponsored 
     by the National Institutes of Health. Through increased 
     support of basic and clinical biomedical research at the 
     National Institutes of Health, researchers will continue to 
     broaden our understanding of life sciences and develop new 
     approaches to preventing, treating, and curing disease.
       The American Lung Association and its volunteers stand 
     ready to work with you and Congress to enact this important 
     legislation. I would also like to take this opportunity to 
     commend you for your leadership and foresight in introducing 
     the Research Trust Fund Act. The Research Trust Fund will go 
     a long way to improving the health of all Americans.
           Sincerely,
                                  Jacqueline D. McLeod, MPH, M.Ed,
     President.
                                                                    ____

                                            Federation of American


                           Societies for Experimental Biology,

                                 Bethesda, MD, September 11, 1995.
     Hon. Mark Hatfield,
     Chair, Senate Appropriations Committee, U.S. Senate, 
         Washington, DC.
       Dear Mr. Chairman: The Federation of American Societies for 
     Experimental Biology (FASEB) supports with enthusiasm your 
     efforts to provide supplemental resources for NIH and 
     biomedical research.
       The Federation concurs that the federal commitment to 
     health research is grossly underfunded. Less than 3 percent 
     of the nearly one trillion dollars our Nation spends on 
     health care is devoted to health research, while the defense 
     industry spends 15 percent of its budget on research. Ample 
     evidence exists to demonstrate that health research has 
     improved the quality of health care in the United States, and 
     is one of the best methods of health care cost containment.
       Therefore, FASEB supports the proposal to create an 
     additional source of biomedical funding, such as through the 
     National Fund for Health Research Act. We are confident that 
     these additional funds would not be used to offset regular 
     appropriations.
           Sincerely,
                                         Ralph A. Bradshaw, Ph.D.,
     President.
                                                                    ____

         National Committee To Preserve Social Security and 
           Medicare,
                               Washington, DC, September 14, 1995.
     Hon. Mark O. Hatfield,
     U.S. Senate, Hart Senate Office Building, Washington, DC.
       Dear Senator Hatfield: On behalf of the nearly six million 
     members and supporters of the National Committee to Preserve 
     Social Security and Medicare, I am writing in strong support 
     of your legislation to increase medical research funding to 
     the National Institutes of Health (NIH).
       Increased research into the causes and potential cures of 
     many diseases related to aging could have a profound impact 
     on the lives of older Americans and their families. 
     Alzheimer's disease, a degenerative brain disorder, afflicts 
     about 4 million people in the United States, and costs the 
     nation an estimated $80 billion to $100 billion a year. 
     Osteoporosis, which causes fragile bones and painfully 
     crippling fractures, costs an estimated $10 billion a year. 
     When families can no longer meet the care needs of relatives 
     with these illnesses, disabled people often end up in nursing 
     homes, where bills totaled $69.6 billion in 1993.
       The Hatfield/Harkin Research Fund legislation to be 
     introduced today is a significant step forward to find cures 
     or better treatments, save lives and dollars. We commend you 
     on your long-time commitment to medical research.
           Sincerely,
                                                Martha A. McSteen,
     President.
                                                                    ____

                                                    Association of


                                    American Medical Colleges,

                               Washington, DC, September 15, 1995.
     Hon. Mark O. Hatfield,
     U.S. Senate, Hart Senate Office Building, Washington, DC.

     Hon. Tom Harkin,
     U.S. Senate, Hart Senate Office Building, Washington, DC.
       Dear Senators Hatfield and Harkin: The Association of 
     American Medical Colleges (AAMC) strongly endorses your 
     proposal to create a National Fund for Health Research. The 
     debate on this year's budget makes it clear that we must 
     identify additional, sustainable sources of funding to 
     supplement the regular appropriation for the National 

[[Page S 13735]]
     Institutes of Health [NIH] if we are to continue to rely upon 
     scientific discovery to improve the health and quality of 
     life for all Americans. In addition, sustained support for 
     the NIH is needed if the United States is to maintain its 
     position as the world's leader in biomedical and behavioral 
     research. The fund you propose is an innovative and necessary 
     complement to NIH funding.
       The Federal Government plays a necessary role in the 
     support of this nation's biomedical and behavioral research 
     efforts. The investment that the Federal Government has made 
     in the NIH has produced a comprehensive network of 
     scientists, physicians, and technicians at more than 1,700 
     institutions across the United States dedicated to the 
     continued pursuit of fundamental knowledge and the 
     application of this information to the prevention, diagnosis, 
     and treatment of disease. NIH-supported scientists have made 
     enormous contributions to the nation's health. In addition, 
     NIH-sponsored research has made significant economic 
     contributions, both locally and nationally. The role that the 
     U.S. biotechnology industry plays globally is just one 
     example of the economic benefits to be derived from NIH 
     research.
       Moreover, your proposal addresses a major cause of disease 
     and death in this country: tobacco. As health professionals, 
     we must do everything in our power to reduce the use of 
     tobacco in this country, particularly among children and 
     teenagers. Your bill is an important part of that strategy. 
     We will work with you to urge all health-related 
     organizations and institutions to support this proposal and 
     to encourage other Senators to cosponsor it.
       Finally, on behalf of the Association's members, I wish to 
     thank you for your leadership and unfailing commitment to a 
     strong, vital medical research effort in this country. We 
     appreciate the continued support and trust that you have 
     placed in the NIH, and by implication in our institutions and 
     faculty. We look forward to continuing to work with you to 
     sustain this national treasure that is so critically 
     important to the nation's health.
           Very sincerely yours,
                                             Jordan J. Cohen, M.D.
     President.
                                                                    ____

                                          American Cancer Society,


                                National Public Issues Office,

                               Washington, DC, September 15, 1995.
     Hon. Mark Hatfield,
     U.S. Senate,
     Washington, DC.
       Dear Senator Hatfield: On behalf of more than two million 
     American Cancer Society volunteers, I am writing to commend 
     you and Senator Harkin for your leadership in introducing the 
     National Fund for Health Research Act. Your proposal combines 
     two critical initiatives: increasing biomedical research 
     funding and protecting children from tobacco addiction by 
     raising tobacco taxes. The American Cancer Society strongly 
     supports this bill.
       Increasing funding for biomedical research is a top 
     priority for all health organizations that understand the 
     role such research plays in treating diseases, reducing 
     suffering, improving the efficiency of our health care system 
     and improving the health status of the entire nation. The 
     American Cancer Society is particularly concerned about the 
     rise in cancer rates. Cancer will become the leading cause of 
     death in the United States by the year 2000. Biomedical 
     research performed by the National Institutes of Health is of 
     vital importance in the fight against cancer. The United 
     States currently devotes less than 3 percent of health care 
     spending to research. This amount is unacceptably low as a 
     matter of health and economics.
       There is no more appropriate way to finance this bill than 
     through a tobacco tax increase. By itself, this tax will 
     discourage about 1.3 million children and adults from smoking 
     and will ultimately save the lives of more than 300,000 
     Americans alive today. Raising tobacco taxes is one of the 
     most important measures we can take to reduce the current 
     epidemic of tobacco use by teenagers.
       More than two-thirds of Republican and Democratic voters, 
     including voters from tobacco-growing states, supports 
     raising tobacco taxes for health-related purposes such as 
     this.
       You have our full support. We look forward to working with 
     you and your staff.
           Sincerely,
                                                 Kerrie B. Wilson,
       National Vice President for Government Relations, American 
     Cancer Society.
                                                                    ____


  Medical Research and Health Care Concerns: A Survey of the American 
                                 Public

          (Conducted by Louis Harris & Associates, June 1995)

       A nationwide Harris telephone poll was conducted of 1004 
     adults in the United States from June 8-11, 1995. Figures for 
     age, sex, race, education, and region were weighted where 
     necessary to bring them into line with their actual 
     proportions in the population. The margin of error for the 
     survey is approximately 3.1 percent.
       Research! America, a national not-for-profit organization 
     dedicated to raising public awareness of and support for 
     medical research, commissioned Louis Harris & Associates to 
     ask questions about medical research as a part of a larger 
     survey focusing on a broad range of current issues.


                               HIGHLIGHTS

       1. Americans oppose cuts in medical research dollars.
       Respondents were told that one impact of proposed changes 
     in the Federal budget would be less money going to 
     universities and their hospitals which teach medical students 
     and do medical research. When asked whether they favored or 
     opposed these changes in the Federal budget, 65% opposed 
     proposed cuts in Federal support for universities and 
     hospitals.
       The younger those surveyed, the higher their response: 
     Among 18-24 year-olds, the opposition to the proposed cuts 
     rises to 75%; among 15-29 year-olds, the opposition to the 
     proposed cuts is 72%.
       2. Americans would pay higher taxes to support medical 
     research.
       73% would be willing to pay a dollar more perweek in taxes 
     if they knew the money would be spent on medical research to 
     better diagnose, prevent and treat disease.
       Results from a November, 1993 Harris Poll were very 
     similar--74% were willing to pay a dollar more per week in 
     taxes if spent on medical research.
       3. Americans urge Congress to provide tax incentives for 
     private industry to conduct medical research.
       61% of those surveyed want their Senators and 
     Representatives to support legislation that would give tax 
     credits to private industries to conduct more medical 
     research.
       4. Americans are willing to designate tax refund dollars 
     for medical research.
       45% would probably, and 15% would definitely check off a 
     box on their federal income tax return to designate tax 
     refund money specifically for medical research.
       When asked how much money they would be willing to 
     designate to medical research, the median amount reported was 
     $23.
       5. Americans overwhelmingly value maintaining the United 
     States' position as a leader in medical research.
       94% of those surveyed believe that it is important that the 
     United States maintains its role as a world leader in medical 
     research!
       6. Americans heartily endorse having the Federal Government 
     support basic science research.
       Those surveyed were asked if they agree or disagree with 
     the following: ``Even if it brings no immediate benefits, 
     basic science research which advances the frontiers of 
     knowledge is necessary and should be supported by the Federal 
     Government.''
       69% of respondent agree; 79% of young people ages 18-24 
     agree with the need to support basic research.
       7. Medical research takes second place only to national, 
     defense for tax dollar value.
       While 45% gave federal defense spending the highest rating 
     for tax dollar value, second place went to medical research 
     with 37% of the respondents giving it a favorable tax dollar 
     value.
       Public education and federal anti-crime efforts ranked the 
     lowest.
       8. Americans want more information about medical research 
     in the print and broadcast media.
       61% of the Americans surveyed would like to see more 
     medical research information in newspaper, magazines and on 
     television.
       77% of young people 18-24 want more medical research 
     information from these sources.
       For further information on the survey or other Research! 
     America activities, contact Tracy Turner at (703) 739-2577; 
     Fax (703) 739-2372.
                                                                    ____


 Organizations Endorsing the Hatfield-Harkin Research Fund Proposal as 
                         of September 14, 1995

       Academy of Radiology Research.
       Alliance for Aging Research.
       Alliance for Eye and Vision Research.
       Alzheimer's Association.
       American Academy of Allergy, Asthma & Immunology.
       American Academy of Child and Adolescent Psychiatry.
       American Academy of Dermatology.
       American Academy of Medical Acupuncture.
       American Academy of Neurology.
       American Academy of Ophthalmology.
       American Academy of Orthopaedic Surgeons.
       American Academy of Otolaryngology--Head and Neck Surgery.
       American Academy of Pediatrics.
       American Association for Cancer Education.
       American Association for Cancer Research.
       American Association for Dental Research.
       American Association of Anatomists.
       American Association of Blood Banks.
       American Association of Colleges of Nursing.
       American Association of Colleges of Pharmacy.
       American Association of Critical-Care Nurses.
       American Association of Dental Schools.
       American Association of Immunologists.
       American Association of Pharmaceutical Scientists.
       American Cancer Society.
       American College of Cardiology.
       American College of Chest Physicians.
       American College of Clinical Pharmacology.
       American College of Medical Genetics.
       American College of Preventive Medicine.
       American College of Rheumatology.
       American Diabetes Association.
       American Federation for Clinical Research.
       American Gastroenterological Association.
       American Geriatrics Society.

[[Page S 13736]]

       American Heart Association.
       American Institute of Nutrition.
       American Lung Association.
       American Nurses Association.
       American Orthopaedic Association.
       American Pediatric Society.
       American Physiological Society.
       American Podiatric Medical Association.
       American Porphyria Foundation.
       American Psychiatric Association.
       American Psychological Society.
       American Skin Association, Inc.
       American Sleep Disorders Association.
       American Society for Bone and Mineral Research.
       American Society for Cell Biology.
       American Society for Clinical Nutrition.
       American Society for Dermatologic Surgery.
       American Society for Investigative Pathology.
       American Society for Microbiology.
       American Society for Pharmacology and Experimental 
     Therapeutics.
       American Society for Reproductive Medicine.
       American Society for Therapeutic Radiology and Oncology.
       American Society for Virology.
       American Society of Addiction Medicine.
       American Society of Animal Sciences.
       American Society of Clinical Oncology.
       American Society of Hematology.
       American Society of Nephrology.
       American Society of Pediatric Hematology/Oncology.
       American Society of Tropical Medicine & Hygiene.
       American Speech-Language-Hearing Association.
       American Thoracic Society.
       American Urological Association.
       Amputee Coalition of America.
       Arizona Disease Prevention Center at the University of 
     Arizona.
       Arthritis Foundation.
       Association for Behavioral Sciences & Medical Education.
       Association for Professionals in Infection Control & 
     Epidemiology, Inc.
       Association for Research in Vision and Ophthalmology.
       Association of Academic Health Centers.
       Association of American Cancer Institutes.
       Association of American Medical Colleges.
       Association of American Veterinary Medical Colleges.
       Association of Medical Graduate Departments of 
     Biochemistry.
       Association of Medical School Microbiology and Immunology 
     Chairs.
       Association of Medical School Pediatric Department 
     Chairman.
       Association of Minority Health Profession Schools.
       Association of Pediatric Oncology Nurses.
       Association of Population Centers.
       Association of Professors of Dermatology.
       Association of Professors of Medicine.
       Association of Subspecialty Professors.
       Association of Teachers of Preventive Medicine.
       Association of University Environmental Health Sciences 
     Centers.
       Association of University professors of Ophthalmology.
       Association of University Programs in Occupational Health 
     and Safety.
       Autism Society of America.
       Cancer Research Foundation of America.
       Citizens for Public Action on Blood Pressure and 
     Cholesterol, Inc.
       Coalition for American Trauma Care.
       Coalition of Patient Advocates for Skin Disease Research.
        College on Problems of Drug Dependence.
       Columbia University.
        Columbia University, Health Sciences.
       Consortium for Skin Research.
       Peter C. & Pat Cook Health Sciences Research & Education 
     Institute at Butterworth Hospital.
       Cooley's Anemia Foundation.
       Cooper Hospital/University Medical Center.
       Corporation for the Advancement of Psychiatry.
       Council of Community Blood Centers.
       Cystic Fibrosis Foundation.
       Drew/Meharry/Morehouse Consortium Cancer Center.
       Digestive Disease National Coalition.
       Dystonia Medical Research Foundation.
       Dystrophic Epidermolysis Bullosa Research Association of 
     America.
       Ehlers Danlos National Foundation.
       The Endocine Society.
       Environmental Science Associates, Inc.
       Epilepsy Foundation of America.
       Families Against Cancer.
       Federation of American Societies for Experimental Biology.
       Federation of Behavioral, Psychological & Cognitive 
     Sciences.
       Foundation for Ichthyosis & Related Skin Types.
       Fox Chase Cancer Center.
       General Clinical Research Center Programs Directors' 
     Association.
       Genome Action Coalition.
       Fred Hutchinson Cancer Research Center.
       Arthur G. James Cancer Hospital & Research Institute.
       Johns Hopkins University.
       Johns Hopkins University, School of Medicine.
       Joint Council on Allergy, Asthma and Immunology.
       Joint Steering Committee for Public Policy.
       Louisiana State University Medical Center.
       Lupus Foundation of America, Inc.
       Lucille P. Markey Cancer Center.
       Medical College of Pennsylvania & Hahnemann University.
       Medical Center of Wisconsin Cancer Center.
       Medical Library Association.
       Myasthenia Gravis Foundation of America, Inc.
       National Alopecia Areata Foundation.
       National Association for Biomedical Research.
       National Association for the Advancement of Orthotics and 
     Prosthetics.
       National Association of Children's Hospitals.
       National Association of Pediatric Nurse Associates and 
     Practitioners.
       National Association of State Universities and Land Grant 
     Colleges.
       National Breast Cancer Coalition.
       National Caucus of Basic Biomedical Science Chairs.
       National Coalition for Cancer Research.
       National Committee to Preserve Social Security and 
     Medicare.
       National Diabetes Research Coalition.
       National Easter Seal Society.
       National Eczema Association.
       National Foundation for Ectodermal Dysplasias.
       National Health Council.
       National Marfan Foundation.
       National Multiple Sclerosis Society.
       National Organization for Rare Disorders.
       National Osteoporosis Foundation.
       National Perinatal Association.
       National Psoriasis Foundation.
       National Tuberous Sclerosis Association.
       National Vitiligo Foundation, Inc.
       National Vulvodynia Association.
       New England Society of Physical Medicine and 
     Rehabilitation.
       New York University Medical Center.
       Northwestern Memorial Hospital.
       Oncology Nursing Society.
       Orton Dyslexia Society, Inc.
       Paralyzed Veterans of America.
       Penn State Hershey Medical Center.
       Population Association of America.
       Radiation Research Society.
       The Family of Christopher Reeve.
       Research! America.
       St. Jude Children's Research Hospital.
       Scleroderma Federation, Inc.
       Scleroderma Research Foundation.
       Society for the Advancement of Women's Health Research.
       Society for Investigative Dermatology.
       Society for Neuroscience.
       Society for Pediatric Research.
       Society of Critical Care Medicine.
       Society of Medical College Directors of Continuing Medical 
     Education.
       Society of Toxicology.
       Society of University Otolaryngologists--Head and Neck 
     Surgeons.
       Society of University Urologists.
       Stanford University School of Medicine.
       Sturge Weber Foundation.
       Sudden Infant Death Syndrome Alliance.
       Sylvester Comprehensive Cancer Center.
       Teratology Society.
       Tourette Syndrome Association, Inc.
       Tufts University Dept. of Physical Medicine and 
     Rehabilitation.
       United Scleroderma Foundation Inc.
       University of Cincinnati Barrett Cancer Center.
       University of Miami School of Medicine, Division of 
     Genetics.
       University of Minnesota, Duluth, School of Medicine.
       University of Nevada, School of Medicine.
       University of Rochester Cancer Center.
       University of Virginia, School of Medicine.
       University of Washington, School of Medicine.
       Wake Forest University, Bowman Gray School of Medicine.
       Wisconsin Comprehensive Cancer Center.
       Yale University, School of Medicine.

  Mr. HARKIN. Mr. President, I rise today with Senator Hatfield to 
introduce the Fund for Health Research Act. This legislation is similar 
to legislation that the two of us introduced during the last Congress 
which gained broad bipartisan support in both the House and Senate.
  Our proposal would establish a national fund for health research to 
provide additional resources for health research over and above those 
provided to the National Institutes of Health [NIH] in the annual 
appropriations process. The fund would greatly enhance the quality of 
health care by investing more in finding preventive measures, cures and 
more cost effective treatments for the major illnesses and conditions 
that strike Americans.
  The fund would be financed by a 25-cent tax on each pack of 
cigarettes and an equivalent tax on other tobacco products such as 
snuff and chewing tobacco. This tax would raise an estimated $4.2 
billion annually.

[[Page S 13737]]

  Mr. President, in addition to providing revenue for health research, 
raising tobacco taxes will protect children and save lives. Every day 
more than 3,000 children become smokers and more than 1,000 of them 
will eventually die as a result of smoking. Raising tobacco taxes is a 
highly effective way to reduce tobacco use by children. A 25-cent tax 
will discourage an estimated 1.3 million children and adults from 
smoking and will save the lives of more than 300,000 Americans alive 
today.
  Additional moneys for the fund would be generated by a voluntary 
Federal income tax check-off. Every year, when filing their Federal 
income tax returns, Americans would be given the opportunity to 
designate tax overpayments and contributions for health research. 
Moneys from the check-off would be deposited in the fund.
  Each year under our proposal amounts within the national fund for 
health research would automatically be allocated to each of the NIH 
institutes and centers. Each institute and center would receive the 
same percentage as they received of the total NIH appropriation for 
that fiscal year.
  Last year Senator Hatfield and I argued that any health care reform 
plan should include additional funding for health research. Health care 
reform has been taken off the front burner but the need to increase our 
Nation's commitment to health research has not diminished.
  While health care spending devours nearly $1 trillion annually our 
medical research budget is dying of starvation. The United States 
devotes less than 2 percent of its total health care budget to health 
research. The Defense Department spends 15 percent of its budget on 
research. Does this make sense? The cold war is over but the war 
against disease and disability continues.

  Increased investment in health research is key to reducing health 
costs in the long run. If we can find the cure for a disease like 
Alzheimer's the savings would be enormous. Today, federally supported 
funding for research on Alzheimer's disease totals $300 million yet it 
is estimated that nearly $100 billion is expended annually on caring 
for people with Alzheimer's.
  Gene therapy and treatments for cystic fibrosis and Parkinson's could 
eliminate years of chronic care costs, while saving lives and improving 
patients' quality of life.
  Mr. President, Senator Hatfield and I do everything we can to 
increase funding for NIH through the appropriations process. But, given 
the current budget situation and freeze in discretionary spending what 
we can do is limited. Without action, our investment in medical 
research through the NIH is likely to continue to decline in real 
terms.
  The NIH is not able to fund even 25 percent of competing research 
projects or grant applications deemed worthy of funding. This is 
compared to rates of 30 percent or more just a decade ago. Science and 
cutting edge medical research is being put on hold. We may be giving up 
possible cures for diabetes, Alzheimer's, Parkinson's, and countless 
other diseases.
  Our lack of investment in research may also be discouraging our young 
people from pursuing careers in medical research. The number of people 
under the age of 36 even apply for NIH grants dropped by 54 percent 
between 1985 and 1993. This is due to a host of factors but I'm afraid 
that the lower success rates among all applicants is making biomedical 
research less and less attractive to young people. If the perception is 
that funding for research is impossible to obtain, young people that 
may have chosen medical research 10 years ago will choose other career 
paths.
  Mr. President, I am pleased that over 130 groups representing 
patients, hospitals, medical schools, researchers, and millions of 
Americans have already endorsed our proposal. And, polling data 
consistently show that more than two-thirds of Republican and 
Democratic voters, including votes in tobacco-growing States, favor 
raising tobacco taxes if funds will be devoted to health related 
programs.
  Mr. President, health research is an investment in our future--it is 
an investment in our children and grandchildren. It holds the promise 
of cure or treatment for millions of Americans.
                                 ______